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Narratives and wounded children...

by afew Wed Mar 28th, 2007 at 11:28:06 AM EST

I just read this from the UNICEF magazine I found in my (hardware) mailbox:

Il faut distinguer le trauma (le coup réel, la blessure, l'indifférence des autres) et le traumatisme qui est la représentation du coup, de ce que l'enfant met dans sa mémoire, que son entourage lui dit, et du discours de la culture qui qualifie les enfants soldats de "monstres perdus, d'assassins..." Il faut donc agir sur l'alentour, en expliquant au village, à la famille les "fracas" subis par l'enfant.


L'adulte ne doit pas se focaliser sur le trauma des enfants, pour ne pas leur apposer l'étiquette: "Il est celui qui a été enfant soldat", au risque de ne laisser comme seul choix que mercenaires aux garçons et prostituées aux filles.

You have to distinguish between the trauma (the real blow, the wound, the indifference of others) and the traumatism that is the representation of the blow, of what the child puts into her/is memory, that the surrounding circle of people tells him or her, and of the discourse of the culture that calls child-soldiers "monsters, fallen, murderers..." So you have to act on the child's surroundings, by explaining to the village and the family the "bust-up" the child has been through.

The adult shouldn't focus on the children's trauma, so as to avoid sticking on the label: "He's the one who was a child-soldier", which bears the risk of leaving the boys with the sole choice of being mercenaries, and the girls prostitutes.

It's by Boris Cyrulnik, French ethologist and neuropsychiatrist, who works with UNICEF on problems faced by kids who have been forced or inveigled into joining war bands.


The thing, he says, is to take the stigma out of what they did - or, above all, how what they did can be described and how they can be labelled (narrative, narrative...). Surround them with ordinary, everyday emotional and educational links. Get them to play music, football. Not pretend nothing ever happened, but not insist on dragging it all out, not dramatize it. Even denial is not such a bad thing - for a time - he says. It's like plaster around a fracture, that keeps everything still as it heals.

The concept he supports is that of "resilience". We can bounce back, even from terrible ordeals:

Boris Cyrulnik: surviving the trauma of life

There is no typical profile. But a traumatized child can still be resilient if she or he has acquired a gut or primitive confidence in the first year of life. Such children take the attitude that “I’ve been loved therefore I’m worth loving, so I live in hope of meeting someone who’ll help me resume my development.” These children feel a lot of grief but still relate to other people, give them gifts of food and look for an adult they can turn into one of their parents. Then they give themselves a narrative identity – “I’m the one who was… sent to the camps, raped, forced to become a child soldier” and so on.
If you give them a chance to make up for lost time and to express themselves, nearly all—90 to 95 per cent—become resilient. They have to be given a chance to be creative, to test and prove themselves as kids, through things like joining the scouts, studying for an exam, organizing a trip and learning to be useful. Problem youngsters feel humiliated when they’re given something, especially if there’s a lecture along with it. But they regain their balance when asked to give something themselves.

Cyrulnik is far from having all the shrink world on his side. Psychoanalysts, in particular, call him a behaviourist (possibly because he studies animals as much as humans - but I don't see the behaviourism in his discourse on culture, labels, and narratives... Am I mistaken? Apparently the concept of resilience came from the behavourists in the 1950s...). He would not bring out his own experience (which he was for years quiet about) in his defence, but it probably influenced his thinking. A Jewish Russian immigrant child in Bordeaux during WWII, he lost his parents and was himself shut up in a synagogue during a round-up organized by Maurice Papon, but managed to escape. The only survivor of his family, he believed himself ready to die of grief. He became France's most charismatic and popular psychologist.

There's more from him in English here.

Display:
Great :).....

Child abuse without violence is traumatizing because well.. it is clearly explained in this diary

Child abuse plus violence... well is traumatizing well..again.. on two narrative fronts... being the rejection of nonsense violence an stronger narrative given that real violence also has a direct real-life effect, it hurts and wounds.

A pleasure

I therefore claim to show, not how men think in myths, but how myths operate in men's minds without their being aware of the fact. Levi-Strauss, Claude

by kcurie on Wed Mar 28th, 2007 at 11:46:48 AM EST
I think Cyrulnik's approach is right. I think the children first need to learn that they are safe and Cyrulnik's way seems to do that.

I am always amazed that the so called experts are so inflexible. Either it has to be pure behaviorism or pure psychoanalysis, or pure whatever... Often a combination  works even better. I think once the children feel safe, they can open up much more easily for psychotherapy. Though I must say I am not a friend of rehashing everything that happened in ones life. My experience is that during sessions subconsciousness/memory sets free those memories that are important to a topic. No need to go and search for it or for everything. Subconsciousness in my opinion has a mechanism were it can incapsulate certain experiences, so that they do not interfere with the general well-being. However, when that mechanism does not work anymore, for whatever reason, it is time to work through that topic.

by Fran on Wed Mar 28th, 2007 at 12:45:30 PM EST
Problem youngsters feel humiliated when they're given something, especially if there's a lecture along with it. But they regain their balance when asked to give something themselves.

It's always the children who give us the hardest time who are desperate for jobs to do at the end of the school day. We have to invent tasks sometimes. The easiest positive feedback to accept seems to be 'Thank you-that really helped...'.  For some of them, it's the only good thing about themselves they can hear...

by Sassafras on Wed Mar 28th, 2007 at 03:35:49 PM EST
it's the only good thing about themselves they can hear...

That is just so important. I think more children than we realize live in an environment of negative opinions about them, that they interiorize. I remember being unhappy at school for some years (I only realized afterwards I'd been unhappy), and making trouble non-stop - then one positive assessment from one single teacher showed me the way out of it.

by afew (afew(a in a circle)eurotrib_dot_com) on Wed Mar 28th, 2007 at 04:01:37 PM EST
[ Parent ]
It has to be the right positive assessment at the right time.  Taking a deeply embedded frame head on is pointless.  Goodness knows, I've tried... But chipping away at its edges, giving a child a chance to believe s/he is useful as a preliminary to feeling worthwhile and liked...children usually know what they need- and sometimes what they need is to sharpen pencils.
by Sassafras on Wed Mar 28th, 2007 at 04:46:37 PM EST
[ Parent ]
This reminds me of an article I read a few years ago on resilience. Charlie Chaplin was used as an example of a person who had gone through great trauma during childhood and had managed to turn it to their advantage.  I've tried trawling but haven't come across the article.

It made me wonder at the time how some people to manage to emerge fairly unscathed from some awful experiences and are stable and successful and then others completely fall apart and their lives are ruined.

Resilience and recovery are such interesting areas and I'm surprised that not more has been done to study them.

It does go to show that it is unfair to make the assumption that a person who has been through severe trauma during childhood, will never recover or be 'sound of mind'. I think of adoption processes which ask applicants if they have been through childhood trauma such as abuse - the implication seems to be that these people are more likely to go on to be abusers, which I find to be unfair.  I've probably digressed anyway.

I'm fairly sure that there is a psychological process that allows experiences to be dealt with and although not forgotten, distanced.  I find myself agreeing far more with forward looking therapies that deal with current feelings and associations and how to turn those negatives into positive or neutral approaches - rather than an in-depth analysis of everything that has happened and how it felt.  I like Cyrulnik's approach.  

by In Wales (inwales aaat eurotrib.com) on Wed Mar 28th, 2007 at 03:48:02 PM EST
I think of the standard approach today, which is that emergency psy-teams are rushed to a trauma scene to "debrief" shocked children - the supposition being apparently that if they don't say it all, put words on it, they won't purge it (it's a cathartic method) and it will fester and make them ill. I wonder if it doesn't make things worse by overdramatising.

Cyrulnik seems to me intuitively to be so much more right. He's not saying it's right to go into total denial about real wounds, a real trauma. But that the representation of that trauma is narrated by the social environment and is likely to be stigmatising, and that this is the first thing that needs handling.

by afew (afew(a in a circle)eurotrib_dot_com) on Wed Mar 28th, 2007 at 04:20:27 PM EST
[ Parent ]
You can't make anyone talk about a trauma when it has only just occurred. Forcing affrontation of the issue reinforces the stimga that something terrible has happened and that by being the subject of the experience they too are terrible in some way by association.

It can also interfere with the natural processes of absorbing what has happened and defining one's own narrative and understanding, which then gives a base to move forward from - perhaps only then is debriefing appropriate in some way.  Quiet reflection works for some. Emotional expression and purging works for others.

I wonder how short term intervention reflects on longer term outcomes?

by In Wales (inwales aaat eurotrib.com) on Wed Mar 28th, 2007 at 04:43:46 PM EST
[ Parent ]
The children are probably the most important, Unesco does good work and Cyrulnik does good work.  If they are getting ATTENTION AND CARING by decent adults, there is a very good chance they will recover to a functioning degree and I applaud.  

Giving the man credit for his personal growth through such a tragedy, I find his professional vision very questionable.  The interview is supposed to go down like sugar, all loose ends neatly tied up, all clear solutions and people may donate.  It is too oversimplified to swallow it.  I feel talked down to by a "psychological neo-liberal".

Cyrulnik only refers to his personal wounds in "third person," while writing about children. Clearly, this is a man who has learned to transform weakness into strength. "I was never put on the `conveyor belt' of life--I've always made my own path," he says.
....
After studying medicine, he followed diverse branches of psychology, such as neuropsychiatry and psychoanalysis, before breaking the sacrosanct barriers between academic disciplines.

A jack of all trades...?  A self-made man... who may be unable to integrate his own trauma into the first person, but advises the rest of the world about it.

A "maverick" that breaks discipline barriers, as if they existed for no reason...  Barriers are not sacrosanct, but other disciplines have not been developed by retards.  There are tomes written on the subject of pervasive attitudes instilled in medical students versus other fields and versus humanities.

It´s really worrisome propaganda fed to a non-alert public and there are gazillion studies on trauma that alert against this simplistic claptrap.  Trauma is not cut and dry and there are too many "well-adjusted" robots walking around and ticking away because people fall for this all the time.  Look at the leaders of the free world!

Our knowledge has surpassed our wisdom. -Charu Saxena.

by metavision on Wed Mar 28th, 2007 at 06:21:17 PM EST
I find this a strange reaction. Let me just point out you  are quoting for a good deal what some journalist or UNESCO writer says about Cyrulnik. Also, that's only an interview I linked to because it's in English. You haven't seen Cyrulnik talking to people (as I have on TV) or you'd know he doesn't talk down to anyone - at least, that's not his public manner.

A jack of all trades...?  A self-made man...

That's most unfair. First, because "jack of all trades" goes with "master of none" which presupposes Cyrulnik is no good at anything. Second, he is in no way a "self-made man" of the kind that expression usually describes. He went through the French educational system and became a hospital specialist, worked in the same public hospital in Toulon for many years. Nothing entrepreneurial or (my God) "neo-liberal" about that.

Discipline barriers don't exist for no reason? Doesn't that presuppose some kind of "invisible hand" that organizes science and fields of human knowledge in an infallible way? Presumably it's up to that teleological guiding genius to reveal from time to time what all the disciplines tell us when taken as a whole, since mere humans are meant to just chisel away within the limits of their chosen field?

Well, no, you say "disciplines have not been developed by retards". Which implies creators and developers of disciplines knew why their discipline had the limits it had and how it fitted into the pattern of other disciplines. Possibly. But it's a static view. Knowledge is constantly on the move and new disciplines grow while older ones (for better or for worse) lose importance. New generations will have a different overall view. Individuals, in that changing context, may see the usefulness of new combinations, that may in their turn define new outlines for fields, or links between them.

simplistic claptrap

Cyrulnik has written a great deal, and I was simply - rapidly - picking out a brief interview or two, so the "simplistic" may be justified on this showing. It's true also that he's something of a "guru", and that can be held against him. But "claptrap"? Care to show how? You refer to a "gazillion" studies of trauma. That say what? (Don't be afraid of being called "simplistic" if you cut corners in replying ;)).

But with "worrisome propaganda", you leave me completely behind. I don't get that at all.

by afew (afew(a in a circle)eurotrib_dot_com) on Thu Mar 29th, 2007 at 03:12:10 AM EST
[ Parent ]
Let's see if I can "simply" express my objections, based on life, not on textbooks.  I don´t believe in one-way answers, or their promoters.

I resent the personality cult piece under the Unesco name.  I am put off by his exceptionality:  "I was never put on the `conveyor belt' of life--I've always made my own path," for obvious reasons.  That´s what brought up a neo-liberal parallel and contradicts his own advice that it requires a caring community effort to "resiliencize" a traumatized child. (Gotta love those re-invented terms.)

His discipline-jumping seems questionable because he is set up as an expert, but he doesn´t develop or improve any of them.  IMHExperience humans and traumas are not comparable, interchangeable or band-aidable.  This attitude seems to treat traumas as commodities in different markets.

The interview includes too many talking points and they are not covered well because the reader is not supposed to need to know much.  It is supposed to touch emotionally and soothe intellectually, which may bring donors, but is a small favor to the cause.  Giving a shortcut solution in one page to the terror-lives of war children, who have no guarantees that it is over, is cold.  It is simplistic because there is no way to condense that subject, but it is minimized in that piece.

I called it worrisome propaganda because it leads one to think it is easily solvable with a good theory, when it is so disconnected from the field practice.

I feel a lot better after reading the Label France interview with Cyrulnik because it is a lot clearer and narrower to the point.

Regarding post-trauma psychotherapy he is flexible and seems aware that it cannot be put off permanently.  I believe no serious psychologist would set up a schedule, but humans tend to delay the uncomfortable and it just gets out of proportion when the next personal crisis comes up.

BC: "Silencing the traumatized prevents their healing"  

One saw I was taught as a volunteer was "what can be expressed, can be healed" and going through a grief process confirmed it was true.

Our knowledge has surpassed our wisdom. -Charu Saxena.

by metavision on Thu Mar 29th, 2007 at 02:30:38 PM EST
[ Parent ]
I'm sorry the material I linked to was not so very adequate - I hunted English-language stuff rather quickly. And, yes, the UNESCO piece is a fundraiser (as btw was the UNICEF piece in my letterbox... I just ignored that aspect as I was reading...).

I also felt sure, from other reading, that Cyrulnik wasn't belittling trauma or suggesting it needed no treatment. Even his point about denial being acceptable as a form of protection was specifically under condition it be temporary.

no serious psychologist would set up a schedule

However, as we have said at different points in these comments, the PTSD doctrine that seems to prevail at the moment sends shrink teams flying in to trauma spots to make the victims talk, the commonly accepted idea being that, if words are not put on what has just happened immediately, trouble will follow. That seems to me both invasive and over-dramatic. Cyrulnik seems to me to show more respect for the traumatized psyche and a better understanding of the social processes involved - that the harm is not just the trauma but how it is represented, what narrative about it prevails in the surrounding community and in the wounded person's mind. Of course, he's not the only one who's saying that, and he does tend to come over as a celebrity.

And sorry, meta, if my reaction to your comment was insensitive.

by afew (afew(a in a circle)eurotrib_dot_com) on Thu Mar 29th, 2007 at 02:54:04 PM EST
[ Parent ]
There is no fault here except the publicity necessary nowadays to get a message across in our oceans of messages.  I can understand why good organizations need it, but at the same time it bothers me that it adds more of the same.

the PTSD doctrine that seems to prevail at the moment sends shrink teams flying in to trauma spots...

I always read it to mean "they are immediately available" and nothing else.  It is essential to have professionals there to ´provide the opportunity, just to be-with´, but I don´t think anyone is asked to talk.  People are in shock, dissociated at that point and would be really abusive to ask them to analyze, but I do think they need a "caring recorder".

Our knowledge has surpassed our wisdom. -Charu Saxena.

by metavision on Thu Mar 29th, 2007 at 04:26:54 PM EST
[ Parent ]
Excellent find, afew...and excellent article. Thank you. I sure could say a lot about this...as this is my area of expertise...

I caught this article at the end of my work day and noted it to return to...and so here I am. The issue of children, trauma (and severe stress and ongoing adversity) and resilience...in association with sport, play and education... is what I am researching exactly...and have been the last two years. Also, add to that the work I have done as a psychologist in the community mental health realm for the last 20 years. I find this article refreshing and correct.

I hope we can talk about this more...and I have intended to...except for my being so into this topic in the day, that I have had difficulty feeling up to talking about it at night. Nonetheless, here are some random thoughts:

It might be safe to say that just everyone is exposed to a traumatic life event at least once in their life. I will say that anyway. And being exposed to a traumatic event does not mean that this is or will become a psychiatric problem. In fact, it is pretty much recognized in the trama field that upwards of 95% of people who experience traumatic events return to their normal pre-event functioning...without any treatment but time. That doesn't negate the importance of therapy or of psychosocial programs that can help people get over these stressful events sooner. I would even say that is encouraged for children to be involved in some sort of program, as they are still developing and can be seriously affected be an early experience of a traumatic event, and a social program can be very healing.

I am also one of those people who can see both sides to approaching work on trauma...or the development of the severe response to traumatic events: PTSD. If a person chooses to go do depth work on this...good for them, but it will not be easy. As a psychotherapist I have seen the effects of other therapists who pretty much forced the re-experiencing of a past trauma on a person (through confrontation), leaving that person psychologically shredded and in much worst shape than they were before. Is that responsible behavior on the part of the therapist? I am one who believes that defenses are there for a reason. I also learned about that early in my training, when a fellow came in wanting to dig into why his life was such a mess. So we went digging..and what we found was ultimately overwhelming for him, and he slipped into drug addiction as a response. I never forced this on him, and tried to be very careful, but I felt awful. One of my training supervisors had these words of wisdom for me: never make person feel something they are not ready to feel. Lesson learned. Even the most strong and resilient, when faced with crushing pain of a re-experienced trauma, can be brought to their knees. Each person has to ask...do I want to go there...hoping it sorts out, but maybe risking opening a pandora's box? Or I do I go forward? I have learned to be extremely cautious on this front. And definitely not to judge the decision "just" to cope better...for many many people...that is a blessing. Most of my work back in San Francisco community mental health days was to teach people effective coping skills, to manage their symptoms, to learn how to communicate and deal with conflict, and even to learn basic living skills. No one will ever be able to convince me that this isn't a valid approach to helping people.

Another tidbit: Research with post-9/11 fireman and other emergency workers in NYC found that debriefing soon after the trauma event was in many instances worse than helpful. The feeling is that it is better to allow persons time to establish their own resilience responses. Only those that are having trouble with coping or having some intrusive symptoms that aren't passing should be given more intensive help.

Regarding kids. I could speak at length of numerous kids programs offering sport & play programs to help them manage adversity. For example, one program in Uganda, The Kids League, has been establishing soccer and netball leagues for boys and girls in the northern region, where there are refugees from neighboring wars, and internally displaced populations seeking safety from the LRA. They have inadvertantly discovered that sports offers structure, stability, and a chance for kids to be integrated. They have witnessed numerous kids who were child soldiers be accepted onto teams, which was so important...and on a number of occasions...if one of these ex-child soldiers was fortunate enough to score a goal and be hugged by his team...whoa, very powerful healing experience. Its not about going back into the trauma..its about moving forward...and that resolves trauma too.

The current project I am trying so hard to develop and fund in Tanzania...is with street kids...and I have every reason to believe that once I get to do the research with them that we will find that kids can be strengthened by having healthy relationships with caring adults, healthy peer relationships (guided by caring adults), learning problem solving skills and being encouraged and supported to give back to their community. This is legitimate healing.

I could go on and on...and maybe should diary it (again) instead...but I can again say that this is an area I have expertise in...and the article about this fellow is a good one. He's doing good work and is right on.

Thanks again, afew!

"Once in awhile we get shown the light, in the strangest of places, if we look at it right" - Hunter/Garcia

by whataboutbob on Thu Mar 29th, 2007 at 06:41:34 AM EST
The current project I am trying so hard to develop and fund in Tanzania

Just a curiosity: what's the project's budget?

"It's the statue, man, The Statue."

by Carrie (migeru at eurotrib dot com) on Thu Mar 29th, 2007 at 06:43:58 AM EST
[ Parent ]
I am trying to fund at least part of my work, plus help the organization capacity build too. We have submitted two large grants so far for $200,000 to $300,000 a year, for 3-5 years (and more being written). My part being approximately a quarter of that. Or, another way to look at it...I will require $20,000 a year per 20% (adding in all my taxes, social costs, my office overhead, travel and % to the University)...which is on the low end, but it gets things moving. I would like to be full time...but every 20% piece buys me more time.

"Once in awhile we get shown the light, in the strangest of places, if we look at it right" - Hunter/Garcia
by whataboutbob on Thu Mar 29th, 2007 at 06:51:28 AM EST
[ Parent ]
I am one who believes that defenses are there for a reason. I also learned about that early in my training, when a fellow came in wanting to dig into why his life was such a mess. So we went digging..and what we found was ultimately overwhelming for him, and he slipped into drug addiction as a response.

Yikes.

"It's the statue, man, The Statue."

by Carrie (migeru at eurotrib dot com) on Thu Mar 29th, 2007 at 06:45:26 AM EST
[ Parent ]
Yes...yikes...and ouch. The psyche is a very powerful thing...and I have come to honor that.

"Once in awhile we get shown the light, in the strangest of places, if we look at it right" - Hunter/Garcia
by whataboutbob on Thu Mar 29th, 2007 at 06:52:46 AM EST
[ Parent ]
I probably should add, this person had life long addiction problems...which was one reason they wanted to dig into the issues. And clearly the trauma drove the addiction for this person. A very painful learning experience for me too...

"Once in awhile we get shown the light, in the strangest of places, if we look at it right" - Hunter/Garcia
by whataboutbob on Thu Mar 29th, 2007 at 07:18:07 AM EST
[ Parent ]
For anyone interested...

Here's a recent little article I had published:

Trauma, sports and resilience

http://www.sportanddev.org/en/articles/trauma-sport-resilience/index.htm

also, last year I co-authored one of the first articles on kids, sports and trauma fort he Magglingen 2005 International Conference on Sport & Play:

Overcoming Trauma Through Sports:

http://www.magglingen2005.org/downloads/02_E_input_trauma.pdf


"Once in awhile we get shown the light, in the strangest of places, if we look at it right" - Hunter/Garcia

by whataboutbob on Thu Mar 29th, 2007 at 06:53:33 AM EST
[ Parent ]
Thanks, Bob. I was thinking of you, of course, in posting this, but I didn't want to commit you to commenting by mentioning you.

You should diary this again when you're ready. You've got a lot to tell us about it.

by afew (afew(a in a circle)eurotrib_dot_com) on Thu Mar 29th, 2007 at 11:19:18 AM EST
[ Parent ]


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