grief, trauma, and resiliency

 “Into every life, some rain must fall.”—Henry Wadsworth Longfellow, 1842
            It may be the holiday season, but it doesn’t mean that our community is experiencing only joy. The holidays are often very difficult for anyone who has experienced a loss, and an especially difficult time to experience tragedy or trauma.
            The following is a culmination of information to help with understanding and managing grief, identifying normal versus extreme reactions to trauma in children, and tips for building resiliency in children.

  The Child’s Trauma Experience--taken from nasponline.org/resources/crisis_safety and School Crisis Prevention and Intervention: The PREPaRE Model

• It is not unusual for children to display symptoms of acute stress after a traumatic or crisis event (i.e. natural disaster, act of violence, death of friend/family member).
• Common initial crisis reactions include:
  • Emotional Symptoms: shock, anger, numbing, terror/fear, guilt, sadness, grief, irritability, hypersensitivity, helplessness, hopelessness, loss of pleasure from activities
  • Cognitive Symptoms: Impaired concentration, impaired decision-making, memory impairment, confusion, decreased self-esteem, decreased self-efficacy, intrusive thoughts, worry, nightmares
  • Physical Symptoms: fatigue, insomnia, somatic complaints, impaired immune response, headaches, gastrointestinal problems, decreased appetite, startle response, decreased libido
  • Interpersonal/Behavioral Symptoms: alienation, social withdrawal, increased relationship conflict, vocational impairment, refusal to go to school, avoidance of reminders, school difficulties, crying easily, change in eating patterns, tantrums, regression in behavior, aggression, risk-taking.
• How adults handle the crisis can have a significant effect on how traumatized children become. It is important that adults remain calm and reassuring to the extent possible.
• In most cases, reactions are temporary and will gradually lesson in days/weeks following the event.
• Exposure to event is not enough to seriously traumatize child; instead, it is based upon the child’s individual experience and how threatening he/she views the event based upon the child’s individual risk factors and perception. The following factors affect the child’s perception:
  • Specific crisis event: Severe emotional trauma is more likely to occur after aggression, events that are sudden/unexpected, events that involve devastating consequences, events with long durations, or intense experiences.
  • Exposure: The closer a child is to the location of crisis and the longer their exposure, the greater the chance that it is viewed as very threatening.
  • Relationships: Those who have relationships with the victims of the crisis, especially strong relationships, are most at risk for severe distress.
  • Adult reactions: Those children who have seen parents and teachers panic, and sensationalized media reports can intensify a child’s reaction.
  • Individual Risk factors: Family factors (children who are not living with their families, have had family violence, have a family history of mental illness, or have caregivers who are severely distressed by the crisis), Social factors (children without network of friends and relatives), Mental health (children with depression or anxiety disorders), Developmental level (younger children who recognize the threat are more likely to have severe stress reactions), and Previous trauma experience.
• Be vigilant for extreme reactions, and get immediate mental health support, especially if they are interfering with daily life functioning (i.e. child not able to play, go to school, etc.) and are long-lasting (i.e. do not lessen after a week or so).
  • Dissociation: Feeling as if in a dream world, feeling as if your body is not yours, being in a daze, emotional detachment, amnesia
  • Intense emotional reaction: hysteria, fear, helplessness, horror
  • Intense hyperarousal: Panic attacks, hypervigilance, exaggerated startle reactions, difficulty falling/staying asleep
  • Significant depression: feeling of hopelessness,loss of interest in most activities, persistent fatigue, complete lack of motivation, withdrawal from people, difficulty feeling positive emotions
  • Psychotic symptoms: Delusions, bizarre thoughts, catatonia
  • Maladaptive coping: substance abuse, self-medication, suicidal or homicidal thinking.
  • Common reactions (see above) that last more than about 2 weeks.