May 27, 2021
Cindy Lopez:
Welcome to Voices of Compassion, CHC’s podcast series providing courage, connection and compassion, highlighting topics that matter to our community, our parents, families, educators and other professionals. My name is Cindy Lopez, today we’re talking about trauma-informed parenting. Now that might sound like something more extreme than what you need, but trauma-informed parenting can provide tools to help every parent support their children. All parents want to provide a nurturing and stable home for their family, where everyone feels safe and loved. Trauma informed parenting can help you do that. Listen in to this podcast episode, as we talk with Dr. Pardis Khosravi, Licensed Psychologist and Clinical Program Manager at CHC. Dr. Khosravi is there anything else you’d like to share with our listeners as we get started?
[00:00:57] Dr. Pardis Khosravi:
I have extensive experience working with youth both in the foster system and youth that have been adopted and so I’ve actually done a lot of trauma informed work in my practice. So I’m really excited to be here today to talk about this really important topic.
[00:01:10] Cindy Lopez:
Thanks so much and we’re thrilled that you can be here with us today. And it’s such an important and valuable topic, even if you’re a parent who you’re thinking my kids haven’t experienced trauma, but really it’s good for everyone to hear.
[00:01:24] Dr. Pardis Khosravi:
Yes, I think it’s strategies that are applicable universally to all kids and kids who have experienced stress and I think everyone has experienced stress in the last year.
[00:01:34] Cindy Lopez:
So what should parents know about trauma?
[00:01:37] Dr. Pardis Khosravi:
So trauma really is an emotional response to an intense event that threatens or causes harm. So harm can be physical, it can be emotional, it can be real or perceived, and it can threaten the child themselves or someone that is close to them. So essentially any event that causes the sense of extreme fear or helplessness for the child and overwhelms their capacity to cope. So things like physical abuse, emotional abuse of course are considered trauma, but things like bullying, community violence, natural disasters, witnessing any kind of harm to a loved one, those are all also considered trauma and so many more things.
And then there’s traumatic grief. So grief that often is sudden or unexpected or just traumatic to the child in some way. And I would say COVID and the pandemic and sort of everything that has happened in the last year could certainly be considered a trauma. I think at the end of the day, it’s less about the event itself and more about the child’s reaction to it. So if a child is experiencing severe or prolonged symptoms that interfere with their functioning, that counts. Trauma can be the result of a single event, but it can also result from exposure to multiple events over time. So you might hear the term cumulative trauma or complex trauma often to refer to this where multiple traumatic events have occurred or a prolonged event, right, like repeated instances of bullying and so experiencing that same type of traumatic event multiple times, or experiencing multiple different kinds of trauma is typically more harmful than a single instance of trauma. But trauma informed parenting strategies can help every parent and caregiver feel more equipped to respond to children’s behaviors, particularly I think in the wake of the pandemic, and the other things kind of going on in our country right now. That increased stress response I think is present for a majority of folks.
[00:03:35] Cindy Lopez:
What you as a parent or an adult might see as a kind of benign event not traumatic event, the response of the child is kind of the important piece of this, is that true Dr. Khosravi?
[00:03:50] Dr. Pardis Khosravi:
Yes. That’s absolutely correct.
[00:03:52] Cindy Lopez:
So then let’s talk for a minute about how children respond to trauma. What kind of behavior might parents observe, and give some examples by groups?
[00:04:02] Dr. Pardis Khosravi:
So when children have experienced trauma, we see the impact everywhere: their bodies, their brains, their emotions, the way they think and their behavior. Oftentimes children will exhibit behaviors that at one point in time was adaptive or helpful. When the child was in danger, these behaviors were important for their survival. The problem is once that child is moved to a safer environment or that traumatic event has passed, their brains and bodies may not recognize that, and so these protective behaviors or habits that have grown strong from frequent use, right, I think about it like a muscle. If we use that muscle repeatedly, it grows bigger and stronger. It takes time for them to retrain their brains and their bodies to learn that those responses are not needed anymore, that they can relax. So we might see behaviors like increased aggression, distrusting or disobeying adults, or even dissociation where they’re feeling kind of disconnected from reality. I think it’s helpful for parents to remember that a child’s behavior while it might be ineffective in this present moment is a learned response to stress. It might be what kept that child safe and alive in that unsafe situation. And so it takes time for them to rewire their brains.
Trauma affects children’s bodies, changes their physiological response to stress. They might be quicker to respond. It changes the way they think. So we might see difficulties learning and concentrating, but it changes the beliefs that they hold about themselves, about the world, about other people. So you might hear, children say things like “I’m worthless, or I messed up, or I can’t trust anybody or everyone I care about leaves me or dies,” right, depending on what the trauma is. We see it in their emotions: they might feel unsafe, they might have a hard time regulating intense emotions, we might see depression, anxiety, low self-esteem. And then we see it in behavior, they might act out, be aggressive, run away, lack impulse control.
And then you mentioned age groups, and I’m glad you brought that up cause that’s an important point, young children and teens are going to respond very differently. And so, you know, young children and I’m thinking ages zero to five, we might see frequent tantrums or clinginess to parents or reluctance to kind of go off and explore the world on their own. We might see the traumatic event be enacted in their play, that’s a really big one and so I can’t tell you how many times I had kids in my practice when the pandemic had first started, where in their play, they were acting out shelter in place or social distancing, or going to the doctor.
With young children, we might also see delays in reaching their milestones or regression in their milestones. So kids who were speaking in full sentences might now be using one or two word phrases for a little while, and then they catch back up. For school-aged children, so that’s ages like six to 12, we often see difficulty paying attention, being withdrawn or more quiet, frequently crying or having a really low frustration tolerance, they get really irritable really quickly, they might talk about sort of scary feelings or ideas, they might have difficulty transitioning from one activity to the next. We might see a change in school performance, usually kids at that age will manifest these symptoms behaviorally. They might withdraw, they might want to be left alone. They might get into trouble more at home or at school and then we might also see that regression again. So we might see behaviors more common to younger children, like thumb sucking, bed wetting, fear of the dark, that type of thing.
And then of course our teens will show these symptoms very differently. They might be either talking about the trauma constantly or, kind of flip side of that, denying that it happened, they’re really avoiding it, avoiding having to think about it. They might be refusing to follow rules or talking back frequently, changes in their sleep or their appetite, nightmares, we might see risky behaviors like substance use or risky sexual behaviors. We might see not wanting to spend time with friends or isolating kind of more of that depression, anxiety stuff coming up. So, you know, based on age group, it manifests differently, but I think across the board we see trauma kind of in behavior and emotions, and in kind of physiological responses.
[00:08:28] Cindy Lopez:
Thank you for tuning in! Just a note, before we continue on with today’s episode, we hope you’re following us on social media, so you don’t need to wait a whole week between episodes to get engaging, inspiring and educational content from CHC. Our social handles are linked on our podcast webpage at podcasts.chconline.org.
It’s probably also important to note that a lot of kids in foster care have experienced trauma and so a lot of times when we talk about trauma informed parenting it might be related to foster parenting as well, is that accurate Dr. Khosravi?
[00:09:11] Dr. Pardis Khosravi:
Yes, often with foster kids or kids who were put into the adoption system, there is traumatic events that they’ve experienced that led to the initial removal from their home and removal from their home and their biological parents is a trauma in and of itself as well. And so they are often coming in with multiple traumas.
[00:09:34] Cindy Lopez:
So Dr. Khosravi, how can parents help their children then? Do you have some thoughts about specific strategies or tools that they can use to support their children through this traumatic experience?
[00:09:42] Dr. Pardis Khosravi:
So I think one of the most important things is to be emotionally and physically available. Often traumatized children will act in ways that try to keep adults at a distance, whether they mean to or not. And so I think as adults providing that attention, that comfort, that encouragement in ways that your child will accept. So younger children might want extra hugs or cuddling, you know teens often that’s not what they’re going to go for, but they might want to spend time with their family. And so following their lead, being patient, but really making an effort to be present and to connect, right so that one-on-one interaction between child and parent is really important.
With younger children we often recommend parents set aside about 15 minutes a day, nothing super long, put phones and electronic devices away and just interact one-on-one with your child. So whether that’s playing a game, or doing some cooking together or something else. Letting the child direct, letting them tell you what they want to do, but doing something one-on-one where they get your full attention during that time, that connection is really important.
With teens, same idea, it just might look a little bit different. Setting aside that one-on-one time to connect, maybe it’s, you know, we’re going to go on a Starbucks run or something, is really important. It helps kids feel connected and feel safe. And I think in line with that, listening, when we’re connecting with our kids, don’t avoid those difficult topics or uncomfortable conversations, don’t push it either. When they’re open to talking about it or when they bring it up, not avoiding it. Letting them know that we are here to listen and it’s really important for parents to understand how their child views the situation, and views what happened. So we’re not lecturing, we’re not telling them what to think, we’re just acknowledging and validating their feelings. So even if they’re worried about something and we think like, oh, that’s kind of a silly worry, taking their reaction seriously.
Correcting any misinformation they might have about the traumatic event. Oftentimes kids will internalize blame, so something bad happens and they say, oh, it’s my fault, and so validating that feeling, like, oh, that must really be hard that you think that it’s your fault, but reassuring them that what happened was not their fault. So we can correct misinformation while still being validating. And it’s important to do that because otherwise they might walk away from that conversation thinking, oh, it must be my fault because I said that and mom didn’t correct me.
Children look to adults for reassurance often after traumatic events. And so not discussing our own anxieties with our children or in front of them, or when they’re around. Keeping those conversations private, and being really calm and reassuring around them, being aware of the tone of our voice. Children pick up on anxiety really quickly, and our reactions might trigger them, when they’re already feeling overwhelmed.
Some other strategies are helping our child learn how to relax, their physiological response to stress gets over-activated often after a trauma. And so teaching them how to practice that slow breathing, calming their bodies, listening to calming music, using positive self-talk, telling themselves like I’m safe now or things are okay now or whatever makes sense for them and modeling that too. If we’re going to practice that slow breathing, let’s do it together. Being consistent and predictable. Routines and structure are helpful for all children especially those who may have experienced chaotic environments before or just unpredictable environments, having a regular routine for meals for playtime, for bedtime. Preparing them in advance if there’s going to be a change in routine. Allowing some control, empowering our kids. Often in traumatic events, they feel helpless and they feel like their control has been taken away and so helping them regain that sense of control in age appropriate ways, so we often talk about giving kids choices where you truly can give them a choice. So it might be with a younger kid you’re in the car, and you might ask like do you want to listen to music or do you want to have it be quiet, because both things are okay with the adult in that situation. We don’t give them a choice if there isn’t really a choice to be had. Or what shoes do you want to put on the black ones or your sneakers, if those are both appropriate options for whatever they’re going to.
With teens, we can do the same thing. We want to stay age appropriate with teens. The choices might be what do you want for lunch today and then give them two appropriate choices.
The last thing I’ll mention is identifying trauma triggers can be really important. So if you noticed a pattern of behavior where your child overreacts, there’s a big behavior or big reaction, emotional reaction that doesn’t seem to fit the situation that’s always a good place to kind of stop and notice and maybe ask your child when they’re calmer later because often when we see those reactions that don’t fit there’s a trigger that reminds them of the trauma, that might be something totally benign and innocuous that just happens to trigger a traumatic memory. So sometimes kids will associate a certain place or a certain smell or a certain phrase or sound or something with the traumatic event. And those might all be things that naturally occur in our everyday environments and the trigger itself is not the problem, it’s that it reminds them of the traumatic memory and so identifying those things, and then intervene, use some of those calming strategies with my child in that moment to help them get through the moment.
[00:15:14] Cindy Lopez:
So when is it important to seek treatment and then does the child’s response to that traumatic experience, does that ever go away, how does that work?
[00:15:25] Dr. Pardis Khosravi:
Yeah, that’s such a great question. I hear that from parents all the time. Will, my child always be affected by this, I think when symptoms are getting worse instead of better, or if symptoms are sticking around for several weeks with no improvement, or if the symptoms are so severe that they’re interfering with the child’s functioning at home or at school, or really severely disrupting family life, or if they’re hurting themselves or others, those are times to seek treatment absolutely. There are definitely times where kids experienced traumatic events and they don’t show a lot of these symptoms, not that it doesn’t impact them, not that it’s not stressful, but kids are very resilient. And so they may not go on to develop symptoms of depression or anxiety or PTSD. And so in those situations I think well treatment never hurts and it’s certainly always helpful, I don’t think it’s as imperative to seek treatment, but I think when the symptoms are really interfering with functioning or if they’re getting worse or they’re not going away, those are really important times to seek treatment.
And I always recommend to parents that they ask some questions of their mental health provider before starting treatment, if the provider has experience working with trauma in children, ask about their experience. And I would also encourage parents to ask the provider, how does the child’s trauma history influence your treatment approach. And really assess and make sure that the provider is a good fit and that your child has a good relationship with a provider before they dive into that work.
And then to answer your second question, I think a traumatic event will always be with them, it’s something that they experienced, but the effects of it will not be with them forever. If they learn the tools and strategies, if they seek treatment and successfully complete treatment, I think we see a lot of kids go on to develop an incredible amount of resilience. And they come out with resilience, they come out having grown as an individual, but I think the experience will always be part of their life story.
[00:7:24] Cindy Lopez:
If there were one thing that you hope our listeners to take away from this episode, what would that be?
[00:17:29] Dr. Pardis Khosravi:
Children are resilient. Children are amazing in their ability to bounce back from difficult things. And so, I want all parents to know that if their child has experienced a traumatic event or a stressful event and they are struggling, there’s hope, and there’s support out there. And so, I encourage parents to reach out to organizations like CHC and all the others in our community, consult with a professional, if you’re not sure. Having a child who’s experienced a traumatic event is stressful for the parent as well and so getting the services for your child and yourself, goes a long way towards getting to that, other side of the hill, right and getting to that place of resilience and growth. And so just remembering that our children are resilient, they will bounce back, and that you’re not alone and there’s a lot of support out there.
[00:18:18] Cindy Lopez:
Thank you so much. There are resources and support for you at CHC So you can look us up at chconline.org. As Dr. Khosravi mentioned, we do have free 30-minute parent consultations. So you can talk to a clinician and talk about your concerns and get some guidance regarding next steps. Also you can make an appointment online to see a provider and find out how you can connect with a professional who can help you in this situation. So, thank you so much to our listeners for joining us today and for listening in, and we hope that you’ll join us next week for our newest podcast episode as well. And thank you again, Dr. Khosravi for your time.
[00:19:08] Dr. Pardis Khosravi:
Absolutely. Thanks for having me, Cindy.
[00:19:11] Cindy Lopez:
Find us online at podcasts.chconline.org. Also, please follow us on our socials. Find us on Facebook at chc.paloalto and Twitter and Instagram at CHC_paloalto. You can also visit our YouTube channel at chconlinepaloalto. And we are on LinkedIn. Subscribe to Voices of Compassion on Apple podcasts, Spotify and other podcast apps, and sign up for a virtual village email list so you never miss an update or an episode. I always love to hear from you so send me an email or a voice memo at podcasts@chconline.org or leave us a rating and review. We look forward to you tuning in each week. After all we are in this together. See you next week.
