Trauma is a complex phenomenon. Many of us have probably experienced an event that we struggle to not only forget, but emotionally cope with. If I were to ask you if you have ever experienced a traumatic event what would you say? Was it severe, moderate, or mild? Was it long-term or short-term? Were you able to easily get over it? Whatever the case may be, a traumatic experience must be an event that we find difficult to cope with overtime. Sadly, many people who tend to lack knowledge about trauma fail to recognize that anything a trauma victim comes in contact with can re-traumatize them. For example, I previously had a client who witnessed his mother slit her throat and commit suicide. Prior to this suicide, the mother had been playing hiding-go-seek outside with all 4 of her children. This child struggled with understanding why his mother would walk away during hiding-go-seek and kill herself. Now, at the age 10, he watches movies with his father that often include crime scenes, murder, and suicide which tends to trigger memories of his mother’s suicide. He is unable to sleep at night, relax, or put the past behind him. Yet, his father is unaware of the reality that he is possibly re-traumatizing his own son with these movies. This article will discuss 7 things we, who are close to trauma victims, should be mindful not to do. I will also give suggestions on what we should do instead.
It is sad to say but a large amount of individual, families, and parents come to therapy with unrealistic expectations about the therapeutic process. I often have parents and families ask the following questions when they see me for the first time:
- “How often will he/she see you?” This question is asked because the unrealistic expectation is that if the child/teen sees me more often throughout the week, progress will happen faster.
- “Will you make him/her talk?” This question is asked because the unrealistic expectation is that I am someone who should make an individual talk about the “bad” things that have happened to them in order to stimulate great progress.
- “Has she/he talk to you about what happened to them?” This question is also asked with the unrealistic expectation that an individual, who just met me and may be slow to warm up, will open up like a fountain and start talking. Many families often tell the child/teen “your therapist is not going to judge you so just open up.”
- “Why isn’t he/she talking about what makes him/her so mad?” This question is asked with the unrealistic expectation that if the person talks about their past, they won’t be so angry anymore.
Sadly, many families and parents believe that a traumatized individual can move past their trauma if they just ”
let it go” and move on. What they fail to realize is that it is very difficult for someone to just start talking about their history. Some people (including children and teens) need to be emotional or have something trigger a memory or feeling in order for them to open up and start talking. It’s not easy to sit down and begin a conversation with an absolute stranger. The reality is that, while I am a therapist, I am still a stranger.
These preconceived notions and unrealistic expectations about therapy do not help the traumatized victim recover, but rather, can add unnecessary pressure to the individual. In a way, pressuring the individual to talk or open up in therapy can be traumatizing, especially if you are “beating” the person over the head with why they should open up. Therapy is not a process by which you just sit down, take a deep breath, and start talking. It is a relationship that must be built over time and that must go at a pace similar to that of any other relationship we may have. Trust must be built, multiple conversations about other aspects of life must occur, and reciprocal interest must be built. It’s a relationship, not a machine. It’s also important to recognize that while it may be easy for someone else to open up immediately, it will be difficult for trauma victims to open up most of the time.
We must also keep in mind that many trauma victims are like wounded children in some aspects. They deserve to take their time in opening up, will fight you if you try to push them to open up or re-live uncomfortable feelings, and are often afraid. Some trauma victims also have attachment problems that create barriers in the client-therapist relationship. A child, teen, or adult who has been abandoned the majority of his or her life will struggle to fully accept a therapist. It may take years before that person trusts a therapist enough to open up. As a result, I have come up with 7 things we should keep in mind before we engage in pressuring someone to open up in therapy:
- Do not force the person to talk about the trauma: Forcing someone to talk about a terrible event is making someone re-live the experience and all of the negative emotions that come with it. Some people just aren’t ready to open that box of worms. The person pressuring the individual to open up is not the one who will have to deal with the psychological, emotional, and sometimes physiological consequences of reliving that experience. If you think of the fact that talking about a bad experience can be, in some ways, similar to the flashbacks of post traumatic stress disorder (PTSD), you will understand how difficult discussing a traumatic event can be for some people. The worst thing you could ever do is threaten someone or give them ultimatums if they don’t discuss their trauma. This is wrong! Completely wrong!
- What you should do instead: Give that person room to explore the trauma and give the the time to open up when they are ready. This may be years, days, or months from now. But the goal is not to force the person to take themselves back to the trauma. You want to help that person cope in the now and this doesn’t always mean reliving the experience (at least at this time).
- Do not curse or yell at the person about the trauma or negative behaviors that are being exhibited: Some children and teens who have experienced traumatic events exhibit negative behaviors such as oppositional behaviors, attention deficits, impulsivity, or lying behaviors. They are wounded children/teens who are hurting inside and their behavior can get very out of control without the right supports. Even for adults who have experienced traumatic events, behavior is often altered by the trauma. For many adults, romantic relationships are affected, communication style, and behavior patterns. In situations like this, it is easy for loved ones, coworkers, or friends to become frustrated and treat the person with indifference, “tough love,” or even use offensive words. This is an awful approach.
- What you should do instead: you want to keep your own emotions as much under control as you can. You being out of control will do nothing but make the trauma victim feel just as out of control. You don’t want the trauma victim to feel unloved, misunderstood, or fought against because once this happens, you have lost them. They are not going to open up for you. In fact, they might just retreat even further into despair.
- Avoid watching movies/television shows or listening to music that talks about the trauma: When it comes to modern pop culture, you cannot help but see movies with vampires, ghosts, or other spiritual or paranormal underpinnings. Most kids love this stuff. But we must be careful when exposing young children and even teenagers to this kind of material if they have had a trauma history. As much as the child or teen might like this material, damage could be done if they are not capable of separating fiction from reality. Many of my clients, ages 12-14, love the movie Paranormal Activity but are often unable to separate scenes of the movie from reality. Some of my clients have even believed they can see and hear things or make things move themselves. They are simply not capable of handing these kind of movies. A traumatized child is often a child or teen who is behind a few years in maturity. We must not forget this. For some adults, movies that speak about abuse, neglect, trauma, or other similar topics may trigger depressed moods or anxious thoughts.
- What you should do instead: only expose the child or teen to movies they can handle and explain to them why you are not allowing them to watch certain movies. It’s tough with today’s kids and teens because all of their friends are doing it, why can’t they?! I would be firm with this one and explain your reasoning. For adults, again, I would be mindful that certain movies may later trigger a flashback or depressed mood. Just know thyself and be mindful of your emotions and moods.
- Pursue therapy with the person. Don’t make them feel they are alone in “getting better:” Unfortunately, there are some trauma victims who are sent to therapy while their entire family remains disengaged and detached from the therapeutic process. I’ve had clients ages 9-12years old in therapy for their trauma while their parent (adopted or biological), grandparent, or sibling refused or did not believe they needed to attend. The “identified patient” was the client in therapy and not the family.
- What you should do instead: open your mind and heart to family therapy. Perhaps therapy for the entire family unit would help the client behave better or accept the trauma. Sometimes a child/teen (or even adult) can do very well in therapy alone, but problems are only evident when the family unit comes together. It’s an interesting dynamic.
- Don’t forget that medication can be helpful for a short period of time: Most people today, who are often very educated to medication as a result of the web, are against medication. But I must remind you that some medication is necessary to help the brain and body return to a state of homeostasis or balance. For example, a muscle relaxer, anti-depressant, or anti-anxiety medication may be very helpful in helping the trauma victim cope with their trauma. Some medications are used for only a short period of time. For example, Buspar, an anti-anxiety medication, is designed to only be used for 4 weeks in some cases.
- Understand that suicidal thoughts and self-injurious behaviors are symptoms: Some people believe that a person is seeking for attention by expressing suicidal thoughts or by self-injuring (cutting, scratching, or burning themselves; pulling hair from the body, or engaging in other high risk behaviors). But for many kids/teen and even adults, traumatic histories often result in post traumatic stress disorder, depression, anxiety, and other symptoms that trigger other symptoms such as suicidal thoughts or self-injurious behaviors.
- What you should do instead: be mindful that suicidal thoughts and self-injurious behaviors are occurring for a specific reason. Attention seeking can be one reason, but there is often a deeper reason for these behaviors.
- Be patient. Healing takes time: Trauma affects every part of who we are – our brain, our health, our emotions, our worldview, our ability to cope, our social connections and ability to socialize, our ability to heal, etc. You cannot rush healing, no matter how long ago the trauma happened. The body, emotions, and mind often goes through a grieving and loss period which often includes symptoms of fear and anxiety. Once this period ends (or becomes more tolerable for the victim), other symptoms might arise or one’s viewpoint might change. Behaviors and moods change as well. Trauma is not easy to deal with.
We must be compassionate, patient, understanding, and willing to love those around us trying to cope with trauma as much as we can. You want to be mindful of the fact that some trauma victims can be unhealthy for you as well. So you want to engage in your own self-care and tune into how you are feeling and reacting to the trauma victim.
As always, I wish you well