An Interview Between Lynn Cameron, MA, Registered Clinical Counsellor, and School Counsellor Catherine Fallis, PhD, RCC

Lynn: What age group of children do you work with?

Catherine: I usually work with elementary age students. That's roughly 5 to 13. Kindergarten to grade 7.

L: Do you usually work more with boys or with girls?

C: More boys than girls. Boys act out a little bit more in the elementary school setting. The setting is more geared for girls, sitting in desks, being cooperative with the teacher. Boys tend to read more slowly and tend to like more activity so they have more trouble settling in the classroom setting.

L: Is there is an age group that you tend to see more than others?

C: I spend more time with the upper intermediate students, ages 10 to 12 because when they are acting out it tends to be more disruptive.

L: How much of the work you do is based on working with trauma?

C: I use a broad definition of trauma so I would say a lot of it. A lot of what I work with is not what the general population would think of as trauma, like working with marital break up or parents arguing or fighting in the home. From my perspective, those are traumatic for children. Those things can be extremely threatening for children.

L: What would your definition of trauma be?

C: It is anything that results in the child feeling that its safety, both physical or emotional, is at risk.

L: Is there one kind of trauma that tends to show up more than others?

C: We call a car accident or a medical procedure or sexual or physical abuse shock trauma. The trauma I see is developmental trauma, where Mom was sick for a while when the child was very young, or if there is a very disorganized household where nothing is predictable in the child's world. It could also be that older siblings are constantly fighting. These may not be single events, but the children nevertheless come to school unable to settle. Their little nervous systems just don't know how to quiet down.

L: Is the trauma happening at home or school or is it medical?

C: It could be any of those. If a child is acting out at school or is a victim to a lot of bullying or unkind behaviour at school, often there is a home issue. My work is to try and figure that out and to see how open the family is to taking a look at that. Often the families are totally supportive. There is a small percentage of children who are born with ADHD-like behaviour or there are difficult situations within their family life or they have had a car accident or a medical procedure. The largest percentage of my work is not on specific shock trauma in the school system. It is more the result of an ill-defined disorganization at home or multiple moves or a mother or father having multiple partners.

L: Are there times when children are most vulnerable, for example, during a divorce?

C: The divorce is the trauma. If children are having difficulty as a result of this, they are often more prone to accidents or fights with their peers. That's typical boy behaviour. Girls will sometimes get quiet.

Kids are more vulnerable, I notice, around holiday times. There is the excitement and anxiety. Especially with so many families where there is separation, they worry about "where am I going for which part of the holiday". I think, when they are in that unsettled state, they are more vulnerable to other things happening to them.

Children who have had an unsettled first few years of life are going to be more vulnerable to other kinds of trauma. Sometimes one family will have multiple things happen--a car accident, somebody dies, they lose their pet. It seems like one trauma makes them more vulnerable in the face of another trauma.

L. What are some of the signs and symptoms of a child having trauma to give parents a heads-up?

C: A parent can learn to be attuned to their child, which hopefully they are by the time their child enters school. They can see when their child is or is not settled. Settled means they look reasonably relaxed, they look like they are enjoying themselves and they are relating to their peers and their family. Unsettled would be some degree off of this and maybe they have a higher degree of impulsivity than usual.

Children who have had trauma are usually more vulnerable to flus, colds and rashes. It definitely affects their health and immunity. Crying, not sleeping well and not eating well are other things to watch for. Also, any unusual repetitive behaviour such as their clothes having to be set out a certain way. At school, the obvious signs are kids getting into fights, clearly angry about something.

Young children who have had something happen, like a car accident or a medical procedure, don't know how to articulate their distress and overwhelm. It is in their nervous systems and sometimes they can't articulate that. They'll just be cranky.

Sometimes girls will get what looks like depression. They become very quiet, not relating with their peers. That can happen when they are very young.

L: What is your goal in working with children?

C: It is the same as with an adult. To help them understand how their nervous system works and how they can learn to self-regulate. Depending on their developmental level, there is more or less subtlety and complication in my explanation of how the nervous system works. But I am teaching the same strategies for grounding, noticing breath, noticing feelings in your tummy. All the same things I do with my kids I do with my adult clients.

L: I have heard you mention settling. What is that?

C: It is when the nervous system gets into the relaxed response and the parasympathetic nervous system is in tune. It's a greater feeling of calmness and for everyone it is a matter of degree. Some kinds are so wound up a lot of the time that it may mean a little less agitation.

Most kids understand the word hyper. I can ask them "Well, what does that feel like?" and then we try to use metaphors or sensation language like "I have a jumping bean in my tummy" or "I'm vibrating." We need to develop their ability to pay attention to those kinds of things so they can consciously settle themselves. That's what self-regulation is--to be able to be aware of what's going on inside. Young children have difficulty doing this.

It is easier to teach a kid how to get through something if it is a specific shock trauma than if it is developmental trauma. Developmental trauma work takes longer.

L: What are the benefits of children learning how to self-regulate?

C: They can develop increased resilience and ability to manage threats and challenges. It helps with their health. It helps with their relationships and, in school, the biggest thing it can help with is their concentration and their ability to attend to their schoolwork.

L: How would you explain what "trauma proofing your kids" means?

C: Any parent is going to want to protect their child from difficult things, but it is important for the parents to understand their own nervous systems. One of the most critical aspects of having a child negotiate a trauma is how settled the parent can be. Daniel Siegal, in his book, Parenting from the Inside Out, says that parents need to do their own trauma work. That's one of the best ways of trauma-proofing your own child. If you are jumpy about every little thing that happens to your child, it's going to make is harder for the child.

A parent's nervous system is meant to be a child's comfort. There are all kinds of things happening between parents and children that are beyond our consciousness in terms of nurturance and attunement. It is subtle. The more a parent can learn from their own experience, the better they will be at being there for their children.

There are specific things you can do before and after medical procedures. Peter Levine describes these well in his books. Being present as much as possible is very important--letting the doctor know that you are prepared, that you know what is happening. The parent will want to be there, not necessarily during surgery but as soon as possible. They may be allowed to sleep at the hospital.

L: In the case of bullying, what would you recommend?

C: The parent needs to manage their own nervous system, as I mentioned, and communicate to the child that you are their advocate, too. It means going to the school if that is where it is happening, speaking to people but not in a way that assumes that your child has no part in it. Bullying is an extremely difficult thing to stop often because it is done outside the view of adults. Girls' aggression is often very subtle. You can support your child in strategies for dealing with it. Kids are caught in the bind between reporting and being seen as a tattletale. Often kids who tend to get bullied are seen as tattlers. You help kids learn that they can make jokes about it or walk away or always be with a group of people. The isolated child is always the most challenging to deal with. If they don't have friends and their personalities are such that other children don't warm to them, it is difficult. I am often teaching children how to be assertive. We model standing firmly on two feet, head up, eye contact, strong voice.

L: For a parent who has a child who is being bullied, is there anything they can do in terms of soothing and settling their child?

C: The best thing is to engage your child in activities where they feel competent and empowered. The important thing is to listen, to affirm their feelings, to help them find out what helped, what worked.

Try to get your child to notice that there was one child who was kind to them afterward, and to focus on that as opposed to focusing on the child who what unkind. Spend some time with the child and then move on unless they are seriously hurt. Get them to take the dog for a walk, play a game with them, tell them to go to their friend's house or have the friend over so that they don't get into dwelling on something. It's important not to draw it out and go over and over it. It's important to move on and encourage resiliency.

L: What would be an overall guideline in restoring a child's resiliency and confidence after trauma?

C: Settle yourself, be available to your child, be knowledgeable about the things they love to do so that you can encourage them in that. Communicate that you believe in them, you believe "we can get through this together", you are a team, you are there for them.

Make sure you get help if you feel the situation is more than you can handle. If your child is very upset and you have other responsibilities and your child loves Aunt Suzy, have the child go spend Saturday with Aunt Suzy. Give yourself a break so you can continue to be there for the child.

You may want to seek professional help for the child. If it is a significant enough trauma like a car accident or a fall, I think it is worth seeking out a counsellor.

L: How would a parent know their child needs professional help?

C: If you see that the child has not begun to self-regulate or if the child is avoiding something that they used to like to do. Maybe they had a bicycle accident and they don't want to get on their bicycle. Give them a little while, a few weeks, and try to normalize it. If it seems that they are stuck on it then that may be a time to get professional help. You can start by contacting your school counsellor, who generally knows about all the resources in the community.

L: Before a trauma like going to a dentist, what would you recommend?

C: Attune to your child. If your child tends to be a worrier, don't tell them a lot of time beforehand, but do give them some notice.

If it's an unusual medical procedure that they have never had before like requiring stitches, it just means being with them.

If it's at the hospital, show them around a bit, make sure they know the doctor, tell them what is going to happen, tell them exactly when they will see you after the procedure. Explain in age appropriate language what is going to be done and why.

L: A lot of parents are busy. What would be the most important things that parents can do so that their children feel safe and protected?

C: Parents need to do their own work, self-regulate their own nervous systems.

Communicate in a calm loving way to your child. When you see your child fall, you are not going to be relaxed. Still, most parents know how to take a breath and act as relaxed as they can manage. Once they know their child is taken care of and the child is not with them, then they can fall apart and have adults that they can go to for help.

The classic situation is if a child has an accident during the day. Try to keep yourself together, take care of everything you need to take of, be there for the child, soothe and comfort the child. Then in the evening, when the parents are together and children are asleep, you can shake and cry and hold each other and get support from each other about this scary thing they had to go through with their child during the day.

L: Anything else you would like to say about trauma-proofing kids?

Trauma is not in the story; it is in the nervous system. There may be things taking place in the child's nervous system that they don't have much control of at the outset. Adults may think children are manipulative, and sometimes they are. But you have to have some understanding about what it feels like to be a child in an adult world. Children can be easily hurt and they can be very resilient if they have the right support.

Lynn M. Cameron M.A. is a Registered Clinical Counsellor, health and wellness writer, and HANS member. Email lynncameron@shaw.ca

Resources:

Your local school counsellor or Family Services,

Catherine Fallis PhD, RCC, chockfall@shaw.ca

References: Peter Levine, Trauma Proofing Your Kids, A Parent's Guide for Instilling Confidence, Joy and Resilience and Trauma Through a Child's Eyes.

Daniel Siegel, Parenting from the Inside Out: How A Deeper Understanding Can Help You Raise Children Who Thrive

Body oriented therapies that are specific to trauma: EMDR

Somatic Experiencing: www.traumahealing.com, Self Regulation Therapy, SensorimotorPsychotherapy: www.sensorimotorpsychotherapy, Bodynamics

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