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Helping Children Cope With The Security Situation

Wednesday, July 9, 2014

The Vivian and Seymour Milstein Family Trauma Recovery Center for Children and Adolescents staff at Soroka Medical Center has the following recommendations for children coping with the current security situation. It may also be helpful for the adults caring for them, and for all individuals struggling to deal with intense trauma.

Since the start of Operation Protective Edge, just a few days ago, we are again experiencing the deterioration in the security situation and the disturbance of our daily routine. This period is a double challenge for parents — a personal one and one regarding their children. It is important that the parents among us know that they are the source of security and strength for their children and that there is a direct relationship between their reactions to the crisis and that of their children’s reactions.

Therefore, it is important that before the parents provide their children with tools to help them remain calm and cope better, they themselves must first find a way to remain composed, with the help of support sources such as friends and family members, conversing with them, and participating in other relaxing activities.

Missiles fired at Beersheva, the southern communities, and the escalation to the rest of the country, arouse in us and in our children feelings of fear and worry that may influence behavior and functioning. The common reactions may be classified into two main divisions, physical and emotional-behavioral.

Physical Complaints

Emotional-Behavioral Complaints

  • Stomachache, nausea, vomiting
  • Fear
  • Headache
  • Crying
  • Dizziness
  • Insomnia and nightmares
  • Blurry vision
  • Obsessive thoughts, and focus on the alarming situation
  • Fatigue
  • Expressions of dependence, and clinging to the parent
  • Changes in appetite — lack of appetite or overeating
  • Refusal to stay alone, fear of separation
  • Oversensitivity, for example: hypersensitivity to noise
  • Regression to behavior of a younger age, such as bed-wetting, thumb-sucking, stuttering, and baby-talk

  • Demanding and aggressive behavior

Remember!
These are normal reactions to an abnormal situation and they usually pass after a few days or weeks. Most of the victims of traumatic events gradually revert to their regular full functioning and emotional balance, without any therapeutic intervention.

Helping Children Cope With the Situation

It is possible and desirable to talk about:

  • Many of us have access to various information sources to keep abreast of the dynamic situation
  • It is important to bear in mind that the children at home are also exposed to the information, but do not always understand or interpret it properly
  • In an era when it is easy to obtain every bit of information (fact or rumor) on the internet, it is important to help the children recognize the facts, separate them from rumors, and provide them with age-appropriate information
  • The children must be allowed to ask about and discuss what they hear and see, so they can negate or verify their fears. Open a conversation with them, tell them what you feel and give them the opportunity to express themselves through questions, joint drawing, writing, play-acting or any other creative idea.
  • Airing feelings and receiving answers to questions serve as calming factors. The message here must be: “The situation indeed is worrisome, but together we can overcome difficulties”.
  • It is important to explain the sights and sounds to the children, and not think that they are incapable of understanding. Rumors and sights will reach the children in a raw state and often not in an age-appropriate manner.
  • Nevertheless, if the child prefers to avoid discussing the situation at this stage, it is important to respect his or her wishes — This is the way they cope.

How to provide age-appropriate information to children

  • Children up to the age of six need simple concrete information with calming messages: “Mommy and Daddy are here to protect you”
  • Elementary school-age children (611) require more detailed information, but still concrete, utilizing examples from their daily life, such as: “It’s like an argument”, “There is a conflict between us and them”. Encouraging comments should be added, such as: “The situation will improve”, “We’ve been through difficult times before” (Cast Lead and Pillar of Defense), “Together we’ll overcome the difficulties”. In addition, tangible suggestions regarding coping methods should be offered — “When you feel afraid, you should …”
  • Adolescents require broader information, including historical, political and ethical issues. The parents should encourage a dialogue in which the teens will contribute their views and positions concerning the situation and receive factual information that conveys the full complexity of the issue. It is important to avoid dramatic, catastrophic declarations, such as: “The State of Israel is in danger”.

Important points to take into account
Feeling secure in an insecure situation — Convey to the children that they can feel secure even now.

  • Feeling in control in a non-controlled situation reduces anxiety.
  • Explain to them cautionary measures that they should take, such as: “Go into a protected area when the sirens sound or Code Red is announced”.
  • Show them the most protected place in the house and together, prepare items that are meaningful to them, such as: a favorite game, snacks, drinks.
  • Stress to them that we know exactly when the missiles are fired and the warning gives us the possibility to find refuge for a few minutes and then go back to routine. We may also mention the “Iron Dome” defense system and its success in downing rockets.

Protection of the Parents

  • Parents are the pillar of support children seek in times of distress and therefore many children, at every age, fear for the safety of all the family members and especially of their parents.
  • In order to increase the security of the children regarding the parents being safe, the parents too must go into the shelter area, as per the instructions of the Home Front Command. Careless conduct, such as being in the house and disregarding the sirens or going to the window to see the missile or its downing, increases the level of anxiety and distress that the children experience and serves as a negative example of irresponsible behavior.
  • When the parent is not at home, it is a good idea to tell the child that the parent went to a place that is near a protected area. The child also must know what to do in emergency situations. We also have to be sure that being left alone is appropriate for their ability to cope on their own in this abnormal situation.

Activities
One of the most unbearable feelings in these times of uncertainty and ongoing tension is the sense of impotency and lack of control. Being occupied and active reaffirms the child’s feeling of self-control, releases stress and pent up energy that floods the body due to the tension. Goal-oriented activities, obviously age-appropriate, starting with helping in the house and all the way to playing “Hot-Cold” in the shelter room bring about a sense of control, serve as a distraction, and release physical tension. Games, dancing, listening to music, watching movies or sports provide enjoyment and improve mood. Also, creating pleasant enjoyable activities in and outside the shelter room, such as listening to music, watching movies, relaxation exercises and physical activities distract the children’s thoughts from the threat, improve their mood, and release physical tension. It is recommended to use humor as much as possible, by watching comedies, telling jokes, and laughing at the absurdities of life. It is also possible to ask the children to write or draw 10 uses for a missile, aside from destructive firing, choose a song to be sung on the way to the shelter room or during the siren, instead of waiting anxiously to hear the ‘boom’. Blowing soap bubbles is an enjoyable relaxing activity that also encourages normal breathing which sometimes is adversely affected in times of fear and distress.

It is permissible to have feelings (and fear)

  • It is important that each parent be sensitive to the children’s reactions, identify signs of distress, and explain and calm the child according to his or her age and understanding. All of us, children and adults alike, experience fleeting feelings and reactions to these events that disrupt our daily routine.
  • Explain to your children that feeling stress is a normal reaction to the situation.
  • Allow each child to express his or her feelings and encourage them to accept the range of feelings of their siblings, even if he or she does not feel the same way.

Limiting exposure to threatening situations
Repeated exposure to stressful events may exacerbate the children’s stress reactions, make it more difficult for them to return to routine and sometimes even cause secondary traumatization (a traumatic factor by itself, making it more difficult to cope with the primary trauma).

Therefore, we recommend:

  • Limit the exposure of the children (and yourself) to the frightful pictures and repeat broadcasts of the threatening news on all the media (radio, TV, internet and mobile phone apps). Be sure to balance and alternate viewing the reports with other television programs and different activities.
  • Try to avoid exposing young children to adult conversations related to fears from the security situation.
  • Avoid having the children participate in activities that they view as threatening or stressful. For example, if they do not want to sleep alone now, allow them to join you or their siblings. When the situation reverts to normal, they will go back to their previous patterns or we will help them return to routine, in the event they do not do so.
  • Encourage going out to leisure-time and educational activities in less threatened areas in order to decrease exposure to danger.
  • If the children are interested in going to friends or family outside the area, it is recommended to allow them to do so, as long as continual frequent contact is maintained with them, in the event the parents cannot join them.

Maintaining daily routine, as much as possible

  • It is recommended to maintain the children’s daily routine as much as possible and thus, convey the message that life goes on, despite everything. It helps give everyone a sense of security.
  • The children must still be expected to fulfill their familial duties, such as: cleaning and keeping order in their rooms, preparing homework, etc. Maintaining routines strengthens the sense of “business almost as usual” and that things will revert to what they were.
  • It is important to allow the children to participate in pre-planned activities with other children of their age, providing they can be held in safe protected premises.

Showers and toilets
Many children are afraid to go to the bathroom or take a shower, worried that there will be a siren then. Some of them are concerned about not hearing the siren, others fear not being able to reach the protected area in time and not being suitably dressed. Sometimes it results in extended abstention or holding back, reducing eating and drinking, asking the parents to join them in the bathroom, or leaving the door open. In order to maintain routine and to reduce anxiety related to these activities, it is recommended to:

  • Suggest that it be done only when there is someone else at home
  • Select one member of the household responsible for announcing the sounding of sirens.
  • Prepare a bathrobe, towel and slippers ahead of time in the shower in the event there is a siren.
  • Measure and set with the child the length of time required to get out of the shower/bathroom and do practice runs to prove that it is possible to get to the shelter area on time.

Remember:

The situation is temporary and abnormal. Everybody’s reactions, adults and children alike, even if they appear to be severe, are normal reactions to an abnormal situation.
These reactions generally resolve gradually, within three to four weeks after the security situation stabilizes.
Parents, friends and teachers play an important role in helping the child return to normal functioning. Most children go back gradually to functioning fully, with balanced emotions, without any need for professional intervention. However, sometimes there is need for professional therapeutic intervention in order to help the child or parents return to routine.

Hoping for more secure and serene times.

The Vivian and Seymour Milstein Family Trauma Recovery Center for Children and Adolescents Staff
Soroka Medical Center

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