For Families > Keeping Kids Healthy > Talking About Tough Topics

Coping With Trauma

by Margery D. Rosen

As Seen In November 1999's Child Magazine
Excerpted From Childhood Revealed: Art Expressing Pain, Discovery and Hope, edited by Harold S. Koplewicz, M.D., and Robin F. Goodman, Ph.D. Copyright 1999 by New York University. Reprinted by permission of Harry Abrams, Inc., Publishers

Mental Health Series, Part 2
Coping With Trauma

Text by Margery D. Rosen

Earthquakes. Shootings. Tornadoes. Whether kids experience these disasters directly or hear about them on the news, they take a toll. Here's what we can do to help.

On an ordinary Tuesday morning in Littleton, Colorado, two heavily armed teenagers slaughtered 12 classmates and one teacher at Columbine High School, leaving 23 others wounded. A 4–year–old watching repeated broadcasts of the terrified Colorado teenagers running from their school building doesn't realize he is seeing a tape. Instead, he thinks that someone is shooting children in many schools across the nation.

A 10-year-old boy is brutally assaulted by a family member. He escapes with a broken collarbone and abrasions on his face and hands. Although his body heals, the emotional wounds are evident by his recurring nightmares.

They are trauma's littlest victims, suffering from an illness most people associate only with soldiers in combat. Posttraumatic stress disorder (PTSD) is characterized by an array of acute, disabling psychological, behavioral, and physiological symptoms triggered by a severely frightening experience and persisting long after the event has taken place.

The number of children affected is staggering. Every year, at least three million children show signs of PTSD. Perhaps they witnessed an isolated terrifying spectacle, such as a devastating hurricane, tornado, or other natural disaster. Or perhaps their ordeal was chronic, persistent domestic or community violence or repeated physical abuse.

Whatever the initial trauma, these children live in a constant state of fearfulness, reliving the experience over and over again in their play, their sleep, their drawings, their speech, or their relationships with others, as they try to make sense of the incomprehensible. Worse still, because some people don't believe that children can be affected even by a single traumatic experience, their symptoms are frequently overlooked or dismissed and many never receive treatment.

A different kind of scared

Frightening things happen to kids all the time, whether it's falling out of a tree, getting stitches, experiencing the death of a beloved grandparent. In most cases, children are scared, sad, angry, or confused for a period of time. Soon, however, they harness their inner strength and move on with a sense of confidence that they can cope when times get tough. It may even be that when something reminds them of the past, they become depressed again for a while. But the grief or panic doesn't interfere with their everyday life. Feeling traumatized is a different kind of being scared. When anyone, young or old, experiences a real or perceived threat to his or her life, certain physiological changes are automatically triggered: the heart rate quickens, stress hormones pour into the bloodstream. In the immediate aftermath of the trauma, almost everyone will have acute symptoms such as nightmares or fearfulness.

But sometimes the part of the brain that triggered the initial alarm goes into overdrive and never calms down. Recurring intrusive recollections of the event cause an individual to remain in a perpetual state of fear and anxiety, on the lookout for signs of danger. Or, like opossums, children may withdraw: emotionally numb, their impassive, blank faces register nothing, but their hearts are racing and their brains are shrieking "Danger!" If the trauma is prolonged, the chances are great that the emotional, physiological, and cognitive scars will be permanent. Their minds literally stop functioning in a normal way; their internal landmarks—the signposts we use to help guide us through life—become skewed.

Some signs of trauma are easy to spot. Infants cry and cling more than usual. Preschoolers regress to soiling their pants, sucking their thumbs, or stuttering. School–age children are unable to concentrate on work or complain of headaches, stomachaches, nausea, or nightmares. They may even convince themselves that the terrible ordeal they witnessed will happen again—and worse, that they were responsible for its occurrence in the first place. However, because many trauma symptoms are less obvious, they are easy to miss or misinterpret—the withdrawn child with the blank facial expression won't be as noticed as a child who wakes up screaming in the middle of the night.

Why kids bounce back

Why are some children able to withstand, even triumph over, shocking events while others are crushed by them? Those who work with traumatized kids have learned that to some extent, the ability to withstand high stress is a question of temperament. Some more easygoing babies are simply more resilient. So, too, are youngsters raised in generally loving, nurturing homes—or those who have found a teacher, coach, or another relative who cares about or believes in them. The age of a child, as well as the duration and source of the trauma, affects a child's ability to cope, too. A 10-year-old who fully understands that his neighbors are on different sides in a war could be more traumatized than an infant in similar circumstances—but it's wrong to assume that the infant will be unaffected because she lacks understanding or the words to express what she sees.

How parents can help

Of course, most children will never be exposed to such horrors. But children see and hear so much that can frighten them, it becomes a challenge to protect them. Here's what you can do:

Honestly express your own fears. If a child senses that you are secretly worried, she will keep her worries to herself. The idea of violence terrifies children, shattering the sense of order, routine, and predictability that makes them feel safe. Pretending you aren't afraid won't work. However, by admitting your fears, and showing them that you can handle them, you show how to cope and you send the message that they can overcome their fears.

Don't dismiss their worries. Let children know that you're available to talk, and when they do open up, encourage them to discuss their fears. Their emotions and feelings deserve to be acknowledged and addressed in a loving, comforting way. If you deny or minimize what a child feels, you handicap her ability to put life's ups and downs in perspective and she'll grow up distrusting her own judgment. Of course, many times we don't have a good explanation for why something happened. In that case, simply listening and giving a child a chance to say what she's thinking can be what's called for.

Put problems in perspective. Keep in mind that, until they are 6 or 7, most children do not have the ability to logically think through something that has happened or to put into perspective an event they see on television. That's why it's critical to limit exposure to the news or to frightening, violent television shows or movies. However, if your children do see or hear something that scares them, use it as an opportunity to teach concepts such as probability.

Put your explanations in terms they can understand. To a 4–year–old who is afraid a tornado will strike his house, you can say, "Will a zebra walk into the living room? Probably not, right?" To your 7–year–old who worries that the airplane you're taking to Grandma's will crash, you can say, "You fell off your bike last week, and that was a bad thing. But it doesn't mean you shouldn't ride your bike. Well, it's the same thing with an airplane. Sure, sometimes planes crash. But most take off and land safely." Also, remind your children that we've learned a lot about how to make the world and our neighborhoods safer. Bring their concerns home by discussing safety in the house, at school, in your community. If there's any good news to come from terrible events, it's that youngsters can learn from their parents about how to handle the powerful emotion of fear.

About the Author

Margery D. Rosen wrote the text for Childhood Revealed: Art Expressing Pain, Discovery and Hope.