Lost Children - post-traumatic stress disorder in children

When we adults think about post-traumatic stress disorder, we tend to think of a reaction to violent events such as sexual assault or combat shock, and are less likely to associate children with post-traumatic stress disorder.

This is of course not true.

Children go through events that may be difficult to digest, and they have fewer resources and ways of coping than adults. Physical events that the child has experienced or witnessed, such as accidents, illnesses and hospitalizations, sexual abuse, domestic violence. Or emotional events such as boycott, divorce, death in the family. Such an event, whether one-time or ongoing, may leave scars, damaging the child's basic assumption that the world is a safe place, and that people can be trusted. A large proportion of children will recover on their own, but some will need help.

The three characteristics that appear in post-traumatic stress disorder in adults will also appear in children, but in a slightly different way. The characteristic of intrusion, which in adults appears as flashbacks of the event, may manifest in children in the repeated playing of the traumatic situation. The avoidance component may appear in a child as regression to age-inappropriate behaviors such as wetting in a child who was already toilet trained, or a return to thumb sucking, or refusal to leave the house or meet with friends. And the anxiety component may manifest as nightmares or excessive crying, fear of the dark, monsters, or clowns, and clinging to a parent.

In older children, in elementary school and above, the signals of asking for help are less obvious, and may manifest themselves in difficulty concentrating, displays of aggression and challenging behaviors, or in refusal to participate in social activity.

Pool therapy for post-traumatic stress disorder in children will first and foremost involve establishing a relationship of trust between me and the child, and between the child and the pool. We can't move forward until we trust each other, until the child knows that they can ask for and receive help, and that they are truly allowed to be vulnerable, to make mistakes, and to fail.

The pool provides a normative place where, on the one hand, the child can be challenged, and on the other hand, alongside the challenges, they has the support of the water and me. We will work on recognizing the child's abilities and resources, and together we will learn ways in which they can cope in places that suit thier abilities, and ways to ask for help where they need it.

All of this is done in a playful, light, and fun way. Processing the trauma, when it arrives, occurs at a pace and in a manner that is comfortable for the child to handle, and in a dosage that is appropriate for their age, ability, and understanding.

The hoped-for result is a strengthening of the child's sense of self-confidence and self-worth, and a better ability to cope with the trauma they have experienced and the developmental and social challenges they face.