(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?