FASD and Fear

Yesterday I lost it with my son. We were at swimming and had put our stuff in our favourite extra big changing room but realised we’d left something in the shower. When we came back with it, another family were innocently going into the changing room thinking it was free. Then came the almost inevitable reaction from my boy, screaming and aggression and shouts of ‘shit girl’. Although I’m more used to this than I have been, the usual wash of shame worked in combination with the cumulative drip drip effect of fetal alcohol symptoms we’d experienced throughout the day. A day which earlier featured real pain and a cut under my eye from a book being thrown at me with force from across the room.

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I really shouted, popped his bag of crisps and threw them in the bin because the idea of just obligingly handing over snacks when he’d just behaved like this felt too galling. But then my son said something interesting. I railed with the usual and seemingly pointless ‘whys’. Why did you say that to the girl? etc. And then he told me. I can’t remember the exact words but he said he was scared or worried that the girl would take his things.

This reminded me yet again of something fundamental about fetal alcohol. Fear. And threat. There are so many areas of the brain that are affected by exposure to alcohol in the womb. We hear a lot about executive functioning deficits, the damage to the pre-frontal cortex at the front of the brain which results in reduced ability to plan, predict and to inhibit impulses. But for many with fetal alcohol it is the combination of this with the damage to the limbic region, the area of the brain responsible for the experience and expression of memory and emotion, that causes some of the most challenging symptoms. I am no neuroscientist so bare with me on this. But from lots of research I’ve discovered the vital role of this fear processing region that includes the hypothalmus, the brain stem and the amgydala.

The Greek word for almond, the amygdala are two almond shaped clusters of neurons often described as the emotional centre of the brain. The amygdala allows the brain to detect and respond to threats and pre-natal alcohol damage often causes disorder in its processing ability. Added to this is the damage to the inhibitory connection between the front and back of the brain. The pre-frontal cortex doesn’t do its job of sending messages to the limbic system to control negative emotion and the related aggressive behaviours.

Fear is primal. In the wild, it serves as a protective mechanism, allowing animals to survive by avoiding predators or other perceived threats. With my son it can be like he is a guard dog, on permanent alert and often stuck in a state of hypervigilant fright. And so much is threatening to him. Depending on how generally anxious and (dys)regulated he is, ending an activity, someone coming into the room, a sudden laugh, being told no, and certainly a family trying to enter a changing room with his stuff in it can all instantly fire him off. It can feel like the smallest things for him are like the equivalent of having a knife held to his throat. And his brain and central nervous system sends him immediately into that flight or fight zone where he is literally fighting for his survival. As in the wild the verbal and physical attacks are his protective response.

And normally he is not able to tell me why so it was great that he could tell me this time. But soon after he told me why, he then asked me why. ‘Why did I say shit to that girl?’ And that is also very revealing. Because mostly I don’t think he understands why he reacts like he does. His brain just does it. And then he is left confused and even more anxious. Which in turn can make him react with even more anger. Or sometimes shame. But I can never be reminded enough that it all comes from fear. And it is easier to feel empathy more than fear myself when I have that reminder.

Because fetal alcohol is not just about fear for the sufferer. The combination of factors which include the threat of physical and verbal attacks, fear of feeling shame in front of others, and fear of the future are a cocktail that can result in very similar threat responses from me. Although I have a better functioning brain that is more able to respond relatively to perceived threat and more able to inhibit an aggressive response, I am also capable of joining my son in the red zone. That sudden searing rage that overtakes and overpowers all else. And again, understanding the basis in fear helps.

For about nine years now I’ve been practicing mindfulness meditation. And lately I’ve been reading some amazing Buddhist books on fear and anger that are really helping me. They are getting me to see that, along with all the heartache and difficulty of my son having fetal alcohol, this experience can also be a teacher. My son’s displays of anger and rage are his protection mechanism for fear and threat. And so are mine. Anger is a way of trying to escape and protect myself from painful, fearful emotions that make me feel helpless. Faced with the threat of an unpredictable attack and all the other layers of fear and grief this brings, my own amygdala fires off, wanting to gain control, power and protection. And wanting to escape from danger.

But in her brilliant book When Things Fall Apart, Pema Chodron talks about ‘getting to know fear, becoming familiar with fear, looking it right in the eye.’ Rather than escaping from fear into other emotions and reactions, she advocates being present and relaxing with it. I find this very difficult to comprehend. As Pema points out, ‘no one ever tells us to stop running away from fear. We are very rarely told to move closer, to just be there, to become familiar with fear.’

And putting this into practice when my son starts hitting me over the head with a plastic fire engine is obviously a work in progress…However, I think the basic idea of getting to know and trying to stay with the emotions I’m feeling rather than trying to escape from them through anger is helpful. Because with his threat levels on such red alert, if I add any fuel to the fire, it just ignites and escalates into a horrible scene and adds more suffering for both of us. Rather than joining my boy in the rage, getting curious about our emotions could potentially help us both.