Dr Chris Moore
Treating Trauma with Hope & Optimism
When children and young people experience trauma and loss, this has significant implications for their sense of self. If we think of the classic internal working model of “I am…”, “Others are…” and “The world is…”, these become influenced by negative thoughts and feelings. The young person can subsequently withdraw or learn to survive through behaviour which is maladaptive outside of the traumatic context. How do we help these young people maintain a more positive sense of self? How do we tap into their strengths and creative optimism and hope for the future? Here are some ideas to consider.
Finding positivity in the present
Edith Grotberg’s research on resilience led to a nice framework which focuses on the young person’s sense of self and relationships with others. This is the “I have…I am…I can…” model. For example, we can help the young person to come up with “I have…” statements such as “People who love me”, “People who want to help me” and “A safe home/school”. The “I am…” statements might include words like “honest”, “loyal”, “funny”, “hard-working”, etc. “I can…” might focus on positive skills and actions that the young person can take in the face of adversity; these might include “Take a few deep breaths and try again”, “Have a break so I can calm down” or “Ask someone for help”.
Another approach which is often referenced in positive psychology is the idea of “What Went Well” (WWW) – looking back at a month, a week or even a day and trying to zero in on the more positive aspects in order to stifle negative thinking. The young person could be supported to write down these times, draw them or even make a power-point presentation with pictures as evidence. This has very clear parallels with the “3 Good Things” approach which continues to be promoted by Dr Pooky Knightsmith on Twitter. We can help the young person to keep a diary of three positive things, big or small, which occurred on a given day so that they aren’t drowned out by negative experiences.
A key aspect of solution-focused therapy is looking for exceptions to a problem. Let’s take the example of a young person who feels very anxious. We can ask questions which open up their perspective from a black-and-white, all-or-nothing interpretation of the emotion. These questions could be “Tell me about times when you weren’t anxious”, “Tell me about times when you were less anxious than normal” and “What about times when you coped ok despite feeling anxious. What was different about those?”. These can show that their anxiety is not absolute and this can open the door to exploring why the anxiety can be reduced at those times. Were they with particular people? Were they engaging in a specific activity? Were they in a certain place? Once those questions are answered, we can try to replicate those conditions to provide more experiences of lower anxiety.
Holding on to Happiness and Success
Enabling the young person to internalise more positive messages and build up a positive sense of self may not be achieved simply through verbal means. Having tangible and personalised reminders will also be very powerful. In her book “Celebrating Strengths” (2008) Jenny Fox Eades recommends making a treasure chest of items related to happy memories. These might be photographs with family and friends, souvenirs from trips and keepsakes as simple as a stone from a beach or a receipt from a cinema trip. Helping the young person to recall those positive events will reawaken those thoughts and feelings in the present day, having a positive impact on their mind and body.
A similar concept is outlined in “Inside I’m Hurting” (2007) by Louise Bomber, where she talks about a “Book of Success”. This gives the young person concrete evidence of their success when engaging in activities – within the school context, this might be written compliments from a member of staff, photographs of the young person having fun and working well, certificates, awards and samples of their achievements. Parents and caregivers might be able to adapt this in light of the coronavirus restrictions; keeping a scrapbook with photos, drawings and paintings, samples of the work they have completed at home, evidence of their “flow activities” (see section below), etc. School staff could help to add to this scrapbook by providing specific and positive messages through the school website, via email or using short and personalised videos. This is particularly important if the young person has a “Key Adult” in school, such as a teaching assistant.
Recognising and Celebrating Strengths
Trauma can distort and conceal the strengths and skills that the young person already has. We need to help them remember their own positive qualities – “funny”, “caring”, “organised”, “sporty”, “helpful”, etc. Visual and concrete methods can be the best way of doing this. These might include making a tower with the words on each block, depicting the words on a puzzle or domino set, arranging magnetic letters on the fridge to spell the words or playing a card game where the young person has to think of a time they showed a specific quality.
Dr Karen Treisman’s has suggested strengths-based jewellery, where the young person can wear a bracelet or necklace depicting their skills and qualities. She also recommends a simple sentence completion task which activates positive thinking about the past and present. Some examples of such sentences might include “The thing which makes me smile the most is…”, “The most recent time I was really helpful to someone was when…”, “A really chilled out day for me would include…” and “The thing I’m most proud of would be…”.
We can also communicate affirmations that guard against stress-induced negative thinking. Again, we can go beyond simply telling the young person about these and have them available as cards in a box, post-it notes in a transparent jar or personalised stickers on a notice board. These can help us as adults to communicate safety as well as positivity. Here are some examples:
· “You are safe with me”.
· “I see the real you and I like him/her”.
· “I’m thinking of you, even when we’re apart”
· “You did the best you could and I’m proud of you”.
· “All of your feelings are ok”
· You deserve to be happy”.
Finding the Young Person’s Flow
One of the founders of the Positive Psychology movement, Mihaly Csikszentmihalyi, coined the term “Flow” following his research on how people achieve peak performance. In his own words, “Flow is being completely involved in an activity for its own sake. The ego falls away. Time flies. Every action, movement and thought follows inevitably from the previous one”. When we are in a flow state, we are working at our absolute best. We are fully engaged and deeply involved, with such focused attention that we have no time to dwell on negative thoughts. Artists achieve a state of flow when they are absorbed with a painting. Athletes experience flow when they talk about being “in the zone” and delivering their best performance from start to finish.
To achieve a flow state, the activity needs to be sufficiently challenging – the young person will switch off or become passive if it is too easy or give up too soon if it is too difficult. It should provide immediate feedback and a sense of achievement from participating or reaching a goal. While the current coronavirus pandemic can restrict access to activities which can provide a flow experience - like going swimming, working out at the gym or team sports – there can still be many personal experiences that help a young person achieve this state. This will very much depend on the young person’s interests and preferences. Some examples might include:
· Drawing personalised pictures for family members.
· Constructing and painting items from a model or figure collection.
· Designing and making a new structure out of Lego or in Minecraft.
· Making time to read a new book.
· Working together with friends in an online video game.
· Listening to podcasts and watching YouTube videos about special interests such as animals, trains or space.
Gareth Morewood’s blogs on Optimus Education have made numerous references to flow. He talks about how flow activities should be pre-planned – scheduling them as part of the daily or weekly routine. If we try to engage in our flow activity as a response to stress, we risk diluting the effect or being so distracted that we engage in a passive or unhealthy activity for a quicker fix. Simply put, flow – and indeed happiness – requires effort. So while there may be school work to complete as the coronavirus lockdown continues, plan time for the young person to engage in activities which are truly stimulating and rewarding. Even if it means that they’re doing your head in by banging away at their drums upstairs for an hour!
Reframing Current Struggles
As I talked about in my “Controlling our Thoughts” blog, our brain is really a magnet for negative thoughts due to its built-in negativity bias. When a young person experiences trauma and loss, this can damage their confidence and self-esteem. We need to be hopeful in how we respond to negative statements and feelings of helplessness. Louise Bomber outlines the concept of “Parts Language” – this is the idea that we’re all made up of different parts and that we are integrated beings. So the young person who might present as very angry or defiant at school can also be very calm, charming and helpful at home or elsewhere. We can articulate this by saying “I can see your kind part shining through – you were so nice to your friend”, “That was a great example of your patient part – you took your time even though it was hard” and “Your angry part is showing right now. I can see how annoyed you are by this”.
We can be creative in labelling positive and negative “parts” as a colourful jigsaw or body map that can be added to over time. This can lead on to talking about how we can control our different parts – like how we can try to turn towards our “relaxed part” when our “anxious part” is turned on. But keep in mind that trauma-induced shame may make this a process that takes considerable time. It will be necessary to work at the young person’s pace. We have to accept and empathise with all of the young person’s parts, even when certain ones create stress in ourselves. It’s also important that we deliver hopeful statements and positive assumptions. For example:
· “I can see that you’re getting better at this”.
· “How pleased are you with…”
· “I know this is scary, but I’m going to be right here by your side”.
· “Which bit are you finding difficult at the moment?”
· “Let’s get better at…”
· “What shall we do when you’re finished?”
· “We learned that we just need a little more practice with…”
Fostering optimism for the future
It’s essential that we give young people hope for the future whilst helping them cope with the present. This might begin by asking for their views on what an ideal future would look like. One approach can involve writing a letter or drawing a picture for their future self. Ruth MacConville and Tina Rae, authors of “Building Happiness, Resilience and Motivation in Adolescents” (2012) suggest asking who and where they will be, what they’ll be doing in this future and who will be with them. The aim is to focus on staying positive, expect the best and set goals to achieve something similar to that ideal future.
“The Miracle Question” is a famous solution-focused approach where a young person is asked to think about their problem suddenly disappearing overnight. Outside of an on-going therapeutic process with a trusted and neutral professional, this question may be daunting or unwieldy if it’s asked out of the blue. But I like the follow-up questions that come with this miracle scenario. “How would you notice?”. “What will you be doing differently from now?”. “Who else would notice?”. These are the kinds of questions we can ask when talking with a young person in general about a better future. Focusing on what they want, as opposed to what they don’t want, helps to frame the future as something which can be strived for and controlled.
Dr Treisman suggests drawing, sculpting or making a collage of wishes for the future in three parts – wishes for myself, wishes for others and wishes for the world. This is a nice use of the internal working model and a way of focusing on a hopeful future in spite of a difficult past or present. She also talks about the concept of a time capsule. I think this is a great idea in light of the coronavirus pandemic and a natural avenue for those children and young people who like to be creative and meticulous. There have been difficult days for children and adults as we adjust to a “new normal” and there will be more to come - it could be a nice project to work on, by storing evidence of positive memories and examples of coping skills, resources and activities which helped the young person cope with difficult periods. Opening that capsule at a later date could be a nice way of showing the young person that they managed change and uncertainty much better than they expected. It could also help them to be optimistic and resilient when they are faced with future challenges.
Bomber, L.M. (2007). Inside I’m Hurting: Practical strategies for supporting Children with Attachment Difficulties in Schools. London: Worth Publishing Ltd.
Bomber, L.M. (2011). What about Me? Inclusive strategies to support Pupils with Attachment Difficulties make it through the School Day. London: Worth Publishing Ltd.
Daniel, B. & Wassell, S. (2002). Adolescence: Assessing and Promoting Resilience in Vulnerable Children 3. London: Jessica Kingsley Publishers.
Fox Eades, J.M. (2008). Celebrating Strengths: Building Strengths-based Schools. Coventry: CAPP Press.
Grotberg, E. (1997). “The International Resilience Project”. In John, M. (Ed). A Charge Against Society: The Child’s Right to Protection. London: Jessica Kingsley Publishers.
MacConville, R. & Rae, T. (2012). Building Happiness, Resilience and Motivation in Adolescents. A Positive Psychology curriculum for well-being. London: Jessica Kingsley Publishers.
Morewood, G.D. Prioritising Well-being: Putting yourself first. Optimus Education Blog: 26th November 2019. https://blog.optimus-education.com/prioritising-wellbeing-putting-yourself-first
Treisman, K. (2017). A Therapeutic Treasure Box for Working with Children and Adolescents with Developmental Trauma: Creative techniques and activities. London: Jessica Kingsley Publishers.
Treisman, K. (2017). Working with Relational and Developmental Trauma in Children and Adolescents. Abingdon: Routledge.