Trauma Can't Be Undone With an Executive Order
On Wednesday, President Trump announced he would sign an order "ending" the family separation crisis. Trump's "zero-tolerance" policy on immigration meant that officials were forcibly separating immigrant parents from their children, even if the parents were legal immigrants seeking asylum. Some of the children were reportedly as young as three or four months old when they were taken. Under the terms of the new order, parents will be allowed to keep their babies, and whole families will be detained by the Department of Defense. This may seem like an improvement over the nightmare of forced separation. But child trauma experts warn that it's far from being a real solution.
There are several problems with simply ending family separation and calling it a day. The most obvious is that the Trump administration has no plans to reunite the families that have already been separated. Over 2,300 children have already been taken. Some are too young to identify their parents, and some have parents that have already been deported, making reunion difficult if not impossible. Kenneth Wolfe, a spokesman for the Administration for Children and Families, told the New York Times that the remaining children will have to remain separated from their families throughout their parents' immigration proceedings - "I can tell you definitively that is going to be policy," he said.
The facilities to which these lost children are being transported have faced multiple allegations of sexual and physical assaulting of minors. According to one pending lawsuit, children in their care were "held down and forcibly injected with [psychiatric] drugs, rendering them unable to walk, afraid of people and wanting to sleep constantly." But even without other forms of abuse in the picture, the trauma of forced separation from a parent ranks among the worst things a child can experience, and can linger for the rest of his or her life.
Children lack the physiological mechanisms to adapt to stressful circumstances the way adults can. People aren't born with the ability to calm down when they're upset; they have to be taught, first by being held and rocked (something which is reportedly forbidden in child internment facilities) and later by having a reliable, protective adult coach them through their distress. When a child experiences enough of what experts call "toxic stress," the brain never develops the necessary stress-management skills, causing long-term mental and physical health problems.
"Long-term, these individuals who have traumatic reactions are at heightened risk of virtually every medical problem," says Dr. Judith Cohen, Medical Director of the Center for Traumatic Stress. "Neurologic to cardiac to pulmonary to reproductive problems… just go down the body and virtually every part is affected."
It doesn't take a medical degree to understand why someone whose brain can't regulate stress is more likely to have a heart attack. Cohen also says these children are at greater risk of substance abuse, along with anxiety, depression, and - for those separated from their parents - separation-induced post-traumatic stress. The symptoms set in right away, and soon become entrenched.
"In the short term, younger kids will likely show signs of regression - fear, bed wetting, crying, withdrawal, loss of developmental milestones," says David A. Wolfe, a psychologist and author focused on childhood trauma, and editor-in-chief of Child Abuse and Neglect: The International Journal. "After a week or more, these changes may become the new norm, leading to the child's fear of adults."
Again: Just holding the children with their families isn't an adequate solution. Though the loss of a parent is particularly harmful, detention and incarceration are by definition traumatic. Holding children with their families was previously forbidden by a 1997 court ruling, Flores v. Reno, which stated that immigration officials had to avoid "unnecessary delay" in releasing detained children (the general standard was 20 days in detention, max, with the parents being released alongside their children to avoid separating them). The Trump order seemingly violates Flores, and in so doing, raises the new possibility of indefinite incarceration for children.
"There are many different types of events that can be categorized as traumatic," says Dr. Erin Hambrick, a clinical child psychologist and Director of Research for the Texas-based nonprofit Child Trauma Academy. Hambrick explains that family separation is an "ACE event," one of the adverse childhood experiences that we know to cause long-term health problems. However, it's not the only adverse experience that may occur in the process of immigration.
"Detaining children and families can also be considered an ACE or traumatic event. In fact, even having a parent who's been detained, not being detained yourself, has been documented as traumatic," Hambrick says. "Children could potentially see their parents in dehumanizing and very uncertain circumstances. Even the uncertainty children will experience in those situations where they will see their parents rendered relatively powerless can be traumatic."
Children rely on the knowledge that their parents are there to protect them; seeing parents hurt, or rendered helpless, can cause lasting damage. Dr. Marsha Griffin of the American Academy of Pediatrics recently told Texas Monthly about her visit to a detention facility known as "the Ursula," where she saw " twenty or thirty 10-year-old boys who were crying and screaming and sobbing for their mothers. And some of them were reaching through the chain-link fence as if they were trying to reach out to their mothers, and screaming." Meanwhile, the mothers "were in identical cages about fifty feet away, unable to get to their sons or help them." Clearly, just being housed in the same facility as their mothers did not negate the terror those boys were experiencing.
This is intolerable for any child, but it can be particularly hard for asylum-seekers, who are now being met with violence from the very country they expected to provide safe harbor.
"Their view of the world has been upset, and where it lands depends on how quickly their lives can be restored," says Wolfe. "They were escaping a dangerous, fearful place, but instead of safety they experience more discord and separation. The most vulnerable kids may be those who have already lived with trauma and fear, and now are forced to go through it again, without support of parents."
Psychologists measure the impact of trauma, not just by the severity of an event, but by its duration - meaning that the odds of lifelong trauma get higher every day the parents and children are detained or kept apart by lengthy immigration proceedings.
"We all know that legal processes take a long time even if you have a lot of money," Hambrick says. "The road toward coming out toward the other end, if that happens at all for some families, is going to be very very long. So even for children that are older, they are going to have a long duration [of trauma], which is another very high risk factor for the long-term mental health issues that we're talking about… We have to think of ways to really decrease, significantly, the amount of time that families are caught up in these processes, and make sure that families are held in these centers for the very least amount of time possible, if at all."
There is some good news: Children can heal from even severe traumas. But they need therapy to do so. And, of course, they need their parents.
"We have very good treatments for young children," says Cohen. "I just read a study today that shows that parent-child interaction therapy and child-parent psychotherapy are very effective treatments for very young children, children from infants to six years old." She also recommends trauma-focused cognitive behavioral therapy for older kids.
In Cohen's recommended therapies, the child and the parent are in the room with the therapist together, working through the trauma as a unit and learning coping skills together: "Children can recover. Parents are critical to their optimal recovery," she says.
So, yes: There is a chance to save these children. But it will not be easy. In order for them to avoid a lifetime of emotional pain and sickness - including health problems that could quite feasibly kill them - we need to locate their parents and return the children to their families right away. We also need those families to be in a safe environment-not in internment camps, or the dangerous home situations these families fled to the US to escape. Finally, we need to ensure that these children have medical and social support to heal.
"Children are still growing," Hambrick says. "They are still trying to decide what type of people they will be in this world. They are still trying to learn what this world is and how to respond. I think we have a responsibility as a people to consider children a protected class, and really think about the fact that these early life experiences, even if we try to ameliorate what's already happened, lots of problematic things have already occurred to these children. We need to think about how we might be providing resources to children in the future who are very likely going to need help."
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