Many children and adults have been traumatized by the recent earthquakes that struck Nepal. However, children show different symptoms and behaviors than their parents and their difficulties can last for many months and sometimes years. When children are frightened, they can show their fears in a variety of different ways depending on their personality and age. Of course, different responses by parents and other caretakers can help children feel safe and help them get back to their normal behaviors.
Children, especially those between 3-14 years, may become very clinging, wanting to be held and not want to leave their parents. They are likely to have trouble sleeping and may be very fearful of the dark. A common fear is being afraid to enter any building even when their parents have reassured them it is safe. Other children become hyperactive and need to run about and become inattentive in school. Older children and adolescents often start to misbehave and disobey their parents as a way of getting attention and asking for help. Depression is another behavior that comes with the fear and helplessness that children experience. Many children will develop physical symptoms such as stomach aches, headaches, and may lose their appetite for food. However, these behaviors are a normal reaction to a traumatic situation and are not a sign of serious psychological problems so parents need to reassure themselves about their child’s situation. Nevertheless these behavioral changes need attention so that children can learn to cope with the trauma and return to their normal emotional selves.
Before we discuss how to help children overcome these problems, we must realize that although an earthquake is a brief event, the aftershocks may last for a long period and are unpredictable. That will result in a lessened feeling of control for both parents and children. Thus emotional recovery from this event usually will take months and some symptoms may reappear for a year or more.
Another issue relates to the trauma experienced by a child’s parents. Obviously, parents have been affected by the trauma of experiencing an earthquake and its physical, financial, and emotional after-effects and that will affect how they react to their child in terms of their own difficulties. They too may feel depressed and fearful, will not have their usual store of patience, and be busy with the many tasks of reconstruction. Parents and other family members need to make an effort to put aside their difficulties to attend to their children as the latter are impacted by the reactions of the adults, and intense parental fear and avoidance will interfere with a child’s therapeutic progress. Moreover, the effort of attending to their child's needs can help distract parents from their own difficulties and seeing their child improve will be therapeutic for any parent.
After an earthquake, a parent’s most important task is to make their child feel safe. Children should be allowed to stay close to their parents, grandparents, and other relatives. Let them hold your hand and have physical contact. Reassure them that you will take care of them when things are frightening. Just saying, “I’m here” is comforting. As much as possible, try to re-establish common routines and telling them where you will be and what you will be doing is reassuring when you are not at home. Try to restart familiar activities, including sports or playtime with friends at the earliest time possible after the disaster. Access to peers is very important for “normalizing” the situation over time because child to child talking and sharing of their fears and experiences is very helpful and serves to desensitize their emotional overreactions. Likewise, parents should ensure children have access to familiar things such as their favorite toys.
Parents should also ensure that the children are kept away from frightening scenes, conversations, or TV or radio reports. They also may need to have their access to computers, ipads, or iphones curtailed if these items provide upsetting images and information. Children are likely to misunderstand what they hear and see, so parents need to correct such misperceptions as they are likely to be made worse in a child’s mind. Children might constantly ask, and in many different ways, if there will be another earthquake or if their house will fall down; parents need to give repetitive reassurances that even if there is another shaking of the ground, they will keep them safe.
Another important task is to help children express their feelings. Often, children, especially young children, don’t have the words to express how they feel so it's the responsibility of the parents to help them name feelings like sad, angry, scared, or happy. Parents should not be afraid of letting a child talk about how they feel as that helps them understand what they are feeling.
Additionally, just talking is helpful and tends to diminish the intensity of their fears and confusion. A child may also want to talk about what happened and that is also helpful. Don’t be surprised if they are taken by some minor and insignificant detail and want to talk about that. Children interpret and focus on things in ways divorced from adult logic and what worries them may be very different from the real worries of their parents.
There is a delicate balance between allowing a child to express their feelings and their recall of events and forcing that on a child who is too traumatized to talk about what happened. Adults will do best by giving a child the opportunity by listening for when they want to talk and that is true for children of all ages. A family member might gently initiate such a discussion by telling the child how the parent felt and the things that scared them.
But if they sense the child is not ready to talk about the earthquake and what happened, then this should be stopped. Children will give cues that they are ready for talking and expressing their emotions, and trying to prematurely force this on them is destructive.
There may be some children who do not want to talk about the earthquake and what happened either because they are too traumatized or because they simply don’t feel like talking. That does not mean that such children are at risk of emotional problems; all children are different and have their own way of dealing with fears and traumas.
In such cases, there are some simple techniques that parents can use to help their child. Cooperative story telling is useful. Parents can ask preschool and young children to tell a story about what happened during and after the earthquake and they can call that “The Earthquake Story Game”. Together they can share their memories of what happened and when. This gives a parent an opportunity to listen and allows the child to make sense of what happened. Also, the parent can then correct things by telling the child what they remember. Children can use a toy to show what happened. They can have the toy animal or doll tell how they felt and what scared them. If the story is difficult then take a break and let the child play with another toy until they are ready for the “Earthquake Story Game” to resume. If possible, always have the child finish the story by telling something happy that happened.
Parents or guardians can also play games to de-intensify fears they might experience with ongoing aftershocks and make them feel they have control over things. Working together, child and parent can take blocks and build something and then announce “earthquake” and knock it down. Then tell the child. “See, we can build it up again so let’s do that”. Another game can be called the earthquake game. Have the child lay on a bed and say, “earthquake” and shake the bed. Then ask the child to say, “Stop” and stop the shaking. Also, you can have your child do that to you when you lay on the bed. Children may want to be very repetitive in playing these games as they do not get over their underlying trauma in only one experience.
Parents can also resort to games to dissuade the fear of loud noises children may develop after earthquake - such as the sound of distant thunder, construction noises, or any loud noise. Parents can have the child make a loud noise and the parent can initially pretend to be frightened, but then say, “Oh that’s only a silly noise like a drum, that’s not an earthquake noise”. Then reverse roles and repeat. The purpose is to have the child feel as if noises are familiar events. Also, that they are in control of their reactions and not feeling helpless. Such games are useful with younger children. With older, more verbal children, teaching them about earthquakes, what they are, and what causes them can be helpful. Parents can explain these things, provide a child with a book about earthquakes, or perhaps a simple computer narrative about the geology and earthquakes will help them understand what happened.
Older, more verbal children are more likely to be able to talk about some of the difficult sights and memories they experienced. If they are ready to talk about that, parents should let them do so. They may sob and even tremble on recalling sights of injured people, animals, and collapsing buildings, and that may be difficult for parents to hear. The things they remember might be very painful and disturbing to hear, but talking about such things will be helpful in the long run.
Children commonly have upsetting dreams and nightmares that are related to their earthquake experience. These are very upsetting, especially for young children who may wake up sobbing and scared. Children may want to talk about these and just listening will be helpful. Listening is very important as having the child relate the dream tends to introduce waking reality to the unrealistic imagination of the dream. Of course, parents can refute the unrealistic images by saying, “Oh that sounds silly. I don’t think that could really happen”. It's important to be aware that upsetting dreams and nightmares may continue for quite some time, but eventually they will become less frequent and less intense and gradually go away with the passage of time.
In summary, families can best help their children cope with the traumatic experience of a destructive earthquake by first making sure they feel safe and secure. They should attempt to get back to normal and usual routines as soon as the situation permits. Adults should allow, but not force their child to express their upsetting feelings and parents can be most helpful by being caring listeners. They should realize that children who undergo such an experience will most likely become traumatized. However, the changes they see in their child, although upsetting, are normal reactions to an abnormal experience and should disappear with time.
(Leve, PhD, is an associate professor of Psychology at the University of Hartford)
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