The Taconic Counseling Group

Marsha L. Shelov, Ph.D.

Children and Trauma: The Role of Parents

      In 1998 American  children have been exposed to more violent experiences including  natural disasters, community violence, personal violence and abuse, than almost at any other time in our recent past. Tornados, hurricanes, televised violent scenes of children killing other children permeate our news, both written and visually. This trend has significantly escalated over the past decade; violence is an everyday occurrence and our children are exposed on a daily basis.  Many concerns  arise as a result of this alarming trend, and it is the purpose of this article to provide a framework for parents to better recognize and manage the impact of such events.

 

Trauma Definition

 

      One of the first,  important questions to answer  is how can we identify which children have actually experienced such a trauma. Trauma occurs when an often sudden or  extraordinary external event overwhelms a child's capacity to cope, creating an  inability to master the feelings caused by the event. The exposure to a terrifying  event as either a victim or a witness, can  result in intense feelings of fearfulness and helplessness,  an emotional terror.  The trauma may be a one time event or the result of repeated exposure to traumatic stressors. Examples of traumatic experiences include but are not limited to:

 

 

      Trauma differs from ordinary stress in childhood in several ways.  First, it generally occurs suddenly, leaving a child no opportunity mentally or physically to prepare for it. Secondly, such traumatic events are unusual, unpredictable, and outside the range of a child's typical experience. Thirdly, as a result of the trauma an extreme feeling of helplessness usually overwhelms the child.  Avenues for coping and making the situation better are not evident or available. To witness an act of intense personal violence can also be traumatic.  A child witness is captive in a passive role and able to attend fully to the horror of the act.  These children struggle with vivid memories of the images and sounds of the scene.  Child witnesses take in the totality of the situations they observe.  Their minds can become flooded with impressions of both the attacker's aggression and the anguish of the victim's emotional and physical suffering.  The severity, duration and proximity of an individual's exposure to the traumatic event are the  most important factors affecting the child's experience of the event.

 

Responses to Trauma

 

      What are the reactions and psychological mechanisms  that are often set into motion by a child's experience of such a traumatic event?  The first reaction is often an increased sense of  fear of further immediate trauma and thus a  loss of a child's usual  sense of immunity to such danger.  Rather than embracing life with a typical sense of openness, a traumatized child may retreat defensively.   Mild or severe, a traumatically frightening event matters deeply to a child.  Even when parents wish to forget what has occurred to their child, the child remembers.  In fact, the child needs to remember, over and over, detail by detail, as part of the healing process.  Children remember through retelling, through play, and through their post-traumatic fears, dreams and unusual behaviors.   All of these varied forms of remembering are indications of the trauma's force but are also part of the child's internal struggle to heal and master the trauma.

 

      Trauma causes psychological wounds.  Healing from the wounds requires time and can be influenced by understanding  parents and important other caretakers  The signs of psychological trauma differ for different children.  The particular aspects of the trauma itself interact with all that is special and characteristic about the individual child to create that child's response.  Parents  should observe their child closely during the following weeks and months to discover the meaning and impact of the experience.  It is important to remember young children may not be able to talk about what happened, and they let you know their experience through play and disruptions in normal routine behavior.

 

      Children generally react to psychological trauma quickly, showing some strain within a few days of the event.  Some children, however, show no immediate signs of trauma and appear to be unfazed or even paradoxically show a striking lack of fear.   Studies suggest that some of these symptom-free children will develop delayed responses over time.  Most children give indications of their distress through one or more behaviors and reactions.  The following are the most common.

 

 

      These signs of trauma and stress are flags to pay attention to.  Often the behaviors of traumatized children are the only indicators parents have of a child's distress.  The child's actions signal a problem and indicate that the child is trying to cope with the problem.  The child's success in coping with and mastering the trauma frequently depends on a parent's capacity to attend to and accept the signals of distress.  Once the behaviors and feelings are understood, the task for parents of supporting the child's recovery becomes clearer and easier.

 

      The nature of the trauma generally has a direct impact on the severity of a child's reactions. Single traumatic events of short durations that do not involve interpersonal violence or threat often have less serious and briefer impact than events of human design that result in physical harm, lasting disfigurement, major disruptions in a child's family and life circumstances, or other persistent reminders of the trauma.

 

The Healing Process

 

      When a psychological trauma intrudes upon the emotional safety of a child's life the child feels that an invisible bubble of protection surrounding him has been violated. The child temporarily loses his prior sense of security from harm.  Following trauma, it is not just fantasies and bad dreams that can be scary; real life must now also be feared.  Fearful children experiencing the impact of a psychological trauma look first and foremost to protective parents and trusted adults for reassurance and support.  The search for signs of comfort, normality and routine in their daily life to undo their sense that life has changed in sinister and frightening ways.

 

      Above all, most children look for signs that nothing has changed in their important relationships with parents and other trusted adults.  And here is the painful paradox of parenting a traumatized child:  in most situations involving childhood trauma, something has changed in the child's most important relationships.  To some degree, parents are emotionally traumatized themselves.  Thus, just when the child is struggling most to comprehend and master a trauma, so are the parents struggling with their own sense of horror and pain.  At the very point that the child is looking to the parent for reassurance, despairing parents may feel that they have little to give.  Although it is beyond the scope of this article, it is crucial for the caregivers to get the emotional support that they need to reduce the impact of their own psychological trauma so that they can begin they essential care taking role of  parenting their traumatized child.

 

Ways to Help Children

 

  1. Immediately following a child's encounter with trauma and sometimes for many months, children need lots of comforting and reassurance.  Infants and very young children are particularly in need of soothing experiences that relax and relieve the tension in their bodies, nursing, rocking, cuddling, singing and music, telling stories, peek-a-boo games and quiet reading together.  A return to the comforting rituals that soothed your child when she was younger. For older children, parents need to match their comforting to their child's need and likes.  Most parents know what is particularly soothing to their child.  Children need to calm their bodies, which are often overwrought with tension. Special comforting at bedtime,  an extra story, a massage, a night light, thinking together of some good dreams to have, a tape recorder with favorite music or stories can be helpful.  Comfort and reassurance are the treatment of choice for children with nightmares.  The terror needs to be directly combated, and soothing is critical in relieving this terror.

 

  1. Children often need basic information about what happened to them.  Information matching your child's age should always be presented simply and honestly, questions answered directly and truthfully.  Follow the child's lead regarding the need for specific information.

 

  1. Tolerance for  regressive behavior.  When children regress, parents need to match their responses to the needs of a younger child..  Try to convey a message that I know you are having difficulty now, we can handle this problem together until you are feeling stronger again.

 

  1. Respect a child's fears.  Acknowledge them, assure your child that the fears will be less frightening over time, that you will be present to help them.  There is, however, a danger in giving a child's fear too much support.  Parents out of fear and concern can miss the signs that their child is ready to move on.  As with most issues finding the middle course between over protectiveness and excessive expectations is the most difficult but best route.

 

  1. 5.     Children experiencing flashbacks and panic reactions can be comforted by   immediate reassurance and education.  Guide children toward the awareness of the present.  During a flashback or panic reaction, a parent can talk to the child about the here and now, reminding the child that the danger is over and that she is not alone.  What is happening is the scary event replaying itself in the child's mind, just like a vide and soon they will be able to turn off  the video. Reminding children that they are safe now.

 

  1. Provide opportunities for talking about feelings.  Children have strong feelings, many of them unpleasant and upsetting to hear.    Telling and retelling about the event is part of the healing.  Setting a particular time for retelling can help contain the fear.

 

  1. Provide opportunities and props for play..  Like retelling, playing out  the trauma is predictable and necessary for many children.  Try to have appropriate toys available for your child, and be there for some of the play experiences.

 

  1. Expect some difficult behavior.  Following trauma, many children's own controls fail them.  They may cry more over little things, make angry demands, show more aggression, and test limits and rules.  The difficult path for parents in responding to this behavior involves conveying understanding and caring while maintaining the rules and limits of the home.

 

  1. Return to the normal routine as quickly as possible.  Children derive comfort from the return to normalcy.

 

  1. Provide  physical outlets for children having difficulty controlling their aggression.

 

  1. Focus  on images of strength and survival.  Children and parents need to be reminded of their strengths and their competence.  Hearing about difficulties they have overcome in the past.

 

When to Seek Professional Help

 

      There are a number of signs that indicate immediate  need for professional help.

 

  1. A child' s posttraumatic behavior is endangering to herself or others.

 

  1. A child whose reactions to trauma is to talk about being dead, to dwell on issues of death and dying or to threaten suicide.

 

  1. A child whose reaction to trauma is to lose all prior grasp on the line between fantasy and reality.

 

  1. Total disruptions in daily life and age-appropriate behaviors.

 

      The following indicators are to be expected during the initial stage of coping with trauma but become worrisome if they persist or intensify.  While each child is unique the following behaviors lasting beyond six weeks is a signal for seeking professional help.

 

  1. A child is continuous to reexperiencing extremes of fear,  nightmares, flashbacks, and separation anxiety.

 

  1. The child's initial regression to the behavior of a younger child shows no sign of decreasing over time.

 

  1. A child continues to experience more than one nightmare per week or shows no decrease in other sleep disturbances originating at the time of the trauma.

 

  1. No decrease in social withdrawal, listlessness, or lack of pleasure in routinely enjoyable activities over six weeks.

 

  1. A child who complains frequently of physical pain or illness for which no medical explanation can be found. This  can indicate underlying unexpressed emotional pain

 

  1. A child who continues to experience vivid terror in response to trauma-related sensory triggers with no decrease in intensity or frequency of these reactions.

 

  1. A child's distractibility interferes with attention and learning at school.

 

  1. Overall changes in the child's personality dating from the time of the trauma  that are dramatic and worrisome to parents and others.

 

  1. A child's post-traumatic reaction or behavior, even if mild is particularly upsetting or bothersome to the child.

 

      Time does matter in seeking professional help.  The earlier that traumatized children go for professional help, the better the chances are that these children will benefit from the help.  The importance of early professional intervention is related to children's internal process of healing from trauma.  Immediately following a trauma, the disturbing memories and feelings are fully available to a child.  With time, the child needs to resume normal functioning.  Frequently children find ways to encapsulate or isolate the disturbing aspects of the trauma over time, perhaps shoving them to a dark corner of the psyche where they will not have to encounter them so frequently.  Children are not always aware of this process of burying the trauma, which gives them some relief from the immediacy of disruptive images and feelings.  Parents, too, may notice the child distancing from the trauma and feel relief that a child is "forgetting" about it.  It is important to remember that most children heal from traumatic experiences.  Help is available and consulting with experienced professionals can provide reassurance and treatment.

 

      Fortunately most children do not encounter traumatic experiences, yet parents need to be alert to the subtle exposure to trauma that may be an aspect of a child's everyday life.  Television, newspapers, magazines all report frightening experiences from natural disasters, child abuse and child violence.  Young children need to be buffered from this and older children need to have help in putting these events in perspective.

 

References:

 

When Your Child Has Been Molested, by Kathryn B. Hagans and Joyce Case.   A good self help guide book for parents.  The Pediatric Clinics of North America:  Violence Among Children and Adolescents, April 1998.  Recent research articles on the impact of trauma on children.

 

Treating Traumatized Children, by Beverly James.  A excellent text primarily for professionals treating children.

 

Children and Trauma:  a Guide for Parents and Professionals, by Cynthia Monahon.  An excellent self-help book.  Much of the material in this article was drawn from this book.