When It's Too Late to "Be Careful"
Note: A version of this article was published in the Ithaca Child, Fall 1996 issue.
When I showed my mother the stitches on my head, she laid down the law: "From now on, wrap yourself up with pillows before you play basketball." We both laughed - but she really did wish she could protect me, from every bit of harm the world has to offer. Parents are like that.
Of course, even the best parents can't protect their children from every hurt. Nor would we want to. Part of growing up is learning to cope with skinned knees and lost games. On the other hand, we consider it a tragedy when a child is exposed to a severe trauma or loss. We read about such children in a Florida hurricane, a California earthquake, a Scotland school shooting, and say, "How awful! I'm glad my child wasn't there."
How could this be so common? We don't have earthquakes here! But we do have: car accidents, house fires, robberies, attacks by bullies, child abuse, divorce and abandonment, deaths of family members, friends, pets... "Wait a minute," somebody always interrupts at this point, "You're just talking about life. Everyone has something like this. Are you saying this is all child trauma?"
Maybe. Let me explain what I mean by child trauma. There are two ways of handling an upsetting experience. Ideally, the child will go through the memories, thoughts and feelings over and over until, little by little, it is somehow mastered, and no longer disturbing. However, some experiences are so upsetting and overwhelming that, instead of facing the memory, the child tries to push it out of the way. This strategy may provide temporary relief, but when the memory is not worked through, it keeps its disturbing power. In fact, the more the child avoids facing the memory, the more stuck he or she will be. And this can happen with many types of experiences, including loss as well as trauma.
When your child experiences a trauma or loss, you may notice some changes, perhaps in attitude, mood, or behavior. Children's natural feelings of sadness, fear, anger, guilt, and helplessness can be expressed in a variety of ways, some of which might not seem to make sense. One child may argue more, become clingy, have trouble getting to sleep, and have bad dreams. Another child might react completely differently, for example, by becoming quiet, withdrawn, anxious and sad. Your child might have other symptoms you don't notice, for example, feeling at fault, thinking a lot about the memory, and being afraid that something like it will happen again.
Remember that these are normal reactions - your child's world has just been shaken up. Such symptoms do not mean that there is something wrong with your child. If all goes well, the symptoms will gradually fade as the child works it out.
You can help your child get through this difficult time by being supportive and reassuring. Some parents try to protect their child after the fact, by not talking about the event. But this just gives the message that it is too scary even for a grown-up to face. The child needs to feel free to talk about it, to express thoughts and feelings at his or her own pace. And the child may need to hear, over and over again, that he or she is not to blame, is safe now, etc. This is also an important time for parents to be consistent in their discipline. After a trauma or loss, children often feel very insecure, and might test parents by trying to get special treatment or by acting up. Although you might be tempted to indulge your child, be careful. Being inconsistent can give your child the message that even you can't be counted on anymore.
Unfortunately, sometimes even your best effort might not be enough. You may be so upset yourself that it's just too hard to handle your child in the best way. Or your child may refuse to let you get through; the trauma or loss may be too severe. Then the child might get stuck. This can happen even when the acute symptoms subside, and the child "seems okay" again. Many children keep their distress to themselves, so as not to worry their parents or seem strange to their friends. Untreated, your child's response to trauma or loss can have long-term consequences. This can range from being more sensitive to similar wounds in the future, all the way to major problems such as long-term behavior problems, depression, anxiety, or post-traumatic stress disorder.
Remember, it will not go away by itself. Your child needs your help. If you feel that your child may be stuck, it is time to consult a child psychologist or other mental health professional. There is no shame in getting help for your family. As a parent, it is your job to handle the day-to-day problems, and to recognize when more help is needed. You wash a cut yourself, but a broken bone you bring to the doctor. Right? The principle here is the same, even if the wound is of a different sort.
There are many child therapists, and it is important to find one who is right for your family. First of all, try to find someone with a good reputation, who has training and experience in working with children like yours. Then schedule an appointment and see if you feel comfortable, if you trust this person to help your family. If you are not sure, you can express your concerns and see how the therapist responds. If you still have serious doubts, it is okay to try someone else. You are the customer and you have a right to choose.
The therapist should keep you involved and informed, even if the focus is on the child. This does not mean that you are told every detail about your child's session, but you should be generally aware of progress, and of what you can do to help. You can usually expect to see progress within a few weeks to a few months, depending on circumstances. You can help the therapist by being reliable, cooperative, and honest.
For better or worse, we can't wrap our children up in pillows, and they will get hurt sooner or later. Then it is up to us to help them through it, so that they can grow stronger from the experience, and not become crippled. Parents can help by being supportive, reassuring and consistent. When the hurt is more severe, or when the child seems stuck, it can be very useful to consult a professional. The good news is that, even after the trauma or loss has happened, you can do a lot to help your child recover. And with recent advances in treatment, there is more reason for hope than ever before.