This commentary was originally published in
The Brown University Child and Adolescent Behavior Newsletter, September 2018, 34, 9.
Immediate Trauma with Lifelong Consequences
Margaret Paccione-Dyszlewski, Ph.D.
Current United States policies toward immigration has ignited robust discussion about parent/child separation. I suspect that most of us intuitively know that the separation of a child from their parent is harmful to the child-- but how damaging and why.
Humans are born with an innate need to connect to others; psychologists refer to this as attachment. This need to attach meets the infant’s physical needs (to be sheltered, nourished, clothe, etc.) and more emotional needs (to be touched, loved, nurtured, etc.) as well. As the infant grows into childhood and adolescence, the reliance on parents for physical security diminishes. The need for social-emotional support increases as the youngster explores his/her world and develops his/her place in it. When these needs are met, this is referred to as secure attachment.
When a child is abruptly separated from the parent, vital needs go unmet, the parent/ child trust bond is broken and the child is thrown into traumatic free-fall.
It is difficult to capture in words the emotional harm caused by this traumatic separation. Simply stated, if a child loses trust in their primary care provider, who can they trust? Children learn about themselves and their relationships with others from early attachment experiences. If these primary relationships are erratic, neglectful, or damaged, children can become overwhelmed by feelings of helplessness and fear and do not learn how to regulate their emotions or ask for help in an appropriate way. They may become overly dependent or detached.
Research has unequivocally demonstrated that trauma can affect every aspect of child development including brain development, social-emotional growth, relationships, selfesteem, and academic functioning and is associated with a wide-range of psychiatric disorders.
Trauma is toxic to the brain and the neurocognitive development of children. Children who have experienced traumatic separation may show early lags in receptive and expressive language, difficulty with sustained attention and concentration, and delays in cognitive functioning. These impairments have been noted in executive functioning, problem solving, ability to transfer learning, organization and response time. Under these circumstances, typical childhood tasks such as making friends, playing sports or doing homework become difficult, if not, impossible. Children with special needs or language challenges are especially vulnerable.
What is more, the effects of trauma can follow the child through their lifespan. In a landmark research study conducted by the health maintenance organization Kaiser Permanente and the Centers for Disease Control and Prevention published in the American Journal of Preventive Medicine (Felitti, et.al. 1998), adults were asked questions about their adverse childhood experiences (ACEs). Over 17,000 adults were asked about ACEs such as emotional abuse, separation, parental incarceration or mental illness that they experienced as a child. Almost two-thirds of surveyed adults reported at least one ACE and more than one in five reported three or more ACEs. Study results revealed that as the number of ACEs increased, so did the individual’s lifelong potential for serious health problems such as asthma, mental distress, coronary heart disease, stroke, diabetes and early death. The risk for social, emotional and cognitive impairment, lowered educational attainment and unemployment also increased. Subsequent research in this area has demonstrated similar results.
People of different cultural, national, linguistic, spiritual and ethnic backgrounds may define trauma in different ways and use different expressions to describe their experiences. Traumatic response and the resulting damage to parent/child separation is common across diverse cultural backgrounds.
Humans are relational beings. The family into which we are born is not a choice. Nonetheless, the bonds of affection and support of family are indispensable. Children need to be cradled in the nurturing presence of family in order to become healthy adults.
Felitti, VJ, Anda, RF, Nordenberg, D, et al. Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The adverse childhood experiences study (ACES). Am J Prev Med 1998 May; 14(4):245–258. doi: 10.1016/S0749-3797(98)00017-8.
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Margaret R. Paccione-Dyszlewski, Ph.D., director of clinical innovation at Bradley Hospital and clinical assistant professor in the Department of Psychiatry and Human Behavior at the Warren Alpert Medical School of Brown University.
Health Check Kids:
Talking to your children about traumatic events
by BARBARA MORSE SILVA, NBC 10 NEWS
Thursday, October 18th 2018 (Source: turnto10.com)
Experts say talking to your children about traumatic news events like school shootings starts with tending to your needs.
"What tends to happen in a tragedy or in the moment is that people focus on the kids and stop taking care of themselves," said Dr. Margaret Paccione-Dyszlewski, a psychologist at Bradley Hospital in East Providence.
"The more centered, the more secure and comfortable the parents are with their own thoughts and feelings about the event, the better the child will be able to react,” said Paccione. "Have the conversation with yourself. Say, ‘OK, what is it when I'm stressed that would help relieve my stress?’ For some people that could be going to the track, swimming. It could be going out to dinner with a friend. It could be meditation."
Then, she said, talk to your child.
"Invite the child to ask questions. Validate what the child is feeling and say, “OK, this bad thing happened,’ and then assure the child that they are safe,” Paccione-Dyszlewski said.
She also said it’s best to stick with your normal routine.
"It's very comforting to a child to stay very faithful to that schedule,” said Paccione. "In terms of the child, if the parent notices, or the adult notices any change in the child's usual behavior -- this might be changes in sleeping patterns, eating patterns, mood swings that are significant or regression in terms of age appropriate behavior -- the place to go-, first line of defense is the pediatrician.”
Another thing parents might want to do is check on your school's emergency preparedness plans and share those with your child to help ease any fears he or she might have.
Paccione-Dyszlewski said how you react will impact how your child will react.
Psychologist tells Lincoln congregation that adults can help children deal with traumatic events
By Donita Naylor
Journal Staff Writer
Posted May 8, 2018 at 10:47 PMUpdated May 8, 2018 at 10:56 PM
As reports of violence, school shootings, natural disasters and nuclear warfare become more prevalent, members of the congregation at Lime Rock Baptist Church asked what they could do to help their children cope.
LINCOLN, R.I. — As reports of violence, school shootings, natural disasters and nuclear warfare become more prevalent, members of the congregation at Lime Rock Baptist Church in Lincoln asked their pastor what they could do to help their children cope.
The Rev. Gene Dyszlewski’s answer was to bring in a speaker who conducts such programs around the state as part of her work as director of clinical innovation at Bradley Hospital. Margaret Paccione, a psychologist who has a doctorate from Fordham University, is also an assistant professor in The Warren Alpert Medical School of Brown University.
She is also married to Pastor Dyszlewski.
Children are incredibly resilient, she told about 17 people who wanted to be more prepared to help their children, grandchildren, other relatives or students.
When they are exposed to tragedy or trauma, even if it’s as far removed as images on television or a lockdown drill at school, they might not understand the event, the vocabulary, such as “active shooter” or “high capacity magazine” or their own feelings.
Guardians such as parents, grandparents and trusted adults can help children, Paccione said, by letting them know they’re safe, by staying calm themselves, by understanding that their child might experience unwanted emotions or return to outgrown behaviors.
Children need the security of familiar routines, and they can benefit from time set aside, such as a family meeting, to talk calmly about an event or what’s troubling them.
Without information, children are left to devise their own answers, she said, and that can be more frightening than the facts. “Nothing is more scary than the boogeyman,” she said.
Watching television with children and posing questions about what they’re seeing can help them discern the difference between advertising and the various kinds of news.
Children need adults to answer their questions as factually as possible, at a level the child can understand. Adults can show that they cry, too, and help a child with emotions, even if painful, are okay.