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Friday, April 18, 2014

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Kids recover quicker from war trauma: psychologist

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Naomi Baum

TORONTO — An Israeli psychologist specializing in trauma says children react to the horrors of war and terrorism in much the same way as adults do, but they tend to recover more quickly.

“The younger you are, the more at risk you are [to trauma],” according to Naomi Baum, director of the resilience unit at Herzog Hospital’s Israel Center for the Treatment of Psychotrauma (ICTP) in Jerusalem.

“Cognitively, adults and children are quite different, but in terms of the way they feel and react to trauma, the emotions are the same,” Baum told The CJN in a telephone interview. “Fear is the same, anxiety is the same. We would like to think that we are shielding our children, but in general, they are exposed to trauma and react to it.”

But children “are more malleable [than adults] and heal more quickly in general.”

Baum will address, via Skype, the third annual conference of Doctors Against Racism and Anti-Semitism (DARA) slated for June 3 at Sunnybrook Hospital’s McLaughlin Auditorium. This year’s theme is “War Trauma and Children.”

The event will also hear from retired Canadian general Romeo Dallaire, who commanded UN forces in Rwanda; Dr. Homer Tien, a trauma surgeon who served in Afghanistan, and Dr. Frank Sommers, a Toronto psychiatrist and child Holocaust survivor who also served in Afghanistan.

The ICTP was formed in 1989 to contend with an alarming phenomenon: an estimated nine per cent of Israelis suffer from post traumatic stress disorder (PTSD), three times the levels in other western countries.

But as Baum pointed out, the ratio of Israelis suffering from general trauma-related distress can spike at 80 per cent in times of war or terrorist attack.

In those instances, “a lot of people are anxious, aren’t sleeping, have trouble concentrating,” she said. “They may not fit the entire standard definitions of trauma, but if people are suffering, we treat them. We don’t have to have a complete PTSD diagnosis.”

Her approach is “not to look at what’s wrong with someone, but at what’s right with them, what works for them as a coping mechanism, and then we try to strengthen what they already have. In a way, it’s looking at the cup half full and not half empty,” she told the news agency Israel 21c in 2009.

In addition to screening children for PTSD, Baum’s program in Israel also trains mental health professionals in how to treat those who are identified. 

She works with local schools, educating the staff about trauma and emotional resilience.

It’s often “very difficult” to measure PTSD distress in children, especially infants, Baum said. “A lot of the information we do get about very young children is from parental reports, and those are obviously coloured by how the parents are doing.”

The ICTP has developed and implemented programs both in the north of Israel, where children were affected by the Second Lebanon War in 2006, and in the south, where rocket bombardments continue to traumatize many residents.

Trauma, said Baum, has a cumulative effect.

“People tolerate a certain amount of trauma, and they get knocked down once or twice or three times, and they pop right back up. But on the fourth time, and it might even be a real small knock, that just floors them.”

Baum has paid seven visits to Biloxi, Miss., to adapt pyschotrauma programs developed in the wake of terrorism in Israel for the treatment of survivors of Hurricane Katrina. She said the process can work the other way, too: survivors of human-made violence can help those who have lived through natural disaster.

She said there’s “some evidence” to show that war and terrorism provoke deeper traumas than natural disasters, “but it’s not entirely conclusive.”

PTSD doesn’t differentiate between the sources of trauma, which has to be life-threatening or perceived as such.

“It could be a car accident or a terrorist attack. Trauma is trauma.”

 To date, the most effective treatment has been cognitive behavioural therapy, or CBT, which uses both cognitive and behavioural therapies to help people cope.

“Some of it has to with processing the traumatic event itself, and some of it has to do with learning how to self-regulate, how to calm oneself down, how to breathe and relax,” Baum said. “And some of it has to do with how to reintegrate [sufferers] back into regular life.”

Asked whether a child can be beyond help, Baum said, flatly, “no.”

For details on the conference, visit www.daradocs.org.

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