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Prepared by the Child and Adolescent
Committee
(NOTE: These questions and answers are designed to assist
parents in understanding dissociation. Consultation
with a professional is necessary for a thorough and accurate
evaluation. For ease of reading, “child” (meaning
child or adolescent) will be used in the answers below, and
the use of “he” and “she” will alternate.)
1. My child’s behavior
and mood can suddenly change like Dr. Jekyll and Mr. Hyde. I
heard about dissociation and wonder if this is what it means?
2. What would cause my child to dissociate?
3. How might my child behave if she
is dissociating?
4. I’ve read and seen movies about dissociation,
especially Multiple Personality Disorder, in adults. Are
children like that?
5. My child seems to have symptoms
of dissociation but has been given many diagnoses: ODD
(Oppositional Defiant Disorder), ADHD (Attention Deficit
Hyperactivity Disorder), and even Bipolar Disorder. What should I do? Should
I pursue this further?
6. Do these symptoms mean that my
child was sexually abused?
7. Can my child get better?
8. What should I do now?
1. My child’s behavior
and mood can suddenly change like Dr. Jekyll and Mr. Hyde. I
heard about dissociation and wonder if this is what it means?
Normal Dissociation:
Before answering this question, a description of dissociation
would be helpful. In many instances dissociation can be considered
normal or non-problematic. Here are some examples:
- A child becomes completely absorbed in an activity and
then is not aware of what is around him (e.g., when playing
a video game).
- A child develops “a make believe world,” but
knows the difference between what fantasy is and what is
real.
- A child (even an adult) can read to the end of a page and
not know what he has read because his mind has gone somewhere
else.
- A child can block out something unpleasant (for example,
a painful injury), without harming his overall functioning.
These instances of normal dissociation do not interfere
with the child’s development and social and academic
progress.
Problematic Dissociation:
Another type of dissociation, that is the focus of this website,
is called “problematic dissociation” or “pathological
dissociation”. As with other difficulties that
people have, there is a continuum or a degree of seriousness
of dissociation. Problematic dissociation can
be considered mild, moderate or severe, depending on many factors
described below. Children can experience varying degrees of
dissociation at different times.
Problematic or pathological dissociation can occur when a
child has to cope with an overwhelming or frightening event,
with multiple frightening events, or with a confusing living
situation (see FAQ 2 below). The child feels very afraid
and helpless and cannot escape from the situation. He
may even fear that he will not survive. To cope with
this, he finds a way to ‘escape’ by blocking off
(dissociating) the terrifying event(s) from his memory, by
blocking off feelings of pain, hurt, and rage, and by blocking
off bad thoughts about himself and those hurting him. He may
go into a trance state or ‘space out’ (zone out,
go blank, or shut down) and not be aware of his surroundings.
This is a survival technique used at the time of the frightening
event and can be helpful to the child at the time. However,
this “zoning out” may continue to happen in other
circumstances, which may keep the child from developing normally — meeting
social and academic expectations, appropriately managing emotions,
and forming healthy attachments.
Young children are more prone to dissociation than older children
because they don’t have the abilities to manage what
is frightening or painful and can’t remove themselves
from the situation. However, the way each child handles
such a situation will depend on many factors. Some factors
may be: a) the child’s ability to calm himself and to
believe his world can become safe again; b) the parent’s
ability to listen to the child’s confusing and conflicting
feelings, and openly discuss the traumatic situation; c) the
availability of prompt, appropriate and supportive services
for the child and parent.
Mild Dissociation:
An example of a mild form of dissociation might be when a child
is at school and is ‘spacing out’ and not listening
or attending to the teacher, without having control over
this behavior. This can interfere with his overall
learning and development, particularly if it happens often.
Moderate Dissociation:
A moderate form of dissociation occurs when a child has developed
the skill to not feel his body being hurt, for example, during
physical or sexual abuse, or medical interventions. This
is called “depersonalization”- a person feels
numb or doesn’t feel his own body. He may be
able to block out other senses as well, like hearing, tasting,
and seeing, which can affect his ability to learn. The
continued use of dissociation can keep him from being aware
of his bodily sensations and functions. For example,
children who have numbed their bodies may not know when they
hurt themselves because they can’t feel the pain. They
may not respond the way we usually expect children to respond
to pain, illness or harm, and their injuries or illnesses
might be missed or minimized.
Another moderate form of dissociation happens when a child
must separate himself (his conscious awareness) from his surroundings
to avoid experiencing the terrifying event. He develops
the skill to not be aware of what is going on around him or
to make what is happening to him feel unreal. This is
called “derealization” — the feeling that
present surroundings seem unfamiliar or unreal in some way. This
may happen during the terrifying event and it can reoccur when
things remind him of the original situation.
Severe Dissociation:
Dissociation at the far end of the continuum happens when the
child, in order to escape a terrifying event, has to separate
so completely from himself that it feels as if separate selves
hold the awful feelings, thoughts and memories. These
are called “dissociative parts” (also referred
to as “dissociative states”). The child
is still one individual, but he
experiences separate parts of himself with separate awareness
or “consciousness.” These parts of the child
can hold the unwanted and unacceptable feelings, thoughts,
and frightening memories away from the child’s ongoing
awareness so he doesn’t experience them. Otherwise,
it would be too hard to go about his daily life and do what
is expected of him. This type of dissociation can
be understood as a disturbance or disruption in his identity:
the child feels as though he has separate parts or states
of awareness rather than the single self that includes all
feelings, thoughts and behaviors.
A child’s dissociative parts can influence the way the
child behaves, feels, thinks, or remembers. Sometimes,
he truly may not be aware of what he has done or experienced.
To others, it may look as though he is lying. This is
called “amnesia,” an inability to recall important
information about present or past behavior or events. The
child may hear voices inside his head, such as an “angry
part” yelling at him or a “helper part” telling
him how to behave. He may or may not give the voices
names of people, animals, toys, or feelings. However, these
parts do not take control over the child’s behavior and
do not present themselves to others; they remain inside the
child’s mind. This is called “Dissociative Disorder
Not Otherwise Specified.”
The most extreme form of dissociation occurs if these dissociative
parts completely control the child’s behavior. The
child presents to others as if he is different people at different
times. This happens when the separate parts control
both his behavior and his awareness. This is called “Dissociative
Identity Disorder.” These shifting parts are very
confusing to the child and to those around him. He may
have considerable periods of amnesia during these times.
It is important to keep in mind that dissociation is an adaptive
response to an abnormal situation. It is creative and
helpful when a child cannot physically escape a terrifying,
painful situation. However, it can become a pattern of responding
even when it is no longer necessary. Such a pattern of response
can cause serious problems for the child at home, at school
and in relationships (see FAQ 3 below).
Conclusion:
Developing a comprehensive picture of your child with the help
of a knowledgeable professional will determine if your child
has dissociation or if his behavior is due to some other
reason. See FAQ 3 for further symptoms that relate
to dissociation.
2. What would cause my child
to dissociate?
Children, like adults, dissociate when they are overwhelmed
by fear or pain, feel helpless, and cannot escape. They
block out what is happening to them and what they are feeling.
Below is a list of the types of situations that may cause
a child to dissociate:
- physical abuse
- sexual abuse
- emotional abuse (yelling, screaming, exploitation,
and/or critical, demeaning statements)
- chronic neglect (repeatedly ignoring the child’s
physical and/or emotional needs)
- witnessing family violence or street violence
- violent or repeated loss of loved ones (including abduction/kidnapping
of the child)
- being cared for by frightened or frightening parents
- physical injury, painful medical conditions and procedures
(e.g., burns, cancer)
- frightening and painful accidents
- being in or witnessing a natural disaster (e.g., earthquake,
flood)
- repeated separation from the person who takes care of the
child and gives him emotional support
- severe and chronic bullying
It is important to remember that, if your child
receives support and feels safe soon after a frightening
event, any dissociation may be temporary and, therefore,
not problematic.
3. How might my child behave if
she is dissociating?
Dissociation can show up in many different ways. You
may notice sudden, changes in your child’s behavior,
feelings and/or attitudes. Sometimes these shifts happen
many times in a day and sometimes they happen less often. Your
child may not be able to explain why she is behaving this way. She
may not even know that her behavior changes.
Below are several lists of changes in behavior, emotions, thinking,
and physical conditions that can occur in dissociation. As
you read these lists, remember that not every child will show
all of these signs or symptoms. Some signs may be mild while
others may be very intense.
REMEMBER, many of these symptoms can occur with problems other
than dissociation. It is the combination of many symptoms
that may suggest dissociation.
Behavior shifts that
are most commonly seen by parents or teachers:
a. Your child may act very grown up one moment and then behave
like a much younger child (even a baby) at another moment.
b. Your child may be aggressive and mean at one point and
then become passive, loving, or caretaking at another time.
c. Your child may talk about herself with different names
or may refer to herself as “we.”
d. Your child may use different voices or specific mannerisms
(for example, picking at her skin) at one time and not other times.
e. Your child may want to wear her favorite outfit or eat
her favorite food, but then later on, or perhaps the next day, she will say
she hates the outfit or food. She may not be able to explain this change
and may say she never liked the outfit or food.
f. Your child may have certain skills or be able to do certain
activities easily and well (handwriting, sports, math, reading), but then,
the next day, may have trouble with them or no longer know how to do them.
g. Your child may seem to ‘space out’ at home,
school, or social events, and not know what is going on around her. Time
may pass and she doesn’t know what happened during that time.
h. Your child’s facial expression may change dramatically
and suddenly from smiling to angry without any apparent reason.
i. Your child’s eyes may appear to be in a dead stare
when you are talking to her (like she is miles away) or she may have a glazed
look, particularly when she is aggressive or raging.
j. Your child may find herself in a place and not know how
she got there. For example, she may be sent to the principal’s
office for misbehaving and not remember leaving the classroom, walking to the
office, or even why she is there.
Emotionally your
child may experience sudden shifts and move from one extreme
feeling to a completely different or opposite feeling without
showing any of the in-between emotions. The reason for this
change in emotion may not be clear or make sense to you.
k. Your child may be calm one moment and
then in the next moment become explosive, aggressive, frightened,
tearful, or panicky.
l. Your child may show emotions that do
not fit what is happening, such as laughing during a sad
and upsetting situation or becoming sad or angry in a joyful
situation.
m. Your child may not show any feelings
at all. She may not be aware of any feelings.
Cognitive shifts
may also be noticed by you. These are sudden changes
in and sometimes contradictory ways of thinking.
n. Your child may be able to do an assignment
quite well on one day, but then not know how to do the same
or similar assignment the next day. Without any additional
teaching, she may be able to do the assignment again later.
o. Your child may make a good choice when
faced with a problem, but when faced with the same problem
later on, she may make a poor choice and not recall the earlier
situation and the earlier decision.
p. Your child may think that a completely
safe situation is extremely unsafe and be very fearful. Or
she may interpret an unsafe situation as safe.
q. Your child may not be able to recall
important events, such as birthdays, holidays, family vacations,
or camping trips.
r. Your child may have no memory of having
done something even when someone saw her do it.
s. Your child may ‘hear’ voices
inside her head. (Children seldom talk about this unless
directly asked.)
t. Your child may report having ‘inside
people’ that say mean things and boss her around. These
are different from the pretend or imaginary friends that
young children commonly have and outgrow.
u. Your child may think badly about herself
(perhaps even feel suicidal) and see the world as a frightening,
threatening place. Then suddenly she may feel good
about herself and the world, and hopeful about the future.
v. Your child may have flashbacks (reliving
a traumatic event) and be unaware of her present surroundings.
Physical or bodily changes may also
occur for your child. Your doctor may not be able to find a
medical problem or cause for your child’s physical pain
or difficulties. These physical problems may be a result
of the tension or anxiety from a trauma that is being ‘held’ (remembered
unconsciously) in the body.
w. Your child may wet or soil without knowing it is happening. She
may not feel or smell it.
x. Your child may get hurt (for example, get a cut or break
a bone) or may harm herself (for example, cutting or burning) and not feel
the pain or be aware that she has been hurt.
y. Your child may have stomachaches, headaches, seizure-like
motions, or other physical problems (for example, difficulty breathing, walking,
genital pain) that cannot be physically explained.
NOTE: The above symptoms may occur
only a few times a year or may be much more frequent and occur
several times a day.
4. I’ve read and seen movies about dissociation,
especially Multiple Personality Disorder, in adults. Are
children like that?
Dissociation is not as obvious in children as it is in adults. As
described in FAQ 1, Multiple Personality Disorder, which is
now called Dissociative Identity Disorder (DID), is an extreme
form of dissociation in which the individual’s sense
of identity has separated into states or parts that may not
always be aware of each other. Most children and adults will
experience less extreme dissociation.
Because the child is young, his dissociative states haven’t
had as much time to develop distinct characteristics or traits. Therefore,
they are less obvious and noticeable than those of adults. Also,
many children’s dissociative states may be closer to
the age of the child (compared to a child part in an adult)
which makes the dissociation more difficult to notice. One
part of the child may behave like a baby or toddler, while
another dissociative part may behave much older and expect
to be treated as an older person.
The good news is that since a child’s dissociative states
are not as well developed as those of adults, the separations
between them are not as strong. A child can more easily
become aware of the parts of himself, and any amnesia (memory
problem) he may have can be more readily resolved.
Here is a list of some differences in child dissociative states
compared to adult dissociative states:
- Changes in voice, mannerisms, and moods in children are
less dramatic than they are in adults.
- Inattentiveness (see
FAQ 3 above) or trance states (see FAQ 3-g above) in children
are often brief and less noticeable, and they are frequently
thought to be attention problems.
- A child may not understand
that the voices or “inside
people” he sees in his mind are unusual. A
child may also feel afraid or embarrassed to talk about them
if they are frightening to him.
- Aggressive or sexualized behaviors,
including self harming, which may occur in a dissociated
state, are usually less serious than those perpetrated by
adults.
5. My child seems to have
symptoms of dissociation but has been given many diagnoses:
ODD (Oppositional Defiant Disorder), ADHD (Attention Deficit
Hyperactivity Disorder), and even Bipolar Disorder. What
should I do? Should
I pursue this further?
Many health professionals have not received adequate training
in the field of trauma and dissociation. Recognition
of trauma and its effects, including dissociative features,
are all too often overlooked in the diagnosis of childhood
problems. Doctors and other clinicians may focus on
the most noticeable behavior rather than look at the total
picture of a traumatized child.
For example, a clinician may describe a child as having a better
known problem such as Attention-Deficit/Hyperactivity Disorder
[ADHD] (www.cdc.gov/ncbdd/adhd/symptom.htm)
because of problems with inattention.
Or a child may be diagnosed with Oppositional Defiant Disorder
(www.emedicine.com/PED/topic2791.htm)
because of angry, uncontrollable outbursts.
As a child gets older and continues to be explosive, destructive
and aggressive, he may be labeled with a Conduct Disorder.
A child with difficulties with memory and learning (see FAQ
3-n, 3-r, 3-s above) may be labeled with a Learning Disability
or Language Disorder.
Children’s fluctuations in behavior, feeling, and thought
(see FAQ 3 above) may be seen as moodiness or as an adjustment
problem related to changes in the environment.
If traumatized children have extreme shifts in behavior, feeling,
and thought, they may be incorrectly diagnosed with Bipolar
Disorder. Bipolar Disorder includes shifts in behavior
and mood, but the shifts don’t occur as frequently (for
example, back and forth in a day) as they do in dissociative
children. Another important difference is that in Bipolar
Disorder (http://www.bipolar.com/index.html) there
isn’t the blocking of awareness, feelings
or memories (amnesia) that is seen in dissociation.
There may be another reason why children receive other diagnoses
when they exhibit dissociative symptoms. Because even
clinicians do not like to think of children as being hurt,
it is easier to talk about a child as angry and oppositional
(Oppositional Defiant Disorder), or explosive (Conduct Disorder),
or reacting to the pain of a severe medical condition, than
it is to talk about (or think about) children as traumatized
and dissociative (Dissociative Disorder).
Parents quite naturally do not want to think about trauma and
its effects on their children. They may prefer to think
that what happened wasn’t so bad. They may believe that
the child was too young to remember and therefore it couldn’t
affect him now. Or they may think that the experience
is in the past and best left alone. Unfortunately, even
if the trauma is not consciously remembered it may still have
considerable effects on a child’s mood and behavior – it
may still be held within the mind and felt within the body.
It is not uncommon for foster and adoptive parents to have
incomplete information about the child’s history, and
thus not report trauma when an assessment is being made. If
the trauma is recognized, Posttraumatic Stress Disorder (PTSD) (www.nctsn.org)
may be diagnosed but the occurrence of dissociation with the
PTSD is minimized.
It is very important that you tell the doctor or mental health
professional treating your child about any trauma (see FAQ
2 above), even traumas during infancy.
You should also tell the doctor or therapist about any strange
behaviors and, in particular, about shifting behaviors (see
FAQ 3 above) you have noticed in your child.
**If a dissociative child is misdiagnosed,
he will not receive the treatment he needs. Treatment for non-attentive
behaviors within a Dissociation Disorder is quite different
from treatment for non-attentive behaviors within an Attention
Deficit Disorder. Accurate diagnosis is crucial!
- If you do not feel that the diagnosis your child has received
is accurate, you have a right to question the diagnosis and
ask for a second opinion.
- If the treatment your child is receiving is not helping,
you have a right to ask the professional to consider other
possibilities, such as dissociation.
- Unfortunately, many children with dissociation receive
numerous diagnoses and are treated with a variety of medications
and unsuccessful therapies over several years before their
dissociation is diagnosed and treated!
There are checklists that can help clinicians in the diagnostic
process. Interviews, observations, history gathering, and contact
with outside resources (school, day care, medical) can also
help to identify dissociation in children. You may want
to ask your doctor or mental health professional about these
checklists:
- Children’s Dissociative Experiences Scale and Posttraumatic
Symptom Inventory [CDES/PTSI], (Stolbach and colleagues,
1997; contact bstolbach@larabida.org).
- Adolescent Dissociative Experiences Scale, version 2 [A-DES,
II], (Armstrong and colleagues).
- Adolescent Multi-Dimensional Inventory of Dissociation
[A-MID], (Dell).
- Child Dissociative Checklist[CDC-III], (Putnam and colleagues).
6. Do these symptoms mean that
my child was sexually abused?
Although many children with dissociation have been sexually
abused, it does not mean that every dissociative child has
been sexually abused. Remember, physical abuse,
domestic violence, neglect, painful medical conditions, natural
disasters and other traumas can also cause dissociation. Please
refer to the above list in FAQ 2 for other causes of dissociation.
Determining if your child was sexually abused should be based
on:
- disclosures of abuse
- behaviors of fear and other behavioral changes when faced
with an alleged abuser
- sexual knowledge beyond what is normal for the child’s
age
- sexualized behaviors that are harmful or intrusive to himself
or someone else
- careful forensic evaluation by a trained professional
Referral to the local child protection service or social service
agency should be made if you have concerns that your child
has been sexually abused. In addition, a qualified
mental health evaluator or therapist/counselor can be consulted.
For additional information:
http://www.aacap.org/page.ww?section=Facts+for+Families&name=Child+Sexual+Abuse
http://www.nlm.nih.gov/medlineplus/childsexualabuse.html
7. Can my child get better?
YES! All levels of dissociation respond well to
specialized treatment, particularly if there is early diagnosis
and intervention, and the child is in a safe environment.
The professional working with your child will:
- Evaluate safety both in and outside the home. Safety
is essential for successful treatment.
- Educate the child’s caregiver(s) about dissociative
symptoms and their meaning, as well as how best to intervene
when symptoms occur.
- Address the problematic behaviors that are interfering
with your child’s functioning.
- Help your child process past losses or disruptions and
develop a healthy attachment relationship with you.
- Create with your child an integrated narrative (the story
of the child’s experiences—be it a single trauma
or many long-term traumas—which includes the child’s
feelings, thoughts, and physical sensations together with
information about the actual events) through talking, playing,
writing, drawing, and attending to bodily responses.
- Encourage integration of the different aspects of the child’s
personality, experiences (memories), feelings or sensations
that have been previously blocked from the child’s
total awareness.
- Coordinate with the family, school and others in your child’s
life to support your child’s progress.
During each step in therapy your child’s therapist will
take note of dissociative signs and behaviors and work with
your child to become more aware of her or his whole self.
** You will also be involved in the treatment. The
single most important part of healing from trauma-related
distress and dissociative barriers is the safe, loving attachment
relationship you create with your child.
8. What should I do now?
First of all, congratulate yourself on taking the initiative
to do the research and reading that you are doing right now. And
second, remember that dissociation is treatable.
You will want to learn as much as possible about dissociation. Information
about dissociation can come from therapists, social workers,
psychologists, school counselors, and psychiatrists. If
the therapist or doctor you are working with is not knowledgeable
in this area and is not interested in learning about dissociation,
you may want to find a new therapist or doctor.
Names of professionals who work in the area of dissociation
can be found in the membership list of the International Society
for the Study of Trauma and Dissociation (ISSTD). Please note
that the ISSTD is a professional association and not a regulatory
body. Therefore, a professional’s membership does
not guarantee competency, but it does demonstrate an interest
in the field of trauma and dissociation. Here are some
questions you may want to ask:
- What does the professional understand dissociation to mean?
- Remember, not all children who dissociate have a dissociative
disorder.
- Dissociation is a blocking out of emotions, physical
sensations, behaviors, or knowledge in order to feel safer
when frightening things happen. It is like hiding
somewhere in your mind where it feels safe while surviving
on the outside in a dangerous situation.
- How does one recognize dissociation in a child?
- Remember the types of shifts in behavior, emotions, thinking,
and body sensations we talked about in FAQ 3.
- What does a child with dissociation need to get better?
- Remember the discussion in FAQ 7
- How will the therapist include you in the therapy?
- Below is a list of ways a therapist may work with parents.
- What type of training has the professional had in dissociation?
- Training can come from reading, professional workshops
and conferences, study groups, as well as university courses
and ISSTD trauma and dissociation courses
A careful and thorough assessment and, if recommended, therapy
for your child will be important. The therapist should
help you to:
- Understand dissociation, recognize when it is happening,
and learn how to talk with your child at those times.
- Develop a greater sense of safety in the home.
- Identify the triggers that start your child’s dissociative
responses and how to decrease these triggers. A trigger
is something in the child’s present experience that
is similar in some way to the situation at the time of the
trauma (for example, cigarette smoke if the abuser smoked
or smelling alcohol if the abuser used alcohol). Triggers
restart the child’s fear and the child is likely to
respond to them just as she did when the actual trauma happened.
- Become aware of the various aspects or parts of your child.
- Establish a word or gesture that can help you reorient
your child when dissociation starts to happen.
- Learn specific child-management techniques that can help
your child assume responsibility for all of his behaviors
and encourage a single sense of self.
The therapist will also work with your child individually
to understand and decrease dissociative responding, process
past traumas, and encourage integration of experiences and
sense of self.
You may find that your child’s behavior brings out strong
negative responses in you or reminds you of bad experiences
you had in the past. If this happens, it is smart to
get some therapy for yourself. It is best to see a different
therapist than the person who is treating your child. But again,
it should be someone who is knowledgeable about dissociation. It
may be helpful to have respite care so you have some time for
yourself. Both you and your child may get along better if you
have some time apart.
As you do things with your child, always refer to your child
as a whole.
Acknowledge your child’s different feelings and thoughts
no matter how extreme they may seem to you. You might
ask your child where those different feelings and thoughts
come from and then talk with your child about appropriate ways
to express those feelings. You might also ask what brought
out (triggered) his reaction and how you can help him feel
safer.
Your most important role as a parent is to be loving, understanding,
and consistent in responding to your child (even though his
reactions and behavior do not make sense to you). At
the same time, there always need to be appropriate guidelines
and consequences for his negative behaviors.
Safety for your child is of absolute importance! You
will want to check each environment in which your child spends
time (home, school, day-care, scouts) to see if anything is
unsafe or feels unsafe. Remind your child that it is
your job, not his, to fix things that do not feel safe. Always
listen and appreciate your child when he talks to you about
his world.
The journey towards understanding your child or adolescent
is bound to be challenging and rewarding. Good luck!
There are several books and articles that you may find helpful:
- The Dissociative Child: Diagnosis, Treatment and Management edited
by Joyanna Silberg (Sidran Press, 1998) contains several
chapters of interest to parents. This is available
as an electronic book from Sidran Press.
- Dissociative Children: Bridging the Inner and Outer
Worlds by Lynda Shirar (Norton, 1996) is written for
therapists but has several chapters at the beginning which
would be helpful for parents.
- Techniques and Issues in Abuse-Focused Therapy with
Children & Adolescents: Addressing the Internal Trauma by
Sandra Wieland (Sage, 1998) has a chapter that would be
helpful for parents.
- Stolbach, B.C. (2005). Psychotherapy of a dissociative
8-year-old boy burned at age 3. Psychiatric Annals, 35(8),
pp 685-694.
- Attaching in Adoption: Practical Tools for Today’s
Parents by Deborah Gray (Perspectives Press, 2002)
has several references to dissociation and many ideas for
parenting scared children.
- Two DVDs that are technical but could be helpful are Identifying
and Responding to Childhood Trauma in Ages 0-5 Years Old and Identifying
and Responding to Childhood Trauma in Ages 6 to Adolescence by
Bruce Perry. Magna Systems, Inc. 2002.
- Two DVD sets that are more practical for parents (and teachers)
are: Understanding the Traumatized Child, Parenting
the Traumatized Child and Teaching the Traumatized Child.
(Cavalcade Productions, 2004)
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