Post-Traumatic Stress Disorder & Children
Children who are experiencing Post-Traumatic Stress Disorder (PTSD) need special treatment and consideration. In order to understand and react to challenging behavior that may result from the trauma that they have experienced, adults must try to see through the child’s eyes. Dr. Becker-Weidman (2008) said that all behavior has meaning and that it is important to focus on what is causing, driving, and motivating the behavior. Children need to feel supported and that they are not alone as they face intense emotions.
Problematic Influences of Post-Traumatic Stress Disorder on Children
Post-Traumatic Stress Disorder children experience impairments in several areas of their lives. They may struggle with relational boundaries demonstrated by a lack of trust, social isolation, lack of empathy, and difficulty attuning with other’s emotional states (Becker-Weidman, 2008). Children may act in ways that make them seem insensitive, but in reality they are distanced from healthy social interaction due to the trauma that they have experienced. Rather than punishing children in a punitive manner, it would be more beneficial to explore the behaviors in a neutral approach that allows the child to feel supported and cared for while pointing out more functional options. Perceived isolation in the processing of recurring traumatic emotions and in following daily interactions will lead the child to continue to feel unsafe.
Children experiencing PTSD need help with emotional regulation and may experience difficulty identifying and expressing emotions. As they struggle to identify and describe what is going on internally, they also strain to communicate their needs and wishes outwardly (Becker-Weidman, 2008). This again is why it is so important to be understanding when a child may seem defiant and resistant to help. Behavioral disruptions should be expected and encountered in a sensitive manner. Poor impulse control, destructive behaviors, excessive risk taking, aggression, sleep problems, and physical symptoms, such as headaches or stomachaches, are often associated with Post-Traumatic Stress Disorder (Becker-Weidman, 2008). So a child who is “acting out” may actually be crying out for help.
Inattention, Confusion and Poor Self-Esteem
Dr. Becker-Weidman (2008) described cognition impairment and dissociation resulting from PTSD. Cognitive impairment would include a child who experiences difficulty paying attention, processing new information, focusing and completing tasks. A child who struggles with executive functions such as planning, judgment, initiation, use of materials and self-monitoring may mistakenly seem out of control or irresponsible. Dissociation would be exhibited by amnesia, distancing of self from existing personal ties and manipulations of reality in order to serve as defense mechanisms. Assisting children after they have experienced trauma that has led to Post-Traumatic Stress Disorder should be the goal since their functioning has been compromised.
Non-compliance or excessive compliance often signify disturbed thought processes. A compassionate approach to addressing these problems will help to regain a sense of safety that will allow the child to eventually express their feelings and needs. Punishments will cause the child to shut down and increase feelings of helplessness. Discussion and support may help the child to uncover and accept feelings that are influencing their behaviors. Professional help should be sought to explore the trauma in a safe environment with therapeutic methods.
Children may suffer in school due to the disruption in thought processes and possible hindrance in communication. Academic and social impairments may worsen disturbances of self-concept such as disturbed body image, low self-esteem that may cause them to feel unlovable and excessive shame that makes them want to hide (Becker-Weidman, 2008). This shame is not related to guilt, but rather how the children see themselves. It is important to remind the children of who they are and why they continue to be loved and valued. These children often feel lost in the trauma and the resulting emotions.
Post-Traumatic Stress Disorder and Play
Children experiencing Post-Traumatic Stress Disorder often tell their story through their play. In attempt to process what has happened they may reenact the trauma scene over and over again. Halgin and Whitbourne (2003) described an example of repetitive trauma-related play as a young girl who was involved in a serious car accident repeatedly reenacts car crashes with her toys. This play should not be restricted because it is not considered to further traumatize the children and restriction may cause further harm. Children often feel impelled to re-create the moment of terror and if not in literal terms, they will do so in disguised form (Herman, 1997). Paying attention to the play and its details is important in order to gain insight of the child’s perspective of the traumatic event. Herman, author of Trauma and Recovery (1997), said that the light-spirited, free everyday play of childhood can be distinguished from grim and monotonous traumatic play because it does not stop easily and does not often change over time.
Becker-Weidman, A. (2008). Treating Children who have Complex Traumatic Stress Disorder. [Live presentation]. New York: The Desmond Hotel.
Halgin, R. P. & Whitbourne, S. K. (2003). Abnormal psychology: Clinical perspectives on psychological disorders. Boston: McGraw Hill.
Herman, J. W. (1997). Trauma and recovery. New York: Basic Books.