A friend recently asked me to write a discourse about children and how parents can be alert to the signs of trauma in their children. I have spent several hours thinking about how to express her idea and my own personal and professional insights. My first thought led me to a recent statement by a client who informed me when his previous therapist suggested that he had PTSD he became angry.
Anger is what I call an “umbrella emotion”. It covers up other emotional reactions that cause us to feel more vulnerable: shame, embarrassment, frustration, fear, and so forth. Stigma, or the negative reaction of being labeled by society, is a motivating factor for many to be angry -or fearful- of accepting they have PTSD or any mental health diagnosis. Or it may be fear of how others will perceive them if/once others discover they have a mental health concern.
Trauma and stress-related disorders include Adjustment disorder (which surpasses the normal reaction to adapting a situation), acute stress disorder, Post-Traumatic Stress Disorder, Reactive Attachment disorder (a childhood diagnosis), and Disinhibited Social Engagement disorder (a childhood diagnosis).
One of the big hurdles I work with clients on is understanding what it means when a person has PTSD. An event, real or perceived, is traumatic when it overrides your usual ability to cope. Real events include witnessing abuse or violence, natural disasters, assaults, and so forth. Perceived events include threats, thinking that you are in harms way, & etc. With regard to hurricane Harvey both qualities are met: the threat of losing your home, the threat of having to evacuate, the threat of losing prized (financial and/or emotional) belongings, having to bunker down in place, the possibility to running out of supplies, the sorrow of hearing what the neighbors or other cities experienced or watching it on television, being overwhelmed, learning someone who know died or was seriously injured as a result, &c. How does one know if their ability to handle the situation is overwhelmed? How can parents be supportive to their children?
Most people (children, adolescents, adults) who are seen for counseling with a trauma- and stressor-related disorder do not act in an anxious or fearful manner. Kids don’t act scared of Dad who they’ve seen beat their mother. Women aren’t just anxious around men who resemble their attacker. Veterans aren’t only anxious about things that remind them of their tour of duty. Clients act angry, despondent, and aggressive as well.
In the wake of Harvey, parents can be on the lookout for:
- increased aggression (a child who never threw things, does; more combative)
- re-enacting upsetting parts of the hurricane (let’s play hurricane; hoarding play food)
- lack of interest in usual toys, activities for most of the day, most days of the week
- sudden crying spells that don’t seem to have a cause/trigger
- avoidance of people, places, and topics that remind them of the hurricane (covers up ears at the mention of hurricanes, Harvey; dislikes being near sheltering locations)
- kids who are “spacing out” or “zoning out”; self-stimulation like tapping fingers or rocking.
- Signs of poor concentration like not remembering everyday tasks, forgetting homework, not able to pay attention in class due to upsetting memories that the child says just happens (or “pops” into their mind); nightmares interrupting sleep; insomnia (hard time falling asleep, staying asleep, and/or early waking).
What can be done?
If kids are re-enacting parts of the hurricane, this is fine. It can be strange to watch. If the children are young enough you can join them. Ask them what are you supposed to do next, let them direct you. This gives them a sense of control and helps them process other ways they could have reacted..
Letting them know that you were scared too, or telling a story about your first hurricane and how your mom/dad/legal guardian helped you through it. Go to the library or onto YouTube for child-friendly information on what is a hurricane. Allow them the ability to learn this is normal for the region. Engage them in emergency preparedness – just like they do fire drills at school. Practice drills at home; ask them what needs to be done, brought, left behind.
Comfort them. Don’t belittle them for crying or having nightmares. It’s one way for them and their minds/bodies to express being overwhelmed. Kids speak through their actions more than their words.
Ask guidance and suggestions from school counselors or primary care providers. They can help you determine if your child would benefit from professional counseling.