“They’re the future of my family, so if you don’t take into account their psychological wellness and the wellness of the whole situation going down that road — it’s a long way to go down that road,” he told CNN. “Educationally, socially — there’s a lot of things that we have to make sure that they’re OK for.”
It will be a long road, indeed, experts say. If Dr. Cheryl Singleton Al-Mateen, the medical director at the Virginia Treatment Center for Children, were treating the 3-, 5- and 8-year-old boys, she’d call a clinical psychologist — perhaps her colleague, Leslie Kimball — and they would take measures to ensure the children felt safe, they say. It’s a vital first step in rest of the children’s lives.
“The impact of trauma is known to be a significant factor (in future health), especially as they stack up in childhood development,” said Al-Mateen, also a professor of psychiatry and pediatrics at Virginia Commonwealth University.
The brain’s stress response system governs the body’s fight-or-flight instinct. If someone saw a bear in the forest, for example, the brain would release stress hormones in preparation to fight or flee the bear, Burke Harris explained. The heart pounds, pupils dilate and airways open.
“And that is wonderful — if you’re in a forest, and there’s a bear,” she said, “but the problem is what happens when the bear comes home every night and this system is activated over and over and over again. … Children are especially sensitive to this repeated stress activation because their brains and bodies are just developing.”
To be clear, neither Al-Mateen nor Kimball has treated Blake’s sons, but they know trauma is cumulative, no matter whom it afflicts. If the boys experience more trauma or they’re not placed on a trajectory to healing, their chances of dying from a host of deadly diseases and conditions begin to multiply, the experts said.
“If these kids don’t get the support and attention, or continue to be exposed to trauma, the more they veer off that trajectory,” said Kimball, who also teaches psychiatry at VCU.
Boy still struggling with aunt’s killing
Amber Carr works hard to keep her 9-year-old son, Zion, on the right trajectory. He’s doing OK, she said, “but he does have his moments when he does need that extra attention.”
At first, Zion blamed himself, his mother said. Jefferson had burned some hamburgers she was cooking for them, and he helped her open doors to air out the house. Early conversations involved his mother “trying to make sure he understood that it’s not his fault,” Carr said.
Zion used to catch his mother crying. At first he would comfort her, but as weeks went on, seeing her weeping would upset him.
“I don’t show it as much in front of him. I try to do it behind closed doors,” Carr said. “I don’t want to trigger something inside of him.”
An intelligent tyke, Zion is not easily fooled. Even when his mom is not crying, he can tell when something’s amiss, she said. He started acting out on occasion. He’d show defiance, slam a door or lock himself in his room. He’d call from school and say he didn’t want to be there. Carr would pick him up, sometimes as often as twice a week, until truancy issues arose. Zion’s mentor tells Carr never to use her sister’s killing as an excuse for Zion’s behavior, she said.
“He’s just being a typical kid, but it’s on a different spectrum,” she said. “I try to explain to Zion that he’s not the only one experiencing something. He was there, but it affected everyone.”
“If it’s overwhelming to me, I can only imagine what it means to him to hear about another incident,” she said.
‘What the hell is in this well?’
Civil rights attorneys Ben Crump and S. Lee Merritt, who represent many Black victims in high-profile police violence cases, have repeatedly spoken of the trauma their clients’ children suffer after violent encounters. Blake’s kids “are going to have to bear their psychological scars forever,” Crump told CNN.
“How (are the children) going to live with this psychological scar of their father being paralyzed by the people who are supposed to protect and serve them?” he asked.
“They’re barely eating. They’re barely sleeping,” she said. “They’re not doing good at all … Who would? What kid would? What child would? What parent would?”
Other ACEs include bullying, disaster, terrorism, displacement, abuse, neglect or loss of a loved one. A caregiver’s struggle with substance abuse or mental illness can also traumatize a child, as can divorce and domestic violence.
In her TED Talk, which has been viewed more than 7.5 million times, Burke Harris said 67% of Americans had experienced at least one ACE, while 1 in 8 had four or more. The pediatrician likened treating ACEs to treating disease.
“One of the things that they teach you in public health school is that if you’re a doctor and you see 100 kids that all drink from the same well and 98 of them develop diarrhea, you can go ahead and write that prescription for dose after dose after dose of antibiotics, or you can walk over and say, ‘What the hell is in this well?'” she told the audience.
‘They’re wondering if they’ll be shot’
With kids like Blake’s, making them feel safe is key to taking the next steps in their treatment, Kimball, the clinical psychologist, said.
“You can’t process trauma when you’re still in the middle of it,” she said.
“Seeing a parent shot, they’re wondering if they’ll be shot,” Al-Mateen said. “That child had that assumption. That’s terrifying.”
“You take care of the body, then try to fix the mind,” she said.
What you tell a 3-year-old differs from what you tell an 8-year-old, Kimball said, and it’s important for therapists to learn what the child understands about the violence she or he witnessed. Let them talk through their fear, she said. Answer their questions.
Remind them of their blessings — their mother or grandparents who were unharmed, for instance — and find comforting toys, activities, food or TV shows, while chipping away at their feelings of despair, disorientation or being overwhelmed. Normalize their world, Al-Mateen explained.
“Your world will be different,” she might tell the children, “but we’re going to make it as much the same as we possibly can.”
When therapy begins
It’s important never to impart false hope or expectations, Kimball said.
“Do your best to assuage fears, but be realistic,” she said. “You can’t keep them in a bubble, but you also don’t want to retraumatize them.”
If children want to visit a father recovering from gunshot wounds, the family should make them aware of his condition, Kimball said. Explain that their dad might be sleeping, or he might not be able to talk.
“Daddy’s going to be hooked up to some machines, and that’s to help him get better, but they’re not hurting him,” Kimball might tell children in Blake’s sons’ position.
A social worker, psychologist or psychiatrist with expertise in trauma will know how to deal with nightmares or flashbacks and provide the child coping tools. If the child is old enough, a doctor might explain the toll untreated stress takes on their body.
Younger children may engage in “play therapy” in which they draw or play with toys and talk about how to help the toy or the subjects of their art, Al-Mateen said.
At some point, recovery requires “exposure work,” Kimball said. The child will need “guided, supportive exposure to the memory of the trauma” to integrate parts of the memory, normalize it and deprive it of its intensity, she said.
With Zion, Amber Carr has tried to tick many of these boxes, she said, though the mother of two concedes she hasn’t attended counseling herself.
“Our parents are our models for how to handle life and emotions,” Kimball said. “It’s important for parents to have resources as well.”
Carr feels she could use more resources, but she’s doing her best while juggling activism and her work as a cosmetologist, she said. Zion is surrounded by family and others who love him, and he’s forged a bond with one of his cousins. He seems on the mend, but Carr isn’t sure she’s doing enough, she said.
“We’re still new to it. It’s day by day,” she said. “It’s only been … 10 months. Call me back in a year.”