Seeking to Remove Scars of Violence
Taking a walk to the corner store is a luxury that Anthony does not have anymore. He’s too afraid to leave his house alone. He hasn’t been able to make it through the night in months without nightmares piercing his sleep. The 16-year-old can’t even concentrate on his schoolwork because the same gruesome scene keeps invading his brain.
Anthony--whose name and some others in this story have been changed to protect them--was sitting outside his Long Beach home several months ago, not far from where some guys were talking to a friend of his. He says he recognized the other boys as gang members. But that’s no big deal in his--boom, boom, boom. Gunfire.
His friend fell down, shot right in front of him. “Run!” Anthony told himself. But he was in shock; his body wouldn’t move.
His friend died the next day. And Anthony, although not physically harmed, can’t seem to get over his fear.
Many youths like Anthony who grow up in the country’s most crime-ridden neighborhoods experience such terror that psychological and physiological trauma can continue long after the shooting stops, medical experts say.
The problem often goes undiagnosed and, with a shortage of specialized counseling, untreated. Now, however, that may change, with a recent increase in money and attention being devoted to the study and treatment of such child trauma.
Late last year, $10 million in federal funds helped establish a national network of 18 universities and medical centers to study child trauma from violence and other causes, improve its treatment and expand the availability of counseling. The National Child Traumatic Stress Network includes three centers in the Los Angeles area and one in San Francisco. Still, doctors say more can be done.
The network’s research effort is headed by a collaboration between UCLA and Duke University in North Carolina. Grants of $340,000 were awarded to Children’s Institute International in the Wilshire District to create a community-based center to treat the city’s immigrant populations and to Miller Children’s Hospital Abuse and Violence Intervention Center in Long Beach.
“It’s a major national commitment to improving the care of traumatized children across all different types of trauma,” said Dr. Alan Steinberg, associate director of the National Center for Child Traumatic Stress at UCLA, which also will study children exposed to natural disasters, war, terrorism, abuse and serious accidents.
After the Sept. 11 terrorist attacks, many Americans temporarily experienced post-traumatic stress, evidenced by fear of airplanes and public gatherings. But the trauma suffered by children in gang neighborhoods is especially powerful, psychologists say, because the violence is continuing, it’s in their own communities and sometimes it’s right before their eyes.
“The impact on the child goes well beyond their post-traumatic reactions, which themselves are pretty bad,” Steinberg said. “A lot of this violence has a pernicious effect on their daily lives.”
Anthony, for example, was so afraid of the gang that he didn’t go to school for two weeks after the shooting. “I just want to stay in the house,” he said, “because I feel like they’re coming to get me.”
The feeling is normal, said Anthony’s therapist, Sara Dickes, a psychologist at Miller Children’s Hospital. Its Abuse and Violence Intervention Center provides treatment, individually and in groups at some Long Beach Unified elementary schools, to children traumatized by violence.
Dr. Cheryl Lanktree, director of the center, said adolescents scarred by violence react by becoming more aggressive or withdrawn. They can be more irritable, show a numbness toward activities, be disruptive in class, get into fights at school or let their grades slide, she said.
“A lot of the time, the teachers just think it’s a bad kid,” Dickes said. “It’s just one of those kids who need to be sent to the principal’s office.”
Trauma can even affect a child’s nervous system, making it more sensitive to stimuli, UCLA’s Steinberg said. Anthony cringes whenever he hears a dog bark.
Techniques to Help Children Open Up
In therapy, psychologists use different techniques, including having children draw pictures or write letters, to get them to open up. Since Anthony began his weekly sessions at the center, he has felt a little better. “I get to come out of the house every once in a while,” he said. “And I get to have someone to talk to about it.”
Whenever he told his mother that he feared for his life, she said gang members would have killed him already if they were really after him. But Anthony wasn’t convinced. After all, violence seemed to follow him.
The shooting on his block occurred shortly after he moved there from downtown Long Beach, where someone threw a brick through his neighbor’s window, then proceeded to shoot up the place. “I was scared because it was just so close,” Anthony said.
Long Beach is no stranger to violence. There were 49 homicides in the city of 438,000 people last year, while San Francisco, with almost double the population at 802,000, had 46.
According to the most recent statistics from the National Center for Children Exposed to Violence, in 1997 about 4 million 12- to 17-year-olds were victims of a serious physical assault and 5 million more witnessed serious violence. A recent Los Angeles Unified School District screening of more than 1,000 students at 11 schools showed that 36% had witnessed life-threatening violence.
“The sad part is that a lot of them see it as the way it’s supposed to be, a way of life,” said Dr. Kathleen Watkins, a psychologist at the Miller center.
Claudia, 16, gets counseling there. Every day, she wishes that violence had not become part of her life. Sometimes, she wishes she had been killed instead of her father.
Claudia said her dad must have been coming home from work. She was inside when she heard gunshots that sounded close. From a window, she watched a car in the driveway of her home near downtown Los Angeles roll into a garage pole. It wasn’t until she went outside that she realized it was her father’s car.
Claudia knew he had been shot, but couldn’t tell where. Blood soaked his shirt and head and spurted out his mouth when he tried to answer her question: “Who did this?” Claudia never got an answer.
Now she can’t get the image out of her head.
“Any time I see a car crash, I think it’s my dad’s car and I think my dad’s in it,” Claudia said. No matter how many photographs she sees of her father smiling and laughing, the sight of him bleeding in the car is the one she remembers.
Steinberg said that phenomenon is called traumatic bereavement. “The mind is drawn to the circumstance of the death, and it makes it difficult to remember the person in a positive way,” he said.
Claudia often daydreams in class about what she would be doing if her father were alive. That’s if she can sit through an entire class without getting annoyed at her teachers.
She also has noticed that she’s more argumentative. “I like to say whatever I feel,” Claudia said. “I just became different; I’m not the same person. Now that my dad’s not here, I don’t even know if I’m sad, anxious, angry [or] lonely.”
Perhaps the hardest part is not knowing who killed her father. She finds herself staring down men with bald heads and baggy clothes, wondering whether they’re the ones she saw fleeing her house that night. If she had only caught them, she thinks. Instead, Claudia said, “You take that anger out at anyone that’s around you.”
Other counseling centers in the Los Angeles area are trying to prevent child trauma from triggering another round of violence, particularly in the inner city. One such project is the County-USC Medical Center Violence Intervention Program. Another is the Family Life Center at Charles R. Drew University of Medicine and Science in Willowbrook, which in 1999 began an after-school program teaching anger management, conflict resolution and leadership skills to 7- to 12-year-olds.
“If we expose our children to positive intervention, then it will reduce violence,” said Marilyn Al-Hassan, director of the Family Life Center.
Dr. Shahrzad Bazargan, the center’s evaluator, said the violence doesn’t have to be directly witnessed to have negative repercussions. “Our kids are woken up in the middle of the night because of police sirens and helicopter activity,” she said. “Their work is going to be affected by this.”
Parents’ Role in Getting Help Stressed
The important thing is realizing when your child needs help, said John, the father of a 13-year-old boy whose mother was shot to death when he was 4. He watched his son come home from school after getting into fight after fight and still didn’t know what was wrong.
“I played his aggression as him being an aggressive, competitive type of guy,” he said, because John Jr. played sports. It started to make sense when he overheard John Jr.’s stepbrothers teasing the boy about his mother’s absence. John Jr.’s mother was found lying dead in the street five blocks from her house in Compton.
“She used to come put me in bed and read a story,” John Jr. said. “When I was 7 or 8, I wondered where she was.” As he realized that his mother was never coming back, he said, “I just pulled my head under my covers and cried [myself] to sleep.”
John put his son in therapy with the Miller center’s Watkins. The youth learned to deal with his anger, and eventually the fights stopped and his grades improved.
He said it felt good to talk about his feelings. “I wasn’t holding it in anymore,” he said.
Watkins had John Jr. compose a series of letters to his dead mother, and others as if she were responding to him. In some, he wrote: “Dear Mom, I was scared of you dying because I wanted you to be a part of my life until it was time for you to die. Love, John.”
“Dear Son, I’m sorry, but it was something that had to happen. It was my fault and I’m sorry for not being able to come see you when you play football. I really wanted to be there for you. Love, Mom.”
“Dear Mom, As I write these letters it does not make me think of you that much. I am starting to get used to it. Love, John.”
“Dear Son, I am so proud of you. I think that it is time for you to stop thinking about me and go on with your life. Love, Mom.”
