Hope
We all know that a deep wound in the flesh will bleed and be painful but given immediate medical attention, the right kind of treatments and professional care - with time it will heal. Yes, it will probably leave behind some scars, which will never fully go away, however one can still lead a relatively normal life.
Child abuse is a devastating gash that causes tremendous pain and will inevitably impact hugely on the individual, the parents and probably the whole family. However, with the right kind of treatment, care and therapy a child can heal and go on to lead a normal, happy fulfilled life. And so, there is a glimmer of sunshine through the heavy clouds.
It is important to know that even if there is just a suspicion that a child has been the victim of abuse, it is imperative for the family to seek professional help and preferably for the child to enter into some form of therapeutic treatment as soon as possible.
Trust
Although trauma can shake the trust and stability of a child, through good attachments with a parent, caregiver or therapist trust can be restored. Believing the child’s story is also crucial in repairing the trust.
Most trauma therapies progress through three phases of treatment recovery which aim to help the child not only move forward but also learn to process what happened in the past. These three essential phases include establishing safety, processing the trauma narrative and finally integrating the story into one’s everyday life.
Safety
In the aftermath of abuse, the first step to recovery is to establish physical safety. This may mean removing the child from the direct danger, which could be the victim’s home and having the child move into a foster home or removing the perpetrator. In a school setting, the child may need to change schools. The weekly therapy session will provide a degree of consistency that will allow the child to begin to feel a sense of emotional safety and containment too. The child will also need to feel safe within their body. Physiological stress can be modified with physical strategies, such as grounding exercises, mindfulness, somatic (body-based) interventions and exercise.
Trauma processing
The second stage of treatment involves processing, remembering and mourning. The child may retell the story of the trauma. With young children, this may be done using pictures or a comic strip or reenacting events using dolls.
This is the time to mourn the loss of what they did not have or what they missed out on such as innocence, lack of protection or perhaps the lack of being believed.
Either way, the reconstruction of the story actually transforms the traumatic memory so it can be integrated into the life story of the survivor. Avoiding the memories can lead to stagnation in the recovery process, whereas on the other hand, approaching the story too quickly can be damaging. Since there is a fine balance between the two, the social worker or therapist will need to approach this phase with sensitivity and patience. The child or individual must be given the message that trauma is not the whole of them, it’s just a part of the tapestry of their life.
If words cannot be accessed which is common for children, they may retell their trauma narrative using words, drawings, painting, collage, a cartoon strip, poems, songs or a play. Although therapy does not necessarily get rid of the trauma, it does allow for the integration of the story. Furthermore, the narrative becomes a testimony. At this stage, there may be a relief from major symptoms of post traumatic stress disorder (PTSD) just through the use of words and retelling. Ultimately a cohesive narrative along with the use of a chronological timeline, helps the child find meaning and make some kind of sense of their traumatic story.
The incorporation of relaxation strategies for somatic stress (such as headache, stomach ache, dizzy, racing heart, etc.) includes focused breathing/mindfulness/meditation exercises and physical activity such as yoga, singing, dance or blowing bubbles. These kind of relaxation skills are taught to the children (and also to parents sometimes to practice at home together with their child.)
Integration
The Latin root of the word ‘integrate’ is intregrare which means to ‘make whole.’ The final stage of recovery is reconnection and becoming whole or shalem in Hebrew, which also brings a sense of peace or shalom. This implies a renewed ability to get in touch with the self. The survivor no longer sees themself just as an abused victim. This is the time to move on, come out of isolation and make connections with others, such as family and friends. Often there are joint child-parent sessions to enhance feelings of safety and belonging.
It is important to be aware that children often feel responsible for other family members and may think that certain family problems are their fault. It is typical that they take the blame for events which were not in their control or their fault, since it is easier to ingest the bad themselves whilst preserving the image of the offending adult, in order that it can remain intact and good.
Parental involvement
During the therapeutic process it is crucial for the therapist to work together with the parents or primary carer where possible by giving them psychoeducation, answering questions, allaying fears and imparting parenting skills.
Parents whose child has experienced abuse is likely to suffer from their own secondary traumatization and will be strongly encouraged to undergo their own therapy and share their own feelings of guilt, anger, shame and grief.
Interventions and treatment approaches
There are many effective intervention/treatment approaches available incorporating those three phases of therapy: safety, trauma processing and integration. A social worker can help to find the right one for the parents and child.
Whilst play therapy has traditionally always been the most popular form of therapy for children since play is the natural mode in which kids express themselves, there are a variety of other possible interventions available such as:
• Expressive therapies (art, drama, music)
• Bibliotherapy (reading and writing)
• IFS (Internal Family Systems)
• EMDR (Eye Movement Desensitisation Reprocessing)
• Sand Therapy
As we have learned, there are many roads that can lead to healing a child who has been wounded by abuse. Ultimately, the single most important factor is for the parent or caregiver to provide safety, unconditional love and security, so that the healing can begin to take place.
For teens: Are you afraid, uncomfortable or maybe ashamed to talk?
It is so important to speak out if something has happened to you and not keep it a secret, but why?
• Firstly, abuse that has not been dealt with can lead to mental health issues now or later on in life
• Secondly, you will feel very relieved if you share. It takes a lot of energy to carry the burden alone.
• Thirdly, speaking up is crucial for your own safety and piece of mind, to help you recover and also to protect others who may be at risk from the same individual.
5 simple guidelines to follow:
1. Find a trustworthy adult who you can talk to, someone approachable – a teacher, a rabbi or maybe your best friend’s mum who can help you get help if you need it.
2. Remember that whatever has happened is not your fault, even if you feel you may have agreed to something. We get put into situations where we feel trapped and may freeze. This is a normal response when we are in shock, and nothing to feel ashamed of.
3. As a rule, trust your instincts. If something feels wrong to you or uncomfortable, then it most likely is. Some situations may be confusing, so it may be helpful to get an objective opinion.
4. Secrets with adults are not ok. If an adult tells you something is a secret just between the two of you, this is a red flag. Be on high alert.
5. It’s never too late to speak up.
If you have no one to talk to, pick up the phone and call:The Chevra Kadisha hotline on 082 499 1010. Or Hatzola Emotional Response Support Line 011 140 3270 It can be anonymous and is confidential too.
Written by Maria Beider