Helping Children Understand Ebola and Traumatic Events

Most of us can remember times in our life when the fear of eminent danger intruded into our thoughts. When I was young I remember watching movies that reflected the increasing likelihood that we could die a horrible death from a nuclear attack. For much of my young life, the sound of a siren or the feeling of an earthquake would bring the thought to my head that the Russians had finally dropped the bomb on us and it was all over. I remember wondering if the bees in the yard were of the African killer variety and fleeing for my life. Today, children have stories in their heads about school shootings, terrorist attacks, and most recently Ebola. Dealing with actual, potential, or imagined traumatic events is a reality that all children face. This leaves parents with the question, what can I do?

The first thing to do is filter information.

Filtering information is most important for younger children as they do not have the cognitive and emotional resources to deal with what they hear. When they hear that Ebola is killing thousands of people in Africa, they are likely to think that they are in danger because they do not understand how far Africa is from their home and how unlikely it is that someone from Africa will be walking down their street. Teens are more likely to understand but are often in a crisis mode and are more likely to be caught up in their emotions and not think things through. Parents can play a key role in limiting the information that their children receive. Such things as limiting how they talk about Ebola and manage their own emotions so that they are not communicating distress to the younger children, reducing the amount of news and social media they are exposed to, and  interpreting information that they have received so they understand that they are safe.

The second thing to do is offer support.

Children and teens who perceive their parents or other caregivers as close and supportive tend to feel more emotionally supported and use that support to shield themselves during times of stress (Dindinger, 2011;  Hammack et al., 2004). Teens tend to quantify the number of supportive peers they have and the greater the number of perceived supportive peers, the more capable they are in dealing with tragedy. This is because they feel they have enough support and social resources needed to handle the problems and stress associated with the perceived tragedy (Dindinger, 2011). It is also important to remember to not automatically dismiss your child or teen's worry. Let them know that you understand their worry and will be there to support them if anything would ever happen. Don't let teens isolate from their peers, instead encourage them to be social.

The third thing to do is understand how your child deals with worry.

The third thing to do is understand how your child deals with worry.

Children and teens have many different coping strategies when it comes to their worries about traumatic events. The following are a few of the strategies that I have observed over the years as I have worked with children and teens.

The Expert - Some children choose to take control and become an expert on the subject. They log into their mind everything that they hear and proceed to tell others in extreme detail how much they know and how important it is to know these things. This gives them the feeling of power over the trauma. Though this helps them deal with worry, they often magnify and increase the spread of potentially anxiety provoking information to others. Others tend to reject them as a "know-it-all" which reduces their perception of social support, a factor that has been proven to increase resilience to potential trauma.

The Bully - Many children will use a feared tragedy to traumatize others by taunting or scaring classmates and/or siblings. For example, a child may start to cough and tell others that they have Ebola and rub against them or cough on them. This strategy is a similar coping skill to that which victims of emotional abuse use when they take on the characteristics of those who have abused them. They do this because they see things in black and white and they believe that they can be either the victim or the abuser. They make the choice not to be the victim, leaving them with the only choice of being the abuser. Taking on the persona of Ebola and pretending to spread it to invoke fear in others may have the similar effect of making them feel powerful, in control, and less helpless. Of course these children tend to be shunned and looked at negatively and have a dramatically reduced sense of perceived social support.

The Escape Artist - Some children try really hard to avoid information about the feared tragedy. These children are good at changing the subject or removing themselves from conversations about it. Their worry tends to be centered on escaping everything, including information related to the feared tragedy. If these conversations are occurring at school, home, or other places that your child frequents you may start to notice them losing interest in these activities or isolating themselves from others. These children often look "checked out" when faced with stressful situations. The challenge with this style is they continually reinforce to themselves that they cannot handle the perceived threat. These children tend to start out looking fearful and anxious, but over time feel more helpless and depressed.

The Magnifier - The magnifier thinks that if they think and worry about the potential tragedy enough they can avoid it. For example, a magnifier who is worried about Ebola will likely build up a barricades of exaggerated rules to prevent even the potential of exposure. They may develop checking and safety behaviors (checking their temperature, avoiding sick people, avoiding airports, excessive hand washing, etc...). They will think about Ebola and make sure they listen to any information that is disseminated. They believe that their worry keeps them ever vigilant and safe. The thought of letting go of worries is like walking on a tightrope without a safety net. Unlike the Expert, when they tell other people about the dangers of Ebola they are likely to be trying to help others and prevent its spread. The challenge with this coping strategy is that the constant focus on safety behaviors and worry gradually increases anxiety and may generalize into a legitimate anxiety disorder.

The Pessimistic Prophet - Some children and teens use their prophetic abilities to foretell the worst possible future so that they can prepare for it. They believe that this future is likely and struggle to function and plan for the future due to the impending doom. They often can't understand why others don't see the coming danger and feel unsafe when their parents don't offer to protect them. The pessimistic prophet may choose to be a voice of warning or become immobilized by their feelings of hopelessness. When they feel like those around them don't listen, support and/or believe them, they tend to feel alone and withdraw.

The Realist - The realist takes a more pragmatic and logical approach to dealing with a potential tragedy. They tend to assess the reality of the threat and engage in strategies such as probability checking (what is the likelihood that this will happen to me?),  reality checking (is there any evidence to support my worry or fear or am I manufacturing this?), and alternative assumption (is there an alternative that is more likely to be true). These children tend to quickly dismiss the likelihood that the potential traumatic event will impact them. They also build up alternative strategies that are more reality-based and not fear-based. Of all the coping strategies, the realist is the most functional and has the most emotional stability. They are more likely to be able to deal with stress and problems and avoid distress related to unlikely problems or problems they have no control over. If your child exhibits this strategy for dealing with worry, encourage him or her. And offer support as they need it.

Not every child clearly fits into one coping strategy category. Some children have elements of many. It is also important to remember the developmental age of the child and how they may exhibit coping tendencies differently. The important thing is to recognize how your child tends to cope with their worries. Once you recognize what they do, you can help them to incorporate some of the healthy strategies that the realist tends to use.

The fourth thing to do is talk with your children.

Once you understand how your child copes with their worries, you can start to identify how their thinking, feeling, and behavior patterns interfere and change how they function.  Talk to your children in a way that teaches them healthy coping skills that can replace their current unhealthy strategies.  This is especially important to do with younger children who tend to adopt the coping strategies modeled by their parents. If your family has spiritual values, help them connect with those values and draw on spiritual strength. Children and teens who rely on a power greater than themselves will often feel protected and function better.

Coping strategies for parents to model.

Probability Checking - For younger children, you should be more direct and tell them that the probability of them being exposed to Ebola is unlikely. Show them on a map how far Africa is from their home. For older children, ask them questions that help them to come up with how unlikely it is that they will be exposed to Ebola (How often do you come in contact with someone from Africa? Do you know anyone who has been exposed to Ebola? What happens when the government finds out someone has been exposed to Ebola? etc...).

Reality Checking - Let your child tell you their worries and then examine the thoughts with them to determine if there is any evidence to support their worry, remembering that feelings do not constitute evidence.

Alternative Assumption - come up with an alternative assumption, often the opposite of the worry assumption, to test and look for evidence. For example, you may bring up the assumption that your child is safe. This is a great time to help them see all the support that they have around them that will keep them safe.

Providing Limited Accurate Information - Teaching your child to get their information from a reliable source (parent instead of rumors from a peer at school) is important. In the case of Ebola, explain to them that Ebola is not spread through the air and that they can only contract it if they are in contact with body fluids from someone who has it. It is often helpful to do this while doing probability checking, as it decreases the likelihood that they will contract it. Make sure you only go into as much detail as needed for your child's age.

The last thing to do is keep the lines of communication open.

Let your child or teen know that you want to talk to them when they are worried and that you are ready to help them when needed. Check in with them from time to time to let them know you are there for them. When parents take time to work through worries with their children it strengthens the parent/child bond in a way that will pay dividends for years to come.

Dr. Rob Dindinger is a clinical psychologist with Child & Family Psychology. He manages the blog: The Road to Personal Growth. Dr. Dindinger is also a contributing author to FirstAnswers.com