Thursday, December 20, 2012

Helping Children Cope with Trauma

While Friday's mass-shooting in Newtown, CT, has been devastating for a great many people, it may be particularly traumatic for the children who survived - not only because they were exposed to the trauma of a shooter in their school, but also because of how children experience traumas and crises. Essentially, a trauma or crisis is anything that overwhelms our ability to cope. The less we are able to understand and process what has happened, the more overwhelmed we feel. We may consequently feel helpless, out of control, fearful, angry, depressed, guilty or ashamed.

Children often have difficulty verbally expressing their emotions, and may find the swirl of emotions they experience during a crisis to be confusing, adding to the intensity of distress they feel. Children are particularly susceptible to crises involving loss and separation, since losses pose a threat to their safety and security. Significant losses may result in feelings of rejection or abandonment, depression, anger, guilt and confusion.

Children also think differently about the world, which leads to particular difficulties understanding and processing traumatic events. Specifically:
-  Children tend to personalize things, and may therefore blame themselves for things outside their control.
-  They also tend to interpret things literally and think concretely, which makes it hard for them to conceptualize traumatic events or realities such as death. For the same reason, children may have difficulty understanding adults' euphemistic ways of talking about bad things, leading to confusion and misunderstandings.
-  Children sometimes have difficulty distinguishing fantasy from reality. They may imagine frightening or unrealistic outcomes, or attribute experiences to supernatural or fantastical causes. As part of this, children may engage in "magical thinking," and believe their own thoughts and feelings can lead to negative outcomes in the outside world (contributing to self-blame for negative events outside their control).

Given all of these unique issues that may affect how children experience trauma, it is important for adults to know how to help them. To be most helpful to children, adults first need to recognize and manage their own emotional reactions. Be mindful of the messages nonverbal signals communicate. Then, with your responses in check, take the following steps:

1) Elicit the child's thoughts and feelings about their experience. Validate the feelings that they are experiencing, and help them label their emotions. Work to understand how the child is thinking about the experience, being mindful of the possibility that they may personalize or apply fantasy or magical thinking to explain events.

2) Soothe the distress. Be consistent and reassuring. Children learn coping skills from adults who model coping, and soothe them during times of crisis. Like all of us, it will be hard for children to think clearly until the intensity of distress has passed.

3) Promote objectivity. Help the child recognize the reality of the situation, and dispute any illogical explanations, particularly self-blaming. Reassure the child that s/he is safe and secure.

4) Engage in problem solving to address any ongoing concerns or immediate issues

5) Watch for signs that the child may continue to be affected by a trauma, and seek mental health services if the child is extremely fearful, angry, or cries frequently; becomes unusually clingy or isolative, or loses interest in things s/he used to enjoy; has difficulty concentrating or making decisions; shows changes in sleep or eating; has a decline in school performnce; or complains of physical symptoms such as headaches or stomachaches.

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