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Invisible Wounds of Deeply Hurting Children

Guest Blogger—Dr. David A. Crenshaw, is a highly credentialed and respected clinical psychologist who for more than 30 years has dedicated his career, Center, books, videotape, projective techniques, and leadership to helping defiant, oppositional, aggressive children.


By Dr. David A. Crenshaw, PhD

A fawn at the edge of the woods watches with a wary eye. Any sudden movement is likely to startle and send the fawn scurrying into the woods. If, however, you don’t approach and be still the fawn may cautiously move a step closer. Children who are hurting deep inside from invisible, but very real wounds are like a fawn on the edge of the woods. They fear being hurt again. They don’t dare approach because they fear that you will add to their pain. As much as they desire the contact, it will not be easy to convince them. Basic trust in some of these children was never established. They did not experience early in life what all children need to develop a sense of security, safety, and trust. They did not experience being cared for, loved, protected and nurtured. Some children do not get this at all, others unpredictably and inconsistently. The moments of nurture and love may be interspersed with anger or cold indifference.

A small group of children experience life as a horror show.  These are the repeatedly abused, often deprived and severely traumatized children who undergo multiple out-of-home placements. Their sense of trust is shattered. These are the children who typically make up the population of today’s residential treatment centers. For these children allowing a modicum of closeness with even the most warm and friendly adult is taking a monumental risk.

Sociocultural Trauma

The work of Kenneth V. Hardy, Director of the Eikenberg Institute for Relationships and Professor of Marriage and Family Therapy at Syracuse University and of James Garbarino at Loyola University advocate for a more  complex understanding of severely aggressive children; not to simply view them as “bad kids.”   When the layers are peeled away what emerges are glimpses of deeply hurting children, who have suffered multiple, profound losses, and all too frequently traumatic losses.  Hardy1 stated that the complex underlying emotional process that is at the core of the child’s aggressive acting-out needs to be appreciated. Unless the losses, the trauma events are faced, the treatment will consist of putting balm on the wounds, but there will be no healing.

Dehumanized Loss

The invisible wounds2,3 so often unrecognized by others and unacknowledged even by the child are thus trivialized and devalued.  The disenfranchised grief of children4 is a result of the cumulative effect of multiple losses never attended to and the unexpressed, buried grief of children that is not recognized, supported or facilitated by the care taking adults.  The end result of such ignored and unsupported grief is often loss of capacity to feel; what Hardy2 refers to as dehumanized loss.  Dehumanized loss plays a central role in the cycle of violence since the inability to feel one’s own pain can result in extreme cases in the child’s loss of the capacity to feel for the pain inflicted on others.

The Emotionally Focused Therapeutic Work

To restore a child’s capacity for empathy with his or her own pain and for the pain of others requires intense, in-depth emotionally focused work.1,2,3,5 This is not short-term work and there are no quick fixes. It involves engaging all the relevant systems impacting on the child and family. It will not be enough to engage the family. The larger systems of school, community, social service, and courts, will all have to be integrated in the provision of services in order for meaningful intervention to occur. Without a safety net of support, regular and reliable communication between service providers, the child and/or family will fall through the cracks. The pressures on these systems to meet an ever expanding level of need, to serve more seriously impaired individuals and families, and the human and emotional toll that this work can exact poses the risk that the systems designed to provide care becomes dehumanized as well.

The Traumatized Child Within

Garbarino6 reminds us that whenever he has interviewed a youth who has committed a violent crime he almost always finds an untreated traumatized child. To provide the intensive treatment that these children and families need, as many studies5 have indicated, will in the long run result in huge cost savings to society.  Furthermore, by making this commitment to providing the intensive services needed to the most vulnerable of our citizens it will be a step towards reversing the insidious devaluing process that results from making the mental health treatment of socioculturally traumatized children in our society a low priority.

The art of healing fawns in gorilla suits requires not taking their anger personally, but realizing anger is how they protect themselves.  They hurt deep inside from invisible, yet very real wounds.  To help such children feel safe, become trusting, and deal with intense emotions, Dr. Crenshaw developed special play therapy techniques.  He teaches his techniques to clinicians, school personnel, and others who work with angry children.


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  1. Hardy, K.V. (2003). Working with aggressive and violent youth. Psychotherapy Networker Symposium. Washington, DC
  2. Hardy, K. V. & Laszloffy, T. (2005). Teens who hurt: Clinical interventions to break the cycle of violence. New York: Guilford Press.Crenshaw, D.A. & Mordock, J.B. (2005a). Handbook of play therapy with aggressive children. Northvale, NJ: Jason Aronson.
  3. Crenshaw, D.A. & Hardy, K.V. (2005). Understanding and treating the aggression and violence of traumatized youth in out-of-home care. In N. Boyd-Webb (ed.),Traumatized youth in child welfare, pp. 171-195. New York: Guilford Press.
  4. Crenshaw, D. A. (2002). Disenfranchised grief of children. In K. J. Doka (ed.), Disenfranchised grief: New directions, challenges and strategies for practice (pp. 293-306). Champaign, IL: Research Press.
  5. Crenshaw, D.A. & Mordock, J.B. (2005b). Understanding and treating the aggression of children: Fawns in gorilla suits.  Northvale, NJ: Jason Aronson.
  6. Garbarino, J. (1999). Lost boys: Why our sons turn violent and how we can save them. New York: Anchor Books, A Division of Random House.
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