Protect Children from Post-traumatic Stress Disorder (PTSD) in a Natural Disaster

Children who live through a disaster may carry the emotional scars for life, which may be severe enough to be described as post-traumatic stress disorder (PTSD). We do all we can to protect our children, but the terrible truth is that disasters sometimes happen, and no matter how vigilant we are, one day a disaster may affect our family. How can you protect your child from developing PTSD?

Some singular events, like a sexual assault, are of sufficient emotional severity that they may lead to PTSD even under the best of circumstances. Natural disasters by themselves, however, need not necessarily lead to such serious consequences, if the child has been prepared and is given the necessary help afterward to deal with the situation. In a natural disaster, the parent can make a big difference in protecting a child from long-term consequences. Because much of our present understanding of PTSD comes from the experiences of soldiers in combat, it's helpful to look there first, and extract valuable lessons for parenting.

There are a number of factors that make it more likely that a soldier will develop PTSD; these risk factors can occur in children as well. Some factors are present before the traumatic event, and some occur after. Parents can learn from these factors how to prepare a child for disaster, and how to help the child recover afterward.

Risk factors for PTSD prior to a traumatic event:

A sense of constant exposure to a danger that could strike unpredictably

Evidence that the danger is real and serious

A sense that the individual is powerless to protect himself or herself from harm

One can easily see how combat creates these situations. Seeing one's friends injured or killed while in the same situations that oneself experiences daily, despite their best efforts, meets all these conditions. How can this situation possibly apply to parenting?

How a parent can make a child resistant to PTSD in the face of a possible future disaster:

There are, unfortunately, some abused children who live each day in the equivalent of a war zone; the advice in this article is inadequate to address situations of this chronic severity. However, even the best intentioned parent can inadvertently create situations that introduce some of these risk elements. How can we avoid predisposing our children to PTSD in the face of a disaster?

For one thing it's not a good idea to "prepare" a child for disaster by stressing the dangers of life at every opportunity. There has to be balance. Be very specific about dangerous situations, and emphasize the importance of managing those risks. If a child has no control over a particular danger, don't harp on it.

For example: A child must learn not to run in the street. Be firm, tell the child it's dangerous, emphasize that message whenever the situation presents itself. However, be specific. Allow the child to understand that this is a danger she can control, by staying out of the street.

You may want your child to be prepared for large emergencies. Good idea, do that, but do it appropriately. For example, teaching a child to call 911 if they see a family member fall and stay down gives the child a sense of power and importance in the situation. It's less helpful to repeatedly emphasize the danger of a parent being incapacitated, which inadvertently gives a child a sense of impending, uncontrollable doom.

A special case is when a parent is terminally ill. In those cases it may be appropriate to prepare the child for this loss, but again, the emphasis should be on what specific provisions will be made for the child, stressing that the child will be loved and cared for, and above all explaining that the illness is not the child's fault. Allowing the child to help in concrete ways, again, gives the child a sense of control and usefulness, even though powerless to prevent the loss. Consult books by William Kroen and Paddy Greenwall Lewis for help if someone you know faces this terrible situation.

Risk factors for PTSD after a traumatic event:

A sense of being personally violated

A sense of being betrayed by an authority figure

A sense that the danger is ongoing

A sense of powerlessness

One factor often cited in the formation of PTSD after a rape is a lack of support after the event. In cases where commanding officers, teachers, mentors or parents blame the victim, PTSD is far more likely to occur. The individual experiences that failure of support as a betrayal and a further violation. There is some evidence, conversely, that an individual who is able to participate in convicting her attacker and seeing him imprisoned both removes the sense of constant danger from an attacker at large and restores the victim's sense of power over her circumstances.

How a parent can protect a child from PTSD after a natural disaster:

It's tempting to assure the child, after a disaster, that everything is over and the danger has ended. It's risky to making such assurances until you're sure the danger is, in fact, over. If the parent tells the child they're safe before the disaster is truly over, the child will experience a sense of betrayal and loss of trust in the parent.

How can you reassure and calm your child without making inappropriate claims of safety? This is extremely difficult; when our child is afraid we want nothing more than to comfort them. It is possible to offer comfort while not providing false reassurances.

Inform the child, to the degree they can understand, of the situation, emphasizing that the parent is there and knows what to do, allows the child to feel confidence in the parent without suffering repeated traumatic surprise with each setback in the situation. Explain what you are doing to get them through safely. Also explain that at some point the emergency will end, and explain what will happen after that. Giving the child a more positive future to focus on will allow them to feel a greater sense of control over the present.

For example, if the family has escaped a flood and is waiting on the roof for rescue, it's probably not appropriate to state that you are now perfectly safe. Instead, communicate relief that you've escaped to a place above the water, and explain that you're waiting now for someone to come with a boat or helicopter. Describe the next steps, and explain that it may take a while. Explain that the child needs to stay with you in order to help you all stay safe from the water, even if he's restless, and then give him a simple task that he can focus on. Tasks might include re-organizing a first aid kit, entertaining a sibling, or even playing with a distracting toy.

None of us can guarantee our children will never suffer a natural disaster or tragedy. The best way to protect our children will always be to prepare ourselves. In other articles I describe ways to prepare your family materially for potential natural disaster. The tips in this article are a start in preparing yourself to protect your child against PTSD. Our child's health is, ultimately, our most valuable treasure.

For more information, visit the National Center for PTSD , and the PTSD pages of the National Institute of Mental Health.