169 - Dr. Jodi Quas: Communicating with Child Victims of Trauma

169 – Dr. Jodi Quas: Communicating with Child Victims of Trauma

Dr. Sandra Morgan and Dave Stachowiak talk to Dr. Jodi Quas about children dealing with chronic stress. When helping children who are under chronic stress, we need to realize that many of their behavioral problems are symptoms of the stress, not just because they are poorly disciplined.

Key Points

Acute stress is normal, and humans can deal with it and recover quickly. Chronic stress leads to long-term health and behavioral issues.
Chronic stress causes many problems in children, and can manifest itself in apparent behavioral issues like inattention.
Some of the stress responses that cause problems outside of the home are actually beneficial to surviving in a high-stress home.
Children who suffer trauma are more likely to interpret people’s expressions as anger.

Resources

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Transcript

Dave: [00:00:00] You’re listening to the Ending Human Trafficking podcast, this is episode number 169, Dr. Jodi Quas: Communicating with Child Victims of Trauma.

Production Credits: [00:00:10] Produced by Innovate Learning, maximizing human potential.

Dave: [00:00:31] Welcome to the Ending Human Trafficking podcast. My name is Dave Stachowiak.

Sandie: [00:00:36] And my name is Sandie Morgan.

Dave: [00:00:38] And this is the show where we empower you to study the issues, be a voice, and make a difference in ending human trafficking. Sandie, one of the things I’m most grateful for over the years of knowing you, is just the wonderful lessons you bring in connecting me and us with so many experts out there. And as I mentioned in the introduction, studying the issues is a huge mission of the Global Center for Women and Justice and particularly around the issue. And today we have an expert from her own backyard, here at the University of California Irvine, that I know is going to really challenge us with some new thinking. And I’m so excited for our conversation today.

Sandie: [00:01:18] I’m looking forward to it.

Dave: [00:01:21] We’re glad to welcome Dr. Jodi Quas to the show today. She is a professor of psychology and social behavior at the University of California Irvine. Her work focuses on children’s eyewitness capabilities, consequences of legal involvement on child victims, witnesses, and defendants, and children’s and adolescents coping with stress maltreatment and trauma. She teaches and conducts training for academic and professional audiences worldwide on these topics. She has received numerous awards for her research and student training, including the scientific early career contributions in developmental psychology from the APA, and the outstanding mentoring award from the American Psychology and Law Society. Dr. Quas, we’re so glad to welcome you to the show today.

Jodi: [00:02:05] Thank you so much. I’m absolutely delighted to be able to speak with you and to hopefully learn from you, while also sharing some of my thoughts.

Sandie: [00:02:13] Well Jodi, you and I have known each other for a few years. I think Judge Maria Hernandez introduced us, and every year I grow to appreciate more the expertise that you bring on how we can use your knowledge, your expertise, your research when we work with youth who are at risk for trafficking or have been trafficked, because communicating with victims of trauma has some minefields in it. For those of us who just want to go in, we want to help you and we’ve got stuff for you, and then we’re really disappointed when they don’t respond well. Because we think our motivation is fantastic and they should appreciate that, right?

Jodi: [00:03:02] Well, I mean for first of all I guess our motivation is fantastic, and I would hate to stop anybody from working hard thinking that their motivation isn’t anything but amazing. So, yes it is. But when you work with highly vulnerable populations including maltreated children, children exposed to chronic violence, children who grow up under conditions of extreme poverty or uncertainty that is all of the children who are at risk for becoming involved in trafficking. It’s really important to take into account the broader lives of these children. And so, when you’re interacting with them, perhaps you’re interacting with them because of a particular trafficking incident or set of experiences related to trafficking. But children come with these entire histories of experiences that have shaped in really profound and long-lasting ways how they respond to the world, how they interpret the world, and how they interact and communicate with others.

Sandie: [00:04:18] So, at Ensure Justice we were looking at the intersection of substance abuse and drug addiction and Andrea Darr, was a guest on our show the last episode. And this kind of helps us drill down from what she talked to us about, with Handle with Care, that when we see these kids we need to understand some of the backstories. So, when you talk about the difference between acute and chronic family stress that really speaks to the environment that they’re in and they don’t have control. So, what do we need to know about that?

Jodi: [00:04:58] It is true that we need to kind of differentiate or at least heuristically acute vs. chronic stress acute stress we all experience. We have bad days, we give a really bad presentation, and these are usually single incidents. In children maybe witnessing a fight, even a violent fight between parent, and these are the kinds of events that we think about when we talk about stressors. And our bodies and our minds, we’re actually fairly well programmed to respond to those acute stressors, even if they’re predictable or unpredictable we mount a response, we attend, we figure out and strategize about how to solve whatever challenge is in front of us. And then afterward we recover or regulate. That’s really different than the kinds of chronic, repeated stressors that really define the lives of many of the children who eventually end up in situations where they are exposed to when involved in trafficking. So, these chronic stressors can be things like extreme poverty, neglect, exposure to physical abuse. Sometimes they’re predictable sometimes they’re not. But what happens when you’re exposed to these chronic stressors is we need to mount a response. And we do, when we have these stress systems that are developed to mount these responses. The problem is that we can’t keep mounting these responses. Over time the stress systems that are activated, they need to adjust, they need to change. And those changes or this adjustment actually have consequences, they have health consequences, they have consequences for how children come to understand and interpret their world, they have consequences for regulation and even academic performance and cognition.

Sandie: [00:07:04] When you’re talking about regulation, can you kind of describe that in layman’s terms for us?

Jodi: [00:07:10] Yes. So, regulation you can think of, I mean at a really basic level, regulation is something like controlling your breathing if you’re upset. So how do you calm down after a stressor? How do you kind of bring yourself under or in control? So, when we think of the consequences, we think of them in a couple of different domains. But the ones that really play out, and we see that really impact children. One of them is in health and sleep. There’s a lot of scientific evidence to suggest that exposure to a kind of chronic stress, so when children are exposed to chronic stress like poverty or neglect that it actually alters their sleep patterns, leading to poorer sleep night after night. Now as an adult, I hate when I get a bad night’s sleep. Imagine that feeling, every single day as a child. That becomes the norm. And when I don’t get enough sleep, I’m grumpy, I’m inattentive, I’m a little irritable, and I’m certainly not going to be as responsive to others. As a result of that, and if you take that down developmentally and you think about that in children, when we have children who we consider at risk; and just to give you one example, when they’re in school and these children might not be performing as well, they might not be listening to a teacher, they might be struggling. We could even think of that as the child is having maybe a learning disability, maybe the child has A.D.H.D. Sometimes we also need to look at the child’s background and look at something as simple but as profound as sleep.

Sandie: [00:09:22] So I have to tell you, I had a student a few years ago who told me that her experience was the stress at home was so intense, that when she got to school, she felt safe, and she relaxed. And she was constantly getting in trouble for falling asleep in class.

Jodi: [00:09:45] Absolutely. And whether they feel safe or not, their bodies weren’t designed to maintain that high level of arousal. And so, any time they could come down, I think children will. But getting in trouble for falling in class if you think about the consequences. I mean there are really some significant consequences, if you have a child who’s falling asleep at school and not learning as well, that child may fall behind, and that child may also begin to think she’s not smart. And when we start to think about the risk factors for trafficking it’s you know dropping out of school, it’s exposure to violence, it’s a lot of these other characteristics that may be interrelated at some basic level.

Sandie: [00:10:47] OK, so this stress, brain loop that you talked about at Ensure Justice. That was really fascinating to actually see in a graphic, what’s happening. Do you think we can do that without a picture?

Jodi: [00:11:04] You know, I can talk you through it. Why don’t you ask me questions, and we can hopefully kind of explain it? When you think of chronic stress, you know our bodies are biologically programmed to respond to stress. So, when we’re supposed to stress, we mount a response. If we go back to our biology days, this is your sympathetic nervous system, it’s that fight or flight response. And that leads to a number of different hormones that actually can activate parts of your brain to respond and you should respond to that stress. But what happens is if that fight or flight, if you’re constantly in that fight mode so to speak, you can’t recover. And so, what happens is not only is there inadequate sleep, there tends to be decreases in attention because you’re in this chronic fight or flight mode and those parts of the brain that are being activated that maybe help initially with attention, can’t sustain themselves. It’s like a workout, you can only work out at an intense level for so long. Eventually, you have to take a break.

Sandie: [00:12:25] When the kids are inattentive, and you know I’ve heard parents say discipline their kids because they think that it’s a behavior issue. Or youth workers or even teachers might try to respond, thinking they’re doing the right thing. But the child actually doesn’t internalize what they’re saying, is that right?

Jodi: [00:12:49] Well, the child is no longer capable because you have this inability anymore for the body to respond and kind of pay attention, and the brain to kind of focus attention. So, you start to see decreases in attention, you see poor memory, you see poor learning. And all of this is because your brain is only programmed to sustain that high levels of stress for so long. And so, what happens is this chronic stress exposure and its influence on these other processes can start to make children really look like they have learning disabilities. It can make them look like they’re inattentive, they can actually mimic some of the characteristics of ADHD even, so attention deficit disorder. If children are exposed to this chronic stress and you now have a child who’s not getting good sleep, night after night. The child is kind of having difficulty with memory, difficulty with learning because of that chronic stress. And so, we have to think about the strategies we use to help these children because certainly if they’re coming into school with all of these other characteristics more discipline and more stress, it’s probably the worst thing you can do.

Sandie: [00:14:22] So, can you show me how that works when we’re talking about their emotions and how they see me?

Jodi: [00:14:30] Yes. And so, while I talked about sleep as a component of health, I’ve talked about this academic and cognitive ability. A third domain where you tend to see significant effects of chronic stress, especially stress that’s due to exposure to chronic violence in the home or in the community, are these what we call them as a psychologist’s technical term are “dysregulated emotions.” And that’s the psychological label, but really it goes back to this lack of control of emotions, lack of understanding of emotions. And this lack of understanding means not only internally in themselves, they are not very good at labeling their own emotions, but these children are actually also not very good at understanding and labeling other’s emotions.

Sandie: [00:15:34] So when I first met you, you had a chart of faces. And that was such an amazing picture for me because there were different variations of smiles and all the way to anger. And you’ve done research using that to help us understand how these kids might look at us when we think we’re approachable. Right?

Jodi: [00:16:01] Yes. And so, one of kind of the classic patterns you see, there’s actually once I name it, it makes sense to people. It’s called a hostile attribution bias. We all have this idea in the back of our heads, it’s that person who always interprets everything else as being a personal attack. And so, there are some people in the world who, no matter what happens, they think it’s personal, they’re angry, and they respond to the world that way. In maltreated children and children exposed to the kind of chronic violence, they have this type of bias. And so, when we’re in a situation that someone’s smiling, we see a smile and we all know it’s a smile. Me, you, children we all recognize a clear smile. We also all recognize an angry face, a very clearly overtly angry face. Where your eyebrows are down, you’re scowling. If it’s a very clear anger expression, everybody recognizes it.

Jodi: [00:17:11] Maltreated children and children exposed to chronic violence, actually are better at recognizing that angry face. And by better, I mean they’re faster and they can identify it more accurately, with less information. So, they don’t need to scan the environment, they don’t need to look around and see what’s going on. Boy, they can pick out that anger face fast. Now if you’re growing up in a chronically stressful, maltreating home or a violent neighborhood or home, being very good at recognizing anger is actually adaptive. And so, when we think of these children, we can’t think of their emotion processes, these types of dysregulation as being completely maladaptive, it’s not. If you’re in a violent home, you need to be very attentive to potential cues of anger because you may need to get out of the way. So, it makes sense. But here’s the problem, for the same children this fast, very efficient system doesn’t stop there. These same children tend to see the anger in a broader range of interactions. And so, if someone shows a very clear anger face, boy they see that anger quickly. But let’s say someone’s face is neutral or ambiguous. While you and I might look at that person and think oh they’re thinking, or maybe they’re confused, or maybe they’re tired. Children in these conditions of chronic stress or chronic adversity, tend to see the anger in those faces. So, this is where that hostile bias comes in. When the situation is ambiguous they still see anger. And so, when you as an interviewer or someone who’s interacting with children, while you’re interacting with the child you may think I’m going to maintain a calm, neutral face because I don’t want to express any emotions, I don’t want to upset a child. But it may well be that a child is interpreting your neutral face as negative, as angry.

Sandie: [00:19:46] Wow so, do I need to smile the whole time?

Jodi: [00:19:49] People ask me that all the time. First, smiling is never bad. But I mean if a child telling you something very challenging or problematic you certainly don’t want to be smiling. But what you can also do is talk about emotion. Labeling emotions, telling children how you feel isn’t bad and it may help give them context for interpreting expression. If there are no other cues, they will interpret ambiguous expressions as being angry. And if there’s the context suggests that the anger could be directed at them, then they will usually react in retaliation in return. And so, if for example, if you brush their shoulder, or if you accidentally look away, they will interpret that as anger towards them. And the consequence is that they’ll either shut off or they’ll retaliate because in their mind they’ve been provoked.

Sandie: [00:21:03] So just one or two more sentences about retaliation. What does that look like? And I’m sitting there with this person?

Jodi: [00:21:11] Well the retaliation can look in a lot of different ways. The simplest form is if someone’s angry, I’m not going to engage, I’m not going to talk to them. And that is one strategy to get out of an angry situation. Another one is to push back, or to yell, to be verbally aggressive in response. And that may be particularly likely given the kind of the nature of a lot of the interactions that we might have with these children. And I mean of course if someone truly does feel provoked, there’s also the potential for a physical response.

Sandie: [00:21:54] Yeah that gets very difficult. And so, many times in our classroom management, in our youth groups, in our nonprofits, after-school programs, we have volunteers who are handling things and their response might be- OK you need a timeout. So, there’s a punishment attached to that. So, then it feels to me, like that might just reinforce the problem. How can we begin to change in how we respond to kids?

Jodi: [00:22:28] I don’t think timeouts are necessarily bad, depending on how they’re framed. And so, a timeout can be a time to gather your thoughts and think about things and calm down, or it can be a form of punishment. So, what you can do with volunteers, with individuals who are on the front line, is they can talk more about emotions, talk more about causes and consequences of emotions, and really label particularly ambiguous interactions. Help children start to interpret them differently. And with those labels, we have found that you can gradually shift or change children’s interpretation. You can’t change them dramatically, and it certainly doesn’t work overnight. But by really labeling, explaining, and talking more about emotion and emotion regulation and strategies, that is one way that we can start to make some inroads.

Sandie: [00:23:45] So we actually start becoming their guide to reading the social cues around them?

Jodi: [00:23:52] Yes, absolutely.

Sandie: [00:23:54] For kids that are in an academic setting, it feels to me that until they can they can learn those kinds of coping skills, that it’s going to be an uphill battle literally a battle for them in surviving in our schools and programs like that.

Jodi: [00:24:15] I think it is two things. Yes, it is a battle. But also, what that suggests is that for a lot of children we can’t separate this kind of emotion domain from the cognitive or the academic domain. They really are integrated and they can work together. And so, to come at an approach of “I’m just going to work on the academic side.” We really do need to take into account the other characteristics and the baggage and the experiences, so to speak that children are bringing to that academic environment because all of those things affect the learning.

Sandie: [00:24:57] Wow. There’s so much to learn, Jody. I’m your big fan, I google you, on your CV you have so many academic journal articles and I’ve downloaded a few of them, and I challenge our listeners to do that as well. How can people learn more about your amazing work?

Jodi: [00:25:17] Well, thank you. You know it’s been such a pleasure becoming a bigger part of Ensure Justice, the conference and then your center. So, let me first say thank you for that. In terms of contacting me, the best way is via e-mail or the web. So, if you just want to learn about me or some of the work that my colleagues and I are doing at UC Irvine, I have a website at the University of California Irvine, and you can google my name, Jodi Quas. And I have a faculty website at the University of California Irvine that will come up. I’m also affiliated with the Center for Psychology and Law at the University of California Irvine. And there are lots of psychologists, and legal scholars, and social scientists who are doing really valuable work that touches on some of the issues that we mentioned today. So, I would encourage your listeners to look at the center website as well. And then people are also welcome to e-mail me at jquas@UCI.edu.

Sandie: [00:26:45] That is very generous of you to make yourself so available. I appreciate that. I also will make sure we put the links to those websites in our show notes, so that people can find that. And as we wrap this episode up, and I want to talk to you for two more hours. It’s so hard to close and stay in our 30-minute timeline. We will invite you back to talk about some of these issues in more depth on the show. And then I also wanted to kind of help listeners who missed the last episode, go back to Handle with Care. Because there is a lot of intersection with what Handle with Care is doing with the research that Dr. Quas has been doing and teaching. And she teaches law enforcement, and educators, and community leaders literally across our nation and globally. Jody, thank you so much for being part of our show today.

Jodi: [00:27:53] Oh it is absolutely my pleasure. And I’m honored to be on it and to be able to be connecting with you and all of your listeners, so thank you.

Dave: [00:28:01] Sandie, it’s always such a pleasure to hear about so many of the experts you’ve brought together to help us study the issues and I challenge our audience to take something you’ve heard out of today’s conversation. Go take a look at Jodi’s website and her work. And take that next step in studying the issue so you can be your voice, and make a difference as well. And we hope you’ll also utilize our website as a resource for all of the past episodes at endinghumantrafficking.org. You go there you’ll be able to not only track down every past episode, but also, you’ll be able to stay connected with us through e-mail. And Sandie, as always, we’ll see you in two weeks for our next episode.

Sandie: [00:28:39] Thanks, Dave.

Dave: [00:28:41] Thanks, everybody. See you in two weeks. Take care.