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Help Your Child Heal from Trauma by Making a Book

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Question

Dear Dr. Laura,
My son suffered a medical trauma. He is angry at me because I held him down for the stitches. I know you recommend making him a story book about it. How should I do this? Thanks!

Answer

I'm so sorry that you and your son had to go through this experience. 

It's very hard for parents to know what to do when medical personnel are holding your child down. Often they ask you to help immobilize your child, but then your child experiences you as helping subject him to pain. In general, I recommend that you not hold your child down, but stay in the room and talk to your child and comfort them through the experience. Studies have shown that the presence of the parent helps the child to feel less pain. I realize that is counter to what medical personnel will often ask, so it can be hard to do. 

In addition to making a book for your son, I advise you to support him to work through his complicated feelings about this medical experience and your role in it by using play to act out the story. You can see more about how to do this in the articles suggested at the end of this article.

But you are asking how to make a book to help your son process this experience. Yes, it can really help children to make a book for any major life event that takes some adjustment. 

Your goal is to help your child heal from the event. To do that, he needs to:

Express those big emotions to a compassionate witness..

Making a book like this gives your child a chance to talk about what happened and to be heard, which helps him to work though those emotions, feel heard, and heal. Many children ask to read and re-read these books over and over, and they tell you more nuances or perspectives each time.

Rationally understand what happened.

Right now your child's story of what happened is a muddle of upset emotions like terror and pain, mixed up with pictures in his mind of whatever he saw at the time. "Telling the story" of what happened helps your child process the experience by building a neural connection between the implicit memory where the upsetting event is recorded (which is visceral, emotional, nonverbal) and a new explicit memory that you're helping him to create, which is verbal and rational.

Build resilience by seeing that his story had a happy ending.

How we see the ending of an event is vitally important in how we remember and process that event. Don't try to "rewrite" your child's experience. But do make sure that at the end, after all the upset has been shared, you discuss the positives. "Josh's body knew just what to do to heal.....Josh told Mommy how scary it was to be held down for the stitches, and Mommy listened and understood and hugged him.  After the stitches, the doctors took good care of Josh and he felt much better." Since humans make sense of their experience by telling stories, you're helping him see his story differently. 

See himself as able to cope with this past event and any similar events that may happen in the future.

Empower your child by helping him see that although he endured a difficult situation, he does have control of some parts of this. There are things he can do if he is ever in this situation again and there are things he can do now to help himself feel better about it

Here's how:

  1. Title. You don't want his medical trauma to "define" his life, so this is not a book called "Josh's Life".....more like  "The Story of Josh's Operation".
  2. Construction. You can use construction paper or white copy paper. Glue on photos and write or print out captions. You can laminate if you want to. Three-hole punch and put into a notebook, or just fold and staple. It does not have to be long or perfect. Assume you will add and revise.
  3. It's your child's story. You can create the book yourself, but better yet, offer your child the opportunity to help you write the book by drawing pictures for it and giving you his own words for what happened, which you write down for him. This helps him process his emotions about it.
  4. You can let your child make drawings, or you can use photos. Then find any specific photos related to the trauma - a photo of your child with a cast on his arm, a photo of the hospital where it happened, a photo of an ambulance. So the first picture is his birth, that made you so happy. Then go fairly quickly through his young, happy life, with photos of the high points, until you get to: "But one day, something very scary happened....Josh had an accident...he was bleeding...Mommy rushed him to the hospital...the doctors had to stop the bleeding with stitches, by sewing up Josh's big cut..."
  5. Listen as you read.
    As you read, listen to and reflect your child's feelings. Be aware that he could go into anger as he feels vulnerable all over again. Keep reassuring him that he is safe now, and that you wish you could have stopped all the pain before. If he you made the book to start, suggest that your child make some pictures for the book. Give him the same paper, and markers or crayons, and let him draw or scribble. He will talk, hopefully, and you can write what he says as the caption. Add his pictures to the book.

    Use everything your child says in the book. If he says "My mommy hurt me" you can write: "Josh was so upset because Mommy hurt him while she held him to get the stitches. Mommy had to hold Josh tightly so the doctors could stitch the wound so it would stop bleeding...Josh was so scared....He was too little to understand why Mommy help him down...Mommy was crying and Josh was crying....He thought Mommy was trying to hurt him and he was so upset....Finally the doctors finished and told Josh he would be okay...but Josh was still mad and sad at the doctors and at Mommy."

    Next page: "Sometimes it was hard for Josh to trust Mommy after this....But Mommy loved Josh very much and she understood. She always protected him."
  6. Empower your child. Ask your child what he wishes he could have said and done at the time. Even fantasizing about becoming a super hero in that moment and destroying the ER is an okay response. He needs to start to see himself as able to handle situations like this. Over time, as you talk, he might start to say things like "I could breathe and calm myself down...I could ask for medicine so the stitches would not hurt and no one would have to hold me down."
  7. Don't forget the happy ending. End your story with something happy, like a photo of you and your son hugging, and one of the whole family. Say that Josh is all well now, his body has healed. Say that sometimes he still feels sad when he thinks about the accident, but he knows he can talk to Mommy and she will always understand, and every day he feels better. It's important to acknowledge that the child still has lingering feelings, but show him a path to deal with those feelings, and it's vital that the story has a happy ending.
  8. Be aware that your son will have big feelings during and after reading this book. Let him vent and rage and cry, and stay compassionate. He needs to get all that out of his system to complete his healing.

Other Articles on Trauma:


Hospital, Medical PTSD after Illness, Trauma

Using Play to Help a Child Who Has Been Bullied, Bossed - This article describes using play to support a child in processing past trauma.

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