Faith and Family: Post-Traumatic Stress Disorder — Whether children or adults, coping looks different for everyone, can take timecomment (0)
April 18, 2013
By Carrie Brown McWhorter
Just as trauma can result from many different events, an individual’s response to the trauma can vary in both severity and duration. The signs of traumatic response may only be obvious to those closest to the affected individual, so it is important to be aware of changes in the behavior and mood of someone who has experienced a traumatic event.
“When an individual acts out beyond normal expectations or limits, that behavior becomes a clue that the person is dealing with a traumatic experience,” said Ted Embry, director of the northeast Alabama region for the Alabama Baptist Children’s Homes & Family Ministries.
Children who have experienced severe trauma, for example, may often bring up the event in everyday conversation or engage in risky behaviors or violent play. Toddlers who have experienced trauma may seem more stubborn or controlling than before and act out by hitting other children or caregivers. Like adults, children may also withdraw and lack interest in activities they previously enjoyed. They may have trouble sleeping or be overly fearful for their own safety and the safety of others.
“Children might have frightening dreams or seem disorganized or agitated, or they might reenact the trauma,” said Renay Carroll, a counselor with Pathways Professional Counseling (a ministry of the Alabama Baptist Children’s Homes & Family Ministries). “The response varies from child to child and person to person.”
Ian Jones, professor of psychology and counseling and Baptist Community Ministries’ Chair of Pastoral Counseling at New Orleans Baptist Theological Seminary, agreed.
In his book, “The Counsel of Heaven on Earth: Foundations for Biblical Christian Counseling” (B&H 2006), Jones writes about the Sept. 15, 1999, mass shooting at Wedgwood Baptist Church, Fort Worth, Texas. Seven people, four of them teenagers, were killed during a Wednesday night youth rally when Larry Ashbrook walked into the church and began shooting. At the time, Jones was a professor at nearby Southwestern Baptist Theological Seminary and responded to the crisis. In the years since, he has interviewed many who were at Wedgwood during the shooting. Each individual involved in a traumatic situation responds differently, he said, because each one experiences the event in a different way. For example, during the shooting, some students thought the shooter was part of a skit — some students were laughing and trying to catch the bullets while others were diving under the pews.
“Each person in that sanctuary was having a different experience,” Jones said. “In the aftermath, some people move on a little faster, but for those who do not recover from the trauma as quickly, the process can be confusing and upsetting.”
One student, for example, was very upset by her inability to concentrate on her schoolwork after the shootings. Two brothers who were in the sanctuary began fighting after the shootings. A minister at the church was speaking about the tragedy at a missions conference in Africa two years later and began weeping inconsolably.
In each case, Jones said, the individuals were responding normally to an event that did not fit with anything they had experienced before. The student had witnessed the death of a friend. The older brother had thrown his body over his younger brother to protect him. The minister had jumped in to counsel others without taking the time to process his own grief. Because each experience of the trauma was different, each individual expressed their anxiety in different ways and at different times, Jones said, which is why no single approach to trauma counseling works with everyone.
“We have to come to each person in a way that brings comfort and assurance,” Jones said. “They need to understand that it is normal to react and give them the tools to deal with their response.”
Children also may sense the pain of their caregivers and experience secondary trauma, even if they themselves were not directly affected. For example, after a tornado hit in Cullman on April 27, 2011, Carroll met with several children who were experiencing trauma. After talking with one of the students, Carroll realized that his grandparents’ house had been damaged in the storm.
“He went to their house after the storm and saw them and their house, which triggered some trauma symptoms,” Carroll said.
The boy’s symptoms were alleviated by helping his grandparents pick up branches in their yard. Carroll said that when children can do something with their feelings, they often feel better.
“Doing something to help allows children to see life getting back to normal, and getting back to a normal routine helps children respond to trauma in healthy ways,” Carroll said.
Still, parents and caregivers should be alert for triggers, like a weather radio alarm or a tornado siren, which can awaken their fears, Carroll said.
Adults may respond to sensory triggers of their trauma in adverse ways as well. Reminders of a traumatic event might include smells, sounds, feelings or even the time of day, according to the “Psychological First Aid Field Operations Guide” published by the U.S. Department of Veterans Affairs. Stories that cover similar events or that “look back” to the tragedy also might trigger fears.
Like children, adults may experience jittery behavior, excessive anger and sleeplessness in response to traumatic events. Some turn to alcohol or drugs to cope. According to the website of the American Psychiatric Association (APA), warning signs like substance abuse and talk of suicide are signs that an individual needs immediate professional help. In the aftermath of trauma, however, the APA suggests that one of the most important things a friend, family member or co-worker can do for a loved one is to be an “active and supportive listener.”
“Listening is a critical part of the healing process,” Embry said. “A traumatized person needs to be able to tell their story in a safe, nonjudgmental way.”
Jones said some people may be able to talk early, others may take a long time. In either case, friends and family members should not step in and start dictating to the victim of trauma. In most cases, the ministry of presence can be the most comforting response a loved one can provide.
“It doesn’t help to say words like ‘I know how you feel’ because the fact is, you don’t, even if you’ve experienced something like this,” Jones said.
“In ministry, we don’t have to come with all this knowledge to help people but instead we can direct them to the word of God and bring the spirit of God into the relationship through affirmation, a prayerful attitude, a gentle touch, a nod of the head,” Jones said.
Jones said we can learn much from Job’s trauma and the response of those around him. In the beginning, Job’s counselors were just sitting with him and providing a comforting presence — and then they opened their mouths. By Job 16, he calls them “miserable comforters.”
“We’re often not aware of the importance of listening because we don’t know how to do it, but there’s power in just sitting and praying with someone who is hurting,” Jones said.
To guide caregivers to be supportive listeners, the APA offers the following suggestions:
- Listen patiently and nonjudgmentally as the person tells his or her story.
- Avoid offering direct advice other than encouraging him or her to find healthy ways — such as exercise — to cope with stress.
- Discourage damaging ways of coping, such as excessive use of alcohol.
- Realize that it takes weeks, months and sometimes years before a survivor of trauma is able to put the disaster behind him or her. At times people who have resolved their symptoms following the trauma have a recurrence of traumatic symptoms during stressful times in their lives, such as retirement, divorce or loss of a loved one.
- Be patient. While it is common for loved ones to become impatient and puzzled over the traumatized person’s inability to get on with life, it is especially important at these times to persevere and continue to listen patiently.
- Do not try to “fix it” for your traumatized loved one. Again the best “fix” is nonjudgmental listening.
When your support is not enough
- Let the person know that experts think that avoidance and withdrawal are likely to increase distress, and social support helps recovery.
- Encourage the person to talk with a clergy counselor or medical professional and offer to accompany them.
- Encourage the person to get involved in a support group with others who have similar experiences.
- Enlist help from others in your social circle so that you all take part in supporting the person.