Starting Early
How to talk about trauma

Studies indicate that most children will be exposed to at least one potentially traumatic event by the time they’re 18. Many of them won’t develop symptoms or require treatment. But many who need help don’t get it, experts say. Here are some things to know about trauma and how to address it.

by Arielle Levin Becker

What is trauma?

Definitions vary, but experts generally say a traumatic event is something that overwhelms a person’s ability to cope. Examples of potentially traumatic events include experiencing abuse, witnessing violence or being in a natural disaster or car accident. But people’s responses vary, and an event that produces symptoms of traumatic stress for one child might not for another.

Neglect, the most common form of maltreatment, doesn’t meet clinical definitions of trauma that refer to a specific traumatic event, but experts say it can be particularly harmful to children’s development. And they say children who are neglected often experience other forms of trauma.

Signs of trauma

Signs that a child could be struggling with trauma include difficulty sleeping, nightmares, appetite problems, withdrawing from normal activities or other changes in behavior.

“If you had a gregarious, outgoing, good student who suddenly becomes withdrawn, sad, [has] difficulty studying, focusing, that’s your biggest thing,” said Kimberly Shaunesey, chief operating officer at Boys & Girls Village, a Milford treatment provider.

Often, traumatic experiences can manifest as negative behaviors, like becoming more irritable, clingy or negative, said Alice Forrester, executive director of the Clifford Beers Clinic in New Haven. She suggested that parents try to determine what’s behind those behaviors, rather than immediately disciplining the child.

What parents can do

Talk about emotional issues early

Experts recommend making a habit of talking to kids about emotions and how their experiences affect them. That can help them feel comfortable mentioning something more serious or traumatic if it occurs.

“People should be willing to have ongoing conversations, which makes a conversation in the more extreme much easier,” said Steven Kant, president and CEO of Boys & Girls Village.

For example, he said, a parent might ask a child how he’s feeling about starting a new grade, or mention that it’s not unusual to feel a little anxious about starting a new sport and that they can talk about it if he wants.

Kenneth Spiegelman, a Manchester pediatrician who trains other medical providers about trauma, asks patients if anything scary or uncomfortable has happened in their lives. He likened it to putting out a welcome mat to let his patients and their families know they can talk to him about serious or traumatic issues. “Unless you invite them to and make it easy for them to, they never will,” he said.

If you know about a potentially traumatic event, talk to your child about how it could affect them

When a student was stabbed at the local high school, Kant urged parents to talk to their teenagers with some basic messages: Experiences like this can make people feel upset or anxious. If you begin to feel that way, we should talk about it. I’ll check in in another month and see how you’re doing.

If you suspect a problem

If you think your child is struggling with something, ask about it the way you would typically talk to him or her, Forrester said. “Is something worrying you?” is one way to start.

The child might say no and not want to talk. That’s okay, Forrester said. Asking helps to establish that you’re willing to listen and someone they can trust if and when they need to talk.

When someone has experienced trauma

Ways to help

Children often believe that things that happen to them are their fault. The National Child Traumatic Stress Network recommends that parents explain to children that they are not responsible for what happened and assure them that they’re safe.  The organization also recommends that parents take a balanced perspective: Take the child’s reaction seriously – don’t minimize it or say, “It wasn’t so bad.” But recognize that children can recover from the effects of trauma.

How to find help

Not everyone who experiences trauma will develop symptoms or require treatment. But for those who do, there are many forms of treatment, including some, like cognitive-behavioral therapy, that have been shown in studies to reduce post-traumatic stress symptoms.

The state’s Infoline, reachable by calling 2-1-1, can provide information about nearby child guidance clinics and other resources. Pediatricians and school counselors are also good sources for suggestions, experts said.

Kant suggested asking kids who they would feel most comfortable talking to.

If there’s an acute situation, families can call 2-1-1 to reach the state’s emergency mobile psychiatric services.

Healing varies

Not every treatment approach works for every person. The same goes for therapists.

“It’s very unique. It’s very individual, and you’ve got to find the right fit,” said Nelba Márquez-Greene, a licensed marriage and family therapist.

While many forms of therapy are short-term or time-limited, Márquez-Greene said it’s important to recognize that healing does not follow a strict pattern.

“There is no timeline for healing,” she said. “Healing is as individual as a thumbprint.”

Get help for yourself if necessary

Márquez-Greene said the instructions on airplanes about oxygen masks – put yours on first, then put on your child’s – apply here.

“The healthier and stronger a parent or caregiver can be, the more likely it is that the child is going to respond to that,” she said. “But if you’re drowning, you won’t be able to be helpful.”

Márquez-Greene’s daughter, Ana, was one of 20 first graders killed at Sandy Hook Elementary School. For her and her husband, a part of the grieving process has been recognizing that their son knows that his parents can’t always keep him safe and shield him from harm, or solve everything.

“Be okay with the fact that you may not be able to fix it,” she said.

People can recover from trauma

“Traumatic events are things that stay with us forever,” Márquez-Greene said. “They don’t have to negatively impact us forever, but they just stay with us forever.” ♦

This was produced as a project for the National Health Journalism Fellowship, a program of USC’s Annenberg School for Communication and Journalism.

Arielle Levin Becker covered health care for The Connecticut Mirror. She previously worked for The Hartford Courant, most recently as its health reporter, and has also covered small towns, courts and education in Connecticut and New Jersey. She was a finalist in 2009 for the prestigious Livingston Award for Young Journalists, a recipient of a Knight Science Journalism Fellowship and the third-place winner in 2013 for an in-depth piece on caregivers from the National Association of Health Journalists. She is a 2004 graduate of Yale University.

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