A "Trauma Story" Told by a Very Young Child
Yesterday was a cloudless Summer day in Southern California, and I was done early with my clinical hours. COVID-19 hit and everything has been on shutdown since mid-March. It’s now mid-September, and I’ve been feeling the need for some sun to drink into my skin. I drove over to the local pool (that is now re-opened, yay!) and lay down on the warmed and water splotched, brown concrete deck. Immediately I was alerted to a distressed toddler in the pool who was, in fact, with a swim instructor protesting into a water safe swim lesson.
S.O.S
Yesterday was a cloudless Summer day in Southern California, and I was done early with my clinical hours. COVID-19 hit and everything has been on shutdown since mid-March. It’s now mid-September, and I’ve been feeling the need for some sun to drink into my skin. I drove over to the local pool (that is now re-opened, yay!) and lay down on the warmed and water splotched, beige concrete deck. Immediately I was alerted to a distressed toddler in the pool who was, in fact, with a swim instructor protesting into a water safe swim lesson. As the minutes sludged on, I found myself on the edge of my bandwidth of tolerance. This toddler was in distress. Instead of acting on my strong urge to leave the pool deck (and relieve my own viscerally triggered memory of being a tiny girl forced into a swim lesson that I wasn’t ready to experience), I stayed anyhow and breathed through my own triggering moments for the next twenty minutes. I wanted to really understand this child’s distress process, and to be frank, my own as well.
No matter the constant protests of, “Towel!”, “Dada!”, “Hug!” and visceral sounds of the attachment cry that only a baby can produce, the swim instructor in her sun-worn, wide-brimmed straw hat remained calm and collected. She made constant, reassuring eye contact with the toddler and used encouraging, simple words with him. She stayed physically connected and responsive to this young boy. Apparently the instructor’s aim was to teach him to roll over onto his back and float after she induced a brief underwater submerge by letting go of him while gently pushing forward her arms. Upon his little head bobbing to the surface, she then guided him to the edge of the pool, and he would pull himself out onto the pool deck. He went through this trial over and over, all the while crying out with “Towel!”, “Hug!”. This was a real survivor reality show - moment, after moment, after agonizing moment! And just like on TV, I knew all would be well in the end. Despite my headspace knowing the outcome, in those excruciating twenty minutes I struggled to stay present, calling on all my robustness to tolerate my own emotional distress in this desperate boy’s calls to survive those moments, the moments that reverberated through my whole body and being. I can only imagine what it was like for him…
Happy Hour
At last, the swim instructor’s voice gave a lilt that implied the lesson was over. Three o’clock, a brand new definition of Happy Hour for me. When the toddler’s father approached the edge of the pool deck, the swim teacher made a polished water-airlift-hand-off of the boy to his dad, and suddenly the protestations muffled into a whimper, then ceased all together as a plush, wide-striped blue and white towel securely bound the little one’s big and raw emotions. Now there were just two little feet and a towhead on the other end. In silence, his father swooped up this little burrito. Teacher gave a pleasant recap of the swim safety lesson while dad agreeingly smiled and nodded. I couldn’t see the boy’s face anymore because he had buried it next to the safety of his dad’s chest and armpit. Finally! My nerves were beginning to calm down a bit. But I was wondering (with a slight dose of worry attached) whether the boy was experiencing a dissociative rebound, or was calmly resting in his father’s arms…
A few minutes later, after father had gathered up his little man, I found myself joined by the swim teacher who has taking a break dangling her shins over the edge of the pool deck (6 ft. apart!) by me. I took this unexpected opportunity to tell her how grateful I felt that someone like her had such importance in the lives of people. Water safety is so crucial for little ones. She returned, “It must’ve been hard to watch because he was having such a difficult time today, but I’m actually used to it.” Searching her hazel eyes I believed her. “With the three-year-olds and older, I can reason with them easier,” she easily imparted. What she told me next put everything into context.
The Trauma Story
“This little guy fell into a pool. That’s why his mom brings him. It’s been a few weeks now…Tuesdays and Thursdays. He usually calms down after a minute or so, but today his dad brought him.” Now I was piecing things together. “The first few times his mom brought him, he’d say ‘Fall! Fall!’ repeatedly throughout the lesson, but he doesn’t do that really anymore.” Matter-of-fact-like she offered, “He only speaks one word at a time.” Before my filter could kick in, I shared back with her, “That makes sense…” I qualified my previous comment that unintentionally blurted out as if I was still thinking to myself. “I’m a psychologist.” I didn’t know how she’d take that in the context of our impromptu conversation, but in that moment I decided to move forward anyway. “In his own way, he must have been telling you his trauma story, just like I think he was doing today.”
Turning Off Alarm Systems
At the risk of her taking it defensively, I first complimented her on being so welcoming and calm in the face of this boy’s abject terror. “I admire how you were able to be so even-keeled just then. This boy truly couldn’t calm down. I think he needed something really important to happen first. Would it be alright if I gave you a tip?”
I thought to myself, “Oh God. Maybe I’d just ruined the moment between us.” “Maybe his distress cries needed your validation [aka therapist-speak: mentalization] first before he could calm himself through your being close to him, holding him in the pool.”
We went on exchanging conversation about her experiences as a swim instructor and my understanding of how kids reveal their traumas. “Really?” She raised her eyebrows. “Yeah. Whatever he brings you in terms of his trauma retelling, you can accept it in the moment verbally and with your presence too, and then with good timing redirect his attention to being reassured— as much as he needs it, moment by moment. Like if he says ‘Fall!’, you can let him know, ‘Yes, you fell into a pool. That was really hard…’ Then take a moment to look into his eyes and acknowledge his way of communication. And then… let him know ‘You’re safe now here with me. I’ve got you!’ If he doesn’t mention the fall but is stressing really hard like today, you can say something like ‘I see you. I hear you. It’s sooo not easy for you right now, and I’m here with you. You’re safe now.’”
I sensed she wanted to hear more, so we continued, “That kind of in-the-moment validation will do a lot to turn off his alarm system because he’s got your great and calm presence, with your reassurances over the span of the whole swim lesson.” Of course because I couldn’t help myself, I went all out. “I feel like letting you know that you’re a kind of trauma therapist yourself for ones like this little boy today!” She brimmed. I was happy too that I took the chance to share in this unexpected exchange with her.
Attachment
“Attachment is where it all happens. The good. The bad. And the ugly,” Ed Tronick, author of the Still Face experiment said. When we help very young children make sense of their experience, when we are able to quickly and responsively repair attachment disruptions, and when we provide a good enough constancy of rapport, children can grow up to be securely attached and robust, even in the face of traumas.
The good news is that “the bar” is actually set pretty low. Attachment theory, notably via Donald Winnicott’s writings, imparts the notion that the standard for secure attachment development is set at about 1/3 of the time (or more) for caregiver-child interactions—and I add here this proportion assumes the absence of emotional, physical, and/or sexual abuse. Wow! It turns out that the human condition is inherently robust. This idea is confirmed by The Adult Attachment Interview (AAI) data that indicate in the world populous, approximately 55-60% of adults are securely attached.
Bottom line is: as adults in a position to influence the lives of children, we can all be inoculators against the effects of big and little traumas. We can all intentionally be the promoters of secure attachment and a protective factor against the development of PTSD and other trauma-related conditions in children. The attachment cry is the human condition’s way of communicating, “I need help!,” and validating this unique communication is just as important as being soothing and calm in any little one’s distress.
Thank you so much for reading my blog! If you have suggestions for future blogs, please email by clicking the red button below.
Photo by Marc-Antoine Roy on Unsplash
What’s at the Heart of Trauma Resolution
Skilled therapeutic intervention is key to resolving trauma, and fortunately there is not just one method or modality to accomplish resolution of traumatic experiences! At the heart of mental/emotional trauma resolution is therapeutic memory reconsolidation as articulated by Bruce Ecker’s (2018) methodology literature review.
When is it trauma?
So many of us have brushed aside the notion of being traumatized because our self-image, our self-talk, our reliable defensive stance in life don’t allow us to reflect inside. “It was my fault. I shouldn’t have been dressed that way. Maybe then they wouldn’t have followed me outta that bar and beaten me up…” is what I heard one new client referred by the Victim Witness Assistance Program tell me when speaking about their most recent hate crime.
My client didn’t consider themself a victim, and they were proud of that. I respected their personal experience of the beating, and I knew their take on it was protective for them. My understanding of their beating (which I didn’t share with them at intake) was that they had likely dissociated from the vulnerable feelings and sensations that were a part of the beating in that dark parking lot. While this client presented a more obvious story of trauma that therapy could, and would resolve, other traumas are less obvious…yet just as devastating to the mind-body psyche.
Interestingly, conscious awareness at the time of traumatic experience is not a prerequisite for people to [subconsciously] register experience as traumatic. At clinical intake, the psychotherapist may hear, “My childhood? Mine was just great. Wonderful parents! Funny thing though…I don’t remember anything specific about it now that you ask.” Only many sessions later may the therapist begin to discover the client’s abusive/neglectful childhood if there is one. This kind of dissociative process happens automatically as a built-in survival mechanism attendant to the human condition. Why? -----because we are built to cordon off that which we cannot metabolize consciously. And kids are especially susceptible to dissociating when life gets to be too taxing for their burgeoning personal psychology in the midst of abuse and/or repeated experiences of emotional neglect.
My client who had been beaten up did not begin to consciously register their trauma until they sensed it was safe enough with me to explore this possibility within a paced, therapeutically shared internal journey. Resolution of trauma came quite slowly. After careful clinical interviewing, it became apparent to me that this client had Dissociative Identity Disorder (DID), and we worked through a serious history of early trauma extending up to the present at age 21 years. Their trauma healing process took a handful of years altogether in therapy with me.
When does the trauma response cease to be triggered?
Skilled therapeutic intervention is key to resolving trauma, and fortunately there is not just one method or modality to accomplish resolution of traumatic experiences! At the heart of mental/emotional trauma resolution is therapeutic memory reconsolidation as articulated by Bruce Ecker’s (2018) methodology literature review. Healed trauma cannot be re-triggered. It’s permanently gone. Erasure of memory’s traumatic aspects connected to the declarative (aka, factual) and episodic recall is complete. This is fantastic news!
At present, there are ten different therapy modalities that have the backing of published scientific research explaining therapeutic memory reconsolidation. Check the list out here. These distinct therapies provide a framework for established best practices in the field of trauma psychology. The International Society for the Study of Trauma and Dissociation (ISST-D) has treatment guidelines for adults which can be found here, and for child treatment of trauma, the guidelines can be viewed here. Working within these guidelines leaves ample room for applying the various treatment modalities alluded to above. FYI, please look them up!
To be frank with you, in my early years of treating Complex PTSD and DID, I hardly knew how to recognize what the heart of the matter was with these clients! I definitely contributed to the well-known statistic of DID clients being in therapy for an average of seven years before being given an accurate diagnosis of DID. Fortunately, I found ISST-D via one of my mentors, and my confidence in working with traumatized clients has blossomed over the years. I now utilize the treatment modality of EMDR as a framework with nearly all of my clients, and it requires a specialized, advanced application with traumatized persons. If you are a client needing trauma-informed care, or if you are a psychotherapist treating trauma, aren’t we so fortunate as seekers and deliverers of therapy at the current time when trauma truly can be healed! Please share this blog with anyone you know who may benefit.
Ecker, B. (2018). Clinical translation of memory reconsolidation research: Therapeutic methodology for transformational change by erasing implicit emotional learnings driving symptom production. International Journal of Neuropsychotherapy, 6(1), 1–92. doi: 10.12744/ijnpt.2018.0001-0092