07/30/2010 06:53 pm ET Updated Nov 17, 2011

Fear and Verbal First Aid for Children

It's a constant lesson. Despite 25 plus years treating trauma, despite everything I know about the power of words and neurochemistry, despite having coauthored two books on therapeutic communication and teaching it across the country, despite spending years healing my own fears, I had to learn it yet again.

The first one was so obvious my husband had to nudge me with his elbow to shut me up. A few times.

We had guests, one of whom was a very gentle, very sensitive seven-year-old boy. Sometime in the evening, just as the sun sunk towards the desert horizon and we were finishing dinner in the courtyard, I suggested he go get his flip-flops.

"Why?" he asked. "The bricks are warm."

The temperatures had been unusually high, hovering most of the day between 100 and 105 degrees.

Completely unconscious as I was scooping up plates and glasses, I let forth a torrential description of every toxic bug we have in New Mexico--scorpions, centipedes, fire ants and on and on. Not to mention the bobcats, the mountain lions, the coyotes and the lizards. Or the roadrunners and how they're really predators. Oh, lest I forget, I told him about the Great Horned Owl that swoops down silently in the night to pick up small, furry creatures. (I am mortified as I write this.)

As his eyes grew big as saucers, my husband tried to distract me: "Jude, you want me to take those with you?" He was trying to get me away from that poor child, but I was on a roll.

"Where are they?" our little guest asked.

"All over!" I said with honest idiocy.

That night he had nightmares and wet the bed. And I had to remind myself of some vitally important lessons.

Lesson #1: Fear is viral

The last thing I wanted to do was frighten that sweet child. The truth was that those things frightened ME and once I started talking about them, I was being moved by my own adrenalin and had lost control of my mouth.

So, after some proper self-admonishment, I brought myself back to basics.

Nothing moves us faster, spreads faster or stops us faster than fear. It takes 1/12,000th of a second for the sound of something moving in the bushes to make our hearts beat out of our chests, our intestines to contract and our hands to sweat.

This massive physiological response involves only a very small part of our brain -- the limbic system, which includes the Amygdala, the Hippocampus, the Fornix and Cingulate gyrus. Some people call this the Lizard Brain because it is located properly in the center of all that gray matter and operates on primitive pistons set only for survival. It doesn't think. That requires the cortex and frontal lobes of the brain, which process, moderate, integrate and execute with judgment. The limbic system reacts.

This reaction is unconscious, vigorous and persistent. And, as everyone who's ever been in a stadium knows, it is contagious, which is why we have to be so careful with what we say and how we communicate.

The other night, my husband and I were sitting outside after a rare and heavy rain. I was watching a couple of hummingbirds top gun it around a feeder when my eye fell on a six-inch, pincer-wielding, armor-bearing bug that connected directly with my Amygdala.

"SCORPION!!!!" I thought, but could not speak. I was sure that our lives were in grave danger. I pointed up to the edge of the portale where the thing had started to move down towards us.

"What?" my husband asked more than once.

I kept pointing.


"That!" I finally yelled.

He went over to look at it. "Isn't that what we saw by the garage that time?"

What we had seen by the garage, I told him, was minuscule compared to the monster in front of us. It had to be a scorpion, look at its pincers, and its claw-like mouth, and its whip-like tail, I argued. I knew it was a scorpion and since I knew that, I also knew I couldn't let it stay there for fear of it stinging the dogs.

Fear. Fear. Fear.

It's fast. And it makes us very foolish.

Because as calm as he started out when he went off in search of a shovel and bucket to gently remove the poor scorpion, my fear had infected him and he came back with only the shovel.

Only after we had dispatched the poor creature did he set me to look on the internet and find out that what I had made such a fuss over was a harmless Whip Scorpion or Vinegaroon, a bug-eating, garden-loving, New Mexico night crawler. Absolutely nontoxic.

I felt guilty and, once again, foolish.

This is what fear does to us. Even though, as we know, it takes 1/12,000th of a second to go to red alert, it takes a lot longer to think a situation through.

Stupid is fast. And, as I found once again in my life, fast is also pretty stupid.

Lesson #2: Start with self-soothing

One thing we all need is the capacity to self-soothe, to move from limbic to cortical thinking. As my own stories have confessed, it is a critical component in the demonstration of good judgment and as others have attested, to survival.

This form of self-soothing is very different than obviously false aphorisms or empty reassurances. This is not delusion or denial or dismissal, either.

When I have experienced it, it is more like having a center. And it is very far from empty. It is a core strength that fills us and calms us when we need it most.

A friend of mine, Lt. Jim Lloyd, was nearly captured when he served as a Navy pilot in Vietnam. He had been on a mission about 150 miles north of the DMZ when his plane was hit and he ejected in the middle of a nearly infinite expanse of rice paddies and open pastures. After hours of crawling, running, and submerging in two feet of water mixed with human excrement, his emotional state wavered.

He tottered on the edge of despair when he reached down deep within and told himself, "I know I'm in a difficult situation, but as long as I have my freedom, I have a chance." Most importantly, he believed he could trust his training to make it out of North Vietnam alive. "Through it all," he said, "I felt I was being led by the experiences of the scores of aviators before me." They knew how to survive and so would he.

That is self-soothing in crisis.

We are not born with this capacity. We learn it. Most often we learn it from our parents or caretakers. Occasionally we learn it from others we meet along the way.

Regardless how we learn it, we need it. Especially children.

Parents who want to raise children who can eventually soothe themselves (and grown-ups who meet Vinegaroons at sunset) can take some very simple steps to do so from the Verbal First Aid protocol.

Lesson #3: Take a breath, get centered, then gain rapport

First things first. Take a breath.

Although I forget this more than I care to admit, when I do remember it, it is a life saver. Brains need oxygen. And the time it takes to forcibly fill our lungs with air when we are shallow breathing affords the brain the few seconds it takes for our cortical functions to kick in.

When we are caring for a child, this is terribly important because, as we saw, fear is viral. If we are afraid or anxious, they become equally if not more so. When we approach a child who's just been hurt -- whether that's emotional or physical -- whatever we say or do must come from as calm and centered a place as possible. In fact, our state of mind is communicated far more quickly than our words and can corrupt what we say in an instant.

When I give talks on Verbal First Aid, the first question I ask is, "What's the worst thing you can say to your spouse when he or she is upset with you?"

And inevitably, in every audience, a group of people scream out, "Relax!"

How many ways are there to use that one word? It can mean so many things depending on the emotional state of the person using it: "Bugger off," "Cut it out," "I don't want to hear it," "You're hysterical." Or, it can mean: "I've got you," "I'm here and you're safe," and "You can trust me."

The difference between the two interpretations of a single word comes down to the existence or failure of therapeutic rapport. Rapport is that state of positive expectation and understanding between two people so that what you are saying is construed in the most positive and healing way possible.

An example: A small boy was taken to the hospital because of severe, acute abdominal pain. He was agitated -- as were his parents. No one had developed any rapport with him or served as an anchor for him in an obviously stressful situation. The doctor examined him in a rush, pulled the parents aside and said in a voice the little boy could still hear, "He's probably got gas." The little boy promptly became hysterical believing he was going to blow up "like in the movies."

My late friend and colleague, Tully Ruderman, used to say, "Rapport is the track on which all future communication runs." With rapport, what we say is interpreted in the best way. Without it, Murphy's Law rules.

Lesson #4: Remember my ABC's

A= Authority.
B= Believability.
C= Compassion.

For parents and caretakers, this is what I call "Kid Whispering." Children take their cues from us, whether we like it or not. How we present -- our energy, caring and honesty -- gives them guidance. Sometimes, we guide well. Sometimes, life gets the better of us and we have to reboot.

The important thing is that we understand that these qualities form the gateway for therapeutic suggestion and our ability to lead children from chaos to calm, from pain and panic to patience and relief. (See Huffington Post article on "Kid Whispering" for more information.

Lesson #5: We're all responsible

I've had people say to me: "Well you're responsible for yourself, for what you feel. I should be able to say whatever I want."

This is true, of course, in a political system. Each of us is politically and legally responsible for ourselves. That is part of being in a free society.

I would, however, point out that it's also just one part of a larger picture and that in a social-emotional-neurologic system, we are all responsible for what we create in the "collective consciousness" or in the environment we share with others. I certainly was responsible for the panic I generated when I pilloried my young guest with stories of mountain lions, black widows and Great Horned Owls. And I certainly was responsible for my contribution to the death of one poor Vinegaroon. While I didn't MAKE my husband respond the way he did, I helped to create the circumstances for it.

This is neither bad nor good. It is simply and honestly the way things are.

I wish it were otherwise and that I were somehow inured and impenetrably defended against other peoples' feelings about me or impervious to thoughtlessly tossed about words, but I'm not. We are all susceptible to what other people say, we all respond biologically and neurologically to the images their words create in our minds. Children especially.

Who hasn't felt the kick in the gut from humiliation? Or the pang of a rejection? Or the physical relief of hearing a simple, "It's okay."

Everything we say, everything we feel has some impact on whatever and whoever is around us. (And if some quantum physicists are right, it may not even matter if they're around us.) We all know this intuitively. Someone walks into a room and the whole mood changes. Someone points at you and laughs and you suddenly need to use the bathroom.

We are connected. And whether we like it or not, whether we vote for it or not, it gives us not only some responsibility, it gives us hope.

If we can create panic, can't we also create calm? As Milton Erickson, M.D. said, "If iatrogenic illness is possible, is not iatrogenic health also possible?"

My mistakes were not pleasant, but they were reminders that we have a great untapped potential to be truly healing with every word we say.