Dr. Jean on working with children in therapy (part 5)

As a social worker and psychotherapist, in her 30 years of clinical practice in trauma recovery, resilience building and holistic mental wellness, Dr. Jean has worked with and talked with people of many ages — including children. 

She has also talked with youth and older people who have survived trauma earlier in their lives.

She reflects with care and sadness on this very difficult subject — and she speaks with honesty and clarity. Please be aware, this conversation may contain difficult and triggering language for some people.

Dr. Jean: Now we're teaching (41:00) children earlier the proper body parts, so that, in a way in prevention, when they're telling us, when we're talking to them, when we ask them, we're using the proper term for body parts and sexual activities. So it's an easier conversation. 

My age, growing up, when you talk to your mom about sex, nobody's telling you anything about it. Babies come from — wherever they used to tell us. 

... I think for us, it's your grandmother or something. Whatever they tell you, it wasn't the truth. It's not ‘mommy and daddy had sex.’ It wasn't that. … They had all kinds of words, and they talk baby words to babies.

And so no, we're not doing that anymore, because you need to teach (children the right words) early. Because so many people are sexually assaulted very early. A lot of pre-verbal sexual assault happens, where people … yeah, things happen early, and you don't even have words for it. 

So when children start to speak, you want them to have words. Because you know, people struggle with emotions from very early. If you're hurting me, it's going to be painful. 

And if I’m four months old, I don't have a word for pain, but you're hurting me. Where does that live? I can't tell my mommy someone did something to me to hurt me. Where does that information go? It's just locked in there, all preverbal. (42:30)

 The conversation comes to a brief pause and time for everyone to check in gently.
Kate: (To Dr. Jean, quietly, acknowledging the gravity and pain of the conversation): How do you have conversations with kids about … whether it's informational or whether it's trying to give them a positive sense of their own bodies and a sense of empowerment or whether it's trying to talk with them if they have experienced trauma? 

Dr. Jean: I was very lucky in my internship to spend a year at the Child Advocacy Center here, the Kids Place. And during one of my first internships, my first client was three years old. I thought, what am I supposed to do with him? (My mentor) said, don't you have three kids? I said, yeah, and she said, go to work. 

So I learned fast how you work with kids. So you come to their level, because they only have limited vocabulary, right? And in the past, we would do a lot of play therapy with them, sand therapy, and they would reenact many things in that way from the views that they've suffered. (46:00) What else? Again, just mostly through play. 

So if you're working with them, you may be playing with them, you may be asking them questions about like, "Well, there's anything that make you feel sad. Is there anything that makes you feel happy? You know, what are the things that make you afraid? You want to tell me about this?” 

Maybe no, maybe later. Sometimes I'll come back to it. Just in a way to be gentle and make them feel safe. Because one of the biggest things any person need is a sense of safety. You know, what am I going to be doing? 

Dr. Jean refers to a moment earlier in the evening when she and Kate were looking for the room on the second floor where JV was setting up for our recording time. We had tried two or three doors on the far side of the house and spoken with one or two people who gently pointed us another way, and then come around to this side. 

Kate went up and looked in, and knocked gently, and talked with JV to check that we had the right place this time, and then beckoned Dr. Jean to say come on up.

Dr. Jean: When we were coming up today and I said I'm just going to wait on the steps down there. And then you're like, okay, come on in, it's safe. By doing this, you're saying it's safe. 

So with children, we want to encourage them, we want to use soft voices, we want to put them in spaces where they're having a little bit of fun, where they feel like, oh, this is play, (47:00) and then they feel more secure. 

And you just be consistent with them. Children need consistency. So you're you're going to come, and you're going to work with Dr. Jean, or whomever the therapist may be. This is somebody who you feel safe with, and you could tell them, or you could tell me anything, and I will keep you safe. 

You just work with them in a way that's to their level, and in a gentle way, and very patient, because the work is slower. 

So yeah, we have a lot of children in the shelter, and the shelter has a child advocate, somebody who specifically works with them in that way. 

Kate: You were talking about doing some work with domestic violence in children and long-term effects throughout more of their life. 

Dr. Jean: Yeah — yeah, that's basically my dissertation. 

Kate: Ah, wow. 

Dr. Jean: So my work, (48:00) for my dissertation I specifically looked at adolescents. And I spoke to their mothers, because it's very hard to get the human subject review board to allow you to speak to children in that way. 

So what I was saying about that is that children witness a lot of the abuse. And because they witness the abuse — sometimes you don't realize they witnessed the abuse. And sometimes you start seeing the child behave certain way, and you’re thinking, what's wrong with this child? 

You think they're being … it's difficult to discipline them, and it's difficult for them to respond to discipline. It's difficult. They're having nightmares, or they may not want to be in school, or they may not be doing well in school. 

A lot of times, when they witness domestic violence, we have to make the assumption that if they do, there are long-term effects. And when we think of what could happen when a child witnessed their mom or their dad being hurt, or somebody else in the family being hurt — because a lot of abusers just don't abuse their partners. They abuse children, and they abuse the animals in their environment. 

So what are the things that children witness? Children witness the physical abuse, children witness the sexual abuse. Sometimes if they don't see it, they hear it. 
Children witness even the silence. Mom and dad used to laugh and talk. And now it's just silent. We eat our meal in silence. I don't see my parents talking. I don't see my parents laughing. 

And then you would say, "Why would that affect a child?" 

Kate: (softly) Oh, of course it would.

Dr. Jean: But it does affect them, because they're wondering sometimes — if the person is silent, (50:00) what’s going on in their mind? We don't know what's going on in their mind. 

So I think some of the immediate effects may be that the child becomes sad, or the child become anxious, if they've been traumatized by what they witness. And each child is different. You may have three children, and one of them feels overwhelmed by everything that is happening, because that's their temperament. 

And they may even feel more attached to the person who is being abused, with what they see. So they may respond differently. So that child may have nightmares, even though the other child may be like, ‘see you later, I'm going to school’ — they compartmentalize that, they put that somewhere away. 

And so one of the things that we're trying to say is — you’ve heard about the adverse childhood experiences? The ACE scores — so there are 10 items on the ACE scores, adverse childhood experiences, (51:00) and one of them is witness and domestic violence. 

There’s witnessing domestic violence, there's being abused physically, there's neglect, there is having a parent who's mentally ill, having a parent with substance abuse, having a divorce and a family, having a family member being incarcerated. I know I'm missing — I got to seven, but there are ten. 

And so if you have up to four of those, the research shows that it correlates with you, when you become an adult, you will have mental health or physical illnesses, diabetes, high blood pressure because of the stress within your body that it creates from having adverse childhood experiences. Again, there are ten items of experiences of children up to 18 years old.