How Should Doctors Treat Childhood Trauma?

I think a child should be “treated” based on how they perceive the events and their own reaction. Some kids in the Sandy Hook incident might not be overly traumaitized at all. Let’s not work them up when they aren’t worked up. Memory has a lot to do with how we react to trauma, and etching events clearly into the minds of people by having them repeat the events to discuss them can actually be negative. We also can add memories which were not even there. It really has a lot to do with the personality of the individual. Don’t get me wrong, I don’t think we should just assume kids are handeling something ok, there should be some sort of conversation where the child can vent their perception of the the events. Kids also pick up on how upset the adults around them are. I do think every child in the school, if we use Sandy Hook as an example, should have the opportunity to talk about the event and professionals watch for signs of a child not coping well, and for parents to be given information on what to look for and where there is help if they need it.

I agree with @JLeslie – there is no one cookie cutter solution for each child or situation. Awareness, sensitivity and availability of qualified support personnel are the key requisites.

I think their treatment is best left in the hands of mental health professionals.

I think mental health professionals probably could use some training and guidance in this. They’re not superhuman. They are probably nearly as lost as everyone else.

I think a lot of us had to deal with childhood trauma of some kind, so I agree with @Jleslie about not making it a huge deal.

I had a kid in 4th grade die from an overturned go-cart, and we talked about it for a few days amongst ourselves, our teacher, and our parent(s). It was traumatic but mainly just because it was our first experience losing a peer.

Doctors have ways of treating the symptoms of trauma but trauma itself is I think best dealt with through a return to normal life together with a willingness to discuss what happened in a sensible realistic way when the occasion arises or the time seems suitable. It would be a long term project.

@JLeslie Let me join @janbb in saying great answer.

@marinelife How do you actualize that? Do you have the entire surviving school population committed to a psych ward? Do you make each go to a psychologist? Who enforces this solution? What legal framework do they use to force parents who disagree with this for their child to stand aside and let the professionals handle it? And even if you could put this plan to action, are current mental health care professionals really always superior to loving parents when it comes to knowing how to deal with the stress the child is feeling?

@burntbonez That’s my sense of it as well. I am sure nearly all would approach it with the best of intentions. But there is truth in the humbling aphorism, “The road to Hell is paved with good intentions.” My guess is that in some (many) cases a loving parent might have a better grasp of what their child is feeling and what that child needs to work through it than a PhD in Psychology that doesn’t know the child from Adam.

@KNOWITALL Exactly. In third grade, a classmate came down with polio and had to be hospitalized. I didn’t really understand what that meant till I learned that she had died of the disease. From that moment on, I understood at a visceral level that we can be immortal, but only for a little while. I worried that I would get polio, or that someone I loved would get it.

I can still remember the feeling of an enormous and looming demon being suddenly vanquished when, in 1955, Dr. Jonas Salk’s vaccine was announced to the world.

@flutherother I’m pretty sure burying the fear under psychoactive drugs is not the way to go. I agree, return to normalcy and observe. It would be great is we could at least provide parents with a list of things to look for.

Studies have shown Pennebaker’s writing therapy to be very effective.

I saw part of Dr. Phil yesterday and he did a show about the child who was taken hostage in AL. The psychologists recommended to not ask the boy to recount the events. That as I mentioned above it further etches the events into the brain and that can lead to PTSD. That allowing his young mind to fog over the exact things that happen is what they want. They recommended that when he seems afraid or upset, like not wanting to get back on his school bus (that is where the kidnapper took him) to ask him how he feels and go over his feelings, but not to ask why he is upset or what specifically happened. I would assume no matter what people, even children, talk through some of what happened to them in some detail, but immediately after events it is good to avoid that sort of conversation.

@mattbrowne Thanks.

@JLeslie Seems counter-intuitive. I wonder if we really know that’s the best approach.

@ETpro It doesn’t seem counterintuitive to me at all. They give “forget” drugs to people who have been through trauma so their memory is not very clear on events. People with PTSD usually show their emotion center in their brain light up when they recall events that have traumatized them, but they also see when other events trigger those emotions it reactivates thoughts of horrible events, even when what is going on currentoy is unrelated. Trying to prevent that connection in the brain helps long term. At least that is what they believe now.

It’s tricky though. Let’s say a woman is raped. The details might help catch the guy and convict him. So what should we do in that situation if the science is right about the brain?

Suppressing bad memories can be counterproductive and modern treatment of PTSD exposes people to the trauma in a safe way to help them cope with their feelings. Children may be different but I think a similar approach would apply.

@flutherother yes, I thought that was the modern therapeutic approach too.

This is to prevent PTSD.

I feel the problem with all mental health help is they tend to categorize everyone into groups. Everyone is different in how they feel, think and act. With that said, children are different too in how they react to trauma. I don’t think all children should be ‘made’ to discuss traumatic experiences. If they are coping well and seem to getting on with normal life, then let them. But if they seem to be traumatized by their reactions to normal life this is when they could use counseling. Parents are so different in their parenting styles and some parents openly discuss terrifying events that happen in their communities. These children seem to cope better when things like this happen. But some parents shield their children from these experiences and children really don’t know how to cope when something terrible happens. Not that I’m criticizing any parent in how they rear their children, I’m just saying that all children are different and should treated individually!

@sujenk7422 I agree. Good answer.