Why help children overcome trauma
Statistics emerge in the communities an urgent and critical need to protect children and young people from developing mental discomfort.
According to the American Society of Positive Care of Children (www.americanspcc.org): adults who have undergone mistreatment from children have an increased risk for the development of physical, emotional, working and relational problems throughout the whole life. Half of the mental discomfort of adults manifests itself within 14 years of age and two thirds within 24 years.
Felitti’s important study on adverse childhood experiences (Adverse Child Experience – Ace – Study) shows theimpact of trauma In the long term on a sample of 17000 people: infantile traumatic experiences are related to an increased risk for mental, physical diseases and behavioral problems from childhood throughout the life span.
Trauma in children
For trauma We mean any experience that undermines the sense of security and well -being of a person, leading it to have distorted and negative beliefs about himself and the world.
The trauma with the “capital T” are in the diagnostic and statistical manual of mental disorders, fifth edition (DSM – 5) those experiences that can lead to post -traumatic stress disorder (PTSD): catastrophic experiences such as natural disasters, violence suffered or assisted, serious accidents; In general experiences of horror, fear for one’s own safety or oppressive pain, accompanied by a sense of helplessness.
The trauma with the “tiny t” are those instead Relational negative experiencesas a lack of emotional tuning, neglect, criticisms and behaviors that lead to experimenting states of helplessness, shame, humiliation, lack of hope.
For a child, the experiences of abandonment, of breaking the attachment bond, mourning, can be considered trauma with a capital T. To these events it can respond with symptoms that may also remain for very long periods of times or leave internal damage even when they decrease in their acute form (Greenwald, 2000).
But for a child also a test gone badly, a quarrel with a friend, the loss of a grandfather, can be traumatic experiences.
The effects of trauma
Trauma brings not only an emotional experience of helplessness and fear, but also an important physical response.
Our body is programmed to guarantee us safety and survival. When we feel in danger we enter a state of hyperactivation and sensory and cognitive information relating to the traumatic event are stored in the nervous system in that excitatory state.
If the experience remains in an unreal state, when something similar is presented in part or completely in the awareness with the aim of falling within the processing system, but with the result of creating further suffering.
The child can experience theIntrusion of mental images In the form of convictions or emotions that present themselves in the form of disproportionate reaction to the present situation.
Some children consider threatening many aspects of their lives simply because they never know when the memory could reappear. The traumatized child can develop a greater sense of danger of the external world, which goes hand in hand with the sense of danger of one’s mind.
The perception of possible threats can lead to symptoms such as restlessness, anxiety, tendency to perceive others as hostile, hyperexcitability. The child can develop a general sense of vulnerability and ineffectiveness or states of emotional duties and typical avoidance behaviors also of the PTSD in adults.
The diagnostic investigation in children
In children, the manifestation of post traumatic symptoms is often quite different from the classic adult PTSD framework. Somatic symptoms or forms of regression may prevail.
The behavior of traumatized children, rather than the criteria of the PTSD, will correspond to that of other diagnostic categories, such as ADHD, generalized anxiety states, depression or provocative oppositional behavior.
These diagnoses carefully describe the behavioral characteristics of the disorder, but often the roots are not faced. Failure to diagnose the trauma can lead to the chronicization of symptoms and lead to adult pathologies such as borderline personality disorder, complex ptsd or dissociative disorders.
And even more than in adults it is necessary to consider the definition of trauma widely, as a disturbing experience that has not been well integrated. And so the aim is to go to the heart of the “mystery”: what has caused the problem and what can we do with this?
How children respond to trauma
Children can be particularly vulnerable, as they are more defenseless and subject to frightening adults and have not yet developed those cognitive, emotional and physical skills that adults have to deal with daily events and challenges.
They are resilient by nature, they must acquire autonomy by overcoming many difficulties and to do this they are equipped with a healthy self -centeredness and a strong sense of their potential. But to achieve success in the acquisition of the evolutionary stages they also have need to feel loved, worthy of care and safe.
The adverse experiences already create the emotional and somatic bases of those that will become post -traumatic beliefs already in preverbal times. For example, a child who has been neglected or who has had non -consistent and predictable care can create convictions such as “I cannot trust adults”, “I cannot bear the changes”, “I don’t care about love”.
These beliefs lead to feelings of anxiety, distrust, anger, fear. And controlling, oppositional, rigid and resistant behaviors to change, which create difficulties in the trajectory of development.
What is EMDR therapy
EMDR therapy (Eye Movement Desensitization and Reprocessing) is a recommended psychotherapeutic psychotherapeutic approach, together with cognitive behavioral psychotherapy (CBT), WHO for the treatment of post -traumatic disorders in children, teenagers and adults.
The EMDR approach is based on the assumption that in our brain there is an innate information processing system that allows the integration of new experiences in existing neuronal memory networks. The memories of traumatic experiences remain stored in a dysfunctional way in memory networks isolated by the others, not integrated and in an excitatory state. Non -trial memories are then stimulated by internal and external stimuli, leading to cognitive, emotional and inappropriate behavioral reactions.
How the EMDR works
There EMDR therapy He works by accessing the memories of the traumatic event and activating the innate processing system through alternating bilateral stimulation (BLS) which can be visual, tactile or auditory type.
With stimulation, the processing process metabolizes the memory that can thus be connected to other information present in memory, leading to an evolution and post -traumatic growth. What is useful for an experience is stored with appropriate emotions and guides the person in his future.
Although some experiences can be stored in a dysfunctional way, the person is intrinsically healthy: once these experiences are tried, we return quickly to a state of balance and positive experiences become more powerful and vivid.
EMDR with the children
History collection
The EMDR work with children can be very similar to that with adults for older children and teenagers or request important adaptations with younger children.
The therapist who works with children first of all meets parents to understand the child’s problem, his operation, his story.
His experiences and traumas that may have contributed to the development of the problem are investigated.
In any case, the taking charge is of the whole family, with particular attention also to the most significant aspects of the history of the parents, as well as their any problems, the unresolved experiences that can be connected with the problems of the child, their beliefs, as well as fears and hopes.
Preparation phase
The therapy proceeds with the construction of a relationship of trust with the child to whom ways are taught to calm down and tolerate the most difficult emotions. The parent’s objectives are reformulated on the basis of what are the objectives that can be shared by the child to increase collaboration and trust.
Identification and processing of traumatic experience
Children may not be able to remember or talk about traumatic memories, but give clues to their experiences and feelings during the game or during their creative work.
In the game, the rich emotional life of the child emerges that must be traced back to his history and experiences. It is from the world of game that we try to understand the child’s perspective, to understand what his behavior is telling.
It is in the game that the Desensitization phase of the EMDR is adapted, more or less similar to the standard protocol depending on the child’s ability. In focusing on the emotions of a puppet, the child can, for example, express his emotions in a non -overwhelming way and the therapist can make bilateral stimulation while the child helps the puppet to overcome his difficult emotions, being careful so that the intensity of the helical emotions are always endured for the child.
Another fundamental aspect of the processing phase is to provide appropriate and useful information to the adaptive processing of experience. Children do not have adult perspective therefore they need help, in the form of information and reassurance compared to issues such as security and responsibility (eg “it is never a child’s fault if an adult drinks and hurts someone”).
Strengths
Children tend to process very quickly because they have very short associative chains, less “history” than adults and therefore less rigid structures. The EMDR works very quickly and effectively in well -adapted children who have experienced a single trauma limited over time.
It can help reduce anxiety related to organic diseases and modify dysfunctional beliefs created precisely as a consequence of the disease.
It can also be used in a very effective way to strengthen positive resources and functional coping strategies when unfortunately the child remains in difficult life situations or in a condition of discomfort (eg a child with ADHD can work on his belief of “being incapable” and on strengthening the belief “I can do this task alone”).
It is never easy for a parent to bring a child to therapy, due to the stigma, of the being involved, of the objectives too often indefinite.
The EMDR approach can be facilitating from this point of view because in some situations he works faster than other therapeutic approaches. It has a targeted approach and the objectives are clear and shared: bring relief from the consequences of trauma so that the child can resume his healthiest life trajectory.
Bibliography
- American Society of Positive Care of Children (www.americanspcc.org)
- Greenwald R. EMDR with children and adolescent. Astrolabio ed., 2000.
- Lovett J. Small Wonders. Healing Childhood Trauma with EMDR. The free press, 1999.
- Lovet J. Trauma Attachment Tangle. Modifying Emdr to Help Children Resolve Trauma and Develop Loving Relationship. Routledge, 2015.
