PARENTS AND PARENTAL CAPACITY MAY BE LIMITED BECAUSE OF THEIR OWN SITUATION

PARENTS AND PARENTAL CAPACITY MAY BE LIMITED BECAUSE OF THEIR OWN SITUATION

q++ Increased understanding of how parent’s situation affect children

q++ Difficult for parents to soothe or calm children when children’s own reactions can trigger parent’s reactions

qDifferent problem areas:

•Parents are withdrawn, not attuned to or available for their children

•       Parent’s need to shield their child hampers the child’s coping

•       Over-protective behaviour

•       Parents create fear through their behaviour

q

RISK FACTORS

RISK FACTORS

qExtent of destruction

qCloseness (proximity) to disaster

qSubjective response

§Experienced death threat

§General distress

qLost loved one or friend

qFemale gender

IMMEDIATE REACTIONS

IMMEDIATE REACTIONS

Physical ( Up to Down)

qMobilisation of the body

•Adrenaline

•Nor-adrenaline

q       |

q       |

qPhysical mobilisation

•Rapid reaction

•Ready to handle danger

q         |

q         |

qBlock/reduce pain

-------------------------------------------

Mental

qq Mental mobilisation

•Previous experience and knowledge available

•Increased sensory sharpness

•Focussed attention

•Strong memory formation

•Rapid processing of information

•

• q Emotional suppression 

    



IMMEDIATE REACTIONS, Health, Trauma and Disaster, Family, Children,

THE USE DEPENDENT BRAIN

THE USE DEPENDENT BRAIN

§1. We are born with more than 100 billions brain cells

§2. Only 12-15 % are connected at birth

§3. The rest happens in the interplay with experience

§4. The genes are the architect

§5. Parents and children’s network are the builders

§6. What happens when there are storms during the 8. construction work?

§10. Use it or lose it – Thorsten Wiesel 1961

§10. Nobel prize Wiesel and Hubel, 1983 .

TRAUMA AND THE DEVELOPMENT OF THE HUMAN BRAIN

TRAUMA AND THE DEVELOPMENT OF THE HUMAN BRAIN

                                                           Neuron Picture

                                                           Brain Picture

Neuron Picture, Brain Picture, Children, Girls Development, Trauma and Disaster, Health, 

PSYCHOLOGICAL CHALLENGES

PSYCHOLOGICAL CHALLENGES

•Natural resilience must be cultivated – there is widespread resilience if the family and wider social fabric can be kept intact

•How do we foster resilience on the individual, family and community level?

•For this to happen community mobilization and supportive social environments are needed

•Most large-scale disasters demand international cooperation

•Mental health issues are no exception to this

•In resource poor countries problems of everyday living may take priority over mental health issues

•Organisational fragmentation, problems in command, cooperation and communication are common – hence IASC guidelines

Children, Family, Girls, Girls Development, Health, Trauma and Disaster,

FAMILY PERSPECTIVE

FAMILY PERSPECTIVE

§Family consequences can be dramatic as events impact family cohesion, structure, communication and role distribution

§Family interaction patterns change in various ways

i.e. parental over protection or parental withdrawal

§Concepts that grasp family dynamics are lacking .

GRIEF, TRAUMA AND ATTACHMENT

GRIEF, TRAUMA AND ATTACHMENT

§1. The attachment system regulates the interplay between the child’s exploration and their need for safety and protection – a biologically based system with regulation mechanisms both on the child and adult side

§

2. This fine-tuned system is totally dependent on the presence of the mother (father). A lack of emotional or physical presence can lead to different forms of ambivalent, insecure or disorganised attachment

§

3. Recent research show that parents that struggle following loss and trauma often have an insecure or anxious attachment

§

4. There is a danger that small children get their attachment disturbed and that parental capacity is reduced .

§5. It is through the fine-tuned interplay between the caregiver and the child that the foundation for future trust, self-worth, identity and ability to regulate feelings are developed

§6. Especially the ability to regulate emotions is important. When the mother (father) soothes or calms down or consoles with her voice, her words and explanations ”it is not dangerous”, as well as her body, the executive systems in the cortex are developed. Gradually the child him/herself can reduce the alarm bells and the action systems (fight, flight, freeze, surrender) in the deeper structures of the brain

§7.With reduced parental capacity this development is under stimulated or deviated

GRIEF, TRAUMA AND ATTACHMENT

THE PSYCHOLOGICAL EFFECTS OF DISASTERS

THE PSYCHOLOGICAL EFFECTS OF DISASTERS

§Wide variety of reactions can be expected in the immediate aftermath

§Among directly exposed prevalence of PTSD is 30-40 %, in general population 10 to 20 %, and among rescue workers 10-20 % (Galea, Nandi & Vlalov, 2005)

§  Most survivors in disasters fare well

§  Some disasters can produce PTSD in majority of victims

§Many bereaved suffer extensively over time – type of loss will determine longevity of reactions

§

Personal growth and community mobilization

•    Increased awareness

•    Change in values

•    Better preparedness

•    Connectedness – strengthening social network ties

Trauma and Disaster Children, Health, 

SUMMARY OF WHAT WE KNOW

SUMMARY OF WHAT WE KNOW

•Violence exposure is especially associated with dramatic and extensive after-effects

•

•Children’s trauma history is the strongest contributor to drug abuse in adolescence

•

•Physical and sexual abuse in childhood is strongly associated with psychiatric problems in adult age

•

•Cumulative traumas in childhood is associated with reduced somatic health in adulthood .

Children, Family, Girls, Girls Development, Health, Trauma and Disaster

DISASTERS AND SOCIETY

DISASTERS AND SOCIETY

•1. Reinforcing social fabric

•2. Cohesion

•3. Altruism, helping each other

•4. Empathy and understanding

•5. Positive meaning making

•6. Resilience

•7. Responsibility

•8. Preventing new disasters

•9. Increased preparedness

•10. Health improvement

•1. Fragmentation of human bonds

•2. Conflict

•3. Individualism

•4. Psychic numbing, denial

•5. Chronic meaning seeking

•6. Vulnerability

•7. Pulverization of responsibility

•8. Lack of plans

•9. Hypervigilance, overreactions

•10 Health deterioration

DISASTERS AND SOCIETY, Trauma and Disaster, Health, Children, Girls, 

RITUALS ARE IMPORTANT BECAUSE:

RITUALS ARE IMPORTANT BECAUSE:

•         They allow for a direct, strong and meaningful way of expressing what we feel in relation to a traumatic loss

•         They bypass words and allow a strong symbolic expression through an act

•         They give form, structure and frames for our thoughts and feelings

•         They confirm our social connection to those we love and allow others to support us

•         They can both start and end, open and close, important aspects of the grief we experience

HOW TO HELP OVER TIME

v     Listen for the hidden meaning in children’s expressions be they verbal or through play

v     Take children’s search for understanding seriously – meet their questions

v     Do not provide rigid answers too fast

v     Help children in placing their loss in a new perspective as they develop and grow older

HOW TO HELP OVER TIME – ADVISE TO ADULTS

HOW TO HELP OVER TIME – ADVISE TO ADULTS

v     Do not talk about the loss too often or repeatedly ask how (s)he is doing

v     Continue to show that you are aware of the loss (s)he has suffered – use passing of important dates to introduce the subject

v     Help them if they continue to seek answers to what happened or they return to these questions

v     Do not give very definite answers to soon – be open to their reflections

v     Help children to place loss in perspective as they develop

HOW CAN ADULTS HELP?

HOW CAN ADULTS HELP?

•         Talk about the deceased with the child

•         Show respect for the deceased and the child’s relationship to the deceased

•         Let child participate in memorializing activities

•         Give the child mementoes of the deceased

•         Help them find language to express feelings

•         Be alert to the child’s feelings about the deceased

•         Help modulate the pain when thinking about the deceased

CONTINUATION OF THE BOND TO THEIR LOVED ONE

CONTINUATION OF THE BOND TO THEIR LOVED ONE

An inner model of the loved one is developed

•Children develop an inner representation of the lost person

•This helps children over time

Adaptive when:

•The child is not preoccupied by the dead person or become very upset when thinking about the deceased

•The bond does not preclude the child from being fully engaged in life

GRIEF IN CHILDREN ACCUMULATED KNOWLEDGE

GRIEF IN CHILDREN ACCUMULATED KNOWLEDGE

The loss will be with the child throughout life

•The child’s perception of the loss changes with increasing age and maturity

•Children return to their loss over time and are dependent upon adults’ continued support and conversations

•Children can fear they will forget their loved one

Most children cope well

•Bereaved children with caring, knowledgeable adults by their side are able to continue life without major psychic disturbance

•However, they continue to process the loss and long for the lost person

•Adverse circumstances in relation to the death (exposure, fantasies), lack of social support, inadequate caring, etc. can lead to more serious consequences
•         Better understanding of what traumatic and complicated grief is
•         When a child is exposed to the drama surrounding the death, traumatic after-effects can in themselves be a problem in addition to grief

•         Clinical experience tell us that fantasies can have the same effect

•         It is difficult to approach good memories when traumatic memories or fantasies are activated at the same time

•         Important to be aware that children seldom tell about such difficulties spontaneously – we have to ask

•