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The Relevance of Trauma

The Relevance of Trauma



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Published by lalitasalins

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Published by: lalitasalins on Feb 22, 2009
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Childhood DissociationWebsiteQuestions Frequently Asked by Teachers
Prepared by ISSTD’s Child Adolescent TaskforceNote:
These questions and answers are designed to assist teachers inunderstanding and managing dissociation in the classroom. Therecommendations below are not asubstitute for professional consultation with a  psychologist, psychiatrist, therapist, doctor specializing in the area of dissociationwhere a careful, accurate handling of possible dissociative behaviorsin school children can be collaborated.
1)What do dissociative children in the classroom look like?
Dissociation can take many forms and can mimic other common problems. Infact, many of the symptoms below can reflect situations and issues other thandissociation. It is the combination of numerous symptoms and often an abruptshift into behaviors described below that most suggests dissociation.In general, dissociative responses in children can be divided into two major behavior groups (though some children present with behaviors mostly from oneof the ‘groups’; others oscillate between the two, with behaviors that can shiftdramatically). 
Overt responses
: (dissociative behaviors in this group are usually difficult to ignore in the classroom because they are often disruptive)
Behavior issues : unusual non-compliance, and/or shifts in maturitylevels from age-appropriate to babyish and immature; refusal toanswer to his/her name and demand that child be addressed by aname other than his or her own; denial of misconduct even whenthere’s clear evidence that the child is at fault (child seems be brazenlylying).
Acting out: abrupt onset of aggressiveness toward peers and/or teacher, sudden use of foul language; rapid and intense emotionalshifts (child is calm one moment and the next is raging or weepy or appears terrified).
Hyper-activity : especially shifts in activity levels from day to day or situation to situation (dissociative children are often misdiagnosed ashaving ADHD).
Learning disorders : dissociative children often have difficulty attendingto learning tasks, and as a result can exhibit learning delays and whatcan seem like learning disorders. A child may be resistant to learningor doing work in the classroom or at home. Dissociative responses areespecially suspected when levels of academic abilities from one day tothe next vary considerably.
Covert responses:
(dissociative behaviors in this group are at timeseasier to miss because they aren’t usually disruptive to the class)
Passivity/Apathy : unusual passive behavior and lack of initiative, thechild doesn’t seem to care whether she takes part in activities or not,whether she does well or not; child’s emotional presentation may seem‘flat’; lack of motivation.
Spacing-out/Inattentiveness : the child day-dreams a lot, stares intospace, seems to be ‘someplace else’, and is not paying attention towhat is going on in the class; may need to be called several timesbefore responding; may seem disoriented or confused about what isasked of him; may seem as if he just ‘woke up’ even though he wasn’tsleeping; may answer completely out of context (as if still replying to aquestion that was asked a while ago, unaware that the class moved onsince); may be very forgetful and need to be told things again andagain.
Extreme compliance : the child is uncommonly eager to please; sheseeks perfection in everything she does; may do things for and bringpresents to the teacher more frequently than other students; may beseen as ‘teacher’s pet’; may seem anxiously in need of praise; may beclingy.Signs of dissociation in the classroom can often be viewed through a lens of CHANGE or SHIFT:
A change in the child’s behavior:a.Increased activity/reactivityb.Decreased activity/reactivityc.Spacing out/glazed eyes/child suddenly ‘not there’
A change in the child’s manner:a.Suddenly fearful without anything frightening happening in the classroom.b.Angry/Aggressive with little or no apparent provocation.c.Suddenly excessively sleepy.d.Unexplainably sad/teary/whiney/babyish 
Predictable shifts in behavior:When you realize that the child’s behavior seems to be tied to certainclassroom activities or specific outside stimuli. For example, if the child seemsokay while in the classroom but every time the students are to leave the roomfor the cafeteria or to go outdoors she gets clingy and weepy. Or if for example, every time there’s a siren outside the window, the child freezes andspaces out.
Why do children dissociate? (also see item #2 in the Q&A for parents—link to page)
Dissociation is a creative and effective coping response to overwhelmingevent/s. In order to survive the overwhelming situation, the child may block
out aspects of the event, feelings, sensations, even knowledge that ithappened from awareness. While helpful during the event, dissociation canbecome a pattern of responding, where even minor reminders—whether thechild knows or doesn’t know what they remind her of—cause the child todissociate, resulting in disruptions to the child’s normal abilities. Thesedisruptions can result in difficulties in many every-day situations, including theclassroom and other school-hours interactions.Dissociation has been documented to follow a variety of childhood traumas.
Interpersonal Trauma :a.Abuse: physical, sexual, emotionalb.Neglect
Medical trauma :Repeated painful medical procedures due to: cancer, burns, accidents,congenital malformations (e.g. cleft-palate, cerebral-palsy), etc.
Environmental trauma :a.Domestic violenceb.Gang violence on streets and in housing complexesc.Povertyd.Immigration (especially when child’s family are refugees who wereexposed to trauma in native country)e.Natural disaster (especially being in or witnessing)
Separation, loss, and attachment trauma :a.Parental mental illness: mentally ill parents may be less able to care for the child, and their responses may be chaotic or frightening; the childmay end up in a care-taking position and have no one to go to for managing her own overwhelm.b.Foster placements (especially multiple placements, where the child isrepeatedly experiencing loss and unknown future).c.Family chaos: multiple family configurations that keep shifting,homelessness, frequent moving from one house to the next (whichmeans the child needs to keep adjusting to new surroundings as wellas at times new schools). 
3.What can make dissociation in the classroom worse?
When a child’s behavior (or what may seem like misbehavior) in the classroomstems from a dissociative response, confronting the child while she isexperiencing dissociation is usually counterproductive and can lead to further increase in dissociation. For example, if a child dissociated because a loudvoice scared her, raising a voice at her to try and ‘get through’ can serve toscare her even more.Restraining or grabbing the child can similarly exacerbate the child’s need todissociate and in some may result in acute escalation of aggression or withdrawal.Similarly, judging the child as a whole (rather than a particular behavior) as“bad”, “lazy”, “manipulative”, “mean” and so forth, only serves to deepen the

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