Whenever anyone, adult or child, suffers a trauma, anything that reminds him of the trauma will serve as a trigger that causes the person to re-experience the same fear, helplessness, and anxiety he felt at the time of the original trauma

A few years ago, Baruch and Pessy were totally baffled by their bright, personable youngest son, Yanky, and his unexplainable symptoms. For a little over a year, this ten-year-old seemed to be overly sensitive to loud noises, especially sirens and alarms. And paradoxically, he would practically have an anxiety attack if he heard the relatively low sound of a smoke alarm chirping due to a low battery.

Baruch, a mesivta menahel, and Pessy, a social worker, were both sophisticated parents who anticipated my questions and answered them without my even having to ask.

“He never had strep,” Pessy volunteered. “So we know it can’t be PANDAS [pediatric autoimmune neuropsychiatric disorders, associated with streptococcal infections]. And even our pediatrician is at a loss to explain why Yanky is acting this way.”

“He also has not been bullied at school or victimized in any way,” Baruch added. “But just to be sure, we have asked him directly, more than once. And each time he assures us that he has not been mistreated by anyone. We have discussed these things openly with all of our children. So we are pretty sure that if someone had started up with him, he would have told us about it.”

I took a standard developmental history of Yanky, asked about all of his four older siblings, and explored some of the family dynamics looking for clues. After coming up empty-handed, I shook my head and validated their confusion. Then I explained that the next step would be for me to meet with Yanky for a couple of individual sessions.

Finally, I asked, “How do you think Yanky will feel about coming here to meet with me?”

“Oh, he’ll be happy to come,” Pessy reassured me. “Before we came here, we asked him how he’d feel speaking with someone who might be able to help him with his fears. And he was totally on board.”

When I met with Yanky, he was as intelligent and charming as his parents had described. After conducting an initial clinical assessment for my first two sessions with Yanky, I was still clueless regarding the origin of his anxiety symptoms. And when I asked him why he thought he was so bothered by loud noises, he just shrugged his shoulders, shook his head, and told me he had no idea.

In the third session, I decided to try to take advantage of Yanky’s precociousness. I began by explaining the concept of associations — when someone has similar emotional reactions to two totally unrelated experiences because of one point of similarity. And I gave him the example of someone hearing a song he hadn’t heard for a long time and then experiencing the same emotions as the first time he heard it. When I saw that he grasped the concept, I asked if he ever had an experience of hearing loud noises and/or sirens at a time when he was also feeling somewhat worried or frightened.