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Intrusive Symptoms: Children's Re-Enactment As Re-Experiencing

Jamie Marich, Ph.D., LPCC-S, LICDC-CS, RMT, edited by C. E. Zupanick, Psy.D.

We have already briefly discussed how children's intrusive symptoms often involve re-enactment that can become evident in their behavior and play. The case of Dominique introduced this phenomenon.

There are several symptoms that are generally discussed in this intrusive/re-enactment conversation as they relate to children. Some signs of emotional or social withdrawal are easy to detect. For instance, you may remember Mark who watched his mother being assaulted at a crack house. He would sit in the corner and stare into space, re-enacting what he was commanded to do, "Shut up and watch." Conversely, withdrawal symptoms may be less obvious, such as emotional disconnection. When children are emotionally disconnected they appear to lack concern about the way their behavior affects others. Many parents and caretakers often complain, "My child feels no remorse, they just seem to have no feelings at all about what they've done."

Many of the symptoms of intrusion, withdrawal, and dissociation look like resistance to form close attachments or a reluctance to engage with others. Because unhealed trauma can affect people differently, sometimes the symptoms look like the opposite side of the coin. Some children will demonstrate an over-zealousness regarding engagement and attachment. Consider children who demonstrate an over-familiarity with strangers. Marissa is one such child. When she is in public, she goes up to everyone and hugs them. Although this can create some social awkwardness, her foster parents are concerned because of the potential safety risk involve. Marissa's teachers have also complained of her 'acting-out' and 'attention- seeking' behaviors and want her to get evaluated for attention deficit issues. While, in the modern area, many of these attention-seeking behaviors automatically get associated with diagnoses like ADD or ADHD, it is important to consider whether or not these "acting out" behaviors are better explained by traumatic injuries or attachment injuries.


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