How Do You Know if a Child Is Traumatized?
While working at a mental health clinic in Harlem years ago, I got used to hearing the most traumatic stories I could have ever imagined. They were the normal way to live for many of my clients. One day a woman in her 40s, who lived in a drug den and had gone through a frightful marriage before her husband was imprisoned, asked me how she could know if her son was traumatized. As a then-inexperienced clinician, I took out the last version of the DSM (Diagnostic and Statistical Manual of Mental Disorders) off my shelf the same way a cowboy would take out his pistol from his belt, ready to shoot off a diagnosis. Diagnostic Tools The last version of the DSM at that time was the IV edition of the handbook produced by the American Psychiatric Association (APA) and used by healthcare professionals in the United States and many other countries as the authoritative guide to the diagnosis of mental disorders. It only included Posttraumatic Stress Disorder (PTSD) — under Anxiety Disorders — and made no difference between applying the criteria to adults and children. It did include, however, an explanation of how it could be difficult for children to report many of the symptoms listed. I was not really able to help the woman that day, and felt the same frustration that had become the regular experience of my days, confronting the incapacity of helping so many traumatized people with so little understanding of the phenomena of trauma. When I couldn’t bear the fru...
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