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Ep 5. Why Trauma Shuts Down A Child’s Thinking Brain · Inside The Consulting Room - Understanding the Child Behind the Behaviour

• 0:00
  SPEAKER_00: Hello and welcome back.
• 0:02
  SPEAKER_00: This is Kim Lee, child and adolescent psychotherapist.
• 0:06
  SPEAKER_00: And this is episode five in the series on mentalizing, the process of mentalization.
• 0:14
  SPEAKER_00: A little earlier I posted something that had to do with personality types, which is sort of connected.
• 0:24
  SPEAKER_00: But I suppose my my point in mentioning this now is that this will be a new series that follows on from this one.
• 0:32
  SPEAKER_00: And I think it's fascinating and something that I sometimes use with older adolescents, and sometimes adults if I see them.
• 0:43
  SPEAKER_00: But what struck me most of all today is the the timing of this particular episode on mentalizing, and it has to do with how it collapses, the circumstances under which that can occur, and how we how we how we see this, how it's expressed.
• 1:04
  SPEAKER_00: So I saw someone today who was experiencing considerable anxiety and at times volcanic anger.
• 1:14
  SPEAKER_00: Now we're talking about a child, and within a very short period of time, it was completely clear to me that the roots of the difficulties that she was expressing through certain forms of behavior really lie in the collapse of her capacity to mentalize, to be able to have insight into, name and tolerate what she was experiencing.
• 1:46
  SPEAKER_00: And as a consequence, these things just burst out.
• 1:50
  SPEAKER_00: And I thought it was sort of it was timely because we have to think about what are the factors that compromise mentalization, which I've described in or the process of which I've described in the preceding four episodes.
• 2:09
  SPEAKER_00: So the question is what happens when a child's world no longer feels safe?
• 2:14
  SPEAKER_00: So far in the series, we've explored how children develop the ability to understand feelings, thoughts, intentions, and behavior.
• 2:24
  SPEAKER_00: And we've seen how relationships help children to build minds capable of reflecting upon themselves and other people.
• 2:33
  SPEAKER_00: But there's an important truth we really have to confront because mentalization thrives in safety, whereas trauma thrives in danger.
• 2:47
  SPEAKER_00: And when danger becomes overwhelming, then mentalization is one of the first things that disappear.
• 2:54
  SPEAKER_00: And to understand why, we need to understand something about the human nervous system.
• 3:01
  SPEAKER_00: And so the brain has two different jobs.
• 3:04
  SPEAKER_00: The first is understanding, and the second is survival.
• 3:08
  SPEAKER_00: Most of the time these systems work together, but when threat is detected, survival takes priority, always.
• 3:17
  SPEAKER_00: And that's not a human flaw by any means.
• 3:21
  SPEAKER_00: It is something which is the reason why our species has survived.
• 3:28
  SPEAKER_00: So imagine a child walking through a forest thousands of years ago.
• 3:33
  SPEAKER_00: There's a certain movement in the bushes.
• 3:36
  SPEAKER_00: The child doesn't stop to wonder and wonder what emotional state that predator might be experiencing.
• 3:44
  SPEAKER_00: The brain does something far more useful.
• 3:47
  SPEAKER_00: It prepares for survival.
• 3:49
  SPEAKER_00: Heart rate increases, breathing changes, muscles tense, attention narrows, the body mobilizes for action.
• 3:59
  SPEAKER_00: The thinking brain steps aside while the survival brain takes over.
• 4:04
  SPEAKER_00: This process still exists naturally today.
• 4:08
  SPEAKER_00: The difference is that modern children are often responding not to predators, but to emotional threats, conflict, fear, rejection, humiliation, abandonment, chaos, and unpredictability.
• 4:26
  SPEAKER_00: Now, for the nervous system, threat is threat.
• 4:29
  SPEAKER_00: Whether the danger is physical or emotional, the response can be remarkably similar.
• 4:35
  SPEAKER_00: And this is why traumatized children often appear confusing to adults.
• 4:40
  SPEAKER_00: Parents frequently ask why did they react so strongly?
• 4:44
  SPEAKER_00: Why did they completely lose control?
• 4:47
  SPEAKER_00: Why couldn't they think about what they were doing?
• 4:49
  SPEAKER_00: And the answer is simple.
• 4:50
  SPEAKER_00: Because they weren't thinking.
• 4:52
  SPEAKER_00: They weren't capable of it.
• 4:53
  SPEAKER_00: They were surviving.
• 4:55
  SPEAKER_00: Peter Fonegie has repeatedly highlighted that mentalization is a highly vulnerable system and vulnerable to emotional arousal.
• 5:07
  SPEAKER_00: As stress rises, our ability to reflect diminishes.
• 5:14
  SPEAKER_00: The more threatened we feel, the less able we become to think about minds.
• 5:20
  SPEAKER_00: Instead, behavior becomes organized around protection.
• 5:26
  SPEAKER_00: This is where Porguer's work and polyvagal theory offers a helpful framework because he describes the nervous system as moving between different states.
• 5:36
  SPEAKER_00: When we feel safe, we enter what is called a ventral vagal state.
• 5:41
  SPEAKER_00: In this state, we can connect, learn, play, reflect, mentalize.
• 5:47
  SPEAKER_00: Our curiosity remains online.
• 5:49
  SPEAKER_00: We can wonder about ourselves and others.
• 5:52
  SPEAKER_00: But when the nervous system detects danger, it shifts.
• 5:56
  SPEAKER_00: The body prepares for fight or flight.
• 5:59
  SPEAKER_00: Emotions become stronger.
• 6:01
  SPEAKER_00: Thinking narrows.
• 6:03
  SPEAKER_00: The world begins to feel less safe.
• 6:05
  SPEAKER_00: And when threat becomes overwhelming, some children will be just shut down.
• 6:10
  SPEAKER_00: They withdraw, become numb, appear uncaring, unreachable, and disconnected.
• 6:16
  SPEAKER_00: Now from the outside, these responses can look very different.
• 6:22
  SPEAKER_00: One child becomes explosive, another silent, one screams, one disappears, yet they may all be experiencing the same underlying problem.
• 6:33
  SPEAKER_00: A nervous system that no longer feels safe.
• 6:37
  SPEAKER_00: And this is one of the reasons trauma can be so difficult to recognize, because trauma isn't always about what's happened.
• 6:45
  SPEAKER_00: Sometimes it's what's happened repeatedly.
• 6:48
  SPEAKER_00: Sometimes it's what should have it's about what should have happened but never did, the absence of something.
• 6:56
  SPEAKER_00: Many people think trauma only refers to catastrophic events, physical abuse, violence, serious accidents.
• 7:05
  SPEAKER_00: And of course these can be absolutely traumatic, but trauma can also emerge from chronic emotional experiences that overwhelm a child's ability to cope, persistent criticism, emotional neglect, unpredictable caregiving, living with constant conflict, being repeatedly frightened, feeling unwanted, invisible, growing up without emotional safety.
• 7:34
  SPEAKER_00: Over time, the nervous system learns a painful lesson.
• 7:39
  SPEAKER_00: The world is dangerous.
• 7:41
  SPEAKER_00: And remember that the word trauma means wound.
• 7:45
  SPEAKER_00: Well the wound is a consequence of an action.
• 7:49
  SPEAKER_00: It may be that the wound appears quite small, but if you have lots and lots of wounds, something's going to change.
• 8:00
  SPEAKER_00: A child learns that other people can't be trusted, they stay alert, they protect themselves.
• 8:05
  SPEAKER_00: And when protection becomes the priority, we're back to that other system, the capacity to mentalize suffers.
• 8:13
  SPEAKER_00: So the child who once wondered why somebody was upset may instead focus on their own survival.
• 8:20
  SPEAKER_00: The adolescent who once reflected upon the feelings or their feelings may react impulsively or aggressively because in that moment the threat to their survival has been activated, not rationally, not logically, but from a primitive central nervous state position.
• 8:43
  SPEAKER_00: And it's not because they lack empathy or care, and it's not because they're manipulative, it's because they're choosing, or it's not because they're choosing to behave badly.
• 8:53
  SPEAKER_00: It's because survival has become more important than understanding.
• 8:58
  SPEAKER_00: And the nervous system has shifted from connection to protection.
• 9:02
  SPEAKER_00: And this is perhaps one of the most important lessons for parents because children cannot mentalize effectively when they feel unsafe.
• 9:12
  SPEAKER_00: We can't demand reflection from a child whose nervous system is fighting for survival.
• 9:18
  SPEAKER_00: And many of you listening to this will probably be able to identify in the way that you have been, in the way that you are.
• 9:25
  SPEAKER_00: Think of those situations when access to thinking has gone out the window.
• 9:30
  SPEAKER_00: Your capacity to mentalize under stress will diminish.
• 9:35
  SPEAKER_00: So we can't teach emotional understanding in the middle of emotional overwhelm.
• 9:41
  SPEAKER_00: First comes safety, then regulation, then reflection.
• 9:47
  SPEAKER_00: And this is really important, and I've said it in different ways at different times in the moment.
• 9:52
  SPEAKER_00: Step to one side.
• 9:57
  SPEAKER_00: The task is not to push.
• 10:00
  SPEAKER_00: The task is to soothe.
• 10:04
  SPEAKER_00: Then some distance and then come back to it when the brain is the executive brain is back online.
• 10:11
  SPEAKER_00: Now I understand that, of course, there are going to be occasions when that's not possible.
• 10:17
  SPEAKER_00: So we come back afterwards.
• 10:18
  SPEAKER_00: But if we're seeing a pattern of overwhelm, a pattern of reactive behavior, then there's something we've got to do in terms of our position relation to relation and with that and to that.
• 10:36
  SPEAKER_00: So instead of why are you behaving like this, we begin asking, what is going on inside the child right now?
• 10:45
  SPEAKER_00: So instead of demanding control, we offer a kind of co-regulation because uh instead of interpreting the behavior as defiance, we're curious about the distress that's underneath it.
• 10:59
  SPEAKER_00: Because behavior that appears irrational often makes perfect sense when viewed through the lens of trauma.
• 11:06
  SPEAKER_00: And the good news is that mentalization can return.
• 11:09
  SPEAKER_00: The brain is remarkably adaptable.
• 11:12
  SPEAKER_00: But I think our task is about to bring that back.
• 11:16
  SPEAKER_00: How do we do that?
• 11:18
  SPEAKER_00: How do we help the child to come back to what's safe?
• 11:23
  SPEAKER_00: So I think it's really also important to say that mentalization is not simply a psychological skill, it's the natural language of a nervous system that feels safe enough to be curious once more.
• 11:39
  SPEAKER_00: So this is really taking us into the territory of other factors.
• 11:46
  SPEAKER_00: The environment is very powerful.
• 11:48
  SPEAKER_00: I have seen children in home environments where the emotional reliability and predictability of the grown-ups is impossible to determine, and where the arousal state of other family members remains on, I won't say red alert necessarily, but certainly standby.
• 12:17
  SPEAKER_00: So that part of the brain that is survival-related has become activated, even if it's functioning at a low level, but it just needs one touch and it's in action.
• 12:27
  SPEAKER_00: What that then means is that the thinking brain is unavailable in that moment.
• 12:35
  SPEAKER_00: So that and that's where mentalizing comes from.
• 12:37
  SPEAKER_00: The thinking brain, the capacity to stop, to think, to reflect what is happening inside me, what am I feeling?
• 12:47
  SPEAKER_00: What do I do with that?
• 12:49
  SPEAKER_00: Children learn this by experiencing it, and it takes time.
• 12:56
  SPEAKER_00: In the next episode, I want to talk about when mentalization isn't disrupted by primary trauma, but by neurodevelopmental differences, such as ADHD.
• 13:12
  SPEAKER_00: And I think this is very significant because we're talking about compromised or potentially compromised mentalization as a consequence of neurological or psychoneurological factors.
• 13:27
  SPEAKER_00: And I'm I'm hoping that this is illuminating because it it will hopefully explain why such people have real difficulty in their capacity for mentalization, in their capacity for uh reading, understanding, and responding in ways which are consistent with what we might regard as being ordinary expectations, but also what happens inside there.
• 14:01
  SPEAKER_00: So thank you for listening.
• 14:03
  SPEAKER_00: I look forward to coming back and speaking with you again in the next episode.