Tragically, another school mass shooting just occurred in the U.S. It’s natural for mental health experts to assist the youngsters and their families to help deal with the horrific experience. However, research from similar traumatic events has demonstrated that rushing in to “debrief” people after trauma with an unfamiliar counselor is often intrusive, unwanted, and may actually be counterproductive. In fact, some studies have found that such immediate “treatment” doubles the odds of a person developing post-traumatic stress disorder.
Bruce Perry M.D, Ph.D., author and founder of the ChildTrauma Academy writes in his book, The Boy Who Was Raised as a Dog and Other Stories from a Child Psychiatrist’s Notebook:
In some of our own work we’ve also found the most effective interventions involve educating and supporting the existing social network, particularly the family, about the known predictable effects of acute trauma and offering access to more therapeutic support if — and only if — the family sees prolonged post-traumatic symptoms.”
In the book, Perry demonstrates that the most effective way to help a child deal with trauma is anything that increases the quality and number of relationships in their life.
What Is Most Important Following Childhood Trauma
While children do need attentive care after a traumatic event, Dr. Perry advises that what they need most of all is consistency, routine, and familiarity. He personally helped counsel the children after the Branch Davidian tragedy in Waco, Texas. The children who made it out lost their fathers, mothers, brothers, sisters, and friends — virtually everyone they knew — in an apocalyptic ball of fire just like their leader had predicted. They were traumatized by the deaths and again because they were programmed to believe that the people trying to help them were the “bad guys.” Perry writes:
The Branch Davidian children who had the best outcomes were not those who got the most therapy, were the least stressed, or were removed from relatives who continued to follow David Koresh’s religion. Instead, they were the ones who had the strongest, healthiest support systems, regardless of their religious beliefs.”
He continues about trauma, in general:
What works to heal them [children] is anything that increases the number and quality of a child’s relationships. We’ve found that what helps is consistent, patient, repetitive loving care. What does not work is well-intentioned but poorly trained mental health ‘professionals’ rushing in after a traumatic event, or coercing children to ‘open up’ or ‘get out their anger out.’
Trauma Shatters Human Connection
Trauma and a person’s response to it cannot be understood outside of the context of human relationships. Whether people have survived a school shooting, natural disaster, or sexual abuse, traumatic experiences affect their relationships the most — with loved ones, with themselves, and with the world. All trauma involves the shattering of human connections at a deep level. And this is especially true for children.
Being hurt or abandoned by the people that are supposed to love you, being harmed by a random stranger in a world you trusted, or being deprived of the one-on-one caring relationships that allow a child to feel safe and valued and become an empathetic adult are profoundly destructive experiences. Humans are social beings and our brains develop within the context of our relationships. Hence, the most damaging things that can happen to a person involve relationships.
Trauma Changes a Child’s Brain
Trauma can actually alter the function of a child’s brain during a stressful event and result in lasting changes in specific brain regions after. These alterations can impair cognitive function and memory encoding and recall in the moment and future. Basically, when a person has a traumatic experience, it can change how their brain responds to stress.
We often think of trauma as some major, adverse life experience, like abuse or a school shooting. Unfortunately, common life experiences can be traumatic. In reality, trauma can come from almost anything. Any experience that makes a child feel unsafe, physically or emotionally, or disrupts the way they cope or function qualifies. Everyday life occurrences, such as the ones below, can have a traumatic impact on a person:
- not having emotional needs acknowledged or met
- poverty and not having physical needs met
- bullying or harassment
- witnessing violence or crime
- a loved one’s substance abuse
- the mental illness of someone close to you
- parental separation or divorce
- the death of a pet or close person
- incarcerated household member
Healing Trauma Is About Healthy Relationships
I find it comforting to remind myself that, while trauma does change the brain, healing does too. And healing is entirely possible.
Recovery from trauma is also about relationships — rebuilding trust, regaining confidence, finding a sense of security, and reconnecting to love. While medications can and do help relieve some of the physical symptoms of trauma and talking to a mental health professional can be very useful, healing and recovering are impossible — even with the best medications and therapy — without lasting, caring connections to other people.
Researchers have found that adults outside of the home, such as mentors, coaches, pastors, teachers, and school counselors, can have a healing impact on the life of children who have had traumatic experiences. Researchers from Harvard University’s Center on the Developing Child determined that the single most common factor for children who develop resilience after trauma is at least one stable and committed relationship with a supportive parent, caregiver, or other adult.
How to Help a Traumatized Child Heal
In a publication released by The ChildTrauma Academy, founded by Bruce D. Perry, M.D., Ph.D. , Helping Traumatized Children: A Brief Overview for Caregivers, Perry outlines the following guidelines in the “How Can I Help” section.
Don’t be afraid to talk about the traumatic event.
Children do not benefit from “not thinking about it” or “putting it out of their minds”. If a child senses that his/her caretakers are upset about the event, they will not bring it up. In the long run, this only makes the child’s recovery more difficult. Don’t bring it up on your own, but when the child brings it up, don’t avoid discussion, listen to the child, answer questions, and provide comfort and support. We often have no good verbal explanations, but listening and not avoiding or over-reacting to the subject and then comforting the child will have a critical and long-lasting positive effect.
Provide a consistent, predictable pattern for the day.
Make sure the child has a structure to the day and knows the pattern. Try to have consistent times for meals, school, homework, quiet time, playtime, dinner and chores. When the day includes new or different activities, tell the child beforehand and explain why this day’s pattern is different. Don’t underestimate how important it is for children to know that their caretakers are ‘in control.’ It is frightening for traumatized children (who are sensitive to control) to sense that the people caring for them are, themselves, disorganized, confused and anxious. There is no expectation of perfection; caretakers themselves have often been affected by the trauma and may be overwhelmed, irritable or anxious. If you find yourself being this way, simply help the child understand why, and that these reactions are normal and will pass.
Be nurturing, comforting, and affectionate, but be sure that this is in an appropriate ‘context.’
For children traumatized by physical or sexual abuse, intimacy is often associated with confusion, pain, fear and abandonment. Providing a hug, a kiss and other physical comfort to a young child can be very reassuring. A good working principle for this is to be physically affectionate when the child seeks it. When the child walks over and touches you, return in kind. The child will want to be held or rocked – feel free. On the other hand, try not to interrupt the child’s play or other free activities by grabbing them and holding them. Further, be aware that many children from chronically distressed settings may have what we call attachment problems. They will have unusual and often inappropriate styles of interacting. Do not tell or command them to ‘give me a kiss’ or ‘give me a hug.’ Abused children often take commands very seriously. It reinforces a very malignant association linking intimacy/physical comfort with power (which is inherent in a caregiving adult’s command to ‘hug me’).
Discuss your expectations for behavior and your style of ‘discipline’ with the child.
Make sure that there are clear ‘rules’ and consequences for breaking the rules. Make sure that both you and the child understand beforehand the specific consequences for compliant and non-compliant behaviors. Be consistent when applying consequences. Use flexibility in consequences to illustrate reason and understanding. Utilize positive reinforcement and rewards. Avoid physical discipline.
Talk with the child.
Give them age appropriate information. The more the child knows about who, what, where, why and how the adult world works, the easier it is to ‘make sense’ of it. Unpredictability and the unknown are two things which will make a traumatized child more anxious, fearful, and therefore, more symptomatic. They may be more hyperactive, impulsive, anxious, and aggressive and have more sleep and mood problems. Without factual information, children (and adults) ‘speculate’ and fill in the empty spaces to make a complete story or explanation. In most cases, the child’s fears and fantasies are much more frightening and disturbing than the truth. Tell the child the truth, even when it is emotionally difficult. If you don’t know the answer yourself, tell the child. Honesty and openness will help the child develop trust.
Watch closely for signs of re-enactment (e.g., in play, drawing, behaviors), avoidance (e.g., being withdrawn, daydreaming, avoiding other children) and physiological hyper-reactivity (e.g., anxiety, sleep problems, behavioral impulsivity).
All traumatized children exhibit some combination of these symptoms in the acute post-traumatic period. Many exhibit these symptoms for years after the traumatic event. When you see these symptoms, it is likely that the child has had some reminder of the event, either through thoughts or experiences. Try to comfort and be tolerant of the child’s emotional and behavioral problems. These symptoms will wax and wane – sometimes for no apparent reason. The best thing you can do is to keep some record of the behaviors and emotions you observe (keep a diary) and try to observe patterns in the behavior.
Protect the child.
Do not hesitate to cut short or stop activities that are upsetting or re-traumatizing for the child. If you observe increased symptoms in a child that occur in a certain situation or following exposure to certain movies, activities and so forth, avoid these activities. Try to restructure or limit activities that cause escalation of symptoms in the traumatized child.
Give the child ‘choices’ and some sense of control.
When a child, particularly a traumatized child, feels that they do not have control of a situation, they will predictably get more symptomatic. If a child is given some choice or some element of control in an activity or in an interaction with an adult, they will feel safer, comfortable and will be able to feel, think and act in a more ‘mature’ fashion. When a child is having difficulty with compliance, frame the ‘consequence’ as a choice for them – “You have a choice – you can choose to do what I have asked or you can choose…..” Again, this simple framing of the interaction with the child gives them some sense of control and can help defuse situations where the child feels out of control and therefore, anxious.
If you have questions, ask for help.
These brief guidelines can only give you a broad framework for working with a traumatized child. Knowledge is power; the more informed you are, the more you understand the child, the better you can provide them with the support, nurturing and guidance they need. Take advantage of resources in your community. Each community has agencies, organizations and individuals coping with the same issues. They often have the support you may need to help you.
Trauma, Brain, & Relationship: Helping Children Heal
I encourage you to watch this very informative video, Trauma, Brain & Relationship: Helping Children Heal, featuring Bruce Perry, M.D., Daniel Siegel, M.D., Marti Glenn, Ph.D., Jeanne Segal, Ph.D., Bryan Post, and other renowned experts in the field of childhood trauma, and attachment and bonding. It summarizes our understanding of how trauma affects children’s behaviors and social relationships.