Solter describes the case of Michael, a five-month-old who showed signs of traumatic stress after a three-day hospital stay for surgery to correct the shape of his head. Babies can’t meet the usual adult criteria for PTSD, which relies on verbal reports of symptoms. But Solter says that after returning home, Michael cried more, experienced night terrors, displayed a regression in his motor skills (he stopped rolling from his back to his stomach as he had previously learned to do), he displayed terror when lying on his back, and had become fearful of strangers. “The implication is that surgery followed by a fairly short hospital stay can be emotionally traumatising to an infant”, Solter said.
Solter prescribed ‘flooding’, a behaviourist term to describe exposing someone to that which they find frightening, until their terror subsides as what’s feared fails to materialise. In this case, the baby was left lying on his back to scream to exhaustion, while his father stayed close by offering comfort. After about 20 minutes Michael calmed down and from that point on he was far happier lying on his back. Occasionally lying on his back again triggered terror in Michael, in which case his parents left him on his back, but stayed close, offering comfort. Gradually Michael’s other problems reduced too and a year later all was well again. However, as Solter acknowledges, this is a single case study, so there’s no evidence Michael would have remained traumatised had the flooding technique not been used.
Flooding should only be used if the trauma is very specific and relatively minor, Solter advises, otherwise gradual desensitisation is recommended. And she warns that a traumatised infant should never be exposed to a situation that an un-traumatised baby would resist.
“It would be useful for paediatric surgeons to warn parents of the possible emotional and behaviour sequelae in their infants following surgery”, Solter concludes.
Solter, A. (2007). A case study of traumatic stress disorder in a five-month-old infant following surgery. Infant Mental Health Journal, 28, 76-96.