Kitchen Table Healing: Helping Children Deal With Trauma

“America’s under attack! Turn on the T.V. quick!” Suddenly I was instantly awake on September 11, 2001. I turned on the television and sat in stunned silence as every channel portrayed the incredible image of billows of smoke pouring from one of the World Trade Center Towers. And as I watched in tearful horror, another airplane, silently and smoothly, flew into the second tower.

Like millions of people, I wondered if what I saw was an opening salvo and what this meant for our country. Were we about to see bombs dropping from the skies? But most importantly, I thought about my children who were at school. I wondered if I should go pick them up, and if they would be safe. Was the school telling the kids what happened? My youngest child was attending Farallone View Elementary School. How should I talk with him about it? What reassurances would he need? I wondered how he could even comprehend this event and the horrific images I could hardly believe.

In a sense 9-11 was the opening salvo. Now with the hunger of a twenty-four hour news cycle we, and our children, are continually bombarded with equally awful images. Osama Bin Laden has been killed. The tsunamis slamming into the cities of northern Japan. Levees blown to release the Mississippi River into farmland and towns. Hundreds of tornados chewing up the South. Five major hurricanes are predicted for this fall. What should we tell our kids about all this? How do we talk about it with them?

Victor Carrion, M.D., is a child psychiatrist, associate professor and researcher at Stanford University School of Medicine. He runs the Stanford Early Life Stress Research Program which investigates the effects of trauma and maltreatment on children, and emphasizes early intervention. He recently made national headlines when his brain imaging study showed that trauma affects the shape and size of the hippocampus in the brains of traumatized children.

A small percentage of children and adults who experience serious trauma in which life threatening harm has happened to them or someone they love will go on to develop posttraumatic stress disorder (PTSD). PTSD is a disorder of fear extinction. The body’s fear extinction mechanism has ceased to function. A person with PTSD experiences three categories of symptoms.

• Hyper-arousal – they are aware of every little noise, easily startled and constantly on edge. It is very difficult to relax as they are always on the look out for danger and hyper-vigilant. Sleep disturbances are common, along with irritability, anger outbursts and difficulty concentrating.
• Intrusive recollection – thoughts of the traumatic event keep coming up unbidden. Nightmares or bad dreams recur. A person might even experience flashbacks in which it feels like they are back in the middle of the trauma all over again, especially when exposed to cues or triggers that remind them of it.
• Avoidance/numbing - effort is made to avoid reminders of the trauma, and not to think about it. It may become hard to feel the normal range of emotions and the ability to demonstrate emotion might be restricted. A person may have a sense that they will not live a long life.

The bad news about PTSD is it does not go away over time and only gets worse. The good news is it responds very well to treatment. I was very fortunate to be Dr. Carrion’s intern while working on my graduate degree. He hired me after graduation to work half-time as a child trauma therapist in a three year clinical research trial. We are doing a 15 session intervention with children who have been through a traumatic stressor in schools in San Francisco and East Palo Alto. The initial results are very promising and it is a privilege to be doing this work. We are in the final stages of our research, finishing treatment with the children and their families and assessing the results.

Lucile Packard Children’s Hospital made a four minute film of Dr. Carrion recently discussing how to talk with kids about Japan’s disaster. The film actually is good advice for parents in talking with kids about any traumatic event.

To sum it up in a nutshell the advice is this.  

• Let your child know they can talk with you about the event. Don’t force the discussion, but let them know you are available should they want to discuss it.
• Be honest about what happened. Your kid is going to get the details from their friends. Being graphic is not necessary, but don’t be afraid to say what has occurred. This will help strengthen the trust between you and your child. 
• Younger children may need to talk through play and drawings.
• Repeat what you say. This can help children feel safer as they try to process their feelings. They are worried that the bad thing may happen to them or their family. They need to be reassured.
• Give kids a sense of control by having them help in some way. For example, participating in a community event that benefits children in Japan can help the child feel as if s/he has some ability to help.
• Talk about positives that have come out of the trauma, such as the way people helped each other.
• Reassure your children that you will protect them and keep them safe.
• It is okay to restrict television exposure to traumatic images.
• Kids with a past trauma history are at greater risk of being negatively affected by exposure to traumatic news.
• If your child seems to worry excessively, consider a professional consultation to assist them.

Rachel Naomi Remen, M.D., writes in her book, Kitchen Table Wisdom, “The kitchen table is a level playing field. Everyone’s story matters…Most parents know the importance of telling children their own story over and over again, so that they come to know in the tellings who they are and to whom they belong. At the kitchen table we do this for each other.”

On the evening of September 11, 2001, I took comfort in preparing a meal for my family. We sat around the dinner table while their father and I discussed the day’s events with our three children. We didn’t really know what it would all mean, but we did our best to reassure our kids they were loved and we would do everything in our power to keep them safe. Kitchen tables can be an intimate sacred healing space. The value of a family meal around the kitchen table to heal the woes of the world simply cannot be underestimated.