5 Common Types of Intrusive Thoughts Your Child Might Have

Intrusive thoughts are freaky. Like an uninvited guest, they pop up and bother us with ideas or images we wouldn’t want to think about on our own. They can be frightening for kids to experience, because it feels like you’re losing control of your own mind. But they’re also unsettling to hear about as a parent, especially if a child’s thoughts are about something taboo, like death or violence.

The truth is, many intrusive thoughts are about taboo subjects. The more upsetting or off-limits something is to think about, the more likely it is to push back into our consciousness as an intrusive thought. It’s sort of an “opposite day” situation, where the things we find the most unpleasant—things we’d never actually want to do—pop up as thoughts or mental pictures.

Just knowing that other people have these types of thoughts can be reassuring, and a first step toward learning to manage them better. So, in this post, we’re going to go over 5 types of intrusive thoughts children commonly experience.

Content Warning: We’ll discuss specific examples of intrusive thougths in this article, which are often about upsetting or shocking subjects.

What Exactly Are Intrusive Thoughts?

An intrusive thought is any kind of idea, urge, image, or impulse that comes to mind when you don’t want it to be there. They can be about anything, but tend to be about subjects that a person finds upsetting, gross, or wrong. They usually happen repeatedly, and they can cause a lot of distress.

Intrusive thoughts are “ego dystonic”, which is a therapy jargon way of saying that they go against a person’s beliefs or don’t sync up with their personality. They can feel foreign or weird. People who have intrusive thoughts are aware that the thoughts are unusual, but can’t stop them from happening.

Intrusive thoughts are a really common symptom of OCD, which often starts in childhood. They can also happen in kids with anxiety or a history of trauma. However, that doesn’t mean every kid who has an intrusive thought has OCD! Pretty much everybody experiences a thought like this at some point. However, less-anxious people are more able to shrug them off as a weird, random event that doesn’t really mean anything. People with anxiety and OCD are more likely to hold on to these thoughts and worry that they mean something is seriously wrong.

What Are Some Characteristics of Intrusive Thoughts?

Intrusive thoughts stand out from the usual noise our brains make all day. If you’re trying to figure out whether your child is dealing with intrusive thoughts, consider the following list. Intrusive thoughts are unique because they tend to be:

• Involuntary: a person doesn’t want to have the intrusive thought, but it happens anyway.

• Repetitive: these thoughts tend to come back again and again.

• Anxiety-triggering: the thoughts can be annoying at best, and scary at worst.

• Out of character: the subject matter is something a person wouldn’t usually think about.

• Inappropriate: often, intrusive thoughts have to do with taboo subjects like sex, death, illness, violence, or bad behavior.

• Unwanted: the person has no desire to act on the thought, which is part of why it’s so upsetting. However, kids with anxiety or OCD may worry that having the thought means that someday they’ll lose control and act on it anyway—that’s not how these thoughts work.

Once you know what to look for, it gets easier to spot intrusive thoughts when they happen.

What Sorts of Intrusive Thoughts Do Kids Have?

Kids tend to have intrusive thoughts about subjects that society thinks are wrong or impolite to talk about—actually, this is true of adults with intrusive thoughts, too! Themes related to religion, sex, death, illness, or immoral behavior are all common when it comes to intrusive thoughts. Children may imagine themselves doing something they don’t really want to do, or see a mental picture of something they don’t like.

Younger children are still in the process of understanding adult concepts like sex, death, and violence, and their intrusive thoughts can reflect this. Even though the subject matter is the same, a child’s intrusive thoughts may not be the same as an adult’s. You might notice that your child’s thoughts are not realistic or logical. This can help set intrusive thougths casued by anxiety or OCD apart from the flashbacks caused by trauma or PTSD.

Next, let’s take a deeper look at 5 of the most common types of intrusive thoughts kids experience.

Type 1: “What If” Thoughts

OCD loves to make people doubt themselves. These “what if” thoughts often happen as a part of OCD, but they’re also one of the more common types of intrusive thoughts in general. A “what if” thought prompts you to question something you thought you knew for certain.

“What if” thoughts can affect people’s perceptions of their relationships, tasks they’ve completed, or even their own identity. Even if you have a clear memory of yourself doing something, the thought injects the possibility that maybe you actually forgot—and something bad might happen as a result.

Some examples of “what if” thoughts children might have include:

• A usually responsible child worrying that they somehow forgot to lock the door, and their dog will run away.

• A teenager who is secure in their sexual identity wondering if they might unknowingly be gay.

• A child who is bothered by thoughts of someone possibly hiding in their bedroom, even after checking under the bed and in the closet.

The hard thing about “what if” thoughts is that reassurance or double-checking only helps for a little while. Eventually, the doubt creeps in again and the cycle starts over.

Type 2: Thoughts About Hurting Self or Others

It can be alarming to hear your child is having repeated thoughts about hurting themselves or somebody else. Just like all other intrusive thoughts, these harm-related thoughts are unwanted and go against the personality of the child. Often, children who have these kinds of intrusive thoughts are described as being particularly kind, empathetic, and gentle.

Of course, any time you hear a child talking about harm, you can’t automatically assume it’s an intrusive thought. You need to rule out other possibilities, like suicidal ideation, which always need to be taken seriously. An intrusive thought—rather than an actual urge—might look something like:

• A child who has images pop into mind of pushing a sibling down the stairs, even though they’d never do something like that in real life.

• A usually kind child has thoughts about stabbing people that are so frightening they avoid being around knives or sharp objects.

• A teenager complains of fleeting thoughts about jumping in front of a train or running into traffic that bother him, because he really doesn’t want to die.

In all these examples, the thoughts are causing a lot of distress. Kids with this kind of intrusive thought don’t want to be thinking about violence, and may take great lengths to avoid being in situations they worry could be unsafe.

Type 3: Thoughts About Doing Something Embarrassing, Unkind or Illegal

Similar to thoughts about harm, this variety of intrusive thought is based on a fear that a child might somehow “lose control” and do something that’s socially unacceptable. Many people experience a stray thought like this, and shrug it off knowing they’d never act on it.

When children have these thoughts, they may not be so easy to shrug off. These taboo behaviors flash into a child’s mind, which makes them worry that some part of them really wants to do that bad thing. They put a lot of meaning into the experience, which leads to more anxiety.

Examples of this type of intrusive thought include:

• A child having thoughts about saying something inappropriate in a public place, like yelling “fire” in a movie theater or “bomb” in an airport.

• A student having bothersome thoughts while at school of saying insulting things to a classmate.

• A child who worries that their thoughts about shoplifting mean that they actually want to steal something.

When a child is truly having an intrusive thought, it’s extremely unlikely that they’ll ever act on it. Thinking and doing are very different things! However, the fear of possibly losing control can be very powerful, and get in the way of a child’s day-to-day life.

Type 4: Sexual Intrusive Thoughts

Even though they are common, this category of intrusive thought can cause a lot of shame and distress for kids. It can be hard enough to talk about the birds and the bees under normal circumstances, and even harder when you’re having your day interrupted by thoughts or images of upsetting sexual situations.

Because they are so taboo, children experiencing these types of thoughts may choose to keep them a secret. Even if children are open about most worries, they may fear that hearing about sexual thoughts will change a parent or therapist’s opinion of them. It can be a relief for children to know they’re not alone with these thoughts and to hear about examples of common intrusive thoughts. Some common worries in this category are:

• Worries about losing control and groping or sexually abusing someone.

• Unwanted thoughts that include family members, animals, or children.

• Fears related to unintentionally getting pregnant or getting someone else pregnant, even when this may not be logical.

There’s nothing pleasurable about these kinds of thoughts. Instead, kids experience feelings of shock, disgust, shame, and fear. Just like kids who have thoughts about harm, children with sexual intrusive thoughts may worry that having the thought means some part of them must want to act on it, and may avoid certain people, places, or activities as a result.

In reality, kids suffering from these types of intrusive thoughts are not violent or bad people: they’re just normal kids experiencing a bothersome mental heath symptom. It isn’t a reflection on their personality or character.

Type 5: Thoughts About Illness, Contamination, or Germs

Most of us have been worried about getting sick at one time or another. Health anxiety is really common, especially in the wake of the recent pandemic. Kids who struggle with intrusive thoughts may worry about sickness, too. They may worry about catching a disease, picking up germs, or spreading illness to other people. But there are some differences between their intrusive thoughts and regular health anxiety.

The thoughts children have about illness, contamination, and germs may be illogical or extreme. They may worry about catching germs from things that aren’t usually considered dirty, or about getting sick with a disease they’re highly unlikely to get. They may also worry about touching, breathing, or eating something that has somehow been contaminated. Some common fears for children with this type of intrusive thought are:

• Repeated fears that their food, drink, or utensils have been poisoned or contaminated by a chemical or cleaning supply.

• Fears that common objects or surfaces may have had germs on them.

• Thoughts about getting sick and dying from a disease such as cancer or AIDS.

• Worries about unintentionally spreading germs or serious disease to loved ones.

Children with these thoughts may avoid touching items with their bare hands, only eat “safe” foods or use “safe” utensils, or repeatedly wash their hands in an effort to avoid transmitting disease. These behaviors go above and beyond the hygiene we’d expect to see in a Covid-conscious kid, and interfere with day-to-day life.

Get Help for Kids with Intrusive Thoughts

As upsetting as they may be, intrusive thoughts are normal and common. Kids dealing with these types of worries are not alone! Sometimes, just knowing this can help soothe children’s anxiety about intrusive thoughts. When children accept these thoughts for what they are—random brain hiccups—it’s easier to just let them pass by without trying to push them down. Over time, this can help the thoughts to happen less and less often.

Other kids will need more support in dealing with their thoughts. This is especially true if the thoughts are accompanied by an urgent need to do something again and again, like washing hands or asking a parent if everything is okay. Kids whose intrusive thoughts begin after a traumatic event should also get support to help them recover.

Exposure and Response Prevention is the most effective tool therapists have to help children with compulsive thoughts and behaviors get their lives back. TF-CBT can help kids and their parents learn skills to cope with trauma symptoms and move forward in life without feeling overwhelmed by flashbacks or memories.

I offer both these therapies in my child counseling practice. I’m based in the Charlotte, NC area, but also work with kids online throughout the states of North Carolina, New York, and Florida. If you’re interested in starting therapy for intrusive thoughts, contact me here.

If you’d like to learn more about intrusive thoughts, check out my other blog posts on the subject:

Intrusive Thoughts in Children, Explained
How to Help a Child with Intrusive Thoughts
Signs of OCD in Children: What Parents Can Look For

What is Prolonged Grief Disorder, and How Does it Affect Kids?

How long is too long to grieve? We all have our own ways of dealing with loss, and there’s no right or wrong way to respond when a loved one dies. Grief never really ends, but mental health experts recently created a new diagnosis for people who grieve intensely for over a year: Prolonged Grief Disorder. Both kids and adults can receive this diagnosis, and attend therapy designed to help them move through their feelings of grief.

Is it really helpful to put a timeline on someone’s grieving process? How can you tell if you or your child is experiencing prolonged grief? Let’s talk about what Prolonged Grief Disorder is, and how you can help a child who is struggling after a loss.

Prolonged Grief Disorder is a New Diagnosis

Grief is a universal emotion, but until very recently it wasn’t considered a mental health issue. Most of us will experience grief during our lifetime. As painful as it is, grief is a healthy, natural response to losing someone we love. Many mental health problems, like anxiety, involve having a big emotional reaction that is out of proportion to the situation. It’s hard to imagine having a reaction that’s too big to the death of a loved one.

Still, grief can seriously impact a person’s life. Like trauma, it can affect a survivor’s relationships with others, their worldview, and their hopes for the future. For a small number of people, grief has a major and lasting effect on their ability to get through daily life. They may feel numb or have a hard time adjusting to the reality of what has happened. They might feel hopeless about the future, or cope with their feelings in unhealthy ways. Prolonged Grief Disorder was created to give a name to people with these kinds of struggles.

Not Everyone Agrees That Grief is a Mental Health Problem

You can find Prolonged Grief Disorder in the DSM-5, the “therapy bible” that therapists use as a guide to diagnose and treat people with mental health conditions. However, not everyone agrees that it should be there. The idea that grief should be listed alongside mental health problems like depression and OCD has been a little bit controversial.

Some critics think it’s not helpful to decide when grief “should” be over, because everyone’s process is so different. Who is to say that one year is the right or wrong amount of time to grieve? The diagnosis could make grievers feel added pressure to “get over it” or “just move on” with their lives after a death. Some grievers already feel this pressure, as phone calls and support from friends tend to fade away in the weeks or months after a funeral.

There’s also worry that putting a label on grief could make a hard time even more difficult for grievers. There is still stigma around mental illness, and being told you have a “disorder” could make a grieving person feel ashamed or as though their feelings are not valid. Many people already feel self-conscious about how they have responded to their loved one’s death—will getting this label make that feeling worse?

On the other hand, getting a diagnosis makes it much easier to get into therapy. People benefit from therapy after all kinds of life transitions, including deaths, and it doesn’t mean the feelings they’re having are wrong. Hopefully, adding Prolonged Grief Disorder as a diagnosis will help therapists and grievers find new ways to get help and heal after loss.

The Symptoms of Prolonged Grief Disorder

According to the American Psychiatric Association, prolonged grief happens when a person has been intensely mourning a loss for a long time. For adults, this means grieving for over a year. For children and teens, this means grieving for over six months. Prolonged Grief Disorder is more likely to happen after the the death of someone very close, like a parent, child, or spouse. It’s also more likely if the death was sudden or unexpected, like from an accident.

Some symptoms of Prolonged Grief Disorder include:

• Shock and disbelief

• Yearning or longing for the deceased person

• Feeling like a part of your own identity is gone

• Feeling emotionally numb, or feeling extreme emotions like sadness or anger

• Trouble returning to day-to-day activities

• A belief that life is hopeless or meaningless

• Avoiding people, places or things that remind you of the death

These symptoms don’t just happen once in a while: they’re present for most of the day, almost every day. They are so frequent and so severe that they make it hard for the griever to keep moving forward in life.

When Children Experience Prolonged Grief

Children grieve differently than adults, and this is true when it comes to prolonged grief, too. You might have noticed above that kids and teens only need to have prolonged grief symptoms for 6 months—half as long as adults—in order to get a diagnosis. Children, in general, move through grief more quickly than adults do. They also tend to work through grief a little bit at a time rather than all at once, giving them time between spurts of grieving to focus on just being a kid.

Kids who have lost a parent, sibling, or other close relative or friend are at risk of developing prolonged grief, just like adults. In addition to the symptoms listed above, a child’s grief may show up in other ways, such as:

• Difficulty believing their loved one isn’t coming back

• Tantrums and intense emotional outbursts

• Focusing on or reliving the details of the death

• Worries that they somehow caused the death with their thoughts or actions

• Anxiety about bad things happening to other family members

Many grieving kids will have some of these symptoms, but kids with prolonged grief will have them most of the time, on most days of the week. Over time, they can lead to social isolation, or added trouble with depression, anxiety, or other mental health problems.

Grieving Children Are More Emotionally Vulnerable As They Grow

Grief on its own is not a mental health problem, but it is a tremendous stress and sometimes even a traumatic event. Grief is painful no matter your age, but it can be especially tough for young children who lose an important person early in life. Bereavement affects kids both in the short term, causing problems like depression, and in the long term, leading to struggles at school, difficulty in relationships, and substance abuse.

Not all bereaved kids will develop these mental health issues. In fact, most children will find healthy ways to keep living and growing through grief. All kids need lots of help from caring adults to understand death, grief, and loss. This is especially true for kids dealing with prolonged grief.

Help for Grieving Kids and Families

As a parent, caregiver, or someone who loves a grieving child, you are your child’s biggest source of support. Many grieving children do not need to attend therapy. Simply having an adult who listens and cares reduces their chance of developing mental illnesses later in life.

You can help your child understand their feelings and find ways to remember and honor their special person together. If you need help finding ways to do this, A Parent’s Guide to Managing Childhood Grief offers over 100 activities you and your child can complete together. Using simple materials and play-based learning, you and your child can share your feelings, learn age-appropriate information about death, and regain a sense of safety after loss.

If you suspect your child may have Prolonged Grief Disorder, a child counselor can help. Therapy gives children a safe place to work through feelings at their own pace, and learn how to cope with the strong feelings that come with loss. If you’re located in North Carolina, Florida, or New York, I may be able to help with in person or online child counseling. You can also run a search for therapists near you using Psychology Today or a similar directory.

Should Children Attend Funerals?

What’s the right age for a child to go to a funeral? Will an elementary-aged child get anything out of the experience, or will it just be scary? Will your tween regret not attending as they grow up? What if your child is really little—2, 3, or 4 years old. Is a funeral too much for them to tolerate?

If you’re a parent who has recently lost a loved one, you may be grappling with tough questions like these. In the midst of planning for a funeral, you’re also having to consider the wellbeing of your child. You want to help your child say a healthy goodbye, but funerals can be a lot to handle, even for adults.

Let’s take a look at the benefits and drawbacks of having your child go to their loved one’s funeral. We’ll talk about why the ritual of a funeral service can be helpful for many kids. You’ll also learn how you can set your child up to have a meaningful funeral experience if they choose to attend.

What Age is Appropriate for a Child to Attend a Funeral?

There is no right or wrong age to attend a funeral. Think about how your child handles other family or group events, like church or holiday dinners. Is your child able to sit for a period of time without melting down? Can they follow social cues like taking turns or being quiet when others are speaking? If so, they should be capable of handling the funeral—provided they want to attend.

Your child’s own wishes are your most helpful guideline when making your decision. In general, if a child is old enough to express a desire to attend, they will likely benefit from having the experience. Even really young kids can benefit from being involved in an important family ritual and getting a chance to say goodbye.

It is true that children of different ages have different needs when attending a funeral. If your child is very young, you may want to think about what a reasonable amount of time would be for your child to participate.

Many Children Benefit From Attending Funerals or Memorial Services

Children grieve differently than adults, but they still need opportunities to express their feelings, talk about their loved one, and say goodbye. Rituals help us all to move through important moments in life, and connect us to something that feels bigger than ourselves. The funeral is the biggest—and sometimes the only—ritual that happens when someone dies.

Grief experts tend to agree that funerals and memorial services are beneficial for many children. They can help bereaved children move forward in their grief process and begin to heal. When asked, adults who lost loved ones as children and weren’t allowed to attend the funeral usually say they regret not being there. As sad and difficult as funerals are, they’re an important part of mourning, and we only get one chance to attend.

Some of the benefits of attending funerals for children include:

• Coming to terms with the fact that a loved one has really died

• Seeing a loved one for the last time

• Getting a chance to say goodbye

• Receiving support from other grievers

• Observing how others grieve, which can reassure a child that their feelings are normal

• Feeling as though they’ve done something important to honor their loved one

There Can Be Drawbacks to Attending if a Child Isn’t Ready

There are a few instances when it’s not the right choice for a child to attend a funeral. If a child is not well prepared, they may leave the funeral feeling worse, instead of better. Children are more likely to have a bad experience if they’re forced to attend the funeral, pushed to do something they don’t want to do, or if they encounter something they weren’t expected to see.

Children should be allowed to take the lead in when and how they participate. If your child doesn’t want to touch their loved one’s body, for example, there’s no need to press the issue. Children who aren’t ready to attend the funeral may experience some drawbacks from attending, such as:

• Increased anxiety or fearfulness

• Distress about confusing things they saw or experienced

• Troubling memories, especially if they were pushed to do things that didn’t feel comfortable

• Feeling a lack of control, if forced to attend

Let Your Child Make an Informed Decision About What Feels Right

At the end of the day, the most important thing is not whether or not your child attends the funeral. What matters most is that your child was given a choice. So much about death is out of our control, especially for kids, who have very little say in what happens. When possible, it makes sense to give some control back to kids and allow them to make decisions for themselves.

Help your child make an informed decision by letting them know exactly what they can expect to happen at the funeral. You can talk about where the funeral will be, who will be there, and what everyone will do to commemorate your loved one. It’s also important to give your child a heads-up about how people might behave, so they’re prepared to see a wide range of emotions from attendees. Finally, talk with your child about how their loved one’s body will appear, and whether or not there will be an open casket.

If your child decides to attend, figure out a way for them to participate that honors their age and maturity level—more on that in the next section of this post. If your child opts out of attending, offer a “Plan B” that is familiar, comforting, and low-key. The plan should include staying with a person your child knows and trusts, in a place that feels safe. New experiences can be stressful for a grieving child, and big outings like special time with friends might lead a child to decline attending a funeral when they’d otherwise choose to go.

Find Age-Appropriate Ways For Your Child to Participate in the Funeral

Kids love having a job to do and feeling included in grown-up activities. This is true for funerals, too. If your child was very close to the loved one who died, finding a way for your child to participate in the funeral or memorial service can mean a lot.

Think about ways that your child might be comfortable contributing in some way to the service. Older, more extroverted children might appreciate being asked to read something aloud. Others might prefer to choose a song or poem for someone else to share. Even something as simple as picking out a bouquet of flowers or choosing a special candle to light can help younger children feel that their voices and feelings matter.

Depending on your child’s age, you may want to consider how long, and to what extent, your child participates in the funeral. Younger children may not be capable of sitting still through an entire service. Coming up with a plan in advance will make it easier for you to follow your child’s lead on the day of the funeral. It helps to select a friend or family member to be your child’s support person. This person can quietly usher your child out of the service if it becomes too much for them to handle.

It’s also worth considering if attending a virtual funeral service makes sense for your child. If your loved one’s funeral is being live streamed, this option can offer some flexibility, especially for younger kids. Your child can watch from the comfort of home and step away as needed if their attention wanes.

Questions to Ask When Deciding Whether A Child Should Attend a Funeral

If you’re on the fence about what’s the best decision for your child, here are a few points to consider. You know your child best, and can probably make good educated guesses about what your child will need in order to process their feelings about a funeral. If you’re trying to decide how to involve your child, ask yourself the following:

• Is my child able to sit still and focus during group gatherings?

• Is my child highly sensitive or prone to anxiety?

• How well does my child currently understand death?

• What was my child’s relationship to the person who died?

• How does my child feel about attending?

If your child is highly sensitive, or doesn’t currently have a strong understanding of what death means, you may need to spend some extra time preparing your child before making a decision.

If Your Child Does Not Attend, Find Another Way to Honor Your Loved One

It’s okay if your child chooses not to attend the funeral or memorial service. As long as they have been given the information they need to make a thoughtful decision, whatever choice they make is just fine. You can help your child experience some of the benefits of a funeral by creating your own rituals at home.

Help your child memorialize their loved one by setting aside time to do something together that feels special. You can think about what your child might enjoy, or consider finding something that was meaningful to your loved one. Reading a book or poem together, planting a memorial tree, cooking a loved one’s favorite meal, or visiting somewhere significant to your loved one are all ways to help your child grieve. Whatever activity you choose, be sure to offer ample opportunities to share feelings and to say goodbye to your child’s loved one.

Help Your Child Navigate Funerals, Grief, and Loss

If your child has recently lost a loved one, the funeral is just the beginning of a long process of mourning and healing. Children need ongoing support from someone they love and trust in order to recover from grief. You can help your child sort through their complicated feelings over time through repeated opportunities to remember and share memories of their loved one.

My book, A Parent’s Guide to Managing Childhood Grief, offers simple ways to support children before, during, and after a funeral. In it, you’ll find activities designed to help kids explore and learn about many facets of grief that can be tricky to talk about. From learning about death and dying to finding meaning and reflecting on growth, the activities can help your family process grief in the days immediately following a death as well as in the months or years to come.

A Parent’s Guide to Managing Childhood Grief is available on Amazon, Barnes & Noble, or through your local independent bookstore.

Intrusive Thoughts in Children, Explained

Every kid worries from time to time. It’s normal (and even healthy!) to wonder about fitting in before the first day of school, or to imagine the worst-case scenario before taking a big test. Usually, these worries are easy for kids to talk about, because they know other kids have felt the same way. They also tend to be time-limited: once the test or first day of school is over, the worries are over, too.

For some kids, worries aren’t so easy to talk about. A troubling thought or mental image might pop up out of nowhere, when a child isn’t expecting it. Their worries may be repetitive and feel very difficult to control. Often, these thoughts are really scary and upsetting. They can be dark, violent, or about a taboo subject. These kinds of worries are called intrusive thoughts.

Kids don’t want to be thinking these things, and know they would never act on the thoughts they’re having. So why do they keep happening? In this post, we’ll be talking about what exactly intrusive thoughts are, why they happen, and when to seek help.

What Are Intrusive Thoughts?

Take a second and imagine an intruder. What do you think of? Someone who busts down the door, unannounced, without being invited. What a scary scenario! It’s safe to assume that most of us would be pretty freaked out to discover an intruder in our home. We’d probably dread having it happen again, and try everything we could to make sure our house was secure in the future.

Intrusive thoughts are the brain equivalent of an unwanted guest. They show up to ruin the party. Intrusive thoughts tend to:

• Pop up out of the blue

• Come back repeatedly

• Feel unlike the thoughts a child usually has

• Be upsetting to the child

Intrusive thoughts are ego dystonic. This is therapy jargon that means a person doesn’t agree with the thoughts, and it may not even feel like the thoughts really belong to them. Intrusive thoughts include imagery that is violent, sexual, or feels “wrong” to a child. Other times, worries about worst-case scenarios might come up again and again. They aren’t things that kids would choose to think about, and they’re often the opposite of what a child would do or hope for.

Kids with intrusive thoughts may feel distressed, anxious, or ashamed. They may not understand why the thoughts are happening, but can guess that not everyone is bothered by their thinking in this way. Because the thoughts feel out of control, children may dread having more and try to avoid them.

At What Age Do Kids Get Intrusive Thoughts?

There is no set age at which intrusive thoughts start. However, they may be more common or noticeable in tweens and teens. Intrusive thoughts are sometimes a symptom of OCD, which can show up as early as age 7 or 8 and as late as the teens or early twenties.

In my child therapy office, it’s usually middle or high school kids who are able to put the weird experience of having unwanted thoughts into words. They are old enough to think about their own thinking and notice their thoughts as they pass by, so they know that something doesn’t feel right.

Although they may not talk about it as much, younger kids can be bothered by these thoughts, too. Because they don’t have the vocabulary to talk about what’s going on, you might see changes in their actions, instead. For example, they may ask for reassurance about the same subject again and again.

Why Do Children Have Intrusive Thoughts?

Now that we have spent the past several paragraphs talking about how difficult and upsetting intrusive thoughts can be, you’re probably wondering why kids get them in the first place. The answer may surprise you! Many people experience intrusive thoughts, and it doesn’t necessarily mean something is wrong. They may happen when a person is going through a lot of stress, or they may just happen randomly.

Having an intrusive thought every once in a while isn’t a sign of mental illness. They can be totally normal, like the brain version of a hiccup. A child with occasional intrusive thoughts can usually brush them off without taking them too seriously.

What Mental Health Problems Cause Intrusive Thoughts?

Children who are struggling with repeated, ongoing intrusive thoughts can’t brush them off so easily. In these cases, a child may be dealing with a mental health problem that needs attention. OCD and PTSD are two common mental health conditions that can cause children to have intrusive thoughts.

Kids with OCD deal with repeated thoughts, worries, or mental pictures that upset or scare them. Kids are bothered by these worries, and feel pushed to do something to make the worry go away or prevent something bad from happening. This creates a cycle of repeated worries and repeated behaviors, called obsessions and compulsions, that take up a lot of time and add even more stress.

Children who have survived extremely frightening or dangerous events may have lingering problems after the fact. While some kids will bounce back, others may be diagnosed with PTSD. Kids with PTSD will re-experience parts of their trauma in some way, often through intrusive thoughts or flashbacks. Flashbacks are vivid memories that pop up suddenly and intensely, almost as if a child is living through the event again.

What Are Some Examples of Intrusive Thoughts in Children?

Most of the intrusive thoughts children have fall into one of three broad categories: worries, flashbacks, and “inappropriate” thoughts. If you think your child may be having intrusive thoughts, keep reading to take a closer look at each category. I’ll share some examples of each intrusive thought type. It can be helpful for both kids and parents to discover that they’re not alone, and many kids (and adults) deal with these kinds of thoughts.

Worries: Children with anxiety or OCD may have repeated, unwanted worries that they cant seem to shake. These are often “what if” worries that focus on something bad that could happen in the future. Other times, these “what if” thoughts could be about something naughty a child worries they could have done. Some children with OCD may also get a nagging sense that if they don’t do something exactly right, they could cause something bad to happen. These thoughts may not always be logical, which can make them even more confusing and bothersome for kids. Here are some examples:

• “What if I throw up in public?”

• “What if I accidentally lied to the teacher?”

• “I have to step on all the sidewalk cracks or I won’t be safe.”

Flashbacks: These are most common in kids with PTSD. Flashbacks may feel like they come out of nowhere, or they can be triggered by something that reminds a child of their trauma in some way. They can include any of the 5 senses, and often activate a child’s fight-or-flight system as if the dangerous event was happening again. Examples of flashbacks include:

• Feeling as though you’re back in the place where a trauma happened

• Having an image of the trauma pop into mind

• Hearing or smelling something you associate with the trauma

“Inappropriate” Thoughts: I put inappropriate thoughts in quotes here because there’s a big difference between thinking something and acting on it. We all have weird thoughts from time to time about things we probably wouldn’t be proud to share. Sometimes, intrusive thoughts are about the exact subjects we try to push away or not think about in our day-to-day lives: things like sex, violence, and criminal behavior. These kinds of thoughts can cause a lot of shame, guilt, and distress for children, who worry these thoughts mean they are bad or naughty. They may have thoughts like:

• Imagining hurting someone else

• Picturing themselves stealing something

• Noticing other people’s bodies or imagining them naked

Are Intrusive Thoughts Normal?

The short answer: yes. Intrusive thoughts can be weird, annoying, or disturbing, but they are totally normal. In fact, most of us will probably have intrusive thoughts at some point in our lives. One recent study found that 94% of people have them, which is a surprisingly huge number.

That number is particularly surprising when you consider that most kids with intrusive thoughts feel like the odd one out. They may worry they’re the only ones who have ever had thoughts like this, and that it means they’re bad or weird. Most adults with intrusive thoughts don’t talk about them with other people, either because they quickly disregard them or because it would feel odd to mention in casual conversation. No wonder kids feel so alone.

So, intrusive thoughts are normal—but we know that they can still cause problems for kids. Those issues aren’t caused by the thoughts themselves. Problems arise when the thoughts are very frequent or intense, or when kids have a hard time dismissing them.

Children with OCD have a tougher time disregarding stray thoughts that the rest of us would shrug off. They may take these thoughts more seriously or begin to fixate on them, which causes the thought to pop up more often. Trauma-related thoughts and flashbacks may be so upsetting that they quickly overwhelm a child.

Help for Kids with Intrusive Thoughts in Charlotte, NC

If your child is complaining of an occasional intrusive thought, a little reassurance and education may be all she needs to feel better. It’s helpful for kids to hear that their thoughts are normal, and can’t hurt them or others. Armed with that knowledge, it may be easier for kids to let intrusive thoughts pass by without taking them too seriously. This reduces anxiety which, over time, can also reduce how often the thoughts happen.

On the other hand, you may be on this page because your child’s thoughts are causing larger problems. Maybe you recognized your child in the descriptions of OCD or trauma. If these thoughts have been happening for a long time, are disrupting your daily life, or are combined with other symptoms, therapy can help.

Cognitive behavioral therapy helps anxious kids learn how to catch themselves when their thoughts aren’t doing them any favors. Being able to put a name to your worries helps you to gently shift your mindset. In CBT kids learn that they have control over their thinking, and what thoughts they choose to listen to. A specialized form of CBT called Exposure and Response Prevention helps kids with OCD break the cycle of obsessive thinking and repetitive behavior.

Play therapy helps younger children work through their complicated feelings after trauma. Kids naturally make sense of the world around them through play, and this gentle, child-led approach lets kids handle scary topics in the way that feels safest to them. For kids who are ready to tell their story more directly, TF-CBT gives children a step-by-step path toward managing strong feelings, talking about their experiences, and coping with reminders of trauma.

If you are looking for therapy in North Carolina, New York, or Florida, I’d love to help. We can meet online or in-person in my counseling and play therapy offices just North of Charlotte, North Carolina. If you’ve got questions or would like to schedule an appointment, contact me here.

What are the Symptoms of PTSD in Children?

Kids are incredibly resilient. One of the things I love about being a children’s therapist is that children are growing and developing every day—they can’t help but grow! This often means that they can progress through therapy at a surprisingly quick pace. Sometimes, however, children can have an experience that is so stressful that it overwhelms their capacity to cope. Parents of children who have endured a trauma often ask whether their child has been seriously affected, or if they may be suffering from PTSD. Keep reading to learn about the signs and symptoms of PTSD, and how these symptoms commonly show up in children.

Categories of PTSD Symptoms

In order to receive a diagnosis of PTSD, a child must have witnessed or directly experienced something that put themselves or a loved one at risk of serious harm. They must also have a number of symptoms in each of 4 identified categories: intrusion, avoidance, negative changes in mood or cognition (thoughts), and changes in arousal or reactivity. These categories are the same for kids as they are for adults, but children often express their symptoms a little differently than their older counterparts.

Intrusive Symptoms in Children

Intrusive symptoms are negative thoughts, memories, or feelings that pop up uncontrollably even though they are not wanted. Many people know that flashbacks can be a part of PTSD, and these are a common intrusive symptom. A child who is experiencing intrusive symptoms may feel like they are right back at the scene of their trauma, and living through it again. These symptoms aren’t under the child’s control, and they may be triggered by people, places, or situations that remind the child in some way of their trauma experience.

Flashbacks, recurring dreams, and strong physical or emotional reactions when reminded of a trauma are all examples of intrusive symptoms. Here’s a few ways they can manifest in children:

• Frequent, recurring nightmares which may or may not resemble some part of the trauma experience: even if your child’s dreams are about something seemingly unrelated, they may be a symptom of trauma if they’re new and/or unusual for your child

• Meltdowns, fear, or anger when your child encounters something reminiscent of the trauma

• Repeatedly acting out scenes through play that are similar in some way to the trauma: this type of play is often very rigid, repetitive, and it may be hard for the child to shift focus to another activity once the play has started

• “Spacing out” when something stressful happens

Avoidance Symptoms in Children

As you can imagine, it feels terrible to have intrusive symptoms that show up when you don’t want them. Children with PTSD begin to avoid people, places, or situations that remind them of their trauma as a way to protect themselves from distressing and overwhelming feelings. They may do this by avoiding external reminders (people and places), internal reminders (their own memories), or both.

In children, avoidance symptoms may look like:

• Refusing to talk about the trauma, or insisting that they are not bothered by it

• Avoiding people who resemble their abuser in some way

• Reluctance to go near the place where the traumatic event occurred

Sometimes, the things a child avoids become more generalized over time: for example, a child whose mother had a heart attack may be afraid of driving by the emergency room where her mother was treated, but may also begin to avoid any doctor’s office.

Negative Changes in Mood or Thoughts in Children

Traumatic events can color a child’s entire worldview. People with PTSD experience changes in the way that they think, feel, and remember things. PTSD can make it very hard to trust other people, especially if your trauma was deliberately caused by another person. Many people with PTSD feel depressed, and they may unfairly blame themselves for what has happened. Some people find they can’t remember parts of their trauma experience.

Adults with PTSD are often able to put these negative beliefs into words: for example, “The world is a dangerous place” or “I’m just waiting for the rug to be pulled out from under me again.” For kids with PTSD, however, these feelings are harder to verbalize. Here are a few ways you might see negative changes in thinking and mood show up in children:

• Low self-esteem

• Lack of interest in seeing friends, or doing things they used to enjoy

• Difficulty with attachment or bonding

• A belief that they caused the trauma, or it was somehow their fault

Increased Arousal and Reactivity in Children

When a person is in danger, the brain and body go into fight-or-flight mode: a surge of adrenaline is triggered in the body, giving the person the energy they’ll need to either physically defend themselves or run to safety. For children with PTSD, their fight-or-flight response may have been activated so much that it now remains “switched on” a lot of the time. Increased arousal, also called hyperarousal, means that the brain is on high alert at times that it doesn’t really need to be, causing that surge of energy and adrenaline in the body. Reactivity means that a person with PTSD has very strong, fast emotional and physical responses to stressful situations.

Hyperarousal and reactivity can look a lot like ADHD in children. I have met a good number of kids who were diagnosed with ADHD before the adults in their lives became aware of their trauma history. Of course, it is possible for kids to have both ADHD and PTSD, but if a child’s symptoms came on very suddenly, it is worth ruling out any possible trauma. Here are a few other ways these symptoms can show up for kids:

• Difficulty concentrating or learning

• Sudden, severe tantrums that seem to escalate from “zero to sixty” very quickly

• Being very sensitive to sounds or small movements

• An exaggerated startle response

• Having trouble falling or staying asleep

• Aggression towards others, risky behavior, or self-harming behavior

How Long Do a Child’s Symptoms Have to Last to Be Considered PTSD?

It is normal and common for many children to experience at least a few of these symptoms in the days and weeks immediately following a trauma. It’s also common for a child to be in a state of shock, and have a hard time processing their feelings about what has happened at first. If your child’s trauma is very recent and they are struggling, it doesn’t necessarily mean they will go on to develop PTSD.

A child’s symptoms need to be happening for over a month in order for PTSD to be considered as a possibility. It’s also good to know that trauma symptoms may not show up right away: a child may not start showing signs of PTSD for weeks or months after a trauma.

Does Every Kid Who Experiences Trauma Develop All These Symptoms?

Not every child who survives a trauma event will develop PTSD. As many as 43% of American boys and girls experience at least one trauma event every year, and many of these resilient kids will be able to “bounce back” from the experience without developing PTSD. Nobody knows exactly why some children develop PTSD while other’s don’t, but we do know that children are more likely to be affected if their abuse happened as a result of violence or abuse, or if they have had repeated trauma experiences throughout their lives.

It’s also possible for children to experience a few of the symptoms listed above, without fully meeting the criteria for PTSD. PTSD is a label that can help us give a name to a child’s experiences and figure out what treatments will work best for them, but many kids have trauma-related symptoms that don’t exactly fit this mold. Trauma-focused therapy can be helpful for these children, as well, if they are bothered by their symptoms but don’t fully meet the criteria for PTSD.

I Think My Child May Have PTSD. How Do I Get Help?

If you suspect your child may have been abused, contacting a Child Advocacy Center near you is a good first step. Your local Child Advocacy Center can give you advice on what to do next, and they have trained professionals who can help determine whether a child has been abused in a way that minimizes a child’s stress and protects their emotions. The CAC may also be able to refer you to local therapists in your area who are trained in PTSD.

If you are looking for a children’s therapist for a child with trauma symptoms, I’d recommend seeking out someone with specialized training in a form of trauma-focused therapy, such as TF-CBT for older children, CPP for toddlers, or TBRI for children who survived long-term abuse or neglect.

Sometimes, grieving children can suffer trauma symptoms due to the nature of their loss. If you’re wondering what’s “typical” for grief and what might be a sign of something more serious, my book for grieving kids and caregivers might be a good place to start. Inside, you’ll find over 100 activities for caregivers and kids to do together to manage grief symptoms.

If you’re looking for more information on childhood trauma, check out my Help for Trauma page for more information and resources.

How to Help Grieving Children Through Christmas

Whether your child has lost a loved one recently or long ago, Christmas can rekindle feelings of grief for children. Happy memories of past Christmases with a parent or family member who has died makes their absence during the holidays even more apparent. Christmas is often described as the “most wonderful time of the year” for children, and the movies, songs, and advertisements targeted at kids can trigger complicated feelings as the holiday approaches. Here are some ways to support a child in your life who is grieving over Christmas.

Involve Your Child in Holiday Planning

The Dougy Center is one of my favorite resources for bereaved children and their families. Their tip sheet for getting through the holidays is an excellent guide for how to discuss an upcoming holiday with bereaved kids. Asking your child how they feel about continuing with holiday traditions helps you to gauge what could be comforting to them, and what might be too painful to handle this year.

Many children benefit from predictable routines, especially after trauma or loss. Participating in Christmas traditions as they have always been done might be just the thing to help some kids. These holiday rituals can help restore a sense of normalcy for children, and give them an opportunity to feel close to family after the loss. On the other hand, some holiday traditions may feel so closely connected to the lost loved one that they are too overwhelming to practice. Asking your child about his or her preferences gives them some control in a tumultuous time. It’s okay to keep some things the same, modify others, and leave some traditions for another year.

However Your Child Feels About Christmas is Okay

Children grieve deeply, but the way they show their grief can be different than adults. Adults can remain in mourning for a long time. Even as they get back to their daily lives, they are aware of their grief. Children, by contrast, often grieve in bursts. This may be because they don’t have the same capacity to handle deeply painful emotions as adults do.

It’s common to see an intense outpourings of emotion from bereaved children, interspersed with periods that are relatively calm. It doesn’t mean the child has forgotten about their grief: they just need to take a break. The child will “pick up” their grief again when they are ready to keep processing it.

Because kids sometimes grieve in bursts, any reaction to Christmas is normal, okay, and healthy. Children need permission to feel mad, sad, guilty, or frightened about celebrating holidays without their loved one. They should also be allowed to feel excited, to enjoy holiday traditions with family, or to anticipate receiving gifts from Santa. Letting a child feel whatever feelings come up for her supports her in working through her grief. You can help support your grieving child by letting her know that her feelings about Christmas are normal, even if they change day to day.

Tell Stories About Your Loved One

Because Christmas is loaded with family memories for most people, it can be a good opportunity to tell stories about a family member who has died. Many children have a strong desire to share stories about a loved one following a death in the family. Sharing these stories can help a child feel connected to their deceased family member, and help them to heal.

If your grieving child is interested in telling stories about her lost loved one, you can support her by talking about favorite holiday traditions. What was the family member’s favorite food? What was a memorable gift the family member gave or received? It can also be helpful to remember less happy memories involving a deceased family member. This shows children that negative feelings are okay to share, too.

Read Children’s Books About Grief

The holidays may be a good time to share a book about death, loss, and bereavement with your child. Children’s books can approach grief in a more general way, which can be less threatening for kids. Books can also normalize the feelings that children have after a death, reassuring them that their reactions are normal and they aren’t alone.

The Invisible String is a classic book for children that doesn’t directly address the topic of death, but talks about how love between a parent and child never goes away. It can be a helpful book for children who are grieving the loss of a family member, as well as children who are anxious or sad about separation from a loved one for any reason.

When Dinosaurs Die is a more educational book that speaks directly about death, and addresses questions children may ask after a loved one dies. Instead of reading this book cover-to-cover, it might be more helpful to pick sections to read based on an individual child’s experience and the nature of their loved one’s death. The illustrated dinosaurs in this book help keep the book feeling safely removed from everyday life, which helps the book feel more reassuring for kids.

Take Care of Yourself During the Holidays

Therapists often use an airplane analogy when talking to parents about self-care. When you’re in an airplane, the flight attendants tell you that, in case of emergency, you need to put on your own oxygen mask before helping a child. The same can be true during grief.

Children rely on their caregivers heavily after a death. They may become more clingy, and need more individual attention, as they heal from their loss. Kids also look to their parents to learn how they should be feeling, and to get reassurance that they will still be safe. Caregivers need to take care of themselves, physically and emotionally, so they can have the strength to take care of their grieving kids.

It’s okay to say no to holiday events, if you don’t feel up to the task. Practicing self-care, especially around Christmas, is really important for a mourning parent. It is okay to let your child see how you’re feeling, even if you’re feeling sad or angry. Parents can show children that it is okay to cry, and also model the ways that both adults and children can care for themselves during grief. It’s also always okay to step away from holiday celebrations and take a break, if things become too overwhelming.

Help Your Child Cope With Grief During Christmas and All Year Long

If your family is grieving this season, you’re not alone. We can’t take a child’s grief away, but parents and caregivers can give children the tools they need to cope with their loss in a healthy way. My activity book for bereaved kids and caregivers is available on Amazon, Barnes & Noble, as well as through small booksellers near you. Inside, you’ll learn how children grieve differently than adults, and get over 100 ideas for hands-on activities you and your child can try together to manage the difficult feelings of grief.

Children may have symptoms of trauma after a death, especially if the loss was sudden or violent. You can learn more about symptoms and help for trauma here. If you’re in the Lake Norman area in North Carolina, my door is always open if you’d like to reach out.

TF-CBT for Preschoolers: Therapy for Early Childhood Trauma

TF-CBT is designed to help preschool children as young as 3 and 4 years old after a trauma.

Preschool Trauma is Common

Trauma is one of the leading causes of mental health problems in children, and TF-CBT for preschoolers can help support the many young children who find themselves affected by trauma each year. Learning that a preschooler has experienced a trauma is terrible news for any parent. As caregivers for children, we do everything possible to shield the young people in our lives from danger. Despite our best efforts, sometimes life happens in ways we didn’t expect or hope for: accidents, violent situations, grief, and loss are not always preventable, and can affect people of any age—including preschool children. Statistically, 26% of kids in the United States will witness or experience a trauma before the age of 4.

Some common causes of childhood trauma among preschoolers are:

• Prolonged separation from a parent due to illness, incarceration, or foster care placement

• A severe accident or illness, such as a car accident or cancer

• Physical, verbal, or sexual abuse

• Witnessing physical or verbally abusive arguments between parents

It’s important to know that preschoolers can be just as affected by witnessing a parent’s trauma as they would be if the trauma happened to them directly. Very young children are so connected to their parents that their own sense of self and safety is wrapped up with their parents’ well-being. Seeing a parent in trouble can be intensely frightening and painful for a preschool-aged child, and can be just as likely to result in trauma symptoms.

How PTSD Affects Preschoolers

While some preschool children will “bounce back” fairly easily from their trauma experience, others might show lingering problems long after the initial event has passed. Trauma symptoms can impact any child’s life, but younger children may especially vulnerable to developing symptoms. Other factors that make trauma symptoms more likely include having special needs or sensory sensitivities, experiencing other life stresses, and having a previous history of trauma or loss.

How can you tell if a preschooler in your life has trauma-related symptoms? Very young kids may not be able to tell us in words what they are going through, but will communicate their trauma through tantrums or crying, difficulty sleeping, frequent nightmares, or problems paying attention or following directions. Parents often observe that their child seems to “regress” to an earlier developmental stage after a trauma, and may suddenly struggle with problems they had previously grown out of, such as potty training or sleeping through the night.

Lots of research has been done on the subject of early childhood trauma. We’re learning that even the youngest children can be just as deeply affected by trauma as older children and adults. Fortunately, we’ve also discovered that preschool-aged children can benefit greatly from age-appropriate trauma therapy tailored to their developmental level. One of the best-researched forms of therapy for preschool survivors of trauma is Trauma-Focused Cognitive Behavioral Therapy, or TF-CBT.

What is TF-CBT, and How Can it Help Preschool Children?

TF-CBT is a form of therapy designed specifically to help children ages 3-18 following a traumatic event, and it can be an especially big help for children in the preschool and early elementary age range. It is an evidence-based form of therapy, meaning that it has been proven effective by research to help children with these symptoms. Through TF-CBT, preschoolers and their parents learn skills to cope with trauma symptoms, helping the child to alleviate anxiety, manage worries, and cope with strong feelings. The parent and therapist gradually assist the child in expressing their thoughts and feelings about the traumatic event and make sense of what happened, so that it no longer feels like an overwhelming experience.

TF-CBT tailored for preschoolers puts a strong emphasis on educating both children and parents about how trauma can cause problems problems with their bodies as well as their feelings. This can be extremely helpful for young children, who may feel quite confused by their symptoms and alone in their experience. Educating children about trauma in an age-appropriate way helps children understand that they are not alone—many other young children have walked in their shoes, and have recovered from trauma to live happy and fulfilling lives.

How does TF-CBT for Preschoolers Work?

During treatment with TF-CBT, preschoolers are taught how to use relaxation and mindfulness techniques to reduce anxiety and mood swings during the day and promote restful sleep at night. While these relaxation skills are used initially to reduce symptoms of trauma, they are also a great life skill that can grow with the child, helping them to manage other stressful situations as they arise.

Since younger children may have more difficulty putting feelings into words and making connections between past and present experiences, TF-CBT for preschoolers relies more on art and play-based activities to help children identify important feelings and develop a better understanding of their experiences. Through art and play activities facilitated by a therapist, the child can work through any misconceptions about their trauma experience, alleviate feelings of guilt or self-blame, and find a sense of closure.

Helping Preschoolers Move Beyond Trauma with TF-CBT

While therapy cannot make a young child forget what has happened to him, it can take some of the power away from a traumatic experience. It can help a child move past this difficult time in their lives and toward other, more hopeful chapters. Many parents and children find that after working through a traumatic event in therapy, children develop more resilience and empathy for others. Children and parents complete the TF-CBT process together by reviewing the child’s growth and learning strategies to help the child stay safe and avoid dangerous situations in the future.

If you’d like to learn more about how to support your preschooler with trauma through TF-CBT, my door is always open. You can also learn more by visiting the official website for TF-CBT.

Drama Therapy for Children: Express Yourself Through Theater

Drama Therapy uses storytelling and make-believe to help children work through feelings

This is the second blog post in my series on drama therapy. Click here to read part one!

Drama therapy is a form of mental healthcare that uses theater techniques to improve the mind-body connection, encourage emotional growth, and provide symptom relief. When drama therapy is used with kids, storytelling, imaginative play, props such as dolls and puppets, as well as theater techniques like improvisation and performance help children to explore their feelings, connect with others, and problem-solve difficult situations.

Drama therapy can be used in both group and individual therapy sessions. Because it helps participants express themselves nonverbally, it works well for people of all ages and abilities, as well as across cultures or when there may be a language barrier within a group. Today, I’d like to talk about how Drama Therapy can be an especially powerful tool for kids in counseling.

Drama Therapy for Children: No Theater Experience Required

Parents might wonder if their child has to have a flair for the dramatic in order to benefit from Drama therapy. Is this a form of counseling just for "theater kids?" Not at all! Kids who are natural performers or have theater experience are a great fit for a drama therapy group, since they’ll be building on their strengths and connecting with other children who may share their interests.

However, I believe that more introverted kids can benefit just as much—if not more—from therapy that uses theater techniques. There’s a lot more to Drama therapy than just performing on stage, and the skills can be modified to meet any child’s needs and comfort level with performing.

Why Drama Therapy is a Natural Fit for Children

If you have a young child in your life, you have probably seen her pretend to be a superhero, or act out scenes from a favorite movie or story using her friends or toys. Children are natural storytellers, and they love to take on the roles of their favorite characters and heroes. This type of play is the foundation of drama therapy!

Kids are naturally inclined to work out their feelings and learn through play. Child therapists like to say that "play is the child's language,” and research has shown that imaginative, make-believe play is a critical part of healthy child development. Even when children are exploring pretend scenarios in play, they are learning important lessons about real life. Drama therapy builds on this natural capacity for imaginative play to help children work through feelings and events that might be too big to describe with words. 

What Kinds of Children Benefit from Drama Therapy?

Drama Therapy has been used to help children with a wide variety of problems. Some of these include:

• Children having problems with relationships, or who need to practice social skills

• Children on the autism spectrum

• Children who are acting out behaviorally

• Children who are recovering from a serious injury or illness

• Children who have experienced trauma or loss

In general, drama therapy can be an asset for any child who has a hard time verbalizing his feelings. Even bright and talkative kids often have a hard time articulating deep, underlying worries or emotions. Even if they can verbalize them, many kids are hesitant to share these deep-down feelings out of a fear that they may become too overwhelming for themselves or others to handle. For these kids, traditional talk therapy alone may not be the most helpful option. Drama Therapy can help children begin to access and explore their emotions in a less threatening, more playful environment.

Benefits of Drama Therapy for Kids

Drama therapy has some unique benefits for children when compared to other forms of therapy. Here are a few of the common positive outcomes for children who participate in drama therapy:

Reduced Social Isolation: Drama Therapy is a community-building activity that helps children build empathy and social skills. Young people have the opportunity to walk in another person’s shoes and may discover that their peers not only understand their worries and problems, but share them.

Increased Self-esteem: Children can experience the confidence that comes from learning a new skill, whether performing for a full house, a group of peers, or an audience of one. Theater performance celebrates the uniqueness of each individual and can help young people to identify their own strengths.

Practicing New Skills: Roleplaying allows kids to try out new coping and social skills in a safe, low-risk environment. The role-player is free to experiment and make mistakes, and discover how different approaches to a problem have different outcomes.

Creative Problem-Solving: Drama therapy increases children’s creativity and spontaneity, encouraging young people to trust their instincts and come up with new, out-of-the-box ways to approach life's challenges.

Improved Emotional Expression: Drama therapy is a great way to more deeply explore feelings that may not be accessible with verbal therapy alone. It can also be a safe way to explore feelings that are too big or scary to talk about directly.

Learn More about Drama Therapy for Children

Drama Therapists are increasingly employed in settings that work with children, such as schools, early intervention programs, recreational facilities, and hospitals. Drama therapy for kids can also sometimes be found in therapy practices specializing in children, such as my own.

To find out more about how Drama therapy can benefit young children, check out the North American Drama Therapy Association’s website here.

If you’re in the Davidson area, I’m a Registered Drama Therapist and would be happy to talk more with you about this unique form of child therapy. You can contact me here.

Therapy for Toddlers with PTSD: Child-Parent Psychotherapy

A Special Therapy for Toddlers with Trauma Symptoms

Can Toddlers Have PTSD?

Trauma has become a buzzword among people who care for children. In the past, the word “trauma” was usually reserved for experiences most common among adults, like war and violent crime. Now, mental health professionals understand that many other frightening experiences, such as abuse, medical emergencies, and witnessing accidents or violent arguments can lead to trauma in people of all ages. In this post, I’ll be discussing how therapy can help toddlers with trauma symptoms and PTSD following one of these experiences.

Doctors, teachers, counselors, and parents are becoming increasingly aware of the ways that traumatic experiences like these can affect children's physical and emotional health. Even children's television programs like Sesame Street have recognized the impact of trauma on young children, and have started to address difficult experiences like grief, foster care, and incarceration in episodes. As hard as it might be to imagine, trauma and PTSD can affect even very young children—including toddlers.

How Trauma Affects Toddlers

Studies have shown that exposure to extremely frightening or violent events impacts a child's ability to learn, form close relationships with family and friends, and can even make kids more susceptible to chronic illnesses later in life. Separation from a parent, even when it isn’t due to a violent or scary cause, can also have similar effects on a child. We also know now that these effects last for a long time: even if a toddler is too young to remember the traumatic event, he may suffer from trauma symptoms like tantrums, anxiety, difficulty bonding with parents, or problems with sleep for years to come if he does not receive the help he needs to move forward.

Therapy for Toddlers with PTSD

While there are quite a few forms of therapy to help older children cope after a trauma, it can be hard to find therapy that is a good fit for very young children. Toddlers often have a hard time putting their feelings into words, and need specialized therapy that incorporates play and nonverbal techniques to help make sense of traumatic experiences, as well as coping skills to manage strong emotions. Child-Parent Psychotherapy is one of the only forms of therapy specially designed for the youngest kids--children under the age of five--who have survived a trauma or loss.

Child-Parent Psychotherapy, or CPP, is a form of play and talk therapy for children ages 0-5 and a parent or caregiver. It is a dyadic therapy, which means that typically the child and parent participate together with support from a therapist. CPP aims to strengthen the bond between parent and child after a frightening event. Because parents are so central to young children's lives, they are especially equipped to help a child return to healthy growth and development.

How Child-Parent Psychotherapy Works

Through CPP, toddlers with PTSD symptoms rediscover how to feel safe and protected after a trauma, and make sense of what has happened to them in an age-appropriate way. Learning coping skills to help the child relax and manage emotional outbursts is another important goal of CPP. Parents can also get support for themselves through caregiver coaching sessions, where they have the opportunity to cope with their own feelings about what happened and receive tips from the therapist on how to handle behavior problems related to trauma.

CPP is an evidence-based therapy, which means that it has been proven effective by scientific research. While not every form of therapy works for every person, CPP has been used successfully with kids from many different cultural backgrounds, and to help with a variety of traumatic events including domestic violence, grief, abuse or neglect, parental separation, and serious accidents. It can be a helpful therapy for children with biological, foster, or adoptive parents, and even a caring relative can serve as a support system in CPP sessions.

Therapy for Young Children After Trauma in Davidson, NC

Coping with a trauma or loss can be an extremely challenging situation for people of any age, but parents with toddlers don't have to struggle with this alone. If you think your young child might benefit from therapy for toddlers with trauma symptoms, please don't hesitate to reach out to me and learn more about this approach. You can also learn more about the impact of trauma on children and how therapy can help here.