The Important of REST when Parenting A Traumatized Child

parenting a traumatized child

By Ron Huxley, LMFT

Parenting a traumatized child can be challenging and exhausting work. It isn’t something that should be done alone without adequate support. Parents must take care of themselves as well as others. You can’t give away what you don’t have… Faith-based families look to God for their help (Psalms 121:1-2) and operate from a place of REST:

“Come to me, all of you who are weary and carry heavy burdens, and I will give you rest.” Matthew 11:28

“He restores my soul.” Psalms 23:

REST stands for RE-store your Soul from Trauma. Our soul includes our entire being: body, mind/emotions and spirt. Each area requires attention. How do we do that when we have an endless to-do list, dealing with continuous problems?

The key is to find rest IN work, not FROM work. It is a mental recognition that we can be in partnership with God and others. We can set boundaries and say “No” to outside activities, not live up to others expectations, and remembering “who you are and whose you are” spiritually speaking. You have to be a “son or daughter”  before you can be a fully functioning father or mother. Seek out spiritual parents to support you as you carry on the work of parenting traumatized children.

List 5 ways you will restore your soul in the next 30 days:

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Children Heal in Healthy Families

By Ron Huxley, LMFT

When parents decide to build their family they don’t want to believe that their child may in up with developmental or special needs that require a lot of time, commitment and yes, money. They are dreaming of the perfect family, playing and enjoying warm, cuddly time together. There is nothing wrong with that but not every dream turns out that way. 

Many families choose to build their family through adoption or end up taking care of a relatives child due to many misfortunes and circumstances. Consequently, many children come with a history of trauma and loss. The dream family is still possible but it must be modified and made more realistic. You have to say goodbye to the old dream to allow room for the new one to unfold.

Research and common experiences proves that children can heal in a healthy family. A child needs a secure attachment relationships in order to maximize all the areas of their lives, socially, physically, emotionally, cognitively and spiritually. 

Because many children comes from insecure attachment relationships, they don’t always know what it means to be in a health family. Their special needs may be based on survival in high stress family situations. Their “abnormal behaviors” in a normal family were perfectly “normal” in their abnormal situations before entering the new home. A bit of rehabilitation is necessary to help them make the internal and external adjustments. 

Trauma situations impact the children development. This includes their brain development as well. The child needs to adapt to overwhelming and hostile environments and can create a position of offensive behaviors that don’t want to submit to parental controls. An internal model develops that believes the world and caregivers cannot be trusted. 

Fortunately, the same brain that adapted to stressful circumstances can re-adapt to calm living environments. This happens over time, sometimes quickly and sometimes not so quickly. This is challenging for parents to understand and cope. 

The brain must be re-activated to change. Experience dictates form and function when it comes to brain adaptation. New, positive experiences that happen repeatedly will open up new neuronal brain growth that allows for a feelings safety and security to settle in. Once this happens, parents can begin to enjoy that “dream family” once again. 

How Trauma Affects A Child’s Brain

Ron Huxley Trains: I am conducting a lot of trainings around the country on “The heArt and Science of Trauma” for parents and professionals, so this video is interesting and validates the information I have researched and teach in my presentations. If you would like a free consult on bringing this training to your organization or system of care, email me at rehuxley@gmail.com

Positive and negative changes after trauma | Psychology Today

Trauma can shatter peoples’ world assumptions. In the process of rebuilding an assumptive world people often report ways in which they change positively. It is becoming increasingly important to integrate this idea into trauma work.
To help do this my colleagues and I have developed a new self-report psychometric tool – the Psychological Well-Being Post-Traumatic Changes Questionnaire (PWB-PTCQ) with which to assess positive changes following trauma.

To illustrate, a sample six items are shown below.

Read each statement below and rate how you have changed as a result of the trauma.

5 = much more so now

4 = A bit more so now

3 = I feel the same about this as before

2 – A bit less so now

1 = Much less so now

1. I like myself____

2. I have confidence in my opinions____

3. I have a sense of purpose in life____

4. I have strong and close relationships in my life____

5. I feel I am in control of my life____

6. I am open to new experiences that challenge me____

Responses to these statements provide an opportunity for people to reflect on how they have changed. 

Did you score over 3 on any of the items? 

Can you think of think of one or two examples in your life that illustrate these changes?

Are there things you can do in the coming weeks that will help you build on and strengthen these changes?

Clinicians will also find the new tool useful as it allows them to bridge their traditional concerns of psychological suffering with the new psychology of posttraumatic growth. The full scale is 18 items so it is not too time consuming and can be used alongside traditional measures of PTSD.

This is not the first such measure of positive changes to have been developed. But there is a difference.

Those of us who study positive changes following adversity are sometimes criticised for offering an unrealistically optimistic view of the world. I don’t think this is true as the literature makes it clear that change can also be in a negative direction. But the critics may be right that this needed to be more fairly recognised in our measurement tools. 

At any single point in time people will have changed in either negative or positive ways.

But existing measures do not offer the opportunity for people to say how they have changed in a negative direction as well as in a positive direction.

Thus, an important and novel aspect of this new instrument is that it recognises that people may also experience themselves as having changed in negative ways.

Did you score under 3 on any of the items?

If you scored under 3 on one or more of the items, is this causing you considerable problems at home or at work?  Is it leading to significant difficulties with family, friends or colleagues?  Have you tried dealing with the problems already, maybe through reading self-help or talking to others? If so, it may be appropriate to seek professional advice.

So as well as giving indications of how people may grow following trauma the PWB-PTCQ can also help people understand the ways in which they need to look after themselves better or flag up areas in which they might need professional help.

The full questionnaire is described in my new book, What Doesn’t Kill Us: The New Psychology of Posttraumatic Growth http://www.whatdoesntkillus.com.

But the book does not go into full technical detail on its psychometric development. For those who do want to learn more the research paper describing the development of the new tool is now available online in the journal Psychological Trauma http://psycnet.apa.org/psycinfo/2011-17454-001/

In the paper we describe the logic behind the questionnaire, its advantages and the research showing its reliability and validity.

I hope this work will interest people. I am always eager to meet new research collaborators – there is so much more yet to be done in this field – so if this new tool does spark some interest in you to use in your own research or clinic please do get in touch.

Ron Huxley’s Reaction: It is good to see a “strength-based” approach to trauma. Trauma has many negative impacts in someones life but it is not destiny. Many people do become stronger and more resilient following a traumatic event. How would score yourself on the measures listed above?

Firesetting: Why kids do it and how parents can manage it

For parents, the dangers of fire are so apparent that the sight of a child anywhere near a flame is enough to send them scrambling. And fortunately, most kids are afraid of fire and understand that it can hurt them and others.

But it’s not unusual for kids to be curious about fire, too. After all, we enjoy campfires and singing over birthday candles. That’s why it’s so important to educate kids about the dangers of fire and to keep them away from matches, lighters, and other fire-starting tools.

Even with the best efforts from parents, kids might play with fire. Most of the time this can be handled by explaining the dangers and setting clear ground rules and consequences for not following them.

But sometimes kids seem to be especially preoccupied with fire and repeatedly attempt to set things on fire, which can be a sign of emotional and behavioral issues that require professional help.

Why Kids Set Fires

Young children who set fires usually do so out of curiosity or accidentally while playing with fire, matches, or lighters, and don’t know how dangerous fire can be. During the preschool years, fire is just another part of the world they’re exploring. Unfortunately, these fires tend to be the most deadly because kids in that age group don’t know how to respond to a fire, and may set it in a small, enclosed space, such as a closet.

As kids get a little older, they might be fascinated with fire. It’s fairly common for them to do things like light paper with matches, set things on fire using a magnifying glass, or play with candles or other things that have a flame. That’s usually not a cause for concern.

But if a school-age child deliberately sets fires, even after being reprimanded or punished, a parent needs to talk to the child and consider getting professional help. That’s especially true if the child is setting fires to larger objects or in areas where the flames can easily spread and cause injury and damage.

Talk with your doctor or consult a mental health professional if your child exhibits behaviors such as:

  • adding more fuel to fires in the fireplace, grill, or campfires, even when told not to
  • pocketing matches or hiding fire-starting materials
  • lighting candles, fireworks, and other things, despite being told not to

Kids might set fires for any number of reasons. They may be angry or looking for attention. They may be struggling with stressful problems at home, at school, or with friends. Some set fires as a cry for help because they’re being neglected at home or even abused. Even if they know how dangerous fire can be, they might have other problems that involve difficulty with impulse control.

Whatever the reason for firesetting, parents need to get to the root of the behavior and address underlying problems. It’s important to consider seeking professional help as soon as possible to prevent serious damage or injury.

Ron Huxley’s Response: I wanted to find an article on firesetting because it is a problem that we (parents and professionals) don’t talk much about. This blog post gives a good introduction into firesetting by children. It follows my “80/20” rule about misbehavior: 80% of the children do it for curiosity and attention-getting. 20% do it for more serious, underlying causes. It is this later group that parents need to take action on immediately by consulting with a professional. How have you dealt with this frightening behavior?

What 9/11 has taught us about trauma

Scientific American has a useful piece on how the immediate treatment of psychological trauma has changed since 9/11. The issue is interesting because recent progress has turned lots of psychological concepts on their head to the point where many still can’t grasp the concepts.

The article notes that at the time of the Twin Towers disaster, the standard form of treatment was Critical Incident Stress Debriefing – also known as CISD or just ‘debriefing’ – a technique where psychologists would ask survivors, usually in groups, to describe what happened and ‘process’ all the associated emotions by talking about them.

This technique is now not recommended because we know it is at best useless and probably harmful – owing to the fact that it seems to increase trauma in the long-term.

Instead, we use an approach called psychological first aid, which, instead of encouraging people to talk about all their emotions, really just focuses on making sure people feel secure and connected.

Although the article implies that 9/11 was a major turning point for our knowledge of immediate post-trauma treatment, the story is actually far more complex.

Studies had been accumulating throughout the 90s showing that ‘debriefing’ caused harm in some, although it wasn’t until around the turn of the century that two meta-analyses sealed the deal.

Unfortunately, the practice of ‘debriefing’ by aid agencies and emergency psychologists was very hard to change for a number of interesting reasons.

A lot of aid agencies don’t deal directly with the scientific literature. Sometimes, they just don’t have the expertise but often it’s because they simply have no access to it – as most of it is locked behind paywalls.

However, probably most important was that even the possibility of ‘debriefing’ having the potential to do damage was very counter-intuitive.

The treatment was based on the then-accepted foundations of psychological theory that said that emotions always need to be expressed and can do damage if not ‘processed’.

On top of this, for the first time, many clinicians had to deal with the concept that a treatment could do damage even though the patients said it was helpful and were actually and genuinely getting better.

This is so difficult to grasp that many still continue with the old and potentially damaging practices, so here’s a quick run down of why this makes sense.

The theoretical part is a hang-over from Freudian psychology. Freud believed that neuronal energy was directly related to ‘mental energy’ and so psychology could be understood in thermodynamic terms.

Particularly important in this approach is the first law of thermodynamics that says that energy cannot be created or destroyed just turned into another form. Hence Freud’s idea that emotions need to be ‘expressed’ or ‘processed’ to transform them from a pathological form to something less harmful.

We now know this isn’t a particularly reliable guide to human psychology but it still remains hugely popular so it seemed natural that after trauma, people would need to ‘release’ their ‘pent up emotions’ by talking about them lest the ‘internal pressure’ led to damage further down the line.

And from the therapists’ point of view, the patients said the intervention was helpful and were genuinely getting better, so how could it be doing harm?

In reality, the psychologists would meet with heavily traumatised people, ‘debrief’ them, and in the following weeks and months, the survivors would improve.

But this will happen if you do absolutely nothing. Directly after a disaster or similarly horrible event people will perhaps be the most traumatised they will ever be in their life, and so will naturally move towards a less intense state.

Statistically this is known as regression to the mean and it will occur even if natural recovery is slowed by a damaging treatment that extends the risk period, which is exactly what happens with ‘debriefing’.

So while the treatment was actually impeding natural recovery you would only be able to see the effect if you compare two groups. From the perspective of the psychologists who only saw the post-trauma survivors it can look as if the treatment is ‘working’ when improvement, in reality, was being interfered with.

This effect was compounded by the fact that debriefing was single session. The psychologists didn’t even get to see the evolution of the patients afterwards to help compare with other cases from their own experience.

On top of all this, after the ‘debriefing’ sessions, patients actually reported the sessions were useful even when long-term damage was confirmed, because, to put it bluntly, patients are no better than seeing the future than professionals.

In one study, 80% of patients said the intervention was “useful” despite having more symptoms of mental illness in the long-term compared to disaster victims who had no treatment. In another, more than half said ‘debriefing’ was “definitely useful” despite having twice the rate of postraumatic stress disorder (PTSD) after a year.

Debriefing involves lots of psychological ‘techniques’, so the psychologists felt they were using their best tools, while the lack of outside perspective meant it was easy to mistake instant feedback and regression to the mean for actual benefit.

It’s worth saying that the same techniques that do damage directly after trauma are the single best psychological treatment when a powerful experience leads to chronic mental health problems. Revisiting and ‘working through’ the traumatic memories is an essential part of the treatment when PTSD has developed.

So it seemed to make sense to apply similar ideas to those in the acute stage of trauma, but probably because the chance of developing PTSD is related to the duration of arousal at the time of the event, ‘going over’ the events shortly after they’ve passed probably extends the emotional impact and the long-term risks.

But while the comparative studies should have put an end to the practice, it wasn’t until the World Health Organisation specifically recommended that ‘debriefing’ not be used in response to the 2004 tsunami [pdf] that many agencies actually changed how they went about managing disaster victims.

As well as turning disaster psychology on its head, this experience has dispelled the stereotype that ‘everyone needs to talk’ after difficult events and, in response, the new approach of psychological first aid was created.

Psychological first aid is actually remarkable for the fact that it contains so little psychology, as you can see from the just released psychological first aid manual from the World Health Organisation.

You don’t need to be a mental health professional to use the techniques and they largely consist of looking after the practical needs of the person plus working toward making them feel safe and comfortable.

No processing of emotions, no ‘disaster narratives’, no fancy psychology – really just being practical, gentle and kind.

We don’t actually know if psychological first aid makes people less likely to experience trauma, as it hasn’t been directly tested, although it is based on the best available evidence to avoid harm and stabilise extreme stress.

So while 9/11 certainly focussed people’s minds on psychological trauma and its treatment (especially in the USA which is a world leader in the field) it was really just another bitter waymarker in a series of world tragedies that has shaped disaster response psychology.

So unusually for a psychologist, I’ll be hoping we’ll have the chance to do less research in this particular area and have a more peaceful coming decade.
 

Link to SciAm piece on psychology and the aftermath of 9/11.

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This isn’t a typical piece for a parenting blog but seeing as how I work with so many traumatized children and since today is 9/11 it seemed appropriate to share a couple thoughts.

One of the first things I teach my clinical interns is that you have to “stabilize” before you can do “interventions.” As therapists and parents we want to help a child talk about their traumas and get it all out. As the article explains above, this is an out dated and incorrect hypothesis about how to manage trauma. What children need FIRST is to know that they are safe and connected to others. This is the first law of attachment if you will and the very thing that so many traumatized children lack. Think about it: trauma destabilizes your sense of safety, so what would be the best intervention? Recreating safety.

It is a common problem for new therapists to want to talk it out. I get social workers and parents pressing me to do this all the time. The fact is that it is the worst thing for the child at first. Before working out issues, let’s create safety and stability at home and school. Build more support system. Give more hugs. Stay longer in the room at night and read that extra book or two. Be more tolerant of the meltdowns and resistance to changes in routine. Follow a routine if you don’t have one. Give back rubs and an extra scoop of ice cream.

What do you do to create safety and stability after a child experiences something traumatic?