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Getting Ready For Summer Vacation

By Madeleine Shenher

Summer is upon us, and your little (or not-so-little) ones are at home for two months. This school year asked a lot of our children; students were expected to be masked up, pivot between in-person and online learning, spend most of their day within one room. At the same time, they were no longer participating in sports, seeing friends or family on the weekends, and so much more. Globally, we saw a rise in mental health concerns, with many individuals, children included, experiencing anxiety and depression as the impact of isolation began settling in.

After a year of many uncertainties, both you and your child may be looking forward to some reprieve this summer as restrictions begin to loosen and we move closer to that “normal” we once knew. However, managing that transition from being at school to being at home can be tricky, so we have put together some suggestions to help breeze into summer holidays!

Build a Routine

Students get so used to following the same routine each day: get up, get ready, get on the bus. They arrive at school, which is planned out for them and follows a set schedule. Then they get home, some free time, have dinner, and go to bed (give or take a few other activities). Once summer rolls around and routines loosen up, parents can see a change in behaviour as bedtimes become more flexible and their free time increases. Creating a predictable routine with your child (or children) can help set some expectations and create consistency in their day, which helps foster a sense of security. If, for whatever reason, a set routine needs to change, let your child know in advance to help them prepare for this change as well. 

Manage Screen Time

Students have spent much more time on screens this year due to increased online and hybrid learning in schools. What once was done with paper and pencil is now uploaded and typed on Google Classroom. While having a break from screens can be a complex boundary to set, studies have shown that increased screen time can be associated with anxiety, sleep troubles, and inactivity. The Canadian Pediatric Society recommends 1 hour of screen time for children ages 2 – 5 and no more than two for children over five years of age. Modeling healthy use of technology (for example, keeping dinner a “screen-free” zone for children and adults) can go a long way too. 

Get Active!

It is no secret that COVID has impacted our physical activity levels; with recreation facilities closed and sports cancelled, children also have seen a reduction in opportunities to be active. The Canadian 24-Hour Movement Guidelines for Children and Youth recommends around 60 minutes of moderate to vigorous activity each day for ages 5 – 17. Get creative! This can look different for every child – maybe bike rides, swimming, or soccer are your child’s jam. Encouraging your child to find an activity they enjoy can help create lifelong exercise habits. 

Reconnect With Loved Ones

This one is pretty straightforward. The neighbours down the street you have lost touch with, the cousins on the other side of town that you haven’t seen as often, the grandparents you wanted to keep healthy. Humans are wired for connection, both young and old! Try to make some time this summer to reconnect and build new relationships with those around you. 

References

Carrington, J. (2020). Kids These Days: A game plan for (re)connecting with those we teach, lead, & love. Impress, LP. 

Centers for Disease Control and Prevention. (2019). Building Structure. Retrieved from: https://www.cdc.gov/parents/essentials/structure/building.html

Domingues‐Montanari, S. (2017). Clinical and psychological effects of excessive screen time on children. Journal of Paediatrics and Child Health, 53(4), 333-338.

Imran, N., Zeshan, M., & Pervaiz, Z. (2020). Mental health considerations for children & adolescents in COVID-19 Pandemic. Pakistan Journal of Medical Sciences, 36(COVID19-S4), S67.

Ponti, M., Belanger, S., Grimes, R., Heard, J., Johnson, M., Moreau, E., … & Williams, R. (2017). Screen time and young children: promote health and development in a digital world. Paediatrics & Child Health, 22(8), 469-477.

https://www.edmonton.ca/activities-parks-recreation

https://exploreedmonton.com

https://exploreedmonton.com/event-calendar

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What is Dissociation

Dissociation is being disconnected from the here and now. 

Daydreaming or mind-wandering are experiences of dissociation that can be normal. Dissociation can be a way of coping by avoiding negative thoughts or feelings related to memories of traumatic events. When people dissociate, they disconnect from their surroundings, stopping any trauma reminders and lower feelings of fear, anxiety, and shame. 

Dissociation can begin during the trauma or after the experience when thinking about the trauma or experiencing a trauma reminder. Dissociation that is connected to trauma memories is considered an avoidance coping strategy. 

Dissociation often occurs without planning or awareness; people who are dissociating are often not even aware that it is happening. Dissociation can interfere with school or other activities that require paying attention and being in the here and now. 

 Dissociation, as an avoidance coping strategy, happens because of feelings of powerlessness to do anything to change or stop the traumatic event. This may lead people’s psyche to trick itself into cutting off the harmful, unbearable, external elements of trauma and suppresses them in the unconscious to cope with feelings of helplessness, pain, and fear. When this dissociation occurs during the traumatic event, the individual is more likely to develop a pattern of dissociating as a coping strategy.

Responses to Stress, Distress, Trauma

  • No two people respond to stress the same way 
  • Can have adaptive or maladaptive responses/changes
  • Changes in cognition
  • Changes in affect
  • Changes in behaviour
  • Changes in neurophysiology
  • Changes in physiology

Healthy Dissociation Can Look Like:

  • “Vegging” (Mind-wandering)
  • Spacing out; daydreaming 
  • Reading 
  • Videogames (in moderation)
  • Film
  • Writing
  • Paint, sculpt, needlework, woodwork

Trauma-Triggered Dissociation Can Look Like… 

  • Glazed look; staring 
  • Mind going blank 
  • Sense of world not being real 
  • Watching self from outside 
  • Detachment from self or identity 
  • Out of body experience 
  • Disconnected from surroundings 
  • Nightmares, terrors

Identifying Triggers

It may be helpful to identify if anything seems to trigger dissociation. Parents and caregivers can document these common signs of dissociation: 

  • Amnesia for important or traumatic events known to have occurred, 
  • Frequent dazed or trance-like states, 
  • Perplexing forgetfulness (e.g., the child knows facts or skills one day and not the next), 
  • Rapid, profound age regression, 
  • Difficulties deriving cause-and-effect consequences from life experiences, 
  • Lying or denying responsibility for misbehavior despite obvious evidence to the contrary, 
  • Repeatedly referring to self in the third person, 
  • Unexplained injuries/recurrent self-injurious behavior
  • Vivid imaginary companionship that controls the child’s behavior (i.e., passive influence experiences), and 
  • Auditory and visual hallucinations. 

Grounding out of therapy (Child/youth or caregiver does) 

  • Have a grounding plan 
  • Notice dissociation 
  • Do physical or mental grounding activity 
  • Have a cognitive coping strategy phrase (“I know what this is”; I can handle it,” I’m fine.”) 
  • Have caregiver, friend, or teacher prompt for the use of grounding plan. Discuss this ahead of time. 
  • Balanced breathing (equal length inhales and equal length exhales)
  • Drumming music
  • Finger tap breathing: breath in 1-5, tapping one finger at a time. Breath out 6-10, tapping opposite hand one finger at a time. 
  • Take a water break 
  • Build a fort
  • Count the colours in the room 
  • Animal walks

More Information

http://www.nctsn.org/resources/audiences/parents-caregivers http://www.isst-d.org/default.asp?contentID=100

http://www.lianalowenstein.com/articlesParent.html

References

Choi, K. R., Seng, J. S., Briggs, E. C., Munro-Kramer, M. L., Graham-Bermann, S. A., Lee, R., & Ford, J. D. (2018). Dissociation and PTSD: What parents should know. Los Angeles, CA, and Durham, NC: National Center for Child Traumatic Stress. 

Gil, E. (2010). Working with children to heal interpersonal trauma: The power of play. The Guildford Press. New York, NY

Soosalu, G., & Oka, M. (2012). mBraining: Using your multiple brains to do cool stuff. mBIT International Pty Ltd. 

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Complex Trauma

What is Trauma?

Trauma is an event or series of recurring events that exposes an individual to an actual, perceived, or threatened disruption of felt safety in a person’s life. This may occur through many aspects of their life like physical, emotional, mental, and spiritual wellbeing. There are many categories of trauma; however, the thread through each category is that an outside observer is not able to define something as traumatic for another person; as it is that individual’s experience of an actual, perceived, or threatened disruption of felt safety. What will be traumatic for individual A will not be for individual B. This becomes even more true when we consider what children experience as traumatic in comparison to adults.

For example, if a tiger was to come into the room you are in now, you would have a fear response. If you were not able to get to safety quickly, this would be experienced as a trauma. A toddler who sees a tiger comes into a room would not know to be afraid if there were no adults in that room scared; therefore, this would not be a traumatic experience for the toddler. In reverse, if a toddler’s primary attachment figure leaves with no notice, warning, or alternative attachment figure, the toddler would become panicked, stressed, and experience this as a traumatic event. If your primary (adult) attachment figure were to leave with no notice, warning, or alternative attachment figure, you might be angry, worried, or annoyed, but likely this would not be a traumatic event for you. 

Complex trauma (sometimes referred to as Developmental Trauma) describes both exposures to multiple traumatic events and the long-term effects of this exposure. These events are often severe and penetrating, such as physical, sexual, or emotional abuse and/or profound neglect. These events typically take place early in life and often disrupt the child’s development and the formation of a sense of self. Complex traumatic events often occur with a caregiver, and as a result, they interfere with the child’s ability to form secure attachments.  This primary source of safety and stability impacts many areas of a child’s healthy physical and mental development.

What are the effects of Complex Trauma?

Traumatic childhood experiences have a profound impact on many different areas of functioning in the child’s life. Children who grow up in homes that have not consistently provided safety, comfort, and protection develop ‘hacks’ to help them survive and function day to day. Children may become hyper-sensitive to the emotions, moods, and behaviours of others, always watching to determine what the adults around them are feeling in order to predict how they may behave. They may mask their own emotions, needs, and thoughts from others, never feeling safe or able to reach out for support or help. 

Complex trauma has major impacts on the child’s attachment structure as well. Through healthy relationships with attachment figures, children learn how to trust others, regulate their emotions, thoughts, and behaviours, and interact with the world; they develop a sense of the safety or lack thereof, in the world and develop understanding around their own value/worth as a person. When these attachment relationships are unstable or unpredictable, children extrapolate and believe they cannot trust others to help them. When a primary caregiver exploits and/or abuses a child, the child learns that they and the world are bad.

When a child has been exposed to complex traumatic events, their brain and body develop to be more vulnerable to stress. These children frequently struggle with body dysregulation; as a result, they may over-respond or under-respond to sensory stimuli. For example, they may be hypersensitive to sounds, smells, touch, or light. They often have trouble controlling and expressing emotions and may react violently or inappropriately to situations. A child with a complex trauma history may develop to have challenges in their future romantic relationships, in their relationships with peers, and with authority figures. Children who have experienced complex trauma also often have difficulty identifying, expressing, and managing emotions and may have a limited vocabulary for feeling states. Their emotional responses may be unpredictable or explosive and are often either internalized onto themselves or externalized onto others.

Trauma Reminders

A child may respond to a reminder of a traumatic event with the same or similar physiological responses they displayed in the original event, trembling, anger, sadness, or avoidance. With a complex trauma history, reminders of various traumatic events are often everywhere in the environment and in relationships. As a result, a child may react often, react powerfully, and have difficulty calming down when upset. As a result of the interpersonal nature of complex trauma, even mildly stressful interactions with others may serve as powerful trauma reminders and trigger intense trauma responses.  Children are often hyper-vigilant and on-guarded in their interactions with others and are more likely to perceive situations as stressful or dangerous, having learned from an early age that the world is a dangerous place where even loved ones can’t be trusted. For those children who do not respond in this manner, they may have learned to “tune out” (emotional numbing/dissociation) to threats in their environment, making them vulnerable to revictimization.

Dissociation is a common trauma response. As a result, it has its own information sheet. 

Trauma Symptoms

Every child will have a unique experience and presentation of trauma symptoms. The following are some examples of possible trauma symptoms that children may showcase. 

•           Upsetting thoughts or images about the event popping into the child’s mind without the ability to stop or control them.

•           Having bad dreams or nightmares.

•           Acting or feeling as if the event was happening again.

•           Feeling upset when thinking about or hearing about the event. 

•           Having physiological responses in their body when they think about or hear about the event.

•           Trying to avoid thinking, talking, or feeling about the event. 

•           Trying to avoid activities, people, or places that are reminders of the event.

•           Not being able to remember an important part of the upsetting event. 

•           Having much less interest or doing things the child used to like doing. 

•           Not feeling connected to the people around the child. 

•           Not being able to have strong feelings. 

•           Feelings as if future plans, hopes will not come true. 

•           Difficulty falling or staying asleep.

•           Feeling irritable or having fits of anger. 

•           Having trouble concentrating. 

•           Being overly careful. 

•           Being jumpy or easily startled. 

Risk and Protective Factors

Some factors help lessen the effects of the severity of the traumas that have occurred. Some of these may include: 

•           Type of event and event severity. Was someone or the child injured that they had to go to the hospital? Did someone die? Were they taken or separated from their caregivers? Were they interviewed or questioned by police, social workers, or other professionals? Was it a one-time event or was it multiple happening over a period of time?

•           How close was the child to the event that occurred? Did it happen to them? Did they witness it? Did they hear it behind closed doors? Were they physically there at the time the events occurred? Did they hear someone talking about it? Did they watch it on TV or see it on social media?

•           How the caregiver reacted to the event. Did they show big emotions? Did they believe the child? Did they meet the emotional, social, mental, and physical needs of the child? Did they get help for the whole family?

•           Trauma history. Is there a history of traumatic events in the child’s life? Has this occurred before? How long has this been happening? The more events that occur increases the chances of traumatic symptoms being present.

•           Culture and community support. Did the community and family come together to support the child? Were there cultural events that helped support healing?  Race and ethnicity play a role as well, both positive and negative. 

Resources

Child Trauma Academy

https://www.childtrauma.org

The Diagnostic Criteria from the DSM-5

The National Child Traumatic Stress Network. About child trauma 

https://www.nctsn.org/what-is-child-trauma/trauma-types/complex-trauma

Understanding and helping traumatized children and their caregivers https://kimsgolding.co.uk

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Free Webinar: How to support your children through the COVID-19 crisis.

One Tree Psychological and Therapeutic Services is happy to announce that we will be hosting a free webinar on Monday March 30th at 2:00pm. This webinar will address the challenges of parenting experienced in the current circumstance of COVID-19. 

Within this webinar, Danyelle Lynch will explore the importance of parents’ relationships with their children and how these relationships can help act as protective factors against the stress and anxiety our children are currently facing. We will also explore how we can focus on building our connections with our children in ways that are realistic, and the importance of searching for “pockets” of play to engage our children in. Parents will walk away with tips and strategies on how to help themselves and their children cope with the fear and anxiety surrounding COVID-19. 

To register for this free webinar, please email danyellelynch@onetreepsychological.ca

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Virtual Play Therapy Now Available

Hello.

In such uncertain times I wanted to take some time to reach out and to introduce myself and share a new play therapy options; I am Danyelle Lynch, Registered Psychologist and director of One Tree Psychological and Therapeutic Services.

The One Tree team and I have been collaborating and brainstorming different ideas and tools to ensure that children, youth, and families are still able to receive supports during these chaotic times; and I think that we have come up with a unique and creative way for children and youth, who typically rely on play in therapy, to still access emotional supports. 

A tool that we often utilize in play therapy is therapeutic storytelling and role playing. We have come with a way to use these same skills to creatively engage children and youth using virtual therapy. In order for children and youth to engage in this virtual therapy, all that is required is a tablet or computer connected to the internet, some paper, drawing and colouring tools, and a 6-sided die (if possible). 

This therapeutic tool can be used to build self-esteem, increase emotional regulation and emotional tolerance, increase problem solving and conflict resolution skills, and increase flexibility in thinking. 

The role of the therapist is to create a world, characters, and scenarios that are 100% catered towards the therapeutic goals of the child or youth, as well as to support the ‘player’ to overcome the hardships in the story and experience success. 

If there is enough interest, we will look at scheduling group sessions for children and youth to increase the therapeutic benefit to include increasing social skills, collaboration, cooperation, and compromising skills. These groups would be created based around age and need. 

Please reach out through facebook or email danyellelynch@onetreepsychological.ca if you are interested in either individual or group virtual sessions. 

We will continue to collaborate as a team in order to find more creative ways to serve and support you and your families! 

Take care,

Danyelle