Trauma

Trauma

If ten people are involved in a car accident, it is likely that a couple will walk away and be unaffected, about six will be unhappy for a little while and get over it and move on with their lives and a couple will be seriously affected in the longer term. They may experience specific or generalised anxiety, bad dreams or nightmares, flashbacks etc. A trauma is whatever feels like a trauma to the child or adult.  Sometimes a child will overhear and misunderstand and then worry to the point that others notice. Children may mis-interpret an event and be fearful of it happening again. They may generalise wildly and believe that now their grandparents have been burgled, it will happen to them. If a friend was involved in a minor car accident, they may worry that every car journey poses a risk. How do you understand what is happening and help the child to get things back into perspective? How can you help your child to deal realistically with some of the bad things that might happen?’

Most people’s lives run quite smoothly most of the time. However, sometimes things go wrong – you only have to read a newspaper to realise that, sometimes, unfortunate things happen to families. Be it a car accident, a robbery, an illness, something bad happens. It is unclear when an ‘adverse event’ can affect a child. There is some research showing that stress in a pregnant woman can affect the physiology of the baby, but this research is still in the very earliest stages. Some believe babies are affected by birth trauma – which seems possible but is not easy to prove.  Certainly, I am aware of one child who was carrying the burden of an accident he suffered at thirteen months, and toddlers have been badly affected by operations before their second birthday. This is significant because a very young child is unable to articulate their fears and memories. He is unable to describe it in words later.  The child is affected by what he perceives to have happened. This may or may not be the same understanding that adults have of the event, but is a very real experience for the child.

The effect of a traumatic event on a child is variable as it is for an adult.  Remember the ten people involved in a serious car accident for example. Two might seem totally untouched, six will be affected for a little while and two may be affected for a long time, perhaps even suffering from Post Traumatic Stress Syndrome. Three brothers who hear that their Grandmother’s house has been burgled may be fine, the fourth may have significant difficulties. Similarly, siblings might be in the car driven by their mother when it is hit by a bus, but only one will have trouble thereafter.

All children may show some adverse response in the short-term. Some sort of regression is common where the child returns to an earlier, younger, state perhaps wetting the bed again, needing a lot of physical reassurance, lots of comfort, and are perhaps very clingy and anxious about the whereabouts of their carers.  Some children refuse to go and play with other children and become reclusive. Some children don’t want to go to school and leave you. Some worry constantly about ‘What if ????’.  Some children withdraw and become frighteningly quiet, or refuse to talk about the event at all – though clearly worrying.  Children may exhibit a range of responses and these might be inconsistent, so that the child seems fine for much of the time. And children can be similarly affected by extreme events presented in the media – many children were traumatised by 9/11, by the school siege in Belsan, Russia and by the Boxing Day Tsunami.

What can you do to help?

Always let school or other significant people know that something has happened to distress the child. I have seen children who began to steal after a parent left – school were quite unaware that this child needed gentle handling. Another child needed constant reassurance after a burglary, since he felt guilty that he wasn’t there to protect his mother. Another was anxious lest he soil himself after his father died – the boy was 12 – but school allowed him to leave the room as soon as he felt the need, and he got through it. If school, or childminders or youth leaders are unaware that the child is having a difficult time, they can neither make allowances when necessary, nor let you know when the problem intensifies or eases.  Reassure the child that Accidents are very rare. This event is a one-off, Burglars hardly ever return. It is important to tell the truth but also to stress that any recurrence is unlikely. I saw a boy who’d been beneath a very large tree when it fell, and narrowly avoided being crushed; another had been in a house that caught fire when struck by lightening. Both were absolutely terrifying events but unlikely to recur for them.

Your child is more likely to respond to your reaction to the event than to the experience itself. Most children have little idea of the probability of any event – how many adults, even, are aware that one is significantly more likely to win a National Lottery [the Big One] than to be hurt in a plane crash!!! If parents are frightened that the burglars might return, then that is something to be really frightened of. Try not to show undue fear. Explain what precautions you are taking to prevent a recurrence, don’t allow the children to hear others emphasising the negative aspects of the event. Don’t make promises you can’t keep. Do not promise you will always come back – things happen. BUT you can promise to do everything you can to live for ever. Give your child plenty of reassurance and cuddles and closeness for some time after a traumatic incident.  Then be ready to move on. Make sure your child has your mobile/cell phone number and is allowed to phone you a couple of times a day for a little while, if this helps; allow him to sleep with you for a few days but then move him back to his room . Stay there for a few days before moving out of the bedroom, and so on. Take things easy, but move on.

Emotional Freeing Technique

A very helpful technique in the immediate aftermath of a disturbing event is Emotional Freeing Technique. See:  http://eftuniverse.com/ There are many reports of this being used after, say, the Bali bombing, car accidents etc and being really helpful.  The technique requires you or the child himself to tap on various acupressure points on the child, talking or allowing the child to tell you about what happened.  If the technique is used very soon after the event, it can minimise the chance of things becoming difficult – if used some time later, it is probably better done in conjunction with other things. Get in touch and we can explore this together. Therapists who use the technique are available world-wide if you would feel happier using someone with experience, but the web site is largely self-explanatory.  EFT asks that you rub both Karate Chop points [on the edge of the hand, below the little finger] together, saying something like ‘Even though this horrible accident happened, I like me very much and I’m amazing’, and then talk through what happened while Tapping five or six times on the following acupressure points : in the middle of the top of your head, above the eyebrow by the nose, by the side of the eye, under the eye on the eye socket, under the nose, on the chin just beneath the collarbone, about one inch out from the middle under the arm where the bra would be. And then you follow the whole tapping sequence again to the Karate chop point.

The whole thing takes less than five minutes. At first, as the Carer, You talk about what happened but pause and Tap for longer if the child becomes anxious or thoughtful at certain points in the story. You will note that more details return to you and the child as you tell the story, and it is often the recall of these memories that will stop the event being traumatic. Use your common sense to decide how well it is going and how long you want to continue for – ten minutes will be more than enough for a young child, when he wants to go and play, allow it.  Always be alert to your child.

When doing this sort of work, you often find  that the child is anxious about something you had barely considered as a problem. Allow your child to lead you.

Most recently I have met children traumatised by a very significant accident, by the manner in which a nurse introduced a needle to him for an injection when he was 5,  and another who was worried that the next oeration might kill her. For all of these, a technique called Eye Movement Desensitisation Reprocessing proved very helpful. There are EMDR therapists everywhere – and often it is more effective for an outsider to work with the child : a parent can feel too involved and become too upset.

Trauma is what is perceived as trauma by the sufferer, we can not determine what is shocking to another person. Obviously you will know if you have been involved in a serious incident likely to affect the child. But you might not be aware if his friend’s Grandma has died and he is worrying that the same thing might happen to you. It is good to have a quiet time at bedtime when the child is softer and often more open to chatting. This tends to be a time when you can talk about ‘things’. That is when you might hear of ‘secret’ but often profound worries, that it would be helpful to address.