Psy. Deniz TAN KUMCUOGLU

Trauma, in its most general definition, is a state of discomfort resulting from an unusual experience that has a lasting effect on the individual’s mental state and personality. It is possible to examine traumas in 2 types as short-term and permanent traumas. While short-term traumas occur as a result of sudden and non-continuous events such as earthquakes, fires, and traffic accidents, continuous traumas include continuous situations such as domestic violence, neglect, abuse. The way of perceiving and making sense of the events or the catastrophic experiences that can create a traumatic effect differs for each individual. According to one person, the situation/event may be experienced by someone else as a traumatic situation, while it may reveal emotions that can be overcome. This situation is shaped by many factors such as the person’s developmental processes, genetic structure, and social environment.

Acute Stress Disorder (Asb)

Acute stress disorder is a condition in which people develop symptoms soon after exposure to a traumatic experience. According to the diagnostic criteria, it should last more than 3 days after the stressful event and should not exceed 1 month after the event. If symptoms persist for more than 1 month, it is not called acute stress disorder. Many of the people who continue to have problems afterward are diagnosed with post-traumatic stress disorder. Events such as serious injuries, sexual or physical abuse, death of a loved one are experiences that can cause acute stress disorder. But not every mourning process turns into trauma.

Post Traumatic Stress Disorder (PTSD)

Symptoms of post-traumatic stress disorder do not usually appear immediately after the trauma. After some time has passed since the traumatic event, people relive the event (flashback) and avoid thinking about the event. They may develop a sense of guilt by holding themselves accountable for what happened. Physiological arousal such as sweating, trembling, focusing difficulties, waking up from sleep and being alert all the time are common symptoms. Prolonged duration of the traumatic event, being a rare condition, and extreme severity increase the likelihood of individuals developing PTSD. At the same time, traumatic situations experienced by people in close circles such as children, spouses, relatives are also one of the reasons that increase the probability of developing PTSD.

Events that may be traumatic for adults may not be for children. In particular, the criteria for trauma before the age of 6 may differ markedly. Experiencing the event directly, especially witnessing or learning what happened to primary caregivers (mother, father, etc.) are situations that may lead to the development of PTSD in children. There is no re-experiencing of the traumatic event, that is, flashbacks, which exist in adults in the 0-6 age period. Because in this period, abstract thinking skills are not fully developed yet. Children may not remember the event, but they avoid evocative objects, people, and situations. When examining post-traumatic stress disorder in children, exposure to traumatic events through the media is excluded. Since the self-centered mindset is dominant at the age of 6 and before, the child only thinks about himself and his relatives, and the events in the media do not turn into trauma. Among the symptoms that a traumatized child may show are retroactive behaviors we call regression. If an 8-year-old child suddenly begins to show the developmental characteristics of younger years, trauma should be suspected. Negative memories may not appear to be distressing to the child, but may arise with re-enactment during play. Children may have difficulty in establishing relationships between events. In cases where they have not experienced the memory that caused the trauma before, they cannot easily express the event because it is difficult for them to perceive the event. For this reason, it is recommended that children who are exposed to situations that can be considered trauma should seek expert support immediately.

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Psk. Deniz TAN KUMCUOĞLU

We can say that there is an extreme tendency towards medical drugs in our society. Most of the time, it is common to use medication based on the symptoms that occur in the body, even if it is not prescribed by a doctor. In cases such as a small cough, fever or headache, we resort to medicine without hesitation. However, when it comes to psychiatric drug treatment, we see that individuals can react negatively by feeling uneasy.

The negative attitudes of families towards drug therapy in mental health stem from the most common misconceptions. Families, especially those who strongly oppose their children’s use of drugs, often try to resort to other treatment methods. The role of brain biochemistry in research on the causes of mental problems in both children and adults is no longer discussed.

Drugs contribute to the solution of existing problems by interacting with the mechanisms that provide communication between nerve cells. Contrary to what is known, drugs used in treatment do not cause people to have difficulty in fulfilling their vital functions or to be disconnected from life. Except for the group of drugs called “benzodiazepines”, no psychiatric drug is physiologically addictive, or there is no such thing as an excessive amount of side effects for each individual. Psychiatrists plan the appropriate treatment in line with “profit-loss” analysis, taking into account the genetic predispositions and individual differences of individuals.

How should it be used? How should it be terminated?

Irregular use of prescribed drugs, or their abrupt discontinuation without a doctor’s supervision, does more harm than good to patients. It is known that abruptly discontinued drugs may cause withdrawal syndrome in individuals. In order for your treatment to provide healthy results, you must strictly follow the instructions given by your doctor. In particular, the curative effect of antidepressant group drugs does not appear in the first 2-3 weeks after they are used. In the meantime, individuals may think that they can’t see any benefit from the drugs, and they may turn to quit the drug.

This false belief causes your treatment to end before it even begins. Similarly, the well-being felt in the process after the drugs start to take effect may reveal perceptions such as “I got better anyway, I don’t need the drug anymore”. However, the termination of the treatment is not dependent on this situation. Continuity of preventive treatment is needed to prevent your disease from recurring in the future.

Do drugs provide a definitive solution?

One of the misconceptions of individuals about psychiatric drug therapy is that drug use provides a definitive solution to every disease or situation. However, the use of drugs in the treatment of mental health and diseases is only one of the treatment methods. Researches made; It demonstrates the visible curative effect of combining drug therapy with treatment methods such as individual psychotherapy, family and couple therapy, or play therapy for children. For this reason, you should adapt to the treatment methods approved by your doctor, and you should not avoid getting information about the drugs you use for question marks in your mind.

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Ps. Deniz TAN

The emotional needs of individuals that are not met, especially in childhood, play a role in the formation of certain schemas.

Emotional deprivation:

It results from the emotional neglect of a child’s primary caregiver, most often the mother. The idea that “I will never be loved enough” prevails. These people, knowingly or unknowingly, put emotional pressure on those people in order to be loved and valued by others. When this pressure disturbs the other person and brings them to the point of giving up on the relationship, the thoughts that I will never be happy are reinforced. This is what we might call a self-fulfilling prophecy.

abandonment:

When a child has a particularly troubled parent relationship; It is a schema that is frequently seen in children of families who cannot establish a commitment due to reasons such as divorce, leaving parents, parents away from home, loss, fighting parents, domestic violence. These people unconsciously start their relationship with the perception that “it will end one day anyway, one day he will leave”. They become overly attached to the people with whom they have an emotional relationship, pretending that there is no possibility of abandonment, and actually create environments suitable for abandonment. For example, a person whose partner does not answer their phone calls may hurt their partner by displaying extremely angry and impulsive behaviors, thinking that they have been cheated on.

submissiveness:

It is a common schema in children growing up with authoritarian, oppressive, punishing, decision-making parents. They think that they have to put the feelings, thoughts and needs of others before their own. They have poor ability to say no. These individuals have 3 different reaction mechanisms.

The surrender response is geared towards submission and surrender, especially by relating to authoritarian people. These people often use the answer “it doesn’t matter” in their interpersonal conversations.

The avoidance reaction means that the individual avoids expressing his own opinion if the other person has a different opinion, and his expressions are limited.

The overcompensation response is the opposite of the delivery response. They pointlessly and irrationally go against the ideas of others. It can also be called a denial mechanism.

Sacrifice yourself:

The schema of self-sacrifice (superman) is like subjugation. The difference between them comes from self-sacrifice. The individual acts by thinking that the other person will be upset if he does not meet the needs of the other person. It is a more reasonable option to feel sorry for him instead. In general, the eldest children of the house, the children who take responsibility, the children whose mother is sick and go from the childhood role to the mother role are prone to the self-sacrifice scheme. In this scheme, we can talk about a hidden narcissism, a mentality such as “I am strong, but I can do it well”. Individuals with the self-sacrifice schema, which is frequently seen in Turkish society, especially in mothers, have the behavior of giving without any response as a response response. They have a deep fear of being selfish and their giving behavior is often exaggerated.

Imperfection:

It is a schema often developed by the children of parents who criticize and judge. They think that they are deficient and inadequate in many aspects. Whatever they did did not benefit their parents. These individuals unconsciously and constantly try to prove themselves to critical people. They aim to look perfect. They do not realize that by criticizing others, they are actually criticizing their own faults. They often put people who accept themselves as they are, that is, non-critical and non-judgmental. Thus, the schemas of imperfection continue to consolidate.

Righteousness/Grandism:

It is a scheme developed by children who are given everything unlimitedly by their parents, who are given whatever they want, or by individuals who were neglected/exploited in early childhood. Individuals think that they have the right to do anything to anyone who stands in their way in a social structure. As a surrender response, they take all rights when their benefactors oppose them. In the overcompensated response, the opposite is the case, they tend to be overindulgent towards others. In some cases, they show avoidance behavior instead of being unfair.

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Psk. Deniz TAN KUMCUOĞLU

In early childhood, babies begin to show a marked interest in all other children. However, since the social skills necessary to play with other children are not yet fully developed, the first types of play are the ones they play alone. After a while, they start to play side-by-side games with their peers around the age of 2. In these parallel games, they play similarly, but they are still not interacting enough. At the age of 2 and a half, with the development of language, imaginary games and games in which communication increase is made. At the age of 3 and 3 and a half, “house-like” games are established, which are cooperative and where the imagination is highly developed.

The period in which peer relationships begin to affect lifelong development in children is the beginning of school. The pressure to be loved and accepted by the society, which is encountered for the first time, begins to show itself. Adoption by classmates is a major factor that can have a long-term impact on a child’s personality development and possible behavioral disorders. According to studies, it has been found that children who are not adopted, excluded and not accepted by their friends are more likely to change school, drop out of school, engage in delinquent behaviors and develop psychological disorders in their future lives. Children who do not have friends are not only “vicious” and “aggressive” children. Besides the children who are not accepted by their friends due to their irritable behaviors, there are also children who are rejected, neglected and not given the opportunity to develop their problem-solving skills. In order to support their children and show that they are there for them in every way, parents tend to intervene immediately in school problems. However, this situation often results in an obstacle to the ability of the child to seek solutions to the problems and to strive for solutions. The child may avoid one-to-one communication with his peers by seeking parental support in every problem he encounters in his life. In such cases, as social relations are negatively affected, the child may become more prone to social anxiety and depression.

In addition to the academic development it contains, the school is effective in many important acquisitions such as social experiences, a sense of competence and success, self-confidence and endurance in the lives of children. In this period, which contributes to children’s self-knowledge and awareness, there are important features such as determining their strengths and weaknesses, making social comparisons, and creating a lifelong positive self-perception. While children who are successful at school and gain a sense of satisfaction from school life develop a positive perspective in their general life; Children who encounter frustration at school and are not adopted may attribute this negative perception to their life-long personality structures. Some peer relationship problems, which do not seem so important to parents, can seriously damage both the meanings ascribed to the child’s bilateral relations and the sense of satisfaction received from social life.

Since friendship is viewed as a continuous social relationship that includes mutual support and trust, especially in peer relationships established during adolescence, it can be seen that adolescents sometimes give importance to friendship rather than family. When it is not realized that this situation is a periodic process, parents may seek help in a panic. Since most adolescents have not yet reached a stable identity structure and have difficulty thinking about the long-term consequences of their behavior, they need support, guidance and cooperation from their peers. For this reason, it is extremely important to develop healthy peer relationships in addition to parental guidance so that they can effectively cope with the problems they face.

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Psk. Deniz Tan KUMCUOĞLU

One of the most common issues that parents want to receive counseling or therapy services for their children is the divorce process. Divorce, which is an undesirable situation in parental relations, can lead to different effects for each family structure. Depending on the attitudes and behaviors of the parents, it can be considered normal, on the contrary, it can turn into a traumatic situation.

“I am enduring this marriage for my child”

“My child cannot bear this sadness, I continue my marriage for his sake”

We often hear phrases like

First of all, it should be agreed on; It is not possible to protect the mental health of the child in a house where one or both parents are unhappy, exhausted, and frustrated. Especially children aged 0-6; By quietly observing communication problems at home and possible physical or psychological violence, they ground their male-female relationships according to this pattern.

Not every problem in the family will result in resentment, separation or divorce. However, the chronicity of communication problems and their becoming a vicious circle will inevitably lead to negative effects on children.

It may be necessary to analyze the possible damages that the child may receive from the divorce process and the damages brought about by the troubles in that house from an outside perspective. The problems that arise in the case of divorce may result in the child’s healthy adaptation to the new situation if the adaptation process is well managed by the parents. However, it is possible to encounter more intense and long-term pathologies especially in children who grow up with chronic problems at home. For this reason, in cases where the problems between the spouses cannot be overcome, it is recommended that the person first consult a specialist for himself. Individual therapy creates the opportunity for the person to get to know himself better, to determine his wishes and expectations, and to acquire different perspectives.

In the dialogues between the mother and father, citing divorce as a relational threat or constantly talking about a possible separation may cause the child to develop an anxious personality pattern in fear of losing it. When the parents agree on the divorce, they should explain the situation to the children when there is no uncertainty.

Divorce and post-divorce situations should be clearly informed. Care should be taken not to spoil the concept of family as much as possible. It should be noted that people have only given up on the role of husband and wife, but the role of mother-father will continue for life.

In this process, feelings such as disappointment or anger about one of the spouses should not be shared with the child as much as possible. Exposure of the child to negative statements about his/her mother or father may damage the sense of trust, and the child may blame himself/herself. Children should be encouraged to share their feelings. Depending on the age group, behaviors such as crying and stubbornness can be observed.

In case of divorce, children may have a tendency to repair the broken relationship of their parents. Being clear about these expectations helps the child’s acceptance process in the long run.

Like children, parents can also show behavioral changes in this process. They may unwittingly display more giving or more flexible behaviors towards the child. In order for children to normalize the divorce and post-divorce process, it is important to preserve their existing order as much as possible. Parental attitudes and boundaries acquired before separation should be continued in the same way. When possible life changes are transferred to the child beforehand, the probability of completing the grieving process in a healthy way increases.

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Psk. Deniz Tan Kumcuoglu