Forever Family: handle with care

That adoption conference in Charlotte was like trying to drink from a waterfall, so much so that I’m still busy processing what we learned.  (You can check out my previous posts about holding space here and here.)  Today I’ll share a little more information about what Ms. Forbes calls the “Billys” of the world and how trauma influences them.

This information is culled from both the conference and one of Ms. Forbes’s books.  All page notations are in reference to the book.  See footnotes at bottom of post.

In Help for Billy, Heather Forbes describes two boys she calls Andy and Billy.  Andy’s mother experienced a happy pregnancy.  She had a supportive spouse and delivered a healthy full term baby.  When Andy cried as an infant, he was soothed and nurtured.  A parent stayed home with him for three years before slowly introducing Andy to the preschool environment.  He was given emotional space and encouraged to express his feelings, and by third grade Andy was an excellent student who was thriving academically (p.9).

Alternatively, Billy’s mother was furious about being pregnant because her partner had lied about being able to father a child.  She was forced to move in with this abusive boyfriend after her family kicked her out.  Billy was born four weeks premature, spent the first two weeks of his life in the NICU, then was placed in day care at six weeks of age so his mother could work.  She had difficulty keeping a job, forcing them to move frequently until Billy was five years old, and he had multiple caregivers during this time.  Billy’s mother was frustrated and did not have financial or emotional assistance, a situation that made her unresponsive to Billy’s needs at home.  His academic struggles began in kindergarten, and by third grade Billy had come to see school as a place of punishment and discipline (p.10).

Two third grade boys, both eight years old, but radically different when it came to how well they function in the school setting.  Ms. Forbes asserts it all boils down to one simple reason: trauma.

The author isn’t just talking about school being more difficult for Billy because his life is hard; she contends the trauma affecting him dates all the way back to the womb.

When a pregnant woman is stressed (as Billy’s mother clearly was while he was in utero), her body produces elevated levels of cortisol, epinephrine, and norepinephrine.  These stress hormones constrict blood vessels, decreasing oxygen to the fetus, and negatively influence the fetus’ ability to develop (p.11).

Kids like Billy spend nine months baking in stress, exposure that causes long term effects on their nervous systems.  Children wired at elevated levels like this can have difficulty with problem solving, paying attention, or simply being able to sit still.  In other words, these kids enter the world already at a developmental disadvantage.

In utero trauma combined with early childhood trauma – which can be anything from adoption to neglect to parents who are overwhelmed, depressed, or disengaged – results in kids who struggle to self-regulate.  They live in chaos and fear, and they have few experiences showing them how to return to a balanced state.  In short?  Billys are programmed with a heightened internal stress level and are ill equipped to handle it.

Ms. Forbes also addressed the window of stress tolerance, and the vast difference between Andy and Billy in this area explains why these children experience life in such discrepant ways. Everyone has a baseline of stress at which we can function, along with a breaking point at which we’ll flounder.  The space between these two points is considered our window of stress tolerance (p.18).

Andy has a relatively low baseline of stress, providing him with a larger window in which to operate before he hits the point of being overwhelmed.  Billy has a high internal baseline, creating a much smaller window of stress tolerance for him.  He is constantly on edge, impulsive, impatient, and has difficulty staying focused.  His stress level interferes with everything from thinking rationally to accessing appropriate emotions (p.20).

Seeing the descriptions of Andy and Billy side by side put things into stark relief for me.  We’ve focused so much energy on the psychological effects of adoption – I simply hadn’t thought about what things were like for Bear and T-man during those nine months of pregnancy.  I can’t speak to it definitively, but it’s logical that each of their birthmothers would have been under enormous stress while making such a huge decision.  It was bound to impact the baby’s environment.

Learning about the window of stress tolerance was another ah-ha moment.  As in, so that’s why a run-in at breakfast or unfavorable answer can completely derail one kid while the other can coast through several disappointments in a day.  It was a real smack upside the head kind of thing for me.

Studying the concept of in utero trauma and how a child’s window of stress tolerance affects his or her interaction with the world has opened my eyes to a whole new way of approaching conflict in the house.


Forbes, Heather T.  Help for Billy: A Beyond Consequences Approach to Helping Challenging Children in the Classroom. Boulder: Beyond Consequences Institute, LLC, 2012. Print.

Forbes, Heather T. (2016).  “Life is Therapy: Embracing Negative Moments as Healing Moments.” Session presented at the 4th Annual Adoption Conference, Charlotte, NC.

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