High Stakes: Effects of Trauma for Adolescents & Young Adults

Over the course of National Foster Care Month, I’ve written about the impact of trauma on healthy development in infants, toddlers, and school-age children, noting that the effects can occur in any or all domains of physical, cognitive, emotional, and social development.  I’ve also made the point that any caring adult in a child’s life – teacher, coach, tutor, mentor, or volunteer – can be a healer. At A Home Within, we put it simply: relationships matter because relationships heal.


This week I want to focus on adolescence, a developmental period that actually goes on over many years, from the physical and cognitive changes during the early- and middle-teen years, to the neurological consolidation that can take place well into the mid-20s. 


Now, whether confronting social pressures from bullying to dating, bearing up under tremendous academic pressure, or simply adapting to a world that now treats them as adults, many youth are navigating the arenas of family, school, and workplace simultaneously, all while their bodies and brains are undergoing the most intense period of rapid developmental change after early childhood. We all know about the physical changes that happen during the teen years, but late adolescence/early adulthood is also a period of cognitive transformation as ongoing neurological development consolidates the pre-frontal cortex to promote complex decision-making, including risk-assessment.  Because the physical changes outpace the cognitive changes during early and middle adolescence, we see many teens engage in risk-taking behaviors without fully considering the consequences of these choices.  For young people with a history of trauma, of course, the risks increase.  Sexually transmitted diseases, early parenting, anxiety, depression, substance abuse, and self-harm all occur more frequently in adolescents whose early lives were marked by trauma.


All adolescents take risks; traumatized adolescents take more negative (i.e., dangerous) risks in more habitual ways.  For example, they might crave more sexual contact because it reassures them emotionally, but abandonment fears have them so insecure about being left that they don’t ask their partners to use protection.  They might have spent years in a kind of numb, dissociated state that leaves them craving physical thrills, so they ride a skateboard without a helmet late at night, weaving through traffic on a busy street.  They might be so distracted at school, where they have trouble concentrating because of anxiety, that they start drinking in the mornings to calm down.  For adolescents, the stakes are high because their behavioral choices can have significant consequences, and  as they approach adulthood, the world around them expects them to assume increasing responsibilities.  As I’ve maintained, though, every adult who comes into regular contact with a traumatized teen has the opportunity to use that relationship develop to promote healing and healthy development.


Shana, a 20 year-old young woman, waited tables at a busy café.  This was her third job in two months; she usually got fired because she showed up late for her shifts.  Shana had a hard time sleeping, and, unsurprisingly, a hard time waking up. When she got a message from Holly, her boss, who said she wanted to talk to Shana about “what’s going on,” Shana was sure she was going to be fired again, so she just didn’t go into work.  On the following Friday, she went to the cafe to pick up her paycheck, Holly asked her to come into her office.


“Are you quitting?” she asked Shana.


“I figured you were firing me.”


Holly explained that she had called because she was worried about Shana, not because she was planning on firing her.  


“Shana, you’re a good worker – when you’re here.  I want you to be able to keep this job for as along as you want it, and I want to be able to give you a good reference when it’s time for you to look for a different job.  But if you quit without giving any notice, or if you keep showing up late, I can’t do that.  If you let me know why you’re having trouble getting to work on time, maybe I can help.”


Shana hadn’t ever thought about getting a reference from Holly; she’d never held a job for very long, and she’d certainly never received a reference from a previous employer before.  After Shana admitted to Holly that she’d had insomnia for most of her life, and that the doctor always told her it was because of anxiety, Holly switched her to the afternoon shift, and recommended a book her sister had used to help her relax. 


Six months later, Shana told Holly she was studying for her GED, and said she needed to change back to the morning shift because she wanted to meet with a math tutor who could only see her in the afternoons.  Holly asked about her sleep problems.


“I know, right?  But I’m doing meditation at night before bed, and that really helps me  fall asleep. I’ve been waking up pretty early, too.  Can I just try it?  If I screw up again, I’ll go back to afternoons and find a different tutor.  Do you think that’s a good plan?”


Shana was now thinking through her choices, and better able to plan for contingencies. She’d also approached Holly this time, and asked for her opinion.  


Because they have trouble trusting, traumatized teens often have trouble asking for help. Adults may have to offer assistance many times over and be willing to be rebuffed many times before their help is accepted. But when the stakes are so high, the difference a trusted relationship makes can be enormous. 

First Steps, Giant Leaps: Trauma Among Toddlers and Young Children

The extraordinarily rapid physical and neurological development of babies continues right into toddlerhood. Children use their bodies to actively explore the world. They roll balls, push strollers, walk along walls, and jump from steps.  As they move and manipulate their bodies in relation to their physical surroundings, they begin to learn how things work. Children also watch the people around them, imitating and copying their actions, for example, pretending to make dinner, feed the baby, or hammer a nail.

Starting At the Beginning: Trauma During Infancy

May 2015 is both Foster Care Month AND Mental Health Awareness Month. This spring we’ve seen a lot of attention to the mental health needs and well-being of foster youth, whether talking about ways to safely reduce the use of psychotropic medications (as I discussed in a previous post), or about the related need to recruit and support relatives, foster parents, and community members to create an essential network of support and healing so that all foster youth have a chance at a happy, healthy future.

Tax Day

While April 15th is far from a national holiday, it is an occasion that brings together millions of Americans, often for complaining and commiserating rather than celebrating. Indeed, in 2014 the IRS received 136,887,000 tax returns, some eligible for refunds and others accompanied by a payment to make up a shortfall in money owed. Some of those tax dollars go toward maintaining the child welfare system and supporting the foster children whose parents are, for a myriad of reasons, unable to care for them.