After a Traumatic Loss

After a Traumatic Loss

William Steele, PsyD, MSW

After a Traumatic Loss

William Steele, PsyD, MSW

William Steele

After a Traumatic Loss

Help for Those Who Care for Children and Families After a Loss William Steele, PsyD, MSW

The National Institute for Trauma and Loss in Children 13725 Starr Commonwealth Road, Albion, MI 49224 Toll Free 877.306.5256 | starr.org/tlc | TLC@starrtraining.org Š2001 Revised 2015

ISBN 1-931310-10-6 starr.org/tlc

After a Traumatic Loss

What would you ask?

William Steele

• Five children witness a friend shoot himself in the head • A parent is killed in a car accident

• A child witnesses the beating of her mother

• Children are unexpectedly deserted by a parent

• An adolescent caring for his terminally ill father oversleeps on the morning of his father’s death

What would you say?

• A child dies in a house fire

• A boy’s sister is brutally killed by a serial killer • A school bus full of children overturns

• A child shows all the signs of post-traumatic stress following her parents divorce

For more information call TLC at: 877.306.5256 or go to: www.starr.org/tlc

What reactions are you likely to hear and see from those who experience a traumatic loss? © TLC

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After a Traumatic Loss

William Steele

Introduction

After a Traumatic Loss identifies specific post-traumatic stress reactions that can be experienced by a child following exposure to either violent or non-violent losses. It provides specific information that families need to know about the impact trauma has on a child’s emotions, behaviors, and learning. It provides parents and professionals with information to help normalize trauma reactions.

Normalizing these trauma reactions helps children overcome the terror that trauma induces.

After a Traumatic Loss addresses specific traumatic losses, such as suicide, in which survivor reactions are somewhat different from grief reactions alone.

After a Traumatic Loss helps professionals by identifying reactions survivors experience. For example, it discusses what they think and feel and how they can behave as a result of the loss. It allows helpers to speak a language that lets traumatized children and families know they are understood.

After a Traumatic Loss can be given directly to family members or may be used during a meeting with the family when reviewing reactions. It can help to normalize what is frequently felt by trauma survivors as abnormal or “crazy.”

We wish to thank the many children and family survivors who have taught us so much about loss. Their courage to share their experiences have helped us help many other children over the past 25 years.

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After a Traumatic Loss

William Steele

TABLE OF CONTENTS Chapter One . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Traumatic Losses: Violent and Non-Violent

Chapter Two . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Reaction to Environmental Trauma

Chapter Three . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .15 After a Suicide

Chapter Four . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Non-Traumatic, Non-Violent Losses

Chapter Five . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Family Responses

Summary and References . . . . . . . . . . . . . . . . . . . . 33

Grief versus Trauma . . . . . . . . . . . . . . . . . . . . . . . . 36

About TLC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37 Information and Resources

TLC Books and Resources . . . . . . . . . . . . . . . . . . . 40

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After a Traumatic Loss

TLC Books and Resources

4 You Are Not Alone for children 6 - 12 years old

4 A Trauma is Like No Other Experience for teens

4 What Parents Need to Know for parents and care givers

Three very helpful booklets to help children, teens, and parents define trauma, understand reactions, and find ways to heal the hurt. Each booklet is geared for a specific age group. These books were written by William Steele as companions to the SITCAP programs, but are very useful individually as well.

After a Traumatic Loss

by William Steele, MSW, PsyD

An excellent reference for all those working with grieving children. Identifies differences between trauma and grief reactions. As children listen to you describe these reactions they see you as someone who truly understands their hidden fears, terror, and confusion. The booklet includes ways for parents to help their child as well.

Brave Bart

by Caroline Sheppard, ACSW

Brave Bart is a kitty who had something bad, sad and scary happen to him. Helping Hannah, a neighborhood cat, helps Bart overcome his fears and become a survivor. Brave Bart normalizes the many trauma-reactions children experience. Parents find it to be an excellent way to talk to and comfort their traumatized child. This book was rewritten for preK and school-aged children.

For more information on TLC books and resources go to: starr.org/store

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© TLC

William Steele

ChAPTER ONE

TRAuMATIC LOSSES vIoLENT AND NoN-vIoLENT

We all know that children experience grief when they suffer the loss of someone close to them either by death, divorce or separation. However, when that loss also traumatizes a child, they experience additional reactions that are quite different from typical grief reactions.

Often many parents and professionals, who help traumatized children, fail to recognize that children are vulnerable to post-traumatic stress, once attributed only to adult survivors of war. Many still believe children are too young and unknowing to be seriously affected by death, divorce or separation. In turn, parents minimize the reactions of children and believe they’ll “grow out of it.” Yet some adults simply do not know the signs of trauma or fail to recognize changes in the child as symptoms of posttraumatic stress.

What kind of event can induce trauma in children?

• Separation from a parent due to the parent’s substance abuse problems, physical/sexual abuse, and/or neglect or abandonment • The murder of a sibling, parent or friend

• Witnessing the murder of a sibling, parent or friend, including witnessing a suicide • The discovery of a body

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• Witnessing a rape

After a Traumatic Loss

• Witnessing physical abuse of a family member or friend

• Death of a family member by fire, car accident, drowning, plane or train crash, or from a hurricane, tornado, flood or earthquake

• Terminal illness and death of a family member or peer

• Divorce

• Adoption

• Simply being a friend or peer of someone who has died, murdered or committed suicide, also induces trauma

William Steele

TLC Certified Trauma Practitioner Certification

TLC Certified Trauma Practitioner Certification lays the foundation for understanding trauma and provides training in the use of TLC's evidence based Structured Sensory Interventions for Children, Adolescents and Parents (SITCAP)®.

For more information on TLC Certification go to: starr.org/training/tlc/certification

When Children are Traumatized

Both violent and non-violent events that involve a threat to someone’s life, or a loss of someone else’s life, would be distressing to almost anyone. Post-traumatic stress can overwhelm children.

When a child is terrorized, what happens? A child may:

• Have trouble sleeping because of nightmares.

• Be afraid to sleep alone or be left alone even for short periods of time.

• Be easily startled by sounds, sights, and smells similar to those that existed at the time of the event. A car backfiring may sound 2

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After a Traumatic Loss

William Steele, PsyD, MSW

Dr. William Steele stablished The National Institute for Trauma and Loss (TLC) in 1990.

He began his work in the field of trauma by taking the lead in helping schools across the country develop crisis response teams in response to the epidemic of suicide among young people in the early 1980’s followed by the epidemic of violence in the late 80’s thereafter leading to the formation of TLC.

He has assisted professionals over the years following such tragedies as the bombing of the Federal Building in Oklahoma, 9/11 in New York and Washington D.C., Hurricanes Katrina and Rita and the 2009 killings (while in school in the presence of students) of a coach in Iowa and a teacher in Texas to name but a few. He was one of the first Americans selected by the Kuwait government to assist them in the aftermath of the Gulf War and continues to consult with agencies related to childhood trauma such as Center for Military Relationships and Families as well as schools across the country.

Dr. Steele has had numerous publications in such journals as the School Social Work Journal, Children and Schools, Residential Treatment for Children and Youth, National Social Sciences Associations, Reclaiming Children and Youth, and publications with Guilford Press, American Counseling Association, Allyn and Bacon.

William Steele

like the gunshot that killed someone or a dog pouncing down the stairs may bring back memories of the sound of someone falling down the stairs and dying.

• Become hypervigilant, forever watching out for and anticipating that they are, or about to be, in danger. (Children who start sleeping on the floor instead of their bed after a trauma do so because they fear the comfort of a bed will let them sleep so hard they will not be able to hear the danger coming.)

• Become irritable, aggressive, act tough, and/or provoke fights.

• Verbalize a desire for revenge.

• Act as if they are no longer afraid of anything or anyone and in the face of danger not respond appropriately; verbalize that nothing scares them anymore.

• Forget recently acquired skills (e.g. reading/writing skills, school sports, etc.).

• Regress or return to behaviors they had previously stopped (e.g. bed wetting, nail biting).

• Children may also develop behaviors, such as stuttering, rocking or head banging.

• Withdraw and want less to do with their friends.

• Develop headaches, stomach problems, fatigue and other somatic complaints not previously present.

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After a Traumatic Loss

• Become accident prone; taking risks they previously avoided and putting themselves in life threatening situations.

• Develop school behavior problems, including a drop in grades and difficulty concentrating for a long period of time.

• Develop a pessimistic view of the future; lose their resilience to overcome additional difficulties; lose hope; and lose their passion to survive, play and enjoy life.

While these changes are not unusual, they often go unnoticed and/or fail to bring a helping response from adults. These changes may become permanent when the child does not receive appropriate help. Often children suffer silently for years with their terror, until one or several of these changes become so intense and problematic that someone eventually addresses the behaviors.

Unfortunately, years later, few people are likely to associate these reactions to the child’s earlier trauma. In turn, whatever type of help that is given often misses the mark and further increases the child’s sense of helplessness and failure.

Generally, parents are able to comfort children who are grieving.

They have learned to be patient, tolerant and understand that grieving children need time, too. However, trauma reactions are so different and unfamiliar that parents often attribute them to other issues. All too often, children are misdiagnosed with disorders such as ADHD or ODD when trauma is not explored.

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William Steele

ABOuT TLC

TLC's mission is to bring out the best in every traumatized child by creating environments where children can flourish.

• Currently 6,000 TLC Certified Trauma Practitioners provide TLC interventions and resources to children, adolescents, families, schools and communities daily.

• Published evidence based research outcomes support the value of TLC school and agency based programs.

• For the past 25 years TLC has provided its Structured Sensory Interventions for Traumatized, Children, Adolescents and Parents (SITCAP®) interventions following incidents such as the tragic mass shooting of school children at Sandy Hook Elementary School in Newtown, Connecticut.

• Over 50,000 professionals have participated in TLC trainings; thousands have given testimony

• A program of the Starr Global Learning Network, an international leader in transformational programs for children, families, schools and communities since 1913.

• In support of the 2009 proposed Developmental Trauma Disorder (DTD) diagnostic category which supports childhood trauma as a serious developmental life experience not adequately defined by the Posttraumatic Stress Disorder.

Left: A happy 4-year-old’s drawing of herself.

Right: A 4-year-old’s drawing of herself after witnessing the brutal attack on her mother.

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