Recovery
Receiving a child
Recovery
VIII. Blank stares from eyes too young for pain, should be playing, should be laughing instead, there is an eerie pause. That time lived once more, time and time again, like a film on repeat leaping forward, grabbing headspace diabolic biography cinematographically displayed, creating unwanted fearful response to a ghostly replay of thoughts best left not thought. Fight or flight or freeze are only basic survival instincts, yet not wholly under our control. VII. In crises, chaos, children can be seen but seldom heard, their felt trauma left unvoiced, unnoticed by the adults. With words they do not express the feelings that overwhelm, lacking vocabulary unfathomability threatens carefully balanced emotions left raw beyond the force of their words to say. Behaviors misunderstood, stomachaches, “I don’t feel good”, cry out for someone to hear. VI. Everything that they knew, the repetition that kept the rhythm of a carefree childhood is gone. In a tent, not a home, without name or address, terrible aftermath, deteriorating unknown future looming, stirring doubts that cloud nights, wondering if there will be better times ahead, or if better times are only times in the past. V. What can be done when you are small and weak having no money to gain influence? How can someone change something seemingly inescapable while being deformed by it all the while? Can victims who are powerless to do anything afford attempts to make a difference at all? IV Evacuate! Displaced, torn from home, teachers, friends on the road or in a shelter. All of it left behind except recollections that bring sorrow Isolation, being in a crowd still leaves a gnawing sense of being alone. IV. The turning point begins with a hand reached out not to rescue but to welcome, receive them to a community reconnection that signifies this child is loved, accepted to a circle of friends and adults that truly cares. V. Someone hurting can put their pain aside for a time to help children regain those bright eyes, lightning smiles flashing brilliantly, irrepressibly infecting us all to work to see change. At first our smiles were pasted over doubts but children’s true smiles have the power to make our laughter real. VI. Every morning is a brand new twenty-four full of possible good, fresh as youth, and just as apt to find a way of exploring new heights or composing, countering exteriorizing those feelings internal to darken each new day. Children’s play contains the rejuvenate process restoring hope for those set in their adult ways VII. In children we can find that innocent restoration that eludes all therapy. If we listen to their words, further listen to young hearts intuitively lacking artificiality, discovering what we lack becomes a fruitful journey with fresh guides who urge us on as we listen to their words, hear young hearts as they narrate, we see what is important and so too they discover VIII. the foundation of recovery; conviction – I am not alone I don’t face, feel, fight – by myself. In truth this is hard to achieve for those who have experience predicting the worst possible eventuality with an incommensurability deducted without including viewpoints without bias born of all the things that we have been through, that make us forget the ones who have never left, who tried to help – the ones the children depend on.
Cinematographically
There is a scene from American Sniper (2014) where Bradley Cooper is staring blankly at a television while the family is in chaos behind him. The sounds coming from the screen are explosions, gunfire, screams and shouting. Except they aren’t. The camera pans to reveal that the television isn’t even on. The sounds are the war zone playing like a rerun in his mind.
Most of our understanding of trauma and PTSD comes from studies with veterans returning from war. Trauma makes the brain hyper-sensitive to threats, giving primacy to the part of the brain responsible for survival. This is a useful adaptation for a dangerous environment but the problem is that it is not completely under our own control. The whole point of an immediate response system is to react quickly, so it short circuits normal thought processes and instantly readies the body for action.
The result is that once the soldiers return home they struggle with readapting back to the safe environment where hyper-sensitivity becomes a liability. Like an advertising jingle or pop song that plays unbidden in your head when triggered, trauma does something similar interpreting signals that were once normal parts of daily life as alerts to heightened vigilance.
Unfathomability
One little boy would stand on the edge of every activity and complain. “This is stupid!” “This is boring!” But he was there every day of the camp. On the last day he was walking through the remains of the village with his group leader. He pointed up to the mountain and said. “On the day of the quake, the mountain came down. A boulder killed the uncle in front of me.” Then he revealed his real trauma, “I had to step on his body to escape.”
Because much of the research on PTSD and trauma has been done with adults, childhood trauma has been focused on similar symptoms, i.e. flashbacks, depression, withdrawal. However, children are not just “little adults”. The major difference is that children are still developing.
Children often lack the vocabulary to express how they are feeling or accurately describe their symptoms. They tend to show how they are feeling rather than tell. So we look for somatic expressions like tummy-aches. We pay attention to things like appetite, social engagement or withdrawal and reactivity.
In the boy’s culture the worst thing imaginable was to step on the dead. Because he had done that he thought of himself as a “bad boy”. So he had started acting like what he thought a bad boy would. He disobeyed, complained, showed disrespect. Even though he was misbehaving, his group leader kept including him, building up relationship. Because of this he felt safe enough to share what he had done. Because of the relationship the group leader was then able to assure him that he was not a bad boy but had been very brave.
It is hard to get to the bottom of what is happening both for adults and for children. There is more going on than what is seen on the surface. What makes it more difficult with children is the lack of words to describe or understand.
Deteriorating
Children thrive on stability, repetition, comforting routine. This is often the first casualty of trauma. Evacuations, displacement, even removal from an abusive home disrupts the child’s known world. This places them in an uncertain environment where trauma compounds
A Ukrainian refugee in Poland had been displaced from his home and moved suddenly to a country where everyone spoke in a different language. His mother shared that he did not want to play with his favorite toys. He no longer wanted to eat. He was aggressive and angry about everything. He certainly was upset about having to attend the camp.
Until some sense of normalcy is restored the situation deteriorates. The future looks like it will continue the present state of unease. Without context or experience children cannot imagine things getting better but assume that this is what things are like from now on.
Inescapable
Because children are dependent on adults, unable to fight back, unable to run away, the most common response to trauma is not fight or flight, but freeze. I describe this in the children that we work with after disaster or war as being like someone has pressed the “pause” button on a video.
The second factor that affects children more profoundly than adults is that while trauma is happening they are not just adapting to it, but are being shaped by it. Their brains are developing, naturally strengthening the parts that are used most.
The result can seem hopeless. They are caught in a situation that is hurting their development that they seem powerless to escape.
Recollections
Loss is the universal language of trauma. Even if they have not lost a loved one, children are grieving the loss of the safe world they used to inhabit. They grieve the loss of friends that they used to play with. They grieve the loss of the routines that used to define secure boundaries in their lives.
The combination of sudden uninvited thoughts and emotions, the inability to even express how they feel, being caught in a hopeless, powerless situation, and sorrow over what they have lost, leaves children feeling alone.
This isolation, the feeling that no one else understands them, is the core problem.
Reconnection
Most relief work is focused on restoring life lines. NGO’s and emergency services work quickly to ensure access to food, water, medicine, and shelter. The needs of children are often overlooked in this because people assume that they need the same things as adults.
Children’s needs are developmental. What this means is that they change over time. The needs of an infant or a toddler are not the same as a school-age child. Again the needs of adolescents is different than children at earlier stages.
Survivors of child trauma often are made to feel like victims. Even though they receive relief they are a number, an outcome, the subject of a project. They can still feel isolated and alone even in a crowded evacuation shelter. Real healing starts not when the child is served, but received.
The Ukrainian refugee in Poland came home from the first day of the camp completely changed. He hugged his mother, told her her food was delicious, and talked on an on about all the Ukrainian speaking friends he had made at camp.
Irrepressibly
A child is received when they are welcomed into community. They are no longer isolated but seen. They are no longer alone in what they feel, but heard. This leads to a feeling of safety and is the first step to recovery. Once this “play” button has been pushed it leads to self-reinforcing activity normalizing as much as possible.
Once children start to play, smile and laugh again their recovery becomes contagious. The hopeless become hopeful and that hope spreads to others. This is the beginning of rebuilding not just the infrastructure and life-lines of a community, but the community itself.
What is remarkable is that it is the powerless who have this power.
Exteriorizing
The hopefulness of children is not in what they say. They are not providing us with new information or a convincing argument. Yet, we are convinced. They are giving us something new but it is not in their words. It is in who they are.
Adults spend much of our time either inside our interior thoughts and emotions or avoiding them through distraction. Children naturally display their interiors on the outside. This is why we look at these outward signs to measure recovery.
When children feel safe, seen, and heard, when they have regained hope and know they are part of a community that values them, they show it. They play, they smile, they laugh. They regain curiosity and explore. They ask questions again.
Artificiality
Adults learn to paper over difficult thoughts and emotions. We use stock phrases, plastic expressions, to avoid bothering others with our problems. This is more socially acceptable than showing everything. The problem though is that we get so good at it that we believe our own myths.
One legitimate approach to therapy is simply to listen until what someone is saying is exposed by their own words as being the mask and not the reality. Once the underlying thoughts and emotions are revealed they can start to be managed.
In a way children because they are bereft of pretense function in a similar way. They remind us of what is truly important. They require us to reacquaint ourselves with unfamiliar practices of wonder, excitement, and joy.
Incommensurability
The result of trauma is a broken calculation. It is the math that adds up all of the pain that has been suffered and decides that a better future is impossible. The pain biases the outcome.
Recovery is a process of restoring the positive side of the equation. Because children are still developing they have not built up the weight of bias of past experience that adults have. They do not fully understand the depth of their loss, instead looking to community to gauge safety or danger.
Once children have been restored, going from “pause” to “play” they become the positive. They add to the equation and eventually tip the whole community into recovery. We start out by helping children like the Ukrainian boy, whose recovery makes a difference in his mother as she deals with life as a refugee herself. A group of refugee families now have each other, and as their children once again play find ways to make it through.
Author Notes
Recovery is a Sudoku Sonnet cycle. Each of the Roman numerals sets the number of syllables per line and the number of lines in the middle stanza. Finally, each line in the middle stanza must be a different number of words. So VIII has eight syllables per line, eight lines in the middle stanza, and usually I try to make the lines start with even 8, 6, 4, 2, and then back out with odd 1, 3, 5, 7. This puts a stress on the one word line at the center of each poem.
The cycle works down from VIII to IV and then reverses and works its way back up to VIII. This a density to the first and last and a starkness to the poems in the middle.