Psychodynamic Perspective and the Correlation to PTSD in Children

This paper is going to explore how the psychodynamic perspective influences how the United States has responded to the influx of undocumented families and unaccompanied minors crossing the US-Mexico border seeing refuge or asylum. There is an emphasis on early childhood experiences influencing the patterning of an individual's emotions. (Hutchison, 2015) The trauma that is experienced by children being separated from family can lead to long-term problems in developing healthy coping mechanisms, mental and physical developmental delays, as well as other negative personality traits that may strain that child's relationships with others into adulthood.

If early intervention and reunification is the answer, the United States should be expediting the process to return children back to their parents.

Issue

In early May of 2018, U.S. Attorney General Jeff Sessions ordered that, in a cooperative effort between the Departments of Justice and Homeland Security, prosecutors are to adopt a zero-tolerance policy for illegal border crossings (Gonzales, 2018). That order included prosecuting parents who are traveling with their children looking to request asylum and fleeing from violence in their home countries, coming from Central and South America. According to NPR's John Burnett, there was an increase of 200 percent in border apprehensions compared 2017. Border Patrol detained nearly 40,000 undocumented immigrants (Gonzales, 2018). In 2015, a document received a revision called the Flores settlement which, at the time of its original drafting, prevented the government from holding migrant children in detention for longer than twenty days. Now in 2018, President Trump instructed Sessions to go to the federal court seeking to modify the settlement; requesting a revision that would allow for children to be kept in detention without a time limit (Kelly, 2018).

The ways in which many attempts to cross the Texas-Mexico border are dangerous and even fatal. Countless bodies are discovered in the desert every year and some remains are never found due to scavengers and weathering; a testament to how desperate many people are to reach the US safely and falling prey to the elements or violence. If an individual survives the unforgiving terrain, border patrol officials are on standby and it is at this point of entry where many families begin to face the nightmare that is separation. Adults are sent to adult detention centers whereas minors are transferred to shelters run by the Office of Refugee Resettlement, a division of Health and Human Services (Burnett, 2018). According to a testimony from Denise Gilman, the director of the immigration at the University of Texas School of Law, a family of three on her caseload is experiencing trauma due to their separation. The two boys, 4 and 10 years old, are having to represent themselves in making their case for asylum, this can happen without an attorney. Gilman states that the eldest boy is currently attending public school and has already been referred to mental health to receive therapy because he's just not doing well because of the trauma that he experienced prior to crossing the border. Combined with losing his mother, it retraumatized him and that will likely have an unfortunate, long-term impact. (Burnett, 2018).

With little sympathy coming from the Trump administration, the government says that its facilities holding unaccompanied children are at 95% capacity with each child spending an average of 56 days before locating a family member in the US that will provide kinship care or a foster home (Burnett, 2018).  This Zero-Tolerance policy that the administration is pushing has taken little notice of the outcry to put an end to the separations; the hope is that the removal of children from the care of their loved ones will act as an encouragement to not seek asylum inside the United States. The children left in the care of shelters run by Health and Human Services are being caught in the political crossfire, ultimately suffering from neglect and untreated trauma. Pressure placed on the system holding these minors for long periods of time will lead to a deterioration in the quality of care, education, and response to the needs and well-being of children being held in the facilities. The existing evidence proves that 'tender-age' children, children who are typically seven and under, are experiencing developmental delays as a direct cause of being placed inside border patrol holding facilities.

Theory

Psychodynamic theory, the brainchild of neurologist Sigmund Freud, is most commonly referenced by social workers who are working with children or families who have experienced some type of trauma. Psychodynamic theory began with Sigmund Freud's belief that humans are driven by biological, gratification-oriented impulses. These impulses are a starting point in better determining outcomes of human behavior. In addition to his impulse theory, Freud hypothesized that sex, or eros, and self-preservation are the primary drives for human behavior. (Holtz-Deal, 2007). Psychodynamic theory helps in understanding how humans make attachments to other people as a consequence of the psychosexual stages that occur early on in life, typically around 4 or 5 years of age. The theory has evolved past the early stages of Freud's psychosexual stages of development and broadened its focus to include explanations for how relationships between people, those experiences, shape personality and can determine choices that are made in adulthood. (Holtz-Deal, 2007). The current focus of psychodynamic perspective is a framework based on the idea that emotions have a central place in human behavior.

Childhood experiences play a role in the development of an individual's emotions and can help predict when problems throughout life may occur. Individuals who experience trauma will frequently use disassociation or ego defense mechanisms to avoid becoming overwhelmed by intense stimuli. This disassociation mechanism in young children can be harmful to their developmental growth, emotional attachment, and overall affect them in a way that would be considered a disorder. Psychodynamic treatment as an intervention validates an individual's experience by addressing the source of emotions, implementing healthy coping mechanisms, and improving resiliency. Application of psychodynamic treatment in practice found that longer treatment, working with children under the age of six, and managing the intensity of the treatment for young children or adolescents led to greater success and improved mental health. (Holtz-Deal,2007). A case study performed by Dr. Ioanna Katsounari, who focused on PTSD in unaccompanied minors, stated that there are few little numbers of studies currently looking at the effectiveness of psychodynamic therapy, specifically in treating PTSD. (Katsounari, 2014) This is not to say that psychodynamic therapy as an intervention is ineffective, it simply has not been explored fully likely due to a general preference of interventions such as cognitive behavioral therapy and pharmacotherapy.

Relationship

Aspects of attachment disorders and mental health issues in young children separated from their family for long periods of time can be explained by psychodynamic theory. Empirical studies show that the emotional and mental health, within the at-risk population of unaccompanied minors separated from family for periods of time, evidence on a spectrum of possible emotional, developmental, and behavioral concerns. The symptoms observed included but are not limited to insomnia, inability to concentrate, nightmares, depression, withdrawal, anxiety, symptoms of PTSD, anger and frustration, loss of interest, low self-esteem, feeling of guilt, lashing out violently, having little optimism for the future, thoughts of suicide, and psychotic behavior (Katsounari, 2013).  The main concept for psychodynamic perspective is that early childhood experiences, like trauma, influence the outcome of that individual throughout their life. (Hutchison, 2015) It will influence their emotions, mental health, and abilities to cope with stressful or overwhelming situations. The children of immigrants experience constant changes to their surroundings as they seek refuge. Children are forced to assimilate to a new language, new surroundings, and new status as being undocumented and therefore at risk of deportation. This can be a painful transition made more difficult and traumatic by being separated from a parent without knowledge of when they will be reunified. (Kristal-Anderson, 2000)

Critical Analysis and Connection

Psychodynamic theory addresses the unconscious or conscious mental activity that drives an individual in their actions and emotional responses. (Hutchison, 2015) Therefore, the connection to psychodynamic theory and the issue is the difficult psychological impact that comes with adjusting ones' identity, especially that of a young child. The conscious or unconscious state of that child is compromised if they cannot blend their understandings of each world. (Kristal-Anderson, 2000) Incompatibility and being unable to cope with the dramatic identity shift will alter their behavior resulting in negative mental health outcomes. These outcomes are not limited to children being separated at the Texas-Mexico border. Similar outcomes are noted in refugees of war and civil unrest from other countries. The psychological trauma experienced by war is elevated by being displaced. Often this impacts the poorest populations, those who are caught in conflict zones and have witnessed violence are at an increased risk for overwhelming internal demands on the psyche. (Boothby, 1992) Boothby notes in his study of displaced children that there have been efforts to ease the mental and emotional toll on unaccompanied minors via family tracing and reunification programs that the community supports, and mental health professionals actively participate to aid in elevating the long-term effects. Despite these programs being in place for war refugees, they fail because they are initiated too late or far too slowly to benefit the children. (Boothby, 1992) In the United States, there has been little to no evidence of any attempt at addressing the mental health needs of these unaccompanied minors.

Psychodynamic Intervention

Children are, by their very nature, vulnerable and without a strong social and family environment, they are more susceptible to internalizing traumatic experiences long-term. The secondary trauma becomes a prominent issue when, and if, the child is reunited with their parent(s) and they have suffered memory loss or develop an attachment disorder and they are now exposed to the direct contact of a parent who has been traumatized by the separation-deportation process as well. (Batista-Pinto Wiese, 2010) Implementing a psychodynamic treatment plan is essential when working with a migrant child, and their parents, to address the emotional and psychological effects. The likelihood of re-traumatizing the child is increased when working with a child who has not developed positive coping strategies. Therefore, therapists should work to empower while stabilizing the external and internal demands that the child may experience and aid in managing anxiety and stress responses. (Batista-Pinto Wiese, 2010)

Conclusion

In relation to the field of social work, psychodynamic theory is successful in understanding as well as responding to the needs of children experiencing trauma due to separation. The empowering intervention process seeking to ultimately reunify families and encourage psychological healing and managing emotions is one way in which psychodynamic therapy improves outcomes for unaccompanied minors. Human behavior in cases such as the beforementioned exhibits the expected responses of emotional distress, trauma, PTSD, and other behavior-altering symptoms. Young children are especially vulnerable to life-altering traumatic experiences due to their lack of development in their emotional intelligence and being forcibly separated from their support system is traumatizing. If the social environment could accommodate what is understood about the effects of separation, then trauma experienced by all parties involved would be alleviated.

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