Trauma is commonly associated with catastrophic events or long term abuse. These events will surely leave someone vulnerable to trauma, but everyday occurrence like a fall, a medical procedure or a bump in a car might also cause a trauma response that leads to long term symptoms and loss of resilience. This is because trauma is not the event. It’s the way the body’s nervous system perceives, processes and assimilates the event.
If the body perceives an event as threating, a fear, flight, fight response is initiated. This mobilises the body to get away from a threat by pumping large quantities of adrenaline throughout the body. We are all familiar with this sensation of a racing heart and shaking, and in our children they cry, scream, shake, flush red or go pale etc. This burst of energy is not something that can be rationalised in the moment, but if ignored or controlled rather than released, then the process won’t complete, and that energy will stay ‘stuck’.
Then there is the ‘freezing’ response to trauma or fear. This again is when the body is overwhelmed with fear, but instead of mobilising to run, the body stops, collapses, the mind dissociates, because it can’t process what is going on. We can see this in the wild when animals ‘play dead’, to try to evade being eaten. In humans we see it when we have been exposed to a traumatic event but they act like nothing is wrong. Or when someone is very quiet after an accident and they just aren’t quite here.
I describe these two states, because 1) There is a lot you can do to help the people around you, so they can complete the cycle of trauma, rather than it staying in the body, especially children 2) As an osteo, health often means helping patients resolve their body responses to trauma. For example, Mothers, fathers and babies that have been through a shocking birth or their entrance into the world did not go to plan, meaning that the start of being a family is very different than they expected. I see children that are exhibiting hyperactive type symptoms, but actually allowing their bodies the release a fight, flight response means they can regulate better. And children who can not tolerate sound and changes in their lives because they have an overwhelmed nervous systems that has ‘frozen’.
First Aid for Accidents and Fall
This is taken from a book call Trauma-proofing your kids by Peter Levine and is a great read for any parent. Making yourself familiar with how shock and trauma is processed will enable you to help when the time is needed. This ensures a completion of the physiological cycle, rather than it getting stuck.
- Attend to your responses first. Take time to notice your own level of fear or concern. Take some good full breaths, and as you exhale slowly, sense the feelings in your own body until you are settled enough to respond calmly. An overly emotional or dismissive adult may either frighten the child or shut down their fear response so it cant be released.
- Keep your child still and quiet. Because your child’s body is surging with adrenaline this maybe difficult. Use a firm confident voice with a ring of authority that conveys a loving manner, that you are in charge of protecting them. Keep your child warm with a jumper or blanket and dont let them move on their own.
- Encourage plenty of time for safety and rest. This is particularly true if your child shows signs of shock (glazed eyes, pale skin, rapid or shallow breathing, disorientation, overly emotional or overly flat expression or acting like nothing has happened) Do not allow them to jump up and return to play. Help your child know what to do by modelling a relaxed, quiet, and still demeanour. You might say something like “After a fall, its important to sit (lie) still and wait for the shock to wear off”
- Hold your child. Avoid clutching tightly, as well as excessive patting or rocking, as it may interfere with natural bodily responses. In older children its suggested that you place a hand on their back or upper arm near the shoulder. A warm ‘healing hand’ can help your child feel grounded as your calmness is directly communicated through touch.
- As the shock wears off, guide your child’s attention to his sensations. The language of recovery is the language of the instinctual brain-which is the language of sensation, of time and of patience. Just as touch is important so is your tone. Softly ask you child how they feel ‘in their body’. Repeat his answer as a question – “You feel okay in your body?” and wait for a response or nod. Be more specific with the next question ” how do you feel in your tummy (head, arm, leg etc)?” If he mentions a distinct sensation, gently ask about its location, size, shape “colour” or “weight”. Don’t worry about what these sensations mean; the important thing is that your child is able to notice and share them. keep guiding your child stay in the present moment with questions such as “how does the rock (sharpness, stingy, ‘owie’ feel now?”
- Allow one or two minutes silence between questions. This may be the hardest bit for parents, but its the most important part for your child. This allows any physiological cycle that maybe moving through your child’s system to release the excess energy and move towards completion. Ques that the cycle has finished include a deep. relaxed spontaneous breath, the cessation of crying or trembling, a stretch a yawn, colour coming back into the face, a smile, an orientation to surroundings or making eye contact. Wait to see if another cycle begins or whether it’s time to stop. keep in mind there is a lot happening in your childs nervous system that maybe invisible to you.
- Do not stir up a discussion about the accident or fall during initial first aid. It’s best not to ask questions to alleviate your own anxiety or curiosity. The reason for this is that the ‘story’ can disrupt the rest period needed for the discharge of excess energy that was aroused. Telling about it can wind kids up. After the release happens, your child may wish to tell as tory about it or draw a picture. Refrain from shaming statements such as “I told you that you would get hurt playing on those stairs”
- Continue to validate your child’s physical responses. Resist the temptation to stop your childs tears or trembling. But keep contact with them, reminding them that what ever has happened its over and they will soon be okay. In order to return to equilibrium your child’s discharge needs to continue until it stops on its own. Your job is to use a calm voice and reassuring hand to let your child know “It’s good to let the scary stuff shake right out of you”. The key is to avoid interrupting or distracting your child, or holding her too tight or moving too far away.
Osteopathy Felicity Booty 