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.

Suicidal Feelings

A certain number of people kill themselves each year, most of whom were suffering from severe depression. Fortunately, 90% of people with depression are able to live full lives while managing their episodes of depressed mood. Only about 10% will end their lives (this number depends on where a person lives – countries vary in their availability of effective treatments and support for depression, so there is a wide international variability in suicide rates).  The pervasive sad mood that comes with depression, as well as the increased tendency among the depressed to obsess on negative thoughts, makes them susceptible to the hopelessness and irrationality characteristic of the suicidal person. People do not “choose” suicide; they fall victim to it as part of their illness.

What are the Implications for Parents?
The link between suicidality and depression should serve as alarm bells when helping our children deal with mental health issues. If we have a loved one who is suffering from depression, it is always prudent to watch out for signs of suicidality. A depressed child is at risk for succumbing to suicidal thoughts; it is up to parents to help prevent this. Vigilant parents can be familiar with the warning signs of suicidality and take action. Moreover, they can do everything possible to get their child the right kind of help. In addition, they can work hard to reduce the other stressors in the child’s life – like school work (negotiate accommodations with the school) and conflict in the home. In fact, when the parents work on their own marriage and parenting skills to increase peace in the home, this can help tremendously.

What are the Warning Signs?
According to the American Academy of Child and Adolescent Psychiatry these signs are:

  • Change in eating and sleeping habits
  • Withdrawal from friends, family, and regular activities
  • Violent behavior or running away
  • Substance abuse
  • Neglect of personal grooming
  • Personality change
  • Difficulty concentrating, persistent boredom
  • Drop in academic performance
  • Marked personality change
  • Frequent complaints about physical symptoms, often related to emotions, such as stomachaches, headaches, fatigue, etc.
  • Loss of interest in previously enjoyable activities
  • Speaking positively about death or romanticizing dying (“If I died, people will appreciate me more.”)
  • Writing about death, dying, or suicide
  • Engaging in reckless or dangerous behavior; being injured frequently in accidents
  • Giving away or discard favorite possessions
  • Saying permanent sounding goodbyes to friends and family
  • Seeking out weapons, pills, or other lethal tools

A child or teen  who is planning to commit suicide may also:

  • Complain of being a bad person or feeling rotten inside
  • Give verbal hints with statements such as: “I won’t be a problem for you much longer.”, “Nothing matters.”, “It’s no use.”, and “I won’t see you again.”
  • Become suddenly cheerful after a period of depression
  • Have signs of psychosis (hallucinations or bizarre thoughts)

The risk of suicide is high among those who have attempted suicide before, know someone who has killed themselves, and are pessimistic about the chances of getting relief from chronic depression. Also, teens who have a family history of mental illness and suicide are more likely to attempt suicide as are teens who have clinical depression or who suffer from active addiction. Teens who’ve already made a suicide attempt have a higher chance of committing suicide successfully. Vulnerable teenagers who suffer a serious loss (like the breakup of a romantic relationship) may try to stop the pain with suicide. A history of physical or sexual abuse, incarceration, alienation from parents and refusal to access mental health services all increase suicidal risk. Males have a higher “success” rate for suicide than females, but females make many more suicide attempts than do males. Also take note if your depressed child suddenly seems unusally happy. Sometimes this switch in attitude happens because a child has decided to end his suffering and he is actually experiencing a state of relief. Remember that depressed mood is a serious and potentially life-threatening condition and should always be professionally treated.

The American Academy of Child and Adolescent Psychiatry recommends taking a child’s suicidal statements seriously. If a child or adolescent says, “I want to kill myself,” or “I’m going to commit suicide,” ask him what he means. Don’t be afraid of saying the word “suicide.” You won’t be giving the teen an idea that he hadn’t thought about. Instead, you’ll help him or her think things through. Ask about depression, anxiety and unhappiness. Don’t just tell the child no to talk that way.  Show interest and concern and get your child to a qualified mental health professional (such as a psychiatrist or clinical psychologist).

Suicidal Behavior in Teens
Teenagers are a vulnerable group. They experience tremendous pressure from all sides: from inside their changing bodies, from their parents, from their schools and from their peers. No one can be perfect in every area and so everyone is doing poorly in something. But teenagers can feel isolated with their failures and setbacks, lacking the perspective that older people have that “we’re all in this together.” Teenagers are intent on fitting in, looking good, being acceptable. If the only group they can fit into is a violent, drug-ridden street gang, then that’ll be the group they might very well join, especially if they have little support elsewhere or few sources of success and strength.

Because the pressure is so intense, many teens do not cope well. Their survival strategies depend to a large extent on their genetic make-up and the strategies they learn at home. Some teenagers have “hardy” genes that help them survive and thrive under stressful conditions. They can laugh their way through almost anything or simply tough it out. Others are genetically vulnerable to bouts of depression. However, the depressed teen is more at risk than depressed adults. Teens are very focused in the present. They have trouble imagining that in a few years life can improve tremendously. Their impulsivity can lead them to put an end to it all right now because they just can’t see any way out.

What You Can Do
Parents can also help buffer teens from stress by keeping the doors of communication open. Make it easy for your kids to talk to you. Keep criticism to a minimum; instead, give praise and positive feedback generously. Have fun with your teenager and try to make your home pleasant, comfortable and safe. Keep conflict down with your spouse. Avoid drama. Take care of yourself and create a healthy model of stress management strategies for your kids to learn from. Create a positive atmosphere. Have a dinner table several times a week and use it to have discussions on politics, human nature, interesting things in the news or whatever—keep talking with your kids. Make your values clear. Bring tradition and ritual into your home.  Accept all feelings without correction or disapproval. Ask for behavioral change gently and respectfully. Never yell at your teenager. Never insult, name call, use sarcasm or any other form of verbal abuse. Instead, be sensitive to your teen’s feelings at all times. Discipline when necessary but only after you’ve warned a child that discipline will occur and only with mild discipline—never affecting the teen’s social life (see Raise Your Kids without Raising Your Voice for safe and effective ways of guiding teenagers).

If your teen demonstrates any of the symptoms of depression or suicidality, talk to him or her about what you are observing and arrange an appointment with a mental health professional. You can call suicide helplines in your area to get information about how to help your child. You can take your child for a mental health assessment. If your child is uncooperative, seek mental health guidance yourself. Since a suicidal person feels isolated and hopeless, any steps that family members take to address the situation can be powerfully preventative. Remember, too, that many parents have walked this road before you. Access on-line and community support if your child has been threatening suicide.

Natural Treatment for Stress Relief

Bach Flower Remedies are one-ounce bottles of specially prepared water (see below for details). Although they are only water, they can affect the way people feel emotionally. In fact, they can help balance emotions so that a person can release stress, upset, hurt, anger, fear, sadness, irritation, jealousy, impatience  and any other distressed emotion. Indeed,  many people report that they have successfully used Bach Flower Remedies to feel calmer, sleep better, worry less, recover faster from upset and heartache, handle parenting stress and work stress better and so on. Many have also reported that they were able to see a reduction in their child’s tantrums, aggressive behaviors, moodiness  or fears because of the use of the remedies.

But the remedies can do even more than help a transitory bad feeling : they can also help correct the tendency to fall into those feelings in the first place. When the remedies are used to treat a chronic emotional issue (like a tendency to be stubborn or a tendency to be explosive), they might actually be assisting in a processes now referred to as  “epigentic healing” – the healing of the gene that leads one to experience chronically negative emotional states. We now know that genes can be turned on and off and this is what appears to be happening when someone takes a long course of Bach Flower Therapy. This means that a child who tends to be very shy can take the remedies over time to reduce the shy tendency altogether. The Bach Flowers do not change personality, however. What they do is enable a person to be their own best self. A very strong-willed, obstinate child will retain his strength of character but instead of just being difficult to live with he will be his best self: a born leader, a confident person, one who can take appropriate action. When the Flower Remedies help a childhood overcome chronic separation anxiety, they leave the child’s personality intact: it is the same youngster without debilitating fear blocking the expression of his true self.

It’s hard to believe that these little remedies can work and it’s best not to even TRY to believe that they will; rather, just try the remedies yourself and observe how you feel while taking them. Or, offer a remedy to your child and observe the child’s behavior over the next days and weeks to see if there is any difference. Bach Flowers sometimes seem to have a dramatically positive effect on both behavior and mood and other times seem to make little difference. (Of course, there is no medical or psychological treatment either that works equally well for every single person who employs it.) In the latter case, it might be that the wrong mix of remedies is being used, but it can also be that a longer period is necessary before change will occur or even that a particular person is not responsive to the remedies at the particular time that they are being offered (i.e. this could change in the future). It can also be that while the Bach Flowers are having some positive effect, a complete treatment  requires other interventions as well including strategies like nutritional support, exercise, psychotherapy and/or medicine.

How are Bach Flowers Prepared and Used?
Dr. Edward Bach, a prominent physician in Britain who died in 1935, was interested in preventative medicine. In his search for something that could boost the immune system to ward off disease or to help the body recover more quickly and thoroughly from illness, he discovered a water-based method of healing that became known as “Bach Flower Therapy.” Modern physicists use principles of quantum physics to explain how water remedies can affect human emotions. Dr. Bach, however, understood the remedies on a purely intuitive level. He felt their effects and he could see what they were able to do to effectively relieve stress and emotional distress.

Bach Flower Remedies are prepared by taking the head of a certain flowering plant and placing it in a clear bowl of pure water. The water is heated in sunlight or on a stove for several hours (depending on which flower is being used) and then the flower is removed. The water is the remedy. It is bottled (and preserved with a bit of grape alcholol) and – in our times – sold in health food stores throughout the world as well as on-line.

Bach Fower Remedies are a form of vibrational medicine, not herbal medicine. They are NOT medicinal. They do not act on the body at all. They don’t interact with other medicines or foods or health conditions or anything. They are the same as water is to the system. However, if someone cannot have even a minute amount of alcohol in their system, they should look for the newer remedies that are made using glycerin instead. In general, however, anyone can safely use Bach Flower Remedies – babies, children, teens and adults, pregnant women and elderly people. Even plants and animals respond well to the Bach Flowers!

How Does One Take Bach Flowers?
If a person is using only one of the 38 remedies, they can take 2 drops from the remedy bottle in a small amount of liquid. They should do so 4 times a day – morning, mid-day, afternoon and evening.

However, most people take anywhere from 2 to 7 remedies that have been mixed together in a “mixing bottle.” To prepare a mixing bottle, one places water in a glass bottle with a glass dropper – generally a  30 ml  (1oz.) amber bottle. (These bottles are sold wherever Bach Flower Remedies are sold and they are called Bach Mixing Bottles.) Then one adds 2 drops from each desired remedy bottle. If a person was using 7 remedies, they would be adding 14 Bach Remedy drops to their mixing bottle. To ensure that bacteria does not grow inside of the mixing bottle, a teaspoon of brandy or apple cider vinegar should be added to the bottle.

This Bach Flower Remedy Mixture is then taken, 4 drops at a time, in hot or cold liquid, with or without food. Ideally, these 4 drops are taken 4 times a day, for a total of 16 drops daily. A person takes them in the morning, mid-day, afternoon and evening.

Adults can put 4 drops of their Bach Flower mixture into coffee, tea, water, juice, soup or any other liquid. Children can take their drops in water, chocolate milk, juice, cereal or any other beverage.

A person takes their mixture until they start forgetting to take it and they no longer need it. (Or, parents give a mixture to a child until the child’s behavior or mood issues have resolved to the point where the parent is now forgetting to give it to the child)  If symptoms return (and they most likely will), the person starts taking the remedy again. In fact a person may end up using the remedy off and on for a year or two (less time in children) before the problematic tendency  disappears completely.

How Does One Know Which Remedies to Use?
Dr. Bach wanted to keep his healing method very simply. A person should be able to read the description of the 38 remedies and decide which ones he needs. Of course, some people feel that they need all 38! However, no more than 7 should be used at a time.

A person could pick up a book on Bach Flower Remedies and decide which flowers they need based on the description of who the remedy is for and what it can do. Also, most health food stores have a pamphlet that explain what the remedies can too. Alternatively, a person can make an appointment with a Bach Flower Practitioner who will be pleased to help them design a remedy for themselves or their child.

Understanding Self-Harm

Hurting oneself on purpose seems to be an odd thing to do, yet the practice is growing in popularity among today’s teens. There is a reason for this: self-harm is a “harmless” way to reduce feelings of anxiety and angst. Due to the ease of modern communication among teenagers, word has caught on that this strategy works. It is cheap, easy and always available – unlike other methods of stress relief like drinking alcohol, taking drugs or even accessing counseling services! As a result, this disorder is highly influenced by peer behavior; when children learn that others they know are hurting themselves, they often experiment with this stress relief strategy themselves. Unfortunately, self-harm is a very dysfunctional behavior that often causes feelings of deep shame, helplessness and inadequacy in much the same way as other addictive behaviors do. For instance, bingeing and purging (overeating large amounts of food and then vomitting or using laxatives) also temporarily dispels anxiety but then causes those same painful emotions of shame, helplessness and inadequacy. Some people feel that self-harm is a cry for attention or help. Parents are naturally distressed to learn that their child has been hurting him or herself. Nonetheless, there is some comfort in knowing that self-harming actions are not necessarily related to suicidality. The goal of sufferers is to inflict minor pain, release endorphins and communicate to family members. Suicidal teenagers don’t practice self-harm; they practice killing themselves and sometimes succeed.

What is Self-Harm?
Self-harm is any action taken to cause oneself pain. Some people hit themselves – slapping their head, their face, their limbs or their body. Some people burn themselves. Some bite their skin or pick at it till it bleeds. Some use a sharp object to make small cuts on themselves – most commonly on their arms but also on other parts of the body.

Understanding the Paradox: Why Do People Do It?
When we are pain, such as when we experience a cut or burn, our brain releases natural pain relievers – endorphins – into the body. The chemicals associated with pain relief are also managers of mood. Hence, cutting and other methods of self-harm does bring some form of temporary relief to a person in distress. This temporary relief can get so addictive, that self-harm becomes a person’s first line of defense against emotions he or she can’t handle.

Experts also believe that there are psychological reasons why self-harm makes sense to the people who do it. Many times, cutting becomes some form of displacement. When emotional pain is too much to bear, “transforming” the emotional pain to physical pain makes it more manageable. Engaging in self-harm is also a way of validating that the pain one feels is real. There’s no evidence of inner distress, but seeing scars and burns are an acknowledgment that one is suffering.

In some cases, people engage in self-harm as an unconscious way of punishing themselves or a cry for attention. There are also situations when self-harm is an attempt to “feel something”; too much pain or trauma can numb one’s self. For people who engage in self-injury, self harm is better than feeling nothing.

Is Self-Harm a Suicide Attempt?
Not usually. However, people who self-harm are at additional risk for becoming suicidal. Therefore, parents need to take self-harming behaviors seriously.

While many who engage in self-harm report that they have no plans to kill themselves (they just want the temporary relief self-harm brings), they are always mentally unhealthy. Healthy people don’t hurt themselves. The mental health conditions typically associated with suicide attempts (e.g. clinical depression, Post Traumatic Stress Disorder, severe anxiety) are often the same conditions that trigger self-harm. It is possible that self-harm activities are not suicidal in and of themselves, but if people are left alone to wallow in progressive mental illness, self-harming tendencies can progress to actual suicidality. Parents and mental health professionals are therefore recommended to take the cautious view and always treat the underlying emotions and mental health conditions of those who engage in self-harm.

What can Parents Do to Help a Child Who Engages in Self-Harm?
First off, be alert. Children and teens who self-harms take extra pains to hide what they are doing; you need to be a conscious and attentive parent to spot what’s going on. Symptoms of self-harm includes persistent wearing of clothing that hide common targets of self-harm such as the wrist, the upper arms and the chest; frequent “accidents” that explains injuries, a high need for privacy, implements like cutters, ropes or lighters in the bedroom, and symptoms of depression.

When you’ve confirmed that your child does engage in self-harm, it’s important that you raise the issue with him or her instead of hoping the behavior will go away on its own. Provide unconditional acceptance and a listening ear. And most importantly, arrange an appointment with a licensed mental health professional.

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.

Unsettled After Death, Divorce or Other Trauma

Although most of us wish that children could be sheltered from the pain in life, the reality is that many youngsters endure real trauma during their developmental years. One of the more common forms of modern trauma is the breakup of the family. Divorce is certainly hard for the adults who go through it but it can actually be traumatic for children – because of the loss of contact with a beloved parent, because of conflict that accompanies it, or because of life changes such as moving away from friends and family, acquiring a “step family” and so on. Death of a parent is another, usually traumatizing, experience that many children endure. But many children endure all kinds of other traumas that are less spoken about such as the serious illness and/or death of a sibling, family violence or chronic, intense conflict, addictions or mental illness within the family and much, much more. Children react to these kinds of intense stresses differently from adults. In fact, parents may not even realize that the child is suffering, since one of the common ways that kids handle overwhelming stress is to “act normal!”

If there has been intense stress in your child’s life, consider the following tips:

No Reaction is a Reaction
Suppose your friend was a passenger in a car that experienced a serious collision. The driver and two other passengers were instantly killed. The car was demolished, blood was everywhere, four firetrucks, 3 ambulances and 5 police vehicles were on the scene within minutes. Your friend miraculously escaped unharmed. Over the next days, weeks and months, this friend went about his or her business as if nothing at all had happened. He or she ate well, continued to joke around and enjoy life, never spoke about the accident and just went on very much “as normal.” Wouldn’t you find that a bit strange?

This is exactly the way many children respond to traumatic events in their lives. Instead of registering the pain and acting it out, they appear on the outside to be completely fine. What has probably happened, however, is that the overwhelming pain has been dissociated – cut off from the child’s conscious awareness. It is stored somewhere where the child can’t feel it just yet. It may surface years or even decades later, as more life stress builds up and eventually triggers it. Sometimes, it remains mentally dissociated for a lifetime, but expresses itself through the body in various forms of physical disease. The reason that children dissociate in this way is that they don’t have the emotional or intellectual resources to assimilate the experience. In other words, they just can’t handle it at the time it is happening.

If it appears that your child is not affected by a traumatic event, in reality he is quite likely affected! However, you can help. First of all, make sure that YOU are talking about the events. Some parents think, “why rock the boat? If my kid isn’t bothered by the tragedy, I’m sure not going to mention it!” Or, parents think to themselves, “the child is too young to understand or care about what is happening. There is no need to discuss it with him or her.” This is exactly the opposite of a helpful response. The child is likely to assume that the incident or events CANNOT be spoken about because they are way too terrible. On the other hand, when parents talk about what is happening and name their own feelings about it, they help children to take in the experience as a legitimate part of life and they help the child learn that his or her feelings about it are normal, expected, healthy and welcome. For instance, suppose a family suffers a crib death of their new baby. The mother can approach their children aged 4 and 6 and say something like, “It is so sad for all of us that our baby died. Daddy and I are so sad right now. You might be feeling that way too. We’re also confused. It’s hard to understand how this happened so suddenly; the baby was healthy just yesterday! You must also be feeling confused. We will all be thinking about this for quite awhile. Eventually, the pain will go away and we’ll all be happy again.” Parents can include any spiritual beliefs that they hold and want to provide their kids with at times of tremendous stress and upheaval.

Physical Reactions
While children may not be able to express their shock and pain in words, they may be able to feel it in their bodies. Headaches, tummy aches, colds and flu’s can all increase as an aftermath of intense stress. Play therapy can help children who are “somatizing” (sending emotions through their physical bodies) and talking therapies can help older kids and teens in the same way. Once emotions are acknowledged, physical complaints often subside.

Sleep Issues May be a Reaction
A child may have trouble sleeping through the night or sleeping alone in his or her bed. Or, the child may have trouble falling asleep or may suffer from nightmares. This may be part of a larger syndrome of Acute Stress Disorder (that happens as a trauma is occurring or within the month following) or Post Traumatic Stress Disorder (that happens more than a month after traumatic events have ended) or Chronic Stress Disorder (the effects of ongoing stress such as living with family violence or addiction or other deeply disturbing issues).

Psychotherapy will help the child clear out the feelings of stress. This will allow him or her to have restful, normal sleep.

Anxiety and Mood Issues may be a Reaction
A child or teen may experience panic attacks, separation anxiety (always wanting to be in the presence of loved ones), increased irritability or chronic sadness. Again, when parents are able to talk about what is happening in the family, children experience fewer emotional symptoms. Sometimes, however, the child or teen may benefit most from personal counseling in order to process the events and lift the burden of stress from the mind oand body.

Misbehavior or “Acting Out” may be a Reaction
Sometimes children become rebellious, disrespectful, impulsive or otherwise poorly behaved at home and/or school in response to stress that is happening at home. Particularly if the poor behavior is a change from previous functioning, parents should consider the possibility of this being a reaction to stress. Counseling for the parents may help reduce the stress in the home and the child’s behavior may simply improve by itself as a consequence. However, some of the stress that may trigger poor behavior are not remediable by parent counseling (for instance, the death of a family member). Nonetheless, parents may benefit from counseling that can address specific behavior and emotional interventions that THEY can provide for their child at home. If these are insufficient, the child him or herself, may need some sort of counseling or behavior therapy.

Bedtime Anxieties

Bedtime anxieties are common and occur for many reasons.

If your child suffers from bedtime anxieties, consider the following tips:

Fear of the Dark is Common and Normal
Children are afraid of monsters, shadows, robbers and all kinds of things that go “bump” in the night. Here are a few things you can do to help them settle:

  • Try Bach Flower Remedies. For vague fears like fear of monsters or the dark, use the remedy “Aspen.” (Add 2 drops to any liquid, 4 times a day until the child is no longer afraid). For specific fears like fears of robbers or fears of being kidnapped, use the remedy “Mimulus.” For night-time panic attacks or hysteria, use “Rock Rose” during the day and “Rescue Remedy” at night.
  • Use “bibliotherapy” – that is, read bedtime stories or make up stories about hero-type children and grownups slaying monsters, being brave, overcoming challenges and otherwise solving problems. When children hear stories about small people conquering big challenges, they incorporate the message into their own self-concept. They come to believe that they are powerful problem-solvers, rather than helpless victims.
  • Leave the light on for your child as he or she falls asleep. If your child wakes up in the night, then it’s fine to leave the light on all night too.
  • If the fear persists, consult a child psychologist.

Fear of Bad Dreams
Children who’ve been suffering from nightmares and bad dreams sometimes don’t want to go to sleep – they’re afraid of having another bad experience. Try to arrange a consultation with a mental health practitioner. A child psychologist will be able to help your child learn tools for ending the nightmares and coping with the fear of them.  Getting professional help is absolutely necessary if your child’s bad dreams are happening as the result of truly frightening life events that the youngster has experienced. For instance, if the child is having nightmares after being bullied at school, or being abused by an adult, or being in an accident or natural disaster – seek professional psychological help.

If your child’s bad dreams are not caused by some terrifying or upsetting life events, you might try some “self-help” techniques first, before seeking professional help for the child. For instance, you can give the child Bach Flower Remedies for a short while to see if that helps solve the problem. Consult a Bach Flower Practitioner to get the most accurate guidance. If this isn’t possible, try giving the child Rescue Remedy before bedtime. If this doesn’t help, try giving 2 drops of “Agrimony” in liquid 4 times a day and see how that goes. Another technique that you can try, is to have the child describe his or her bad dream. Then help the child tell the story again, with a new, much better ending. Have the child tell you the new dream over and over – maybe twice a day for a week or so. See if this helps end the fear. Finally, experiment with “crystal healing.” Go to a rock & mineral store and buy a small piece of amethyst for your child to hold at night. Tell the child that the amethyst can help make bad dreams go away. See if this helps your youngster. If it does help, it really doesn’t matter whether the help came from the placebo effect (just believing that it would work) or because amethyst can actually prevent bad dreams!

Children and Teens can Suffer from Anxiety Disorders
During the daytime, everyone is busy. Although both children and adults can be anxious during the day, they can be even more anxious around bedtime. Defenses fall away as we get ready for sleep. Those who are anxious by nature, will find that anxiety rises as the mind and body begin to relax and get ready for sleep. At this point, children and teenagers may be so overwhelmed with anxiety that they can’t sleep alone in their beds or their rooms or they can’t fall asleep or stay asleep. Some children and teens start to ruminate – they think and think and think about everything under the sun. Or they start to worry. Or they just feel vague unease. Or they begin to feel symptoms of panic. Different kinds of anxious feelings require different interventions. It is best to have your child’s anxiety treated by a qualified mental health professional like a psychologist.or psychiatrist. If the anxiety is mild, you might try some self-help techniques first. As above, you can consider Bach Flower Remedies. Try to find a Bach Flower Practitioner to prepare a remedy bottle for your child. Alternatively, your child might respond well to EFT (Emotional Freedom Technique). There are many therapists who can teach this technique to you and your child and there are also excellent on-line resources and books where you can learn the technique yourself. Children can also learn simple versions of Mindfulness Meditation that help ease anxiety. Find a teacher who works with young people or find a psychologist who practices Mindfulness Based Psychotherapy or Mindfulness Based Cognitive Behavioral Therapy (MBCBT).

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.

Anxious and Stressed Teens

Anxiety is an unsettled, restless, uncomfortable state of mind that can affect people of all ages. Anxious teens may feel worried, stressed or panicky and can experience anxious feelings occasionally or frequently, mildly or intensely. Teenagers who have a lot of anxiety – the kind that interrupts their sleep, interferes with their functioning or causes them intense stress – should be seen by a mental health professional for assessment. Anxious feelings range all the way from normal levels of stress and worry that most people experience, all the way to symptoms of bona fida anxiety disorders – it takes a professional to determine what is going on when anxious feelings are anything more than minor and occasional.

What Triggers Teen Anxiety?
The teenage years are times of high stress, hard decisions and strong emotions. Teen anxiety can be triggered by many events in the teen’s life such as a broken relationship, a parental divorce or academic pressure in school. In addition, teenagers are living in a fast-paced, constantly changing world which creates its own pressure – there is no time to be still and settle in. Social pressures are particularly intense for this age group: kids worry about fitting in, feeling accepted, developing relationships, handling peer pressure and more.

What Parents can Do to Help?
Parents can be part of the problem or part of the solution. For instance, parents can put excessive pressure on teenagers by being too disapproving, too critical or too punitive. On the other hand, they can help relieve stress by being both accepting and gently guiding. They can offer encouragement, praise and validation, keeping the parent-child relationship primarily positive in the ideal 90-10 ratio that is healthiest for this age group (see Raise Your Kids without Raising Your Voice by Sarah Chana Radcliffe for details about building a positive relationship with teenagers). Empathetic listening, ready humor and general acceptance go a long way to helping teens feel confident and emotionally secure.

Moreover, parents can guide teens toward activities that provide stress relief such as sports, drama clubs, volunteer work, and even part-time jobs. Parents can also encourage downtime, family fun (board games, outings, hobbies) and even cooking! A short vacation or even a few hours out of the house for some one-on-one quality time can often work wonders with an adolescent. Parents can even play some relaxing music in the house to help set a calm mood. Of course, reducing family stress (no yelling, fighting, marital battles, etc.) will also help reduce teen anxiety. If parents are experiencing stress of their own, they shouldn’t share it with their teens but rather with other supportive adults.

Warning Signs
There is a difference, however, between normal levels of worry and stress and levels that would be best treated with professional help. If a parent notices the following symptoms of anxiety, he or she should discuss them with a doctor and/or ask for a referral for to a  mental health professional (preferably and adolescent specialist) for assessment:

  • Inability to follow through with usual routines  (like getting to class on time, doing homework, doing one’s household chores, keeping one’s room cleaned, grooming oneself properly and so on)
  • Compulsive thoughts (inability to stop thinking about/worrying out loud about certain topics)
  • inability to make a decision without excessive input from others
  • Peculiar habits (i.e. arranging things, checking things, excessive washing, lengthy praying, repeating words or phrases, needing excessive rituals, refusing to touch certain things, wearing gloves inappropriately, and any other strange behavior
  • Agitated behavior (shaking, inability to settle down, stay still, sleep)
  • Disturbed sleep patterns (insomnia, early waking, nightmares)
  • Strange or excessive fears or worries
  • Refusal to go certain places (like malls or parties) or be with certain people or engage in age-appropriate social activities due to anxious feelings
  • Chronic unhappy or irritable mood
  • Addictive behavior (may stem from anxiety)
  • Self-harm such as cutting oneself, picking at one’s skin (may stem from anxiety)
Anxiety Disorders
There are several different types of anxiety disorders, all of which are thought to have biological roots. GAD (generalized anxiety disorder) is a state of chronic worry about everything and anything. Panic Disorder is a focused type of anxiety that may involve panic attacks with or without fear of leaving home unattended. Simple Phobia can involve any intense fear of any one thing like fear of needles or heights or flying. Social Phobia is a type of anxiety that involves fear of being judged negatively by others. PTSD (post-traumatic stress disorder) is an anxiety disorder that is triggered by experiencing or witnessed a life-threatening event. OCD (obsessive-compulsive disorder) can occur spontaneously or after a strep infection and involves anxious thoughts and compulsive rituals. Often teens with anxiety have other disorders as well – depression, ADHD, eating disorders and addictive disorders among others. Fortunately, all anxiety disorders respond well to treatment. Today there are many treatments besides medication that are quite effective – therapies, stress-management training, meditation-based interventions, alternative treatments and more. The sooner you get help for your anxious teen, the sooner your teen will enjoy peace of mind.