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.
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Photo by Marc-Antoine Roy on Unsplash
Triggering During the COVID-19 Outbreak: People with Complex PTSD
With COVID-19 cases escalating, I see both obvious and subconsciously concealed similarity to threats and danger from past trauma; this all gets understandably triggered in a person’s complex PTSD. What can people who suffer from complex PTSD do to mitigate the sometimes sudden and intense triggering these days?
March 17, 2020
Governor of the State of California, Gavin Newsom issues a “stay in place” mandate until April 17, 2020, for all of California except for essential activities and services such as food take out and delivery, grocery store shopping, obtaining essential healthcare services, mail delivery, going to laundromats, etc.
Week One
In my small corner of the world where I sit in my California psychotherapy office, still most of my clients have elected to come in for their regular therapy sessions. At initial check-in, some of my clients have been a bit rattled, but still doing alright. With dedication I have disinfected my sky blue pleather couch between sessions and offered Crabtree & Evelyn hand sanitizer before and after each meeting. I’m told my new ritual has had an effect of reassurance and caring.
Week Two Of The COVID-19 Mandate
My clients dealing with complex PTSD are mostly feeling pretty isolated and more triggered by the COVID-19 pandemic. Themes of isolation, helplessness, doom, lack of personal agency, and escalating anxiety are central. I look across my carved wood coffee table into red-faced countenances, forward-rounding shoulders, words of irritable disbelief about human nature, and eye sockets sometimes quickly tearing up at check-in.
Mitigating Triggers
With COVID-19 cases escalating, I see both obvious and subconsciously concealed similarity to threats and danger from past trauma; this all gets understandably triggered in a person’s complex PTSD.
What can people who suffer from complex PTSD do to mitigate the sometimes sudden and intense triggering these days?
I realize this blog may be bordering on therapeutic advice; however, I am simply trying to promote mental health and awareness in a time of crisis. People who may not have access to a therapist and who have histories of early, ongoing caregiver neglect, physical abuse, emotional abuse, and/or sexual victimization need to know it’s really understandable that they experience elevated triggering in these unprecedented times.
Nonetheless, here are my thoughts.
1. Calm down the nervous system first.
Common knowledge is that a heart rate below 94 beats per minute maximizes access to higher brain functionality in the cerebrum versus absorption into the emotional brain’s reasoning and strong influence. Diaphragmatic breathing or any sustained controlled breathing techniques will do a relatively quick reset for the nervous system to set itself at a lower idle. This opens up greater conscious brain capacity to adapt to the situation at hand.
2. Hold in mind and sustain the most adult perspective (that is connected to the grounded reality of present life).
Allow the five senses to perceive the moment’s reality: name things of a similar color in the room, register different sounds heard in the room, make saliva in the mouth, plant feet into the floor with arms hugging the torso (repeat several times), notice any scents or have pleasant soap to smell.
3. Thank what is inside the mind and body communicating a sense of threat and danger.
Express gratitude for the ongoing attention and care promoting survival that has persisted all these years. Be non-judgmental, friendly and curious about the messages offered in whatever form they appear--as much as possible.
4. Help what’s inside to know the difference between what’s past and what is now true in terms of the adult self’s:
ability to protect what happens to the body, where the body is now in point of fact, and how much the adult perspective can help bring what’s inside up to current knowledge with the times. Allow what’s inside to communicate their different reality perspective, fears, way of protecting the body, etc. Remember to be curious and friendly to the messages received from within.
5. Be gentle with what’s inside please.
Through your adult perspective, offer calm and certain reassurance that the body will be protected and cared for; after all, that’s the job of the adult self. What’s triggered inside has successfully accomplished the job of sounding the alarm. Now it can be time to rest inside new understandings.
Get Help If Needed
If you yourself are experiencing triggering due to COVID-19 fallout and are in imminent danger of harming yourself or others, please call 9-1-1. And if you have been struggling with complex PTSD, the mitigation of triggers suggested in this blog merely serve as a starting point to deal with the situation at hand. Please consider getting professional help to alleviate your symptoms and struggles related to complex PTSD.
The International Society for the Study of Trauma and Dissociation has as therapist referral link for you.
Be well, and please take all necessary precautions to keep your body as safe and protected as possible in these times of the COVID-19 spread amongst our global population. Your care and attention to this matter really makes a difference!
Photo by Amin Moshrefi on Unsplash