Happy to Help
askmenot,
I am quite happy to share my experience. PTSD is complicated and if sharing my experience helps you help another, especially a child, then I am happy to oblige.
I have had PTSD since I was a young child, but only diagnosed about a year ago. I have not experienced it as severely as your young client has, so may not be all that helpful, but I have two decades of experience with children in counselling, therapy and in the classroom and I am studying psychology.
If I was reaching out to a child like your client, I'd simply make the visits highly predictable with a clear and simple, unchanging approach and easy to meet expectation. If you ask him to connect with you through a piece of string, then have that piece of string in place for every visit, tie it to his chair and to yours before he arrives and encourage him to hold onto it during your visit. If he continues to lock himself away, play the same music or read him the same book or poetry or have the same art activity, even if he doesn’t do it, you do it so he can see that every time, the same thing happens .... If he is that locked up inside then creative distraction would be best.
The reason I suggest this is that it can be very difficult to open up with PTSD. There have been times that my carer has begged me to respond to him during high anxiety. I have intended to, I have full intention to, but I can't get past the freeze in my brain and I can't find the words I need to do it. I'm always hopeful in those moments that he will just wait so that I can make my way through the haze to get to him. If he just lightly holds my hand that helps create a connection and helps bring me back. (although that may be inappropriate for your client) When he does just wait, without impatience, I feel the familiarity of the situation and sometimes I am able to break through, sometimes it takes an hour before I can communicate, sometimes less. The communication is often just sounds and splutters of despair as I really am struggling to feel something, to know something about the experience to share with him, but it is a start and usually leads to a few words.
If you maintain the same approach every time, I would imagine that somewhere in his locked up state, your client will begin to notice the familiar pattern. Predictability is very important for PTSD, from smells, to background noise, to the temperature in the room to the tempo and pitch of your voice – be consistent with him so that he feels the safety of predictability and can think about making his way out. When I am feeling that lost, I don’t want to talk about it, I need a familiar distraction, music is best, I have one track in particular that I put on repeat and that brings me down. My carer will sometimes chat quietly to me about my self and about my dreams – affirming myself to me, telling me how wonderful I am and what my greatest qualities are – that is amazing, it helps to reconnect my emotions and to reintegrate the past with the present.
Another reintegration technique is physical touch. To be stroked firmly on my back from left to right, crossing the midline, is healing and grounding. Then down my arms and legs with brisk strokes. I learnt this when working with a child who had sensory integration disorder. She had to be brushed with a soft brush a couple of times a day to help her desensitise. I had my carer try it on me with a shower brush, It helped release some blocked emotions, I wept and wept. It really worked, perhaps his body needs that kind of help too, perhaps he trusts someone enough to do that for him or you could teach him to do it for himself.
I have no advice on medication.
I’m afraid that is all I have to offer for now. I do hope that you find a way to make him feel safe and help him make his way back to himself.
All the best.
