Elements Prior To Traumatic Intervention In Children And Adolescents
Regardless of the therapeutic approach, any psychotherapeutic intervention with children and young people requires knowing how to properly adapt said intervention.
To do this, we must begin the therapeutic approach from the perspective of neurodevelopment and attachment, adequately understanding the emotional and maturational states associated with the experience of trauma that they may have experienced.
To the extent that the trauma was earlier and present resources are scarce, The initial focus of the intervention should be directed to the interaction game. That is, fostering the relationship through play, stimulating curiosity in order to achieve, through said play, both regulation and bonding.
Play is an extraordinary means of captivating attention and interest. This implies that the child therapist has to possess or develop the ability to integrate the game in a playful and pleasant way, which is not a duty in the therapeutic process, but rather pleasure and curiosity.
In addition, they must be able to convey to the family that the game is therapeutic per se, and involve them in it if the parents are prepared for it. If they are, they must participate in the game dynamics and promote them between sessions; Otherwise, parents will have to be prepared in advance, to the extent possible. There is nothing that links more and better than sharing moments of joint satisfaction.
In the case of adolescents, it will be very important have batteries of dynamics that captivate your interest and that they are means to access your internal world.
Integrating attachment figures or caregivers into the process is essential; We do not have a child or adolescent without parents or caregivers. They are the ones who have the ability to cushion the impact of life, both positive experiences and negative experiences.
The best intervention is not one that is directed exclusively at the symptoms presented by the boy or girl or young person, but is one that also includes how the bond, the relationship within the family system, amplifies or hinders getting out of the cycle of the symptom or problem behavior.
The biological aspects of attachment
When the attachment is not secure enough, hormonal biology can serve as a guide to the states that we want to emulate and achieve so that an evolution in the attachment style towards a more secure attachment occurs.
In safe interactions, a balance occurs between various hormones. On the one hand, oxytocin, which stimulates the bond and is activated when we show interest through warm facial expressions, eyes, glances, with caresses and hugs, with empathy and full attention directed towards someone or towards ourselves ( as occurs in meditation).
So, Oxytocin makes it easier for us to focus our attention on the positive sensations and emotions of the experience. ; It is the shy hormone that is inhibited by a lack of interest and contact.
In addition, these safe interactions promote the presence of serotonin, known as the hormone of joy or self-esteem, since we secrete it before the joy of success and achievements, as well as when we discover the satisfaction and pride that the other feels when becoming aware of our merits. Likewise, serotonin is also facilitated by sport, nature, and is inhibited by stress, lack of sleep, adversity or bad news.
And the third hormone present in the safe interaction is dopamine, which is secreted by pleasure, excitement, pleasant and pleasurable sensations.
For the baby and child, all this pleasant sensory experience is achieved in contact with their main attachment figure, usually the mother. It is not surprising that it is said that the separation of a baby from its main attachment figure, usually the mother, generates a reaction similar to withdrawal.
And if we observe the game well, we will see how it is the ideal activity that can lead us to that relaxed and pleasant relationship, in which the therapist and the parents focus all their attention. In this interaction through play and relationship, the balance between the three hormones occurs.
Play therapy
Play therapy knows very well the benefits of play; so that, the combination of game dynamics in the psychological stabilization phases in which we are encouraged to experience what has been missing or is missing in family interactions, opens up new opportunities for us to repair or amplify regulatory systems.
All of this will promote both dyadic regulation in contact with the other, as well as self-regulation without falling into the over-focusing of the game, where the other is annoying.
Know read the child’s body expression in the present moment a reflection of pain and its defensive dynamics in the face of the problem situation and the family relationship, is essential, and this gives us the opportunity to create a state of co-consciousness that will allow us to transform and change underlying beliefs.
In childhood and adolescence, therapy is based on the interrelation generated through the game and the development of the narrative. Both allow the child and the young person to take ownership of their story. And it is essential that the family system supports and works hand in hand. If this does not happen, we will only be able to solve the symptom temporarily.
Trauma intervention
Sometimes we therapists are too bold when it comes to childhood and adolescence and we consider that, with a child, anything goes: telling a story, tapping while we tell it, etc. And we are not aware that we are exposing the minor, with early traumatic experience, to information and an internal experience that he does not know how to communicate or handle.
Therefore, it is essential to be properly trained in trauma-focused therapies such as EMDR, and carry out the training course of child and adolescent therapy, in order to become a good practitioner of EMDR for children and adolescents.
EMDR Europe recommends that only therapists trained in EMDR for children and adolescents intervene therapeutically with the EMDR model with the child and adolescent population and with adults who present some cognitive disability, since only they will be prepared to make the necessary adaptations to each stage of development. cognitive, emotional and psychomotor development.
Author: Cristina Cortes Viniegra, EMDR Trainer for Children and Adolescents and Director of Vitaliza Health Psychology.
