Why Children May Tell Their Trauma A Dose At A Time

Last week, I had the honor and privilege of attending an all-day conference sponsored by the Behavioral Health Alliance of Rural Pennsylvania. Dr. Bruce Perry from the Child Trauma Academy was the featured guest speaker for the day.

Dr. Perry is a world-renowned neuroscientist and child psychiatrist

He is also the author of the very popular book The Boy Who Was Raised As a Dog and the creator of the Neurosequential Model of Therapeutics. In addition to the Child Trauma Academy’s very rich variety of articles and other information on its website, Dr. Perry also has his own YouTube channel where you can listen to some of his lectures. I highly recommend both.

Over the years, I have attended as many Dr. Perry lectures as I possibly can as he travels all over the United States and the world. Many years ago we formed a friendship when he was regularly coming to the Philadelphia are. I was even able to present with him for a group of about 300 kindergarten teachers from the School District of Philadelphia. That was another thrilling moment in my life!

At the conference last week I was once again impressed by a concept Dr. Perry offered around dosing.

He shared that when someone, especially a child, has experienced something very intense, powerful and overwhelming, that person often is not ready or able to talk at all about their experience. If pushed to share, the stress can re-traumatize them, making them shut down even more. It certainly can damage a sense of safety and trust in a relationship.

If someone significant to the child begins an interrogation, particularly if that child is already feeling fragile and vulnerable, the child can feel another layer of being overwhelmed and unsafe—certainly not the intention of the parent or caregiver, but the reality of what the child may experience.

To illustrate his point, Dr. Perry told a dramatic, graphic true story about a child who had seen his mother murdered.

For many weeks after this had happened, the child had not and would not talk about what he had seen or heard. People began to wonder if he had blocked it all from his memory.

Not so, said Dr. Perry. The day came when the child was in the food store with his father, going through the checkout line. He was young enough to be sitting in the cart. When the checkout person casually said hello to him and asked how he was doing, he replied, “My mommy got shot and she’s dead.” The shocked cashier responded with something like, “Oh I am so sorry to hear that!” The child said nothing more about the experience to her or anyone else for quite a while. He said as much as he could say and then needed to retreat.

Dr. Perry shared that this was an example of how children need to dose their stories, especially when they involve something extremely frightening or painful.

It is as if the brain needs to titrate or carefully allow small, manageable parts of the story out, one “drip” at a time, similar to titrating a controlled dosing of the medicine.

As I have been thinking about this, it occurs to me that it is a helpful principle for parents to understand. It’s not only useful for when something horrific happens, but in everyday experiences where children have to deal with frightening, powerful, scary or overwhelming experiences.

If we can be sensitive to how important it is to give the child the power to decide if, when and how much to share, it honors the child. It can also be done in a way that does not reactivate the original feelings and sensations that were overwhelming and painful.

Think about how a parent might quiz or interrogate a child who comes home looking as if he was in a fight, with scratches and red marks on his face, clothing torn. Of course, the first reaction by a parent is, “Oh my gosh! What happened to you?”

Unless it is absolutely necessary to know what happened because there needs to be some kind of immediate action, it can be better to allow a child some time to regroup mentally and not to feel that he has to go back and describe, therefore relive whatever happened to him.

A parent might say, “I can see that something happened to you and that I’m guessing someone beat you up or somehow you got into a fight. Let’s help you get cleaned up and when you’re ready, if you would like, you can tell me more about it.”

I can hear people already saying, “But I have to know what happened because I have to do something about it!” Again, unless there are concerns that there needs to be in immediate response, it might be better to wait even for a little while and then to get only a few pertinent facts rather than force the child to go into great detail.

Parents can show they are interested and available, and at the same time will not pressure their child to reveal potentially overwhelming details of a story.

Then over time, it becomes more likely that the child will recognize how safe and trustworthy their parents are as they respect their need for some space. And yes, it can be a balancing act to communicate the kinds of messages that are supportive and yet not intrusive.

Dr. Perry’s talk gave me a lot of think about around this idea of respecting and appreciating dosing. I think it is an important parenting principle that requires good judgment on the part of parents to know if, when and how much to ask their children to share their scary or upsetting stories. It can be helpful for parents to realize that respecting this principle of dosing can promote healing and recovery while strengthening the parent-child relationship.  Food for thought!

Invitation to Reflect

  1. Have you noticed that your children sometimes tell only short parts of emotionally intense stories? Does it help you to know that they might be dosing?
  2. How do you think becoming more aware of the importance of dosing might change how you interact with your children?

Diane Wagenhals, Director of Institute for Professional Education and Development, Lakeside Educational Network

Image Source: http://www.childtrauma.org