Sarah McKennon, MA, QMHP Parent Trainer, 11/28/16
Child Trauma is defined as a single incident or a series of traumatic events that THREATENS the life, physical or psychological integrity of a child, or someone important to that child.
While this information was originally intended for parents and caretakers of traumatized children it can be useful for a wider population of children who exhibit an inability to manage their emotions. Traumatized children and adults are able to heal and gain emotional control using the tools mentioned in this article. Children heal much quicker than adults as their brains have more pliable plasticity since it is still growing. Neuroplasticity allows the brain to rewire after it has been damaged even in adulthood. Many of us have witnessed the recovery of stroke victims, this is because of neuroplasticity. Traumatized people have experienced an imprint in their brain that damaged their reaction and emotional wiring. They get stuck in “fight or flight” mode when reminded of their trauma. Reminders can be as simple as a smell, room set-up, even a facial expression, tone of voice, or a silhouette can bring back a memory of the trauma.
Studies have shown there are some children who exhibit the same behavior and emotional struggles as traumatized children though it appears they have never been through a serious traumatic experience. Children diagnosed with autism, sensory integration disorders and processing disorders may display these struggles. Children from military homes where the parents suffer from unreported or untreated Post Traumatic Stress Disorder (PTSD) from deployment may struggle this way. In studies done with military children some children, were given the label “secondary PTSD” due to their struggles. There are many other children whom suffered similarly that were from homes where parents were not military but they had experienced trauma and remained untreated for PTSD.
Parenting Matters has worked with parents having unresolved childhood trauma symptoms and found that many of their children suffer from PTSD symptoms. The traumatized parent(s) created emotionally unstable environments in the home due to their unresolved PTSD. In these situations chronic emotional outburst from the traumatized parent(s) created new traumatic experiences for their children. Trauma is about perception of threat to the onlooker. Unmanaged emotions create chaos and danger to those around them. For this reason the following information is useful in many different parenting scenarios.
Children that have experienced trauma or that have extreme emotional struggles coupled with a disability, should be offered correction and discipline differently than children that don’t. When assessing children with disabilities the long term outcomes of using these tools are not as clear. Disabled children may perceive some social situations as unsafe due to past experiences. Many of these children have suffered from bullying and harassment from impatient people. These social interactions could have been perceived as traumatic experiences for the child. Because of their disabilities many of these children are unable to explain if this is so and this makes long term analysis of the following recommendations more challenging. The disposition of disabled children appears calmer and more confident when these methods are utilized consistently by caretakers.
The effects of trauma can be re-lived when children receive typical punitive type disciplines. While correcting negative behaviors should still be done in order to properly prepare the child for independence, approaches must be considered for best possible outcomes. Parents must recognize that these children may experience typical correction differently because of their past traumatic experiences. For example, a “time-out” may cause the child to feel isolated or unsafe. Many common discipline practices can trigger “fight or flight” reactions and cause further behavioral struggles.
When the child responds with intense negativity to correction or discipline, something may be reminding them of their initial traumatic experience. This reminder triggers a “knee jerk” response to the situation. The trigger causes the child’s body to become flooded with adrenaline and cortisol in order to survive the experience. These hormones are available in the body as a survival mechanism and for endurance purposes, it is produced during high-stress situations. Because they are extremely powerful hormones, too much adrenaline can cause serious complications on the body and the child’s ability to manage stress. Attention problems and violent outbursts are linked to the overproduction of adrenaline and cortisol. Children may appear confused, out of control or immature during such episodes.
This population of children are able to be given guidance that will foster positive self-discipline in their futures. The approach should be done in a empathetic and considerate way, which presumes the child is not acting in an intentionally manipulative manner. Often their intense behavioral responses are in reaction to the loss of control they felt during the traumatic event (s). Parents and other disciplinarians should approach behavioral disruptions in a calm and reasonable way. Parents must avoid taking complete control away from the child in order to encourage healing. The caretaker’s emotions should remain out of the situation. Agreed upon boundaries and interventions should be applied almost robotically in all environments when possible. This allows the child to know the response they will receive because it is predetermined.
For instance if the child often displays noncompliance, the parent or caretaker can develop a plan. They advise the child at a neutral time before an emotional crisis, they are issuing a standard consequence for typical behavioral outburst (hitting, cursing, etc.) in order to protect and prepare the child for their future.
The child and parent negotiate an agreement to limit unsupervised activities until child shows appropriate responses to requests, utilizing a predetermined period of time (also negotiated with child). This eliminates the need to relive the problem and defend parental decisions. Such a response also decreases adult emotional turmoil or second guessing and provides the security of predictability for the child. Some children are extremely sensitive to correction after trauma. They may respond more positively to being able to earn an activity outside of the daily routine. Resistance and protest regarding the idea of earning privileges (video games, television, peer play) is common initially. After the new routine is regulated a decrease in behavior struggles will foster a sense of security in the child. Allowing the child to work hard to earn privileges back when the removal of them can not be avoided is another approach that can give the feeling of control.
Preventive Measures: Parenting methods can be put into place to create an environment that offers the child more control over their own choices and actions. Reward systems are a great way to foster motivation. They encourage children to manage their struggles and utilize coping skills. Parents or disciplinarians should develop these type systems when there is no crisis occurring. The initial presentation of the system to the child includes an empathetic response that touches on the parent’s desire for the child to feel safe and to become a strong and independent young person. A reward system offers the child the ability to earn things they have an interest in. Many traumatized children utilize certain activities to escape their environment and may become isolated in them and create a learning deficit of sorts. For example, a child reads books, plays an instrument or plays video games so much they miss out on daily living skills, age appropriate social experiences, personal hygiene practices, or educational situations that un-traumatized children are performing or experiencing. This then creates a deficit for them in these arenas. The reward system allows the child to earn their desired activity after they have completed the requirements of normalized daily living.
Unlearning and Relearning: Parents and caretakers of traumatized children must unlearn parenting practices. They must unlearn their sense of justice and discipline. They must check their emotions and unlearn reactions. The children must learn or relearn emotional control and focus. Often times simple tasks and attention to detail must be relearned. The brain experienced a change during the trauma (an imprint was made) and it needs to be changed again to correct triggered reactions. Relearning offers healing through security and mastery of tasks, creating self-confidence and peace in the child. Learning or re-learning takes time, like when we learn to fold laundry. Until we learn to slow down and place pieces of the clothing accordingly, they appear messy and we feel frustrated. A child learning or re-learning tasks may display anger and frustration towards the requirements. In response, parents should be calm and patient as the child adjusts. They should assist them until the task is mastered. If the child is resistant to independence they may be desiring to spend more time with the parent. The parent should consider giving them some extra 1-to-1 fun time if they can get the task done independently. Modification to the performance requirements of tasks in a the reward system should be made slowly or as needed while the child becomes normalized in their routines.
For example, the parent could offer the child the reward of “video game time”. Initially the child completes their chores for “video game time” but complains while doing the required tasks. The parent then adds a “good attitude” option for earning time and alters the time ranges.
Complete homework = 10 minutes video game
Complete homework with a good attitude = 15 minutes video game
Complete chores = 10 minutes video game
Complete chores with a good attitude = 15 minutes video game
Speaking kindly, softly and with a good attitude for 1 hour = 10 minutes video game
Following directions (simple commands) of parents with a good attitude = 10 minutes video game
***Disclaimer-some children are great accountants and will manipulate and bargain, confusing the parent or caretaker so they can get more of the reward then intended or possible. This should always be reflected on and reward system and placed on hold until parent is confident in the system working for the benefit of all involved. Also game time should be limited to appropriate intervals 30 minutes- 1 hour per play time then back to the real world***
Coping Skills: Because traumatized children process some social interactions differently it is essential they understand how to utilize coping skills to work through the stressful feelings different environments or situations can create.
The best way to teach coping skills is through example. Parents should reflect on the individual child’s personality type and their ability to perform certain coping skills. The parent should role play by creating situations where they (the parent) can perform the coping skill the child could benefit from. The parent then practices the desired coping skill while talking out-loud in front of child about their (parent’s) personal need to manage their stress.
For example, to teach the coping skill of deep breathing and refocusing, a parent could use an example of blowing a hot cookie, blowing out a candle or making a wave sound. The parent would create a scenario that causes stress for instance being unable to locate their keys/phone. The parent exhibits great frustration and walks around trying to locate the item. Then the parent announces they will pause and take a deep breath to help them calm down and refocus. They then complete an example scenario like putting out their hand and blow on it like there is a hot cookie they are cooling in it or they blowing on their finger like it is a candle or blowing a feather they had in their pocket from their hand. The parent does this deep breathing by blowing hard three times times. They talk out-loud, admiring the way the feather floats or talking about the cookie they must cool off. Then they articulate how they feel better and calmer since they took deep breaths and once again desire to attempt to locate their keys/phone. Further problem solving techniques might then be displayed if the child is still paying attention. The parent talks out-loud about retracing their steps from the last point they recall having their keys/phone. This displays success in the coping skill of deep breathing and refocusing when they find their keys. Another situation is then created later and the parent does not have the feather so they pretend to blow a feather or cool a cookie again to encourage the deep breathing process. They discuss how they remember how they felt better after blowing the feather or cooling off the cookie and how the deep breathing calmed them. Now the child has an example or two that they can recall when they feel stressed. The parent can use the role play as a reminder and encourage the child to take a deep breath and refocus when they see the child is becoming overstimulated. Code phrases like “cool the cookie” or “blow the feather” could be developed from these role plays to remind children discreetly to calm themselves.
Expectations: Parents often set the expectations regarding acceptable child behavior based on how they were raised. This must be adjusted after a child experiences a traumatic event. Parents and caretakers should not throw expectations they had out completely but instead recognize the traumatic event requires healing and refocusing on what the future should hold. The expectation now is to heal trauma and prepare the child to grow and become independent, successful, functioning adults. When parents focus on a healing expectation then it can be easier to choose disciplinary techniques based on what the child needs, not on a sense of justice.
Emotions Check: Parents must do an emotions check and evaluate if they have a tendency to explode or have extreme emotional outbursts (reactions) in the home environment. Then they must resolve these struggles and find more positive productive interactions (responses). Caretakers and parents must be in control of personal emotions, especially anger. Reactions (yelling, cursing, insulting others, sarcasm, grimacing facial expressions, harsh touch, stomping, slamming, etc.) are reactions and not thought out responses. A Response would be calmly redirecting, deep/reflective listening, recognizing personal shortcomings, apologizing, being present and silent, etc. These responses are in the best interest of all involved and have been premeditated or thought through before being offered to others. Children should see and hear the positive resolution type conversations just as loud and more often than disagreements and frustrations. Often children hear the conflict of adults and do not see the resolutions. Sloppy emotional hygiene must be corrected immediately and examples of mature resolution must be displayed. Many parents struggling in this area argue in front of children then make up in private. This must be reversed for healing to occur. A rapid change for the caregiver can make the parent feel uncomfortable and they may begin to second guess their choice to provide such a change. Justice and old beliefs must be set aside for healing of the brain to occur. When the child is validated with healthy examples, they are empowered to change their own reactions to responses. They do this by recalling the modeled reconciliation of caregivers that they have seen in the environment.
Modeling: Parents and caretakers should offer consistent modeling of appropriate behaviors. Intermittent modeling will cause confusion in the rewiring process of the traumatized brain. Correct modeling requires that when the caretaker feels angry they excuse them self. The parent says, “I’m feeling angry right now and need to sit in the other room for ten minutes, be quiet and calm down.” This is good emotional modeling and is a coping skill. Children do what is modeled eventually, be it good or bad. Those with physical and emotional abuse in their history may try to get their parents angry because they’re testing them. They do this test to see if the caretaker is going to abuse them or be rid of them (“fight or flight” reaction). A calm and consistent presence (response) will eventually make the child feel safe, but testing is usually a part of that. It is very normal and natural for caretakers to feel angry in response to strong anger from a child. A traumatized child will not be able to calm down if the adult can not do it first. Anger feeds anger and leads to explosions. When parents are angry and defensive they are in a “knee jerk” reaction and are not offering supportive parenting (response). Peoples’ brains contain something called mirror neurons, which cause people to have emotional reflections. This reflection is felt in us when we feel the feelings of others around us. When a child is extremely angry, those around the child can feel that anger. If parents and caretakers are able to manage themselves and calm their anger, then the child can start mirroring the parent’s calm demeanor. Another consideration parents and caretakers must evaluate is their own experiences with trauma. Parenting children with trauma can easily bring parental trauma to the caretaker’s memory. This may cause them to need to refocus (respond) to avoid reliving emotional symptoms (react). If a parent notices some of those type issues coming to mind often, they will need to seek counsel with a mature adult or counselor, so they can process those feelings and stabilize their parenting abilities.
Validating a Child’s Emotions: After a behavioral episode parents and caretakers should address the child’s emotions first before problem solving, offering advice, or giving consequences. Children with trauma can have a hard time identifying emotions and are often struggling to understand the physical feelings an emotion causes them. When a child exhibits emotions and behaviors that are too pronounced or over reactive, they have emotional dysregulation. For example, a parent requests a simple routine task be completed and the child then throws a huge fit, cursing and stomping around the house and then crying uncontrollably. To help the child, parents should deal with the emotion first. Being present in a nonjudgmental way and at an appropriate time encouraging the use of a coping skill. Then the parent should acknowledge what emotion was presented (anger, sadness, frustration) and be sure the child was feeling the same emotion they believe they witnessed. Often children do not understand the feelings their body has when they experience an emotion, this confusion can trigger an outburst. Once the child is calm they can explain to the caregiver what caused the outburst (child was late, worried, unable to concentrate, etc.). The parent can then move forward with reassurance that the caregivers are there to help with emotional struggles and life circumstances. Natural consequences should be discussed and recognized. Because of the time dealing with the outburst the child is now late for an activity on the daily schedule. They may have missed dinner, a television show, or ride to an event, etc. The child should then be brought back into the daily schedule and reminded of goals. Later at a neutral time caretakers should follow up or debrief about dangers of outbursts. They could ask, “What is something we can do to help you get your anger out that won’t hurt anyone?” Sometimes children display anger when they are feeling scared because the fear feeling is similar to what they felt during the traumatic experience. Those feelings trigger an anger reaction for children that have been traumatized (fight or flight). Parents help the child regulate by teaching responses.
Avoiding Power Struggles: Children with trauma backgrounds often create power struggles. They have a strong desire to stay in control. Such control was lost during the traumatic event and all subsequent feelings of possible control loss trigger strong reactions initially. Parents and caregivers assist the child in developing healthy response skills to replace the strong reactions. Children that have not experienced trauma often feel taken care of and usually do not feel like they have to control everything. Traumatized children often feel confused, unsafe, abandoned, abused, or that the world is not safe. They report feeling like they must be in control to keep themselves safe. They do not do this purposefully and parents should recognize they have an overload of adrenaline and are reacting to just that. This is not a situation that can be won. To avoid power struggles, first give them as much power as you can (choices, responsibilities, respecting their opinions). Have a planned verbal response when child begins an argument like “I love you and am preparing you for your future independence.” or “Seems you are avoiding something.” These standard remarks end the verbal struggle and create security through predictability.
Time-in: A Time-in is a great way to teach self control when children are out of control. This consists of removing the child from the stimulating situation and sitting with the caretaker until they are calm. No physical or emotional interaction is needed. The parent can remind the child to use coping skills like regulating their breathing through deep breathing exercises or by handing the child a tissue or a cool rag. Requiring a separation from others for discipline (like time-outs or going to your room) gives the child the message that they are bad and it will not help calm them down in a productive way (coping skills). If others are in danger they should be asked to leave the area when possible. Parents should model this behavior – if the parent feels upset they verbalize their emotions and model taking some time to calm down.
Offering Choices: Children should be offered choices (clothing, food items, television shows, video games, activities etc.) as much as possible. They do not need to be given free range but instead advised what is available of at least two. Consequence choices are of great importance. During a neutral time create a list of problem behaviors (creating unrest or unsafe situations) and with the child develop suitable and applicable consequences.
For example, if they refuse to turn off the television on time they do not earn their next television time after one warning. If they do not complete chores they do not earn free time after two reminders.
Do not decide on consequences in the middle of a crisis. The child has too much adrenaline and cortisol flowing to be able to make decisions accordingly. After an episode and when the child has recovered give choices as much as possible and help the child to recognize natural consequences. Some natural consequences could be:
Threw phone=broke phone/no phone
20 minute tantrum=missed car-pool to soccer practice/no soccer
Have the child recommend their own consequence first. Many healing children will offer better consequences for themselves during their remorse than the predetermined ones, so offer them this opportunity. Ask the child what they think should happen to make everyone feel safe again. If the response is suitable accept it, this offer the child a feeling of control. If it is not, give the predetermined consequence that matches the behavior.
References:
Paul Tough, How Children Succeed: Grit, Curiosity, and the Hidden Power of Character. New York: Houghton Mifflin, 2012.
Bessel Van der Kolk, MD, The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma. Penguin Books, New York. 2014.
Heather Forbes, Help for Billy: A beyond Consequences Approach to Helping Challenging Children in the Classroom. Boulder, CO.: Beyond Consequences Institute, 2012.
Charlotte Silver, Can Childhood Trauma Shorten Your Life? Alternet, 24 Dec. 2013.
Martin H. Teicher, Scars that Won’t Heal: The Neurobiology of Child Abuse, Scientific American, March, 2002
David Bornstein, Teaching Children to Calm Themselves. The New York Times, March 19, 2014
Rebecca Ruiz, How Childhood Trauma Could Be Mistaken for ADHD. The Atlantic. Atlantic Media Company, 07 July 2014.
Kenneth R. Ginsburg, and Martha M. Jablow. Building Resilience in Children and Teens: Giving Kids Roots and Wings. Elk Grove Village: American Academy of Pediatrics, 2011.
John Medina, Brain Rules: 12 Principles for Surviving and Thriving at Work, Home, and School. Seattle Washington Pear, 2008.
John Medina, Brain Rules for Baby: How to Raise a Smart and Happy Child from Zero to Five. Seattle, Washington, Pear, 2010.
Daniel Siegel, Mindsight: The New Science of Personal Transformation. New York: Bantam, 2010.