Back From the Brink: A Family Guide to Overcoming Traumatic Stress, by Don R. Catherall, Ph.D.
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7
GUIDELINES
FOR PARENTS
The most difficult trauma for any parent is the one that strikes their child. If you are such a parent, you're experiencing all the feelings you'd have for any other traumatized family member, with another dimension. Your feelings of responsibility and helplessness are enormous. You may be uncertain about the extent of your child's traumatization and how to interpret her behavior. And in the midst of taking care of her, you must take care of yourself. As you try to provide the right kind of response you fight your inclination either to deny or to overreact to the crisis. After a while, you may come to feel that you're scrutinizing your child and creating problems where none exist. If you and your spouse have different perceptions about the degree to which your child is affected, this creates additional family tensions.
A child's reaction to trauma doesn't always manifest
itself in the same way it does with adults. Nor are they free to indulge in
the same coping behaviors as adults. Indeed, many children manifest their
psychological distress so differently from adults that it can easily go
unnoticed. For example, they often develop sleep‑related problems; they
can't go to sleep, they wake up frequently, they become especially fearful at
night, or they have bad dreams. Most children also regress in their physical
and emotional development. They may have greater difficulty controlling their
bladder or bowels, often redeveloping a problem (such as bed‑wetting or
thumb‑sucking) that they'd previously outgrown. They frequently develop
separation anxiety and find it very difficult to tolerate being away from their
parents. Often, they start wanting to sleep with their parents again. And they
may develop entirely new symptoms, particularly phobias in which they become
highly fearful about some specific situation.
The traumatization of a child produces a trauma response
that involves the entire family. From the outset, you yourself are traumatized
because your ability to relate to your child's trauma is so extreme that you
feel as though it happened to you. Dealing with this is complicated. You must
provide the best possible environment for the recovery of the entire family,
while maintaining a constant grasp of what your child needs. The guidelines for
dealing with adult trauma are a beginning, but there are other factors that
must be addressed when a child has been traumatized. Let us consider some of
the ways in which children differ from adults and how these differences affect
their reaction to trauma.
Children are amazing creatures, both more fragile and more resilient than adults. They tend to express their feelings without inhibition; if a child likes you, he makes no secret of it, and if he doesn't like you, that's also readily apparent. Yet there are situations in which a child's feelings are less apparent, such as when there is conflict between his parents and the child is uncertain about his loyalties. When a child is uncertain about right and wrong—particularly in regard to his own behavior—he’s prone to inhibit his feelings more. And when a child has been traumatized, he may become inhibited about the expression of feelings related to the trauma. Yet children, like adults, need to explore and examine those feelings in order to come to terms with a traumatic experience.
Developmental Level
The first factor to consider with a traumatized
child is his developmental level. Psychologists break child development up into
many components such as language development, moral development, physical
development, intellectual development, emotional development, and social
development. Any of these areas can be relevant to a child's traumatization.
The child's language development certainly bears upon his ability to talk about
the trauma, while his intellectual development affects his ability to make
sense of the experience. And the child's moral development affects his view of
himself and others in regard to the trauma, as does his physical, social, and
emotional development.
You may worry that you don't have enough expertise
to assess your child's development, but I've found that most parents have a
solid grasp of where their children are developmentally. You may not have a
vocabulary of psychological labels, but you probably know what kinds of things
your child can and cannot yet do. If you have questions about where your child
is developmentally, you should consult a child psychologist or child
psychiatrist.
Even if you feel confident in your understanding of
your child, I recommend you make at least one visit to a professional. Even if
all is going well, it won't be a waste of time because it's an opportunity for
you to compare your impressions with those of the professional and to develop
a relationship with someone upon whom you can call if the need arises. A
child's development changes rapidly, and one consequence of this is that new
developmental stages often bring renewed experience of the trauma. In effect, the
child reworks his resolution of the traumatization as he enters new
developmental levels and views it from different perspectives. For example,
the meaning of a trauma is different to a child at different levels of
intellectual development as it is influenced by his ability to generalize and
conceptualize dangers.
A Heightened Sense of Vulnerability
Preschool children are enormously dependent upon others
to take care of them and consequently are subject to feelings of the most
extreme vulnerability. Most adults are protected from these raw feelings by
their many skills for dealing with the world, as well as by their illusions of
security. But young children are still in the process of developing these
skills and manufacturing these illusions. Thus, they can be thrust into the
deeper feelings of vulnerability very quickly.
Children protect themselves from vulnerable feelings
using different means from adults. They place greater reliance upon mechanisms
like fantasy. Comic book and video superheroes, for example, are extensions of
children's fantasies. These superheroes are always endowed with powers that
allow them to overcome their vulnerabilities. Indeed, superheroes are often
portrayed as trauma survivors themselves, usually having been traumatized when
they were children. Superman's home planet was exploded and his parents
killed; Batman's parents were killed by a criminal. Rather than being
overwhelmed by their vulnerability, these superheroes developed abilities and
powers that enabled them to help others stricken by trauma.
Equally interesting is the fact that virtually all
superheroes have secret identities and hide their powers from the world. This
allows a child to relate to the fantasy that he may appear vulnerable on the
outside but secretly he's invulnerable and therefore not really affected by
the threats and stresses of a hostile world. These fantasies may appear superficial
to adults, but they are amazingly powerful in helping children cope with life.
Not only is the traumatized child upset by what happened
and fearful of it happening again, he's now acutely aware of how vulnerable he
is in regard to any number of dangers—not just the same one as the trauma
involved. And not only must he come to terms with the specific trauma that he
endured, he must find new ways of convincing himself that he's safe in general.
In the meantime, he'll likely regress to an earlier developmental level, be
more fearful, and be more in need of his parents' physical presence.
Part of the process of reachieving a feeling of
security will be the resurrection of fantasies and illusions of security, such
as in the superhero play referred to in Chapter 1. Your child's play will
involve considerable fantasy and replaying of the trauma from many different perspectives.
This is a healthy process in which she learns to master her fears.
If your child seems to be stuck on replaying the
same situation over and over (for more than a few weeks), she may be having
trouble finding ways to overcome the conflict that's expressed in the play.
That can be a signal that she needs the help of a therapist, especially if she
has other symptoms such as bed‑wetting, tantrums, or other outbursts,
refusal to separate from the mother, or a regression from levels of development
that she had attained before the trauma. But the child who repetitively replays
the trauma is less worrisome to me than the child who is so constricted and
shut down by her traumatization that she cannot engage in even that spontaneous
process. Those children should definitely receive therapy.
Alice, as a four‑year‑old, was molested
by her parents' housekeeper's twelve‑year‑old nephew. The
molestation consisted of the boy exposing himself and making Alice take off
her pants. He told her not to tell, but Alice didn't like what happened and
told her mother. Both parents talked with Alice about it. Although she was
upset, she was open about it and seemed to accept that she was safe. But within
a few weeks, she was found pretending to have a penis and to be showing it to
another child. It came up in her play frequently after that.
Her parents contacted a therapist. The therapist saw
Alice for a couple of sessions but concluded that Alice was simply working on
what had happened by bringing it into her play. She had no other symptoms and
seemed to have put the episode into a category of bad things that happened but
did no permanent damage. The therapist counseled the parents about how to
respond to Alice's play and stayed in touch with them over the following year.
Alice did fine; she had several talks with her mother about the event, then
lost interest in it and it disappeared from her play.
Children do not forget the same way adults do. Their
minds are soaking up information at a much higher rate, and they don't possess
the psychological mechanism that allows adults to simply forget things that are
too disturbing. This mechanism, called repression,
is an unconscious process that apparently becomes available to children in
the early years of elementary school. Before that, children cannot avoid overly
disturbing thoughts and feelings by repressing them, so they must employ a
different mechanism. Children under six primarily rely upon a process called dissociation, in which they replace the
disturbing thought with something different. This replacement process is quite
far‑reaching. It's not simply that the one thought is replaced by
another; rather, the child's entire state of mind is shifted.
The traumatized child uses dissociation to shift from
feeling small and vulnerable to a state where he can feel more powerful and
invulnerable. All children use dissociation, though the content of their
fantasies varies. Some children dissociate to a pleasant place where there are
no dangers, while others dissociate to a world of secret powers. Dissociation
is worrisome when the child begins to think of himself as a different person
altogether, in order to feel that the bad things are happening to someone else. Children in situations of
severe, ongoing abuse frequently resort to dissociating right out of their
personality. In order to avoid the terrible thoughts and feelings associated
with abuse, the child develops alternative personalities (multiple personality
disorder) to which to escape.
If you believe your child is dissociating, please
don't let my reference to alternative personalities frighten you. Again,
dissociation is a normal phenomenon in which all children engage and an important aspect of how they cope with
trauma. Children dissociate to some degree whenever they engage in fantasy, a
major form of their play. Every time your child pretends, she is dissociating
to some extent. By four to five years old, children know the difference between
their pretend world and the real world. If you fear your child has lost that
awareness or is not behaving like herself, consult a professional.
Rachel was a teenager when she ended up in
residential treatment for her psychological problems. When she was younger, her
parents were physically abusive of her, punishing her with severe spankings
and locking her in closets. When she was older, they tried to control every
aspect of her life. Yet Rachel went around with a little smile on her face and
never complained. She had learned to "go to other places" when she
didn't like what was happening around her. After her experience with her cruel
parents, she never got very close to people and couldn't trust anyone. As a
young child forced to sit in the dark in a cramped closet, she'd become adept
at imagining herself in different circumstances. It required many years of
intensive treatment for her to give up her fantasy world and risk letting her
life be real again.
Rachel is an example of an unhealthy extreme
reliance on dissociating. It was her primary means of coping with her situation
and became a way of life for her. That's partly because her trauma was of the
recurring variety; she learned to expect it and to anticipate it by being off
in her "other place." Most children dissociate as part of dealing
with their traumatization; indeed, it's an important element in children's use
of fantasy. We're only concerned when it goes awry.
Importance of Parents
The parents' importance in maintaining a child's psychological
balance cannot be overemphasized. A child doesn't possess the skills,
knowledge, experience, or strong ego to cope with life's daily
difficulties—much less the exceptional ones required by traumatization. But
nature has provided a way for her to survive, even flourish, despite life's
inevitable frustrations and disappointments—you. Before she develops her own
strong ego to guide and support her, she can rely upon your ego.
When I refer to the ego, I'm talking about that part of us that is responsible for
learning to deal with our environment—for planning our actions and managing our
internal emotional tides. Adults are able to calm themselves when they get
overwrought, discipline themselves when they would like to act impulsively, and
maintain an appreciation for who they are and how they see themselves fitting
into the larger scheme of things. Your child is unable to do these things for
herself; she must rely upon you. She's particularly dependent upon your ego to
help her deal with traumatic situations. She can weather the storm if she
continues to have access to a strong, reliable parent who provides the
stability and security that she's unable to provide herself.
The preschool child's relational trauma is embedded
in his relationship with his parents. His experience of a relational trauma is essentially
determined by you—your attitudes about him, your ability to mediate between him
and the greater social world, and your personal well‑being and capacity
to deal with the trauma. If your view of him changes, his view of himself will
suffer. If your relationships with your social world change or if you interfere
with his opportunities to develop a social world, he may suffer the effects of
a relational trauma.
The younger he is, the more your child depends on
your ego functioning to maintain his own. If your ego falls apart or if you
stop providing support for him, it's as if he were directly traumatized once
again. If your child is traumatized and you can't deal with it, he'll be
unlikely to be able to deal with it either. That's why it's essential that you
take proper care of yourself, so that
you can be stable for your child. He bases his sense of security on his reading
of you and your confidence. If you find that you're unable to provide that stability,
get professional help for yourself so that you can do your job for your child.
Of course, one of the worst traumas a child can experience is to have something happen to his parent. The child's sense of himself as an individual is still poorly developed and very dependent upon his parents. In this culture, children don't achieve much emotional separateness until the latter stages of elementary school. They remain physically dependent upon their parents through adolescence, and many are financially dependent upon their parents well into adulthood. Throughout all these stages, the loss of a parent causes a profound disruption in the child's sense of self.
The Impact of Separation
Since you play such a vital role in helping your
traumatized child feel secure, separations from you are extremely difficult
for your child. Children in early grammar school may cling like two‑year‑olds
again. Your child becomes more aware of her vulnerability and depends more
explicitly upon you. Parting from you comes to represent a sudden exposure to
all the dangers at once, and a moment of separation can become a crisis of
major proportions. You may have difficulty understanding the depth of her fear
at that moment, especially if the separation is to be brief (such as going out
to the car to bring in the groceries).
This separation anxiety may be played out
differently by different children, but it's an issue for all traumatized children.
It often comes up at bedtime. Bedtime can become a major battlefield because
sleep can come to represent the state of total vulnerability that she
associates with your absence.
Many traumatized children return to the familiar
sleep routines they learned when they were younger, such as holding stuffed
animals, saying their prayers, or having their parents read to them. But they
may lack such familiar routines to deal with waking up in the middle of the
night with nightmares or night terrors. Many traumatized children want to
sleep with the parents again because they are too afraid to sleep alone.
Parents often give in to this request, because battling over sleeping
arrangements can be too great a hassle. You may have found it necessary to do
this, but you should work toward helping your child regain her ability to sleep
alone. If sleeping with you becomes the new norm, you'll be faced with an
additional problem in the future.
One way or another, your child is likely to regress
in dealing with separation from you—whether by having sleep problems, avoiding
school, or just refusing to let you out of her sight. You must respond to her
increased separation anxiety by recognizing the fear and not requiring her to
do more than she can handle, though it's often not easy to know how much that
really is. Your goal is to help her return to the level of competence she'd
acquired before the trauma, so that she can resume her developmental path. It's
a mistake to allow her to regress—such as resuming the habit of sleeping with
you—and then accept this behavior as the new status quo. If you communicate
acceptance that the regressed behavior is now the norm, it can interfere with
her development.
Knowing how fast and how hard to push her to resume
greater levels of competence is tricky, however. But no one knows a child as
well as her parents do. You know when her tears indicate terror and when
they're more of a manipulation. You're a good judge of how quickly she's able
to tolerate separations. And you can facilitate her progress both by
encouraging her and by setting appropriate limits on the regressed behavior.
As your child gets older, his dependence upon you
changes. It will be a long time before he truly abandons his reliance upon you,
but as he matures, other people join you in their importance to him. This
change is reflected in his fears. Up until elementary school, his primary
concern tends to be that something physical might happen to him or to you. But
around age six, he begins to worry about more social kinds of issues, involving
how others view him. As he advances through grammar school, he worries about
being ridiculed by his peers or not performing well in school or athletics. By
the time he reaches adolescence, fears about being different are a major factor
in how he makes decisions. The meaning of a trauma, too, changes with his age.
For a young child, a disfiguring accident is a brush with death; for an
adolescent, it is rather the "kiss of death" because it makes him
different and more likely to be rejected by his peers.
The shift here is from physical to social concerns.
A child who was traumatized when younger may reconsider the trauma and have to
rework his resolution of it as he grows older. It becomes a new trauma as he
focuses on how it makes him different from other kids. He may become symptomatic
again—or for the first time—as he struggles with the newly discovered
implications of what happened to him. And as he approaches adolescence, he's
less able to rely upon the stability of his parents' egos in order to cope. He
must come to terms with the trauma more on his own. Even if he does regress and
allows his parents to determine how he deals with it internally, he'll
eventually have to come to a personal resolution. Otherwise, he'll remain
dependent upon them and gain no confidence in his ability to deal with life.
Children aren't born with defenses; defenses develop
as the child matures. Preschool children use immature defenses that aren't as
sturdy as those of adults. Young children rely heavily upon denial—they simply
insist that they're not experiencing a disturbing thought or feeling, or that
a disturbing event hasn't occurred or doesn't bother them. For example, a child
who's angry with her mother may yell "I'm not angry." Even though
it's clear to her mother that she's angry, she's not aware of it. In traumatic
situations, the child may insist that she's not frightened or that the
situation wasn't frightening. This style of protecting herself is all right,
but there aren't a lot of backup defenses if denial proves inadequate.
Children's limitations in this area are revealed
when we try to get them to talk to us about their traumatic experiences.
Preschoolers don't have the ability to discuss the trauma dispassionately,
which requires the defense mechanism of emotional numbing. Thus, in
encouraging the child to recall the trauma, we can easily push her beyond her
capacity to protect herself. When this happens, she may insist on not talking,
say "No, no," or literally put up her hands and try to push away the
distressing thought and physically protect herself from the assault of the
questioning.
In Chapter 4, we saw that the development of meaning
is an essential aspect of the recovery process. This is as true for children as
it is for adults, but it's different for children. Their capacity to think
abstractly develops very slowly, extending all the way into adolescence. Your
child's explanations for the event might make no sense to you. Sometimes young
children exhibit "magical thinking"—believing that thinking a thing
makes it so. Your child may find a way to believe that the trauma can never re‑occur
because of convoluted reasons, such as insisting a burglar would not return
because he was just "testing" the house for security.
Your child's process of finding meaning for her
trauma will be different from your own. Sometimes she will follow the same
logic as you; at other times she'll have her own logic. When she talks, you may
be deceived into thinking that you understand the subject in the same way she
does, only to discover later that she came away from the conversation with an
entirely different meaning—one with which she may still be satisfied. Because
they are different ages and at different developmental levels, children in the
same family often form very different meanings and have very different reactions
to the same trauma.
Pablo and Juanita had three sons, Manuel, age four,
Raul, age seven, and Pablo, age nine. Pablo Senior committed suicide, and
Juanita felt it was best to keep this from the boys. All the boys knew was that
their father had died a violent death, but they were unclear on the details.
Lacking a clear understanding about how their father died, each boy had his own
story. Although it was not acknowledged in the family that there had been a
suicide, it is most likely that Juanita's feelings about the way her husband
died affected the children's stories.
In therapy, the boys were each asked to draw a
picture of what had happened to their father. The differences among the
drawings were extreme, but they were quite instructive in revealing the way
each boy explained this trauma. Pablo, the oldest boy, drew his father
endangering himself in a foolhardy fashion. Raul drew his father being
assassinated by an evil stranger, and Manuel drew an auto accident. In addition,
each boy developed his unique reaction to the event: Pablo was depressed, Raul
became a clown, and Manuel was angry.
I think Pablo somehow recognized that his father was
responsible for his own death and so became depressed. Raul avoided any
awareness of either his father's problems or his own feelings—by creating an
evil stranger and hiding behind the mask of a clown. And Manuel, as the
youngest, may not have appreciated his father's responsibility for his own
death and felt freer than the others to express his anger about the loss.
Parents are often distressed to discover that their child is playing out the trauma situation with other children. Children use play to examine, reexperience, and master traumatic events and to provide meaning for them. A child's interest in replaying out situations related to the trauma should not be squelched, though it may need to be structured. Depending upon the nature of the trauma, it is sometimes best to provide a protected setting for the child to do this play.
We'll discuss your response to your child's
traumatic play at the end of this chapter. Some parents feel comfortable
engaging in this play themselves, but others prefer to take their children to a
professional therapist so that the majority of this playing can occur in the
best possible environment. Here are some things that all parents should do if
their children have been through a traumatic experience.
Guidelines for Helping Traumatized
Children Recover
Your first goal is to make your traumatized child
feel safe again. You must help him feel that the traumatization is not going to
recur. This may mean taking behavioral precautions and/or reassuring him of
your awareness of and preparedness for the danger. Safety is his first
concern—little progress will be made until he feels that the trauma is not
going to recur. This may not mean anything more than speaking to him about his
feeling unsafe, but he needs to know that you're tuned in. It also helps to
reassure him that you will not ignore his perceptions of danger.
One night while Joey, a four‑year‑old
boy, and his sister Maggie, a six‑and‑a‑half‑year‑old
girl, were at home with a babysitter, a small fire broke out in the kitchen
that threatened to overtake the entire house. The babysitter handled the
emergency well, first getting the children outside and then calling the fire
department from a neighbor's house. The fire department came and put the fire
out. The children also handled it well at the time by being obedient to the
babysitter and remaining calm. But after several days, Joey began to express a
great deal of interest in fires and how people come to die in them. He began to
have sleep problems and obsessed about the many things that could happen to
him when his parents were absent. Later, separations started to become major
battles, and his mother contacted a therapist.
The therapist drew the family's attention to the
fire and suggested it may have traumatized Joey. His parents immediately took
a number of steps to deal with the boy's fear that another fire could occur,
especially when they were out. They installed smoke detectors, placed several
fire extinguishers in the house (including one in the kitchen), and practiced
fire drills. The beauty of their effort was that they did it all as a family. Everyone
came up with ideas, which included a family visit to the local fire station to
meet the firemen.
Joey's symptoms cleared up very quickly. He
personally dealt with the trauma in a number of ways, including playing with
toy fire engines with his father and sister. His parents remained firm about
separations. They acknowledged his fears but maintained that they had to be
away at times and that they would always make sure he would be safe with
someone while they were gone. But they took the possibility of fire very
seriously, and they treated the issue as a family problem—not as simply their
son's problem! I believe that because Joey felt his fears were taken very
seriously and was reassured, he was able to relinquish his less realistic
separation fears.
Reestablish Normalcy
One of the most important conditions that allows
your child to function at her maximum potential is a consistent, predictable
environment to live in. She requires consistency to be able to deal easily with
her external environment, but it is also necessary for the internal
contributions it makes to the development of her personality and the
maintenance of her psychological health. She places particular importance on
the image of herself that is reflected in the ways you deal with her. Your view
of her has a formative influence on her character, and if that view falters,
she will suffer.
Every traumatized child needs her own personal place
to return to, where she can feel secure. Here she feels most herself and has
the greatest chance of overcoming the effects of the traumatization. In order
to help her recreate a safe place, you must communicate your positive view of
her. You must communicate interest in hearing about the trauma and sympathy for
the overwhelming emotions, but you must also communicate that life hasn't
changed all that much, that she's still the same person and you expect her to
live by the same standards as before the trauma. You might say something like:
"Something terrible happened, but we love you just as much as ever, and
you still have to take a bath and go to bed on time." This is one of the
most reassuring messages your child can hear; now she can return to squabbling
with you over bedtimes.
Hear the Fears, But Bedtime Is Still
Bedtime
If your child doesn't feel secure, it may be
necessary to make changes in the old routines. If your child was bitten by a
stray dog, he may now refuse to go outside alone because he feels unsafe. Your
only response here is to accompany him outside. It would be wrong to put him back
into a situation where he genuinely feels unsafe—it doesn't build courage or
character or anything like that. But if he generalizes his fear to include
situations that are far afield of the unsafe one, he may be developing a
different kind of problem. He may refuse to leave your side at all, even in
the safety of home. Be clear in your response to him that you know what the
danger is and will see to it that he is safe from it. Help him distinguish
situations that have potential dangers from those that don't.
Most children react to trauma by becoming more dependent
upon their mother again, so a mother's job is to accept the increased
dependency and reassure the child that she is available. But her long‑term
goal is for the child to reattain separateness. She must take seriously the
child's fears, and change some rules and routines while insisting that others
remain the same. In the following example, the fears are accepted as
reasonable. The parents explain what they've done to address the real danger,
and they talk with their child about his fears, but they also communicate that
his fears don't alter the basic needs of the family. If you're in a similar
situation, you might try saying something like this:
"We're going to go out tonight and leave you
here with Aunt Leslie and Uncle Jerry. We've talked with them about what
happened when the man came into the house. The window he got in through is
barred up now, and no one can get in through there or any of the other windows.
Aunt Leslie and Uncle Jerry know that you're scared of being left alone again,
and they won't leave you alone at all. One of them will be with you all the
time. We're going to be at the Wilsons, and Aunt Leslie and Uncle Jerry have
the phone number there. We'll be home by 10:00 and we expect you to be asleep
by then."
If the child balks at being left with the relatives,
you can question him: "Don't you feel safe with Aunt Leslie and Uncle
Jerry? What do you think can happen? Would it help if you could talk to us? If
you want, we can call just before your bedtime and talk to you then. I know you
don't want us to go out, but Mommy and Daddy need to see their friends. We
wouldn't go if we didn't know for sure that you would be safe with Aunt Leslie
and Uncle Jerry. All the phone numbers are written down for you. Here's the
police number, the next door neighbor's, and here's the Wilsons', where we'll
be."
For some parents, the most difficult part of dealing
with their child's traumatization is retaining their view that the child is
psychologically all right. If you see your child as damaged and irrevocably
changed, you'll inevitably communicate this to him in the many subtle and
non-subtle ways we influence our children. And the more you communicate a view
that he's permanently damaged, the more you'll hamper his confidence that he
can overcome the blow. Even a physically impaired child must be seen as a whole
person who resides in a damaged body. The child may be inevitably changed in
ways that will restrict his future, but the soundness of his emotional life
does not have to be permanently destroyed.
You and your spouse must help each other get past
such fears so that you can provide the best possible environment for recovery.
If your fears persist, you should seek professional help for yourselves. A
fearful parent is not helping a fearful child; your child measures his
confidence in himself by his perception of your confidence in him.
You can reassure him by telling him something like:
"I know you're scared that it could happen again. But we've tried to make
sure it won't. We know that what happened was terrible and that you're still
scared. But you'll get over this thing, and you'll still be you. We still have
you, and you still have us. We love you just as much as we ever did, and now
that we know how this can happen, we'll do everything we can to see that it
never does. It's very scary, but you're still okay."
Maintain Your Own Emotional Stability
To a large degree, your child's sense of self
depends upon your confident view of her, but her continued sense of security
depends upon your confidence in yourself and your own stability. Your ability
to remain calm in the face of emotionally distressing experiences provides a
vital function for your child. In traumatic situations and their aftermath, she
gauges her security by her perceptions of your confidence. Do you appear
confident and in control of yourself, despite the frustrations and fears that
the situation evokes? Or do you display considerable anxiety and feelings of
helplessness and being overwhelmed? If you appear stable, in control, and not
overly worried, your child is much more likely to feel secure and to
reestablish her own confidence and competence in dealing with life.
Provide a Stable Recovery Environment
The first step toward providing the ideal recovery
environment involves your image of your child. You must recognize that your
child is not permanently damaged in the sense of being no longer able to deal
effectively with life. You must communicate this recognition based on your
actual belief that it is true. Come to terms with this! This belief alone will
provide an emotionally stabilizing influence on your child in which he can
begin to come to terms with what has happened to him. In addition, realizing
that it is true can help stabilize you.
We all know stories of children and adults who
successfully deal with the most terrible of physical disabilities. Every
individual who manages to make such an enormous adjustment is able to do so
because she still feels herself to be a whole person. The same holds true for
recovery from severe emotional trauma. Your child's ability to hold on to his
sense of himself as a whole person is primarily dependent upon his perception of
your perceptions of him.
Your second step is to convey your own emotional
stability to your child by remaining calm yourself. This doesn't mean that
you're never upset or unsure. Nor does it mean that you should present an
artificial "happy face" around your child that parodies your real
feelings. Rather, it simply means that you should make an effort to be steady
for your child when you're together. You can discuss his fears and your own
assessment of the dangers that may exist, but the central issue is that you
must not burden him with your own fears. For your own emotional support, you
must go elsewhere. You can be close to your child, but, above all else, he
shouldn't be made to feel he must reassure you. If you need to "fall
apart," do so at a time and place to which your child won't have access.
It's best if you have someone else to do this with. It will relieve your
temptation to use your child as an emotional confidant. If you don't have a
spouse, do everything possible to find adult emotional supports for yourself!
I recommend that you talk with your child about her traumatic experience. But you should realize that it will probably not go as it would with an adult. Your child may not be willing to talk about it in the setting or at the time your schedule dictates, nor in the same way. The timing and pacing will be largely determined by your child. She may not talk about it at all, but expresses it through other means, such as in art or play. You must be open to these alternative modes of "discussing" the trauma. You can ask about it, but don't force her to talk if she isn't ready. Instead, let her know you're a willing audience, and be prepared to stop and try to understand whenever she expresses something related to the trauma.
One of the frustrations of dealing with traumatized
children is that they often cannot tell us what we feel we need to know. Some
parents pressure their children to talk about the trauma. If you find yourself
doing this, you should realize that it does more harm than good. Despite your
own feelings of helplessness, you must respect your child's style of dealing
with the trauma (even if it's nonverbal) and work with it, not against it. A
child constantly questioned about the trauma is likely to feel that she's done
something wrong and/or that she's still not safe.
If she's able to discuss it calmly, it's all right
to ask her questions to make sure you know everything she can tell you about
it. But, if you question her endlessly because you never feel that you know
enough, she can come to feel persecuted. In any event, your child may never tell you everything you would like
to know. Young children have a poor ability simply to recall events; their
memories work better at recognition than
at recall. That's why your kindergartener gives monosyllabic answers when you
ask about her day. She really doesn't recall much about it. Yet later, she
sings a new song or tells you detailed stories that give you an idea of how
much she did learn. These memories aren't forgotten—they don't emerge until
something stimulates them. She hasn't developed the adult's tricks of
organizing memories so that they can be retrieved easily.
Help Your Child Sort Out the Feelings
It is helpful to know the facts. Unfortunately, many
traumatized children cannot supply adults with adequate information. Children
who have been abused are often sworn to secrecy and fear retribution or getting
their abusers in trouble. If you were present during the trauma, your factual
knowledge won't be a problem. But if you were absent, you can easily become
obsessed with your need to know exactly what happened, particularly if the
trauma was recurring.
What's more important, however, is to learn how your
child felt and continues to feel about the incident. Probe gently by saying
something like: "It can be very confusing to have something happen like
you've been through. We often don't know how we really feel after something
like that. Some children would be scared, but others would be angry. How did it
make you feel? Sometimes we feel one way at the time, and then we feel another
way afterward. Do you remember how you felt at the time? What about now? How
do you feel about what happened?"
Responding to the Traumatic Play
When your child expresses something trauma‑related
in his play, the best response you can make is to show that you recognize the
message and to comment about the feelings involved. This is your opportunity to
learn how he feels and help him sort it out for himself. For example, if a dog‑bitten
child draws a dog biting a boy, you may talk about his being scared, but you
may discover that he also feels angry or guilty. You may not know what feelings
he ascribes to the dog—was the dog angry or scared? The child often doesn't
know himself and is looking to you for help.
The following approach would be helpful to the
child: "Oh, that doll's hitting the other doll with the baseball bat. Does
that mean he's angry? I guess that's why people hit other people. I wonder how
the doll feels about being hit. She probably feels pretty bad. She probably
doesn't understand why someone would hit her like that. Maybe she's angry
too. Or maybe she's just afraid she'll get hit again. What do you think?"
You don't have to be a professional therapist to
talk to your child about the feelings he's experiencing. It's very helpful for
him just to have his feelings recognized and validated with words like:
"You're scared, I would be too." The most
damaging feelings are those that are never discussed. The child then lives alone
with emotions that are overwhelming to him. If you're not certain what your
child is feeling, ask about possible feelings, such as: "Maybe you're
angry that we didn't prevent this from happening."
This chapter has focused on the child who's been
traumatized directly. But as I indicated in Chapter 3, the effects of trauma
touch all members of a family. Hence, even when the trauma occurred to an
adult, the children are affected. Some of the things I've had to say in this
chapter certainly hold true for that situation as well, particularly the need
for the parents to maintain their own emotional stability for the children. But
there's another whole level of recovery in which you can help your entire
family, regardless of whether the survivor is a child, an adult, or the entire
family. That level is when you do things as a family to deal with your trauma,
which is the focus of Chapter 10. Dealing with a family member's traumatization
as a family can bring the family together as they've never been before.