The Body keeps the Score –
Brain, Mind and Body in the Healing of Trauma 
by Bessel van der Kolk, M.D  

NOW UNABRIDGED ON AUDIO CD
​read by Sean Pratt.
Duration: 16 hours 20 minutes
£35
 
What a wonderful book – authoritative, erudite, compassionate and beautifully written.

Dr Bessel van der Kolk combines the curiosity and analytical mind of the scientist with what Judith Herman calls, “the passion of the truth teller”, and the refreshingly humble outlook of a man in awe of his patients.

But a word of caution, this book is a challenge. Think twice if you are easily shocked, offended, or likely to wallow in guilt for doing what you believed to be best practice at the time. All we can ever do is our best and our best changes all the time, as van der Kolk himself has also had to acknowledge in his 30-year career.
 
To summarise the content I’m going to start in the middle of the book because it is here that van der Kolk makes the bold statement that developmental trauma is “the hidden epidemic” in society. As a trainer I talk to parents and teachers about attachment and trauma, many of whom think trauma is a fringe topic affecting a minority of children.  Van der Kolk would argue otherwise. He compares the (US) public health budget devoted to both heart health education and smoking cessation with the barely mentioned topic of childhood abuse, the cost of which exceeds cancer and heart disease in the USA.  To halve the rate of depression, drastically reduce alcoholism, IV drug use, domestic violence, suicide, prison admissions and improve workplace performance he believes we need to eradicate child abuse.
 
Even obesity comes in for a radical rethink. Diets, bariatric surgery even a sugar tax may look like a solution to a major health crisis, but for the trauma survivor society’s problem may actually be their solution, eg, being big may be a health risk in the long term, but for now being the biggest boy in class may be a way to feel safe from bullies, or being an overweight girl may stop unwanted sexual attention. Brace yourself for the research from one chief of medicine that most of his morbidly obese patients were survivors of child sexual abuse. Van der Kolk wants to get this “hidden epidemic” out in the open. When he asks, “how do you turn a newborn baby with all its promise and infinite capacities into a thirty-year-old homeless drunk?  He gets us to acknowledge how much relationship rather than genetics shapes development. So, while there may be a gene for alcoholism, for example, stressful experiences impact on genetic expression both in the womb and after birth.
 
Throughout the text van der Kolk gives us a glimpse of his own childhood and family traumas. He also tours the many dubious practices of the psychiatry profession over the course of his career, from the brutal to the inspired, focusing frequently on the profession’s more recent obsession with pharmaceuticals. Drugs such as Prozac transformed the lives of many depressed patients from the late 1980s onward, but in van der Kolk’s experience they did not work for war veterans with PTSD. The difficulty arose when medication was seen as the go to “fix it” for mental health problems rather than being part of a holistic treatment package. Drug benefits lay in their ability to dampen reactions not heal the illness. In the case of the half a million US children on antipsychotic drugs, medication has improved things for adults by making the children easier to control! Van der Kolk reports huge over prescribing in the children of low-income families and children in foster care. Shockingly, even thousands of under fives have been prescribed antipsychotics, reducing their aggression but also their motivation, playfulness, curiosity, general functioning and socialization.
 
Thankfully, amid the horror stories are accounts of the author’s inspirational teachers, such as the psychiatrist Elvin Semrad who discouraged him from relying too heavily on psychiatry text books and diagnostic labels which obscured his perceptions of real patients. Instead, he urged getting to know and respect the person while acknowledging that, “most human suffering is related to love and loss”. Teachers have also appeared in the form of patients such as Marilyn who told him his reassuring platitudes only made her more lonely and isolated because, “it confirms that nobody in the whole world will ever understand what it feels like to be me.”
 
Through his experience of working with patients Van der Kolk has  concluded that “all trauma is preverbal” whether it happens in infancy or adulthood. This doesn’t mean that it can’t be talked about but that talking rarely gets to the truth because it reactivates the experience of trauma in the body. Experiments with fMRI scans show that trauma activation stops the brain’s speech centre (Broca’s area in the cortex) from functioning. Consequently, the traumatised continue to live in isolated “speechless horror”. He questions accepted therapeutic practices in the light of what we now know from brain scans, research and experience and advocates alternatives such as yoga, EMDR, mindfulness and others that put trauma survivors back in touch with themselves.
  
There is so much in this book that cannot be summarised. I have only selected morsels to tempt and tantalise. In doing so, I feel that I have done it an injustice by missing out so much of the content on attachment, traumatic memory, the anatomy of survival, neuroscience and the numerous and varied paths to recovery. There is a huge focus on relationship and connectedness and our innate drive to be part of a tribe, which goes against the cultural norm of being an individual, competitive and self made. You have to read it to begin to grasp the breadth and depth of its reach but I’ll leave you with this summary by the author himself, “Trauma results in a fundamental reorganisation of the way the mind and brain manage perceptions… For real change to take place, the body needs to learn that the danger has passed and to live in the reality of the present. [We need] to think differently not only about the structure of the mind but also the processes by which it heals.”
 
Happy listening!
 
Reviewed by Sheila Lavery

The Simple Guide to Child Trauma by Betsy de Thierry


‘The Simple Guide to Child Trauma’ by Betsy Thierry is exactly as the title suggests - straightforward,  informative  and easy to read.  

I highly recommend this little book – it is so accessible and  so kindly written. A book as the author says ‘designed to bring hope.’ 

In reviewing this book I cannot do better than David Shemmings who has written the foreword.

‘What the guide does is elegantly and quickly is bring a large amount of research – from psychology, social work, neuroscience, biochemistry and genetics – directly to the busy but interested parent and carers and professionals working in this field.  It translates complex ideas into practice-rich language for adults who need to understand the inner worlds of children, rather than simply explore their wishes and feelings.

I particularly like the way the author ‘speaks’ to birth parents as well as adoptive parents and foster carers,  and this compact book could also be read by young adults who have experienced relational trauma.

This is a book to regularly return to when we are struggling to make sense of behaviour and looking for workable and practical ideas for ourselves and for the children we are loving and teaching.

Edwina Grant 
January 2017

The Neurobiology of Attachment-Focused Therapy - Enhancing connection & trust in the treatment of children and adolescent by Jonathan Baylin and Daniel A Hughes 

The focus of this book is set with a quote from Colwyn Trevarthan Emeritus Professor of Child Psychology and Psychobiology, University of Edinburgh.
“If we are to protect young children from harm …we will have to value more and give response to what children bring to human life-the eager spirit of their joyful projects beyond their seeking to survive.” 

How can therapists and caregivers help maltreated children recover what they were born with: the potential to experience the safety, comfort, and joy of having trustworthy, loving adults in their lives? 

In order to address this question this book shares the work of Dan Hughes and Jon Baylin in their development of a science based model of attachment focused therapy that links clinical interventions that are informed by an understanding of brain functioning on attachment and relationships. Thus Dyadic Developmental Psychotherapy (DDP) is linked to neurobiological processes.

Neuroscience shows that negative experiences lead to the development of a neural “alarm system” called the mid brain defence system linked to chronic defensiveness- the core of blocked trust.

The treatment is to target the mid brain alarm system – the part of the brain sensitised by pain suppression and chronic defensiveness evident in children who have developed blocked trust –the suppression of inherent relational needs due to poor care. 

The prefrontal cortex is activated in order to support new learning and move from mistrust to trust. This is done through techniques of reversal learning, fear extinction, memory reconsolidation, reflection, and reappraisal. The therapy ensure adults send messages of approachability and trustworthiness into child’s brain. i.e. not being defensive adults in order to ensure provision of comforting enjoyable experiences with adults. Safety is key in developing this trustworthy environment. 

Underpinning this approach are the key DDP elements of PACE – playfulness, acceptance, curiosity, empathy which are utilised by the therapist in work with children, parents and families. 

The content of the book is laid out in such a way that the reader is informed by the new science of attachment and the bio behavioural processes of trust, mistrust and trust building. This is rich and informative. The focus then leads on to the means of change in the brain functioning in order to bring about therapeutic intervention. There are summaries for some chapters (those providing theoretical background) which are an excellent learning aid. The chapters on intervention are very well illustrated with clinical examples which bring alive the approach as well as reminding the reader of the pain for the children and families involved. 

In drawing the book to a close the focus is directed to the future and the possible expansion of the DDP model looking at more processes to decrease chronic stress and defensiveness. 

The linking of the constantly developing information on brain functioning with attachment focused therapy is very successfully achieved in this book which will provide those working with children and families with potentially both an increased body of knowledge and an improved skill base.

​Ann Rooney
Consultant / Trainer

There is no better guide to how children develop their rich emotional, relational, and creative lives than is the wisdom of Colwyn Trevarthen, Jaak Panksepp and Phyllis Booth.  In this book, all three make it clear that reciprocal play--play that involves joy and delight, magic and music, often rough and tumble, always engaging in the back and forth of spontaneous encounters and movements--is a central component in the full development of children.  
            
In the first chapter Trevarthen and Panksepp summarize clearly their view of human development:  “We are born with a moving body, ready to share its rhythms and melodies of joy or anguish.  Our vitality is by nature that of a dancer or musician, and this intelligence in movement gives us signals to be shared. (p. 39).”   In the Forward, Booth gives us a brief glimpse of how Winnicott saw play between the child and psychotherapist as being at the heart of the creative changes that such meetings attempted to foster.   Play too, is the central core of Theraplay, a treatment modality developed by Booth that moves play from the focus on the symbolic play of traditional therapies to the reciprocal, expressive, movements of delight and engagement that occurs within Theraplay between the child and therapist and the child and parent. 
            
Attachment theory and research stresses the importance of safety that is established in the infant-parent relationship within which the young child learns within joint activities with the parent to regulate their affective states and begin to make sense of the world.  The reciprocal, moment-to-moment engagement--often characterized by music and  rhythms that have been called “the dance of attunement”-- between infant and parent is the foundation for the child becoming safe to explore the larger world of relationships with peers and developing interests.  Through reciprocal play, the rich inner world into the minds and hearts of others--family and friends--becomes open to the child.
            
When children have had the misfortune of developing a troubled or disorganized attachment with their original caregivers, these children need to develop relationships with their new caregivers that feature the presence of comfort (for attachment) and joy (for companionship).  Repetitive nonverbal communications that express empathy, delight, interest, and wonder are central in these children learning that they are able to trust these caregivers.  Joint activities that involve music and dance, spontaneous intentional movements requiring a shared focus and cooperation are important ways to engage these children to develop their trust.  Similar activities with their peers are often crucial both in helping the child to both return to the past with joint activities that they had needed but did not receive, as well as moving into the future into groups of friends. 
            
Inclusion, Play, and Empathy offers a great variety of ways to become engaged with children who have had difficult beginnings while guiding them to participate in those spontaneous, joint activities of creative play that they desperately need.  Music and dance, but also all sorts of shared intentions and activities, are presented in this book as ways that will facilitate children’s neuroaffective development in group settings.  Therapists from many countries and all persuasions share their insights attained through their creative therapies that are likely to offer ideas for engaging children to both parents and professionals alike.
 
These programs cannot replace the child’s need to develop safe relationships with their primary caregivers characterized by comfort and joy.  However they may well complement such relationships and, in fact, the child’s participation in these crucial experiences of play with peers, maybe actually help them to become more open to exploring a closer relationship with their caregivers.  The therapies presented in this well-edited book are excellent examples of “therapies that enhance the deep creative and restorative powers of human nature (p.49).”

Dan Hughes PhD
​Founder of DDP

Parenting a child who has Experienced Trauma.
​By Dan Hughes with Matthew Blythe
Published by CoramBAAF
​
Dan Hughes defines simple and complex trauma; explains the effects of both and the aims of supportive treatment programmes. This part of the book is tightly packed with vital information to educate parents and advice on how to begin to understand and support their children; particularly those who have experienced complex trauma. Hughes suggests that parents and therapists need to “mentally search for the child under the problems and help that child emerge”. 

By being Playful, Accepting, Curious and Empathetic (PACE) parents can communicate that they love their children “for better or for worse”.  Being and relating in this way helps parents give their children the experience of greater safety, even though their children are wired to distrust them. PACE also enables parents to be “emotionally strong, present, confident and comforting” and able to protect their ability to care. Hughes deals with the differing relational needs that traumatised children are likely to have at different developmental stages of their lives. He also provides a very useful introduction to the educational and social issues traumatised children contend with. Hughes theoretical introduction is complimented by the final section of the book in which Matthew Blythe describes his life as the father of his adopted twin boys. Here we hear how early trauma impacts on the development of each of the boys and how Matthew struggles to understand and support them. Their roller coaster journey together will be familiar to adopters and adoptees as well as full of insight.      

My 21 year old son has also reviewed the book. He says: “As a young adult who has experienced complex trauma, I found the section about the effects of childhood trauma very useful.  It helps explain why I feel the way I do sometimes and why I behave in the way I do sometimes. This information has given me ideas about how to help myself”.

“The chapter on symptoms, prognosis and treatment describes how my early life felt to a point of scary accuracy! The treatment suggestions, based on Playfulness, Acceptance, Curiosity and Empathy (PACE) make sense and, if put into practice consistently, work well. However I would say I struggle with the empathetic response that Hughes suggests. I don’t want somebody walking in my shoes with me. I want them beside me, but pushing me on with reassurance. Some people may gain a sense of greater safety from empathy but I do not. That said, the section on helping your child develop internal safety is helpful. It explains that telling someone to ‘forget about it’ or ‘get over it’, is very likely to fail. This is because even as little as a smell or sound can make you feel unsafe/angry/irritated.”

“Some parts of the book seemed obvious to me, however not many people have been through interpersonal trauma. I think the people who will benefit most from this book are teachers, mental health professionals, the police and anyone else working with young people. They all need this knowledge and understanding to get beyond reacting to how young people behave.”

Roberta Manners and HH

​Improving Sensory Processing in Traumatized Children 
By Sarah Lloyd 
​
This excellent little book provides a timely reminder of the significance for fostered or adopted children of the sensory and movement experiences to which they have been exposed in early life.  


The author, Sarah Lloyd, suggests that when we think of trauma and neglect we usually draw on theories around Attachment and Trauma.  Bringing theories around Sensory Integration into the picture can add helpful insight and by helping babies and children to “go back” and become more in touch with themselves at a bodily level, they become more able to deal with their emotions.

Sarah Lloyd draws on her experience of working in Fife as part of the Springfield Project to write the book. Based on her considerable experience as a Specialist Occupational Therapist and Play Therapist, she reminds us that secure children have lots of movement and emotional experiences that allow the brain and central nervous system to develop good, strong pathways.  The things we take for granted such as rough and tumble play, carrying a baby on a hip, the “jiggling” interaction that we have with babies, are all helpful in developing their vestibular system.  By contrast, children affected by trauma and neglect lack not only the warm interaction from caring adults but also the movement experiences, beginning in-utero, that go alongside this. They often have poor muscle tone, poor posture and poor balance.  Sensory Integration Theory is thus very useful if used alongside Attachment Theory.

The third section of the book provides some helpful exercises which can be used to  increase sensory awareness in children. The author gives really good examples of how, starting with the tactile system, games such as taste tests, blow football, food that gives sensory stimulation, “feely” bags, “Simon says”, doing “wheelbarrows” and using a yoga ball can all be helpful. Many of these exercises and games fit well with what we know from PACE (Dan Hughes), from Theraplay, from the “Brainchild” work of Viv Hailwood or the interventions on perception and the senses offered by “Motorvate”. 

In this helpful little book Sarah Lloyd reminds us that, “relationship experiences combined with bodily and movement experiences form the development of social and emotional skills and learning”.  She offers us ways of identifying the gaps in the development of children who are affected by trauma and neglect.  Her generous sharing of exercises provide a valuable tool for parents and for professionals too. I feel sure that there’s another book to be written by this experienced practitioner and hope that she will write further.

**** star rating   
Heather M Drysdale 
Systemic Psychotherapist/Adoption and Fostering Consultant

The Little Book of Messy Play by Sarah Featherstone

The Little Book of Messy Play has long been a favourite publication for all practitioners involved in the area of early years education.

The book provides a range of suggestions for play using a number of creative methods to engage all the senses. Many of the activities described are useful not only for professionals involved with children but also for parents and carers who are needing inspiration to provide play which entertains and stimulates a range of age groups and abilities. 

The activities included not only promote communication and language skills but also promote gross and fine motor skills and the development of social and emotional skills. Although primarily aimed at 0-5 year olds, I believe the projects are easily adapted and transferable for older children; particularly those who have missed out on key developmental stages and would benefit from the opportunity to ‘catch up’ on early life experiences. The chance to regress and get messy, mucky and dirty can be irresistible and can reignite the inner child in us all.

Our own personal family favourite, which captivated two 2 year old girls, was “Catch a Creature”. We have already discussed our plans to recreate this at the beach and have talked about how we might adapt the concept (my word, not theirs) for Halloween by making scary green and orange jelly complete with edible worms!

My only minor criticism would be the use of a safe outside space is desirable. However, that aside, many of the activities suggested could provide the inspiration for a range of summer projects and could be put to good use at a Family Fun day or organised Summer event. Enjoy!

​Catriona Walker

‘A Guide to Therapeutic Child Care -What You Need to Know to Create a Healing Home’ by Ruth Emond, Laura Steckley & Autumn Roesch-Marsh

REVIEW
I am so envious of the authors of this book -they have written the book I really wish I could have written myself! This is not another outcome driven piece of research that leaves carers and practitioners feeling hopeless or undermined, nor is it a simplistic set of tips or techniques, instead it goes to the heart of what therapeutic care is all about. It recognises the passion and loving commitment that characterises the best intuitive practitioners but also encourages a reflective and thoughtful approach drawing on research and theory.  

The authors’ style is beautifully lucid and clear but this simplicity is deceptive, as throughout this work they have embraced the complexity and messiness involved in providing therapeutic care for desperately hurt and distressed 
children. All the authors currently hold academic posts and this book is embedded in theory but this is communicated in a totally non-intrusive way.
Concepts from psychodynamic theory are effortlessly interwoven with neuroscience, while an attachment based developmental approach underpins the whole work. Ideas from trauma and resilience theories help to make sense of the impact of adversities and children’s different developmental trajectories. 
Although theory never overwhelms the reader, the authors have ensured that references are available for those who want to explore particular topics at greater depth. 

The core of this book is deeply relational. Every chapter highlights the importance of connections between people as the essential route to healing and recovery. The pain underlying the perplexing behaviour of children is ever present but the authors also recognise the emotional cost to adults of staying in touch with this distress. Throughout the book there is an emphasis on the importance of formal and informal organisational support mechanisms as well as adults finding their own effective individualised self-care strategies. The authors model a relational approach in the way the book is constructed and also through their courageous and reflective sharing of their own practice. The authors address their readers directly as other human beings, posing questions, sharing practice and suggesting useful everyday approaches that might help their readers to connect in a deep and healing way with children.  

The content of the book addresses the opportunities and challenges that are central to the daily shared experience of adults and children in therapeutic care settings. Alongside an introductory chapter on child development the authors explore how to attune to children who may have experienced only hostility and danger from adults in previous relationships, explain the importance of providing containment to children who have never been helped to process their 
overwhelming emotional experiences and consider how to be alert to the different forms of communication, conscious and unconscious, that can happen between people. They examine the symbolic, social and psychological meaning of the everyday rhythms and rituals of life with a special emphasis on the importance of food. They also discuss some of the difficult or complicated areas of being alongside hurt children such as the importance and complexity of touch between adults and children and also the challenge of responding firmly but lovingly to ‘pain-based behaviour’.  

Finally they locate the therapeutic work firmly in the context of the child’s chronological journey by explaining the critical role of ‘memory keeper’ that those caring for children should take on. In addition to this developmental 
perspective they highlight the need that all children have for connections to the wider world through their relationships with other important adults, their friends and the communities in which they live.
 
The particular needs of children with disabilities are recognised throughout the book in an inclusive and helpful way. The authors have successfully achieved their self-imposed task of ‘acknowledging the difficulties and celebrating the magic of healing care’. Residential child care workers and foster carers, interested in providing therapeutic care, have waited far too long for this book! In my opinion all new carers and residential workers should be given a copy before they even meet their first child! I have already begun the distribution process!!
Judy Furnivall  
Lecturer/Consultancy Lead CELCIS
Trustee SAIA

​Review of  “The Great Big Book of Feelings” by Mary Hoffman and Ros Asquith
 
At first glance, this book is jam packed with child-like illustrations that are colourful and exciting to look at.  These show mixed emotions in picture form which I feel a young child would find easier to relate to than a sentence exploring a feeling.
​
Excitement, happiness, fear, boredom and cheekiness are some of the emotions explored in this book.  It moves through the different feeling visually with illustrations and minimalistic narrative.  However it provides ways to deal with feelings we don’t enjoy such as boredom or sadness, which is such a positive way a child could look at these feelings. 

​The use of questions throughout means a child could interact with you when reading, thus opening up to you; something that may be difficult for them, in a casual and less pressurising way.  Mary and Ros look at feelings in the family, school and out in the big bad world.

This book is full of wit and charm as well as sensitivity and I would encourage you to read this to young children to allow them to open up or to provide answers on how to cope with strong emotions and feelings in a calm way, with the book even containing a hide-and-seek game with a cat that will keep you and the child on your toes!
 
Reviewed by Anna Laidlaw

Review of My Big Shouting Day
Author-illustrator Rebecca Patterson.

I love this book.   I am sure there are several  reasons  as to why it was awarded the Roald Dahl Funny Prize… the illustrations and narrative are just two.  Anyone who has had the care of a child will identify with what looks like a rough day from beginning to end.  

Bella, the child in question (and star of the book, though the mother  is the real heroine  for her patience) starts her day off with finding her baby brother in her room, crawling on the floor licking her jewellery and that is the start of the shouting. Nothing…..absolutely nothing in her day goes well from here on in…..her egg, her shoes, the broken biscuit, not letting her friend be a princess, the itchy ballet outfit, lying on the pavement with her leg stuck up in the air are just some of the problems Bella, her mother and brother suffer throughout the day.  

It is a book that you can read with a child (preferably when they are not having a’ Bella Day’). The large shouty writing encourages the reader to provide the volume and tone of each thing Bella is complaining about. The wry looks of Mum and other bystanders are also noticeable. Eventually after the ‘too hot bath’ and ‘too minty toothpaste’ Bella eventually succumbs to being tired and gives in to her mum reading her favourite book to her.  Bella recognises she had had a big shouting day, and apologised to her Mummy (now, I know that may seem unbelievable  but stick with me on this!).  The heroine Mum says we all get those days and offers the hope of a better day tomorrow.  And like all good stories,  Bella has an absolutely fantastic day all day.  And they all lived happily ever after. 

Well maybe not really, but do give this book a go, I bet your little ones and big ones will enjoy it.  Reading this out loud, making funny voices and faces with story telling can be a great way of connecting and enjoying a bit of time with your child.  I think this could become a favourite for children and parents alike as it affords the opportunity for fun time together, and you can also slip in a few messages along the way.  Enjoy.

Rita Grant
Adoption Support Manager
St. Andrews Children’s Society.

​The Body keeps the Score – Brain, Mind and Body in the Healing of Trauma by Bessel van der Kolk, M.D      £21
 
What a wonderful book – authoritative, erudite, compassionate and beautifully written.

Dr Bessel van der Kolk combines the curiosity and analytical mind of the scientist with what Judith Herman calls, “the passion of the truth teller”, and the refreshingly humble outlook of a man in awe of his patients.

But a word of caution, this book is a challenge. Think twice if you are easily shocked, offended, or likely to wallow in guilt for doing what you believed to be best practice at the time. All we can ever do is our best and our best changes all the time, as van der Kolk himself has also had to acknowledge in his 30-year career.
 
To summarise the content I’m going to start in the middle of the book because it is here that van der Kolk makes the bold statement that developmental trauma is “the hidden epidemic” in society. As a trainer I talk to parents and teachers about attachment and trauma, many of whom think trauma is a fringe topic affecting a minority of children.  Van der Kolk would argue otherwise. He compares the (US) public health budget devoted to both heart health education and smoking cessation with the barely mentioned topic of childhood abuse, the cost of which exceeds cancer and heart disease in the USA.  To halve the rate of depression, drastically reduce alcoholism, IV drug use, domestic violence, suicide, prison admissions and improve workplace performance he believes we need to eradicate child abuse.
 
Even obesity comes in for a radical rethink. Diets, bariatric surgery even a sugar tax may look like a solution to a major health crisis, but for the trauma survivor society’s problem may actually be their solution, eg, being big may be a health risk in the long term, but for now being the biggest boy in class may be a way to feel safe from bullies, or being an overweight girl may stop unwanted sexual attention. Brace yourself for the research from one chief of medicine that most of his morbidly obese patients were survivors of child sexual abuse. Van der Kolk wants to get this “hidden epidemic” out in the open. When he asks, “how do you turn a newborn baby with all its promise and infinite capacities into a thirty-year-old homeless drunk?  He gets us to acknowledge how much relationship rather than genetics shapes development. So, while there may be a gene for alcoholism, for example, stressful experiences impact on genetic expression both in the womb and after birth.
 
Throughout the text van der Kolk gives us a glimpse of his own childhood and family traumas. He also tours the many dubious practices of the psychiatry profession over the course of his career, from the brutal to the inspired, focusing frequently on the profession’s more recent obsession with pharmaceuticals. Drugs such as Prozac transformed the lives of many depressed patients from the late 1980s onward, but in van der Kolk’s experience they did not work for war veterans with PTSD. The difficulty arose when medication was seen as the go to “fix it” for mental health problems rather than being part of a holistic treatment package. Drug benefits lay in their ability to dampen reactions not heal the illness. In the case of the half a million US children on antipsychotic drugs, medication has improved things for adults by making the children easier to control! Van der Kolk reports huge over prescribing in the children of low-income families and children in foster care. Shockingly, even thousands of under fives have been prescribed antipsychotics, reducing their aggression but also their motivation, playfulness, curiosity, general functioning and socialization.
 
Thankfully, amid the horror stories are accounts of the author’s inspirational teachers, such as the psychiatrist Elvin Semrad who discouraged him from relying too heavily on psychiatry text books and diagnostic labels which obscured his perceptions of real patients. Instead, he urged getting to know and respect the person while acknowledging that, “most human suffering is related to love and loss”. Teachers have also appeared in the form of patients such as Marilyn who told him his reassuring platitudes only made her more lonely and isolated because, “it confirms that nobody in the whole world will ever understand what it feels like to be me.”
 
Through his experience of working with patients Van der Kolk has  concluded that “all trauma is preverbal” whether it happens in infancy or adulthood. This doesn’t mean that it can’t be talked about but that talking rarely gets to the truth because it reactivates the experience of trauma in the body. Experiments with fMRI scans show that trauma activation stops the brain’s speech centre (Broca’s area in the cortex) from functioning. Consequently, the traumatised continue to live in isolated “speechless horror”. He questions accepted therapeutic practices in the light of what we now know from brain scans, research and experience and advocates alternatives such as yoga, EMDR, mindfulness and others that put trauma survivors back in touch with themselves.
  
There is so much in this book that cannot be summarised. I have only selected morsels to tempt and tantalise. In doing so, I feel that I have done it an injustice by missing out so much of the content on attachment, traumatic memory, the anatomy of survival, neuroscience and the numerous and varied paths to recovery. There is a huge focus on relationship and connectedness and our innate drive to be part of a tribe, which goes against the cultural norm of being an individual, competitive and self made. You have to read it to begin to grasp the breadth and depth of its reach but I’ll leave you with this summary by the author himself, “Trauma results in a fundamental reorganisation of the way the mind and brain manage perceptions… For real change to take place, the body needs to learn that the danger has passed and to live in the reality of the present. [We need] to think differently not only about the structure of the mind but also the processes by which it heals.”
 
Happy reading!
 
Reviewed by Sheila Lavery

THESE REVIEWS ORIGINALLY APPEARED ON THE SCOTTISH ADOPTION WEBSITE AND ARE REPRODUCED WITH PERMISSION

The Huge Bag of Worries tells the story of Jenny and her struggles with her increasing number of worries. Big worries, small worries, worries about all manner of things. No matter what Jenny tries to do, the worries just won’t go away and worse still, they keep growing...

Thankfully, help is at hand, in the shape of a kindly neighbour, who knows a thing or two about tackling a worry. Her words of wisdom and range of strategies soon help Jenny to lighten her load and finish up with a smile on her face!

This is a lovely children’s book, which would appeal particularly to those in the early years of primary school. It is enhanced by lively and witty illustrations, which help bring the story to life. The depiction of worries as furry creatures living in a bag also offers great creative options for working with children in a similar vein, to conceptualise and manage their own personal worries. The story has a reassuring message and the strategies offered by the neighbour are widely transferable and could be used by children again and again.

As a story, it stands alone as enjoyable read. For children struggling with worries on a range of levels, it is a terrific resource for supporting them to understand and manage these.

This months review comes from Naomi Head, a Senior Practitioner in the Placement Team.

THIS MONTH'S REVIEW IS A LITTLE DIFFERENT -
A POSTER AND PRACTICE NOTES FROM THE FAMILY PLACE
​
Using Theraplay to support transitions from fostering to adoption by Dr Vivien Norris and Sally Twigger.

Dr Norris begins the practice notes by stating “Although it is widely recognised that support over the transition from fostering to adoption is essential, many are uncertain how best to do this in practice”.

We recognise that transition is a complex process which carries with it many hopes and expectations for all involved.  It can be a tense and emotional time for the child the adopters, the foster carers and professionals.

Prospective adoptive parents will all have had their own particular journey to adoption, they will have attended preparation groups, have under taken an intensive home study , been to an approval panel and will have known the details of the child they have been matched with for a number of weeks, and will be desperate to meet and claim the child.  The adopters will want to begin to get to know the child to establish a relationship as soon as possible.  They may also feel nervous about being surrounded by other people who know the child well.  This can result in adopters feeling vulnerable and intimidated by an experienced foster carer who has effectively built up and managed a relationship with their child. 

The co-ordination process can be emotionally painful for foster carers who have cared for the child for a long time sometimes from birth.  Foster carers will have supported the child through some difficult experiences.  They will have integrated the child into their family and will have developed empathy for the child’s experience.  They will have supported the child to meet their developmental milestones and will have established rhythms’ and routines that the child will be familiar with.  Many foster carers can experience difficult feelings about the imminent separation from a child in their care.  This can be even more complicated and sensitive if the foster carers have previously expressed an interest in caring for the child on a permanent basis.

The workers have also known the child and supported the child through difficult and distressing times.  They will have contact with the birth family and will have facilitated family contact which is often fraught.  They will have been instrumental in removing birth parents parental rights and responsibilities and are invested in securing a good outcome for the child parents who will meet the child’s life long needs and offer the child an opportunity to heal, grow and develop.  In my experience everyone comes to co-ordination with hopes, dreams and high expectations, and it is possible to lose sight of the child’s needs when so many conflicting adult needs are at the forefront.

In her piece Dr Norris reminds us that children who are transitioning from one family to another, and who have a history of developmental trauma face complex difficulties.  They are likely to have a fragile sense of trust in adults and sensitivity to being triggered into a survival state, or to regress to earlier ways of relating which means they may move away from rather than towards their main attachment figure (the foster carer) at times of significant stress.  They are also likely to hide their fear and miscue; that is to give signals that they are fine and self-sufficient when they are feeling frightened.  In addition their capacity to think and make sense of what is happening to them is likely to be highly compromised and exacerbated by fear.  They may not be able to process and retain information or respond to logic and their sense of time may be distorted. Foster carers will often report that things have been explained clearly to a child but ‘they act as if they haven’t heard it’.  Alongside age related development and a child’s concept of time, children who are highly anxious may be able only to think in minutes or seconds and any discussion of the future beyond that may be meaningless.  This obviously presents challenges in terms of how to be of most help to children who are moving family.

The purpose of a transition is to move a child from their foster carers to their  adoptive parents.  This is usually achieved.  In my opinion that makes how we do the co-ordination even more important as we should be child focussed and protective of the child recognising their distress as described by Dr Norris.
The co-ordination plan focuses on practical arrangements but these arrangements should be put in place to support the child to transfer their sense of trust from his primary care giver to their adoptive parents. 
Dr Norris’s approach helps us to put the child in the centre and supports the child to make use of their main attachment figure.

With my colleagues I have put into practice Dr Norris’s approach to good effect. The use of theraplay in transition has made everyone more aware of the importance of transferring established loving ritual.  We are more conscious of need to know more about the child’s rhythms and to transfer these from the foster carer to the adopters. We are more conscious of putting in place a co-ordination plan aims minimise the trauma that the child will experience during the transition.  We want to know what soothes and what excites the child.  We pay greater attention to the continuity of the sensory environment and to the non verbal means of communication such as touch, play, music and transitional objects.

I have found the poster helpful, as it supports us to think about the impact of developmental trauma and the implication for the child when they are experiencing another move.  It is helpful to think about potential issues, the implications and goals that underpin the transition process.

This model recognises the foster carer as central in supporting the child throughout coordination and it is essential that they are well prepared for and well supported throughout this process.  Their social worker has a crucial role in relation to this and needs to be available to the foster carer during the co-ordination process.  Foster carers need to be enabled to undertake this piece of work and it is important that other departmental demands are kept to a minimum where possible (e.g. additional foster placements, LAC Reviews for the child).

As Dr Norris points out even children who are well prepared for moving placements can find the experience confusing and anxiety provoking.  This model recognises and accepts the child’s experience and helps us all to remain child focused throughout this difficult and challenging process.

I would recommend that all workers, foster carers and adopters read Dr Norris’s piece alongside her chapter in "Healing the Hidden Hurts".

Anne MacKenzie 
Senior Practitioner at City of Edinburgh Council

Keeping the Little Blighters Busy: 50 refreshingly different things to do with your kids before they're 12 3/4 by Claire Potter 

This is a great book to dip into for ideas on how to encourage play, and spend fun time with the children - or set them off and leave them to it!

​Bright and accessible, it gives a range of imaginative activities that cost little or nothing to set up and enjoy, and which are fun and exciting - it is not just another things to do with sticky-backed plastic sort of read.

In fact, it is brilliant book for parents who need more ideas on what to do with their kids and how to encourage imaginative playtime. It is aimed at ages 3-13, though the adults will have as much fun as the kids when joining in on many of the activities. 

The book is divided into sections making it easy to home in on the solution you need, or you can flip through it and pick up something that catches your eye - I particularly liked the “if you like this you could look at page…”  footnotes.

I found the suggestions imaginative but simple to set up, and applicable to all sorts of situations – rainy days at home, creative stuff in the garden, walks in the park or round the neighbourhood, new takes on Halloween and Christmas, all at low or no cost and generally easy to set up.  

The author also give a little bit of background as to how she came up with the idea, which rounds the book out. All in all it was an inspiring and warm hearted read, I will definitely be trying out a few of these activities with my 2 boys.

Ruth F, Adoptive parent

The Teacher’s Introduction to Attachment: Practical Essentials for Teachers, Carers and School Support Staff by Nicola Marshall

Teaching colleagues and school support staff are frequently in search of knowledge, understanding and skills to assist them in meeting the needs of some of our most vulnerable children- those who have experienced early developmental trauma. 

Within education circles some would argue that meeting the needs of this group of children presents one of the greatest challenges to fostering an inclusive education system and to realising the aspirations of Getting it Right for Every Child.

Nicola Marshall’s book is a helpful addition to the range of resources designed to support staff and carers to respond positively to the often complex challenges presented by children with attachment difficulties. 

She describes her book as a “down to earth, practical and accessible look at the world of attachment and trauma, particularly in educational settings” – and that is precisely what it is. 

While drawing on the work of many well-known writers and practitioners in the field, notably Dan Hughes, Bruce Perry, Kate Cairns and Louise Bomber amongst others, Marshall expresses the hope that the reader will find that her book comes from a real place of experience. The experience she refers to is that of being the parent of three adopted children, who she describes as being the reason for the book; having given her the inspiration to try to help others understand the impact of early trauma on children.

                 “The key to most things in life is awareness and understanding.
                   Once you have that the strategies are easier to find”. 

While there can be little doubt of the truth of this statement, many teachers may assert that while the understanding is essential, it is not sufficient, and that what is needed in schools is the means to implement practical effective strategies on a day to day basis. The fact that Nicola Marshall manages to cover both theory and practical strategy, and more importantly link them meaningfully in a relatively short 147 pages should add to the appeal of this book for busy school staff. 

The book is divided into four parts. Part 1 looks at theory and starts from the perspective of some of the puzzling behaviours and responses of traumatised children, acknowledging that we need to ‘take a step back’ and look at what may have happened in the lives of children before they came to school, to really understand the feelings behind the behaviours they present. This is a fundamentally important point, highlighting as it does that effective support for children needs to look beyond and behind behaviour. Teachers and other school staff frequently report that ‘traditional’ and often tried and tested approaches are simply not effective and this can lead to frustration and hopelessness for staff and children alike.

This section covers trauma, its meaning and causes as well as describing the attachment cycle, brain development, the consequences of disrupted attachment and attachment styles. Marshall acknowledges that there is more to say on this subject but her hope is that there is sufficient information in this to allow an understanding and that readers will be inspired to seek a greater depth of understanding through the references and resources provided. Although I have some reservations about describing attachment styles in a resource such as this, as it can reinforce the risk of tendencies to ‘classify’ and label children, there is enough in the later sections of this book to counter- balance any such propensity.  

Part 2 focuses on the Guiding Principles of working to support children. In this section the principles outlined are – Relationships over Programmes, Emotional Age over Chronological Age, Structure over Chaos, Time in over Time out and Sensory Less over Sensory More.  These sound principles for working with children who have experienced trauma and disrupted attachment are helpful for practitioners not only in thinking about the needs of children but also in providing a framework for considering the application of supportive approaches in their particular context and setting.  As such they are useful in helping staff and carers to begin to think about the practical application of strategies with the children they work with on a day to day basis. 

Part 3 goes on to focus specifically on areas of concern in an effort to deepen understanding of the needs of children and some strategies which may be of benefit. This is a practical and helpful overview of some of the main issues and builds effectively of the previous sections covering toxic shame, identity, empathy, trust, control and self-reliance, self-regulation, memory and organisation and changes and transition. Each chapter considers the possible underlying causes of concern, examines the implications for the child and his/her development, the signs that the particular area may be a difficulty for the child and focuses on what can be done to help. It manages to give greater insight into the complex and puzzling behaviours which can perplex (and sometimes defeat staff and carers) as well as offering advice about effective strategies to support children to overcome early adversity and settle to learn. 

Marshall provides examples and weaves some of her own experiences throughout.  This gives the book the flavour of what she describes as ‘heart knowledge as well as head knowledge’ and as such will resonate with those experiencing the challenges of living with or working with traumatised children.
The final section of the book picks up some of the areas not readily captured by the previous parts and looks at, for example, the important issues of secondary stress, communication and triggers.  

It also has a short section on rewards in school – an area that can be especially difficult within a whole school context. Marshall suggests that there is a need for a conceptual shift towards a relational approach which focuses on encouraging expression and integration in order to help a child feel safe, nurtured and good about themselves. She also makes some important points about expectations of change and the resilience and tenacity needed by staff and carers to stick with children in their journey to overcome early adverse experience.

In summary, Nicola Marshall’s book is an easy to read and helpful contribution to the burgeoning resource for school staff and carers in their efforts to help children who have experienced trauma and disrupted attachment to flourish; and as its cover attests, will be a welcome addition to any school’s staff library.

Alison MacDonald
Principal Educational Psychologist  

Yoga Games for Children. Fun and Fitness with Postures, Movements, and Breath
by Danielle Bersma & Marjoke Visscher

​
Namaste and welcome to our yoga games book review! 

I was ably assisted in this review by two small volunteers aged 4 and 7, who agreed (a TV bribe was admittedly involved) to test out the ‘yoga games’ from this book with me. 

The authors suggest working through a series of the games, beginning with breathing, then yoga postures and relaxation, providing a structure which is similar to that of an adult yoga class. The games are designed for children between 3 and 12 with age recommendations for each game. We managed 40 minutes in all, which was far longer than I would have anticipated, especially as early notices were mixed.

“Yoga’s not my thing, I don’t like it!”

We started with a few breathing exercises, the most popular of which was ‘Blowing Leaves’ which as the name suggests, encourages  awareness of the breath travelling in the body by blowing leaves around the room. A good storm ensued. We then tried ‘Animal Sounds’ and running around making a bee noise was also popular so we had a go at ‘Feeling Sounds Through the Back’ with the children sitting back-to-back and taking turns to try and to feel the resonance of one another’s singing or talking. Both declared they could hear the noises ‘in my ear’ so possibly this one needs some practice!

Moving on to poses, the  control needed for the ‘Cobra’ proved difficult, but more light-hearted exercises with suggestions to make the noise of a lion or make a funny face were met enthusiastically and we all especially enjoyed ‘The Sun Salutations for Children’ which included the instruction to ‘try to look silly’. A passing Granny was even successfully co-opted to this exercise. The sun salutations were great fun despite the clouds in the sky outside, and our 7 year old reviewer had learnt the sequence off by heart after a few turns.

Another surprising highlight was ‘Tree’ pose, which initially both children became very frustrated by. But with some gentle hand-holding for balance and a wee bit of patience they eventually really enjoyed gaining mastery of balancing on one leg. We needed a lie-down after all that work… The relaxation exercise ‘White Light’ was thoroughly resisted by the ever-fidgety 7 year old present, 

“I didn’t really enjoy that!”

But greatly enjoyed by Granny at the end of a long day and by our 4 year old reviewer who reported, 

“I actually did feel a white light in me!”

The book is simply laid out and easy to use and adapt to a range of situations and ages. It is primarily aimed at group-work or school settings but even with our very small group we still had a huge amount of laughs. The focus is very much on having fun and enjoying the movements. There are also lots of opportunities for children to talk about how the exercises feel and to develop physical and emotional self-awareness through them. Several games employ the cotton wool balls familiar from Theraplay® games, so these could easily be introduced with a Theraplay® game or two. Just choosing a few yoga games and having fun with them was a lovely way to spend a wet summer evening.

This months review comes from Ariane Critchley, a Senior Practitioner in Scottish Adoption's After Adoption team.

Review

The Bean Seed by Judith Bush & Robert Spottswood.

"The Bean Seed" by Judith Bush and Robert Spottswood, is a book I can relate to better than anything else I’ve read in my entire life.  
To those who haven’t yet read this book will think that sounds crazy – how can someone relate to a seed? 

If you take a moment to think about what a seed requires in order to grow into a strong, healthy plant, and compare it to the things a child needs to grow into a strong, healthy young adult, it is much the same thing, metaphorically speaking. 

Think of a seed that hasn’t been planted properly, with no soil and no water, left out in the sun, abused and neglected.  Now think of it not as a seed, but as a child.  Without blankets, food, water, nurture and care a child will do the same as the seed in this book.  They will start to believe that they are worthless.  That they don’t deserve the love and attention they so much desire, and that only way to survive is to take care of themselves.  They keep all their feelings inside so they don’t show weakness, they build walls so they don’t get hurt and they have developed the inability to trust that anyone else can or will look after them at this vulnerable time in their lives.

"The Bean Seed" is written in such a way that it is easy enough for a child to read with their parents as a bedtime story, or even on their own and while they may not understand it completely, they will relate with the little bean seed on some levels without really knowing it.  As the child matures and becomes more aware of the story and its meaning, it will be easier for them to comprehend as everything finally clicks in their mind.  The simplicity of it however does not mean that an adult will see it as too juvenile or think they will not be able to relate to a child's book.  It is set out with pictures and large text, and written in plain, easy to understand english, but the deeper metaphorical meaning of the book is what adults like myself will be able to take from the book, so don’t judge it by its cover. Sometimes because of the startling innocence and naivety of children’s books it allows the mind to understand things in a more profound way, there is no jargon or unnecessary complex words, just the truth written as if a child had written it themselves. 

I would definitely recommend this book to anyone, be it an adult, teen or child. For me this book was an eye opener because I had never fully been able to understand and come to terms with my feelings, and I couldn’t figure out why I don’t trust other people, why I feel the need to do things by myself, why I keep my feelings to myself and why I build so many walls.  "The Bean Seed" explains it all.  Children do these things to protect themselves, so they don’t get hurt again. It allows the reader to feel like they are not alone, that other people out there have been through a similar experience and that although the feelings they have are natural, it is okay to let go once in a while and let other people take care of you, that it’s okay to trust people again and that it is safe to grow into a strong, beautiful, healthy person that is valued and respected by those who love them. 

A beautiful story and absolutely worth a read. 

Foetal Alcohol Spectrum Disorders: Parenting a child with an invisible disability by Julia Brown and Dr Mary Mather

I am an adoptive parent of two children who have Foetal Alcohol Spectrum Disorders [FASD] and I would have welcomed this book as a valuable resource when they were first diagnosed.

Chapter 5 is excellent at discussing what does not work with FASD children before discussing what does work in Chapter 6 .

The main learning for parents is to develop and be able to be consistent in a daily routine and provide a structured supervised environment.

The following chapters concentrate on the problems FASD children have sensory processing, eating, temper tantrums and sleep or the lack of sleep.

It gives strategies on how to deal with the behaviours and communication and looks to education, social interactions and the move to independence.

The book highlights that everyone caring for a FASD child must accept there is no cure. This is lifelong disability, and one which must be managed and not solved.

My only slight criticism is that the interaction with the birth families and the emotional trauma they suffered before they came into care was not commented on.  Often these children have lived with their parents for a period of years and they need the opportunity to be nurtured and fill in these missing gaps and heal in their emotional life.

My two are now in their late teens, and the problems and need for care is ongoing as their inability to manage time and money continues.  There is a lack of services once they get past 18 and unawareness of adult social services regarding the lifelong needs of FASD Adults.

However difficult parenting these children can be, the rewards and fulfilment of the task is immense and one I am very glad I undertook.

I recommend this book to any adopters, foster carers and parents of Children with FASD.

Susannah MacKay