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.
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
When to Seek Professional Help
There are a number of signs that indicate immediate need for professional help.
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.
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.
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.