DOCTOR'S HOUSE CALL

"Traumatic Stress Strategies" - January, 2005

Dr. Mark Lerner is a clinical psychologist who focuses on helping people during and in the aftermath of traumatic events. Since a significant number of adoptive children have been exposed to traumatic experiences, Dr. Lerner has a special interest in understanding the psychosocial and behavioral needs of these children. He is the President of the American Academy of Experts in Traumatic Stress, www.AAETS.org
and the originator of the Acute Traumatic Stress Management intervention model, www.ATSM.org.

Dr. Lerner wrote and produced the newly released audio book, Surviving and Thriving: Living Through a Traumatic Experience www.DrMarkLerner.com . He is the Editor and Publisher of Trauma Response and Trauma Response E-News, the Academy’ s official publications, and the author of four books. Dr. Lerner maintains a special interest in helping adoptive parents to meet the unique needs of their children.

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In a recent column, you described the impact of traumatic stress on the parents of adoptive children. Could you provide some specific strategies to enable parents to cope more effectively?

Traumatic stress is pervasive in the adoption process, potentially affecting not only the adoptive child, but other parties involved—including adoptive parents. For those readers who did not see the column that you have referenced, let me briefly discuss adoption stress. I will then offer 10 Strategies to enable parents to cope more effectively.

A significant number of adoptive children have been exposed to traumatic events including, but not limited to, neglect, physical and sexual abuse, and various degrees of abandonment. It is my conviction that we recognize and address traumatic stress early—potentially preventing acute stress reactions from becoming chronic stress disorders. We certainly don’t wait to address physical trauma. And, in the same way, we must not wait to address traumatic stress.

Traumatic stress may be defined as the feelings, thoughts, actions and physical reactions of individuals who are exposed to, or who witness, specific events that overwhelm their coping and problem-solving abilities. Beyond the adoptive child, many parents experience traumatic stress, or perhaps more appropriately called adoption stress, due to significant (1) pre-adoption stressors (e.g., fertility problems and loss), (2) stress associated with acquisition of an adoptive child (e.g., serious medical concerns and “misunderstandings”), and (3) post-adoption stress (e.g., tremendous life changes with new responsibilities).

Following are 10 Strategies to enable parents to cope more effectively with adoption stress:

1) Become knowledgeable about traumatic stress. By having an awareness and an understanding of the feelings, thoughts, actions and physical reactions that you are experiencing, you will regain a sense of control.

2) Realize that your reactions are normal responses to abnormal circumstances (e.g., a miscarriage, “losing” the arranged child, becoming aware of an adoptive child’s medical condition, etc.).

3) If you find that stress is causing you to react physically (e.g., rapid heart rate, breathing increase, sweating, etc.) use quick relaxation techniques to regain control. Take a slow deep breath by inhaling through your nose, hold the breath for 3 seconds and exhale through your mouth. Upon exhalation, think the words “relax,” “let go,” or “I am handling this.” Repeat the process a second time. Use this technique when you become aware of physical reactions or when your thoughts become overwhelming.

4) Understand that adoption stress may compromise your ability to make your best decisions. If you find it difficult to concentrate when another individual is speaking to you, focus on the specific words they are saying—work to actively listen. Slow down the conversation and try repeating what you have just heard. Don’t make important decisions when you are feeling overwhelmed. Use the advice my father gave to me—always sleep on an important decision.

5) Realize that repetitive thoughts and sleep difficulties are normal reactions. Don’t fight the sleep difficulty. Try the following: Eliminate caffeine for 4 hours prior to your bedtime, create the best sleep environment you can, consider taking a few moments before turning out the lights to write down your thoughts—thus emptying your mind. Try reading or listening to peaceful music.

6) Give yourself permission to rest, relax and engage in some non-threatening activity. Take a walk, bike ride or swim. Physical exercise will help to dissipate the stress energy that has been generated by your experience.

7) Adoption stress may create a desire to withdraw and isolate—creating a strain on significant others. Remember that your family and friends have no way of knowing why you have closed down and pulled away—leaving them to imagine the worst regarding your relationship. Communication must continue. Share your feelings with family and friends and stay connected. Resist the urge to shut down and retreat into your own world.

8) Create a journal. Writing about your experience with adoption may help you to expose yourself to painful thoughts and feelings and, ultimately, enable you to assimilate your experience.

9) If necessary, seek the assistance of a professional or turn to your spiritual leader. If you find that the process is too powerful, allow yourself the advantage of professional and/or spiritual guidance, support and education.

10) Try to maintain your schedule. The adoption process can easily disrupt the sense of normalcy. We are all creatures of habit. By maintaining our routines we can maintain a sense of control, at a time when circumstances may lead us to feel a loss of control.

More important than any strategy, is to understand that whatever happens during peak emotional experiences in your life, the gifts of life and the losses of life, becomes etched in your mind forever. As an adoptive parent, seize the energy from adoption stress. It can propel you to set realistic goals, make decisions and take action. Adopting a child is a gift that will bring a whole new sense of meaning and purpose to your life.

Addendum: The information and advice provided is intended to be general information, NOT as advice on how to deal with a particular child's situation and or problem. If your child has a specific problem you need to ask your pediatrician about it -- only after a careful history and physical exam can a medical diagnosis and treatment plan be made.

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