(AGENPARL) – lun 21 novembre 2022 By Marialuisa Roscino
Analysis of community surveys conducted in Europe and worldwide have confirmed the extent of abuse in the community. They show a prevalence rate of 9.6 per cent for sexual (13.4 per cent in girls and 5.7 per cent in boys), 22.9 per cent for physical and 29.1 per cent for mental abuse, with no real gender differences. Few studies have been conducted on neglect, but analyses of research conducted worldwide show that the prevalence is also high: 16.3% for physical neglect and 18.4% for emotional neglect.
How can a child be helped to overcome trauma? And what consequences can childhood trauma have in the long term, but also in the short term if neglected? We asked Dr Adelia Lucattini, Psychiatrist and Psychoanalyst of the Italian Psychoanalytic Society (SPI) and the International Psychoanalytical Association.
Dr Lucattini, what is meant by psychological trauma?
By psychological trauma, we mean the consequences on the child’s mind of stressful events that are sudden, unexpected and very intense. Childhood trauma can also be caused by a repeated series of small events that are apparently not stressful at the time, but which, due to a ‘cumulative’ effect, become so after some time.
Traumas cause negative feelings in children such as fear, insecurity, anxiety, feelings of incapacity and a constant state of alarm. They lose their acquired certainties, fear the present and cannot imagine the future. The anxiety and depression resulting from the strong emotional tension often causes physical agitation, irritability and insomnia, which is why a diagnosis of ADHD may be made at first.
What can cause childhood trauma?
Children have a specific vulnerability because they do not have sufficient rational capacities to understand and decode events correctly. In addition, they have emotional fragility and are affectively and psychologically dependent on their parents. We know that children are creatures of habit; the constancy of events is necessary to structure their personality. Many traumatic events are often not recognised by parents and adults. These include major physical illnesses in early life, moving house, loss of pets, illness of one of the parents or grandparents, emigration, change of school. Currently, we observe an increase in cases related to the Covid-19 pandemic and the war in Ukraine, due to the fear of losing parents, falling ill or dying.
Dr Lucattini, what are the short-term and long-term consequences of childhood trauma?
The short-term consequence of severe trauma is Post-Traumatic Stress Disorder (PTSD) that lasts up to six months. It manifests itself with intrusive thoughts or dreams of the trauma, anxiety, depression, psychomotor agitation, hyperreactivity, decreased attention and concentration. In the long term, there may be anxious-depressive symptoms, emotional dissociation, disturbances in interpersonal relations with ‘sick’ relationships, isolation/avoidance or emotional dependence, psychosomatic disorders. If there is no processing of the trauma, the emotional wound and psychic pain make one insecure, vulnerable, fragile. In some cases, if, as a defence, the severely traumatised child identifies with the aggressor (‘Stockholm syndrome’), he will repeat on others the aggression, abuse, violence suffered.
How can one tell if a child has suffered trauma?
First of all, signs of distress must be detected: insomnia, fear of going to school, the need to always sleep with parents, the appearance of nocturnal enuresis, frequent crying, hyperactivity both at home and at school, fear of going to grandparents’ or staying with friends. Parents should observe their children, ask them how they are, take an interest in what they are doing and try to find out if there have been stressful events or situations that have upset them.
How can you help a child cope with trauma?
Parents must show interest in them, make assumptions and ask questions, talk to them. It does not matter if you do not immediately ‘guess’ the cause. The very fact that there is an interest on the part of the parent in what the child is thinking and feeling, that in itself provides relief. Naming emotions (sadness, fear, worry) allows children to understand that their parents know they exist and what they are called. Since, to feel loved, it is necessary to feel understood, trying to understand them and what happens to them, in itself, it makes the child feel protected and loved. They feel ‘held’ in their parents’ minds, contained in their emotions, calmer and less afraid.
In your opinion, is it possible to make children overcome their fears or remove major traumas from them through ‘play’ and ‘sport’?
Certainly, playing is children’s main activity, the only one they are interested in. Play is a fundamental tool for getting in touch with oneself and the world. All toys are transitional objects, as pediatrician and psychoanalyst Donald Winnicott teaches us, and every place where one plays is a transitional space, that is, objects and places that connect external reality with psychic reality.
Playing with an adult who likes to play is therapeutic although not psychotherapeutic.
Sport can be of great help if there is always a dimension of play, which is never coercive or violent. Sport combines the physical activity necessary for children, for the mind-body unity typical of childhood, and organisation through rules. For this, it helps relieve tensions, internalise methods and rules, and be in a group with peers, under the guidance of an adult guarantor of their respect.
Can you explain the specific difference, which there is between the state of mind of children ‘feeling a certain fear’ and having suffered a trauma and how, in your opinion, parents can intervene?
Many fears are common in children and depend on their age and the developmental stage they are going through. Parents are generally not alarmed by their children’s normal fears because they remember experiencing them in their childhood. Trauma-related disorders, on the other hand, are unusual, intense and long-lasting. Children are inconsolable, do not respond to reassurance and become intensely agitated whenever they are exposed to the traumatic event. Sometimes, they have very intense psychophysical reactions, run away and ‘lose their minds’, in which case, they must be held and hugged tightly until they calm down.
What advice would you give in this regard?
– Always talk to children and try to put yourself in their shoes and help them to open up slowly.
– Do not accuse, mock or blame them for how they feel.
– Encourage them to talk about themselves by giving examples from their own experience. Children feel encouraged by stories from their parents and grandparents.
– Never ignore the signs even if your child’s pain is difficult to bear. It is the adults who protect the children by trying to contain the suffering they feel and the uncomfortable situation they are often also experiencing.
– Have contact and talks with the teachers in order to expose the child’s difficulties. Teachers, especially if they have psychoanalytic training, can implement ‘therapeutic’ interventions and behaviour, even if not psychotherapeutic.
– Follow children in sports activities, talk to coaches and ‘coaches’. Accompanying them, picking them up. The journeys when you are together are precious moments to talk and feel good together.
– Do not isolate yourself, but try to create a network with family members, grandparents, uncles and even friends.
– Create ‘special’ moments when you can be together, completely dedicated to your children, play with them and ‘enjoy’ them, away from the commitments and stresses of everyday life.
– When in a family, there are major traumatic events, even before the children have noticeable symptoms, it is a good idea to contact a child psychoanalyst who can follow the child and the parents. This is a form of prevention and a guarantee of well-being for the child and the whole family.