Dealing with Trauma: Questions and Answers with Local Professional Counselor

Melissa McCauley, Licensed Professional Counselor, LPC, NCC, CRADC, was gracious enough to talk with The Edina Sentinel to give important information in relation to processing and dealing with traumatic experiences on a community-wide scale.

We are grateful for her insight and willingness to participate in this interview.

See below:

Q: What is a traumatic event?

A: A traumatic event is a shocking, scary, or dangerous experience that affects someone emotionally. These situations may be natural, like a tornado or earthquake, or they can also be caused by other people, such as a car accident or an act of violence.

When a traumatic event happens within a small community, the impact can be widespread – the initial impact starts with everyone directly involved and extends to the immediate and extended family, to friends, peers, classmates, co-workers, neighbors, first responders and other officials, church and faith families, and even beyond that –  to people who may not even know the people directly affected by the event.   It seems logical that people directly involved in traumatic events generally respond with shock, confusion, fear and have other physiological and emotional stress reactions. But it isn’t just the people directly involved who may respond this way – often people have what we call secondary trauma, where they, for a variety of reasons, react with similar emotional and physiological responses as the people experiencing it firsthand.  For example, someone who wasn’t in a tornado might be deeply empathetic for other people and their pain and personally feel shock, confusion, not be able to sleep as well, be obsessed with watching every newscast and be irritable with other people.  Or similarly, a person who is not directly impacted by the event but has had prior trauma in their own life, may respond with intense fear or be unable to eat for days.  A third scenario is someone who interprets an event personally, even though they are not directly involved, such as interpreting that due to the event, no one is safe and they respond in fear and begin avoiding people.  Sometimes people providing services to impacted persons, such as educators, first responders, law enforcement, media and counselors, will have secondary trauma.   How a community reacts to a shocking, scary or dangerous experience really has as much to do with our own personal histories, emotional health, personalities and interpretations as it does how close we are to the event.

Q: When a community has such a traumatic experience, how do we start the process of dealing with it?

A: During the initial days and week following the event, or a person’s first knowledge of a traumatic event, we really need to focus on making sure basic needs are met and a sense of safety is established.  Our most basic human needs are food, shelter and a sense of safety.

The very first step, before reaching out to someone following a traumatic event, is to examine yourself.  What are your thoughts and emotions? It is important to make sure that you are not in panic or experiencing emotions so intense that they will impact another person negatively.  For example, being so scared or angry about the traumatic event that it creates or escalates the impacted person’s fear and anger.  So, it’s important to take time to notice how you are feeling and what your thoughts are, and even asking yourself, “am I in a state of mind that I will be helpful or cause more damage?”  If you aren’t sure, it might be best to do some self-care first because adult behavior and reactions are important influences in how children and teens perceive safety and respond to trauma.

Because personal reactions to trauma vary so greatly, we need to be really careful about making judgments following a community traumatic event.  Judgments can create and spread misinformation, cause undue additional trauma for victims and all those involved in the event, create a heightened sense of fear, and cause division between people, families and the community when people need each other more than ever for support.  In traumatic events caused by humans, the humans contributing to the trauma often experience overwhelming emotional and physiological stress reactions, just like those impacted by the trauma.

Q: What should we do? Talk to each other? Talk as a family? What about the school staff, parents and other adults? What does the adult aspect of processing a trauma look like? Who should adults be talking to? Who should school staff be talking to? Each other? Professionals? Should they avoid laying out their fears to their children?

A: When something traumatic happens, and people ignore the impact and avoid talking about it, it creates an environment where I learn my thoughts, fears, concerns are not important.  Individuals can start to think there is something wrong with who they are because this thing is bothering them but no one talking about it or wants to listen to them.  Trauma shakes our sense of safety and if it appears like I am supposed to get over something and just move on, without processing how I feel about it or really try to understand it, then I get not only the message that my world isn’t safe, but that I’m not ok either.  We add trauma to trauma.

So the first thing we want to do is create an environment where it is safe to talk about the trauma and emotions without concern of whether there will be judgment or ridicule, undue negativity, or punishment; where emotions and thoughts will be respected even if not agreed with; where a youth can tell their story or talk about how it impacts them without interruption; and where the youth can ask questions and not be ignored, receiving answers from adults that are honest and appropriate for their developmental stage.  Once you are committed to establishing an emotionally and physically safe zone, invite youth to share.  Try not to wait for a child or teen to say something to you first – reach out to them.  We want to make sure our kids are doing ok so we need to be the ones to start the conversations.

Conversations can occur on several levels.  As adults in a family unit, first talk with each other and share thoughts and emotions, then decide how you want to approach your children.  Professionals, such as school officials and community leaders, need to be in organized discussion with each other, sharing and supporting each other, bringing in other professionals for additional support as needed.  Kids need to be able to talk with each other openly as well, to process as a group.  Peers benefit greatly from talking and helping each other, whether those peers are adults or youth, so individual and group conversations are helpful to process and heal after a traumatic event.  I think for some people, they need to be able to process at an individual level, as well as with other people in their family, within their organizations and peer groups, and even on a community level.  Everyone is different in how they will react to a trauma and there should be lots of opportunities for expression and support and healing.

Adults will naturally process things at a different level, intensity and breadth than teens and adolescents and adult-only conversations should be taking place if the information, opinions and plans are outside the emotional and developmental stages of the children involved.  Adult concerns and fears and needs, if expressed in front of youth, can actually intensify the fears and concerns of the kids.  I think we can be honest with our kids that we have concerns without divulging details and create an environment for them where they trust that we will keep them safe and their lives will not be this chaotic forever.

Q: What are the best ways to start these conversations?

A: Ways in which a community or family member can help adults that have been impacted by trauma include: when reaching out to an adult, contact the person to make sure they have food in the home, offer to run errands or take care of a responsibility, or field phone calls/guests while they get some sleep.  A person could also say, “I’m sorry for what you are going through and I’m here to listen.  What would make you feel more comfortable or safe right now?”   If someone wants to talk about their experience privately, be sure to respect privacy by not sharing that conversation with other people.

Ways parents and other family can help youth and adolescents impacted by trauma include: 

For children ages 5-11, this is a difficult age to adjust to traumatic changes and loss.  Regressive behavior is most typical for this age group, including irritability, whining, clinging or separation anxieties, and competition with siblings for parental attention. There could also be withdrawal from peers and school avoidance. They rely heavily on their parents and family members to help them cope because they have not developed their own coping skills at this time.  Your calmness, patience and tolerance is important to your children.   Relax expectations at home and school for a time – youth can be numb and feel unable to perform, such as on tests.

Give this age group opportunities to have discussions with adults and peers.  You might say, “People have been talking about this and you may have heard things that confuse or upset you.  It is normal to feel upset or afraid or any other emotion you might have.  I want you to know you are safe and we, and other adults who care about you, are working hard to keep you safe.  What are some of the feelings or thoughts you have been having?” For kids who are less verbal or choose not to share (at any age) offer expression through journaling or art or music and just be present with the child, gently encouraging and letting them know you are available when they need you.  Listen with your whole attention and reassure children by word and action. Focus less on temporary, immature behavior and give additional attention and reassurance.  Shield younger children from media reports and adult conversations.  Spend extra individual time with the youth and do things together as a family and community.

For pre-adolescents ages 11-14, peer reactions are significant with this group and they tend to relate better with their friends than adults.  They need to feel their reactions are normal, appropriate and shared by others.  Stress reaction behaviors may include competition for the attention of teachers or parents; sleep and appetite disturbances; school problems such as headaches, vague aches and pains, skin eruptions and psychosomatic complaints; and may experience stress in hyperactivity or defiance.  Teens may exhibit the same stressers as the pre-adolescents, but they may additionally feel guilt or helplessness because of their inability to help.  They may also minimize their reaction to the traumatic event.  They are often focused on the interests of their own age group and are stressed by the disruption in peer group activities.

You can often be more direct with older youth and teens, talking openly about fear, anger and anxiety, asking them if they would like to talk about what has happened, answering questions as honestly as possible.  Responses should be aimed at lessening tensions, anxieties and possible guilt feelings. Provide them with truthful, succinct information about events.  Encourage contact and activities with their peers.  Provide structured but undemanding responsibilities and temporarily relax expectations at home and school.  And give additional individual attention.  If a teen doesn’t want to talk about anything, reassure them you are there if they change their mind and let them know they can come to you at any time in the future.   Avoid sharing any strong personal views, biases or feelings about a traumatic event when speaking with older children and try to avoid being judgmental or blaming if a traumatic event was caused by humans.  For older youth and teens, it is important to offer other safe and responsible people for them to talk to if they don’t seem to want to engage with you or if you are uncomfortable talking to them.  Encourage them to be cautious with social media reports and conversations so that there is “down time” from hearing about or discussing the event.

Q: What if these conversations lead to children opening up about incidents that need to be reported?

A: As I mentioned earlier, we respond to trauma from our own life experiences.  Trauma and acute stress will often bring up past issues that we have never talked about.  If a child shares information about any violation of their personal safety or emotional/physical well being or someone else’s, these issues should be reported.  People often say well, if I report it will cause more trauma.  We actually further traumatize people by not taking their reports seriously or taking action steps to rectify what happened and to validate that their experience was important.  If in question about who to share information with, remember that there are reporting agencies, such as the Missouri Child Abuse and Neglect Hotline, and law violations should be reported to law enforcement.  Find a professional you trust to share your concern with and they can generally guide you to the proper resources.  Pastors, counselors, and other helping agency professionals can all listen and guide you the proper direction as well.

Q: What are some of the signs parents should look for in their children to determine whether professional help is needed (if a counselor or therapist is needed)?

Children and teens traumatized by events often experience an overwhelming sense of loss – including loss of feeling safe, loss of trust in others and loss of personal power.  This loss may show up as physical symptoms such as headaches, nightmares or excessive sleeping and loss of appetite/overeating. It can also display in behavioral changes, especially in young teens and children who haven’t developed the skill to express themselves in words.

Not everyone who experiences a traumatic event or is impacted by it will react strongly and often, after the first few days or week, people tend to resume their daily activities and return focus to more normal things.  Once the shock of an event has subsided, people often talk about the event less and return to normal routines and activities, without intense thoughts and emotions surrounding the event, which is a healthy sign.  But what if that doesn’t happen after a couple of weeks?  How do we know when there is a problem?

In some cases, the stressful thoughts and feelings after a trauma continue for a long time and interfere with everyday life. For people who continue to feel the effects of the trauma, it is important to seek professional help. Here are some signs that a child, adolescent or adult may need help include:

• Worrying a lot or feeling very anxious, sad, or fearful
• Crying often
• Having trouble thinking clearly
• Having frightening thoughts, reliving the experience
• Feeling angry
• Having nightmares or difficulty sleeping
• Avoiding places or people that bring back disturbing memories and responses.
• Thoughts of self-harm or death
• Consuming drugs and alcohol, or if an adult, increasing use

Physical responses to trauma may also mean that an individual needs help. Physical symptoms may include:

• Headaches
• Stomach pain and digestive issues
• Feeling tired
• Racing heart and sweating
• Being very jumpy and easily startled

Signs of difficulties for younger children may include:  a regression to an earlier developmental stage – bedwetting, fear of strangers/darkness monsters, speech difficulties, refusing to separate from a parent during the day or insisting on sleeping with a parent; significant changes in eating or sleeping patterns; and continuing to talk about the event or exaggerate it several weeks after.   Older children may exhibit some of the same reactions.  In addition, pre-adolescents and teens may have behaviors that include: loss of interest in social activities with peers and adults, withdrawing or even isolation; fear of or refusal to go places; sustained decline in school performance; consistent failure to complete their responsibilities, including schoolwork or chores; and aggressive behavior at home or school.

Those who already had mental health problems or who have had traumatic experiences in the past, who are faced with ongoing stress, or who lack support from friends and family may be more likely to develop stronger symptoms and need additional help.

If an educator, parent, grandparent, friend or peer, pastor, community member or anyone else has concerns about a child, teen, or adult, it is wise to seek professional help.

Melissa McCauley with Focus Therapy in Edina, MO is offering free screenings to the community.  She will be available to meet with children, teens, adults, parents and families who are struggling now or in the future as a result of this community traumatic event.  You will be given the opportunity to share openly, with confidentiality ensured, and if you and/or the counselor determine there would be benefit from additional support or treatment, the counselor will personally assist you to make contact and appointments with a mental health professional in the surrounding communities, or location of your choice, for follow-up services.  Contact Focus Therapy Professional Counseling Services at 660-342-4904.  Mental health professionals are legally and ethically mandated to maintain privacy and confidentiality of clients (and will explain the few extenuating circumstances where that confidentiality can be breached) and strive to create a safe and comfortable environment for clients to share their thoughts and feelings openly.  

National Child Abuse Hotline 1-800-4-A-Child

Missouri Child Abuse Hotline 1-800-392-3738

Knox County Sheriff’s Office 660-397-2186

Edina Police Department 660-397-3251

Focus Therapy Professional Counseling Services at 660-342-4904

Missouri Access Crisis Intervention (ACI) Hotlines 1-800-356-5395/1-844-341-2390

Mark Twain Behavioral Health Crisis Line 1-800-356-5395