Helping Traumatized Children
The child will experience and process the very same material differently at different times following the trauma. In the long run, the opportunity to process and re-process many times will facilitate healthy coping. This re-processing may take place throughout the development of a given child. Even years after the original trauma, a child may 'revisit' the loss and struggle to understand it from their current developmental perspective. An intensity of emotional feelings will often be seen on various anniversary dates following the trauma (e.g., one week, one month and one year). Children may develop unusual fears of specific days—"Bad things happen on Fridays."
One of the most important elements in this process is that children of different ages have different styles of adapting and different abilities to understand abstract concepts often associated with trauma such as death, hate or the randomness of a tornado's path or a drunk driver hitting their car.
3. Should I talk to others about the traumatic event?
Yes. Inform adults and children in the child's world what has happened. Let teachers, counselors, parents of the child's friends and, if appropriate, the child's peers know some of the pain that this child is living with. Sometimes this can allow the people in the child's life to give them the small amount of tolerance, understanding or nurturing that will smooth the way. People can often be intolerant or insensitive when dealing with the traumatized child "Isn't it about time they got over this?" When you see that this is occurring don't be shy about taking this person aside and educating them about the long-lasting effects of traumatic events and the long process of recovery.
4. How long do these reactions last?
An acute post-traumatic change in feeling, thinking and behaving is normal—persistence or extreme symptoms are not. Many clinicians working with traumatized have noted that the persistence of symptoms beyond three months is associated with increased risk for problems. If symptoms of re-experiencing, avoidance, fearfulness, sleep problems, nightmares, sadness or poor school or social functioning persist beyond three months, they need to be addressed. If they persist for six months or if the symptoms interfere with any aspect of functioning, you should have the child see a professional. If the child is in therapy, communicate this with the therapist. Find out if school performance has been affected. Watch for changes in patterns of play and loss of interest in activities. Be observant. Be patient. Be tolerant. Be sympathetic. These children have been terrified and hurt.
In many cases, some form of post-traumatic symptom can last for many years. Indeed, more than thirty percent of children living through traumatic stress develop some form of post-traumatic stress disorder (PTSD). This is a chronic disorder requiring the attention of mental health professionals.
© Bruce D. Perry, MD, PhD and the ChildTrauma Academy. For more information about the work of the ChildTrauma Academy, please visit ChildTrauma.org.