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Let me begin by describing a different crisis, in another nation at another time, that families had to endure together, which has taught us a lot about how to speak to our children during emergencies. During WWII, Nazi Germany regularly bombed residential neighborhoods in England in the middle of the night. These bombings were not aimed at factories, critical infrastructure, or other strategic targets. They were devised solely to terrorize the British population into submission. This was a war crime perpetrated against the British people. (Imagine the families in your neighborhood being awakened nightly to bombs falling on them and their neighbors at 3am!) Parents hurried their children into bomb shelters, some spent their entire nights there, and some stayed overnight in subway tunnels. Important studies were done about the long term effects of these bombings on the children who lived through them. The children whose parents were calm and confident during the bombings did not experience much fear or anxiety; as adults, they do not look back at these memories and terrorizing, and did not experience long-term symptoms of trauma. Those children whose parents were terrified also became terrified and experienced these bombings at traumatic, because they felt (through their parents’ anxieties) that their lives and their families’ lives were in danger.
Children, especially young children, do not generally sense danger on their own if they are not directly experiencing pain or direct threats of violence and intimidation. Children rely on their parents to protect them, and are therefore attuned to their parents' sense of danger. If parents have confidence that they can fulfill their responsibilities to face danger competently (despite their uncertainty and ultimate inability to control every outcome), then this sense of safety as well as their confidence and feelings of competence are internalized by their children. When parents are overwhelmed or parylzed with fear, their children feel unsafe and endangered because their barometer for safety (i.e., their parents’ emotional state) is flashing with signals of fear and peril.
The above paradigm is helpful for how we think, in general, about the right way to talk to our children during emergencies, including the current Covid-19 crisis. I am hearing many parents describe what they believe is their obligation to help their children talk about their fears or anxiety during this crisis. They aim to be empathic parents and to stay attuned to their children’s feeling states. This way of thinking is understandable; after all, we believe that it is generally unhealthy (or even damaging) to discourage our children from talking about their fears or other negative feelings. But this empathic sensibility is misplaced during actual emergencies or disasters.
Therefore, I have written this essay to dispel this common misconception among thoughtful parents who are emotionally attuned to their children. In fact, it is counterproductive and an error in our emotional judgment to encourage our children to talk about fear and anxiety during this crisis. Children need reassurance and a sense of safety at this time. Children are not afraid of viruses or infections; parents are. When parents try to encourage children to talk about their fears, they are projecting their own fears onto their children. What I mean by “projecting their own fears” is that I believe it is the parents, themselves, who are feeling anxious and fearful. Then, in trying to contain or minimize their feelings of fear, they imagine that their children must be feeling fearful. But, by asking children to talk about their concerns of the virus, they are injecting fear into their children which they would not have had otherwise. This is not the time to encourage everyone to talk about their fears and anxieties. If children are anxious and express their fears, parents should answer in a truthful and directly reassuring manner. After reviewing a bit of medical knowledge about the virus, I will give some tips on exactly how to do this.
The popular media in the U.S. is, at least in my opinion, doing an excellent job in the last two weeks of keeping the public well-informed regarding our most current medical knowledge about Covid-19. My remarks are based on today’s best medical information, but some of these remarks might become obsolete as our scientific knowledge about the virus changes by the hour. Nevertheless, because the main point of this essay is how parents should talk to their children (and not how to prevent infection and transmission), the basic principles I am spelling out here should apply even if specifics for infection precautions change. It is also important to note that I am talking in this essay about families where children do not suffer from illnesses that compromise their respiratory or immune systems.
As we are all now aware, Covid-19 is a highly contagious virus which can cause serious respiratory illness. It first appeared in January 2020 in Wuhan Province, China, and quickly spread to most countries in all continents. Covid-19 belongs to a larger group of viruses referred to as “coronaviruses,” named because of the physical structure of their microscopic protein capsules. It appears that the vast majority of healthy children (perhaps as many as 99.9%) survive Covid-19 infections with no or very few symptoms of illness. Therefore, the danger of this virus to healthy children appears to be extremely low. For healthy children, we do not really need to worry about protecting them from the virus. To the contrary, we need to protect the world from our children. Because children regularly touch surfaces, touch other children, pay no attention to where their hands have been in general, and thoughtlessly put their fingers in their noses and their mouths, they simply cannot be trusted to observe any social-distancing or hygiene precautions if they are allowed to interact with their friends or classmates. If allowed to freely socialize, children will certainly infect one another at a very high rate without even knowing it. They will also infect their teachers and coaches. They will bring the virus home with them after being infected by their peers and proceed to infect their siblings, parents, and grandparents. Because the vast majority of children do not become ill from the virus, we are not particularly worried about them becoming sick. We are worried that they will make others sick, and therefore we have shut down our schools and their other social engagements so they will not become infected with or contribute to the transmission and spread of the Covid-19 virus.
If Covid-19 were allowed to spread naturally, it would likely infect the vast majority of the world’s population. In the United States alone, tens of millions of children would be infected. We are really not sure how many children might be at risk for succumbing to this disease if that many were infected, but even one-hundredth-of-one-percent would be many thousands of children nation-wide. If one-hundred-million middle-aged and elderly Americans would contract the illness, millions of adults could die. Beyond the direct risk of death caused by Covid-19, tens of millions of people would become seriously ill and require hospitalizations, well beyond the capacity of what our health care facilities could possibly handle. Our medical system would become totally overwhelmed and unable to continue delivering the usual urgent or emergency medical care that our communities require on a daily basis. This means people needing life-saving medical and surgical treatment in our hospitals for heart attacks, pneumonia, diabetes, motor vehicle accidents, cancers, and other infections might not be able to obtain the vital care that our system provides for millions of Americans routinely. The lost work and failed businesses from such widespread illness would likely create a cascading financial crisis, and could potentially cause a collapse of our financial system. Through social distancing or home-sheltering, we are each playing a vital role in a coordinated, global effort to stop the virus spreading through the entire population. Without scaring our children about these potential catastrophes, we can emphasize the important role that they play in protecting people from getting sick and preventing the spread of this diesase.
The risk to our children (again, I am not talking about children with other medical illnesses or who are immunocompromised) is very low. The risks to adults under 60 without predisposing medical conditions, though not negligible, remains low. But the risk to our parents and those with other medical conditions is substantial, and the toll it would take on our medical system and society could be severe or catastrophic.
We should know that our children are safe, and we should emphasize that if they are scared. We should explain, “The germs being passed around do not make children sick, but they can make older people sick, as well as people who have other medical problems.” When asked why the can’t go to school or see their friends in person, we can sa, “Children are not allowed to attend classes at school or play with their friends because, since we can’t even tell which children have the virus, we need to keep them away from each other so they won’t catch the virus from a child who doesn’t know he’s sick.”
We should emphasize, “The best way to avoid making other people is sick to avoid catching the virus ourselves.”
We should say, “The Governor of our state has made rules for us to follow to make sure that our family, and all of the other families in our state, will stop the virus from spreading.”
If your child says, “Daddy, what if I have the virus and I don’t know that I have it, and I make you get sick?” I would answer, “That’s so nice that you are worried about keeping me safe. But it seems like you don’t have the virus because we have already been in close contact and I don’t feel sick at all. The best way we can prevent me or anyone else in our family from getting sick is to follow the Governor’s rules to avoid contact with anyone outside of our house.”
If a package is delivered at the house, and your child is worried about an exposure, I would say, “I threw away the packaging and I washed my hands as soon as I touched it. That is what the doctors are saying we can do to avoid catching the virus from the surfaces of objects that come into our house.” The same can be said about items you purchase from the grocery store.
If someone in your family is positive for Covid-19, you will obviously be following our doctor’s medical advice about extra precautions for isolation of that person from everyone else in the family, and you can answer questions reassuringly about how you are observing all of those precautions to prevent an exposure. You should emphasize that this relative may feel sick for a short while, but the doctors expect him to get better soon. If someone in your home suffers from illnesses which put him or her at greater risk of exposure, the same idea applies; you will reassure everyone that you are doing exactly what the doctors told you about how to make sure that no one else catches the virus from this family member.
Finally, we should tell our children that we are enjoying the good things that come out of this crisis. Most of us will be spending more time together as families. We are acting as part of a collective, national and even global community. This is an opportunity for our children to learn sophisticated and important values of responsibility, collaboration, and duty to others. The vast majority of us will get through this unscathed, medically. There will be hard economic times ahead for many of us, but our governments will do their best to lighten the burden. There will be some illness and yes there will be some tragedy, which we are together striving to minimize. But let’s keep our focus on the immediate priorities in our homes: Stop the spread of the virus, and reassure our children that we are safe.
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Nachum Binyamin Klafter, MD
דר' נחום בנימין קלפטר
7502 State Road, Suite 2280
Cincinnati OH 45255-2800
Phone (513) 474-8900 Fax (513) 231-0653
nachum.binyamin.klafter@gmail.
Judaism and Psychoanalysis - Nachum (Andrew) Klafter, MD