Intimate Portrait: Terry Smolar, PhD

I treated a 9-year-old boy who was brought to see me because he was afraid buildings would fall down. He had seen the twin towers collapse on 9/11 and showed signs of a posttraumatic stress response. He had problems sleeping, had anxiety attacks, and woke up with frightening nightmares. During the day, his mood was irritable. He started throwing tantrums and was increasingly unfocused in class. During a fire alarm in school, he got extremely distressed and needed to be rushed to the emergency room because he couldn’t breathe.

Children who are traumatized need time to feel safe in order to open up and talk about what frightens them. It is important to create an atmosphere of acceptance, openness, and warmth.

In the beginning, I asked the boy general questions-about his family, his school, his teachers, the students he plays with. I simply conveyed interest in him as a person, and he began to trust me. He gradually was able to express his feelings without being afraid that they would be obliterated.

I really had to help this boy see that buildings were not going to fall, that he was not going to get hurt, and that his parents were not going to dis-appear. It took a lot of play therapy, in which we set up little dwellings that opened up into a real house with furniture and little people. He created scenarios with these little figures, he started acting out his fears of dreadful things happening, bombs falling. We talked about his sense of how he can control these terrible events, so nobody was going to get killed.

I did a lot of puppeteering with him. Something would always happen to one of the children, and the puppet would yell, “help, help we have to do something about it!” He would make up a story and learned ways to deal with frightening situations in a constructive way. Trauma symptoms can last for a long time. I was surprised that it took him only 18 months to get rid of his symptoms. He formed a very powerful relationship with me.

He called me Dr Terry, and I was his “feelings doctor.” The elevator men in my building are very friendly and, when he came to his sessions, they would ask him, “How are you today?” And he would say, “Oh, I’m okay, but I’m going to be better because I am seeing my feelings doctor!” It is amazing how children develop a sense of control over their environment when they are able to tell you how they feel.