Treating Childhood Trauma

Part 1 of 2: A conversation with Mara Mulcahy LICSW, MSW childhood trauma specialist

In honor of my son Jonah’s recent pet loss I invited Mara over to drink tea and talk trauma.  She refused to eat the incredible Costco coffee cake I had rationalized calories for the occasion, but other than that she was a pleasure to interview.  Mara is a second generation clinical social worker who attended Smith (the Yale of MSW programs), and has been around the mental health block.  Currently parent educator at North Seattle Community College, she’s the former supervisor of Ryther’s Outpatient Mental Health program and worked as a child therapist with traumatized children. 

Me: You sure you don’t want any cake?  It’s like the best thing on the planet.  Okay so tell me about trauma. 

Mara: Trauma happens.  It’s horrible and can be one of the most difficult things.  We all want to shield our children from painful experiences but trauma is nothing we plan on.  This understanding may help absolve parents of guilt.

Me:  What can parents do once they know that their child has been traumatized?

Mara:  Take a deep breath and get grounded.  Understand that a lot of reactions are normal.  Some kids have large feelings (are expressive) and some seem to have an absence of emotion and then show the trauma as behavior.  For instance, a two year old might tantrum, regress and lash out physically.  If kids can talk about what happened they usually act out less.

Think of trauma like wound care.  How would you treat somebody after surgery?  Trauma is an internal injury and healing takes time. 

Me: How do you think about trauma in terms of categories?

Mara: Catastrophic trauma is anything involving police or emergency equipment.  This includes sexual trauma, violent acts against a person, natural disasters and terrorism.  In a catastrophic trauma, everyone including the parents are traumatized and people naturally go into survival mode.

Me: What should parents do after taking the aforementioned deep breath?

Mara:  Number one is to listen, hear their words, and believe your child.  Sometimes we discount children’s reactions and realities.  Be present, nurturing and open. 

The next category is Unexpected Loss or Accident.  This is the “stuff happens” category.  Parents need to be prepared to help your child put language to their experience and to answer questions.  It might take longer than you think for your child to complete their grieving. 

Me: Say more about childhood grieving.

Mara:  Kids don’t always have a logical response.  For instance after a tragic loss a child might ask, “Does this mean I can’t have my play date this afternoon?”  This act of displacement (focusing on something less upsetting to avoid the big feelings of the real issue) is just your child’s way of giving you information about what they need.  They need normalcy, boundaries, structure and guidance. 

Me: How does a parent know if their child needs therapy?

Mara:  Some signs your child needs therapy include:

*If a child is pre-occupied with feelings and memories related to the trauma

*If the meaning they are making is skewed (“it’s my fault” or “if I had a big sword this wouldn’t have happened)

*If a child is very shut down and regressive (acting younger)

*If the parent is stuck.  Parents have their own history and if they share similar trauma it’s overwhelming and they shouldn’t have to handle it on their own. 

*If the child is afraid to go to sleep because they have terrible nightmares and the parent can’t help them.

Me: If a child is discussing any suicidal ideation (thoughts or feelings of wanting to kill themselves).

Me: So what can parents do to help their children at home in addition to getting therapy if their child has been traumatized?

Mara:  Rely on what your child has previously found comforting.  Slow down, this is not a time for any big changes.  Get good sleep.  Use proximity (closeness).  Not always talking, but being available and reliable to talk if your child wants to. 

Stay tuned for Part II next week!  Thrills, chills, car chases and Daniel Craig’s pectoral muscles!  Okay, none of the aforementioned, but trauma advice a-plenty!