Toxic stress in childhood is a theme of significant and increasing interest. There are numerous reasons for that, accumulated through the years of research, which provide conclusive evidence that stress/trauma causes many short and long term effects in children, thus imposing a risk for a series of diseases in their adult life. For example, it significantly increases the incidence of myocardial infarction and lung cancer, as well as immunological and malignant diseases in adulthood, in comparison with the population not exposed to stress in childhood. We are not writing here about the stress related to everyday activities and challenges of growing up, but about the stress related to family violence, to witnessing physical violence, exposure to corporal punishment, neglect, sexual abuse, peer bullying and similar.
The moment parents are informed that their child has been born with or has acquired some developmental disability is remembered, because it is something which completely changes family life in the long run. Every parent experiences a process of mourning and abandoning fantasies about the child held before, all in a very short period of time. Then there is the phase of recovery and adjustment to new circumstances of family life. Various studies showed that timely counselling and informing about the nature of their child’s disability, as well as about the possibilities of recovery and education, significantly reduce parental stress and their concerns and help them in the process of adjustment to raising their child.
Phases of denial and withdrawal
It is a very sensitive period when the recovery is preceded by phases of denial, refusing to accept there is disability, phases of withdrawal, distress, anger, and possibly despair due to the feeling of helplessness. These phases may vary in length, but it is important to take care that parents do not remain in any of them for too long, because it delays recovery and adjustment to the challenges of caring for the child. Various methods of coping with emotional reactions are expected from family members. Consequently, their mutual relationships also change.
Emotional support during counselling is an important aspect of their recovery, primarily by accepting their emotions which can be very unpleasant, like guilt, loneliness and shame. Emotional support initiates parents’ coping with difficulties and finding stimulating methods of caring for their child which shortens the period of denial. At the same time, it helps parents in overcoming their feeling of helplessness and in adopting an active attitude in treatment and rehabilitation of their child.
By emotional support we show how important we are as individuals and how we are ready to offer understanding and help in order to alleviate the existing situation. It is helpful to be aware of the fact that every family of the child with disability stretches beyond its limits emotionally, socially, financially, easily leaving parents void of their sources of energy.
Helping professionals and parents as partners in dealing with children’s disabilities
Helping professionals often have an opportunity to see how sometimes a little attention is needed to help a parent regain balance, under the conditions that the support is offered in an acceptable way and at the right moment. Therefore, although it may seem that it takes much time to set a diagnosis and start with treatment or rehabilitation, we should not underestimate the importance of moments during the initial counselling which may lead to changing the way parents comprehend, cope with, and solve problems.
Empathy and natural behaviour in the relationship are of utmost importance, and so is our ability to teach and be ready to learn at the same time. Besides the necessary level of empathy, it is important to be able to maintain a professional orientation to the goal of problem solving at the same time. In order to balance these two positions, the humane and the professional, we need to advise and at the same time build a partnership with parents in dealing with their child’s disability.
Counselling parents includes providing useful information or even demonstrations of some skills necessary to care for their child, but it also includes supporting perseverance on the part of the parents, where the therapeutical aspect of counselling is emphasised. Parents can have difficulties in recognising their child’s specific needs and show insecurity regarding the appropriateness and efficacy of some educational and rehabilitation procedures. In communication with parents we inevitably reach a point which, due to its nature, or emotional intensity, or some other adverse circumstances in the course of the child’s treatment, may seem insurmountable and where we, as counsellors need to stop, take a break and try to consider the situation from a distance in order to alleviate the feeling of pressure. That therapeutical aspect of counselling is impossible to neglect, since parents are often under the influence of strong emotions and overwhelmed with fear about the future of their children and with difficulties in coping with everyday stress.
Accepting emotional conditions of parents non-judgementally
We need to take a stance in which we accept parents’ emotional conditions non-judgementally and to try to understand the situation from their position. Some individuals are especially sensitive to criticism, possible feeling of being rejected, especially if they have a history of multiple traumatic experiences. They may have trust issues, in other words they very carefully consider and test whom they can trust. Respecting that, it is important to be patient and not rush the process. We should not forget that in communication, our impulse to solve something urgently (unless the case is really urgent), as well as impatience, are experienced as some sort of pressure which may produce a reaction opposite of what we wanted.
Sensitivity for what has been said and how it has been said, and for the whole communication context, helps. It helps to show interest not only for the child, but for other family members as well. That is how we help parents to express their experience and their perception of the situation with their child and then we help them in searching for solutions. That is how parents become ready to change their subjective perspective according to the findings regarding interventions in their child’s interest.
In the course of therapeutic counselling we often hear the parents say and we see ourselves how challenging life situations cause changes in the ways how we perceive some situation and which meaning we attribute to that situation, which often leads to changes in our belief systems, helps us find meaning and leads to new levels of personal integrity.
Written by: Sanja Jusufbegović, clinical psychologist
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