Walking Wounded: Children in Pain
How do you recognize the signs that a child is covering up a trauma, crisis, or hurt?
Come with me, I’m fading underneath the lights.
Come with me, Come with me, Come with me now…
Can’t you see the signs? — Creed, “Signs”
Kids today are complex. They grow up faster than we imagine, and they face issues that were nonexistent — or at least more hidden — when we were children. And as children’s ministers, we often find ourselves trying to interpret what kids are really going through based on the signals they’re sending. Is Sarah struggling to make friends? Has Keisha’s father come home? Is Mark being held back in school this year? Is Vickie prepared for her family’s move? Is it possible that Peyton is being abused at home?
Traversing a child’s inner world requires attention, compassion, intuition, and common sense. It’s a minefield-laden world we live in, and unfortunately, children are all too often the casualties. Part of our role as children’s ministers is to support families as they safeguard kids’ overall well-being — and there are many instances in which that well-being is threatened, ranging from abuse to self-confidence issues. How do we recognize the signs that a child is covering up a trauma, crisis, or hurt?
We asked three experts for their advice. Pulitzer Prize-winning author and researcher Robert Coles, Christian clinical psychologist Dr. Gary Hackney, and Christian counselor Steve Rossi offer their insight into kids’ secret worlds.
Proceed with Caution
If we see kids for only one or two hours per week, is it really possible to assess whether a child is living through trauma or crisis? The answer is complex. The experts say yes — adults with limited contact with kids are often able to spot trouble through behavioral indicators and other signals kids send. But in the same instances, adults may misinterpret or miss these signs, so it’s necessary to proceed carefully. The best rule of thumb is to observe and interact with the child over a period of time — that way you can distinguish between a child who’s acting out because he didn’t get enough sleep the night before and one who’s dealing with internal trauma or stress. Use these observation tools.
- Communicate — “Talk to the child,” says Coles, author of over 50 books, including The Moral Intelligence of Children (Random House). “There’s nothing like a good conversation. I wouldn’t advise getting into a lot of psychological gobbledygook…You see a child who’s ailing or hurting, you try to figure out what it’s about.” Coles also suggests checking with the parents or with other teachers and adults who know the child to gain clearer understanding. It’s also important to do a bit of self-assessment when you’re preparing to talk with a child. “Find out what it is about the child’s behavior that’s bothering you,” says Coles. “[Then] ask the child directly. Tell the child what’s on your mind in a friendly and direct way.”
- Monitor — When a child’s behavior or appearance seems out of the ordinary, it’s important to monitor the change and try to assess how dramatic it is. A strong signal that a child is hurting comes in the form of an abrupt change that takes hold; for example, a child who’s normally outgoing and happy suddenly becomes withdrawn or cries inexplicably. “Any significant change in [a child's] behavior,” says Rossi, can be a signal of something amiss. “But it’s got to be particular to that child. And every child is different,” he adds.
See the Signs
There are common indicators that a child is experiencing trauma of some kind. The key is to remember that what’s normal in one child may not be in another — so look for a consistent change in that particular child’s behavior. Here are signals that may indicate something is wrong.
- Regression — Children (infants included) regress to earlier developmental stages when trauma occurs. Behaviors such as thumb sucking and soiling clothes may reappear.
- Exaggerated Fears — “Fears come back that belong to a younger age,” says Rossi. For example, it’s not age-appropriate for a 10-year-old to suddenly fear loud noises.
- Anxiety — Kids have startle reactions that are exaggerated and seem out of place. For example, a child might overreact to a distant ambulance siren.
- Emotional Insecurity — Clinging, crying, and difficulty separating from parents may signal that something’s amiss. Conversely, so may a reluctance to return to parents.
- Withdrawal — This is more than shyness, so look for signs of children who were once social now pulling away from others. The child may “zone out,” seem distracted, or be detached.
- Extreme Emotions — Children may cover up a deeper issue with irritability, belligerence, or excitability. The child may be overly aggressive or overly withdrawn. The child may cry for seemingly no reason.
- Listlessness — The things that used to make the child happy no longer do.
- Physical Complaints — A child frequently complains of a stomachache or headache, but there are no other signs of illness, such as fever, vomiting, or diarrhea. On the other hand, you may observe bruises, injuries, and other signs of physical abuse.
- Verbalized Complaints — Older kids express fear, a sense of doom, nervousness, and unhappiness.
- Change in Habits — The child may not sleep or eat the same as before. Also, a child may neglect his appearance and seem to be disheveled or have poor hygiene.
- Acting Out in a Sexually Inappropriate Manner — Hackney gives the example of a kindergarten-age girl who insisted on rolling on top of boys in her class during nap time and trying to kiss them.
Kids seem to have a natural instinct to “cover up” when something is wrong — so often their behavior becomes very exaggerated or completely reverses as they try to overcompensate for their feelings. Kids hope that no one will notice for a lot of reasons — they fear the consequences of discovery, they worry about being different, they resist the unwanted attention, and the list goes on. But if you notice a child’s behavior change dramatically and consistently, your antenna should go up, says Christian clinical psychologist Hackney. Watch the child and take note of his or her behavior over a period of time. Talk to the child, talk to adults who know the child, and talk to the parents. “If [a child is] very nervous, very upset, then you get the hair twiddlers, the nail chewers, the constant pickers. There’s something going on in [the child's] life to cause this to happen…It’s really hard when you see kids only a couple hours per week. What you want to do is look at change. Behavior change is always motivated by something,” says Hackney.
If you suspect or know that a child is experiencing a crisis or trauma, the experts offer these tips for assisting the child.
- Talk. Don’t be afraid to talk about the problem with the child and parents if it’s been established that there is a problem. Often, “we dance around the issue.” says Rossi. “Talk about it.”
- Treat it seriously. “This child is suffering,” says Rossi. “By connecting with that suffering…we’re less likely to say or do something that is going to worsen that situation. The worst thing we can do is be insensitive or do nothing.”
- Take action. “Out of fear, adults will do nothing. Out of fear of litigation, people will back away from doing something that could help,” Rossi says. “Being too tough, being too rough, not responding, saying ‘you’ll get over it,’ saying ‘time will heal’ — these are the worst things we can do. Often adults don’t want to deal with it when they notice changed behavior.”
- Don’t be clinical; be human. “Sometimes we’re so busy imposing our knowledge on these poor kids…,” says Coles, “that they get lost in the midst of that kind of imposition of thinking and analysis.”
- Don’t label or diagnose. “Most people are not qualified to diagnose,” says Rossi. People who aren’t mental health experts simply don’t have the knowledge or expertise to diagnose a child. As children’s ministers, our role is to be alert to problems, support the child, facilitate getting the child or family help, and in cases of abuse or neglect, notify authorities according to your ministry’s protocol.
- Use your head…and your heart. “Common sense is not to be dismissed. That’s a very important part of our humanity…reaching out to children mind, heart, and soul,” says Coles.
- Be objective. Don’t let your emotions take over.
- Get in touch with the child. “One of the things that adults do is they try to look at a child through adults’ eyes,” says Rossi. This won’t work; remember what it was like to be a child and then approach the child with those sensitivities in mind.
- Don’t underestimate the child’s suffering. Hackney’s work has been primarily with victims of abuse — ranging in ages from 18 months to 87 years of age — and he says that people deal with trauma’s ramifications all their lives. He says, “Abuse or neglect may not meet legal standards, but it is still traumatic to a child.”
- Don’t underestimate your ability to connect with the child. “Let us not underestimate our own possibilities and our own humanity in the form of our willingness and eagerness to be of assistance to children,” says Coles. Work in Progress Experts are optimistic about kids’ resiliency — especially those in a church community and those who experience the love and concern of caring adults. “Children who are churched seem to fare a whole lot better” when it comes to overcoming trauma, says Rossi. The church provides a caring community, support system, and belief system that unchurched kids typically don’t have. “If God is the healing agent — talk about resiliency, talk about power and healing,” says Rossi.
Coles emphasizes the importance of making a human connection with a hurting child. “Try to draw the child out, not be analytical and point out behaviors. Be human, responsive, caring, and interested. Have a conversation, play a game, find a way to connect without creating an analytical moment. Share a glass of milk or an ice cream cone,” he says. To connect with a child, approach him or her in a calm, safety-oriented, soothing, non-threatening way.
Kids needs a soft and understanding approach that helps them relax and feel safe. Talk about feelings. Adults can draw kids out by expressing their own feelings, then asking the child for his or her opinion. This allows a child to get a sense of safety about sharing his or her feelings. “The bottom line is reassurance,” says Rossi. Coles says, “We are human beings who can be hurt, also who can be healed by time and new experiences and people with whom we connect.”
He’s optimistic about a child’s ability to heal, regardless of the trauma suffered, and he cautions against our adult tendency to limit children. “[We can't] be too fatalistic and almost categorize the child as…a child who’s been hurt, [as though] he’ll never get out of that because we’ve imposed an airtight label on him.” Ultimately we serve God, and we serve children. As their supporters, friends, teachers, and caregivers, we’re often faced with difficult situations. While we can’t heal every hurt, or diagnose or prevent every problem, we can focus on serving children when they’re in need. We can be there for children as the great I AM is there for us.
We can be present as God continues to be present for us. “We keep our eyes and ears open for pain and hurt,” says Coles. “Those pains and hurts are expressed by children sometimes indirectly, but we’re human beings, we know these children…It’s our responsibility and our opportunity as adults to learn from children, to respond to their cries of distress, and to let those cries of distress fall upon our eyes and ears, our hearts and our minds and souls in such a way that we reach out and say, ‘Yes, here I am.'”
Counseling Basics for the Novice
If you find yourself faced with a child who’s hurting — and you’re uncertain of how to proceed — use these counseling basics to connect with and support the child.
- Actively listen. Stop what you’re doing and really listen to what the child is saying. This means even repeating back what the child has said to you — for instance: “What you’re saying is you feel uncomfortable when other kids tease you about your scar.”
- Emphasize safety. By creating a safe environment for kids, they won’t resist confiding in you. Let them know that you’ll never judge them or make fun of them for anything they say or do.
- Be empathetic. By definition, this means to vicariously experience another person’s situation. Try to put yourself in the child’s shoes and imagine what he or she is feeling — then treat the child how you would want to be treated. Don’t be in a hurry to solve the problem; sometimes the child only needs to talk.
- Don’t promise to keep a secret. While confidentiality is highly important and kids need to know they can trust you, the simple fact is some secrets absolutely cannot be kept. Let the child know you’ll respect his or her wishes for secrecy as much as you’re able, but that for his or her protection, you may need to let another adult know what’s happening.
- Get help. If a child’s situation requires intervention of any kind, follow your ministry’s protocol and get help. This will most likely begin with notifying your children’s ministry director or senior pastor.
Jennifer Hooks is associate editor of Children’s Ministry magazine.