Children Who Witness Violence
It was 1991. In my office, Terry's mom was concerned.
Shortly after his 4th birthday party, he had developed a host of baffling new symptoms and behaviors: he cried to stay home instead of going to his previously beloved child care, he had nightmares and insisted on sleeping with his parents, he complained of stomachaches, he was aggressive towards other kids, he overate compulsively, and he threw major league tantrums with little provocation.
"Hmm..." I said. (Easily stumped, I say 'hmm...' a lot). His physical exam was OK. I could find no apparent medical cause.
"What about stress?" I asked his mom. "Anything going on that could be upsetting him?"
"Not really," she replied. "Everything is pretty much the same at home and at day care."
"Hmm..." I mused sagely, and probed no further. "I'm not sure what is going on. I think he's OK, however. Let's just see how it goes."
What a privilege it has been for me to watch this program flourish and help so many kids! How lucky am I to have been schooled by Betsy and her wonderful group of clinicians to recognize and ask (as I did not, much to my shame, in 1996) about children's experiences with witnessing violence.
And for those of you out there experiencing relationship violence, know that your child definitely is aware of and responding to what is going on. Know that healing can occur for both you and your little one. The only shame is in not asking for help, not just for your sake, but for the little silent victim cowering in the corner.
Of course, I've just scratched the surface of this issue.
For more info, read Betsy's book:
Related Topics: Technorati Tags: pediatrics, domestic violence, post traumatic stress disorder, PTSD, health and wellness
Shortly after his 4th birthday party, he had developed a host of baffling new symptoms and behaviors: he cried to stay home instead of going to his previously beloved child care, he had nightmares and insisted on sleeping with his parents, he complained of stomachaches, he was aggressive towards other kids, he overate compulsively, and he threw major league tantrums with little provocation.
"Hmm..." I said. (Easily stumped, I say 'hmm...' a lot). His physical exam was OK. I could find no apparent medical cause.
"What about stress?" I asked his mom. "Anything going on that could be upsetting him?"
"Not really," she replied. "Everything is pretty much the same at home and at day care."
"Hmm..." I mused sagely, and probed no further. "I'm not sure what is going on. I think he's OK, however. Let's just see how it goes."
I didn't see Terry's mom for another year, at which time she disclosed that she and her husband were estranged. "We weren't getting along for a long time and our relationship got really bad. We were fighting all the time and it could get pretty nasty."
"Hmm..." the light slowly dawning. "Do you think that could have been what has been stressing out Terry all this time?"
"No way," she said emphatically. "He's always been asleep or in another room during our worst fights. I don't think he's at all aware of how bad things have gotten. After all, he's just a baby."
"Hmm..." the light slowly dawning. "Do you think that could have been what has been stressing out Terry all this time?"
"No way," she said emphatically. "He's always been asleep or in another room during our worst fights. I don't think he's at all aware of how bad things have gotten. After all, he's just a baby."
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Fifteen years ago, a social worker named Betsy Groves was working in an inner-city Boston health clinic. She took note of the increasing numbers of kids coming in with complaints much like Terry's. It took a while, but one day Betsy had a revelation: many of these young kids had witnessed violence - usually domestic, occasionally in the community. Contrary to the common wisdom that little ones couldn't show a post-traumatic stress response to such experiences, she was convinced that was exactly what she was seeing.
At the time it was a revolutionary notion. In retrospect it seems obvious. Of course witnessing violence, especially to your mother, is a major stressor for a child of any age. Of course children, in their own developmentally consistent way, would demonstrate all kinds of "post-traumatic stress" symptoms - physical, emotional, behavioral - following such an episode. Of course we adults didn't want to believe that these innocent creatures were affected by the chaos around them (much like when we in the medical profession used to say that infants could not feel pain).
Because they bore no physical scars and because we clinicians were largely unaware of their existence, Betsy dubbed these kids "silent victims."
At the time it was a revolutionary notion. In retrospect it seems obvious. Of course witnessing violence, especially to your mother, is a major stressor for a child of any age. Of course children, in their own developmentally consistent way, would demonstrate all kinds of "post-traumatic stress" symptoms - physical, emotional, behavioral - following such an episode. Of course we adults didn't want to believe that these innocent creatures were affected by the chaos around them (much like when we in the medical profession used to say that infants could not feel pain).
Because they bore no physical scars and because we clinicians were largely unaware of their existence, Betsy dubbed these kids "silent victims."
Next week, the Child Witness to Violence Project, which Betsy founded at Boston Medical Center, celebrates its 15th anniversary. This wonderful program offers parental counseling, child psychotherapy, and parent-child relationship support to help these young children heal before these traumatic experiences become engrained in their souls: so that the child doesn't come to identify with the aggressor and one day become violent herself; so that the parent can learn how to help their children feel safe and find shelter from the storm; so that the child can play out and express her fears and hopes.
**************************************
What a privilege it has been for me to watch this program flourish and help so many kids! How lucky am I to have been schooled by Betsy and her wonderful group of clinicians to recognize and ask (as I did not, much to my shame, in 1996) about children's experiences with witnessing violence.
And for those of you out there experiencing relationship violence, know that your child definitely is aware of and responding to what is going on. Know that healing can occur for both you and your little one. The only shame is in not asking for help, not just for your sake, but for the little silent victim cowering in the corner.
*************************************
Of course, I've just scratched the surface of this issue.
For more info, read Betsy's book:
Beacon Press: Boston, 2002.
or go to their website: www.childwitnesstoviolence.org
Related Topics: Technorati Tags: pediatrics, domestic violence, post traumatic stress disorder, PTSD, health and wellness
2 Comments:
Question: does this have to be physical violence? What about parents who just fight dirty, say, call each other names and say other terrible things? Seems to me that if they both fight that way, it's different from if one does and the other doesn't. Of course this site is about children's health, not marriage counseling, but I wonder what you think about the effects of, let's say, mismatched arguing styles on a child.
Any environment that contains abuse - be it physical or verbal/emotional can be damaging for children. Responses to "dirty fighting" may not be as extensive as the post-traumatic responses Dr. P. discusses, but they can be very severe nonetheless. The shared message of any such behavior - hitting or name-calling - is that the victim is worthless. Exposure to such messages from one or both parents can influence children have their own relationship problems in the future, among other emotional problems. You can find marriage counselors in your area through:
www.therapistlocator.net
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