Moving Beyond Trauma

How to tell if your child is traumatized

2009-08-24T17:54:00.000-07:00

Every child has moments of sadness in response to life’s disappointments, but how can you tell if your child has been traumatized?

Unlike adults, children are not always able to express their emotions in words. Therefore it is critical to pay attention to significant behavioral changes, particularly those that occur following an injury, illness, death of a loved one, or catastrophic event such as a natural disaster or major accident. Divorce, separation, or other disruptions to family life, such as moving to another city or changing schools, can also be difficult for children to tolerate and could lead to problems adjusting.

Children who experience a major loss or other traumatic event respond in many different ways. Some may have difficulty sleeping, or develop a fear of the dark. Others might have a loss of appetite, throw tantrums, or be more irritable or impatient than usual. Children are incredibly resilient, and such symptoms usually subside within a few weeks or months without any clinical intervention or counseling. However, if your child displays any of the following symptoms for six months or longer, you may want to have them assessed by a licensed mental health professional.

Sleep disturbance: sleeping too much or too little, avoids going to bed at night, nightmares or terrors, restless sleep, sleepwalking, or talking in sleep, refusing to get out of bed or having difficulty waking up in the morning

Change in appetite: eating more or less than usual, loss of appetite, refusing food, hording or hiding food

Irritability or tantrums: excessive arguing or complaining, hysterical crying and screaming in response to changes to daily routine or minor disappointments

Worry or anxiety: fear about personal safety or the safety of loved ones, persistent fantasies involving death, illness, or other distressing events

Violent or aggressive behavior: throwing objects, destruction of property, hitting, kicking, punching, yelling, or threatening siblings, other children, adults, or pets

School refusal: not wanting to go to school, refusing to do homework or engage in other academic activities

Loss of interest: dropping out of sports or other extracurricular activities, not wanting to interact with friends or other children, indifferent towards toys or other things once found enjoyable

Regressed behaviors: bed soiling, thumb sucking, wanting to be held constantly, separation anxiety

Acting out behavior: lying, cheating, stealing, promiscuity or inappropriate sexual activity

Somatic complaints: headaches, stomach aches, or other aches and pains not caused by a medical condition

Repetitive play: Re-enacting the traumatic event over and over through play
Phobia: sudden development of irrational fears that interfere with daily functioning

Suicidal ideation or attempts: talking about wanting to die or wishing they were dead, engaging in high risk behavior or self harm such as cutting, scratching, burning, or hitting, suicidal threats

Alcohol or drug abuse: drinking or using illegal drugs, taking more than recommended amount of prescribed medication, overuse of over-the-counter medication

It is important to remember that some children might not display any of the above symptoms in response to trauma and seem to go on with life as if nothing happened. This is not unusual and should not be cause for alarm, nor is it necessary to encourage a child to “talk about” the event. Trying to make children talk about their feelings or a distressing event may seem like a good idea, but it can cause more harm than good. Imagine for a moment something painful or difficult that has happened in your life. Now imagine someone asking you about it on a daily basis. Do you really want to be reminded of it all the time? For many children, talking about a distressing event can cause them to experience it all over again which may be re-traumatizing. With children, it is better to let them share if they need to, calmly listening to whatever they have to say and using reflective or mirroring statements to let them know you hear them without adding interpretation or asking probing questions.

Finding Flow

2009-08-14T11:20:00.000-07:00

You know when you’re in the flow. You move through life with focus and momentum that comes almost without effort. Things seem to come easily, synchronicity abounds, and you feel alive, energized, and in harmony with your surroundings. It’s as if you’ve found the perfect wave and if you can just keeping riding it, it will carry you to the shore of all your dreams and goals. Athletes call it “the zone,” and sports psychologists use many methods, including hypnosis, guided imagery, and meditation, to help their clients get there. Yogis call it Dharana, a state of total focus and concentration in which we are able to eliminate distractions and achieve deeper awareness. Indeed many systems of thought recommend various ways to harness the vital life forces that energetically sustain and nurture us on our path through the world. Some of these systems refer to the flow as the Tao, the way of universal light, being in alignment with a higher power, walking the medicine path, etc.

These systems exist partially because while most of us know the feeling of being in the flow, most of us also know all to well how it feels when were not. We feel “off,” things don’t seem to be going our way and obstacles appear to block our progress at every turn. Things may seem stagnant, or feel as though we’re moving backward. It’s as if we’ve been caught in a vortex that is bent on pulling us down into a bottomless sea of darkness.

In nature, vortices come into existence when oppositional forces cause a certain element (usually water or air) to form a spiraling, sometimes helix shaped, motion around a center point. A familiar example is a shower drain which is designed to utilize gravitational forces to draw water into a septic, sewer, or grey water system (for the environmentally conscious). A common New Mexico phenomenon, the dust devil, is another example. Dust and debris get drawn into the air by swirling currents of wind. However, more menacing phenomena, such as tornados, hurricanes and the massive oceanic whirlpools known as maelstroms provide us with a much clearer idea of the destructive potential of the vortex.

Obviously, resistance to such forces is likely to be exhausting, if not futile. It’s exponentially more difficult to row upstream, or ride into the wind as it is to simply “go with the flow.” Yet what are our options when we don’t like where the flow is taking us? What can we do when we find ourselves caught in a vortex of self destruction? Anyone who has tried to manage panic attacks, recover from depression, or beat an addiction has probably had the experience of feeling swept up by an energetic force greater than oneself. Anyone who has successfully overcome one (or all) of the above has probably done so not by sheer strength of will, but by harnessing a more powerful energy—a counter vortex, if you will.

I have a dear family friend who used alcohol and other substances for years recreationally, but ultimately found herself at the mercy of a serious addiction to alcohol and cocaine. Her family and professional life suffered greatly, until at the urging of a friend she began to attend 12-step meetings. Incredibly, she was able to break the addictive pattern, and was even joined in her sobriety by her husband. Thirty some years later, instead of drinking and using drugs together, they spend time together exercising and cooking.

I have another friend who at a certain point in her life became severely depressed. The depression worsened until she decided she would be better off ending her life. The downward spiral seemed endless and she had lost all hope. However, someone told her to see a psychologist who asked her if there was even one thing in her life that brought her joy. There was. She was an artist and she loved to paint. She began to paint everyday and with time the depression subsided and she found herself enjoying life again.

Both of the above cases illustrate the power of both the vortex and counter vortex. Addiction and depression can feel insurmountable, as if they have a life of their own, and energetically speaking, they do. However the support of AA, the “high” of exercise, the loving connection of family and friends, and the creative drive to make art and gourmet food provided an equally and ultimately more powerful counter vortex that helped draw these individuals out of the old circular pattern and into a healthier, more fulfilling one.

When we feel as if we are at the mercy of forces beyond our control we don’t have to give up. We don’t have to allow ourselves to be swept away be the current. We also don’t have to fight it. Once I was caught in a rip tide on a trip to the beach with my family. I tried to swim back to shore but soon found myself shaking with fatigue. I was no match for the powerful forces intent on pulling me out to sea. I stopped to rest, and breathe, then called for help. My Dad yelled out to me to start swimming sideways, parallel to the waterline. To my surprise I found that and after a few minutes I had entered another current that carried me back to safety.

Finding flow means making a choice to seek out and harness a new and different force. It might be a very small thing, barely noticeable at first, but when we pursue it and give it energy it will grow. Pretty soon it will become an equal and/or greater force than that which we wanted to escape and we will find ourselves back in the flow that feels like it’s taking us where we want to go.

The Good News About Anger

2009-06-30T13:23:00.000-07:00

Anger often gets a bad rap. Frequently clients come in to my office and tell me that they think something is wrong with them because they feel intense rage and anger. Often these individuals have come to think of anger as a problem to be solved, and are usually a bit shocked when I tell them that anger itself is never really the problem. Obviously what we do when we’re angry, like yelling at people, breaking things, kicking the dog, or other behaviors can be a problem, but anger is just an emotion. It’s neither good nor bad. It’s simply a source of information.

Similar to sadness and shame, anger is not a feeling people like to have—though it seems to be the most popular of the three! Indeed, anger is often a “cover” emotion for deeper and more distressing feelings, but for now let’s focus on authentic anger. (Perhaps I’ll blog another time about what to do when anger disguises or dominates other feelings . . .)

So if anger isn’t a problem, what is it other than a distressing emotion?

Aristotle said, "Anybody can become angry - that is easy, but to be angry with the right person, to the right degree, at the right time, for the right purpose, and in the right way - that is not within everybody's power, and is not easy."

Hold up Aristotle! Are you saying there’s a “right” way to do anger?

Let’s consider for a moment how different the world would be if Ghandi hadn't been angered by the injustice of the salt tax in India, or if Rosa Parks hadn’t been so fed up with sitting at the back of the bus that she refused to move, or if Martin Luther King Jr. hadn't been outraged by the horrors of racism. What if Cesar Chavez hadn’t gotten pissed off about the treatment of migrant workers in California?

The truth is, anger is our built in alarm system for detecting injustice. It is also an important step in the correction of injustice as it is one of the emotions we tend to feel when something happens to us that we don't like. If our anger didn’t draw our attention to the times we are treated badly, and we were to go on as if nothing were wrong, then we run the risk of letting it happen again and again.

So the purpose of anger is to tell us when something is unjust, and it calls us to take action. However, I’m afraid I must disagree with Aristotle’s idea that it is not within everyone’s power to be angry with the right person, at the right time, for the right reason, and in the right way. I believe each of us can and does have that power, and that it can be strengthened with practice. Next time you get angry about something try asking yourself the following questions before you act so you can make sure that your response does not perpetuate more damage and injustice:

1. Are you angry to the right degree?
Take a moment to determine just how angry you are. Rate it on a scale from 0-100. Then consider whether the situation warrants your level of anger. Sometimes our anger exceeds a reasonable level when we are overwhelmed, tired, or stressed and can indicate to us that we need to take better care of ourselves. The same conditions can leave us desensitized to things that actually deserve our outrage. It’s important to be able to ascertain if we are over or under reacting to a situation.

2. Are you angry with the right person?
Are you really angry at the person in front of you in line at the grocery store or are you actually angry with your spouse who you argued with earlier? Displaced anger is as common as it is counter productive. How are you going to resolve things with your partner by yelling at the person taking forever counting out their change at the check out counter? Sometimes people take out their anger on the people around them, and sometimes they take it out on themselves. If something goes wrong do you automatically blame someone else? Or perhaps you take all of the blame yourself? Rarely is one person 100% responsible. Then there are those times when we become angry at God for something that was beyond our or anyone else’s control. Before we take any action, it’s best to be very sure we are angry with the right person.

3. Are you angry for the right reason?
Remember the saying, “Don’t cry over spilled milk?” The lesson is that getting angry or upset about an unfortunate accident isn’t helpful. If anger’s purpose is to provide the energy needed to create change and act as a reminder to move into action and stop injustice, then accidents, which by definition are neither planned nor preventable (no matter how careful we are) do not a right reason make! Being angry for the right reason means being angry about an injustice, deceit or act of negligence that inflicts harm on another person.

4. Are you angry at the right time?
Is your anger based in the present or has it been building up over time and is just now exploding? Is there anything you can do about what you’re angry about? Would some present action be appropriate? People can carry anger around with them for years, holding a grudge against another person or themselves yet never taking any corrective action. Outdated anger is like an old blanket that once kept us warm and protected us from the elements, but is now scratchy and full of holes, no longer serving any purpose except to make us and our loved ones uncomfortable. In other words, anger about the past only irritates us. Anger is a catalyst for change, and we can't change the past, so being angry about it won't really help us.

5. Are you angry in the right way?
Ask yourself if you are showing your anger in the right way—a way that is consistent with your values and personal integrity. Or perhaps your tendency is not to show your anger at all, and instead try to hide it and not let anyone know it’s there. When people hide their anger, never letting on how upset they are, it festers internally like a painful ulcer. Often that kind of anger manifests as stomach aches, migraines, cramps, and other physically painful somatic symptoms that arise when unexpressed anger lives in our bodies. People who hide their anger like this are not showing their anger in the right way because they’re not showing it at all!
Yelling, being violent towards others or oneself, silently bearing the burden, acting out, or failing to act, generally doesn’t change anything either and just leads to more misery. Standing up for what we think is right, speaking our minds, and holding ourselves accountable for our actions and others accountable for theirs is being angry in the right way because it allows for an opportunity to appropriately address a correctable situation.

After answering the above questions, take another moment to rate the degree of anger you are now experiencing. Has it changed at all? Perhaps it’s dissipated some or you’ve discovered that you’re not really angry anymore. Or perhaps it’s increased and you’re realized that there are some areas in your life that require some attention or action and you now have the energy to deal with them.

The good news about anger is that we do not have to be controlled by it. When we ask ourselves the five questions, we give ourselves a chance to think things through and can avoid inflicting further harm by letting anger get the better of us. By paying attention to anger, whether it’s mild frustration or red hot rage, and the things that provoke it, we are less likely to overlook or ignore issues that need to be addressed and we can take the time to determine the appropriate action to take.

Beyond Trauma

2009-06-22T11:53:00.000-07:00

We live in a wildly unpredictable environment, and trauma, defined as extreme or life threatening stress, is par for the course. Over a lifetime, few of us are able to look back and declare a trauma-free existance. However, not all of us will wind up "traumatized" by such life experiences. A child who falls out of a tree and breaks his or her arm could be described as suffering from a "trauma," but that child may be back in that tree the next day (or after the arm heals) without a second thought while another, who suffers the same injury, will avoid climbing trees for the rest of his or her childhood, perhaps even for life.

It is important not to assume that what traumatizes one person will have the same effect on another. The degree of traumatization experienced after a traumatic event, is very subjective and depends a great deal on the amount of resiliency present in that individual. Resiliency can be defined as our ability to cope with and adapt to adverse situations. As a clinician specializing in trauma recovery for people from all walks of life who have experienced various and often multiple traumatic events including combat, sexual assault, domestic violence, severe car accidents, and natural disasters, a big part of my work includes helping the client access their own unique resiliency resources. These resources may be intrinsic (faith, determination, sense of humor) or extrinsic (presence of loved ones, community support, nature). They may be long standing or recently acquired. Regardless, I have found that an individual's ability to harness and access that which supports, empowers, and heals is what allows movement beyond trauma and a return to wholeness.

To that end, it is of vital importance that we spend time each day taking care of ourselves by doing something we love. Whether you've already experienced a great deal or trauma or have managed to live a charmed life thus far, the practice of self care and self healing keeps our resiliency reservoirs full, so that if by chance (since traumas are not usually planned), we happen to meet up with unfortunate circumstances and wind up experiencing a trauma, we do not face the situation from a place of depletion or scarcity, but a place of strength, ability, and indominable spirit.