Resistance, both conscious and unconscious, may
provide a useful, protective defense from psychological pain. Yet, it is often destructively attached to a false attitude or belief, impeding us in important endeavors. Such appears to be the case with the reluctance of many parents to seriously consider the enduring emotional impact of a dog bite on their child.
The initial protective reflex can be understood as the parents’ desire to avoid and deny unseen harmful consequences beyond the visible physical wounds. People automatically strive to initially minimize a trauma in most circumstances. The family’s or neighbor’s dog, more often than not, inflicts the wounds. This is as if the wounds were caused by a family member or friend. In addition, it is the rare parent who feels no responsibility for the attack. Both facts create additional explanations for resisting, avoiding and denying the possibility of serious latent injuries to the bitten child.
The typical child, following the attack and its physical repairs, observes his parents’ unhappy responses whenever the attack is recalled. Children avoid intentionally causing their parents any unhappiness. Consequently, the bitten child rarely if ever mentions the event.
The majority of these accidents involve children under age ten. Most attacks involve the child’s body above the shoulders. Adults forget the perceptions they had as children of the “bigness” of their former world. As adults we require extra thoughts and sensitivity to retrofit our minds to capture the child’s everyday sense of smallness and vulnerability even before an accident. Attacks to the face and head leave the child with frightening memories the child is reluctant to consciously recall. They may appear through nightmares, unexplained irritability and other unusual behaviors. Or the child may prove “successful” in hiding the after-effects of the trauma.
Parents and child unwittingly collaborate to deny and avoid exploring the latent, unseen impact of the dog attack beyond the physical repair and healing of the flesh wounds. The parents conclude that if any residual effects exist, they are “insignificant”.
Every dog attack on a child is unique. Consideration must be given to the age and size of the child, the size of the dog, the location of the bite, plus the real and perceived severity of the wounds. Additionally consider, the arrival of help, as seen by the child, the quality of physical and emotional support provided by adults, (including physicians and nurses), and the emotional response of adults to the attack in the initial days post-attack, as observed by the bitten child.
Consider, for one example, a small dog biting the lower leg of an eleven year-old girl that required three sutures and healed without any recognized residual. An individual fitting this description became a professor in child & adolescent psychiatry and repeatedly saw little importance in this essay’s message.
In another example, a four year old boy is severely bitten in the face by a mastiff. Does anyone think this boy “got over it” after the facial scars healed?
A third example, a seven year-old boy, son of a gifted Chief of an Emergency Department in a hospital in So. California was bitten several times on his head by a neighbor’s dog. That attack caused profuse bleeding. Fortunately, the father was home, immediately took his son to his ED for repair. On the advice of the family attorney, the boy was evaluated a year after the attack to determine if there was any residual to be considered in a pending law suit. Both parents were stunned when they observed their son breakdown during that interview. The son revealed, while choking back tears, the post trauma load that he had carried, solo, for a year.
In conclusion, if your child suffers the misfortune of a dog attack, please, seriously consider the possibility that emotional issues may persist. If you have any doubts, it will be worth the time, money and energy to identify emotional residuals or experience the peace-of-mind that your child’s recovery is complete.
R. Larry Schmitt was born in Iowa in l936. He graduated with eleven classmates from high school in Phelps, WI. He completed his undergraduate and medical degrees at the University of Wisconsin, Madison. An internship was completed at Philadelphia General Hospital. Following that internship, he worked as an Assistant Surgeon for the USPHS in Juneau, Alaska treating Alaska Natives. The next four years found him completing residencies in general and child psychiatry at the Menninger School of Psychiatry in Topeka, Kansas. He moved to San Diego in l969 where he practiced in La Jolla until retiring in 2005. During his practice, he taught and supervised in the Division of Child/Adolescent Psychiatry. He currently volunteers at the UCSD Free Clinic with continuing contact with residents in child and adolescent psychiatry.
He is boarded in both general and child psychiatry and a Life Fellow in the American Psychiatric Association.