By Pamella Siller, MD

Text and Image published in in collaboration with the Jewish Press

2002

Rochel pulled the covers even more tightly over her head in a futile attempt to drown out the sounds. She knew, without looking, that her father had been drinking too much at the Weinstein’s L’Chaim, and he would be mean tonight. She was dreading the next day, knowing that she would not be able to hide the dark circles under her eyes after a sleepless night. Dark circles definitely do not befit an 18-year-old girl, who is looking for a suitable shidduch…her ticket to a better life.

Esther lay still, trying to make herself as small as possible. She knew that her step father would come looking for her. The first time he came to her bedroom, it seemed innocuous, and she received little gifts. However, two months later, threats became the norm.

Aron sat in his closet gripping a baseball bat. If his father came for him, he would defend himself. He knew he could do this! He would no longer be anyone’s punching bag!

Please don’t die, please don’t die! Chani sat by her mother’s bed, sobbing. She knew her mother was pregnant, but the baby should not have come this early. She wished someone was home, and Hatzalah was taking so long!!!  Long after dark, her father returned and told her that her mom went to heaven, and she would never see her again.

2018

Rochel smiled softly to herself, as she tucked her newborn into his crib. She thanked Hashem daily for her gentle husband, and the blessings of her children. Although still plagued by sporadic nightmares, she found comfort in confiding her memories and fears to her husband.

Esther, now known as Ellen, looked around her room. She pulled on her pants, and took a long drag on her joint, chasing it down with a vodka shot. Anything to dull the constant pain and numb her feelings.

Aron took a deep breath as he looked around the park. A perfect day to spend outdoors with his two sons. But he was prepared. Concealed under his jacket was a Colt 22. He was a perfect shot, compliments of many hours of practice at the shooting range, as befitting the policeman he became. One couldn’t be too careful, as he knew well. Anyone could have hidden violent intentions. Nobody would hurt his sons!

Chani’s father lit a yortzeit candle. His beloved daughter, Chani, had taken her life 7 years prior.

Resilience

Trauma is defined as “a deeply distressing or disturbing experience,” which can come in many forms. Approximately 70% of adults were exposed to a traumatic event at least once in their lives. These experiences generally have a lasting impact on those individuals, affecting their feelings, behaviors, and outlook on life.

Some, such as Rachel, vow to never again allow themselves to be subjected to trauma, learn from mistakes of others, and rise above their past. Others, such as Esther/Ellen, distance themselves from all reminders of the trauma, remaking and remodeling themselves. However, unless properly dealt with, their anger can consume them, leading to destructive choices and lifestyles. Aron became hypervigilant, but channeled his fear into a constructive lifestyle choice, and found a way to strive to protect himself, as well as society. Chani chose suicide, the most permanent, and heart-breaking way to escape unbearable pain.

Why did all of these individuals choose such vastly different paths through life?

There are many variables which impact the trajectories and outcome of those subjected to trauma. Resilience, is the ability of an individual to adapt to a change or traumatic event in their lives. Although this is thought to be innate, or inborn, there are many factors which are contributory.

• The age of the child can be protective, or detrimental. An older child usually has more coping skills and life experience which can be drawn upon. The younger the child, the more damaging the impact. If the trauma occurred when the child was preverbal, although the memory is present, the child may never find the words to express it, nor be able to process the feelings associated with it.
• An acute trauma may be more easily dealt with than chronic trauma, as feelings of safety may quickly become eradicated by repeated exposure, and fear becomes the new norm.
• The ability of adults to convey a sense of ease and control, goes far in allowing a child to feel safe and secure.
• Pre-morbid functioning, the way the family or individual functioned before the upheaval also impacts on resilience. The greater the communication and cohesiveness prior to the trauma, the more likely that the individual will have a positive outcome.

However, of utmost importance, is the ability of the child to process their feelings, fears, hopes, and expectations, in a safe, secure, warm, and nurturing environment. Individual and family therapy is imperative, possibly with the addition of psychotropic medication if needed. These outlets allow the child to move forward, succeed in life, and rise above their past.

Pamela P. Siller, MD is a Board-Certified Child, Adolescent and Adult Psychiatrist who provides medication management as well as individual and family therapy to children and adults. She maintains a private practice in Great Neck, New York. Dr. Siller is also the Director of Child and Adolescent Psychiatry at the Interborough Developmental and Consultation Center in Brooklyn, and an Assistant Professor of Psychiatry at New York Medical College. She also provides psychiatric evaluations for the NYC Department of Education. Dr. Siller can be reached at 917-841-0663.