Helping Kids Through Trauma and PTSD

We all deal with stress everyday. Rushing to get to school in time, making ends meet during a recession, dealing with a particularly annoying in-law — stress is a part of life. And in most occasions, the stress we face is manageable.

But some sources of stress can be incredibly intense, overwhelming and beyond our physical and/or emotional resources to deal with. When this happens, the stressful event is said to be traumatic. All parents want to protect their children from things that can unsettle or harm them. But sadly, there are many things in life that even the most conscientious of parents can’t control. Our children may witness or experience traumatic events despite our best efforts to shield them. When this happens, they may have difficulty bouncing back. Sleep disturbances, sadness, anger and fear may plague a traumatized child long after the traumatic event has ended.

What is a Trauma?
Trauma is a psychological reaction to highly stressful events, particularly those that threaten life or safety. When an experience is considered traumatic, it means that the coping resources of the person witnessing or experiencing it are not enough to deal with the impact of the event, and some degree of psychological shock or breakdown occurs. Events that most people consider traumatic include vehicular accidents, crimes, natural disasters and physical or sexual abuse. Although parents may think that trauma results only from catastrophic events like war or rape, it can actually occur as a result of more normal and common events. For instance, a child can be traumatized by being chased by a dog, by a harsh reprimand from a teacher, from a threatening bully, or from being laughed at while giving an oral report. What makes an event traumatic differs from person to person, as individual coping abilities must be taken into account. Personality factors, psychological profile and past history all play a role in producing a traumatic reaction.

A trauma response often includes symptoms like reliving the event over and over again (by obsessing about it; experiencing intrusive thoughts that interrupt thoughts and activities), panic attacks, nightmares, numbness & fog responses, avoiding people, places and things that trigger a memory of the event, depressed and/or angry mood and increased nervousness (startle response).

Trauma can initiate a syndrome that shows up long after the traumatic event or events have ended. Like an initial trauma response, it affects physical and emotional functioning causing nightmares, hypervigilance, panic attacks, intrusive memories, numbness and other symptoms; the syndrome is called PTSD or Post-Traumatic Stress Disorder. It can occur weeks, years or decades after the traumatic events have passed.

Those who have some level of anxiety to begin with and those who have suffered several previous traumatic incidents are more likely to develop PTSD than other people. Lack of a support system or lack of adequate emotional support right after a trauma, also increases the chances of developing PTSD later on.

What is the Best Way to Handle PTSD?
PTSD is a mental health disorder that can be effectively treated. Self-help is part of the process for teens and adults, including finding support groups, reading up on PTSD, engaging in effective stress-management routines (including regular exercise, relaxation techniques and routines for self-care), utilizing alternative treatments to strengthen the nervous system (such as herbal remedies, Bach Flower Therapy, Aromatherapy, homeopathy, accupuncture and so forth). Parents can help incorporate calming strategies into a child’s routines.

Parental support is critical when a child is dealing with trauma. Unlike adults, younger children don’t yet have the ability to understand what they are going through. Not only is the original event traumatic, but their trauma symptoms too, can be traumatic. For instance, physical symptoms like tremors and nightmares, mental symptoms like obsessions and hallucinations, and emotional symptoms like fear and anxiety can be overwhelming for a child to be experiencing.

The first line of business is to help children manage their emotions. Encourage them to talk about their feelings. A traumatized child may talk about the same thing over and over again, and this is okay. The content of the sharing is less important than the process of getting things out. If a child finds difficulty in expressing what he is going through verbally, either because of age or because of the trauma, then consider non-verbal ways of venting emotions. Letting it all out can also be done using drawings and pictures, clay sculptures and toys, play-acting, and storytelling.

Second, give your child a rational explanation of the traumatic event, that is appropriate to his or her age. The more information the child has, the less he or she is likely to generalize the event to other situations. For instance, knowing that a car crashed because it skidded on the snow can help a child feel safe in cars with good snow tires and in cars driving on dry roads. Without this information, the child may conclude that all cars are dangerous at all times. (While this is in fact true, the healthy state of mind is one of sufficient denial that a person can comfortably drive and be driven at all times. Phobic and traumatized people, on the other hand, over-exaggerate the likelihood of a catastrophic event occurring again, such that they can’t live in a normal way.)

When a child is suffering rather mild symptoms, parents may find that self-help interventions are sufficient. For instance, learning how to do EFT (emotional freedom technique) with the child may complete calm the youngster’s nervous system. However, parents may prefer to take their child to a child psychologist who practices EFT or EMDR. Both of these techniques are used to rapidly heal the trauma of one-time events. If the child is experiencing many symptoms of trauma, it is essential that parents DO NOT try the self-help approach. Instead, they should take their child to a mental health professional who is specifically trained in the treatment of PTSD.

The Bach Flower Remedy called “Rescue Remedy” can help reduce temporary and chronic symptoms of trauma and is especially effective for home-management of symptoms in between psychotherapy sessions. If you are aware that the child has just suffered a traumatic event (like watching someone get badly injured or being personally assaulted, injured or threatened), offer Rescue Remedy immediately. It may help prevent a traumatic reaction from setting in.

However, the fastest and most effective way to end the debilitating symptoms of PTSD is to get the proper professional help. Not all mental health professionals are equally trained in the treatment of PTSD. Make sure that your practitioner is! Therapeutic interventions include EMDR (Eye Movement, Desensitization and Reprocessing), EFT and other forms of Energy Psychology, TIR (Traumatic Incident Reduction),  and other specific tools for the treatment of trauma.

The good news is that children respond well to treatment of trauma. They can experience a complete healing of their symptoms and a return to “normalcy.” In fact, child are often even happier, calmer and more mature after trauma therapy than they were before the traumatic event(s) occurred.

Helping Your Child Cope with Traumatic Events

All parents want to protect their children from things that can unsettle or harm them. But sadly, there are many things in life that even the most conscientious of parents can’t control. Our children may witness or experience traumatic events despite our best efforts to shield them. When this happens, they may have difficulty bouncing back. Sleep disturbances, sadness, anger, fear, or other symptoms of trauma may plague a traumatized child long after the traumatic event has ended.

What is a Trauma?
Trauma is a psychological reaction to highly stressful events, particularly those that threaten life or safety. When an experience is considered traumatic, it means that the coping resources of the person witnessing or experiencing it are not enough to deal with the impact of the event, and some degree of psychological shock or breakdown occurs. Events that most people consider traumatic include vehicular accidents, crimes, natural disasters and physical or sexual abuse.  Although parents may think that trauma results only from catastrophic events like war or rape, it can actually occur as a result of more normal and common events. For instance, a child can be traumatized by being chased by a dog, by a harsh reprimand from a teacher, from a threatening bully, or from being laughed at while giving an oral report. What makes an event traumatic differs from person to person, as individual coping abilities must be taken into account. Personality factors, psychological profile and past history all play a role in producing a traumatic reaction. A trauma response often includes symptoms like reliving the event over and over again (obsessing about it; experiencing intrusive thoughts), panic attacks, nightmares, numbing and fog responses, avoiding people, places and things that trigger a memory of the event, depressed and/or angry mood and increased nervousness (startle response).

How can Parents Help Children Cope with Trauma?
Parental support is critical when a child is dealing with trauma. Unlike adults, younger children don’t yet have the ability to understand what they are going through. Not only is the original event traumatic, but their trauma symptoms too, can be traumatic. For instance, physical symptoms like tremors and nightmares, mental symptoms like obsessions and hallucinations, and emotional symptoms like fear and anxiety can be overwhelming for a child to be experiencing.

The first line of business is to help children manage their emotions. Encourage them to talk about their feelings. A traumatized child may talk about the same thing over and over again, and this is okay. The content of the sharing is less important than the process of getting things out. If a child finds difficulty in expressing what he is going through verbally, either because of age or because of the trauma, then consider non-verbal ways of venting emotions. Letting it all out can also be done using drawings and pictures, clay sculptures and toys, play-acting, and story-telling.

Second, give your child a rational explanation of the traumatic event, that is appropriate to his or her age. The more information the child has, the less he or she is likely to generalize the event to other situations. For instance, knowing that a car crashed because it skidded on the snow can help a child feel safe in cars with good snow tires and in cars driving on dry roads. Without this information, the child may conclude that all cars are dangerous at all times. (While this is in fact true, the healthy state of mind is one of sufficient denial that a person can comfortably drive and be driven at all times. Phobic and traumatized people, on the other hand, over-exaggerate the likelihood of a catastrophic event occuring again, such that they can’t live in a normal way.)

When a child is suffering rather mild symptoms, parents may find that self-help interventions are sufficient. For instance, learning how to do EFT (emotional freedom technique) with the child may complete calm the youngster’s nervous system. However, parents may prefer to take their child to a child psychologist who practices EFT or EMDR. Both of these techniques are used to rapidly heal the trauma of one-time events. If the child is experiencing many symptoms of trauma, it is essential that parents DO NOT try the self-help approach. Instead, they should take their child to a mental health professional who is specifically trained in the treatment of post-traumatic-stress-disorder (PTSD). PTSD is the name for the cluster of symptoms that occur in reaction to a traumatic event. The “p” in this label for “post traumatic” points to the fact that trauma symptoms can suddenly occur months, years or even decades after the original traumatic event(s). The mind/body seems to wait for the “right time” to release the memory of the event(s).

Technqiues like EFT and EMDR can also be used as part of a longer therapy addressing more chronic forms of trauma (such as being subjected to chronic bullying, physical abuse or incest). These and other interventions are specifically designed to heal both the memories and the bodily reactions and return the child to his normal state. In addition, the Bach Flower Remedy called “Rescue Remedy” can help reduce temporary and chronic symptoms of trauma and is especially effective for home-management of symptoms inbetween psychotherapy sessions.

The good news is that children respond well to treatment of trauma. They can experience a complete healing of their symptoms and a return to “normalcy.” In fact, children are often even happier, calmer and more mature after trauma therapy than they were before the traumatic event(s) occurred.

Refuses to Go to a Mental Health Professional

In an ideal world, consulting a mental health professional would be as easy as consulting a medical doctor – and as stigma-free. Unfortunately, many people still feel an element of shame, embarrassment or other type of awkwardness about going to a psychological professional. Some people still think that mental health professionals only deal with people who are “crazy” and understandably don’t want to be an identified member of such a population. In fact, in the “olden days” mental illness was poorly understood and derogatory terms such as “crazy” were used to describe people who we know know were suffering from various biological disorders such as schizophrenia, manic-depressive disorder or delusional disorders. Psychiatrists and clinical psychologists can now help mentally ill people feel and function better than ever before. Moreover, modern mental health professionals assist not only those who are suffering from true mental illness, but also those who are completely mentally healthy. They help almost everyone to function in less stressful, more productive and happier ways, helping  them achieve their full potential in every area. People who access mental health services in order to feel and achieve their best, tend to be more emotionally sophisticated, open-minded and growth-oriented than those who do not. In other words, it is often the most mentally healthy people who consult mental health pofessionals today.

Although YOU may know all this, your child may not. In fact, your child may have the old misconception that going to a mental health professional means that there is something wrong with you. As a result, he or she may not want to see a mental health professional, even though you know that this is exactly what is needed.

If your child refuses to go to a mental health professional, consider the following tips:

Explain to your Child what Mental Health is and what Mental Health Professionals Do
As previously mentioned, there are many misconceptions that float around regarding the mental health profession — and even young children could have heard of them through playmates and peers. It’s important then that you explain carefully that mental health is just one aspect of our health. Emphasize that healthy people access mental health services in order to learn new skills, improve relationships, reduce stress and emotional discomfort, feel better physically, and achieve more in school or life. Be specific too – talk about the various tasks that mental health professionals perform such as psycho-educational assessments, mental health assessments, family counseling (to reduce conflict or help cope with stress), remove and/or manage fear, anger or sadness, and much more.

Your child may not recognize or agree that he or she has an issue that requires intervention. As a parent, you are in charge of your child’s well-being. If your child had an infection, you would insist on medical attention. Similarly, if your child needs help for an emotional problem, it is up to you to arrange it. If the child in question is a teenager, you might have to deal with resistance – be prepared. First try to motivate the youngster with reason – explain the possible benefits of assessment and treatment. If the child still refuses to cooperate, let him or her know that, privileges will be removed. For example, “No you don’t have to go to see Dr. Haber, but if you decide not to come, you will  not have the use of my car until you change your mind.” Think of whatever consequences might help motivate your adolescent to cooperate.

Tell children what to expect at their first session. If there will be art or music or toys, let your child know that the session should be very enjoyable, even while the therapist is learning about the child’s issues and learning how to be help. If it will be a talking therapy, tell the child how the therapist might open the conversation, what sort of questions might be asked and how the child might approach the conversation. Tell the child how to handle tricky situations like not wanting to talk or open up too much or feeling not understood or being fearful. In other words, prepare for everything!

Gently but Clearly Explain Why you are Referring Them to a Mental Health Practitioner
Tell your child why you have scheduled a mental health consultation. Explain that the consultation is meant to help the child and is not some sort of negative consequence! Kids who are caught breaking the law, or even family rules, are often scheduled for counseling in order to find out the reason for the misbehavior. Children who do not do well in school are referred to educational psychologists for assessment of learning disorders or other causes. Depressed or anxious teens may be sent to psychiatrists or psychologists for treatment. If you are having relationship difficulties with your youngster, make sure to participate in the counseling process in some way, either having joint sessions with the child or having individuals sessions just like the child is having, or both.

Negotiate Confidentiality Boundaries Beforehand
A tricky issue for children in therapy is confidentiality. It’s common for some kids to have hesitation talking to a mental health professional. For them, counselors are just their parents’ spies — a way parents can gather information about them. It’s important that parents (and maybe the mental health professional him or herself) clarify beforehand that all issues discussed within sessions are confidential, and that only the generic nature of issues discussed would be revealed to parents. Similarly, the mental health practitioner can specify what will remain confidential and what sorts of information cannot remain confidential, giving the child the opportunity to share or withhold information knowing the limits of confidentiality.

Tell your Kids that They can Terminate a Consultation Anytime
It’s important that kids actually enjoy their therapy experiences. Negative therapy experiences may affect them negatively throughout life as they refuse to get much needed help because of traumatic memories of therapy in childhood! Therefore, make sure that your child LIKES going to therapy or change the therapist, or the type of therapy, or even consider stopping therapy for the time being and trying again later. Usually, mental health professionals are good at establishing rapport with their clients and child and adolescent specialists are particularly skilled at making kids feel comfortable. Nonetheless, if your child remains uncomfortable after a couple of meetings, end the therapy. Adults also need to feel comfortable in therapy in order to benefit and they, too, have the right to “shop around” for a compatible therapist or therapy approach. Since there are so many different types of treatments and so many therapists, there; they will do their best to get your child feeling at ease before they start an actual intervention. But many factors can cause your child to be uncomfortable with a mental health professional. It’s helpful then that your child knows that you are at least willing to consider enlisting a different professional, or terminating sessions if there are significant concerns.

Help for Angry Parents

Grownups sometimes act like children. This is great when they’re playing with their kids – it can make for a rollicking good time. However, it’s not at all great when the child-like behavior consists of having tantrums, slamming doors, calling names, making mean faces or otherwise acting like an out-of-control pre-schooler. While such behavior in a youngster is completely unacceptable and requires remediation, it is so much worse when it occurs in a parent. It upsets the whole household –  disturbing, frightening and sometimes even physically harming family members. Despite the harm that parental anger can cause, it is a fact that normal parents get mad. What can parents do, then, to minimize the harmful effects of their own rage, irritation, resentment and other forms of anger?

Anger in the Home
Anger, itself, is a feeling – an emotion. It is experienced physically as a tightening of muscles, a holding of breath and/or a rush of adrenalin. Anger is not a behavior. A person behaves a certain way when angry. The behavior that occurs depends on the person’s inborn nature, upbringing, education, training and personal development. Some people choose to “act out” their anger, actually demonstrating what they are experiencing inside. They are so upset that they feel like screaming – and they do. They are so upset that they feel like kicking someone or something – and they do. They are so upset that they feel like saying terrible things – and they do.

Other people choose to put a lid on their anger and withdraw until the mood passes. They, too, are so upset that they feel like screaming – but they don’t. They, too, feel like kicking, throwing or smashing something or someone – but they don’t. They feel like saying all sorts of terrible things but they refrain. Instead, they remove themselves from the scene that is triggering all the upset and take themselves to a place where they can let the energy move through and out of their body and mind. If knowledgeable and skilled, they may even speed that process along by using a technique or strategy that helps them to rapidly process their anger and completely resolve it. Otherwise, they may do the best they can on their own and finish the job up later with the help of the offending party and/or a third party.

Consequences of Parental Anger
Many people fall somewhere in the middle of these two styles – showing some anger and also showing some restraint. Obviously, showing less anger will cause less damage to all concerned. However, it is unfortunately true that ANY amount of visible and/or audible anger causes SOME amount of harm. Minor anger causes temporary hurt, moderate anger has stronger negative effects on children and intense anger tends to have intensely negative effects. We wish it wasn’t so because, as I suggested earlier, we all get mad sometimes. We wish that we could “get away” with expressing some of that anger since it often feels so good to move it through our body, our mouth and our muscles.  Unfortunately, when a person expresses rage, someone else experiences abuse (mistreatment, disrespect, emotional and/or physical harm). In other words, it is as if the angry person spews out his or her venom, literally vomiting bad energy onto whoever he or she is yelling at. The recipient of the anger feels soiled and damaged. Frequent exposure to this sort of toxic energy actually damages developing human beings.

The Parental Model
In addition, parental expression of anger is also a teaching tool. Adults show their kids how anger is expressed. Screamers all too often raise screamers (by showing their kids a destructive technique) and always leave their children deprived of a healthy model (by failing to show them a constructive way to negotiate strong emotion). Although a child can overcome his parents’ anger style, it is a challenge we don’t really want to present to our youngsters. Parental impulsiveness, lack of maturity, lack of skill and lack of self-control not only hurts children in the moment, it also hurts them for a lifetime as they either mimic the destructive behavior in their own families or they struggle against its effects inside themselves.

Choosing Healthy Ways to Express Angry Feelings
Feelings and behaviors are two different things. We will all feel angry at times because it is one of the emotions that is there for our own protection. However, none of us needs to act badly when we’re angry. We can tell a spouse or child that we are upset; there is no need to shout. We can impose negative consequences on children; there is no need for insult or other hurtful words or actions. We can always be mindful of our own dignity and the dignity of others even when we’re frustrated, hurt, insulted, exhausted, troubled or otherwise emotionally challenged. But we can’t choose these healthy communication tools while adrenalin – the fight-or-flight chemical – is coursing through our brains and body.

The trick, then, is to find effective ways to turn off anger CHEMISTRY so that rational and healthy choices can be made in the moment. The calm brain can make good choices, but the agitated brain just reacts however it wants to in the moment, without regard to the long term consequences of those actions.

The ability to turn off the chemistry of anger is a learned skill. It involves any technique that calms the body down. Slowing the breathing is one such technique. When a parent is feeling upset, he or she can purposely start to breathe more slowly and evenly. It will take a number of minutes before anger chemistry stops flowing, so patience is required. Leaving the conversation, drinking a tall glass of water, walking around the block – all these activities can help the brain recover. But the most valuable action even after one has left the conversation, is to slow the breathing more and more. The heart will also slow down, the muscles will relax and the brain will finally work again!

Removing feelings of helplessness is another important tool to help prevent and reduce anger. Parenting books, anger management books, classes,online resources, counseling, social support, spiritual guidance and a host of other resources are available to help provide tools, options and techniques to handle complex parenting situations. Being prepared and having a clear philosophy in advance can definitely help prevent rage attacks. If someone has tried all of these approaches and still gets angry easily, then adding several physical tools can help too: daily exercise, herbs, acupuncture, homeopathy, Bach Flower Therapy, essential oils and psychotropic medications can all help soothe the easily agitated psyche.

Anyone who cares enough about his or her family to learn how to eradicate anger-induced bad behavior can succeed. We can all be well-behaved parents – if we really want to be.