Children in Belfast have 66riot symptoms"

Press, Volume CXI, Issue 32629, 10 June 1971, Page 7

Children in Belfast have 66 riot symptoms"

It is now 18 months after the first wave of rioting, looting, and burning in Belfast’s heavily-populated Falls area. Most people have forgotten the few short days in which more than 300 persons were seriously injured, 500 houses burnt to the ground, and 4000 men, women, and children suddenly made homeless.

But a large group of children are still unable to forget the sharp emotional trauma of August, 1969. These are the children still handicapped by psychiatric symptoms which were clearly precipitated by the first-hand experience of violence; symptoms that in many instances have persisted long after the child’s home area has been perfectly peaceful. The juvenile rioters, the pet-rol-bomb throwers, the minimobsters have been getting the headlines, but the emotionally disturbed children have been forgotten by everyone except their parents. However, the problem remains. I am still seeing children suffering from fainting attacks, phobic anxiety, even asthma and epilepsy, which had their onset during rioting. Many are unable to go to school, or even to go into the street alone. These cases are disturbing not because they are unusual, but because they are typical. MEMORIES

Take, for example, Liam, aged 10. His memories of 1969 are of crowds running up the street, of gunfire, and of someone shouting, “the Protestants are coming, and they’re going to kill all the children.” He felt sick and broke out in a sweat He stayed awake the next few nights listening for gunfire —and hearing some. Then he had his first attack of asthma, which has persisted intermittently since. He cried often and slept poorly. Gradually these symptoms sweating, nausea and asthma—began occurring in response to almost any loud noise, particularly to shouts; cars backfiring; blasting at a nearby quarry. With psycotherapy, he gradually improved—although it is difficult to treat a child whose symptoms are based in reality. But his family was recently rehoused in the suburbs, and he is now almost symptom-free. Margaret is aged 10, one of a large family burnt out of the Lower Falls in August, 1969. They have since then "squatted” in various temporary homes, hopelessly overcrowded.

One night her street was the scene of a vicious gun battle between troops and rioters, the combatants spilling over into her front garden. She screamed, started to shake, then fainted and had to be taken to the hospital. Since then, even though the area is now peaceful, she still cannot" eat or sleep; she is underweight and subject to constant attacks of fainting. She is kept awake at ni~ht by fantasies of fire and

burning. She has improved somewhat, but progress is slow. She says, “There are six of us in one bed. I sleep nearest the window so that my baby brother won’t be hit by a bullet.” Sean, aged 11, was evacua-

ted from his home in August, 1969, following rioting and massive exposure of the area to CS gas. He says: “Th.ere were 12 of us in the house. We heard the shooting and saw men covered with blood. The CS gas was terrible. The lady who lived upstairs was very kind and gave us hankies with vinegar to put over our faces, but we still felt like we were going to choke. The lady said the Protestants were coming to shoot us all or burn us. We were very frightened we were all crying.” HALLUCINATIONS Later Sean began to have vivid hallucinations of a big evil man with frightening eyes. He decided the man was a Protestant, because: “He looked different from us. He was bad, and he was trying to kill me.” Night terrors, tremors, and fits of crying began. He began to have these hallucinations in the classroom and would run outside. His school work deteriorated.

After psychiatric treatment he was able to accept these hallucinations as a projection of his own fears and they disappeared. But the other symptoms remain. He is continuing to lose weight. These stories could be duplicated at least a dozen times. There is also Mary, aged 13, who has epileptic fits precipitated by any reference to fires, gas, or burning. And Seamus, aged 9, develops sweating and tremors when he has to go out in the street.

Perhaps it is scarcely surprising that the great majority of children subjected to the kind of experiences recounted by Sean and Liam developed acute nervous symptoms at the time. Sleep and appetite disturbances and separation anxiety were, indeed, common. However, most recovered as soon as the focus of violence had shifted to another part of town. The children who concern a psychiatrist most are those whose symptoms, even then, persisted

and worsened—children like Margaret and Seamus. At the same time, a broad similarity between these and all other members of the group carries some implications for prevention and treatment—as well as providing a fascinating insight into the mental mechanisms by which a child deals with stress of this type. Superficially, the symptoms represent a form of conditioning.

Later experiences remind the child—either consciously or subconsciously—of the earlier stressful events, and trigger the same acute reaction. Liam’s first attack of asthma followed gunfire; later attacks are precipitated by almost any sudden loud noise.

This is, of course, an oversimplification. Since all children in the riot areas did not develop chronic symptoms, other factors must have been operating. But, as evidence accumulates, these factors now seem fairly clear. First, vulnerability. Each affected child had at least one parent who was himself emotionally disturbed by the violence, and there was a previous lack of physical robustness on the child’s part. Further, there was the psychodynamic role of the stress itself, in other words, the symptom served a useful purpose for the child. Margaret's fainting attacks, for example, represent a switching-off of reality when it became intolerable for her.

PERSONALITY The nature of the symptoms also depended heavily on the child’s personality—his strengths and weaknesses. Susan, a chronically ailing child, developed incapacitating gastric complaints. Margaret, a histrionic girl, presented fainting fits and screaming attacks, and Peter, shy and timid, developed double vision—thus effectively preventing his having to go out in the street. It was as if each child had his Achilles heel: The point at which distress was exhibited following a failure on the part of the immediate family to respond adequately to the child’s need during the period of acute threat. Taking it another way, it seems at present as if a healthy, well-adjusted child in a stable family is unlikely to develop persistent psychiatric symptoms as a result of civil disturbances — also that the attitude of the parents in the same situation is an important preventative. One 10-year-old boy said, “My parents were very calm, so I wasn’t scared. If they had been frightened, it would have been awful.”

Dr Morris Fraser, the writer of this article, is a child psychiatrist at the Royal Belfast Hospital for Sick Children. The article is from the New York Times Feature Service, through NXP.A.