I am concerned that in the process of trying to help the survivors of the murder rampage in Newton, the children may be further traumatized. If a child who has been subject to a traumatic event does not wish to talk about that event, he/she should not be forced to do so. Some people think that a child who witnesses such a terrible and almost unimaginable calamity must have an awful reaction deep down that must be expressed outwardly for that child to remain well. This is not true. Different children have different responses. Even their experiences are different. One child hears popping sounds coming from the next room. Another child may be splashed with blood from a friend who has been shot multiple times. These two children have had very different experiences even though they were both present at the same event. They should not be treated in a group!

In such a setting children often pick up the idea that they should be feeling terrible, even when they had been largely oblivious to what was going on. Some adults think, “Of course, they must have seen and known what was going on,” but that is not necessarily true. The feelings they are presumed to have, but do not, are not “repressed.” They are simply not there. A child who is inexplicably oblivious to an inescapable, overwhelming trauma will be injured by having his/her attention drawn unwillingly to think about this experience. The impact of such an experience is often defined by the way the children are “instructed” to feel during the days and weeks following this event.

Following the first attack on the World Trade Center, I was called to suggest treatment for a class of young kids who were caught in an elevator with their teacher. The elevator was filling with smoke. The teacher handled the situation adroitly by singing songs with the kids and acting calmly. The children were fine. I told the authorities that I thought the children should not be entered into any kind of treatment. They were doing fine—and they would not be fine, if they were asked over and over again, “How did you feel?” The implicit message is that they should be feeling bad.

These are some suggestions:

  1. Find out how a particular child experienced this awful event. If the child does not seem to have understood what happened, or does not have an obvious reaction, do not bring it up. I think this child should not be present at memorial services, at least at the young age of most of these children.
  2. Even with such a child—who seems to be doing well—spend more time with him/her. Try to protect the child from others who will wish to talk about what happened for emotional reasons of their own.
  3. On the other hand, if a child is upset, listen to him/her. Do not rush to reassure the child until you have heard about the exact dimensions of that child’s concerns. What is upsetting to some children might not be at all what an adult might reasonably have expected. It might have been hearing loud noises, or being afraid of someone coming back to kill more children, or it might have been being left alone in a classroom. Once it is plain about what is upsetting the child, it becomes imperative to reassure the child.  It is often the manner and emotional state of the parent that influences the child, rather than the words that are said. It is important, therefore, that the parents have themselves under control.
  4. Try to maintain the child’s ordinary routine.
  5. If the child is inconsolable, I think it is reasonable for that child to be given a minor tranquilizer since these drugs seem to suppress the emotional aspect of memories. Of course, this course of treatment should be brief and would have to be undertaken under the guidance of a physician.

The bottom line: do not presume to know what the child is feeling and thinking. Find out. Do not convey the idea to the child that he/she should be more upset than he/she seems to be.(c) Fredric Neuman Follow Dr. Neuman's blog at fredricneumanmd.com/blog

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