According to one of the core concepts, traumatic experiences are inherently complex (NCTSN Core Curriculum on Childhood Trauma Task Force 2012). All the traumatic events usually involve varying traumatic experiences. In case of Amarika and her family, their traumatic experience was witnessing a life-threatening injury. Amarika’s mother, Makisha Lawrence, was shot in the presence of her daughter.
Such an event was traumatizing to the child (Amarika) since she actually witnessed the incident. She watched her mother fall on her back after the bullet hit her. Such traumatized children usually experience subjective reactions to such cases.
Lieberman and Knorr (2007) described shooting as one of the potential traumatic stressors for children, likely to cause negative outcomes since the children may not be able to cope with the negative influence of the situation (p. 416).
Amarika showed these reactions by having changed her behavior. She refused to eat and could not sleep. She was also a different person, when with her aunt, Latanya. She did not want to play with her and could not calm down even when her favourite show was on.
Harris, Lieberman and Marans (2007) argued that traumatic experiences that displayed unexpected danger affected the victim’s behaviour. Some of the changes in behavior may include becoming aggressive, emotionally withdrawn or showing attentional issues.
The experiences causing such changes may include witnessing to domestic and community violence (Harris, Lieberman, & Marans, 2007, p. 392). Amarika witnessed a case of community violence in which the victim of shooting was her own mother.
Similar to any traumatized child, Amarika considered possible protective actions as a result of her trauma. She could not stay away from her mother since she was scared of losing her.
However, this led to conflicts. Her mother did not like the fact that she followed her around everywhere, and this caused the feelings of fear in Amarika’s heart since she did not understand why her mother avoided her. Her mother’s reactions further aggravated Amarika’s traumatic event.
Understanding risk factors
Amarika’s trauma occurred within a context that included both the child-intrinsic and the child-extrinsic factors. Saxe, Ellis and Kaplow (2007) argued that different concepts should be considered in order to understand the child’s traumatic experience. In order to properly understand them, one needs to have an understanding of the child, his or her social life and the surrounding environment.
The child-extrinsic factors included her familial environment since Amarika’s grandmother always left her behind when she went to visit her daughter in the hospital. The risk associated with such traumatic experiences is the fact that they usually generate secondary adversities and may act as reminders to the child of such traumatizing moments (core concept).
Even after Amarika’s mother had been discharged, Amarika always wanted to accompany her wherever she went since her mother’s absence acted as a trauma reminder and affected her recovery. Amarika’s doll also acted as Makisha’s trauma reminder since it reminded her that she was not with her daughter at the time of the incident.
According to Saxe, Ellis and Kaplow (2007), a proper understanding of the various aspects that determine the traumatic experience is vital especially when treatment is under the consideration. Such knowledge may useful in developing intervention strategies that may be used by the victim’s family members in order to ensure that the individual effectively recovers.
According to another core concept, children usually exhibit varying reactions to trauma and loss. Amarika’s reactions varied in intensity, frequency and duration. For example, she could neither sleep nor eat. She only took milk. Lieberman and Knorr (2007) argued that traumatized children may show anxiety and be impulsive. They also usually have trouble sleeping. Mika’s mother observed that Amarika became used to fall on her back intentionally.
She could lie motionless and this puzzled Makisha. This particular type of posttraumatic reaction was influenced by the nature of her traumatic experience. When her mother was shot, she fell on her back and lay motionless. Imitation of that event was made in an attempt to understand what her mother felt when she had fallen on the ground after having been shot.
This was also her only way of communicating her concerns for her mother’s wellbeing. Lieberman and Knorr also argued that children engage in posttraumatic play (2007). They may perform a similar activity repetitively as a way of telling the story of what happened (Lieberman and Knorr 2007, 420).
Carla needed Amarika to communicate (non-verbally) what she had observed at the crime scene. For that reason, she brought toys for her to play with. Barrows (2004, p. 176) argued that ‘play therapy’ was one way of communicating with non-verbal children. It is also a way of maintaining emotional contact with the child.
Carla had a good understanding of this concept. Therefore, she keenly observed Amarika in order to establish a repetitive behaviour that may have related to the traumatic event.
Traumatic experiences affect not only the child but also the entire family and other caregivers (according to another core concept). Harris, Lieberman and Marans (2007) argued that traumatic experiences had a great negative influence on not only the child’s life but also on the lives of those around them (p. 392).
They proved that as those individuals (around them) were affected, their children’s health development was also compromised in the long run. In Amarika’s case, her grandmother was obviously affected. She feared mostly for her daughter’s safety. However, such a situation usually disrupts the interaction between the caregiver and the child. In this case, the grandmother seemed to be neglecting Amarika as she went to the hospital to visit Makisha.
She was so worried about her daughter that she did not realize what she was doing to her granddaughter. Therefore, her concerns impaired her ability to provide care. Consequently, that reduced sense of protection and security having caused Amarika to react negatively to Latanya and Mrs. Lawrence’s efforts to support her.
Amarika’s family needed to know how to provide care for her to ensure she could adjust to normal life. Carla explained to Mrs. Lawrence how her actions were affecting little Amarika. She knew that something bad had happened to her mother and instead of her grandmother attending to her, she was left alone. Her grandmother’s concern about the effects on her granddaughter helped in Amarika’s recovery from the traumatic experience.
Traumatic experiences may significantly affect development in children (core concept). Carla suspected that Amarika’s development had been influenced negatively by the accident. Particularly, she thought that Amarika’s ability to walk had been affected. Fortunately, Amarika was only trying to communicate something with actions.
According to another concept, culture may influence the traumatic experiences that a child and family go through. Amarika’s family is made up of African-Americans, and their neighbourhood is characterised by frequent violence. Amarika’s grandmother explained Carla the history of shootings in the neighbourhood.
She disclosed personal information and told that she had lost several close family members because of such violence. The fact that their neighbours were killing people who lived next to them made the whole family feel that they could not be safe in their own neighbourhood.
In her book, Child abuse and Culture: Working with diverse families, Fontes (2005) described how different cultures dictated how families viewed and understood child abuse and neglect. According to the author (2005), the case of child maltreatment is relative since it hugely varies within different cultures. She argued that culture influenced the way how people responded towards social, political and economic contexts.
Amarika’s family reacted towards the whole issue according to their cultural beliefs. The author also stated that different cultures dictated how one should have cared for or raised the children.
Makisha was seen yelling at Mika (Amarika) to make her stop throwing toys. She also threatened to spank her if she continued to throw them. Makisha’s culture may permit spanking as a part of disciplinary action. However, this may not be the same for the other cultures.
Challenges to the social contract usually influence how one responds to trauma and recovers from it (core concept). The negative outcomes are evidenced in cases when figures responsible for order in the society, such as police officers and judges, neither protect the citizens from harm nor ensure that justice is served. In the case of Amarika and her family, the local police officers did not do anything to help them cope with their situation.
This was also the case for the previous cases of violence that had resulted in the loss of family members, such as Gus. Mrs. Lawrence complained that the police did not do a thing to solve the issue. Instead, they asked if Gus had been involved in drug trafficking. Moreover, they did the same when it came to Makisha’s case.
They inquired whether she was in some gang. This made the grandmother feel as if the people who were meant to help bring solutions only made things worse.
Another risk involved in working with traumatized children is that it may arise stress in care providers and make it difficult for them to care for the victims effectively. For example, Carla had to assure Amarika that her mother loved her. In several occasions, Amarika’s mother neglected her daughter since she did not understand what she wanted.
She also denied her cookies claiming that Amarika had to understand that she could not always get whatever she wanted. Makisha was also not comfortable when Amarika followed her everywhere. However, this was negatively affecting the child since she had expectations of her mother’s social roles and responsibilities. According to Amarika, Makisha was not fulfilling them. Therefore, Carla had to strengthen the child’s belief in the social contract.
She had to convince Amarika that her mother understood that she had been scared of the accident happened and that she had been missing her too, while having been in the hospital. She also explained to her that her mother was not neglecting her, but only wanted some privacy at various occasions.
An understanding of protective factors
Danger and safety are major concerns in the lives of traumatized children (NCTSN Core Curriculum on Childhood Trauma Task Force 2012). What Amarika had experienced greatly undermined her sense of protection and safety. Watching her mother being shot and lying helplessly on the park grounds was very traumatizing to her, and this explains her abnormal behaviour thereafter.
The fact that she could not let her mother go away from her without showing concern shows that she was feeling insecure. Her mother had to learn how to make her child feel safe and understand that Amarika did not have to follow her everywhere.
In order to ensure her recovery from the traumatic experience, her mother had to reassure her that she had recovered from the injury and that the incident was not going to happen again. Makisha had to win over her trust in order to make her feel secure.
Protective and promotive factors are usually helpful in the reduction of the adverse impacts of trauma (core concept) (NCTSN Core Curriculum on Childhood Trauma Task Force 2012). Promotive factors played a major role when Amarika’s mother was in the hospital. Amarika had to be encouraged in order to ensure that she positively adjusted even as her mother was still in the hospital.
Promotive factors were introduced after the traumatic effects had occurred, and Carla played an important role in guiding Amarika’s mother and grandmother to discover a proper way of handling the situation.The protective and promotive factors were mainly the child-extrinsic factors. Amarika had a strong social support network that consisted of her mother, grandmother and aunt, Latanya.
Her family members cared for and supported her, and that shows that these factors were strong. A successful implementation of those factors, both before and after the traumatic experience, ensured that Amarika quickly recovered from the harmful effects of the particular traumatic experience. Play therapy also worked effectively since it ensured that Mika opened up and communicated about her concerns (Barrows, 2004).
References
Barrows, P. (2004). Playful therapy: Working with Autism and Trauma. Int Forum Psychoanal, 13(1), 175-186.
Fontes, L. (2005). Child abuse and culture: Working with diverse families. New York: The Guildford Press.
Harris, W., Lieberman, A., & Marans, S. (2007). In the best interest of society. Journal of Child Psychology and Psychiatry, 48(3), 392-411.
Lieberman, A., & Knorr, K. (2007). The impact of trauma: A developmental framework for infancy and early childhood. Psychiatric Annals, 37(6), 416-422.
NCTSN Core Curriculum on Childhood Trauma Task Force (2012). The 12 core concepts: Concepts for understanding traumatic stress responses in children and families. Core Curriculum on Childhood Trauma. Los Angeles, CA, and Durham, NC: UCLA-Duke University National Center for Child Traumatic Stress.
Saxe, G., Ellis, B., & Kaplow, J. (2007). Collaborative treatment of traumatized children and teens. New York: The Guilford Press.