Our Hearts Go Out to Centennial

Image via Huffington Post

Last week, just one day before the anniversary of the shooting at Sandy Hook Elementary in Newtown, Connecticut, an 18-year-old teenager opened fire in Arapahoe High School in Centennial, Colorado, critically injuring a fellow student before taking his own life. For a community still traumatized by the incidents at Sandy Hook, not to mention the Century Movie Theater in Aurora in 2012 and Columbine High School in 1999, this can be understandably overwhelming.

These situations occurred in environments that had been associated with safety and trust and now something scary and unsafe has altered that perception. These events have evoked many strong emotions – anger, sadness, fear, disgust, helplessness, anxiety – not only for those individuals directly impacted, but also for those who have been exposed through relational associations, or simply media exposure.

It is natural for children and teens to seek out adults to help them process these types of experiences. This presents a unique challenge to parents and teacher because just as the youth are attempting to organize their thoughts, cope with their feelings and make some meaning of these events, the adults are engaged in the same process. I have received many requests from parents and the media asking questions about how to talk with children about these terrible events without increasing the children’s anxiety and fears about the world.

The National Child Traumatic Stress Network offers some good guidelines to answer this difficult question.

Suggestions for Adults

• Take care of yourself. Do your best to drink plenty of water, eat regularly, and get enough sleep and exercise.

• Help each other. Take time with other adult relatives, friends, or members of the community to talk or support each other.

• Put off major decisions. Avoid making any unnecessary life-altering decisions during this time.

• Give yourself a break. Take time to rest and do things that you like to do.

Things to Do for Children

• Spend time talking with your children. Let them know that it is OK to ask questions and express their concerns and feelings. You should remain open to answering new questions and providing information and support. You might not know all the answers and it is OK to say that. At the same time, don’t push teens to talk if they don’t want to. Let them know you are available when they are ready.

• Find time to have these conversations. Use time such as when you eat together or sit together in the evening to talk about what is happening in the family as well as in the community. Try not to have these conversations at bedtime, as this is the time for resting.

• What does your child already know? Start by asking what your children already know and think about what they have read, heard or experienced. Listen carefully in an accepting and non-judgmental manner. As children express their thoughts and beliefs listen for misperceptions and misinformation. Be attuned to how their perceptions are making them feel and validate those experiences before providing information to correct them. Say something like “This really scared you! I can see the way you are thinking about this made you feel that way.” Then respectfully correct their inaccurate information. Provide this new information in a simple, clear and age-appropriate manner.

• Help your children feel safe. Talk with them about their concerns over safety and discuss changes that are occurring in the community to promote safety. Encourage them to voice their concerns to you or to teachers at school.

• Maintain expectations or “rules.” Stick with family rules, such as curfews, checking in with you while with friends, and keeping up with homework and chores. On a time-limited basis, keep a closer watch on where they are going and what they are planning to do to monitor how they are doing. Assure them that the extra check-in is temporary, just until things stabilize.

• Address acting out behaviors. Help them understand that acting out behaviors are a dangerous way to express strong feelings (like anger and grief) over what happened (e.g., cutting, driving recklessly, engaging in unprotected sex, abusing drugs or alcohol). You can say, “Many of us feel out of control and angry right now. Some people may think drinking or taking drugs will help somehow. It’s very normal to feel that way - but it’s not a good idea to act on it.” Talk about other ways of coping with these feelings (distraction, exercise, writing in a journal, spending time with others).

• Limit media exposure. Protect them from too much media coverage, including on the Internet, radio, television, or other technologies (e.g., texting, Facebook, Twitter). Explain that media coverage and social media technologies can spread rumors and trigger fears about the event happening again.

• Be patient. Children and teens may be more distracted and need added help with chores or homework once school is in session. It is normal for all humans to have a stress response to any potential threat in the environment. Reactions such as increased startle responses, increased emotional reactions, anxiety, decreased attention span, intrusive thoughts and disrupted sleep may be present for the first month after the exposure. For most people in the community these reactions lessen and we are able to re-establish our equilibrium after about one month. For individuals more directly impacted this time period can be extended due to continued exposure to reminders of the events and more complicated feeling of loss and grief.

• Ask for professional help. If the reactions continue or the family feels unable to manage the situation due to overwhelming emotions or lack of knowledge and support, contact a professional to assist you and the family through this experience.

Children are dependent upon their caregivers to help them feel safe and create meaning of experiences in their world. The adolescent is in the process of transferring dependency needs from the parents to peers and possible romantic partners. How a child and the adolescent processes these types of experiences is greatly influenced by the nature, quantity and quality of the interactions they have with the significant adults and peers in their lives. A well regulated, attentive, responsive parent can help the child re-establish a sense of safety and security and manage distressing emotions. The child, within this protective relational nest, and the adolescent within their relational network can learn that at times bad things happen, to good people, in basically a good world.

Helping Children Cope with Disaster

Colorado fifth-graders airlifted out of Jamestown, CO during the recent flooding. (via TIME)

In the wake of several recent disasters, especially the Colorado floods, the children in your life may have some important or challenging questions. Young children are dependent upon their caregivers to help them feel safe and create the meanings of experiences in their world. How a child processes these types of experiences is greatly influenced by the nature, quantity and quality of the interactions they have with the significant adults in their lives. A well-regulated, attentive, responsive parent can help the child re-establish a sense of safety and security and manage distressing emotions. The child, within this protective relational nest, can learn that at times bad things happen, to good people, in basically a good world.

The National Child Traumatic Stress Network offers some good guidelines to assist parents having to address difficult questions.

Suggestions for Adults

• Take care of yourself. Do your best to drink plenty of water, eat regularly, and get enough sleep and exercise.
• Help each other. Take time with other adult relatives, friends, or members of the community to talk or support each other.
• Put off major decisions. Avoid making any unnecessary life-altering decisions during this time.
• Give yourself a break. Take time to rest and do things that you like to do.

Things to Do for Children

• Spend time talking with your children. Let them know that it is OK to ask questions and express their concerns and feelings. You should remain open to answering new questions and providing information and support. You might not know all the answers and it is OK to say that. At the same time, don’t push teens to talk if they don’t want to. Let them know you are available when they are ready.
• Find time to have these conversations. Use time such as when you eat together or sit together in the evening to talk about what is happening in the family as well as in the community. Try not to have these conversations at bedtime, as this is the time for resting.
• What does your child already know? Start by asking what your children already know and think about what they have read, heard or experienced. Listen carefully in an accepting and non-judgmental manner. As children express their thoughts and beliefs listen for misperceptions and misinformation. Be attuned to how their perceptions are making them feel and validate those experiences before providing information to correct them. Say something like “This really scared you! I can see the way you are thinking about this made you feel that way.” Then respectfully correct their inaccurate information. Provide this new information in a simple, clear and age-appropriate manner.  
• Help your children feel safe. Talk with them about their concerns over safety and discuss changes that are occurring in the community to promote safety. Encourage them to voice their concerns to you or to teachers at school.
• Maintain expectations or “rules.” Stick with family rules, such as curfews, checking in with you while with friends, and keeping up with homework and chores. On a time-limited basis, keep a closer watch on where they are going and what they are planning to do to monitor how they are doing. Assure them that the extra check-in is temporary, just until things stabilize.
• Address acting out behaviors. Help them understand that acting out behaviors are a dangerous way to express strong feelings (like anger and grief) over what happened (e.g., cutting, driving recklessly, engaging in unprotected sex, abusing drugs or alcohol). You can say, “Many of us feel out of control and angry right now. Some people may think drinking or taking drugs will help somehow. It’s very normal to feel that way - but it’s not a good idea to act on it.” Talk about other ways of coping with these feelings (distraction, exercise, writing in a journal, spending time with others).
• Limit media exposure. Protect them from too much media coverage, including on the Internet, radio, television, or other technologies (e.g. texting, Facebook, Twitter). Explain that media coverage and social media technologies can spread rumors and trigger fears about the event happening again.
• Be patient. Children and teens may be more distracted and need added help with chores or homework once school is in session. It is normal for all humans to have a stress response to any potential threat in the environment. Reactions such as increased startle responses, increased emotional reactions, anxiety, decreased attention span, intrusive thoughts and disrupted sleep may be present for the first month after the exposure. For most people in the community these reactions lessen and we are able to re-establish our equilibrium after about one month. For individuals more directly impacted this time period can be extended due to continued exposure to reminders of the events and more complicated feeling of loss and grief.
• Ask for professional help. If the reactions continue or the family feels unable to manage the situation due to overwhelming emotions or lack of knowledge and support, contact a professional to assist you and the family through this experience.

 

The Earlier the Better

There has been a great deal of attention in the media lately on Colorado’s child protection system and its failure to effectively carry out its charged responsibilities. In the worst cases reported, children who were known to the system were left unprotected and died due to abuse and neglect. Although the Department of Human Service became the focal point of the media attention, similar neglect of children and adolescents has occurred for many years in the mental health system. Children and adolescents who have been victimized or who have suffered from mental illness have been a low priority. With a growing awareness of the long term impact of early childhood and adolescent experiences on the developing brain, these practices are beginning to be challenged.

David Finkelhor (2008) states that, “children are the most criminally victimized people in our society.” Children’s level of dependency and their inability to make independent decisions about the people with whom they will associate increases their risk for victimization. A child who is victimized might be at as much as 60 percent greater risk for future victimizations.

Childhood is a developmentally dynamic period of time when the brain is exceptionally sensitive, both positively and negatively, to environmental stimulation. In fact, as a species our brains are pre-programmed to change in response to experience. The human brain is immature at birth but develops rapidly during the first five years of life. At birth the brain is only 25 percent of the weight and size of an adult brain, seventy percent by age three, and ninety five percent compared to an adult by the time a child is ready for kindergarten. The brain’s plasticity – its ability to change in response to environmental stimulation – allows us to adapt to our environment in order to survive and grow. A child’s 100 billion neurons, each with 15,000 synaptic connections, three times as many as an adult, are just waiting for experiences that will mold the structures and organization of his or her brain, enhancing or inhibiting functional capabilities.

Early social interactions appear to turn on the infant’s incredible capacity to learn and explore the environment.  Active social engagement with a responsive caregiver activates the mechanisms that begin to install the wiring that will allow a child to carry out more complex functions, speaking, reading , writing  and relating  effectively. The quality and quantity of positive, engaging, stimulating and soothing relational interactions creates a growth producing environment that will facilitate the expression of the child’s potential.

The same neural flexibility that allows a child to learn how to walk, talk and play also makes him or her vulnerable to the long term impact of negative experiences. Exposure to physical, sexual and emotional abuse, neglect, and violence during sensitive early developmental periods, adverse experiences which can be further complicated by a lack of caregiver support to buffer the impact of associated stress, interferes with a child’s developing brain. Those neural systems associated with a stress response are activated frequently, get strengthened, and become sensitized. Because the higher, more complex regions of the cortex associated with affect and arousal regulation, fear modulation, empathy, insight, response inhibition, problem solving, and decision making are undeveloped, these children are prone toward avoidance rather than an approach mindset when faced with life’s challenges. They also have a tendency to see life’s demands not as opportunities to explore but threats to defend against. As a result, children exposed to negative experiences and diminished caregiver support early in life often struggle with peer relationships, academic challenges and making healthy life choices.

Many of the social problems we face today – school drop outs, substance abuse, aggression, child abuse and poor physical health – are strongly correlated with exposure to early childhood adversity. Programs that focus on the prevention of these events are extremely important. However, effective early interventions are as important because the more negative repetitions the brain receives, the more these experiences get wired into a person’s neurobiology.

Highly threatening events, such as physical or sexual abuse in a child’s life, create high arousal affective physiological states. Due to actual threats from the perpetrator, a perceived risk of loss of the love a parenting figure, or fear of bodily harm, many children begin to physically or psychologically isolate and experience prolonged shame, self-blame and despair. These negative affect states generate powerful hormones and neurochemicals that alter the developmental trajectory of the evolving neural networks in the brain. When an individual is exposed to an adverse event an internal negative emotional state is created. If that emotional state is prolonged that state can becomes a more enduring personality trait.

One of the goals of Denver Children’s Advocacy Center (DCAC) is to improve the child protection system’s response to children who have been allegedly victimized and to reduce the negative long term impact of exposure to terrible life events. We do this by coordinating law enforcement, child protection, medical and mental health treatment, and even educational services to facilitate an effective response to children and families while increasing community safety. Rapid, 24 hour a day access to a trained forensic interviewer, who conducts sensitive interviews in a non institutional setting, reduces the threat to the family and child, increases the potential for a disclosure, and lessons the likelihood that multiple interviews with an assortment of child protection system partners will be necessary. Research has shown that when children and family have to repeat their painful, humiliating stories over and over again there are profound negative effects on their recovery.

At DCAC, victim advocates are available to support the child and family and to help them navigate the system to access necessary resources. Coordination with both internal and external service providers increases the potential for smooth transitions to trained service providers in the community. Our goal is to have the child’s and family’s needs at the center of the process and to have child protection professionals work together in one setting for the benefit of the child. Getting the right intervention, at the right time, with the right professional increases the potential for the right outcomes for the child, family and community.

Denver Children’s Advocacy Center strives to be a trauma-informed organization that provides services in a developmentally sensitive, culturally responsive manner. The work that is carried out at DCAC is the result of a collaborative effort of caring child protection professionals to improve the lives of children and families in our community.  With all the focus in the media on what has not been working, it is important to note the successes that take place every day in the two Victorian houses on the corner of 22^nd and Federal Boulevard.

*Finkelhor,D. (2008). Childhood Victimization:  Violence, Crime and Abuse in the lives of Young People. New York: Oxford University Press

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Your comments and questions are welcome.

Please feel free to post below or to contact me directly at jerry@denvercac.org

Clear and Present Safety

“I can only hope it helps for you to know that you’re not alone in your grief, that our world, too, has been torn apart, that all across this land of ours, we have wept with you. We’ve pulled our children tight.”

President Obama, 2012


All too often we are called together as a nation and asked to observe, tolerate and process the thoughts and feelings associated with the viewing of horrific events.  Some are natural, like hurricanes, tornadoes and earthquakes. Many others are human inflicted – school and theater shootings, children starved, burned, beaten, or abducted and never found. As a species, because we were slow and relatively weak, human survival depended upon relationships and the formation of social networks. Through evolution, humans had to develop specialized neurons to read the intentions of others not only to ensure an individual’s safety but also the safety of others in the social group. Because we were so dependent on the group for survival, the same neural network that communicates that the body has been injured (pain) also gets activated when we experience a threat to our connection to our social group. These groups of mirror neurons allow us to resonate with the internal state of others and sense both the sequence of actions that are coming and the emotional energy that motivates those actions. When the group is threatened there is a biological response to “circle the wagons” and move into a defensive mode of thinking and behaving. The perception of threat activates an automatic behavioral and hormonal response designed to increase the chances for survival. Whether that threat or perceived threat is directed at us or at others in our social group, our biology reacts to protect us.

Our stress response system activates a total body-mind reaction that mobilizes resources and prepares us for action. Neurochemicals that flood our brains and bodies shift us out of our thinking brains and into our survival brains. Sugar is released into the blood stream from the liver and muscles, oxygen levels increase, heart rate and blood pressure increase, and our immune system is activated and prepared to fight infections.  Our attention gets focused on the threatening stimuli and our impulses drive us to protect ourselves through aggression or withdrawal. As the fear rises we begin to lose higher order executive functioning, the ability to modulate our fears and regulate our arousal levels, and the ability to encode information and express our thoughts verbally.  We are in a biological state designed for action not sophisticated problem solving.

Our brain’s way of recording experiences is through associations – a threatening experience gets connected to other events that elicited a similar internal state. Fear begets fear and the system becomes sensitized to danger. As a reaction to these biological changes a person can begin to see threat when none is present; or they can avoid any situation that triggers a stress response and miss important cues that can signal danger.

As we watch the images on our television of the scene of a terrifying event and hear the commentaries on what took place, our body and brain react as if we are facing a similar threat. We attempt to make sense of something that seems senseless. We resonate with the feelings of the victims and their families. We imagine that this could happen to us or to those we love. We feel a wide range of emotions and we experience in our bodies that which took place somewhere far away as if it was happening in our town. Our safety and assumptions about a benevolent world are threatened. We all struggle to put these types of violent acts into our mental models of a just and fair world. In order to accomplish this we begin to polarize the world and people in the world into categories of good and evil.

We want to reestablish an internal and external equilibrium. In order to manage feelings of helplessness and powerlessness generated by hearing and observing the impact of terrifying activities, we have a strong need to move toward action. We want to send money, make calls, advocate for the creation of policies and laws, and work to contain the perceived evil from the good. We reach out to our leaders to do something to make us all feel safe again. In an effort to respond to the crisis, at times we are willing to push through system changes that probably would not have been approved at another time. In our haste we are at risk of missing the important impacts of such policies – impacts that may result in the loss of liberties and freedoms we all value as a nation. Feeling safe outweighs any abstract concept of freedom during these times of crisis.

What we need most from our leaders at these critical times is for them to be present, attentive, and attuned to the fears and pain of the victims and the nation. We need them to acknowledge what has happened but not identify with the sense of hopelessness and helplessness – to inspire the nation to use these painful moments to bring all of us closer together and remind us of the power of relationships and community. We can make a difference and create a better world but we also must grieve our losses and heal our wounds. We want our leaders to put aside their personal agendas and work together to make us feel safe in the short run and not betrayed in the long run.

With the ever expanding media coverage of these terrible, horrifying experiences, we will have to learn how to effectively cope with disasters. Intense traumatic events will always transform us but it is up to us to determine if they will transform us for the better or for the worse. It does not matter if you are the President of the United States, a leader in your community, a teacher, or a parent. How we handle these events will serve as a model for how our children will learn to manage these types of events in their future. Children don’t always listen to us but their neurobiology makes them experts at imitating us. As adults we must reestablish a sense of physical and psychological safety, tolerate and manage our emotions, grieve our losses, and maintain hope that we can make a difference that will make the future brighter.

At a psychobiological level it is true that they are all of our children!

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Your comments and questions are welcome. Please feel free to post below or to contact me directly at jerry@denvercac.org