If you reread some of the history of disasters, the responses of children were hardly recorded. Families are usually in turmoil; everybody is upset. And nobody stops to think what's happening to the children . . . We do not stop even to explore the possibility that the children might be upset, and more than usually upset, and persistently upset over time . . ." Dr. E. James Anthony, president, the American Academy of Child Psychiatrists.
On July 15, 1976, 26 schoolchildren aged 5 to 14, along with their schoolbus driver from Chowchilla, Calif., were kidnaped on the way to a swimming outing. The bus was hijacked by masked men "with," as the children later recalled, "huge guns."
They spent the next 27 hours in an electric state of terror and anxiety -- part of the time in the bus, about 11 more hours driving around in two blackened vans and the rest of the time literally buried alive in a stifling moving van sunken in the dry river bed of an abandoned rock quarry.
They had virtually nothing to eat or drink and no toilet facilities. Two of the older boys and the bus driver finally managed to dig themselves and the rest of the children out. The kidnapers were captured, tried, sentenced . . .
Five years later, some of the children were still playing games with names like "Burying Barbie," in which the doll is buried and reburied in a cement pit. Or "Travelling Barbie," where she goes on long bus trips but always gets back safely.
The children's ordeal, although it may never fully end for some, now may have contributed significant new insights to professionals dealing with the child victims of both natural and man-made disasters like earthquakes, kidnapings, the witnessing of the murder or rape of a parent.
Some of the results suggest that seemingly less traumatic events -- a trip to a hospital emergency room, for example -- may leave lasting effects of which neither child nor parent may be aware.
Dr. Lenore Terr, a child psychiatrist from San Francisco, heard about the Chowchilla kidnaping on a trip to nearby Yosemite with her physician husband.
She wanted to volunteer on the spot, but didn't know to whom, and she didn't want to interfere on some other psychiatrist's turf. About five months later she learned through a newspaper article that some of the parents were upset because the traumatized, although physically uninjured youngsters were receiving no psychological aid. She called the first name on the list. "You're an angel," said the parent, "from heaven."
One way or another, Lenore Terr has been involved with the children of Chowchilla ever since.
She studied them during the 5 to 13 months after the kidnaping and then returned after four years and studied 25 of the 26 children again. Most recently, Terr studied a group of 25 "normal" school children in two other central California valley farm towns similar to Chowchilla.
She presented the latest of her studies at a recent meeting here of the American Academy of Child Psychiatrists, part of a special academy project on "Children of Disaster," a subject as yet little explored in the annals of child psychiatry.
Among her major discoveries, Terr found two previously undocumented "long-term manifestations of childhood psychic trauma":
* Children, even 4 or 5 years later, had "pessimistic expectations for a bright future."
* More than half had recurrent dreams in which they dreamed of their own deaths.
"The psychic trauma in Chowchilla," she told her colleagues, "was extreme. The kidnaped children experienced 27 hours of continuous stress, and they reacted with overwhelming fear to threats of separation from family, anticipation of death and terror of further terrorizing experiences. As it turned out, in 4 or 5 years no child was spared the traumatic effects of the experience."
In the control group five children expected to live less than 70 years (and mostly predicted death in their sixties).
One Chowchilla child believed her life would end by the time she was 12. Several others saw nothing beyond their thirties. Most, in contrast to the control group, had severely "blunted" perceptions of their futures.
Among the randomly chosen children in the "normal" group, Terr found that those who saw their futures limited, even on a moderate scale, and those who, when asked, described recurrent nightmares, all had experiences of "sudden intense fright and overwhelming helplessness." In one case there had been an early sexual assault. In another, a trip to a hospital emergency room after an attack by a dog. The children, Terr was surprised to find, had not connected those earlier incidents to their nightmares until they discussed them with her.
Indeed, she said, she found "10 extremely frightened children among the 25 so-called normals, five of whom were probably traumatized."
"This suggests to me," she told her colleagues, "that traumatic events and their psychological aftermaths are far more common than we might have expected.
"I really wonder from looking at this group how much severe fright in childhood is never worked through and is, rather, swept under the rug in the expectation that it will simply disappear."
Terr speculates that these individual frights might "disable a few ego functions, without a knockout blow to the whole coping apparatus," which is what she found among the Chowchilla children.
There is a widespread perception, says Terr, that "severe fright is a potentially toughening experience." On the contrary, she says, "from my studies of the Chowchilla children, the answer is no. Extreme psychic trauma limits the individual, forces him to spend time and energy playing, dreaming, reenacting very mundane and trauma-related things. And it narrows his life philosophy."
For example, Terr found that the children in her control sample, when asked to describe fears, mentioned earthquakes or economic collapse or world war or nuclear holocaust.
But the Chowchilla children tended to scorn earthquakes, fires or accidents. Some reported how much more frightening the kidnaping had been than any fire or earthquake could be. "Severely traumatized children do not ignore issues of world concern because they are tough," says Terr. "Instead they narrow their spheres of concern to such items as their own rooms at night, to things closer to home."
In the first year fears were extremely prevalent -- panic reactions to strangers, fear of vehicles in general, school buses specifically. In addition to fears directly "kidnap-related, there were more mundane fears like being outside alone, fear of the dark, of being exposed. It was so pervasive that it looked like they had lost their trust altogether, their sense that they could trust the world."
The children were also "terrified by the dreams of their own deaths," says Terr, "because of the folklore that if you die in a dream you're dead, that you won't wake up. The public," she notes dryly, "knows more about Joseph and his dreams than about Freud's theories." So people tend to think of dreams as predictive, rather than reflecting past trauma.
Another very common finding was the "discovery" by the children of "omens," that -- had they been interpreted correctly -- might have kept the kids off the bus that day. One even decided it was because he'd "stepped in an unlucky square." Another child recalled he'd seen the movie "Dirty Harry," years before with his father, and his father had asked him what he'd do if someone held a gun on him. The child didn't answer. After the kidnaping the child tortured himself with the idea that he'd missed an opportunity to learn "what to do."
The repeated games, Terr points out, are well rooted in traditional Freudian therapy. "Freud called it unconscious compulsion: When an overwhelming horrible thing happens, you want to rework it somehow to make it come out right, and you want to relieve your anxiety that way."
Among presentations on ways to help children "work through" events of overwhelming trauma was Dr. Robert Pynoos' on interview techniques with young children who have witnessed the rape, murder or suicide of a parent.
Pynoos and his colleagues at UCLA have provided the traumatized youngsters with drawing materials and encouraged them to draw "whatever they like, but something they can tell a story about." Even very young children whose "drawings" are little more than scribbles and children who are mute and unresponsive to direct questions can be helped, he says, by the emotional release in "fictionalizing" their trauma.
This kind of "working-through" therapy was employed in the wake of the massive earthquake in southern Italy almost exactly two years ago: Nov. 23, 1980.
Dr. Rose Galante, a member of the Academy of Child Psychiatrists, was teaching at the University of Milano when the earthquake virtually wiped out a number of thousand-year-old mountain communities. In no more than two minutes, 4,000 people were dead, tens of thousands were homeless and 116 villages were damaged or destroyed.
Rescue efforts were so disorganized, she says, that "untold numbers died under the rubble after calling pathetically for help for days. This was later to add intense feelings of anger and bitterness to the grief of the stricken population."
Galante volunteered her assistance and engaged in both a research and therapeutic effort to help the children of one village, Calabritto, and compare them with other villages where no such therapeutic effort was made.
Visiting the children every few months for about a week, Galante led them through drawing, discussing, story telling and finally acting out.
"We drew a huge map that was about 3-feet-by-6-feet of the town of Calabritto. I brought doll-house toys, cars, buildings and the children began deciding how the story was to go. Eventually they would make up an earthquake, shake the table and have all the toys fall on the floor. This was accompanied by a great deal of shrieking, laughing, shouting and glee as they insisted usually on killing everybody and there were no survivors . . . they seemed to want to organize the experience in a much neater and tidier way than it actually happened by having everybody be dead so they would have to start over."
From this, under Galante's guidance they worked into planning for a future for Calabritto. By the end of a year, she says, they demonstrated significantly less trauma than children surveyed in five other villages.
"The trauma had disabled them, but it had not blocked them. The children go on."
Lenore Terr is concerned and somewhat bitter that the California Court of Appeals recently overturned one of the grounds on which the Chowchilla kidnapers had been convicted: kidnaping with intent to do bodily harm.
"Actually," she says, "if they'd cut off the children's arms, they couldn't have harmed them any more than they did. And I know they'd have been convicted of bodily harm for that."
The children no longer talk about the kidnaping very much, but they are still, says Terr, very much at risk.
"It's as though all the good work their parents did in mothering them and loving them and giving them basic trust -- and they are good families -- but no matter how secure, all that was taken away with one single blow . . ."
Says child psychiatrist James Anthony, "We are still learning about the acquired vulnerabilities or resiliencies of children. Not all become consistently disturbed. All may be shaken at the beginning, but some will bounce back. Others will become very, very severely disturbed.
"We need to learn the extent to which children can be differentiated. It occurs sometimes when a child is sent to the hospital . . . it is quite clear that some children can take that fairly well and some cannot. And it is trying to offer the child at risk a great deal of help and assistance on the way that may change the course of some of these disastrous events.
"It is," he says, "a new and exciting field."