Sarah Waters is a psychotherapist experienced in working with the effects of abuse, neglect, and childhood trauma. She also specialises in the Dan Hughes family therapy and parenting model, Dyadic Developmental Practice (DDP) 1.
Sarah is a Steering Group member of Therapists for Medical Freedom, as well as a member of HART 2 (Health Advisory Recovery Team) where this article was originally published. HART is a group of highly qualified UK doctors, scientists, economists, psychologists, and other academic experts who came together over shared concerns about policy and guidance recommendations relating to the COVID-19 pandemic. This paper examines trauma informed principles and practice, particularly in relation to babies, children and young people and asks:
Can any therapist, practitioner or organisation that calls itself trauma informed ethically do so if it is adhering to Covid-19 guidelines?
- Half of 16–25-year-olds said their mental health has worsened since the start of the pandemic.3
- As many as 10 million people, including 1.5 million children4, are thought to need new or additional mental health support.
- There has been a 20% increase in babies5 suffering non-accidental harm.
- Two-thirds of domestic abuse victims6 were subjected to more violence from their partners during lockdown.
- There has been a 25% reduction7 in pre-pandemic learning for primary school children and a 30% reduction for secondary school children.
What is Trauma Informed Practice?
Trauma informed practice8 has been a popular concept over the last 10 years particularly within schools. Councils, charities and even police forces have also fully embraced the idea and adopted the venerated tagline. Trainings of between a few hours or a few weeks have been provided, after which trainees have considered themselves trauma informed. While it is acknowledged that some of these practitioners will have undertaken more rigorous and in-depth trauma/child development training, many will have not. Despite the claims by trauma training organisations that children and young people’s wellbeing, mental health and social/emotional needs are top priority, in a Covid world of unchallenged restrictions can they still claim this to be true?
To put things more into context, a programme, organisation, or system that is trauma informed8, as defined by the US Government (also used as the benchmark in the UK):
- realises the widespread impact of trauma and understands potential paths for recovery
- recognises the signs and symptoms of trauma in clients, family, staff, and others involved in the system
- responds by fully integrating knowledge about trauma into policies, procedures, and practices
- seeks to actively resist re-traumatisation
Rather than following a prescribed set of policies and procedures, a trauma-informed approach adheres to five key principles:
The struggle to prioritise children’s emotional needs
It was only at the beginning of this century that neuroscientists were able to visibly identify (through fMRI scans) the devastating effects of trauma9 on children’s brains. And only then was it acknowledged by governments who, rather than support families to try to mitigate it happening by investing in early intervention10, ploughed their resources into trying to deal with its devastating effects. This strategy however has huge financial and emotional implications, outlined most recently and extensively by the Royal Foundation Centre for Early Childhood11 set up by The Duchess of Cambridge. The devastating consequences, such as an increased risk of long-term mental health difficulties and the intergenerational repetition of abuse, has already been proven, but persistently ignored, or dabbled in then discarded, such as the Sure Start Initiative12 launched in 1998. Today Sure Start has dwindled to a shadow of its former self, a reminder of the lack of foresight/care that politicians and councils have around the importance of supporting parents at the most critical point in a child’s development – pregnancy and the first 2 years of life.
Numerous psychologists since the 1950’s, most notably John Bowlby13, have campaigned diligently to reform antiquated and abusive child rearing attitudes and practices, particularly focusing on the very early years in a child’s life. Experiences of loss, fear, control, abuse and neglect, often caused by what are now termed ‘Adverse Childhood Experiences (ACE’s)14 have been scientifically and irrefutably proven to inhibit the development of children’s brains and to negatively affect their emotions, behaviour, relationships and life chances. It is now widely accepted amongst psychologists and psychotherapists that, if children and young people are to thrive, these harmful factors need to be avoided at all costs.
It is also widely accepted that if this has not been possible, these harmful factors need to be fully understood and mitigated in a trauma informed way as children get older. Considering this, those of us in these professions (and others), have felt a huge relief over the last 10 years that children were finally starting to be treated humanely at last. The grim, genetic-deterministic view of human relations seemed to be fading into the past. The greatest contribution that Bowlby and all that have followed him have made to the wellbeing of our culture, is the understanding that children are extremely vulnerable but must be resilient to survive. Most importantly, we have learnt that this resilience, in its most damaging form, means adapting in various ways to a hostile environment to ensure this survival.
For the first time in history, the idea that a society’s destiny rests upon how it treats its children had scientific foundations and was being acted upon and promoted – at least in schools and other trauma informed organisations. Children’s needs were at last being put first and professionals (but unfortunately to a lesser extent parents) were trained to understand, recognise, and promote these needs as, after all, how we treat our children will shape our future. A trauma informed army was born – championing the necessity for safety, love, acceptance, connection, close relationships, play, empathy and most importantly – the absence of fear.
Then along came Covid 19…
And with it a catalogue of guidelines (not laws), taken up at great speed, without any psychological risk assessments whatsoever. All trauma informed knowledge and practice was abandoned as adults, some fuelled by unions, demanded that they were kept ‘safe’ – despite what this might mean emotionally for the children and young people in their care. A disease that has a median Infection Fatality Rate15of 0.05% for under 70-year-olds globally seemed to derail trauma informed practice entirely. There was no mention of how emotionally damaging the measures potentially would be, at all, in the back-to-school trainings (that I attended) provided by numerous child development/trauma ‘experts’ across the UK. What happened to the trauma informed principles of realising, recognising, responding to, and most importantly resisting trauma inducing practices?
It does not seem to matter that babies, children and young people are having to bear the emotional brunt of a pandemic that mainly affects the over 80’s16. In fact, it even feels as if some schools relish in masking and segregating their pupils, acting as if the guidelines were in fact law and that they have no choice in the matter. No one can deny that the mental health of the young17 has been catastrophically impacted over the last year and the question I would like to ask is how can children’s emotional needs so easily be set to one side like this? My understanding is that adults are meant to protect children and not the other way around. Why aren’t trauma informed practitioners and organisations recognising this devastation and standing up for the children in their care? It is astonishing and heart breaking that children’s emotional needs have been so quickly trampled upon and disregarded after the long-fought journey to get these needs recognised.
From new-born babies to teenagers – all are potentially being made to emotionally suffer in their own way. One of the most pernicious and potentially damaging practices that I can see is the routine wearing of face masks around the very young. Anyone who has done any trauma informed training will know of the Still Face Experiment18. It shows the devastating effects, in a very short time, on a baby whose mother stops smiling at it for only a few minutes. A recent discussion paper in The Journal of Neonatal Nursing19 highlights the difficulty in determining what facial expression a person is exhibiting behind a mask which may present severe challenges for infants and young children. They depend on their parents’ facial expressions, coupled with tone and/or voice to regulate their reactions toward others. They advise that health professionals should understand the potential effects of prolonged mask wearing to minimise any potential long-term impact on neonatal development and optimise psychological outcomes for babies, infants, children, and their parents. I have not seen one piece of literature that warns of the dangers of this distressing practice. Everywhere I go, every day I go out, I see evidence that this message is not being passed onto parents by those that are trained to know better.
Bliss, a charity for babies born premature or sick, have stated that 70% of parents20 have said they are more likely to have found it difficult to bond with their baby if the neonatal unit where their infant was being cared for had put time limits in place, as part of Covid parent access restrictions . Equally I have heard distressing stories of women being made to wear masks when in labour. Many of us know of the devastating restrictions that were put in place around partners and family being allowed to be with women when they were giving birth, often leaving them vulnerable and distressed. This will have a knock-on effect to the birth and bonding process, which can have lifelong affects. These same women have been denied face to face support after the birth, leading to an increase in Post Natal depression and loneliness. All for a disease that, as of March 2021, sits at no 24 in the UK as the leading cause of death21.
Enough has been written in other studies about the numerous detrimental effects, both emotionally and developmentally, on school children over the past year22 particularly around the wearing of face masks and social distancing. The trauma informed might find it interesting revisiting Steven Porges Polyvagal Theory A subconscious system for detecting threats and safety23 and what he terms neuroception; a subconscious system for detecting threats and safety. No wonder there is an explosion of psychiatric disturbances, learning difficulties and dysregulated behaviour in children whose nervous systems have been activated by the fear messaging they have been subjected to in schools (and almost every other environment) every day for over a year. And what is the governments answer to this trauma reaction, again with little protest from the trauma informed professionals? Behaviour Hubs24 – as “parents and teachers know that orderly and disciplined classrooms are best”.
Being exempt from facemask use brought its own traumas with it – it is excruciating for a young person or teenager to stand out at school and be different to everyone else. I have heard numerous stories of coercive and bullying behaviour, from teachers and other pupils, against the very few with the strength to stand up for their human rights and not wear a facemask or be invasively tested every week. The list of indignities goes on and on – with the lateral flow/PCR testing pantomime throwing up enormous efficacy, safety, and ethical considerations. Children’s and young people’s lives and education are being continuously disrupted by a flawed system that seems to fish for positives25 amongst this age group and cause misery and loss of income for the adults in their lives. The indignity of being tested and the potential dangers26 from the ethylene oxide used to sterilise the tests again are ignored or deemed worth the risk so that adults can feel safe and damn the effects on the children.
New groups quickly mobilise to safeguard the young
Groups of concerned parents have had to set up campaigning groups, such as UsForThem27 to fight for our children’s human rights and to try and safeguard them. They very quickly realised last year that the professionals, trained and paid to look after our children’s mental health weren’t and aren’t realising, recognising, responding, or resistingthe traumatic measures being put in place. The wearing of face masks in therapy sessions28 is another example and a practice that was also taken up speedily by charities and agencies who support traumatised children and young people (and adults). Again, this was a guideline and not a law, yet therapists put their own physical safety concerns over and above the psychological safety of the children and young people under their care, despite the fact they could sit 2m apart and supposedly ‘keep safe’. Research has shown that wearing face masks in sessions could have a highly detrimental effect upon communication success, with a plethora of undesirable consequences. These include reductions in safety and wellbeing, impacting upon overall clinical outcome levels. Is this another example of adult’s fear levels superseding the emotional needs of young people and therapists putting their own fears higher on the agenda than the psychological safety of their clients?
Government use of a Psychological Campaign to Effect Compliance
Maybe the psychological campaign29 orchestrated by the government’s behavioural unit, Spi-B (of whom members openly admit to ‘ethically questionable’ use of fear tactics to encourage mass compliance of the UK populace) has something to do with all of these extreme measures being so rapidly put in place? Have professionals who are trained to recognise and be alert to psychological and abusive tactics been as unable or unwilling as the rest of the population to spot the psychological behavioural tactics? One theory is that the vast majority of the population are now so fearful they are operating from the reptilianpart of their brain30 that limits being curious, open and engaged and merely keeps us stuck in survival mode. But again, brain development and its workings are a large part of trauma informed training, so it is extremely puzzling as to why this is not being recognised or challenged.
The decision by the government to scare us into submission was a strategic one. The minutes31 of a meeting of the Government’s expert advisors (SAGE) on 22/03/20, a forum that includes psychological specialists, displayed a clear intention: ‘The perceived level of personal threat needs to be increased among those who are complacent’ by ‘using hard-hitting emotional messaging‘. They knew that a frightened population is a compliant one. And haven’t they delivered. Just like a highly abusive parent or partner our government is employing coercive, gaslighting, fear mongering tactics to seemingly scare its citizens into complying. Isolation, restriction of movement, threats, intimidation, occasional indulgences, humiliation (shaming those who don’t comply/making us stand in line) and enforcing of trivial demands have all been used. The list is endless – and is exceptionally traumatising – and unquestionably highly unethical.
Those of us who work or have worked within the field of domestic abuse will recognise these tactics within families and try to protect children (and adults) who are under threat. Being trauma informed needs to be all encompassing, not only considering the effects of trauma, but also understanding, challenging, and trying to change any psychologically manipulative behaviours we are witnessing. Why are trauma specialists, psychologist’s, therapists, teachers, and child behaviour experts not recognising and challenging what is going on now? These are the questions that need to be asked as the UK’s children and young people hurtle towards the ultimate sacrifice for the adults in their lives – being psychologically coerced, and therefore unable to give Informed Consent (let alone be Gillick Competent), into taking a highly controversial, experimental ‘vaccine’32 for an illness that they are at very low risk from that has a 99.997% survival rate33.
Considering the authorities and organisations that have implemented the Government’s suggested Covid-19 guidelines and medical interventions for young people impulsively, without risk assessment, reflection, or critical analysis; I wonder if trauma informed practitioners and organisations are denying their experimental nature alongside the potentially long term, harmful, physical, and psychological effects. The long awaited and so warmly welcomed trauma informed world, that championed children and young people’s emotional needs, is now, in my opinion, supporting them, in collusion with the government. They are supporting them to adapt to a hostile, fearful, abusive, and hence traumatic environment that inhibits the long awaited healthy emotional development that we have all be waiting for. It is imperative to remember:
THE UN CONVENTION ON THE
RIGHTS OF THE CHILD
ARTICLE 3: THE BEST INTERESTS OF THE CHILD MUST BE A TOP PRIORITY IN ALL DECISIONS AND ACTIONS THAT AFFECT CHILDREN
TRAUMA INFORMED PRACTICE:
- SAFETY FIRST – ENVIRONMENTS & RELATIONSHIPS
- THE IMPORTANCE OF TOUCH
- BEING SOCIALLY ENGAGED
- ENRICHED ENVIRONMENTS
- Isolates and deprives children of social support/play
- Being forced to stay at home creates tension and fear
- Threats of fines/criminalisation causes emotional & psychological distress
- Isolation/loneliness affects sleep and physical health
- Increases risk of and escalation of all types of abuse/family discord
- Lack of in person support – one to one or in groups (although support groups of up to 15 have been ‘allowed’ throughout)
- Takes away support of school and potential safeguarding measures
- Disproportionately affects/sets back learning more for the vulnerable/ disadvantaged
- Minimises opportunities for outdoor exercise and vitamin D (needed for healthy immune function)
- Activates the fear system (threat/death/contamination/danger)
- Less socially engaged adults/minimal social engagement system (hostile face)
- Activates the social defence system (neutral/cold/blank face)
- Interferes with neuroception: detecting cues of safety
- Minimises emotional availability/Increases the chances of miss attunement/not connecting
- Offers lowest level of safety cues and signals “All is not well in my world”
- Creates minimal pro-social environment
- Minimises “Connection as a biological Imperative” (Dr Stephen Porges)
- Minimises playful atmosphere
- Signals people are dangerous
BEHAVIOUR HUBS IN SECONDARY SCHOOLS
- Not understanding what vulnerable children need
- Isolation rooms as places of punishment will trigger rage/fear and/or panic/grief systems
- Threat of being punished/expelled creates anxiety and despair
- Enforcement of more ‘rules’ develops habits of compliance
- Led by behaviour advisors – not trauma experts
- Will more young people who aren’t able to manage their behaviour be expelled & recruited into County Lines? 34
- Play opportunities are diminished and isolation increases
- Law of propinquity = the less we interact with each other the less we perceive psychological safety
- Isolation/restriction of movement and gathering is a form of coercive control
- Making young people stand on circles/between lines/stay apart develops habit of compliance and is humiliating
- Minimises social support and connection
- Enforcing trivial demands such as having to stand apart, limiting how many people are allowed to be together reinforces who is in control
- Not being allowed to get close/hug family members creates fear, guilt & a lack of emotional closeness
MEDICAL INTERVENTIONS/ INFECTION CONTROL
- Enforcing demands such as hand sanitising creates fear and develops habit of compliance
- Hand sanitiser ingredients/cleaning products can be toxic/damage the skin
- Constantly testing healthy children is humiliating and may create germ phobia
- Some of the ingredients in the tests are at best dangerous and at worst lethal26
- The efficacy of the tests is highly questionable25
- Constantly cleaning teaching environments creates fear and may create germ phobia/OCD/Health Anxiety
- The experimental ‘vaccines’ have not yet proven to be safe 32
This issue begs a final question:
Is the impact of Covid-19 governmental guidance the ultimate ACE 14 that is going to tragically reverse the upward trajectory of young people’s fortunes just as it had started?
- Laura Dodsworth. A State of Fear p231. Pinter & Martin Ltd 2021