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DISCLAIMER: Things like sexual abuse, death of a nuclear family member, witnessing extreme violence, or experiencing a debilitating medical condition are all examples of things that go beyond the scope of what is discussed below. The strategies offered may be helpful in such cases but they should be done in consultation with a dedicated child psychologist or psychiatrist who oversee care. Further, I am not a mental health professional and am simply providing insights I have learned from following the advice of mental health professionals for parents in the literature. None of my advice should EVER be considered medical advice.
Growing up can be rough... Often times we romanticize it retrospectively "boy I wish I could just be a kid again..." but there are several moments in early in every human life that do not mesh with our rose colored picture of our childhood. This, admittedly way too long blog post, is what to do when that happens to YOUR kid...
They get appendicitis and wind up in an emergent surgery; they fall off a bike and wind up in an ER with nine stitches in our chin; they lose a close family member to an aggressive disease; they're in a minor car accident; they witness a person on the street have a medical emergency; they go to the dentist 👀. All of these things are what I call "Everyday Traumas." They are regular parts of growing up that often do not require professional therapeutic intervention but yet can affect kids profoundly, especially if they go unprocessed.
The bad news is that these everyday traumas of life are unavoidable. The better news is that with some simple strategies parents can not only help their kids process these events but actually set them up to be more resilient with respect to future everyday traumas of childhood and for the rest of their lives. Remember, everything that happens (whether we wish we could prevent it or not) is an opportunity for growth with our kids if we engage patiently and intentionally.
For the rest of this piece I'm going to be using an example from my own life. When my son was four, he fell and split his head open on the leg of a coffee table (on the only 3 inch section that wasn't coated in foam.... unbelievable...) Subsequently, he had to go through two additional compounding traumas: the insertion and removal of complex stitches at a plastic surgeons office (the latter without local anesthetic) designed to eliminate what otherwise would be an extremely prominent facial scar. After this ordeal what followed was numerous symptoms consistent with someone who has had an everyday traumatic experience in childhood. I processed that the experience with him, in accordance with best practices, as outlined below.
Step 1. Remember your goal
Before you ever engage your child about their trauma, you need to be clear on what the goal of the processing is. Don't worry, you don't have to come up with it; the goal is the same every time. Have the child tell the whole story of the event. To understand why, I want to use an analogy. Picture your child's conscious mind as a computer with an external hard drive attached. When something happens in their life, a memory is created and saved on the computer. A few days (or hours) later it is moved off the computer onto the hard drive where it is stored until it is needed. When your child recalls the memory, it is moved back onto the computer where they can consider it. When they're done with it, it will move it back off the computer, and onto the hard drive. Every-time the memory goes through that "hard drive to computer back to hard drive" cycle, it is changed slightly and stored differently. That's essentially how short and long term "normal" memories work.
With a traumatic event, however, the memory is saved in a "corrupted" form. The file is essentially "unreadable" on the computer of their conscious mind because it was saved like a deconstructed puzzle. When it is moved to the "external hard drive" of long term memory, not all of the memory leaves the computer. Sensations, disorienting fragments, intrusive images, and especially feelings remain behind on the computer, popping up whenever they are triggered, often causing confusion, anxiety, and fear. The simplest way to "get rid of" these fragments is to slowly, methodically, put together the puzzle, so that a comprehendible narrative is constructed; aka a "readable" file that can be considered and then stored. That may seem scary, confusing, and insurmountable but remember, the goal, in simple terms is to have them tell the whole story of the event. That's it.
Step 2. Begin reconstructing the narrative
The first thing you want to establish when it comes to reconstructing the narrative for an "everyday trauma" are the beginning and end points. It is natural to want to hyper-focus in on the specific "event" but its best to start the story before everything went off the rails (in my son's example, he was happily playing in the living room with toys) and conclude the narrative after a natural resolution (we were home, safe, making lego-sets without pain). The reason to begin here is that it allows for your child to have two "safe zones" to return to in the story. Your child may choose to have different beginning and end points (perhaps they want the narrative to be the entire day even though the entire trauma only lasted 15 minutes) and you should respect their autonomy to do so.
Once you set the beginning and end points, start back at the beginning and offer your child an opportunity to tell the story on their terms. The only questions you should ask are "How did that make you feel?" and "what happened next?" They may enlist your help in recalling details; do so willingly and calmly. If you cannot yet tell the entire story yourself without getting overwhelmed by your emotions, take a break and go through this entire piece with your partner or a friend first with YOU in the place of your child. Remember, this event was likely traumatic for you too and it's totally fine to need a minute.
If your child can reconstruct the entire narrative, including their feelings about what was happening, great. Skip to step 4.
Step 3. Scrubbing the Timeline
If your child struggles to reconstruct the narrative, especially being overwhelmed by certain aspects or feelings that telling the story drums up, offer them the option to pause or even skip particularly emotionally charged parts of the story or even return to the "safe zone" at the very end. This tactic is a well established method in therapy (as outlined in "Trauma and Recovery" by Judith Herman and applied to parent child relationships in "The Whole Brain Child" by Dan Seigel and Tina Payne Bryson) for helping people who are particularly overwhelmed.
For my son, the parts we had to skip were less related to the injury itself and more related to the events while in the chair at the plastic surgeon's office. The key triggers for him were the headlamp on the doctor (which was unavoidable but effectively blinded him adding to the terror), the severe pain in his forehead (Harry Potter IRL), the feeling of being restrained, and his feeling that no one was listening to his cries for help (who wouldn't be traumatized). Over time, as the puzzle begins to come together, offer nudges to tell more of the frequently "skipped" parts. Offer to tell those parts from your perspective first. If they agree, don't sugarcoat it. Tell it like it was but always make sure to end in the safe zone.
Over time, they will "scrub the timeline" of the event less and less, telling more of the narrative in order, with emotional details, and without assistance. They may have set-backs where the return to skipping a specific detail after they previously were able to share about it. Don't force it. It takes time.
If, after a couple weeks of attempting this, you feel like there is little to no progress and you need to reach out and get professional help, DO IT! Repressing (aka not talking about) the event may seem attractive but it can be dangerous. It's better to be safe and get help now for a few isolated sessions and a followup, than to have your child go their whole life (for example, if I not processed with my son) with an irrational fear of doctors, bright lights, coffee tables, and a tendency to feel claustrophobic
Step 4. Reincorporation
You've hit the goal. Now have them do that 5-10 more times increasing the duration between retellings (a day, then a few days, then a couple weeks, months, etc.) You can also change it up by having them draw pictures of the event, even act it out with you (sometimes hyperbolically). By the end, they will (depending on developmental stage) not only reconstructed the narrative but begun to make meaning out of the narrative (expressing what they learned from it, how it made them more brave, etc.) Don't force this process, let them make the meaning for themselves. If they don't, don't worry. Eventually they will.
Today my highly sensitive son not only can tell his trauma beginning to end to perfect strangers without getting overwhelmed (yes this happened in Target last week) he has also made some meaning out of it. Two weeks ago, for instance, he displayed staggering empathy (considering he's only 6) toward me when I cut my thumb with a kitchen knife and my wife (former ER Nurse) and I were discussing whether a trip to the hospital for stitches was necessary. He also said the other day he was "glad" it happened for two reasons: first, he can explain it to his friends who might be scared of getting stitches and; second so he can fully relate to Harry Potter when his forehead scar hurts. This "meaning making" is the final stage in recovery and signals to us that we have reached a point where the puzzle has been put back together, the "file" is readable and stored on the hard drive of our long term memory.
Moreover, in my OWN meaning making process of his trauma, I was struck by how much more resilient he was to an outpatient dental surgery he had to have this summer. Many of the same triggers existed (doctors, restraints, bright lights) and this time without his parents present. Truly all, this was my worst nightmare but because of our intentional work with his stitches, had developed neural pathways to help him narrativize his next traumatic experience with far less effort.
In fact, the afternoon after his surgery he was already asking me "Dad, when do we start telling the story skipping the bad parts? I'm ready."
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