Trauma, the Autonomic Nervous System, and Symptomatic Responses in Children

I have just finished reading Dr Suzanne O’Sullivan’s excellent book “The Sleeping Beauties“, which I really recommend: https://www.waterstones.com/book/the-sleeping-beauties/suzanne-osullivan/9781529010572 . O’Sullivan is a neurologist with a particular interest in Functional Disorders (where the patients presentation isn’t objectively caused by biological disease eg. an infection, a lesion, or insult to the substance of the body). One of the phenomena she describes is children with the brilliantly named“uppgivenhetssyndrom“.

Enhancing this no-end is the short Netflix Documentary “Life Overtakes Me”:

Known in English as “Resignation Syndrome“, this is a profound and serious presentation in asylum seeking children in Sweden (very topical at present with Ukraine’s war against Russia and the horrendous trauma repercussions of this). They stop talking, eating, and even moving – as if they are in a deep state of sleep.

Finally, we can learn a lot more as clinicians by looking at the biological theories behind these withdrawn, catatonic-type states. Here is a very good paper by Kasia Koslowska et al – “Asylum-seeking children in shutdown: Neurobiological models

https://journals.sagepub.com/doi/full/10.1177/25161032211036162

The Polyvagal Theory in particular is something we should be teaching medical students and trainees.

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