For a number of adopted children, their early experiences can leave lasting marks, including Post-Traumatic Stress Disorder (PTSD). PTSD is a mental health condition that can develop after someone experiences or witnesses a traumatic event. Although it’s often associated with war veterans or victims of violence, children who have experienced neglect, abuse, or repeated changes in caregivers can also develop PTSD. The trauma might not be as visible as physical wounds, but the emotional scars are very real. This is especially true for many adopted children who may have spent time in foster care, orphanages, or other unstable environments before finding their forever home.
While adoption provides the stability of a loving home, it’s essential to acknowledge the potential trauma that may exist in a child's past and how this can affect their emotional health.
Disclaimer: Adoption does not equal PTSD. Many children are provided with loving homes before being adopted, and this is not a one-size-fits-all scenario. The aim of this blog is to educate and provide understanding around how adoption and PTSD can be linked together.
Why does PTSD happen?
The early years of a child’s life are critical for emotional and psychological development. When a child experiences instability, loss, or trauma during these formative years, it can disrupt their ability to trust and form secure attachments. For some, their biological parents may have been unable to provide a safe, stable environment, leading to early separations or neglect. A child may have witnessed or experienced violence, been exposed to substance abuse, or faced extreme neglect in their biological home.
Even children who were placed for adoption shortly after birth may struggle with a sense of abandonment or loss, which can contribute to emotional trauma later in life. Children in the care system, especially those who have spent time in multiple foster homes or institutions, can experience what’s known as 'complex trauma'. This form of trauma arises from prolonged exposure to stressful or harmful environments. Unlike single-event traumas, like a car accident or a natural disaster, complex trauma is ongoing, with children often having no sense of safety or control.
Example: Liam’s experience with complex trauma
Liam was adopted from an Eastern European orphanage at the age of nine. His adoptive parents, Sarah and Michael, were thrilled to bring him home, but they soon realized that their journey with Liam would be more complex than they initially thought. During the adoption process, Liam had been very quiet and compliant, often following instructions without complaint. However, as the months went on, they began to notice subtle signs of distress. Liam avoided physical affection, flinching when anyone tried to hug him, and preferred to spend long periods alone in his room. He rarely shared his thoughts or feelings, and when asked about his life before adoption, he would shut down completely.
At school, Liam's teachers noticed that he struggled to focus and had trouble making friends. Though he wasn't disruptive, he often appeared withdrawn, sitting on the sidelines during group activities. On several occasions, his adoptive parents also witnessed sudden outbursts of anger that seemed to come from nowhere. One day, while trying to teach Liam how to ride a bike, he threw the bike down in frustration and stormed off, shouting that he "couldn't do anything right." It became clear to Sarah and Michael that there was something deeper at play beyond normal adjustment difficulties.
After consulting a child psychologist, Liam was diagnosed with PTSD, stemming from early neglect, prolonged instability, and multiple caregiver changes in the orphanage. He had never known the security of a single, consistent caregiver, and his experiences in the orphanage had left him wary of trusting adults.
The trauma Liam had experienced in his formative years had deeply affected his ability to form healthy attachments and regulate his emotions. His avoidance of affection and outbursts were not signs of rebellion but coping mechanisms developed to protect himself from further emotional harm.
Liam’s therapist introduced attachment-based therapy, a process designed to help him form a secure and trusting bond with his adoptive parents. This therapy focused on creating safe, predictable routines at home and encouraging positive, non-threatening interactions with Sarah and Michael. They learned techniques to support Liam when he became overwhelmed, such as offering comforting objects or creating calm spaces where he could retreat when anxious.
For Liam, small steps were crucial. At first, even sitting next to his parents while watching a movie felt like a huge leap. Over time, they made gradual progress, he began accepting gentle hugs and started to express his emotions in healthier ways, such as drawing or through quiet conversations before bed. His adoptive family learned to meet his emotional needs with patience, understanding that healing would take time.
At school, with the support of his therapist and teachers, Liam also received accommodations to help manage his concentration difficulties. He was paired with a mentor who worked with him on social skills, encouraging him to participate in group activities at his own pace. Although he still struggled with forming close friendships, Liam started to feel more comfortable interacting with his peers.
Sarah and Michael continue to work closely with a trauma expert, ensuring that they remain sensitive to Liam’s emotional triggers and offer him the support he needs. Although his healing journey is ongoing, Liam now feels safer in his home and has begun to trust that his adoptive family will be there for him, no matter what. Each small breakthrough, whether it’s a shared smile or a moment of spontaneous affection, is a reminder that trauma doesn’t have to define Liam’s future.
PTSD can manifest differently in children than in adults. Adoptive parents and caregivers need to be aware of potential signs. Please note this is not a substitute for medical advice.
Symptoms and how to help:
Flashbacks or Nightmares: The child may relive past traumatic events through nightmares or flashbacks, which can be highly distressing.
How to help: During flashbacks or after nightmares, stay calm and reassuring. Create a safe, quiet environment and offer physical comfort, such as a gentle touch or holding their hand. It’s important not to minimise their fear but to let them know you’re there to help them feel safe again. Grounding techniques, such as helping them focus on their current surroundings by describing the room or asking them to name objects, can also be helpful.
Avoidance: The child may avoid certain places, activities, or people that remind them of their traumatic past. This avoidance can lead to withdrawal and isolation, and they may shut down any conversations about their life before adoption.
How to help: Avoid forcing conversations about their past. Let the child set the pace and be patient with their need for space. Provide gentle encouragement by inviting them to participate in low-pressure activities they enjoy, which can foster a sense of safety and connection. Over time, with trust, they may open up when they feel secure.
Hypervigilance: A child with PTSD may be constantly on edge, feeling unsafe even in situations where there’s no immediate danger. This could manifest as being easily startled, having trouble sleeping or displaying outbursts of anger.
How to help: Establish predictable routines and clear boundaries to create a sense of security. In moments of hypervigilance, reassure the child that they are safe and that you are there to protect them. Offer calming activities such as deep breathing exercises or using sensory objects like soft blankets or stress balls to help them relax.
Emotional numbness: Some children may struggle to express or feel emotions, distancing themselves from others as a coping mechanism.
How to help: While connecting with a child experiencing emotional numbness can be difficult, showing consistent care is crucial. Engage in activities that don’t require direct emotional expression, like playing games or drawing, to create a shared experience without pressure. Validate their feelings and remind them that emotions are normal, offering support without pushing them to feel or express something they aren’t ready for.
Difficulty forming attachments: Trust issues may make it hard for the child to bond with their new adoptive family. They may fear rejection, which could result in them pushing people away, even when they crave connection.
Example: Sarah’s journey with PTSD
Sarah was adopted from the foster care system at the age of six, following a turbulent early childhood. Before finding her forever home, Sarah had been moved between three different foster families and had witnessed significant domestic violence within her biological family. The instability of her early years, combined with the trauma of witnessing violence, had a profound effect on her emotional development. By the time she was placed with her adoptive family, she had already learned to mistrust adults and was struggling with feelings of fear and confusion.
At first, Sarah’s adoptive parents, Rachel and David, were hopeful that a stable, loving environment would help her settle in quickly. However, they soon began to notice troubling behaviors. Sarah would often have sudden outbursts of anger, sometimes over seemingly small things, like not getting her way at dinner or being asked to do a simple task. She became easily frustrated and would sometimes scream, kick, or throw things when she couldn’t express her emotions. Any attempt to talk about her past was met with complete silence or intense defiance.
As the weeks went by, the situation worsened. Sarah began waking up in the middle of the night, crying or screaming from terrifying nightmares. These night terrors became frequent, and Rachel found herself sitting by Sarah’s bedside for hours, trying to calm her down. During the day, Sarah would often seem distant, as though she was reliving the fear and chaos of her past.
Recognising that Sarah’s reactions went beyond normal adjustment difficulties, Rachel sought help from a therapist who specialised in childhood trauma and PTSD. The therapist explained that Sarah’s outbursts and night terrors were likely linked to her early experiences of violence and neglect, which had left her feeling unsafe, even in her new home. Sarah was diagnosed with PTSD, and the therapist recommended play therapy combined with Cognitive Behavioral Therapy (CBT) to help Sarah process her trauma in a way that was age-appropriate and non-threatening.
Play became her outlet for sharing what she couldn’t put into words. Her therapist would use dolls and storytelling to gently guide Sarah through scenarios that mirrored her experiences, allowing her to process the fear and confusion she had internalised. Slowly, Sarah began to trust the therapist, and through drawing and imaginative play, she started to open up about the things she had seen and felt in her biological home.
CBT helped Sarah learn how to manage her overwhelming emotions. Together with her therapist, she developed strategies to recognise when she was feeling scared or angry and how to calm herself down when those feelings arose. Rachel and David were also heavily involved in the process, learning about trauma-informed parenting to help them better understand Sarah’s needs and emotional triggers. Instead of reacting to her outbursts with frustration, they began responding with patience and empathy, acknowledging her emotions and helping her feel heard, even when she struggled to express herself.
The night terrors, once so frequent, gradually became less intense. Sarah learned grounding techniques, small actions like squeezing a stress ball or focusing on her breathing, that helped her calm down after a nightmare. Rachel also created a nighttime routine that made Sarah feel safe, including reading her favourite stories and leaving a nightlight on, which reassured Sarah that she wasn’t alone.
Although Sarah’s journey is ongoing, the progress she has made reflects the power of patience, understanding, and professional support. Rachel and David now have the tools to navigate Sarah’s trauma-related behaviours with compassion, and Sarah, in turn, is learning to trust that she is safe and loved in her new home.
Each step forward, from diminishing night terrors to Sarah’s growing ability to express her emotions, is a testament to the resilience that can flourish when a child receives the right care and attention. While her past trauma will always be part of her story, it no longer controls her future. Sarah’s adoptive family continues to work with a trauma specialist to ensure she receives the ongoing support she needs, and they are hopeful for her continued healing and growth.
Supporting your child
As daunting as it sounds, PTSD in adopted children is manageable with the right support. The key is understanding the child’s history and being patient in your approach to healing. Therapeutic support such as trauma-informed therapy can be incredibly beneficial. Therapists trained in trauma and attachment disorders can work with the child to process their experiences in a safe, supportive environment.
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): This specialised form of therapy addresses the emotional and psychological impacts of trauma. It helps children process their trauma while teaching them coping strategies to manage their symptoms.
Play therapy: For younger children, play therapy allows them to express their emotions through play, a natural form of communication, helping to process trauma in a non-threatening way.
Eye movement desensitisation and reprocessing (EMDR): Often recommended for older children and teenagers with PTSD, EMDR helps them relive traumatic events in a controlled way, allowing them to heal from painful memories.
Therapeutic parenting: Adoptive parents can aim to create a stable, nurturing environment by being consistently available, patient, and loving. Understanding trauma responses and recognising that behaviours like tantrums, withdrawal, or defiance are often trauma responses rather than deliberate defiance can help parents respond with empathy.
Resources to Consider
The Adoption Support Fund (UK): Provides financial support for adoptive families to access therapeutic services, including trauma-informed therapy and counseling.
PAC-UK: The UK’s largest independent adoption support agency, offering therapeutic services and training for parents on how to respond to trauma in a child. They specialise in support for children experiencing PTSD.
American Academy of Child and Adolescent Psychiatry (AACAP): Offers articles and practical advice for adoptive parents on seeking therapy and interventions for children with PTSD.
The Post-Adoption Support Network: Provides online forums and in-person groups where adoptive parents can share their experiences and receive expert advice.
While PTSD can feel overwhelming for adoptive families, it’s important to remember that with the right support, children can heal from their traumatic pasts. Adoption offers a child stability, love, and the chance to build new, positive experiences. Families who approach adoption with patience, empathy, and an understanding of trauma can help their child heal, grow, and build a future free from the shadows of the past.
Comments