Traumatized Child | Kay Trotter

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All Posts Tagged: Traumatized Child

Boston Marathon Bombing Helping Children Cope

Boston bombing 4-15013

After yesterdays (April 15, 2013) trauma events at the Boston Marathon its important for adult and parent to know how to help children reeling from the aftermath of the Boston Marathon Bombing especially since many children are easily overwhelmed with fear. In response to a  some children react with severe emotional responses — fear, grief, post-traumatic stress. Moreover, such experiences and other events that threaten a child’s sense of worth and well-being can produce intense personal distress.

Until things calm down after yesterdays bombing, it will be normal for your child to show signs of worry and fear. They may have trouble eating or sleeping.

Two weeks from now, if your child still isn’t eating or sleeping normally, or shows other warning signs such as extreme irritability, melancholy, lethargy and reluctance toward or fear of activities he or she once enjoyed, call your pediatrician or seek counseling for your child.

Its important for parents to create a sense of safety for your children 

Provide Caring and Support – Listen to your child’s concerns and answer their questions in direct, factual, age-appropriate ways. (Be careful of giving TOO MUCH information, especially with younger children.)

Children around 5 and younger don’t need to know. Very young children will only recently have mastered the skills of walking and talking, and they may not be able to express their anxieties and fears. Although you may think they are too young to understand what is happening, even very young children can absorb frightening events from the news or from conversations they overhear. Don’t let them watch news stories while they’re in the room. Wait for them to ask about what happened. If they don’t ask, continue business as usual.

Older children are likely to ask questions. You can initiate a conversation by saying, “I know you’re hearing and seeing a lot about what happened at the Boston Marathon bombing. How does this make you feel?” Or select pictures in a book or ask the children to draw pictures to express feelings. Then talk about the pictures. Take the lead from the child as to how much they need to talk about and know about the situation. Keep answers to questions simple, giving only what is needed.

Listen to comments of children as they play. 

Are there clues here that need further conversation?

When there is a situation outside of the home that is frightening, limit the amount of news your children watch or listen to. You don’t need to hide what’s happening in the world from your children, but neither do they have to be exposed to constant stories that fuel their fears. Children may have trouble distinguishing between TV shows that blow up buildings, and the factual news reports of a tragic event. Explain, “Yes, this really did happen. It is a sad time, but we will come through it.”

Realize that extra stresses may heighten normal daily stresses. Your children might normally be able to handle a failed test or teasing, but be understanding that they may respond with anger or bad behavior to stress that normally wouldn’t rattle them. Reassure them that you just expect them to do their best.

Two main questions children are likely to think about, whether they actually ask them or not, are: “Could this happen to me or to someone I love?” Remember that a young child cannot understand, “We just have to trust in God.” They trust in parents, and parents are supposed to protect them. So, while the answers are never easy, again try to keep them simple. “We don’t expect this to ever happen to you or anyone you love. You are always loved and have a loving circle of family and friends.” People sometimes choose to do bad things.”

Be careful what you say in front of children. Keep your emotions in check. If we are lamenting the state of the world and saying things like “I’m afraid to go anywhere anymore,” children will start to feel the world is indeed a scary place.

Expressing Feelings – Provide opportunities for your child to express their feelings. Use toys, puppets, books, music, water play, play dough, painting, and puzzles (creating order out of chaos). Let your child know that you have some of the same feelings they have. Be honest about your feelings, but temper them. Encourage your child to communicate their thoughts and feelings. But balance is again the key: Don’t let the talk escalate and overwhelm children.

Provide Opportunities for Meaningful Participation – Help your child come up with ways they can address the crisis themselves: i.e., raising money, sending cards and letters, forming a Peace Club. Participation gives children a sense of purpose and competence in their own lives and a belief that they can make a positive impact on their own lives and influence and change the lives of others – their peers, family and community.

Increase Pro-social Bonding – Provide your child with positive activities to do together that give them a sense of purpose and mastery in the situation.   Through mastery – a child develops self-efficacy by mastering their environment and learning that what he/she does makes a difference in the world.

Set Clear, Consistent Boundaries – Strike a balance between addressing concerns and getting back to a normal schedule. Boundaries are important to children because they give clear messages about what’s expected. Children need the safety of familiar rules and routines.

Set and Communicate High Expectations – Express your certainty that your child can cope with the situation and faith in their strength and inner resources.  When children have clear, consistent boundaries and high expectations, the are more likely they are to grow up healthy, because boundaries and expectations provide children with the support they need.

CHILDREN REACT DIFFERENTLY AT DIFFERENT AGES

In a crisis, children have similar feelings to adults. They often show their feelings in actions rather than words.

1–4 years: Thumb-sucking, bedwetting, fear of the dark, clinging to parents, nightmares, not sleeping or broken sleep, loss of bladder or bowel control, speech or feeding problems, fear of being left alone, irritable, fretful

5–10 years: Aggression, confusion, competing for attention, avoiding school, nightmares, poor concentration, tummy aches, headaches, fear of the dark, fear of being hurt or left alone

11–13 years: Changes in appetite, broken sleep, antisocial behavior, school problems, anxiety, aches and pains, skin problems, fear of losing friends and family, acting as if it hasn’t happened.

14–18 years: Physical problems (rashes, bowel problems, asthma attacks, headaches), changes in appetite and sleep, lack of interest in things they usually enjoy, lack of energy, antisocial behavior, poor concentration, guilt. Some of these are part of the ups and downs of this age too.

Here are some helpful books to ready to children

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A Terrible Thing Happened – A story for children who have witnessed violence or trauma

When Dinosaurs Die: A Guide to Understanding Death

 Tear Soup: A Recipe for Healing After Loss

 

If you would like Dr. Kay Trotter to come talk to your group you can contact her at: Kay@KayTrotter.com or 214-499-0396.

Dr Trotter also post regularly in her FaceBook fan page http://www.facebook.com/DrKaySudekumTrotter.

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Create a Sense of Safety After a Crisis

Child in crisisWhen reeling in the aftermath of the Connecticut school shooting, many children are easily overwhelmed with fear. In response to a crisis some children react with severe emotional responses — fear, grief, post-traumatic stress. Moreover, such experiences and other events that threaten a child’s sense of worth and well-being can produce intense personal distress.

Until things calm down after yesterdays school shooting, it will be normal for your child to show signs of worry and fear. They may have trouble eating or sleeping.

Two weeks from now, if your child still isn’t eating or sleeping normally, or shows other warning signs such as extreme irritability, melancholy, lethargy and reluctance toward or fear of activities he or she once enjoyed, call your pediatrician or seek counseling for your child.

CREATE A SENSE OF SAFETY 

Provide Caring and Support – Listen to your child’s concerns and answer their questions in direct, factual, age-appropriate ways. (Be careful of giving TOO MUCH information, especially with younger children.)

Children around 5 and younger don’t need to know. Very young children will only recently have mastered the skills of walking and talking, and they may not be able to express their anxieties and fears. Although you may think they are too young to understand what is happening, even very young children can absorb frightening events from the news or from conversations they overhear. Don’t let them watch news stories while they’re in the room. Wait for them to ask about what happened. If they don’t ask, continue business as usual.

Older children are likely to ask questions. You can initiate a conversation by saying, “I know you’re hearing and seeing a lot about what happened at the school in Connecticut. How does this make you feel?” Or select pictures in a book or ask the children to draw pictures to express feelings. Then talk about the pictures. Take the lead from the child as to how much they need to talk about and know about the situation. Keep answers to questions simple, giving only what is needed.

Listen to comments of children as they play. Are there clues here that need further conversation?

When there is a situation outside of the home that is frightening, limit the amount of news your children watch or listen to. You don’t need to hide what’s happening in the world from your children, but neither do they have to be exposed to constant stories that fuel their fears. Children may have trouble distinguishing between TV shows that blow up buildings, and the factual news reports of a tragic event. Explain, “Yes, this really did happen. It is a sad time, but we will come through it.”

Realize that extra stresses may heighten normal daily stresses. Your children might normally be able to handle a failed test or teasing, but be understanding that they may respond with anger or bad behavior to stress that normally wouldn’t rattle them. Reassure them that you just expect them to do their best.

Two main questions children are likely to think about, whether they actually ask them or not, are: “Could this happen to me or to someone I love?” Remember that a young child cannot understand, “We just have to trust in God.” They trust in parents, and parents are supposed to protect them. So, while the answers are never easy, again try to keep them simple. “We don’t expect this to ever happen to you or anyone you love. You are always loved and have a loving circle of family and friends.” People sometimes choose to do bad things.”

Be careful what you say in front of children. Keep your emotions in check. If we are lamenting the state of the world and saying things like “I’m afraid to go anywhere anymore,” children will start to feel the world is indeed a scary place.

Expressing Feelings – Provide opportunities for your child to express their feelings. Use toys, puppets, books, music, water play, play dough, painting, and puzzles (creating order out of chaos). Let your child know that you have some of the same feelings they have. Be honest about your feelings, but temper them. Encourage your child to communicate their thoughts and feelings. But balance is again the key: Don’t let the talk escalate and overwhelm children.

Provide Opportunities for Meaningful Participation – Help your child come up with ways they can address the crisis themselves: i.e., raising money, sending cards and letters, forming a Peace Club. Participation gives children a sense of purpose and competence in their own lives and a belief that they can make a positive impact on their own lives and influence and change the lives of others – their peers, family and community.

Increase Prosocial Bonding – Provide your child with positive activities to do together that give them a sense of purpose and mastery in the situation.   Through mastery – a child develops self-efficacy by mastering their environment and learning that what he/she does makes a difference in the world.

Set Clear, Consistent Boundaries – Strike a balance between addressing concerns and getting back to a normal schedule. Boundaries are important to children because they give clear messages about what’s expected. Children need the safety of familiar rules and routines.

Set and Communicate High Expectations – Express your certainty that your child can cope with the situation and faith in their strength and inner resources.  When children have clear, consistent boundaries and high expectations, the are more likely they are to grow up healthy, because boundaries and expectations provide children with the support they need.

CHILDREN REACT DIFFERENTLY AT DIFFERENT AGES

In a crisis, children have similar feelings to adults. They often show their feelings in actions rather than words.

1–4 years: Thumb-sucking, bedwetting, fear of the dark, clinging to parents, nightmares, not sleeping or broken sleep, loss of bladder or bowel control, speech or feeding problems, fear of being left alone, irritable, fretful

5–10 years: Aggression, confusion, competing for attention, avoiding school, nightmares, poor concentration, tummy aches, headaches, fear of the dark, fear of being hurt or left alone

11–13 years: Changes in appetite, broken sleep, antisocial behavior, school problems, anxiety, aches and pains, skin problems, fear of losing friends and family, acting as if it hasn’t happened.

14–18 years: Physical problems (rashes, bowel problems, asthma attacks, headaches), changes in appetite and sleep, lack of interest in things they usually enjoy, lack of energy, antisocial behavior, poor concentration, guilt. Some of these are part of the ups and downs of this age too.

For more information on crisis response and counseling, check out these resources:

How parents can help children through traumatic events

Roles Play Therapist plays Post-Disaster Engagement and Empowerment of Survivor

The Teachers Role When Tragedy Strikes

Here are resources that I find helpful for talking to children about violence and death: 

The American Academy of Pediatrics on School Shootings

University of Minnesota on Talking to Kids About Violence Against Kids

National Association of School Psychologists on Talking to Children About Violence

What I consider to be one of the best articles on talking to children about death (by Hospice)

Explaining the news to our kids from Common Sense Media.

If you would like Dr. Kay Trotter to come talk to your group you can contact her at: Kay@KayTrotter.com214-499-0396, or visit her web site http://www.KayTrotter.com.

Dr Trotter also post regularly in her FaceBook fan page http://www.facebook.com/DrKaySudekumTrotter.

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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.

FAWNS IN GORILLA SUITS

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.

Resources

Rhinebeck Child and Family Center, LLC

Books – DVD’s – Consulting – Training

www.childtherapytechniques.com/

References

  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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