Psychiatrist says poor management of trauma can lead to emotionally dead adults

Staff reporter

Sunday, February 23, 2020

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At least one of every three childen living in inner-city communities is exposed to violence that has left them so traumatised that some of them grow into hardened killers, according to one psychiatrist.

In fact, consultant child and adolescent psychiatrist Dr Ganesh Shetty has pointed out that 25,000 children are seen annually at the 20 child guidance clinics across the island, but there are not enough child psychiatrists to attend to them. According to him, only one out of 20 children actually accesses the services offered at these clinics.

“This is a problem everywhere, but here in Jamaica it is worse. There is not enough of us to help the children. We only have three child guidance clinics in Kingston and St Andrew and, in my estimation, we have nearly 25,000 children who need help, but we try to do our best,” Dr Shetty told the Jamaica Observer last week.

“Gunmen don't just appear out of nowhere and come to kill us; they are born and they face all kinds of traumatic experiences; they get used, abused and neglected, traumatised, and then at some point they become emotionally dead killers,” added Dr Shetty, who is also a child and adolescent psychiatrist with the child guidance clinic in the Kingston and St Andrew Health Department.

Dr Shetty made the revelations against the background of the five-year-old boy who was last Monday shot in the leg as gunmen sprayed his 27-year-old mother with bullets, killing her. That boy, he said, will need immediate and ongoing psychological therapy, having witnessed his mother's death at such a young age.

On Tuesday, the Observer reported that the boy's mother, Shantoll McCarthy of a Jones Town address, had been found with multiple gunshot wounds at her home after residents called police to the area.

The boy reportedly ran to a relative's house in the community, his clothes soaked with blood, carrying the news of his mother's gruesome death.

“Dem shot up mi mother and she dead, and dem shot me too,” were his words to relatives.

“This boy is traumatised, and he also has to deal with the grief from losing his mother. This is what you call traumatic grief, where both trauma and grieving happen simultaneously,” Dr Shetty explained.

“If he develops post-traumatic stress he will have a lot of re-experiencing of the situation. He might have nightmares and flashbacks. Even when he is playing, he might play with themes of what happened like guns and killing.

“It definitely will affect his emotional state and his behaviour. It will also affect his academic performance and level of achievement going forward, and it will also interfere with his ability to grieve his mother's death, because as soon as he thinks of mother he will think of murder. He might become very withdrawn, clingy and tearful — basically afraid for his own life,” said Dr Shetty.

“At least one out of three children in inner-city communities is traumatised and suffers from post-traumatic stress disorder. This is the story for many of the children,” he said. He argued that while the five-year-old boy's ordeal got the attention of the media, “There are so many children who experience it indirectly, living in violent communities where maybe someone next door or down the lane was killed and they experience post-traumatic stress, and at some point, if left untreated, they shut down the whole emotional system.”

Speaking to the likelihood of the five-year-old boy avoiding a transition to violent behaviour, due to his experience, Dr Shetty explained that, along with therapy, the boy should ideally be removed from the community if it remains volatile.

“If this five-year-old gets the help he needs, the chances are very good that he will grow up normal, but it has to be immediate and not just two or three sessions. We will have to track this child for years to make sure that he actually overcomes, because some children don't show any symptoms for over six months or more,” the doctor said.

“We will have to help him to learn how to relax when all the reminders and triggers come his way. But if he remains in the community and in the night he is hearing gunshots, he will be triggered constantly. There is a need for him to be safeguarded from that community if it is still violence-infested,” said Dr Shetty.

“A lot of the times it is not safe for them to stay there, and so they are moved, not because we like to take the children away from their home; in fact, that is the last option we have for them. But then sometimes the environment is so toxic and hostile, to protect the children we have to move them,” he added.

He indicated further that, while removing children from these volatile environments is ideal, it is oftentimes not feasible.

“We don't have a foster care system where we can insert the children, and only people who are committed to a certain extent will go into foster care,” he said.

Dr Shetty also explained that children who are traumatised not only develop anxiety problems, which is post-traumatic stress, but they also develop anger issues.

In the meantime, Dr Shetty said much emphasis should be placed on supporting the boy's relatives.

“We will definitely have to help the family in how to be supportive and not be impatient with him, because he might be demanding and defiant sometimes.

“We need to take him to a point where he can actually be comfortable in grieving his mother. Nobody can replace his mother, but other family members will have a big role in making him feel that although mommy is gone, he has an auntie or dad, or someone who is there for him and he will be okay,” said Dr Shetty.

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