On April 20, 1999, two students in trenchcoats started shooting their fellow classmates at Columbine High School in Colorado. It only took minutes for them to kill thirteen people, and about twenty-five minutes later, they took their own lives.
Responding to the chaotic aftermath as a member of the Red Cross Disaster Mental Health Team that day was Joannie DeBrito, a licensed clinical social worker and marriage and family therapist. DeBrito was stationed at a nearby elementary school to assist students rescued from the high school. Once there, the teens answered questions about the shooting and were reunited with their parents.
“A large number of kids were clearly shaken,” DeBrito recalls, “but they appeared to be in a normal state of shock that resolved, for the most part, once they saw their family members. But one young woman was hysterical. We were curious about her reaction, because it was so different from the others.”
DeBrito and another mental health professional sat down with the teen, held her hand, and quietly questioned her since the police had instructed them to gather as much information as possible about what students had seen and heard. As they spoke with the student, they learned that in the past six months, this girl’s father had collapsed at church due to a heart attack, her mother had been severely injured at home, and her brother had been shot at work. As she spoke, nearby fellow students nodded as if to confirm the truth of her story.
“No place is safe,” the girl said through gasps of breath and hysterical tears. “I can’t go anywhere and be safe. Church isn’t safe, home isn’t safe, work isn’t safe, and now school isn’t safe. Where can I go to be safe?”
Since these things had happened, the teen had been having trouble sleeping, was having nightmares, and spent most of her time in her room so she could avoid anything that might be a threat to her safety. DeBrito and the other experienced mental health professional recognized these behaviors as symptoms of post-traumatic stress disorder (PTSD).
Every day, numerous events occur locally and globally that threaten the health and safety of human beings. Natural disasters, automobile accidents, physical and sexual abuse, and violent crimes are all examples of what we call traumatic events. But not every traumatic event causes a disorder. Most people can sort through the circumstances that threatened their life or safety, or that of someone else, even when those experiences left them feeling vulnerable and fearful. It’s what disaster specialists call resiliency: the ability to regain your mental and emotional stability when you’ve been knocked off balance by a stressful event.
What is PTSD?
Simply put, post-traumatic stress disorder is:
Post: It occurs after the event or situation is over.
Traumatic: The life-threatening event caused the trauma.
Stress: The trauma is causing stress.
Disorder: This stress is intense enough to disrupt or impair your daily routine and life.
Symptoms of PTSD include
- re-experiencing the traumatic event or events through intrusive thoughts, flashbacks, or nightmares,
- avoidance of thoughts, feelings, or reminders of the traumatic event(s),
- your thinking growing more and more negative about the traumatic event as time goes by,
- increases in irritability; aggressive, self-destructive, or reckless behaviors; or disruptions in concentration or sleep.
What’s the Impact?
A child who’s experienced trauma might regress in regard to skills he’s already learned. For example, a child who’s been successfully potty trained for some time may regress back to wetting the bed at night. The impact on teens can show up in their behavior: they may become disruptive, disrespectful, and destructive. These behaviors can put a strain on the relationship between you and your child.
But because we might not be aware of all the traumatic events our children have experienced, we might not recognize that these behavior changes are related to a crisis in their lives. For example, kids may not talk about an incident of sexual assault or bullying, out of fear that you may respond in anger or in a way that embarrasses them. So if your child is displaying some inappropriate behavior, take time to ask some questions. As parents, we often react by placing limits on inappropriate behavior, which is likely to result in our teens becoming more isolated at a time when they desperately need connection with others.
Kids may be confused about the changes in their own behavior. What they don’t know is that exposure to the traumatic event actually changes the anatomy and physiology in their brain in a way that’s not normal for their stage of life. When the anatomy and chemical makeup of the brain is disrupted and changed as a result of trauma, your child’s memory system and ability to cope with stress are also disrupted. Because of this, she develops new and usually unhelpful ways of coping with the aftereffects of the trauma.
So now your child is left with dangerous trauma changes in the brain. If she’s feeling isolated, that may lead her to feel afraid, confused, and alone. At that point, self-injury or thinking about suicide might seem plausible to her, since it’s a way to cope with and escape the pain of the situation.
Action You Can Take
Children and parents affected by PTSD can begin to address specific concerns by following these steps:
- Contact a licensed mental health professional with knowledge and experience in treating people who have been traumatized, to learn how to manage and respond to PTSD symptoms and develop healthy coping skills.
- If you can’t find or afford a therapist, look for a support group at your child’s school, at church, or at your local community center.
- Be supportive, empathic, and compassionate. Let your child express honest thoughts, feelings, and emotions related to the traumatic event(s). Those closest to your child can also offer the safety and security of a long-term relationship that has the potential to heal in ways that modern medicine and psychotherapy cannot.
- Be sure to communicate that healing is also related to spiritual health. Try to help your child connect with supportive pastors, youth leaders, and Christian peers who can listen, pray with him, and seek guidance from Scripture when appropriate.
Be a LOVESAFE Parent
The LOVESAFE acronym can help you remember what to do:
Listen. It’s helpful for you to listen to your child’s experiences of the traumatic event without trying to correct distorted perceptions or offer words of comfort. Listening communicates an interest in engaging and understanding what your child is experiencing.
Observe. To decide whether or not professional help is needed, take time to observe and record any changes in physical, emotional, or social patterns you have seen in your teenager since the traumatic event happened. The important word here is patterns, because patterns, rather than one-time, out-of-the-ordinary occurrences, may indicate a problem. Look for patterns of behavior that are different from pre-event behaviors.
Validate. When you tell your child that her post-trauma thoughts and feelings are real and understandable, you may help her avoid feeling crazy, which is a common reaction after experiencing a traumatic event. You don’t have to be in agreement with her thoughts or feelings, just validate their presence. Your child needs to know it’s acceptable to have some strange thoughts or feelings, even though it may not be reasonable to act on them.
Engage. Social connection with friends and family members is vital after experiencing a traumatic event. Help your child choose people to be around who are likely to be a comfort and who will encourage healthy interaction. It’s important too, not to overdo the amount of time your child spends with others. Be careful not to plan celebrations that are intended to help him forget about the event: he may feel this is harmful.
Teach self-care. Encourage your child to stay hydrated, eat small meals throughout the day, participate in some physical activity, and get plenty of sleep. These steps toward self-care help reduce stress and facilitate healing. Remind him about God’s care for him, too.
Allow alone time. There’s a tendency for us to hover over our child after a traumatic event. But too much attention can cause her to dwell on the event more than is necessary. She needs short periods of time alone to engage in quiet, safe activities she enjoys. Also, since her concentration is likely to be disrupted after a crisis, she needs time to gather her thoughts.
Find support. Recovery from PTSD usually requires help and support from friends, family members, teachers, pastors, doctors, and mental health professionals. Help your child recover by finding those resources in your community. Identify people who will listen and be patient with your child’s struggles rather than those who might want to offer unsolicited advice or offer a quick-fix solution. It’s also vital to encourage fellowship with other Christians who can offer spiritual support.
Encourage. Frequent and consistent encouragement of your child’s recovery from PTSD is necessary to instill hope in him and for you to feel hopeful yourself. This is especially true when your child experiences symptoms that feel involuntary and difficult to control. Encouraging him to engage in regular, rigorous, and safe exercise may help him diffuse the disruptive physical and emotional reactions to trauma.
While professional help from skilled practitioners is necessary for your child to recover from PTSD, equally essential to your child’s health is a loving, engaging relationship with you, friends, and family members.
The treatment for PTSD may be fairly lengthy, so make sure you get some support too. You’ll need respites that can come from regular, relaxing times spent with good friends, participation in a church small group or Bible study, or counseling.
Controlled Breathing Technique
A simple technique to teach all your children is how to control their breathing. This can be helpful when they become anxious or excited before a sporting event or an academic test, or when they’ve experienced a traumatic event.
When people feel panicked, they may start to breathe hard, hyperventilate, or hold their breath. This tends to cause them to feel more panicked, so it’s important for them to get their breathing under control. It’s not very helpful to tell panicked people to just breathe, however. Instead, you can teach them the following breathing exercise that will help them return to a normal breathing pattern. Try this for yourself, and then teach it to your children.
- Inhale as you count to four; hold for the count of five; then exhale as you count from six to ten.
- Next, inhale as you count to four; hold for the count of five; and exhale through puckered lips to ten.
- Finally, inhale as you count to four: hold for the count of five; and exhale as slowly as possible through puckered lips to ten.
- Repeat steps one through three for as long as necessary to return to normal breathing.
If you’re doing this exercise with someone who is actively panicking, have the person focus on your face as you talk through the exercise. Counting out loud for him or her also helps.