“Being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives.“
Tips on how to work with young people with trauma or PTSD (Post-Traumatic Stress Disorder) :
(Fundamentally it’s the same as with any person or animal exhibiting signs of distress – listen, observe, stay calm and adapt.)
The widely accepted first step to helping a child with trauma or PTSD or CPTSD (Complex Post-Traumatic Stress Disorder) is that safety and connection must first be established, before improvement and development strategies can be implemented.
Relationships (non-dependent) and a safe space to work, play and make mistakes should be the foundation on which the personal and educational journey will begin. Obvious things to avoid are: Saying “No” and directing comments using “you”, “will”, “must” or “should” i.e., “You will complete the first task by lunchtime.” Simple inclusive techniques can be very effective. Refer to “I”, “we” and “us” wherever possible. Inclusion in your speech opens the possibility of inclusion in the sessions. Communication can begin with very simple, non-patronising questions. Ground the trauma sufferer in the ‘here and now’ and ask them to comment on something in their immediate environment, i.e., “Is it warm enough in here?” “Is it quiet enough?” “Are you thirsty?” etc.
Then examine what’s going well and build strategies around this. Comfortable successes, within the child’s range of ability are confidence-building. It’s helpful to think of working at 75 percent of the possible target. If that means focusing on non-academic tasks, then that’s the level at which the child needs to work. Allow the young person to let you know when they are ready to push their limitations (socially and educationally.) Set regular opportunities for comfort breaks (to keep stress levels as low as possible.)
Shame can halt a young person’s ability to express and explore, as they may believe that having a ‘need’ is shameful, weak, and an imposition on everyone involved. This is where we need to be patient. Often, misunderstanding this process can cause the healthy attachment to break or stall. The loss of attachment can reinforce the fear of rejection and abandonment which is often rooted in a fear of death and (or) guilt of existence. Consistency and just being ‘present’ are powerful tools here. Offering acceptance without judgement and maintaining healthy boundaries will reassure and empower the young person.
We also need to be very mindful of what their behaviour is communicating. This may highlight a need that is not (yet) being met. Trauma is stored as a bodily experience and sometimes needs to “come out” as such, either as a sensory experience; physical or kinaesthetic experience; movement; play; process; mess; or emotional expression. Allowing this to happen at the child’s pace and in a safe way is important. We simply need to observe, remain flexible and reassure. But of course, we need to make sure everyone is safe and supported, including ourselves. That is why historical behaviours are important to consider when planning a session, because past ‘suppressed’ behaviours or coping mechanisms can often re-surface.
Small, careful steps, and slow but solid progress at the initial stages, often create remarkable successes further along in the journey. Patience is a very valid form of action.
“Your emotions grow out of your relational history. Even if you’ve had the most adverse set of early experiences when you immerse yourself in new relationships with space for mismatch and repair, meanings of hopelessness can be transformed into meanings of hope.”
