The instinctual trauma response

Child's Brain PTSD shutterstock_114591085

Editor’s note: On behalf of the staff and Board of Key Ministry, we’d like to extend our congratulations to Jolene Philo for having received a “starred” review in Publisher’s Weekly (the top review publication in the U.S.) for Does My Child Have PTSD? A starred review means the book should get a second look from libraries, book stores, and other entities that can get it into the hands of families who need it. This is a truly special honor…this is the first such honor ever received by her publisher (Familius). Here’s Jolene…

Welcome to the fifth post in an ongoing series about childhood trauma and PTSD. So far, the series has explained why I write about PTSD in children, what words like childhood developmental trauma and PTSD mean, myths about this mental illness, and what causes childhood trauma.

The Instinctual Trauma Response (ITR) Model

Today’s post takes a look at how the brain responds to perceived danger. Many models exist about the brain’s instinctive response to threat. The one that makes the most sense to me–and I hope will make sense to you, too–is called the Instinctual Trauma Response (ITR) model. It was developed by Dr. Louis Tinnin and Linda Gantt, the founders of Intensive Trauma Therapy, Inc. (ITT) in Morgantown, West Virginia.

ITR’s Seven Stages

In the 1990s Tinnin and Gantt identified a consistent pattern of response to threatening events. The pattern is common in both children and adults and consists of seven stages. Here is a brief look at each stage.

Startle: A quick, intense response which puts the body on high alert.

Thwarted intention: After the initial startle, the body releases a surge of hormones to prepare for fight or flight. When fight or flight aren’t possible, the thwarted intention response kicks in.

Freeze: The body enters a frozen state of numbness and immobility, at least for a moment or two, when intentions are thwarted and there is no hope of escape.

Altered state of consciousness: If the freeze state lasts for more than a few moments, many people enter an altered state of consciousness. Adults often describe this state as watching a movie of themselves or that they feel themselves shrink deep inside their bodies and their bodies seem to become shells.

Body sensations: A variety of sensations, such as pain, can experienced during different stages in the ITR model. All of the sensations are stored as non-verbal memories (in both children and adults) and are stored in the right brain. They remain there as non-verbal memories—bodily sensations that can’t be put it into words.

Automatic obedience: This instinctual response causes a threatened person to automatically obey a perpetrator’s demands in order to survive the immediate threat.

Self-repair: After the threat passes, a person tends to the emotional and physical wounds of trauma. Sleeping, eating, rocking, going to a quiet place, and washing are all forms of self-repair.

How the ITR Stages Look During Childhood Trauma

As has been mentioned before in this series, the best way to understand what happens during childhood trauma is to consider everything from a child’s point of view. So let’s re-examine each of the seven stages through child-colored glasses again.

Startle. Babies are startled by little things like a light being flipped, a pan crashing to the kitchen floor, or by unfamiliar people coming into the room. Baby fingers splay, arms go rigid, and the babies cry. Babies who have a secure primary caregiver startle less often as time goes on. Even so, toddlers and preschoolers tend to jump, gasp, or cry at things adults shake off. Their lives are a continual replay of Dorothy, the Scarecrow, and the Tin Man entering the haunted forest: “Lions and tigers and bears! Oh, my!”

Thwarted intention. Fight and flight options are nonexistent for babies. They have no way to fight or flee. Eventually, kids grow strong enough to hide from perceived danger or to pitch magnificent fits. But for the vast majority of little people, life is a series of thwarted intentions. Therefore, we should not be surprised when kids consider the world to be a more traumatic place than do adults.

Freeze. Children tend to move very quickly from thwarted intentions into the freeze state. Children who experience similar, repeated traumas go through the two previous steps so quickly and automatically may appear to have skipped themcompletely. They may freeze at the slightest hint of threat. No jump. No gasp. No attempt to fight or run. They simply freeze. Their brains may go offline for a while. If they’re young enough, they may squeeze their eyes shut because they think that when they can’t see the threat, it can’t see them either.

Altered state of consciousness. Gaze aversion may be the baby version of an altered state of consciousness. When overstimulated or threatened, they tend to disengage and shut out the stimuli. Older children enter this stage by telling themselves, “This can’t be happening. It must be a dream.” Children also flee threats through daydreaming. They hide in a world of their own making, a world they can control.

Body sensations. This step in the process can pose a great risk for infants and young children because from birth to age three, children are nonverbal. They have no words, so all their bodily sensations are recorded as nonverbal memories. The memories are like terrifying movies playing over and over inside the brain. As children get older, their rational mind can’t explain these sensations. It is no wonder that adults living with unresolved childhood trauma often think they’re going crazy.

Automatic obedience. Though it is uncomfortable to think about any child being in the situation where they reach this stage of the ITR model, it is important to understand traumas that can impact children profoundly. For children in life and death situations, automatic obedience is an appropriate survival response. Also, they live in a society that expects children to obey adults. So babies undergoing hospital procedures learn to lie quietly when people hurt them. Toddlers surrender when grown-ups touch their private parts. Young children do whatever their parents say to avoid a beating or verbal abuse. Automatic obedience is often the only survival weapon children have until their old enough or big enough to fight back.

Self-repair. Children are relieved when a traumatic situation ends. They instinctually seek out people they trust to comfort them. (Think about a baby reaching for Mommy’s arms after immunizations.) Children without a trustworthy comforters may snuggle up to their favorite blankie or a stuffed animal. They may regress and suck their thumbs again or insist on a bottle instead of a sippy cup. Older children may revert to baby talk or demand a nightlight at bedtime. These behaviors are attempts to return to a safer, more comfortable time before the trauma happened.

Hope for Those Who Have Experienced Childhood Trauma

Learning about how a child’s brain perceives and responds to danger can be disturbing unless we keep a few things in mind. First, though all children face perceived threats and go through the stages of ITR, the majority experience no long term traumatic effects. Second, children dealing with unresolved trauma or PTSD that develops from it can be successfully treated. They may recover completely if treated early enough. Even those who receive therapy years later can learn to successfully manage and cope with the residual effects. The next post in this series will discuss symptoms in children of different ages that indicate the need to seek treatment. Until then, remember much hope exists for children living with unresolved trauma or PTSD.

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JoleneGreenSweater.jpgDoes My Child Have PTSD? is designed for readers looking for answers about the puzzling, disturbing behaviors of childen in their care. With years of research and personal expererience, Jolene Philo provides critical information to help people understand causes, symptoms, prevention, and effective diagnosis, treatment, and care for any child struggling with PTSD. Available for pre-order at Amazon.

About Dr. G

Dr. Stephen Grcevich serves as President and Founder of Key Ministry, a non-profit organization providing free training, consultation, resources and support to help churches serve families of children with disabilities. Dr. Grcevich is a graduate of Northeastern Ohio Medical University (NEOMED), trained in General Psychiatry at the Cleveland Clinic Foundation and in Child and Adolescent Psychiatry at University Hospitals of Cleveland/Case Western Reserve University. He is a faculty member in Child and Adolescent Psychiatry at two medical schools, leads a group practice in suburban Cleveland (Family Center by the Falls), and continues to be involved in research evaluating the safety and effectiveness of medications prescribed to children for ADHD, anxiety and depression. He is a past recipient of the Exemplary Psychiatrist Award from the National Alliance on Mental Illness (NAMI). Dr. Grcevich was recently recognized by Sharecare as one of the top ten online influencers in children’s mental health. His blog for Key Ministry, www.church4everychild.org was ranked fourth among the top 100 children's ministry blogs in 2015 by Ministry to Children.
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