Hello and welcome to
HEALTH FOR A LIFE TIME
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I'm your host, Don Mackintosh,
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and we're glad that
you've joined us today, and I
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think today's program
is going to be especially
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helpful to many people.
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Over the last number of months
there have been all kinds of
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natural disasters and these
have a big effect on our health
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both physically and mentally.
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Today to talk to us about
that problem and some solutions
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is a physiatrist from
Pittsburgh, Pennsylvania.
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Manjula Borge and we're glad
that you're here with us doctor.
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Thank you for having me.
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You have gone through
a residency now in adult
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psychiatry and you're now
working on another fellowship
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it's called in child
and adolescent psychiatry
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in Pittsburgh.
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Yes, that's right.
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So you've had a lot of
experience talking with people
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and you told me before
the program that you were very
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interested in doing this program
because you felt like you
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wanted to give something
more than just a donation,
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you want to help people who
have gone through the trauma.
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Yes, I was interested especially
after the resent hurricanes that
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we have experienced here in the
United States - Katrina, Wilma.
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The natural disasters overseas,
the earthquakes in India and
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Pakistan and other
natural disasters that have been
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occurring and on
the increase, actually.
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So, I was just interested
to find out what kind of
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mental illnesses one can
experience after this natural
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disasters and what we can
do as professionals and as
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lay people to help individuals
who have been traumatized.
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Yes, and as we've gone
through some of this material
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beforehand, I know it's
going to be very useful,
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you may want to get a pen
or a pencil and write down
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some of these thoughts.
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I think you'll
really enjoy the material.
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I guess the first thing we need
to talk about is how to define
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a disaster or a trauma.
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What is the definition
for a disaster or trauma?
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Well, after any person who
has experienced or witnessed any
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event such as combat, rape,
torture, natural disasters,
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accidents in which the physical
integrity of them or others
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was threatened, has
experienced what is called a
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traumatic stress reaction.
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So they can experience it or
they can even witness an event
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where death was
involved or physical injury to
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themselves or others.
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So September 11 would have
been a traumatic thing for the
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entire country.
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Absolutely.
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Watching some television
programs might be that as well.
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It could be for some
people depending on how a person
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reacts if you see other people
in a dying or experiencing very
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horrible events where their life
was threatened can experience
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traumatic stress reaction.
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But we're talking about these
huge hurricanes and different
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things whither it be Sumatra,
where some people may be
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watching, or where ever
they are, these are called
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traumatic events.
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What are some normal reactions
to a traumatic stressor?
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Before we go into the normal
reactions I also like to talk
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of some other experiences
where people can have...
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where they can
experience trauma.
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For example if a person is EMT
worker or policeman or a fire
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worker or a person who is taking
care of a medical personnel
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working in burn units or trauma
units where the stress level
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is very high and mortality
is high, they also have
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experienced what
we call as trauma.
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So this is a wide
spectrum of people that could be
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impacted in what
you're going to be sharing to
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help all these groups.
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Sure, it can be people who
go to help out and help in the
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trauma after a disaster
that they also can experience it
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after seeing injury or death.
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So what are some normal
responses to traumatic events?
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Well, some normal
responses we can talk about some
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emotional things that
people can go through.
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Emotional reaction is shock.
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People are very
shocked like, how could this be
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happening to them? Is this real?
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This could have never
been happen, they may have felt
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secure in whatever situation
they were in and now that's all
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shattered and they feel
very shocked and they go through
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what's sometimes called denial
that this is not happening
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to them, or it can't be
happening, this is unreal
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it would never
have happened to me so
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they can go through denial or
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they can go
through a lot of anger.
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Anger that this has happened
to them or why when things were
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going ok, how
come this can happen?
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You know something making
it worse, a lot of resentment,
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a lot of hate towards
authorities or towards people
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who are maybe not necessarily
responsible towards of people
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they think could
have done a better job.
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They have a lot of
hatred involved with that.
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Sometimes they could have
a lot of guilt that how they
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could have done something
better or they could have
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gone away from the
trauma sooner or they could have
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called someone or they
could have done something.
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They feel a lot of guilt
involved with the trauma.
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This is certainly what we heard
as we listened to people going
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through these
natural disasters. Listen
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to the interviews on
television or reading about it.
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Those are exactly the
things that are being said.
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Absolutely.
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They feel a lot of guilt that
they were not able to evacuate
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maybe earlier or
didn't think earlier,
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and they also could
go through a lot of fear.
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Fear is very...
it's a normal reaction.
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It's normal to be
fearful after what has happened.
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Fear can bring a lot
of anxiety, anxiety about
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feelings of whatever is going
on around, whatever the chaos
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around that can...
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These are all normal.
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If these are
happening that's healthy?
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Yes.
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What about physical things?
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Are there other physical things?
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Yes, they can go through
a lot of physical problems.
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They can have a lot of
tension, muscular tension.
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And that's normal.
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Yes.
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Fatigue, people can
get tired very soon.
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They can have a lot of somatic
complaints, abdominal pain,
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nausea, feeling
distressed, diarrhea.
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They can have sweating.
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They can be anxious.
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They can have what we call
paresthesia or difficulty in
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sensations for the extremities.
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They can have
paraesthesia or numbness.
00:08:08.39\00:08:09.83
And that's normal?
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Yes, this is normal.
00:08:10.84\00:08:12.11
So the person might be
wondering what are they going
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through? Why are
they feeling this way?
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They just need to realize
that after seeing a devastating
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event or events that
they can experience these
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physical symptoms.
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They can have head aches.
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They can have dizziness.
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They can have some
emotional cognitive problems
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What about inter-personally?
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Inter-personally they can have
a lot of relationship issues.
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They can have a lot
of relationship problems
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with their spouses, with their
families, with their children
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because of their stress.
00:08:51.56\00:08:53.40
For example, middle aged men
they might feel that they need
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to take care of their family
or should have been there and
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they feel this overwhelming
stress now that things have
00:09:01.59\00:09:05.51
fallen out of control.
00:09:05.54\00:09:08.15
They feel loss of control,
and this makes them very angry,
00:09:08.18\00:09:12.87
and makes them
probably more argumentative with
00:09:12.90\00:09:16.54
their spouse or more edgy
with their children and with
00:09:16.57\00:09:20.21
their other family relatives.
00:09:20.24\00:09:22.08
They can also have
a lot of depression.
00:09:22.11\00:09:25.90
Depression can be
there, and people can feel
00:09:25.93\00:09:33.91
hopeless, very hopeless,
very shameful, shameful of
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what has been
happened, what is going on.
00:09:37.84\00:09:41.02
They can feel hopeless.
00:09:41.05\00:09:43.41
They can feel helpless.
00:09:43.44\00:09:44.67
They can feel lonely.
00:09:44.70\00:09:45.94
They can feel abandoned.
00:09:45.97\00:09:47.78
And these are all normal things.
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Yes, absolutely.
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What about spiritually?
00:09:49.99\00:09:51.06
Are there some
spiritual things that happen?
00:09:51.09\00:09:53.13
Spiritually, yes, people can
wonder... some people get angry
00:09:53.16\00:09:58.89
with God and wonder
why this happened to them.
00:09:58.92\00:10:02.11
They might blame God and say,
"Why did You did You let this
00:10:02.14\00:10:05.64
happen to us?"
00:10:05.67\00:10:06.64
"Why did my child have to die?"
00:10:06.65\00:10:08.17
"Why did this natural disaster
have to take place and my family
00:10:08.20\00:10:12.78
was lost?"
00:10:12.81\00:10:15.18
So they can have a lot of anger
towards God, a lot of hatred,
00:10:15.21\00:10:18.79
a lot of resentment towards
God, a lot of questioning
00:10:18.82\00:10:22.10
God like, Why
are you doing this?
00:10:22.14\00:10:24.82
Some people might feel guilty
that they did something, they
00:10:24.85\00:10:30.03
lived bad lives and
then this is their punishment
00:10:30.06\00:10:33.74
received from God, but I think
00:10:33.77\00:10:36.81
there is another
spiritual aspect also after
00:10:36.84\00:10:38.58
natural disasters that
can happen is some peoples'
00:10:38.61\00:10:41.82
relationship with
God can get closer.
00:10:41.85\00:10:43.89
They might look at it as a sign
to get closer to God and they
00:10:43.92\00:10:50.07
might think that their
lives were not good enough
00:10:50.10\00:10:51.66
and God is giving them a
sign to improve their lives.
00:10:51.69\00:10:55.54
They might start going more to
church, become more spiritual,
00:10:55.57\00:10:59.09
start praying more.
00:10:59.12\00:11:01.75
So that's a good thing.
00:11:01.78\00:11:03.05
Yes, absolutely.
00:11:03.08\00:11:04.53
These are just
normal reactions. What are
00:11:04.56\00:11:06.56
the risk factors when
going through a traumatic event?
00:11:06.59\00:11:10.06
Several risk factors that
when you have the loss of a
00:11:10.09\00:11:15.38
neighborhood or
community or family that...
00:11:15.41\00:11:18.25
That describes
Katrina doesn't it?
00:11:18.28\00:11:20.14
Definitely, absolutely, yes.
00:11:20.17\00:11:21.54
One time you'll be near a child
and the next thing you might
00:11:21.57\00:11:27.10
not be able to see
your child or family.
00:11:27.13\00:11:29.02
That's very
devastating to somebody.
00:11:29.05\00:11:31.74
So loss of
community's support from family.
00:11:31.77\00:11:38.18
Loss of property is
another risk factor.
00:11:38.21\00:11:41.31
If you come and see your
house just totally gone...
00:11:41.34\00:11:44.96
Yes, I heard these people
saying, "Look this house has
00:11:44.99\00:11:46.80
been in our family for
400 years and now it's gone.
00:11:46.83\00:11:49.25
When you see something that
was a place of security or a
00:11:49.28\00:11:53.36
place of attachment for you
and then you see it in shambles
00:11:53.39\00:11:57.00
it's very devastating to
have some kind of illness after
00:11:57.03\00:12:03.31
a trauma.
00:12:03.34\00:12:04.89
So those are some of the things.
00:12:04.92\00:12:07.57
You could also feel if there
is a risk to the health of the
00:12:07.60\00:12:13.40
person from the environment.
00:12:13.43\00:12:16.45
It could be like loss
of water supply or shelter.
00:12:16.48\00:12:21.85
That can be also another factor.
00:12:21.88\00:12:24.14
You said some of the other
things were fear for safety?
00:12:24.17\00:12:27.95
Yes.
00:12:27.98\00:12:28.95
Fear of death?
00:12:28.96\00:12:30.04
Absolutely.
00:12:30.07\00:12:31.04
Or injury?
00:12:31.05\00:12:32.02
Sure.
00:12:32.03\00:12:33.00
Seeing a dead body,
seeing people being injured, not
00:12:33.01\00:12:35.85
knowing that if you can get out
from here without being injured
00:12:35.88\00:12:39.16
is definitely a risk factor for
developing trauma afterwards.
00:12:39.19\00:12:45.48
Bringing up old
traumas that were pre-existing?
00:12:45.51\00:12:48.68
Sure, previous history of
traumatic experience is another
00:12:48.71\00:12:53.89
risk factor for
developing up another trauma.
00:12:53.92\00:12:56.62
So history of traumatic
experiences, having medical
00:12:56.65\00:13:01.02
conditions before that can
be exacerbated so your health
00:13:01.05\00:13:06.04
conditions can worsen,
psychological distress...
00:13:06.07\00:13:10.41
What about relationally -
divorce, job loss, separation?
00:13:10.44\00:13:13.30
Absolutely.
00:13:13.33\00:13:14.30
If someone has had experienced
that before, a divorce or job
00:13:14.31\00:13:18.59
loss, that is a risk factor for
developing mental illness after
00:13:18.62\00:13:23.21
trauma.
00:13:23.24\00:13:24.53
We're talking
with Dr. Manjula Borge.
00:13:24.56\00:13:27.15
She is trained in psychiatry
both in adult and now a
00:13:27.18\00:13:31.30
fellowship in child
and adolescent psychiatry.
00:13:31.33\00:13:34.24
When we come back we're going
to talk about what the impact of
00:13:34.27\00:13:37.18
trauma can be on children
and what we can do now to help
00:13:37.21\00:13:41.11
with these situations.
00:13:41.14\00:13:43.12
This is a very important program
and I know it's going to get a
00:13:43.15\00:13:46.20
great help to many people.
00:13:46.23\00:13:48.11
You may want to give someone
a call and have them tune in
00:13:48.14\00:13:50.98
right now and join
us when we come back.
00:13:51.01\00:13:53.77
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Welcome back.
00:14:55.02\00:14:56.00
We're talking
with Dr. Manjula Borge.
00:14:56.03\00:14:59.47
She's a psychiatrist
from Pittsburg, Pennsylvania.
00:14:59.50\00:15:03.18
And we're talking about natural
disasters and mental health.
00:15:03.21\00:15:06.90
We're talking about what
can happen, the trauma that can
00:15:06.93\00:15:09.34
come to people.
00:15:09.37\00:15:10.34
And, Doctor, we were saying
that this trauma can really
00:15:10.35\00:15:12.84
effect in many different ways.
00:15:12.87\00:15:14.46
There's some natural things that
come up and those things are
00:15:14.49\00:15:17.36
happening you
described that that's good.
00:15:17.39\00:15:19.20
Those are good signs.
00:15:19.23\00:15:20.76
That means
you're not blocking it.
00:15:20.79\00:15:22.79
You pay a cost at
some time but you're really
00:15:22.82\00:15:26.28
addressing those things,
00:15:26.31\00:15:27.28
and then secondly, you went
through some of the negative
00:15:27.29\00:15:30.09
things that can happen.
00:15:30.12\00:15:32.30
It's very important to
keep in mind that a person can
00:15:32.33\00:15:36.10
experience these normal
reactions after a traumatic
00:15:36.13\00:15:40.50
event.
00:15:40.53\00:15:41.50
If they're going through it
they might feel that what is
00:15:41.51\00:15:45.96
happening to them.
00:15:45.99\00:15:46.96
The trauma is probably like
clearing or getting better but
00:15:46.97\00:15:50.80
they're loosing it or going
crazy but one should be aware
00:15:50.83\00:15:54.83
that there are certain
natural and normal reactions
00:15:54.86\00:15:58.64
after a huge, traumatic event.
00:15:58.67\00:16:00.82
And some of those were
eye-opening like numbness in
00:16:00.85\00:16:04.21
the extremities
and not feeling them.
00:16:04.24\00:16:05.91
And some people think,
"What is that?" but that's
00:16:05.94\00:16:07.50
normal.
00:16:07.53\00:16:08.50
And what about
children and trauma?
00:16:08.51\00:16:10.56
Are there specific things
for children in trauma that
00:16:10.59\00:16:13.17
you want to share?
00:16:13.20\00:16:14.29
As you can imagine children
are very vulnerable to trauma
00:16:14.32\00:16:18.45
after disasters.
00:16:18.48\00:16:20.03
And according to the
00:16:20.06\00:16:21.38
American Psychological
Association between 14-43%
00:16:21.41\00:16:25.57
of children have experienced
at least one traumatic
00:16:25.60\00:16:29.73
event in their life time.
00:16:29.76\00:16:31.43
Wow, that's a lot.
00:16:31.46\00:16:32.43
Yes, yes.
00:16:32.44\00:16:33.41
Is that up from before?
00:16:33.42\00:16:34.39
I'm sure it's on the
rise especially after these
00:16:34.40\00:16:37.78
natural events
that we're witnessing.
00:16:37.81\00:16:40.75
So the way children experience
their trauma can be a little bit
00:16:40.78\00:16:45.61
different from how adults
experience them and we need
00:16:45.64\00:16:48.94
to be aware of that - parents,
teachers, those who are working
00:16:48.97\00:16:53.08
with children definitely
need to be aware of that.
00:16:53.11\00:16:56.01
Let's click through some
of those real quick so we can
00:16:56.04\00:16:57.84
put it on the mind
what we need to be aware of.
00:16:57.87\00:16:59.80
What should we look for?
00:16:59.83\00:17:00.84
Sure, children might not
want to do their homework.
00:17:00.87\00:17:04.22
That sounds like something
they don't want to do anyway.
00:17:04.25\00:17:07.58
Could be true to some
point, but if a child has been
00:17:07.61\00:17:12.15
previously going to
school doing their homework and
00:17:12.19\00:17:16.66
then you start noticing that
the child is not interested.
00:17:16.70\00:17:20.74
The child might not
express that they are afraid
00:17:20.77\00:17:23.10
after the trauma.
00:17:23.13\00:17:24.31
They might even say that, you
know, "I'm not afraid. " But you
00:17:24.34\00:17:28.18
can notice other
differences going on for example
00:17:28.22\00:17:30.66
like not doing their homework,
not wanting to go to school.
00:17:30.69\00:17:34.22
You can see what's called
separation anxiety - children
00:17:34.25\00:17:38.27
don't want to
leave their parents.
00:17:38.30\00:17:39.53
Because they
want to be together.
00:17:39.56\00:17:40.62
Absolutely, yes,
you can see that.
00:17:40.65\00:17:42.28
Sometimes we called
what we call avoidance.
00:17:42.31\00:17:46.17
They might not want to talk to
people or be in places or have
00:17:46.20\00:17:50.63
conversations - anything
that reminds them of the trauma
00:17:50.66\00:17:53.96
they might want to avoid them.
00:17:53.99\00:17:55.76
And the way children show
that could be very subtle.
00:17:55.79\00:18:01.23
Adults might not
definitely recognize it.
00:18:01.26\00:18:04.57
For example, a child who
has corn flakes for breakfast
00:18:04.60\00:18:08.51
might not want to
eat corn flakes any more.
00:18:08.54\00:18:10.98
So this might be taken as...
for an adult it might be seen as
00:18:11.01\00:18:17.18
"Why is this child
not eating breakfast?"
00:18:17.21\00:18:19.95
It might be looked at as nothing
related to the trauma whereas
00:18:19.98\00:18:25.23
the child is showing his or
her anxiety through that way.
00:18:25.26\00:18:29.47
Another example is a
child who has been through,
00:18:29.50\00:18:32.45
let's say fires,
00:18:32.48\00:18:33.85
and after that event of the fire
they might want to set fires.
00:18:33.88\00:18:39.74
Actually physical fires?
00:18:39.77\00:18:41.34
Yes.
00:18:41.37\00:18:42.34
Better keep on top of that!
00:18:42.35\00:18:43.92
Yes, absolutely, and one needs
to be aware that they're not
00:18:43.95\00:18:46.96
trying to worsen the situation
or they're not trying to make
00:18:46.99\00:18:50.98
things worse but this is their
way of reenacting the trauma.
00:18:51.01\00:18:56.12
This is the child's way
of reenacting the trauma.
00:18:56.15\00:18:58.32
For example after a hurricane
a child might come home
00:18:58.35\00:19:01.52
and might start twirling,
play as twirling around,
00:19:01.55\00:19:06.89
or hiding under
furniture. So this is the way
00:19:06.92\00:19:10.97
a child is
expressing what they understand
00:19:11.00\00:19:15.02
of the trauma.
00:19:15.05\00:19:16.02
Your definition of trauma can
be from television programs and
00:19:16.03\00:19:20.46
other things and especially
probably the younger the child
00:19:20.49\00:19:23.85
the less able they are to
see whither or not that's real
00:19:23.88\00:19:27.12
or not.
00:19:27.15\00:19:28.12
So it's very dangerous, maybe
would you say, to have kids be
00:19:28.13\00:19:31.38
watching
television when they're young?
00:19:31.41\00:19:34.40
Absolutely, you know I
think parents need to be aware
00:19:34.43\00:19:39.29
of what their
children are watching, and they
00:19:39.33\00:19:41.19
need to be aware of how
much their child can handle
00:19:41.22\00:19:45.58
watching on television.
00:19:45.61\00:19:47.56
If your child is very sensitive,
very vulnerable to things that
00:19:47.59\00:19:53.78
are distressing, the
parents need to be aware of that
00:19:53.81\00:19:57.37
and not show those kind
of things to their child.
00:19:57.40\00:19:59.83
Have them watch 3ABN.
00:19:59.86\00:20:01.07
Yes, that's a good idea.
00:20:01.10\00:20:02.78
You said also there were
different ages and different
00:20:02.81\00:20:05.48
categories where they
respond a little differently.
00:20:05.51\00:20:07.97
Yes, children for example,
younger children let's say
00:20:08.00\00:20:11.31
lesser than 5 years old, might
regress and they can regress
00:20:11.34\00:20:16.14
in ways such as if they were
toilet trained they might start
00:20:16.17\00:20:21.43
bed wetting again.
00:20:21.46\00:20:23.45
So that's important to keep
in mind because parents should
00:20:23.48\00:20:26.89
not be very critical
about it or anxious about it.
00:20:26.92\00:20:30.94
They should be supportive to
the child and realize that the
00:20:30.97\00:20:34.69
child is going through a
period of distress and anxiety.
00:20:34.72\00:20:39.06
That's why they're
feeling and they're doing this.
00:20:39.09\00:20:42.30
Another thing that the child
might do is become very clingy,
00:20:42.33\00:20:46.32
very needy, very helpless,
become very child-like.
00:20:46.35\00:20:50.17
Age 0-5?
00:20:50.20\00:20:51.17
Yes.
00:20:51.18\00:20:52.15
And then the next category up,
older than 5, elementary school.
00:20:52.16\00:20:54.83
Elementary school kids might
not recall memories of what
00:20:54.86\00:21:00.77
happened of the event.
00:21:00.80\00:21:01.96
They might just block it out.
00:21:01.99\00:21:04.34
This is not that they are
going through... it just might
00:21:04.37\00:21:10.41
be that they don't remember
certain aspects of the trauma.
00:21:10.44\00:21:13.76
They're not able to
recall certain aspects.
00:21:13.79\00:21:16.33
They might also go through
they might not want to do their
00:21:16.36\00:21:21.31
homework, like I
mentioned earlier.
00:21:21.34\00:21:23.59
They might also
become very aggressive.
00:21:23.62\00:21:27.70
These are adolescents now?
00:21:27.73\00:21:28.92
Yes.
00:21:28.95\00:21:29.92
They might become aggressive.
00:21:29.93\00:21:31.73
They might also become very
"spacey," they start staring,
00:21:31.76\00:21:36.29
and start getting blank spells.
00:21:36.32\00:21:38.82
That could be one of them.
00:21:38.85\00:21:39.88
Anybody think of suicide?
00:21:39.91\00:21:41.76
Adolescents, definitely yes.
00:21:41.79\00:21:43.61
They might think of suicide.
00:21:43.64\00:21:44.82
They might become
depressed and suicidal.
00:21:44.85\00:21:48.03
They might start using drugs
and alcohol to deal with their
00:21:48.06\00:21:51.36
anxiety, and like I
00:21:51.39\00:21:53.10
mentioned, they might
also become very argumentative
00:21:53.14\00:21:55.67
and aggressive -
that's the adolescent.
00:21:55.70\00:22:00.16
So Dr. Borge, we've talked
about the signs and symptoms.
00:22:00.19\00:22:03.05
We've talked
about what can happen.
00:22:03.08\00:22:04.05
Look, I'm listening here
and I'm saying, "That's exactly
00:22:04.06\00:22:07.35
what's been happening. "
00:22:07.38\00:22:08.35
I've seen it in my
congregations as a pastor.
00:22:08.36\00:22:10.51
I've heard about it
and seen it on television.
00:22:10.54\00:22:12.35
This is exactly what
people are going through.
00:22:12.38\00:22:14.40
Now, we've
focused more on children.
00:22:14.43\00:22:18.04
We maybe can do another
segment together focusing on
00:22:18.07\00:22:20.95
adults, but we
focused on the kids.
00:22:20.98\00:22:22.70
What can we do to help them?
00:22:22.73\00:22:24.29
What's the treatment
in our last 5 minutes?
00:22:24.32\00:22:27.05
It's very important to educate
the children and let them know
00:22:27.08\00:22:31.85
what has been happening, what
is going on, tell them about the
00:22:31.88\00:22:36.57
disaster, so that they are
not in the blind, they're not
00:22:36.60\00:22:40.55
feeling that
they are in the dark.
00:22:40.58\00:22:44.26
So children can pick up
anxiety by adults very quickly.
00:22:44.29\00:22:49.81
And I think if a person is
anxious and nervous and tries
00:22:49.84\00:22:54.83
to minimize the situation, I
think that is not a good idea.
00:22:54.86\00:22:59.01
You need to express to the
child what is going on, educate
00:22:59.04\00:23:02.56
the child and also need to give
them hope that, "Well this has
00:23:02.59\00:23:06.50
happened but this is
what we're trying to do
00:23:06.53\00:23:08.85
to get things better. "
00:23:08.88\00:23:10.38
So that's a very important part.
00:23:10.41\00:23:12.17
Getting them in normal
routine is very healthy.
00:23:12.20\00:23:16.26
That gives them sort of
a structure in their life.
00:23:16.29\00:23:19.50
For example, school is a
good example taking the children
00:23:19.53\00:23:23.37
back to school and
letting them do their regular
00:23:23.40\00:23:27.61
school work is important.
00:23:27.64\00:23:29.50
Educating the
teachers is important.
00:23:29.53\00:23:31.90
If a child has been through
a trauma, they might be more
00:23:31.93\00:23:34.81
anxious or might be more
irritable and teachers...
00:23:34.84\00:23:38.80
Somebody might start
a fire, like you said.
00:23:38.83\00:23:40.34
A school need to be
aware of that so that they can
00:23:40.37\00:23:45.94
understand the child's
reactions a little bit more.
00:23:45.97\00:23:49.29
Another way of giving control
to the kids is to allow them to
00:23:49.32\00:23:53.65
pick up their clothes.
00:23:53.68\00:23:54.80
Allow them to choose
the menu for their meals.
00:23:54.83\00:23:58.02
That gives them
a sense of control.
00:23:58.05\00:24:01.01
If a child starts
to cry, that's ok.
00:24:01.05\00:24:03.94
Allow them to cry and
express what is going on.
00:24:03.97\00:24:07.71
Just be
sympathetic and understanding.
00:24:07.74\00:24:10.40
What adults can do
also is help themselves.
00:24:10.43\00:24:15.04
Studies have shown that if
a close adult to the child is
00:24:15.08\00:24:20.88
very anxious and nervous
and hopeless there's more chance
00:24:20.91\00:24:26.67
for the child to
feel the same way.
00:24:26.71\00:24:29.02
Whereas, if the adult is more
in control, hopeful and positive
00:24:29.05\00:24:34.53
the child is also
going to feel that way.
00:24:34.57\00:24:36.39
So what adults can do
is take care of themselves.
00:24:36.42\00:24:38.93
They can exercise.
00:24:38.97\00:24:40.76
They can take care of
their health, get into a better
00:24:40.79\00:24:43.67
routine so that they will
not transmit this anxiety, fear,
00:24:43.70\00:24:48.16
and more trauma to the
child who has already been
00:24:48.19\00:24:51.75
traumatized with
whatever is going on.
00:24:51.79\00:24:53.89
So give them a sense of safety.
00:24:53.93\00:24:55.81
Absolutely,
safety is very important.
00:24:55.85\00:24:57.88
Safety is first.
00:24:57.91\00:24:58.88
You have to protect the
child from any further trauma.
00:24:58.89\00:25:02.87
What about the person
that's watching that says, "That
00:25:02.91\00:25:05.03
sounds easy, go out and
exercise, take care of my
00:25:05.06\00:25:07.13
health and nutrition,
but I don't have a house.
00:25:07.17\00:25:09.21
I don't have a grocery store.
00:25:09.25\00:25:10.49
I don't have this,
I don't have that. "
00:25:10.53\00:25:12.04
What do you say to that
person that's going through
00:25:12.08\00:25:14.85
that right now?
00:25:14.89\00:25:15.86
Well, it's important to get in
touch with your family, with the
00:25:15.87\00:25:19.64
community and with the
resources that are available.
00:25:19.67\00:25:23.26
That is key.
00:25:23.30\00:25:24.58
Find out, and get the
source of information.
00:25:24.62\00:25:26.59
Find out what is going on
and what they need to do to help
00:25:26.63\00:25:31.85
themselves.
00:25:31.88\00:25:32.85
You know if you feel hopeless
and if you feel that I can't
00:25:32.86\00:25:35.72
do anything, then
chances are for you to recover
00:25:35.76\00:25:39.02
are more difficult.
00:25:39.05\00:25:41.61
But if you go out there and get
the resources that are available
00:25:41.65\00:25:45.68
you're helping yourself,
helping the people around you.
00:25:45.72\00:25:49.65
That's very important.
00:25:49.68\00:25:52.07
So be hopeful going out
and looking for the resources
00:25:52.11\00:25:55.99
and getting that
is very important.
00:25:56.03\00:25:59.17
Now you talked earlier about
different ages of children.
00:25:59.20\00:26:03.15
Is there a different way
to educate a 0-5 year old
00:26:03.18\00:26:07.17
vs. an elementary
school vs. an adolescent?
00:26:07.21\00:26:09.49
Are there different
ways to go about that?
00:26:09.53\00:26:11.77
Or is it pretty much
the same for every age?
00:26:11.81\00:26:13.99
I think different ages the
requirements are different.
00:26:14.02\00:26:18.21
For example for a child
0-5 years might not necessarily
00:26:18.25\00:26:21.84
need to know what is going
on around them or what is the
00:26:21.88\00:26:25.82
impact of the
situation in detail compared to
00:26:25.85\00:26:28.88
an adolescent.
00:26:28.92\00:26:29.95
So you can still explain to a
younger child what is going on
00:26:29.99\00:26:33.49
but in simpler terms, in
terms that they can understand.
00:26:33.53\00:26:38.10
You can allow them to draw
to express what is going on.
00:26:38.13\00:26:42.66
Draw something that
has happened like if it's a
00:26:42.70\00:26:45.70
hurricane or something.
00:26:45.74\00:26:46.71
You know, explain to
the child in simpler terms.
00:26:46.72\00:26:49.60
They understand
pictures much better.
00:26:49.64\00:26:51.25
You can have what they call
at schools now they're having
00:26:51.29\00:26:56.55
"After Katrina. "
00:26:56.58\00:26:58.36
They gave the teachers
Katrina handbooks so that the
00:26:58.40\00:27:02.28
children can draw
and color in that,
00:27:02.31\00:27:05.18
so that they can learn that way.
00:27:05.21\00:27:07.25
Whereas, for adolescents they
might not be interested in that,
00:27:07.29\00:27:11.80
and I think they might want
to talk to you and find out more
00:27:11.83\00:27:14.14
of what is going on.
00:27:14.17\00:27:15.93
So you can explain to
them things a little bit better
00:27:15.96\00:27:18.40
in detail.
00:27:18.43\00:27:19.40
Are there any spiritual
resources that those who have
00:27:19.41\00:27:23.76
been through
trauma should consider?
00:27:23.80\00:27:25.48
Absolutely.
00:27:25.51\00:27:26.48
I think prayer is very
important - prayer with your
00:27:26.49\00:27:30.17
family, with your community.
00:27:30.21\00:27:31.78
If you do that with the school,
you need to increase the time
00:27:31.82\00:27:35.09
that you do this so that
you will feel strengthened.
00:27:35.12\00:27:37.58
The normal routine and
just drawing strength from your
00:27:37.62\00:27:40.04
normal rituals?
00:27:40.07\00:27:41.04
Absolutely.
00:27:41.05\00:27:42.02
Thank you so much,
Doctor, for being with us.
00:27:42.03\00:27:44.36
This has been very
useful and we appreciate it.
00:27:44.39\00:27:47.24
And thank you for joining
us on Health for a Lifetime.
00:27:47.27\00:27:50.92
Hey, if you've been through
trauma, we're praying for you.
00:27:50.95\00:27:54.56
We hope this
program has been helpful.
00:27:54.60\00:27:57.02