Have you ever received a phone or text message from someone you are close to that says, “I thought you today.”? Or perhaps, “thinking of you.”? This can be such a boost in our day when we receive a message like this. It can also be something we say to ourselves when we are grieving the loss of a loved one. For children, teens and adults who have experienced trauma their thoughts and memories can become confused. They can have no memory due to dissociation. Dissociation is a way the mind has of dealing with traumatic thoughts and feelings that separates conscious awareness from the painful experience. Some of the behaviors and symptoms of dissociation in children and teens are:
- Having “black outs” or a trance state: can last momentarily to longer periods of non-responsiveness, to excessive sleeping or fainting, to states described as coma.
- Autobiographical forgetfulness: Child will often say “I forget” or report they have no memory of events.
- Fluctuating attention
- Rage episodes
- Regressed behavior
- Belief in an alternate self or imaginary friend: important to differentiate between normal imaginary playmates and fantasy material related to the trauma.
- Depersonalization – disconnection from normal body sensation This is not uncommon in adolescents, so it is important to discern the origins of the depersonalization.
- Derealization: disconnection from true perception and sense of self.
- Somatic complaints e.g. headache, stomach aches, other undiagnosed pain, unusual pain tolerance, pain sensitivity.
- PTSD symptoms: nightmares, night terrors, disturbing hypnagogic hallucinations, intrusive traumatic thoughts and memories, re-experiencing or flashbacks, traumatic re-enactments, numbing and avoidance.
- Self-injurious behavior: cutting, burning, scratching, head banging.
What mental health professionals look for are patterns of behavior to help us understand what the true internal state is for the child or teen. There are times when kids will say they don’t remember when they are just having a difficult time saying what needs to be said. Children often avoid owning up to their behavior out of guilt, shame or perhaps fear of getting in trouble. Sometimes the event has been so painful the self-protective strategy used is dissociation. Finding a well trained and highly experienced therapist that can discern dissociation from normal childhood experiences is vital to helping the child or teen work through the problem. A well-trained therapist will focus on building an empathic connection with the whole child, even the parts that have been disowned.
Our goal is to help the child integrate the parts of self that have been set aside due to trauma through a loving supportive, empathic relationship. We rely on parents, school personnel, pediatricians and any other significant others to support the child and build similar connections that the child can rely on. This is the child’s treatment team. The staff at Treehouse Family Counseling Services, PC is a treatment team that works together to integrate all the broken pieces.
Mary Ruth Cross, MS, MFT, NCC, RPT-S
CEO/Owner Treehouse Family Counseling Services