Newsletter
#175 for Internationally Adopting Parents
May 18, 2016
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Psychomotor Agitation with the Anti-Social Content in Internationally Adopted Children and Adolescents
B. Gindis Ph.D
Psychomotor Agitation (PMA) is a series of unintentional and purposeless motions that stem from mental excitation and anxiety of an individual.
A child afflicted with complex childhood trauma (having Developmental Trauma Disorder - DTD) has a distorted Central Nervous System (CNS) processing with major deficit in self-regulation of emotions and overt behavior. This child is easily frustrated and tends to accumulate tension related to this frustration. In certain situations, usually in familiar, structured, and monitored circumstances with an authority figure in sight and capable of managing the child's behavior, these children can for some time preserve control of their behavior. However, when tension is mounting, the ability to sustain the outburst diminishes, and the child releases tension through physical agitation that may take form of the a-social actions: physical or verbal aggression and damage of property/things. This psychomotor agitation is mostly unintentional and purposeless and stems from the traumatized child's anxiety. Inner tension is a feeling of nervousness, and an overwhelming mood discomfort. This drive makes purposeless actions practically unavoidable, almost compulsory for a child. For a by-standee it is impossible to empathize with or even understand the tension that is so extreme that it forces movement, but this is what happens.
By releasing tension through motor restlessness, the child experiences relief in spite of making his or her life miserable by often hurting other people and destroying property. They sometime laugh and smile in the midst of their destructive actions or when they are reprimanded or punished. This famous "orphanage smile" is reported by many parents and clinicians and is extremely frustrating for adults who live and work with traumatized children.
It's important for parents and school personnel to realize that this behaviour does not have purpose and does not have "triggers". It has inner dynamic dictated by the child's nervous system and is relatively free from the environmental influences. It may start "out of the blue", it may disappear for several hours to several days, and reappear again without visible causes. That is why the traditional behaviour modification techniques and programs are often not successful with this type of conduct: nothing serves the purpose of "attracting attention" or "avoiding an assignment": it's just a tension release.
The question remains why this psychomotor agitation is released in such an anti-social manner; with physical aggression against peers, siblings and parents, with destruction of property, with violation of societal norms and school regulations? Young post-institutionalized children just do not know any other ways of releasing this tension, and one of the methods of preventing PMA anti-social nature is to teach them socially acceptable ways to discharge it.
Treating psychomotor agitation with anti-social content when it starts is hardly possible until the child is exhausted and the excitation of their CNS subsides (similar to tantrums that are a specific case of psychomotor agitation). However, it is possible to prevent PMA through relaxation techniques, attention redirection, and verbal interactions before the cycle starts.
What can be done in the school to address this issue?
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