Bad things happen to children. As much as we’d like to, we can’t change that. What we can do is try to help kids recover in as healthy a way as possible. We can encourage and nurture their natural resilience.
What is resilience? Resilience is the attainment of desirable social and emotional adjustment despite exposure to considerable risk. What kind of risk are we talking about here? We’re talking about everything from being a victim of a terrorist attack to being a victim of rape to being a victim of divorce to being a victim of a bad teacher in school or a really tough neighborhood. Because all of those things happen to kids. Some of these problems are worse than others, but they’re all real problems that can be serious stressors to kids.
When we talk about trauma, we’re not talking about an adverse experience. We’re talking about the failure to recover from that adverse experience. It’s not the experience itself that causes the trauma, it is the subjective experience of that event that causes the trauma, the not-entirely-adaptive response to that experience. It’s the way that we emotionally respond to it, the way that we think about it, the way we sort of “file it away.”
Support is key to recovery
That’s why a child’s response to a disturbing experience depends not only on his temperament and what’s happened to him in the past, but on what happens after the experience—the kind of support he gets from his environment. If he has an effective support system, he has a good chance of recovering from the trauma. If he has an ineffective support system, or no support system at all, his chances are much worse.
It helps to think of it in terms of something called social ecology. This derives from the work of a psychologist named Urie Bronfenbrenner. Basically, what Bronfenbrenner said is that there’s no such thing as a person. There’s only a person within a context. You may see me and find that I’m very well behaved, but you don’t know what I’m like at home. I might be very well behaved at home as well, but you just don’t know. It depends on the context.
What we’re talking about with social ecology is a caretaking environment that includes, but extends beyond, immediate family, to peers, to school, to larger community settings, and ultimately to cultural and political belief systems.
A child exists in what Bronfenbrenner called a microsystem. The microsystem includes things like family, school, peers, religious affiliation, workplace, and neighborhood. All of the social and interpersonal entities with which the child interacts directly comprise this microsystem.
The more support there is in a child’s ecological system the better the outcome’s going to be.
Of course there are individual attributes that relate to the development of resilience: intelligence, social skills, coping skills (the ability to stay psychologically organized even when you have strong emotions, to be calm enough to think), an optimistic temperament, and a sense of agency.
But the research on resilience shows that communities are the things that make a difference. Communities include parents, siblings, teachers, friends, and other peers who share the same experience as the person who’s been traumatized. If a child can make contact in her community, especially with peers who have shared experiences, that makes a huge difference in terms of ultimate outcome.
To go back to Bronfenbrenner’s model, in the microsystem, what’s going to be adaptive is having a supportive relationship with a caring adult. If a child has experienced a trauma, the family is going to be the primary source of support. But what sometimes happens is that there are loving adults who themselves are so overwhelmed by whatever has happened that they may not be available. Which is why, if there are other caring adults in the community who can pick up the slack temporarily, that makes a huge difference. Living in caring neighborhoods, going to school where there is support, and belonging to youth groups—these are all activities that will be helpful in terms of fostering healthy adaptation.
Treating the family
I saw a case where a mother was driving a car; the child and the father were in the car. They had an accident. The father died. The child survived. The mother survived. But the mother felt so guilt-ridden about having driven the car that she was unavailable to her daughter. Until we could help the mother, she couldn’t help her daughter. With adequate support and treatment, once everything got sorted out, she was a wonderful, loving, exceptionally competent parent. But she needed some mental health services first.
If you look at the data, the things that make the biggest difference are the community interventions, not the individual interventions. I’m a psychiatrist, so my bias was to think that the individual interventions were going to make the biggest difference. But if you look at the data, it’s the community interventions.
After a traumatic event, families have to shift roles and goals. Sometimes what happens is that an older child will have to take care of a younger sibling. Sometimes a child will have to do the cooking and cleaning, because the parents are unavailable to do that. Sometimes a parent who was a stay-at-home parent has to go out and get a job and earn a living, because there isn’t enough money to sustain the family. Families have to shift their goals, and sometimes they have to shift their emotional or physical settings.
Rebuilding structure and routine
External support becomes more important, then, as a means of restoring predictability. What you want to do is to re-establish a kind of predictable routine. That helps to establish a sense that there is a future. Organization is unbelievably important. When things are chaotic, it’s very difficult to conceive of a future. Some kind of structure is vitally important. This can often be provided by participation in group activities, and sometimes what helps the most is being able to help other people. That’s very, very important.
Access to health care, mental health care, social services, and religious institutions all have been shown to make big differences in terms of fostering a resilient response to traumatic experiences. This is called empowered collaboration. When you’ve got children who’ve experienced traumatic events, families who have experienced traumatic events, you need social support systems all working together.