Medical Trauma, part 5: What Parents Can Do, Steps 1&2

Remember the story in Part Three about the two-year-old who has a complete meltdown because his mom does the worst thing ever: she cuts his cupcake in half? This mom does what any parent will do: she tries explaining how two halves equal one whole, how the cupcake is still a cupcake, still the same amount, still good to eat, yet her kid screams and wails, and she finds herself thinking, Really, did I have to cut the damn thing in half? What was I thinking? What is wrong with me?

We’ve all been there. Our kid is losing it because of something completely outrageous, and there we are, talking reason to her. It’s an equally outrageous hope that we can appeal to our kid’s intelligence. When has any kid ever snapped out of a tantrum, saying, “Gee, I never looked at it like that. I’m being ridiculous. Thanks for pointing it out!” This isn’t to say that we can’t ever appeal to their logic, but we have to first talk to our kids’ emotions before talking to their intellect. When it comes to medical procedures which, by their very nature, intellectually confuse and emotionally overwhelm children, we have to start with the emotional side of things.

Before voicing what you think your child might feel, try to draw out her feelings. Some kids will be able to tell you how they feel, and others won’t. This is partly age dependent, but sometimes even older, insightful kids won’t want to share their feelings. Reading kids’ books together about a child having a medical procedure can help elicit feelings. The intervention in the book doesn’t have to be the same or even very related to your child’s procedure for her to make the connection between the story’s character and her own upcoming experience. The book is simply opening doors to talking. You can approach it directly and ask your child, “In what ways do you feel like the girl in this story?” Or you can be more indirect and ask only about how the girl in the story might feel. Either approach is fine, and you’ll probably know which is most suited to your child. If you’re not certain, start with the indirect approach and work towards the more direct one.

To whatever extent your kid can put words to his feelings, you can then voice the possible feelings he might have. Unless you are fairly certain what your child is feeling, it’s best to present possibilities of various feelings. You might say, “When a kid has to go to the hospital, he might feel scared and confused. It might feel new to him and he won’t know what’s going to happen. It’s like the hospital feels really big, and it’s normal for a kid to feel a little lost. I wonder if you have any of those feelings.”

The most important thing to remember is that you’re validating whatever emotions your kid is having. If you just told your kid that the hospital is big and it’s normal to feel lost, you don’t want to then add, “But that’s a silly feeling. Don’t worry about that.” Saying this negates and devalues his feelings, sending the message that he shouldn’t have those feelings. Instead, you might add, “If you’re feeling lost, that’s okay because I’ll be there to make sure you aren’t actually lost.”

Your job isn’t to take away his feelings but to acknowledge them and offer other ways of looking at things. For instance, while you validate your child’s fear of the doctor, you can also add that you’re not scared of the doctor. In fact you think the doctor can help even though the procedure might hurt your child. You might say, “I know you’re scared of the doctor, and you don’t know her very well. But I do, and I know how she helps lots of kids like you. Maybe if you knew the doctor like did, you wouldn’t feel as scared. But just remember that I’m not scared, and maybe that will help you.”

Often what a child needs is emotional reassurance rather than solutions to problems, many of which have no solution. For example, a parent once told me, “How can I tell my kid I’m there making sure she’s safe when in reality, I’m not?” Her daughter was six and wanted her mom beside her during the surgery. “They wouldn’t let me in the operating room even if I was sure I wouldn’t pass out.”

I told the mom, “Sometimes it takes a little creativity in how you put it. You don’t lie, but you speak to what your daughter needs emotionally. What if you told her something like this: ‘We will be thinking of each other the whole time. If I can’t be in the room with you, I’ll be right next door. I’ll always be thinking about you, and watching over you with my mind. We’ll be connected in that way, and I’ll keep you safe.’”

This was the best the mom could offer, but because it spoke to her daughter’s needs—not just for a feeling of safety but to remain connected to her mom—her daughter felt reassured.