When she was a child, Kristen Garland spent a lot of time alone in her room with the door locked.
Maybe the lock could keep away the men who abused her. Maybe the lock could stop her flashbacks, or her nightmares of a strange man entering her room.
When the lock wasn’t enough, she’d run away.
“I was like, ‘I don’t feel safe here, I don’t feel loved here, so why should I be in a situation where I’m not being heard?’” said Garland, now 28.
While she was growing up in Richmond, Garland was sexually abused several times, she said. She took it out on herself —occasionally contemplating suicide — and she took it out on the world, developing uncontrollable anger and getting into fights. She often ran away, taking refuge in the homes of family members and friends she could trust.
Her story is one of tragedy and trauma morphing into strength and perseverance. Now 28, she has devoted herself to becoming a good role model to her 2-year-old son, Kristopher, and regularly speaks about her experiences.
But what she experienced as a child is far from unique. According to the Virginia Department of Social Services, there were 9,578 founded cases of child abuse in the fiscal year that ended in June of 2017. Of those, 842 were categorized as sexual abuse. The year before, there were 8,764 cases of founded abuse, and 858 were considered sexual abuse.
Emily Griffey, policy director with Voices for Virginia’s Children, a nonprofit child policy and advocacy group, said the numbers in Virginia have increased slightly due in part to the opioid epidemic and parents dealing with substance abuse.
For decades, research has shown that when children experience trauma, they’re more likely to engage in risky behaviors later in life, like heavy drinking or drug use. Treating someone for substance abuse, for example, isn’t just about tackling the current addiction but about addressing the trauma haunting their past.
And trauma often ends up becoming cyclical — when one generation experiences it, subsequent generations are more at risk.
In the last few years, Virginia has increased its effort to understand and expand trauma-informed care, which is a framework for treatment that acknowledges past trauma and seeks to prevent re-traumatization.
“I try to boil it down: This trauma that has gone on in these young people is really hurting, it’s just unhealed hurting, and the roles we are in are roles of healers,” said Keith Cartwright, behavioral health wellness consultant with the state’s Department of Behavioral Health and Developmental Services.
The first step is education. Cartwright has been making presentations across the state to build awareness of trauma-informed care and adverse childhood experiences, which are stressful or traumatic events like abuse or neglect. The more of those experiences a child has, the more likely they are to be physically unhealthy later in life, struggle in school or at work, develop substance abuse problems or experience further violence as an adult, among other negative outcomes.
Nineteen percent of Virginia’s children experienced two or more adverse childhood experiences in 2016, the last year the data was available, according to the Annie E. Casey Foundation’s annual Kids Count report. That’s more than 350,000 children, or 1 in 5 kids, said Griffey. She suspects that’s likely an undercount.
“This is about how the brain develops and how that translates into what that means for a person’s health and well-being over the course of their life,” Griffey said. “If we can intervene here in this space early on and protect children from adversity, then we can change their trajectory for a lifetime.”
But the shift toward a more empathetic approach when treating behavioral problems is slow, and requires adjustments across the board in Virginia, not just in the agencies that deal directly with mental and behavioral health. The problem is society-wide, Cartwright said, and requires other stakeholders such as schools to become trauma-informed.
“If our children don’t feel safe, we have a lot of problems,” said Sen. Barbara Favola, D-Arlington, the chair of the legislature’s Commission on Youth, which has heard presentations on trauma-informed care. “It’s a very dangerous situation. We want communities, neighborhoods that are safe, stable, where people can feel secure and flourish.”
The trauma Garland, who lives in Richmond’s Bellemeade neighborhood, experienced as a child followed her into adulthood because she was looking for love and a way to forget the past, she said. She pursued relationships with men she knew were violent and abusive because she wanted any affection she could find.
“It was a real tragedy,” she said.
It took her more than 20 years to find her voice.
“My whole entire life, I was blaming myself,” she said. “And it wasn’t my fault. So I don’t feel guilty anymore. I don’t feel like it’s my fault anymore. I overcame it. I’m on the right path now.”
BREAKING THE CYCLE
On a rainy Saturday in early June, Garland made her way slowly to the stage at the Peter Paul Development Center in Richmond, teetering on sparkling high heels and escorted by her father.
When Garland gets dressed up, she holds nothing back. Her eyes were rimmed in dazzling blue makeup that complemented the soft purple streaks in her hair, and she wore a simple white dress and delicate purple jewelry.
It was a special occasion, she said. Though many of her friends and family members already knew about her experiences, that day in June was the first time she declared openly to the world that not only had she experienced immense trauma as a child, but that she was prepared to fight for herself and others around her.
She started by introducing the organization she launched to help those facing trauma, Empowerment for Women and Men. Then she told her story.
“Me as a little girl, I didn’t have a lot,” she said, choking up as she spoke.
“It’s okay!” a friend called from the crowd.
She started again, explaining that she and her mom weren’t close as she grew up, and that she depended a lot on other family members who were always there for her. And she saw others going through similar situations turn to drugs or more violence as a way to cope with the pain.
They need to stop covering the pain up, she said. They need to talk about it.
“And I can tell you, the stuff I have been through is long gone, baby,” she said. “It’s no more. So never be afraid to speak out about abuse, never be afraid to speak about rape. You have to fight.”
Mental health experts might say Garland found her resilience, that all-important trait that helps so many withstand trauma. At its heart, resilience is simply the ability to cope with a traumatic experience.
Resiliency is the key to breaking the generational cycle of trauma, Cartwright said, for both children and adults.
He has been spreading education about adverse childhood experiences to community services boards across the state, which provide mental and behavioral health services to area residents. The goal is that those organizations will then be able to share that information with their own communities.
He’s seen mothers break down during a presentation because they finally make the connection between how their own trauma has affected their parenting.
“I think just in knowing that is a starting point to breaking the cycle,” he said.
One of the first steps for the state is developing a definition of trauma-informed care, because many who work in the behavioral health field have different definitions. Gov. Ralph Northam in June established the Children’s Cabinet. Among its tasks developing a definition and standards for evidence-based trauma-informed care.
“I think sometimes people get hung up because they think trauma equals behavioral health treatment, and a lot of what we’re talking about is not necessarily on that treatment level, although that’s helpful and necessary for some folks,” said Nina Marino, director of the office of child and family services with the Department of Behavioral Health and Development Services.
“But it’s about what opportunities does a person have in their life, what doors open and don’t open for them, what systems could help or further harm, even if that’s unintentional?”
Favola said she sees the state shifting from taking a punitive approach to a child’s behavior to trying to determine the root cause.
“The biggest policy goal that I have not achieved yet but I’m working on is, I would like to ensure that any child who has witnessed domestic violence receives counseling,” she said. “And studies show that if you can intervene proactively, if you know the child has been in a traumatic situation, if you can, at that time, get the child into counseling, you’re going to make a big difference.”
A key to developing resiliency for children is having a supportive adult to rely on, said Allyson Halverson, public education manager with SCAN, or Stop Child Abuse Now, in Northern Virginia.
“It could be the parents or caregivers in their lives or maybe it’s a school teacher or a member of their church or a close family friend or extended family,” she said.
That was certainly the case for Garland, who attributes her ability to overcome her trauma to several adults, from godparents and close family friends to counselors she met along the way.
One of her counselors, Roxanne Barnes, first met Garland when she was a troubled teenager. Then, Barnes shifted her work to focus on adults. She began working as Garland’s case manager again about a year ago.
Barnes said that, even when Garland was a teenager, she was always eager and willing to help other people and stand up for them.
In her line of work, she said she sees a lot of people who have had the same experiences as Garland – more than she would like.
“I would say some make it through it, but you have a few that don’t make it through it,” Barnes said.
Garland said her ability to speak out, her faith, her son and the supportive adults in her life have made the difference.
“I’m shocked at the person I was, and the person I am now,” she said. “It’s still hard for me, I will say, it is. But I can’t keep carrying it, because it’s not going to make me a better person, it’s not going to help me.
“Look at me now. I’m here. I’m alive. I’m living.”