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“My New Brother or Sister Experienced Trauma”

What Does that Mean?

Complex trauma: “Think younger”

Many folks will adopt a child who has suffered complex trauma—multiple traumas that are simultaneous or occurring in a sequence, are chronic, and begin early in childhood (Cook et al. 2003). The institutionalized child arrives after inadequate care-giving—neglect—due to the modest caregiver-to-infant ratio found in orphanage settings. This son or daughter has also suffered abandonment, the move from homeland, loss of culture, loss of orphanage friends, and possible loss of siblings. There may be the trauma of pre-natal drug/alcohol exposure. Child welfare and infant adoptees undergo similar experiences. Sadly, there will be those children who join their families after the traumas of emotional abuse, physical abuse, and/or sexual abuse.

Complex trauma interrupts development. The newly chosen child presents as “younger” than his or her chronological age. Let’s take a look at this concept of “social and emotional age” as opposed to “chronological age.” It is really a key matter when blending siblings that have arrived in the family along different avenues—birth and adoption.

The Vineland Adaptive Behavior Scales offers one way to test the actual age at which a child is functioning—in four main areas—in comparison to the child’s chronological age:

Table 2.1 The Vineland Adaptive Behavior Scales

Communication domain	Daily living skills domain
ReceptiveHow the individual listens and pays attention, and what he or she understands.ExpressiveWhat the individual says, how he or she uses words in a sentences to gather and provide information.WrittenWhat the individual understands about how letters make words, and what he or she reads and writes.	PersonalHow the individual eats, dresses, and practices personal hygiene.DomesticWhat household tasks the individual performs.CommunityHow the individual uses time, money, the telephone, the computer, and job skills.
Socialization domain	Motor skills domain
Interpersonal relationshipsHow the individual acts with others.Play and leisure timeHow the individual plays and uses leisure time.Coping skillsHow the individual demonstrates responsibility and sensitivity to others.	GrossHow the individual uses arms and legs for movement and coordination.FineHow the individual uses hands and fingers to manipulate objects.

Source: Sparrow, Cicchetti, and Balla 2005

On the following pages are two sets of Vineland scores. We can see the impact of trauma on these children’s development in a very simple, concise way. Subsequently, we will discuss the most pertinent ways these types of developmental delays affect sibling relationships when these kids with histories of complex trauma are introduced to age-appropriate brothers and sisters.

Robert

Robert was adopted from Eastern Europe when he was six months old. His complex trauma included abandonment, pre-natal alcohol exposure, and neglect.

Robert’s current chronological age is 11 years, one month. Robert’s actual abilities are:

CommunicationReceptiveExpressiveWritten	1 year, 9 months5 years, 11 months9 years, 2 months
Daily living skillsPersonalDomesticCommunity	5 years, 11 month7 years, 7 months8 years, 11 months
SocializationInterpersonal relationshipsPlay and leisure timeCoping skills	1 year, 11 months3 years, 2 months2 year, 3 months
Motor skills domainGrossFine	Age equivalentAge equivalent

Robert, at the chronological age of 11, has development that is scattered. In interpersonal relationships he functions at one year, 11 months. He plays like a pre-school age child—three years and two months old. His ability to get dressed, complete chores, and behave out in the community are more in accord with children about ages six to eight. Robert is “young” when we compare his chronological age to his social and emotional age. Brothers and sisters expecting Robert to play like an 11-year-old will quickly learn that he cannot perform to this level. Taking out the trash, vacuuming, and feeding the pets are all chores that Robert may require help or supervision to carry out correctly.

Betty

Betty is a domestic adoptee. In foster care she experienced abandonment, neglect, separation from three older birth siblings, and three foster care placements. She finally arrived in her adoptive home at age 14 months. Betty’s current chronological age is four years, four months. Betty’s actual abilities according to her Vineland score are:

CommunicationReceptiveExpressiveWritten	1 year, 3 months2 years, 6 months4 years, 5 months
Daily living skillsPersonalDomesticCommunity	3 years, 1 month4 years, 6 months3 years, 1 month
SocializationInterpersonal relationshipsPlay and leisure timeCoping skills	1 year, 1 month0 years, 4 months1 year, 10 months
Motor skills domainGrossFine	2 years, 1 month3 years, 6 months

Betty, like Robert, is not performing at her chronological age of four years, four months. Her receptive skills—what she hears, her capacity to pay attention, and what she understands—lag three years behind. There is an almost two-year gap in her ability to express herself—four years, four months as opposed to two years, six months. She struggles to form relationships, to play, and to move forward with rudimentary coping skills.

Betty and Robert are not unique or “worst case” scenarios. They offer the opportunity to recognize that the child arriving may be “younger” than expected. Social, emotional, physical, physiological, and cognitive domains of development are not proceeding within the parameters expected for the child’s age. Let’s now look more fully at some of the issues this presents when attempting to navigate close sibling relationships.

Complex trauma: The types of delays created

Attachment

Touch is critical to human development. Loving touch sets in motion a healthy attachment. Attachment, in turn, is the context in which all development—cognitive, social, emotional, physical, and neurological—becomes possible. In essence, our attachment to a nurturing caregiver sets in motion all facets of our human development.

Attachment, in family life, is also the blueprint for all subsequent close relationships. Attachment is a relationship (Gray 2012). If you have parented (or cared for) an infant, stop for a moment and think about the hours you spent holding, stroking, touching, rocking, caressing, kissing, and hugging the baby. As your child grew, touching and holding continued—hugs and kisses before getting on the school bus or while bandaging a cut knee, snuggling while watching television or reading books, pats on the back for accomplishments, stroking hair as a gesture of affection, and lots of kisses and caresses just out of love.

As a result of consistent and predictable parental nurture and support—the cycle of needs—this child develops a secure attachment. The child trusts his parents to meet his needs: “My parents are always there for me.” He feels good about himself: “I am worthwhile.” He seeks out his parents when he needs help or comfort: “I can rely on my parents.” He has absorbed the skills to navigate life. He can develop solutions, handle stress, regulate emotions, follow directions, complete tasks, and the list goes on.

He demonstrates empathy and remorse: “I have hurt Mom’s feelings. I need to make this right.” He strives to have fun. He explores his environment. He seeks parental praise for a job well done: “I want to please my parents.” He enjoys intimacy. He seeks out companionship: “I want to be around others.” He can do all of these things within relationships with parents, his brothers and sisters, peers, teachers, coaches, neighbors, and so on. His blueprint is “I am safe within relationships.” He applies his secure model of attachment to all human interactions.

Figure 2.1 Cycle of needs

In adulthood, this secure attachment will allow him to continue to have close interpersonal relationships. He will feel love and give love. He will understand that his past—emotional baggage—will not interfere with his capacity to interact in his marriage, with his children, in his career, and so on.

Inopportunely, many adoptees arrive in the family having been deprived of enormous amounts of emotional and physical nurturing in the months or years prior to their adoption. Or their sense of touch, love, and affection may have become skewed because abuse has taught them that affection is sexual or that being beaten is the way touch is administered from a parent to a child. Their style of attachment and their ability to navigate relationships reflect their traumatic experiences and is insecure. Of course, parents want their son, daughter, and sibling-to-be to have the capacity to give and receive affection and to know that their mom, dad, brother, and sister are reliable. Yet adoptive family members need to understand that there might not be “love (attachment) at first sight!”

Attachment is a process that takes Mother Nature 18–36 months to complete! In that time period, the healthy parent works at forming that attachment—feedings at 3 a.m. are work—albeit pleasurable work! The child with a history of complex trauma may not simply move into the home and form an attachment. Trauma has distorted the blueprint! In some instances, the relational template was fractured hours or days after the abandonment, or even pre-natally by drug and/or alcohol exposure. We aren’t just talking about the older arrivals. Even infants can enter a family with attachment interruptions. Therefore, forming an attachment to your adopted son or daughter, and between your resident sons and daughters, may take work—a lot of it!

Clay was adopted from India at age two and a half. He entered his adoptive home with a view of adults as uncaring because of his pre-adoptive abandonment and institutional deprivation. He felt as if there was something wrong with him and that this inherent defect caused the lack of nurture he received in the orphanage. He also thought this had led his birth mother to abandon him. So he sought to make himself unlovable to his new family. He refused to shower. He hoarded food that would spoil in his bedroom. Foul odors would permeate the home. He would often wear the same clothes day after day. He spent long periods of time in his room away from the family. He refused to participate in family fun such as watching movies or playing cards.

Clay’s parents sought years of professional services to help Clay form meaningful relationships with them and their younger birth son. Finally, when he was age 13, a successful course of therapy was implemented. Today, Clay seeks interaction with the family. His sense of self has improved significantly. He no longer keeps bologna under his bed and he bathes daily! Board games are becoming a weekly event for Clay and his little brother.

This example illustrates that attachment difficulties impact each member of the family. Clay’s parents were sad that he could not enjoy being with the family. They lamented the child they had hoped for when they traveled to India. There was anger as well for the negative behaviors that daily affected the running of the family. He was unable to reciprocate affection. He cringed each time he was hugged by his mother, father, or brother. Overall, he paid very little attention to his younger brother, who desperately wanted Clay to play with him. Clay and his family lived under these circumstances for approximately ten years before finding an effective treatment. In essence, they worked for ten years to develop a relationship with their son and between their sons!

Insecure styles of attachment

Four main styles of insecure attachment develop when a caregiver and an infant don’t attune well. Newcomers arriving with a pattern of insecure attachment will adversely impact parents and the children already present in the family at the time of the adoption.

“Adopting a sibling into the family can be fun but also can be stressful. When you first meet your new brother or sister, you will probably feel very happy and good about helping a little child out. But, as they grow up and possibly turn out having attachment issues like my sister, it can get hard. I started feeling as if my life was never going to get back to normal again. It made me want to get rid of my new sister.”

Avoidant attachment

This child’s model of relationships is that parents or others are not all that useful in meeting needs. So there is no point in seeking assistance. Connecting is limited; this adoptee refrains from engaging in meaningful interactions. There is little willingness to explore the environment or to play. The desire—early in life—to have an emotional connection was so frustrating that this child learned to tune out in order to survive the rejecting, neglecting relationship. Family members of children with avoidant attachment commonly report:

“He never asks for any help.”

“He takes what he wants without asking.”

“He stares when he wants something. He won’t ask.”

“He never asks politely. It is always a demand. ‘I’m thirsty.’”

“He is always bored. He can never think of anything to do.”

“She doesn’t play.”

“We came home from our birth son’s band concert. He didn’t even act like he noticed we had been gone.”

“He can be alone in his room so long that we forget he is there.”

“As soon as someone starts talking, she glazes over.”

“He’s always where the family isn’t. If we’re watching a movie, he’s in his room. If we’re in the front yard cleaning up, he’s behind the house.”

“She wanders off when we are shopping or she walks way ahead of us.”

Ambivalent attachment

This attachment style has two subtypes. One is demonstrated by a child who is anxious or “clingy.” This child fears the parent may disappear at any moment. This child displays considerable distress when separated from parents, although she often isn’t comforted when the parent returns. In fact, the returning caregiver may be met with anger and a rejection of efforts to reconnect with the adoptee. The focus of this child is on the parent. She wants to dominate the parent’s time and attention. Parents of ambivalently attached children may arrive at therapy saying:

“I can barely go to the bathroom. She is at the door wondering if I am in there!”

“We try to go out with friends and he acts so ‘bad’ the babysitter or our other kids call. We have to return home.”

“She follows me throughout the house. If I turn around, I practically run into her.”

“She can’t sleep in her own bed at night. She has to get in bed with us, or we find her on the floor next to our bed.”

“He won’t go to sleep until my husband, who works second shift, gets home from work. He has to know we are both in the house before he will go to bed.”

“She can’t go to a sleepover.”

“She has to be with us at church. She won’t stay in the Sunday school class.”

“She interrupts when any of my other children try to talk with me.”

“If I am trying to help one of the other kids, he’ll create such a disturbance that I have to tend to him.”

A second type of ambivalent attachment is seen in the child who appears to “push” and “pull”—“I want you.” “I don’t want you.” These children had birth parents or caregivers who exhibited inconsistency in responding to his needs: sometimes they were unavailable or unresponsive; at other times they were intrusive. The caregiver misread the child’s signals. Thus, internally, this youngster is uncertain as to his own needs and emotional state. This is a child who may not soothe easily, even when Mom or Dad is providing exactly what is necessary to aid in calming him. A parent of this type of ambivalently attached child may state:

“She asks for help with her homework, and when I come to help her she tells me I am doing it wrong: ‘That isn’t what the teacher said.’”

“When I have bananas, he doesn’t want one. If I don’t have a banana, look out, there will be a huge fit.”

“Getting dressed for school is so difficult. We pick out an outfit and a few minutes later it isn’t right. He is screaming and shouting that he can’t possibly wear the red shirt! It is so hard to help my son and daughter get ready for school with all of his chaos.”

“She asks for a hug and when I give it to her, she pinches me or hugs so tight I have to ask her to let go because she is hurting me.”

“We have a great time making brownies, and then she won’t eat any with us.”

Disorganized attachment

Disorganized attachment is a mix of the attachment styles discussed above. These boys and girls lacked the ability to be soothed by their birth parents because these early caregivers were a source of fear or abuse. These children must cope with the loss of their birth parents on top of resolving the terrifying events that most likely led to the separation from the birth parents. Children with disorganized attachment have been found to be the most difficult later in life, with emotional, social, and cognitive impairments (Siegel 2001).

These parents report many of the themes as pointed out in the ambivalent and avoidant attachment descriptions. Yet these parents also report, “He can do something that just incenses me or his brother. There is a big fight. Then, five minutes later, he asks me what we are having for dinner. It’s like nothing happened! He can’t figure out why we are still angry!” Or: “When once of us is infuriated with him, he smiles. We all struggle to control ourselves!” Many abused children utilized smiling or hugging the past perpetrator as a defense against further abuse. They thought, “If my abuser is happy with me, maybe he won’t hit me today.” When triggered, this coping mechanism appears again in the adoptive family. These styles of attachment defy and defeat an overarching family goal—fun, happy family interactions, and close, loving family connections.

Separation from siblings further complicates attachment

Don, Betty, and Mary were removed from their birth parents early one morning. By evening, each was placed in a separate foster home. In one day they lost the only parents they had ever known as well as each other. Can you imagine losing your entire family in one day?

Sergei came to America at the age of nine. During his years in Russia, he moved through three orphanages. His older brothers continue to reside in institutional care in Russia.

Luis resided in an orphanage in Mexico for almost six years. He developed a close tie to another boy who was in the orphanage. He refers to this boy as his brother to this day. Luis has ongoing guilt regarding the fact that he now has a rich life full of food, toys, and family members while this brother remains in residence in grim conditions. Luis has a profound sense of sadness over the loss of this brother.

Pam resided with her three brothers in their birth home, and then the four siblings resided in a foster home for several years. Unfortunately, the foster mother was diagnosed with multiple sclerosis. She decided not to proceed with her plans to adopt the children. The news of her medical condition and the need to move to a new home caused the children’s mental health to deteriorate. The end result was that all four children were placed separately. Pam, now age 11, has come to terms with the loss of her birth parents. She was able to process their acts of neglect, abuse, and abandonment and conclude that she is “better off” being adopted. However, the loss of her siblings is an ongoing struggle. She continues to create fantasies of the four children reuniting and living together again. This is not possible as two of her brothers were adopted, while the other aged out of foster care. This brother’s whereabouts are unknown.

The stories above are included to demonstrate the types of scenarios that lead to sibling separation in countries across the continents. Kids separated from brothers and sisters aren’t always easily able to accept their new siblings. For example, Pam resides in an adoptive family in which she has two brothers and three sisters. She has been reluctant to form any type of relationship with any of these children. In fact, she regularly plays by herself. She resents the fact that these children have had the opportunity to grow up together. She wants to know, “Why didn’t I get to grow up with my brothers and sisters? They get to.”

Further, Pam and the other children above—international and domestic—are frequently convinced that as they mature, they will be reunited with the brothers and sisters from whom they were split. Kids with this type of reunification fantasy see no reason to make connections with the resident children in their adoptive homes. “I don’t want ‘new’ brothers and sisters. I want my ‘old’ family back.”

Luis’s and Sergei’s cases alert us to an issue that plagues international adoptees. Children who reside together develop ties to each other. They think about the children left behind at the orphanage. They have difficulty comprehending that they can be happy while these children—birth or perceived brothers and sisters—reside in conditions far less plentiful than what their adoptive family has to offer. Such survivor guilt is difficult for these adoptees to overcome. It impedes integration into the new family system.

Emotional development

This realm of development includes the ability to identify, express, and regulate feelings. These skills create the capacity to enter into reciprocal emotional relationships. There is currently much information available regarding traumatized children and emotional development. The emphasis is on emotional dysregulation—dissociation and hyperarousal, more commonly known as flight or fight.

Each time a healthy parent picks up a baby who is wet, hungry, or craving attention, the youngster calms. Repetition of this dance (cycle of needs) helps the brain, as it matures, to learn the skill of self-calming. As kids move through pre-school and into grade school, they can express and manage their own feelings. The skill of emotional regulation has transferred from parent to child. Brain growth is “user-dependent.” It needs repetition of experiences to develop the skills necessary for the individual to function (Perry and Szalavitz 2006).

Children with histories of trauma lacked a nurturing adult to lead the dance. The orphanage setting or chaotic birth home isn’t able to soothe the crying infant with the consistency needed to develop regulatory capacities. In fact, the stress of living in a chaotic and/or neglectful environment creates a brain—a human being—more vulnerable to stress (real or perceived). The infant or toddler traumatized prior to adoption arrives in the family with an overactive stress response system. So she will enter the states of flight (dissociation) or fight (hyperarousal) easily and long after placement in a healthy family system. Again, brain growth is user-dependent. Early developed patterns will continue to have disproportionate importance to how the brain functions (Perry and Szalavitz 2006). Repetitive experiences during infancy and the toddler period will continue to influence the way the brain causes the person to respond long into adolescence and perhaps adulthood.

Thus, traumatized children are analogous to deer. Deer flee in an instant when frightened. Deer are hypervigilant—always wary of their environment. Traumatized children operate in a similar fashion. They are physiologically in a state of alarm, of “flight” or “fight,” even when there is no visible threat or demand. So a stressor arises. Perhaps there is an argument with a sibling or a firm parental request to sit down and complete homework. This over-reactive child feels stressed. He quickly moves to fight—yelling, stomping, slamming doors, etc.—or flight—staring off into space, withdrawal to a bedroom, biting his lip, playing with his fingers, or providing no response as to whether his mom’s request was even heard. We have all experienced dissociation while driving the car. We arrive at our destination with no memory of steering the car! We were immersed in a deep, internal thought process which typically defies memory as well.

I have worked with many children with histories of complex trauma who spend a majority of their day moving in and out of dissociative states. These kids miss large chunks of information. They aren’t hearing their parents, brothers, sisters, peers, or teachers. This phenomenon affects every aspect of their interaction with people inside and outside of the family. Dissociation and hyperarousal are excellent methods for surviving harsh and overwhelming experiences. They are poor coping skills when utilized in a fun, loving family or in the classroom.

In describing Gina, their now 13-year-old daughter whom they adopted, John and Nancy stated:

“We never know what is going to set her off. Everything can be calm and off she goes—shouting, swearing, running up and down the stairs. This can go on for several hours. Just the other night, we decided to play board games. We popped popcorn and made hot chocolate. The whole family sat down and she started screaming. We tried to ignore it. However, it was hard to ignore someone screaming while we were trying to have fun.”

Nancy went on to say that incidents like this are particularly disruptive to the whole family, which also includes their two birth children, Joshua, age nine, and Carol, age 11. She continued by discussing that she expected that their lives would be more hectic with three children. She expected there would be more transportation issues, more homework to help with, more laundry, and so on. To Nancy, what the adoption of Gina brought to the family was chaos. Plans often had to change based on her hyperarousal. Promises of activities or one-on-one time to Joshua and Carol were broken.

It is also important to point out that neglect causes other problems. As pointed out previously, children need nurture and acknowledgment in order for cognitive, social, physical, neurological, and emotional development to proceed along a healthy path. If this psychological stimulation is not provided, the brain’s pathways that were ready to grow through experiences with caregivers wither and die.

 • If babies are ignored, if their caregivers do not provide verbal interaction, language is delayed. It is difficult to express feelings with this deficit.

 • If a child does not receive kindness, he may not know how to show kindness.

 • If a child’s cries go unheard, he may not know how to interact positively with others.

(Child Welfare Information Gateway 2001)

This additional information related to neglect is especially important for the family adopting internationally. Again, the ratio of caregivers to babies and toddlers in institutional settings is often poor. Review of countless hours of orphanage video clearly demonstrates five or more infants with one caregiver. This would be the same as a family having quintuplets—except that, in an institutionalized setting, a mother, mother-in-law, sisters, church members, and neighbors aren’t available to help out.

Cognitive development

A part of intellectual or mental development, cognitive activities include thinking, perception, memory, reasoning, concept development, problem-solving ability, and abstract thinking. Language, with its requirements of symbolism and memory, is one of the most important and complicated cognitive activities.

In her book Toddler Adoption: The Weaver’s Craft (2012), Mary Hopkins-Best describes rudimentary cause-and-effect thinking and problem-solving skills as developing between 12 and 18 months of age.

It is quite common when a family enters our agency for services that they proclaim, “He is so smart!” And indeed it is usually true. Intelligence tests confirm that many traumatized children have a good level of overall intelligence, which is often translated into being bright. However, without the capacity to reason or generate solutions to problems, the smart child is impaired.

Alice is age nine. She was adopted when age four. Her adoptive family includes a 12-year-old birth son. One evening, at age one and a half, social workers had arrived at her birth home and removed her. Her birth mother did not participate in reunification efforts and so Alice never saw her again. Her perception of her removal is that she was “stolen.” This is certainly understandable. What else would a toddler think when women come into your home, take you, and then give you to another family? Alice has stolen on a regular basis since coming to reside with her adoptive family. Jewelry, video games, pens, and pencils disappear routinely, despite consequences much to Alice’s dissatisfaction.

Alice lacks basic cause-and-effect thinking. She repeats the same behavior over and over. She does not learn from her mistakes or consequences. She is deficient in creating solutions to solve her problem of feeling stolen. The only way she is able to demonstrate her confusion for the loss of her birth mother is to re-enact the event of stealing.

Imagine the problems this may pose for Alice’s family. It will be difficult to instill morals and values into the older birth son while Alice continues to steal. He questions, “Why can’t my parents make her stop stealing?” He becomes angry when she steals from him. Then he feels guilty for the constant conflict in their relationship. At different times, Alice has stolen from relatives’ homes. This is a cause of much embarrassment.

Another area of cognitive development that poses difficulty for adoptive families is that of concrete thinking. The concrete thinker sees the world as black or white. There is no gray. There is limited or no abstract thinking. The concrete-thinking child often appears defiant.

Cody, age 11, has been stealing since he was placed with Dan and Rita seven years ago. Dan stated, “Cody, you have sticky fingers and it needs to stop!” Cody, puzzled, began to feel his fingers. He replied, “Dad, I washed my hands a few minutes ago. My fingers aren’t sticky.” Dan, annoyed, said, “Cody, you know what I mean.” Cody replied, “No, really, I washed my hands just a few minutes ago.” Dan then stated, “Enough. I don’t want to hear anymore.”

Actually, Cody had no idea what his father was talking about. His immature thought processes only allow for literal interpretations. Because of this, arguments frequently occur due to the child’s exacting manner. The rule “no running in the house” is taken as fact. Kids like Cody do not understand that implied in the rule about running are similar behaviors such as hopping, skipping, and jumping across the living room. A once peaceful household may become teeming with anger and frustration. Exasperation permeates the home. The family’s ability to relax and have fun gradually diminishes.

Lastly, many traumatized children, due to their cognitive delays, receive labels as being learning disabled (Perry 1997). Tutoring and special education services require time to locate, negotiate with a school district, and monitor, as well as time if travel is involved or meetings need to occur. The child with special needs begins to dominate the family’s time.

Social development

This domain of development includes how the child interacts with other people—individually and in groups. The development of relationships with parents, brothers and sisters, and peers, assuming social roles, learning the values and norms within groups, internalizing a moral system, and eventually assuming a productive role in society are all social tasks.

The development of social skills is emphasized in today’s society. Parents spend much time involving their children in a variety of organized sports. There are also martial arts, dance classes, band, camps, and play dates. It is with good reason that we strive to teach children social skills:

 • Children have a high probability of being at risk unless they achieve minimal social competence by about age six. The risks of inadequate social skills are many: poor mental health, dropping out of school, low achievement, other school difficulties, and poor employment history (Peth-Pierce 2000; Katz and McClellan 1991; McClellan and Katz 1993).

 • Indeed, the single best childhood predictor of adult adaptation is not school grades and not classroom behavior, but rather the adequacy with which the child gets along with other children. Children who are generally disliked, who are aggressive and disruptive, who are unable to sustain close relationships with other children, and who cannot establish a place for themselves in the peer culture are seriously at risk (Hartup 1992).

Social skills begin to advance in early infancy. Infants only months old watch and imitate others, are sensitive to social approval and disapproval, are interested in getting attention and creating social effects, and enjoy simple games such as peek-a-boo and bye-bye. The 12- to 23-month-old likes to lug, dump, push, pull, pile, and knock down. She also likes to climb and kick. During this time period, there is pleasure in stringing beads, learning to catch a large ball, looking at pictures in books, nursery rhymes, and interactive games such as tag. By 24 to 35 months, there is lots of physical play such as jumping, climbing, rolling, throwing and retrieving objects, and pushing self on wheeled objects. This is also the age of developing first counting skills, as well as the time children begin to draw and mold with clay. Children of this age enjoy matching objects, sorting objects by size, and playing with patterns. Imaginative play increases. The main interest is still in parents; however, there is the beginning of cooperative play with others.

This last sentence is a key point for any family wanting all of their children to play and get along. Social skills develop early and they develop within the parent–child relationship. Later, at about age three, kids are more inclined to participate in group play with other children including their own brothers and sisters. In effect:

 • Social competence is rooted in the relationships that infants and toddlers experience in the early years of their life. Everyday experiences in relationships with their parents are fundamental to children’s developing social skills (Peth-Pierce 2000).

 • In particular, parental responsiveness and nurturance are considered to be key factors in the development of children’s social competence (Casas 2001). Children who have close relationships with responsive parents early in life are able to develop healthy relationships with peers as they get older (Peth-Pierce 2000).

Consider the chosen daughter who was confined to her crib in her orphanage, or the child who resided in a birth home wherein he was neglected and abused and was consumed with his own survival. Toys there were minimal, as was quality adult interaction. This child enters an adoptive family with limited ability to play. The expectation that the adoptee will make a playmate for the birth and/or previously adopted children is immediately shattered. In fact, it is not uncommon that neglected children chronologically ages eight, ten or 12 years old are still parallel playing. They have not developed the skills to know how to enter a group. They are unable to take turns, lose graciously, or play a game according to the rules. Frequently, they move from toy to toy. They are unable to choose an item and sit for a period of time to enjoy the item. Other children simply sit among their toys not knowing exactly what to do with them. Their play is often filled with themes of their life experiences.

Tammy is currently age six. She joined her adoptive family four and a half years ago. She enjoys playing house. However, Jean, her mother, states, “When she plays house, she lines up many dolls—five to ten dolls. Then she goes from doll to doll, offering each a bottle or a diaper change. Really, she is playing orphanage.”

Paula, the adoptive mother of two female siblings, described that doll after doll had been purchased. “One by one, their clothes disappeared, and their arms and legs were removed. It was as if they were breaking the dolls in the same manner they felt broken by the sexual abuse they had sustained at the hands of their birth father.”

Such social lags create a variety of difficulties in the adoptive family. The resident children lose interest in playing with their new brother or sister, as do children in the neighborhood. Invitations to parties and play dates, for the adoptee, may be rare. This area often leads typically developing children to make statements such as “I don’t want to play with him. He’s no fun.” “I want to go to my friend’s house alone. He is embarrassing to have around my friends.” “Do we have to adopt him?” “Why can’t we send her back to China?” Frequently, the brothers and sisters will begin spending more time at the neighbor’s house than at home.

“My friends and I have to always go into my room and lock the door so that my brother doesn’t keep bothering us. He’ll scream and pound on the door until Mom or Dad calm him down. Whenever we offer to have him play with us, he goes crazy. He only wants to play what he wants to play, and he will scream until he gets his way. No one wants to play with him because we always have to play what he wants or else he will throw a big fit and cry and scream. It gets really embarrassing when he throws fits in front of my friends.”

Delayed moral development also impacts adoptive family interactions. Moral development is the capacity to control one’s own behavior internally (Santrock 1995). We can all most likely recall a childhood situation in which our peers wanted us to do something that would definitely lead to parental disapproval and consequences. Instantly, the following thought popped into our heads: “My mother would kill me if I did that!” Our moral system went into effect and we were able to make a decision about how to best handle the situation. Mom and Dad were with us—internally. Everywhere we went and in all situations, their voices resonated as a guide to our conduct.

Moral development is a process that involves acquiring and assimilating the rules about what people should do in their interactions with other people. The process requires reasoning skills and the ability to feel a wide range of emotions—empathy, sympathy, anxiety, admiration, anger, outrage, shame, and guilt. When models who behave morally are provided, children are likely to adopt their actions (Santrock 1995). Many adoptees lacked moral models while in residence with their birth families or in institutional settings. They witnessed violation after violation of principled behavior while experiencing and witnessing abuse, neglect, and drug use. Therefore, they enter the adoptive family with a system of morals and values in direct contrast to that of the parents, brothers, and sisters.

Moral development consists of three stages. In pre-conventional reasoning, moral thinking is based on rewards and self-interest. What is right is what feels good and what is rewarding. Conventional reasoning sees children adopting their parents’ moral standards, seeking to be thought of by their parents as a “good girl or boy.” Post-conventional reasoning is the highest stage at which the person recognizes alternative moral courses, explores the options, and then decides on a personal moral code (Santrock 1995). Adoptive parents may find that the child they adopt displays pre-conventional reasoning well into adolescence or beyond. They may not internalize the parent’s moral standards—or at least not quickly.

Grant, age 16, removed a chocolate cream pie from the refrigerator and sat down at the kitchen table. He ate almost the entire dessert. Made earlier for the church bake sale, the pie was not for consumption by the family. This had been made quite clear by Sarah, Grant’s mother. Sarah was livid when she came into the kitchen. Grant, adopted by Sarah and her husband at age three, violated rules and boundaries daily. If he wanted to use a tool, he simply took it, never returning it. If he wanted money, he took it from Sarah’s purse. If he wanted his brother’s stereo, he took it. If he wanted his sister’s CD player, he took it. The list could go on and on. Locks had not worked; he would find ways to remove them. Door alarms offered no solution either; he dismantled them.

The end result of Grant’s lack of morals was a family in emotional turmoil. On the one hand, each family member was angry with Grant for ravaging through their personal possessions for years. On the other hand, each had concerns for his future. If he did not stop this behavior, what kind of a life would he have? Would he be able to work? Would he go to jail?

Complex trauma: Special focus on orphanage life

Institutional settings have a “culture,” as do families. Institutionalized children spend a bulk of time with other children. They reside in a group environment wherein interaction with peers is dominant. The child adopted internationally has learned about group living, not about family life. Children learn this group philosophy at very early ages. Certainly, it is not uncommon to see children adopted at 12 months old and up (and in some cases younger) operating in a family as if the parents only exist to provide food, clothing, and toys. These children seek little adult interaction beyond that which is essential. In essence, the child feels as if he has been moved to a different orphanage. Your family may have more food, better-quality food, a softer bed, nicer clothing, and an abundance of toys, yet the adults are looked at as caregivers rather than parents. Sibling relationships are skewed as well. In some cases, the adoptee attempts to use siblings to meet his needs. The adoptee is more comfortable with children. It is the sibling who approaches the parents for snacks, drinks, new toys, and privileges on behalf of the adoptee. In other instances, the adoptee may avoid forming relationships with siblings if he is uncertain as to whether or not the siblings will remain in the family. After all, he thinks, many orphanage friends left the orphanage to be adopted, to move to another orphanage, or because they were ill.

This situation may be compounded by the use of professional child care soon after the adoptee has arrived in his new family. A room full of children and staff resembles an orphanage to the formerly institutionalized child. Depending on the number of hours the child is in a child care program, the child’s integration into the family may be inhibited.

Table 2.2 Orphanage culture vs. family culture

Orphanage culture	Family culture
Survival/self-reliancePoverty, governmental policies, lack of staff education, lack of medical care, etc. may cause an atmosphere in which the meeting of physical needs prevails. Meet­ing psychological needs not a priority.	Reciprocity/trustParents desire to have and raise a child within an environment of caring and sharing. This meets the child’s physical and psychological needs.
UncertaintyCaregivers may not provide nurturing. They change shifts, leave to pursue other employment, or may be a source of abuse. Peers leave as a result of adoption, a move to a different orphanage, illness, or death. The child learns that people go away. “Those who should provide me affection do not. Those who should pro­tect me do not always do so.”Often, there is little or no focus on the child’s future due to the demands of meeting the day-to-day basic needs. The child internalizes a one-day-at-a-time attitude as tomorrow everything may be different.	PredictabilityParents instill trust and safety by consistently meeting the child’s needs. The child learns that parents behave in predictable ways. “I can rely on my parents.” The child transfers this knowledge to other spheres of life such as, “I can rely on my teacher.”There is emphasis on the child’s future. Parents provide education and experiences essential to carry out career goals, marriage, family life, friendships, etc. The child internalizes the family’s values. The child views investment in the future as valuable and worthwhile.
RoutineOrphanages utilize a regimented routine to provide for children. Children eat on a schedule, go to the bathroom on a schedule, sleep on a schedule, and so on. This schedule is based on a timeline created by the staff. The child may not learn to regulate bodily functions. The child does not learn to express his needs. The child may determine that he meets his own needs. For example, “I hold my own bottle. I provide my own food.”	Internal regulationFamilies also utilize routines to carry out daily tasks. However, the routines are more flexible and take into account individual needs. For example, an infant is fed as the infant expresses a cry of hunger. An older child may be provided three meals per day and snacks on request. The family accommodates its members, rather than the members totally accommodating the routine. The child learns many valuable life skills from this: reliance on parents, delaying gratification if parents are involved in meeting the needs of another family member, internal regulation of bodily functions, interdependence, cooperation, etc.

Complex trauma: Special focus on sexual abuse

Sexual abuse is a difficult topic to think about. Speaking with kids about sexual matters is hard too. Many youngsters adopted via the child welfare system will arrive after suffering the atrocity of sexual abuse as well. Clinical experience with boys and girls adopted from institutional settings makes clear that such settings are not immune to sexual abuse. The arrival of a sexualized child is shocking.

Five-year-old Jeffrey arrived from Bolivia. Present in the family were two parents and their two children by birth, ages ten and 12. Motivated to adopt by a desire to provide a child a loving home, the family was surprised by Jeffrey’s perpetual stealing, hoarding of food, and destruction of household items. However, the family was devastated when Jeffrey sneaked into their female birth child’s bedroom during the middle of the night and attempted to “get on top of her.” In therapy, Jeffrey talked of the chronic sexual activity between children in the orphanage. The institutionalized children, lacking adult nurture, utilized sexual gratification as a means to offset their fears and loneliness.

Julie and Robert, the adoptive parents of two typically developing adolescents, decided to adopt five-year-old Lori as a result of strong religious convictions to give to someone less fortunate. The family received little information regarding Lori’s pre-adoptive history. However, they felt little concern. They believed their experience as parents would ensure that Lori would do fine in their home. Lori’s arrival was met with several welcoming parties attended by supportive extended family members as well as friends from their church and community. At one point in therapy, Julie stated, “She received 16 Barbie dolls, two Ken dolls and a Barbie Dream House. We were trying to teach our older children that sex outside of marriage was not acceptable. Yet, in Lori’s play, Ken was always in the hot tub with five naked Barbies. Everything became sexual with Lori.”

Shelia and Wendell have one child by birth. Staci is 14. She is attractive and smart. Their second child, Yvonne, joined the family via adoption at age two. She is now 12 years old. Recently, condoms have been turning up in her back pack, purse, jeans’ pockets, and her bedroom. The family’s home is located within walking distance of the school. When Yvonne was late in arriving home from school one day, Shelia began canvassing the neighborhood looking for her. When she could not spot Yvonne, Shelia began knocking on neighbors’ doors asking if anyone had seen Yvonne. Indeed, one mother reported that Yvonne had come home with her 13-year-old son. The two were “upstairs listening to music.” This parent went upstairs to let Yvonne know that Shelia was waiting for her. There was quite a rustle on the other side of the boy’s bedroom door as the two attempted to put their clothes on.

Subsequently, Wendell and Shelia presented this situation to their family physician. After much discussion, Yvonne was placed on birth control. The family has increased their supervision of Yvonne. Shelia and Wendell have also engaged in extra conversations about sex with Staci. They became fearful that Staci would be influenced by Yvonne’s behavior.

John is 14 years old. He was adopted by Marcy and Dan when he was age ten. The couple also has two birth children, presently ages 11 and eight. Marcy and Dan have made great efforts to monitor their children’s use of the Internet as well as the music they listen to and the movies they watch. However, John always seems to find ways around their parental controls. Each time he obtains access to the Internet, he downloads pornography. Pornography turns up in the bedroom he shares with his younger brother, in the bathroom, in his backpack, and once it was left, in plain sight, on the dining-room table!

Eventually, the couple sought professional assistance. Over time, John described sexual abuse by several men and his birth grandfather. It became clear that the pornography was his way of attempting to let Dan and Marcy know that he had been sexually abused. He was also verifying that seeing men having sex with women made him feel heterosexual. As long as he was “excited” by what he considered “normal” sex, he did not feel as if his sexual experiences with men had “caused him to be gay.”

The vignettes above show that adopting a child—young or older—may mean dealing with pornography, masturbation, homosexuality, sexual identity confusion, pre-marital sex, birth control, the sexual abuse of one child by another, and so on. Being proactive about sex and sexuality may not come easily to some adoptive parents, but, as the above stories indicate, proactivity is an invaluable tool for families adopting children coming from traumatic backgrounds. I’ll revisit this topic in Chapter 12 to provide tips that will ensure the safety of each child in the family.

Complex trauma: Special focus on domestic violence/physical abuse

Physical abuse and domestic violence are also traumas affecting both domestic and intercountry adoptees. Here are some examples:

Dustin and Kristen entered their pre-adoptive family at ages five and four. Shortly upon their arrival into this family, Dustin became angry with a neighbor child and immediately located a plastic bag. He then attempted to place the bag over the child’s head. Fortunately, an adult intervened. When asked why he had done it, Dustin was quite clear that his birth father often “beat me with a belt” and “tied bags over my head” when he was angry. It was certainly a long time before Dustin was able to play without adult supervision.

Mark, a four-year-old, arrived into his adoptive family after a four-year stay in a Ukrainian orphanage. Attempts to discipline Mark were often met with his running to cower in a corner or a closet. Frequently, he would cover his face and shout, “No, please don’t hurt me!” Bewildered by this behavior, the family sought mental health services. Over time, Mark described that some “orphanage ladies” would hit the children with sticks for behavioral infractions. He assumed the adoptive family would do the same.

As our examples make clear, children who were physically abused or who witnessed domestic violence in their birth or foster home or a foreign institution may move into the adoptive home and hit, shove, push, kick, and so on. The intensity and frequency of this behavior is well beyond “normal sibling rivalry.” Traumatized adoptees will repeat the patterns of behavior they learned in a dysfunctional birth home or orphanage until they learn a new way to act. Aggression can be a behavior resistant to change.

Infants and toddlers who have experienced deprivation may become aggressive as they mature. This latter group wasn’t shown love in infancy. So their moral development will lag behind. They may not be able to show affection, empathy, and remorse until parents have the right tools and therapy to help teach these skills. These kids have distorted thoughts in addition to their immature development. They may think that aggression is a means to solve problems. The strongest person gets his way or gets more of his wants and needs met.

A child who has been a victim of unpredictable physical abuse learns that if this abuse is going to happen, it is far preferable to control when it happens. As a result, children who have been physically assaulted will frequently engage in provocative, aggressive behavior. They believe that the adoptive home operates as did their orphanage or birth home. This means that the child is soliciting anger—from parents and siblings. He believes it is easier to provoke a “beating” than to wait for one to occur. Indeed, in my clinical work with adoptive parents they report, “I never thought I could be so angry!” Brothers and sisters also report, “I get so angry with him that I hit him back.” “She makes me so mad that I get in her face and scream at her. I just can’t help myself!” “Once he made so mad, I pushed him onto the couch!”

Complex trauma: Conclusions

Interwoven into the content of this chapter are examples of some of the behavioral difficulties presented by children adopted through intercountry programs and from the child welfare system. The behaviors presented thus far are in no way exhaustive.

“When they first came, we played like regular brothers and sisters. Later, that period ended. I expected to have some fun brothers and sisters to play with. It’s not fun at all. Sometimes my brother plays with me, but my sister and I don’t even talk most of the time. I expected a happier family. I ended up with a family that isn’t so happy. I am mad about that. I am mad at my brother and sister, but mostly I am mad at my parents because they made a decision that changed my life.”

These behaviors stem from an inability to form a healthy, loving attachment, or due to the adopted son or daughter feeling the need to avoid attaching to his or her adoptive parents, brothers and sisters. The heartache of abandonment is a pain the child fears re-experiencing. Subsequent losses of foster families, a favorite orphanage caregiver, an orphanage mate, classmates, foster siblings, pets, neighbors, church members, and so on only serve to reinforce that relationships lead to hurt. Provoking the family with negative behaviors leads to anger. Anger creates distance in the relationships. The adopted son or daughter thinks, “Distance is safe. My heart won’t break again.” Fear of intimacy and grief for past losses and traumatic insults cause the child to act out to self-protect.

The behavior stems from fractured development. The child is one age chronologically and a younger age socially and emotionally. The new son joining the family at the chronological age of four may actually function as a one- or two-year-old. He is a much “littler” child than expected. Or the newly arrived daughter may not meet age-appropriate developmental milestones as she matures. The developmental interruptions are most prominent in the areas of cause-and-effect thinking, problem-solving skills, abstract thinking, moral development, delayed gratification, the ability to identify, express, and regulate emotions, accepting responsibility, sense of future, initiative/interest in environment, play and social skills, and reciprocity.

In essence, the child with a history of complex trauma arrives with all major foundational skills ruptured or cracked. Like a house with faulty foundations, the structure falters. This is true also for human development. New growth cannot occur at a “normal” pace when the foundation isn’t solid and stable.

Readers can also glean that trauma contributes to how a child thinks. Remember Pam? She didn’t want to form relationships with her adoptive family’s typical children. She wanted to return to her “old” family and her birth siblings. Thus, she rarely engaged with her brothers and sisters. She felt no need to form positive relationships with these “new” kids. Thus, her thought process drove her behavior.

The negative behaviors of the child joining a family through adoption often become a major source of frustration, anger, and despair for parents and typically developing children. In fact, the child-by-adoption becomes the identified problem in the family. His temper tantrums, lying, inability to enjoy outings, poor table manners, poor hygiene, destruction, and so on are blamed for the entire state of the family. Life begins to revolve around “fixing” the problem—the adoptee—so the family can resume life in the same manner as prior to the adoption. Time, energy, and financial resources are devoted to the child with complex trauma issues.

The fallout from this scenario has many facets. Valuable time with the birth and/or previously adopted children is lost. The resident children perceive that the way to get attention is to act out or overachieve. Or, observing the stress their parents are already under, they harbor their thoughts and feelings. Anger and resentment build. The children in the family, prior to the adoption, begin to dislike the adoptee. Then they feel guilty for having these feelings about their sibling.

In essence, the arrival of the child with complex trauma may create a complex family system. As this book unfolds, readers will be offered an in-depth look at these “common challenges” that arrive when a child with a traumatic past joins the family. Then I’ll offer an array of solutions to offset the long-term impact of importing a traumatized child into a healthy family system. Each member of the family—adoptee, parents, and the children already in the family—can flourish and thrive. There is a path to navigate to connected relationships in your family!

This is pictorially presented in Figure 2.2.

Figure 2.2 Complex trauma and the creation of a negative emotional climate

Chapter summary

 • The son- or daughter-to-be may arrive with a social and emotional age much “younger” than his or her chronological age. Or the adoptee may mature at a pace slower than what is considered to be within “normal parameters.” The new sibling’s social, emotional, physical, and cognitive delays can present challenges for brothers, sisters, mothers, and fathers.

 • The adopted child may struggle to form a secure attachment to her parents and siblings. Her past relational model is skewed. She may present with an insecure attachment that is avoidant, ambivalent, or disorganized. She fears re-experiencing the pain that comes with the loss of past caregivers, birth parents, previous brothers and sisters, orphanage mates, classmates and so on. The family built by adoption won’t forge strong connections upon first sight. Navigating satisfying relationships with parents and between brothers and sisters will take time.

 • A special focus must be placed on those children arriving post-institutional living, as well as after the atrocities of sexual and physical abuse. Each of these traumas presents its own unique concerns. The child arriving from the orphanage understands group living, not family life. The sexualized child may present safety issues and may hasten the need for parents to provide sexual education to their birth and/or previously adopted children. The aggressive child believes that hitting, kicking, pushing, and shoving are the way to get wants and needs met. He seeks to elicit anger from moms, dads, brothers, and sisters. Such behavior is shocking to the family that previously enjoyed peaceful, fun, loving interactions.

 • Fallout—post-adoption—is normal. Although offering a home to a child in need extends untold positive benefits, it may also bring frustration, exasperation, aggravation, sorrow, jealousy, woe, despondency, despair, unhappiness, and more. Negative feelings afflict adults and kids alike. Knowing this in advance helps moms and dads circumnavigate such conditions. Prepared for the rough patches, the family quickly finds the alternate route to a contented state.