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December 11, 2013
Posted in: Hot Topics
A central goal of this website is to foster psychological resiliency among children and adolescents. In that service, we’ve strived to provide educational resources, to de-stigmatize the suffering of those who might need more help, and to recommend general techniques, strategies and policies that we feel can positively impact the lives of young people today.
However, we sometimes forget to stress that children are intrinsically resilient. More than a hundred thousand years of evolution has wired our young minds to bounce back with impressive dexterity, even in the face of horrific events and obstacles.
And let’s be honest—there has been no shortage of horrors. School shootings, lengthy wars, earthquakes, hurricanes…these have come to seem commonplace in our news these days. We know that most of us, thankfully, do not experience such tragedies up close and personal, but research shows that even experiencing such events through television or other media may generate tremendous stress. How are our kids doing, we worry, in the face of all this awfulness?
Better than you’d think.
This conclusion is based both on our experience as clinicians, and on the growing body of research that guides us toward protecting our children in these difficult times. As we approach the 1-year anniversary of the horrible events in Newtown, it’s worth taking pause and recognizing the remarkable strengths that young people bring to our worried world.
We know through multiple investigations of both natural and manmade disasters that most kids do well after one or two months. Indeed, that’s why the diagnostic criteria for acute stress disorder is different than that for post-traumatic stress disorder (PTSD). Almost everyone who experiences a terrible event, or series of events, will acutely suffer; there will be nightmares, heightened anxiety, decreased levels of functioning, and, in many cases, developmental regression. But, give it a month or two. After a bit of time, only about 1/3 of these kids will show signs of PTSD, and even that number is somewhat in question. It may be that far fewer have symptoms as they get older. While kids who are already vulnerable, particularly those who suffer from anxiety, may be more prone to PTSD, the general everyday kid, though initially shaken up, fares very well.
This, of course, doesn’t mean that we ought to just leave kids alone after an awful event. That’s not really possible in the first place. They’re our children—we love them, and we can’t help but look after them when bad things happen. More importantly, however, through studies of earthquakes in Turkey, hurricanes in New Orleans, kids living through the Gulf War, and shootings across the globe, we have, as a culture, become increasingly able to identify kids who are at particular risk for more lasting problems. We also have better and more evidence-based notions of what to do to decrease the overall burden of suffering.
The closer you are to awfulness, the higher the risk that you’ll suffer more, and for longer periods of time. Kids who lived even on the other side of Manhattan did better than kids who were near Ground Zero after 9/11. Kids who witnessed a public shooting did worse than kids who only heard the sound of gun shots. To this end, we can reach out to specific children with special services; many public health efforts are designed to triage interventions in exactly this fashion.
But, some kids who repeatedly watch such events in the media may be affected as well.
So, who is at greater remote risk?
Well, as noted above, kids who are anxious tend to react more. And, girls appear to be more prone to PTSD than boys. Age is also an important factor. Very young kids who watched the World Trade Center collapse over and over again did not understand that this happened once; to them, it was an ongoing catastrophe. In addition, younger kids who didn’t understand where New York was located were terrified, as if their home in Georgia were right nearby.
Older kids and teenagers were found to be more wary of the world. Even teenagers in San Francisco, after watching the events of 9/11, became more worried about earthquakes, something they had previously lived with and never worried about. The world just seemed more dangerous. But, even there, few developed PTSD.
There are other influences to consider. Kids are mindful of their parents’ reactions. Younger kids in the Gulf War who were displaced by rockets firing in their neighborhoods developed acute stress disorder and PTSD. But, those whose parents, especially mothers, were seen to be in control—who could soothe and comfort them—fared much better than those with seemingly overwhelmed parents.
And for the parents, it has been noted in both wartime scenarios, and in the aftermath of school shootings, that family supports are essential for ongoing mental stability for the entire community. As you might expect, these then trickle down to the kids.
In all the studies, talking with your kids about your and their reactions is very important, as is talking at a level that they can understand and comprehend. After all, we speak with a 5-year-old differently than we do with a 15-year-old.
Finally, we know that some kids will want to talk about their experiences, while other kids won’t. The best ticket to resiliency is to let the kids themselves call the shots. Forcing a child to discuss a traumatic event despite his fervent objections has been fairly strongly linked to worsening traumatic symptoms. On the other hand, if a child knows that there’s someone to talk to, and is willing to take advantage of that opportunity, he or she, as a rule, will likely fare better.
We know, most of all, that a carefully-coordinated and individually-sculpted public health intervention plan provides the best protection. Despite what the media may suggest, disasters remain rare (thankfully), and each disaster is unique. As such, our societal response to these events ought to be equally specialized. This is especially important as we look at any catastrophic event in particular. Socioeconomic and cultural differences need to be actively considered. Neighborhoods must be rallied. Families must be involved. And, we must work with our kids to determine how we can best help them. We need to know ourselves, our families and our kids—their strengths and weaknesses—and tailor our approach to them in a unique way. But overall, we need to emphasize that there is more safety and good in the world, more to be grateful for than to worry about. Worry doesn’t help, and is usually just wasted energy.
Here’s one way of thinking about these sometimes overwhelming issues:
Kids are like rivers: they’re going to keep flowing. Our role as parents, teachers and clinicians is to ensure that our children’s course is altered as little as possible, and, no matter the circumstances, always for the better. Remember: A river is awfully hard to hold back.