- About Child Trauma
- What Experiences Might Be Traumatic?
- What Is Child Traumatic Stress?
- Reminders and Adversities
- Risk and Protective Factors
- Recognizing and Treating Child Traumatic Stress
- Signs of Child Traumatic Stress
- Preschool Children
- Elementary School Children
- Middle and High School Children
- Impact of Child Traumatic Stress
- What Families and Caregivers Can Do to Help
- Treatment for Child Traumatic Stress
- More Ways to Find Help
- Other Organizations
- Healing Childhood Trauma in Adults
- Symptoms of Trauma in Adults
- Emotional Symptoms
- Physical Symptoms
- Behavioral Symptoms
- Potentially traumatic events can include:
- What does childhood trauma look in adults?
- Common Trauma Misconceptions
- Treatments for Overcoming Childhood Trauma
- Cognitive Processing Trauma Therapy (CPT)
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
- Eye Movement Desensitization and Reprocessing (EMDR)
- Narrative Exposure Therapy (NET)
- Prolonged Exposure Therapy
- Signs You May Be Dealing With Lingering Effects of Childhood Trauma
- Defining trauma
- Signs of childhood trauma
- Post-traumatic stress disorder
- Attachment and relationships
- Emotional regulation and responses
- Physical health
- Childhood Trauma’s Lasting Effects on Mental and Physical Health
- Understanding adversechildhood experiences
- Lingering effects of stress:risk factors
- Level of trauma
- Duration of trauma
- Effects of childhood trauma
- Physical responses
- Emotional responses
- Support and treatment forchildhood trauma
- Hear what your child issaying
- Watch for clues
- Talk it out
- Ask for help
- Take care of yourself
- Adults: It’s not too late todeal with childhood trauma
- Supporting adults who have experienced trauma or abuse in childhood
- Why does this happen?
- What are the symptoms of complex PTSD to look out for?
- When to consider the diagnosis of complex PTSD
- How can a GP help?
- What are the best treatments for those with complex PTSD?
About Child Trauma
A traumatic event is a frightening, dangerous, or violent event that poses a threat to a child’s life or bodily integrity. Witnessing a traumatic event that threatens life or physical security of a loved one can also be traumatic. This is particularly important for young children as their sense of safety depends on the perceived safety of their attachment figures.
Traumatic experiences can initiate strong emotions and physical reactions that can persist long after the event.
Children may feel terror, helplessness, or fear, as well as physiological reactions such as heart pounding, vomiting, or loss of bowel or bladder control.
Children who experience an inability to protect themselves or who lacked protection from others to avoid the consequences of the traumatic experience may also feel overwhelmed by the intensity of physical and emotional responses.
Even though adults work hard to keep children safe, dangerous events still happen. This danger can come from outside of the family (such as a natural disaster, car accident, school shooting, or community violence) or from within the family, such as domestic violence, physical or sexual abuse, or the unexpected death of a loved one.
What Experiences Might Be Traumatic?
- Physical, sexual, or psychological abuse and neglect (including trafficking)
- Natural and technological disasters or terrorism
- Family or community violence
- Sudden or violent loss of a loved one
- Substance use disorder (personal or familial)
- Refugee and war experiences (including torture)
- Serious accidents or life-threatening illness
- Military family-related stressors (e.g., deployment, parental loss or injury)
When children have been in situations where they feared for their lives, believed that they would be injured, witnessed violence, or tragically lost a loved one, they may show signs of child traumatic stress.
What Is Child Traumatic Stress?
Children who suffer from child traumatic stress are those who have been exposed to one or more traumas over the course of their lives and develop reactions that persist and affect their daily lives after the events have ended.
Traumatic reactions can include a variety of responses, such as intense and ongoing emotional upset, depressive symptoms or anxiety, behavioral changes, difficulties with self-regulation, problems relating to others or forming attachments, regression or loss of previously acquired skills, attention and academic difficulties, nightmares, difficulty sleeping and eating, and physical symptoms, such as aches and pains. Older children may use drugs or alcohol, behave in risky ways, or engage in unhealthy sexual activity.
Children who suffer from traumatic stress often have these types of symptoms when reminded in some way of the traumatic event.
Although many of us may experience reactions to stress from time to time, when a child is experiencing traumatic stress, these reactions interfere with the child’s daily life and ability to function and interact with others. At no age are children immune to the effects of traumatic experiences.
Even infants and toddlers can experience traumatic stress. The way that traumatic stress manifests will vary from child to child and will depend on the child’s age and developmental level.
Without treatment, repeated childhood exposure to traumatic events can affect the brain and nervous system and increase health-risk behaviors (e.g., smoking, eating disorders, substance use, and high-risk activities). Research shows that child trauma survivors can be more ly to have long-term health problems (e.g.
, diabetes and heart disease) or to die at an earlier age. Traumatic stress can also lead to increased use of health and mental health services and increased involvement with the child welfare and juvenile justice systems.
Adult survivors of traumatic events may also have difficulty in establishing fulfilling relationships and maintaining employment.
Reminders and Adversities
Traumatic experiences can set in motion a cascade of changes in children’s lives that can be challenging and difficult. These can include changes in where they live, where they attend school, who they’re living with, and their daily routines. They may now be living with injury or disability to themselves or others. There may be ongoing criminal or civil proceedings.
Traumatic experiences leave a legacy of reminders that may persist for years. These reminders are linked to aspects of the traumatic experience, its circumstances, and its aftermath.
Children may be reminded by persons, places, things, situations, anniversaries, or by feelings such as renewed fear or sadness. Physical reactions can also serve as reminders, for example, increased heart rate or bodily sensations.
Identifying children’s responses to trauma and loss reminders is an important tool for understanding how and why children’s distress, behavior, and functioning often fluctuate over time.
Trauma and loss reminders can reverberate within families, among friends, in schools, and across communities in ways that can powerfully influence the ability of children, families, and communities to recover. Addressing trauma and loss reminders is critical to enhancing ongoing adjustment.
Risk and Protective Factors
Fortunately, even when children experience a traumatic event, they don’t always develop traumatic stress. Many factors contribute to symptoms, including whether the child has experienced trauma in the past, and protective factors at the child, family, and community levels can reduce the adverse impact of trauma. Some factors to consider include:
- Severity of the event. How serious was the event? How badly was the child or someone she loves physically hurt? Did they or someone they love need to go to the hospital? Were the police involved? Were children separated from their caregivers? Were they interviewed by a principal, police officer, or counselor? Did a friend or family member die?
- Proximity to the event. Was the child actually at the place where the event occurred? Did they see the event happen to someone else or were they a victim? Did the child watch the event on television? Did they hear a loved one talk about what happened?
- Caregivers’ reactions. Did the child’s family believe that he or she was telling the truth? Did caregivers take the child’s reactions seriously? How did caregivers respond to the child’s needs, and how did they cope with the event themselves?
- Prior history of trauma. Children continually exposed to traumatic events are more ly to develop traumatic stress reactions.
- Family and community factors. The culture, race, and ethnicity of children, their families, and their communities can be a protective factor, meaning that children and families have qualities and or resources that help buffer against the harmful effects of traumatic experiences and their aftermath. One of these protective factors can be the child’s cultural identity. Culture often has a positive impact on how children, their families, and their communities respond, recover, and heal from a traumatic experience. However, experiences of racism and discrimination can increase a child’s risk for traumatic stress symptoms.
Recognizing and Treating Child Traumatic Stress
Learn about the signs of traumatic stress, its impact on children, treatment options, and how families and caregivers can help.
Childhood traumatic stress occurs when violent or dangerous events overwhelm a child’s or adolescent’s ability to cope.
Traumatic events may include:
- Neglect and psychological, physical, or sexual abuse
- Natural disasters, terrorism, and community and school violence
- Witnessing or experiencing intimate partner violence
- Commercial sexual exploitation
- Serious accidents, life-threatening illness, or sudden or violent loss of a loved one
- Refugee and war experiences
- Military family-related stressors, such as parental deployment, loss, or injury
In one nationally representative sample of young people ages 12 to 17:
- 8% reported a lifetime prevalence of sexual assault
- 17% reported physical assault
- 39% reported witnessing violence
Also, many reported experiencing multiple and repeated traumatic events.
It is important to learn how traumatic events affect children. The more you know, the more you will understand the reasons for certain behaviors and emotions and be better prepared to help children and their families cope. Learn more about the types of trauma and violence and types of disasters.
Signs of Child Traumatic Stress
The signs of traumatic stress are different in each child. Young children react differently than older children.
- Fearing separation from parents or caregivers
- Crying and/or screaming a lot
- Eating poorly and losing weight
- Having nightmares
Elementary School Children
- Becoming anxious or fearful
- Feeling guilt or shame
- Having a hard time concentrating
- Having difficulty sleeping
Middle and High School Children
- Feeling depressed or alone
- Developing eating disorders and self-harming behaviors
- Beginning to abuse alcohol or drugs
- Becoming sexually active
For some children, these reactions can interfere with daily life and their ability to function and interact with others.
Impact of Child Traumatic Stress
The impact of child traumatic stress can last well beyond childhood. In fact, research shows that child trauma survivors are more ly to have:
- Learning problems, including lower grades and more suspensions and expulsions
- Increased use of health services, including mental health services
- Increased involvement with the child welfare and juvenile justice systems
- Long term health problems, such as diabetes and heart disease
Trauma is a risk factor for nearly all behavioral health and substance use disorders.
What Families and Caregivers Can Do to Help
Not all children experience child traumatic stress after experiencing a traumatic event, but those who do can recover. With proper support, many children are able to adapt to and overcome such experiences.
As a family member or other caring adult, you can play an important role. Remember to:
- Assure the child that he or she is safe. Talk about the measures you are taking to get the child help and keep him or her safe at home and school.
- Explain to the child that he or she is not responsible for what happened. Children often blame themselves for events, even those events that are completely their control.
- Be patient. There is no correct timetable for healing. Some children will recover quickly. Others recover more slowly. Try to be supportive and reassure the child that he or she does not need to feel guilty or bad about any feelings or thoughts.
Review NCTSI’s learning materials for parents and caregivers, educators and school personnel, health professionals, and others.
Treatment for Child Traumatic Stress
Even with the support of family members and others, some children do not recover on their own. When needed, a mental health professional trained in evidence-based trauma treatment can help children and families cope with the impact of traumatic events and move toward recovery.
Effective treatments trauma-focused cognitive behavioral therapies are available. There are a number of evidence-based and promising practices to address child traumatic stress.
Each child’s treatment depends on the nature, timing, and amount of exposure to a trauma.
Review Effective Treatments for Youth Trauma – 2004 (PDF | 55 KB) at the National Child Traumatic Stress Network.
Families and caregivers should ask their pediatrician, family physician, school counselor, or clergy member for a referral to a mental health professional and discuss available treatment options.
More Ways to Find Help
Many U.S. agencies and other groups offer research and support related to child traumatic stress.
Healing Childhood Trauma in Adults
Childhood trauma is a frequent occurrence.
The SAMHSA’s National Child Traumatic Stress Initiative (NCSTI) reports that by the age of 16, two-thirds of children report experiencing at least one traumatic event. According to the American Psychological Association, “A traumatic event is one that threatens injury, death, or the physical integrity of self or others and also causes horror, terror, or helplessness at the time it occurs.”
This can encompass many different situations and may be different for each person that comes in contact with that event.
Learn More About Our Trauma Treatment Center
Symptoms of Trauma in Adults
There are a number of different ways in which symptoms can manifest for adults living with childhood trauma.
Unfortunately, there is no clear-cut recipe to follow when diagnosing an adult with immediate signs of trauma, however, there may be some common physical, emotional, and behavioral symptoms of trauma victims. Listed below are just a few common warning signs of someone living with trauma.
- Emotional outbursts
- Panic Attacks
- Poor Concentration
- Night Terrors
- Lack of Energy
- Physical Illness
- Sleep Disturbances
- Eating Disorders
- Numbness or Callousness
- General disorientation
Keep in mind that these are just a few common symptoms of trauma victims, and often times many people can exhibit a number of these symptoms or may even show none at all. If you or someone you know are showing signs of trauma, it is important to seek immediate professional help. Highland Springs Specialty Clinic is a renowned trauma and PTSD treatment center in Utah. Please call us today for more information about our program and recovery methods.
Potentially traumatic events can include:
- Physical, emotional, and sexual abuse
- Community or school violence
- Sexual exploitation
- Sudden or violent death of a loved one
- Witnessing or experiencing domestic violence, disasters or terrorism
- Refugees or war experiences
- Serious accidents
- Life-threatening illness
If untreated, childhood trauma can have long-lasting effects. Trauma can affect children’s mood and their ability to regulate their emotions, they are 2 times more ly to develop depression and 3 times more ly to develop anxiety. The sooner the trauma is addressed through therapy, the better the chance for the child to have a full and successful recovery.
Get Treatment Today
What does childhood trauma look in adults?
Childhood trauma in adults can impact experiences and relationships with others due to experienced feelings of shame, and guilt. Childhood trauma also results in feeling disconnected, and being unable to relate to others. Studies have shown that adults that experience childhood trauma were more ly to struggle controlling emotions, and had heightened anxiety, depression, and anger.
Common Trauma Misconceptions
Adults living with childhood trauma doesn’t necessarily mean they will be unable to have a full life. If, however, trauma starts affecting an individual’s day-to-day life it is important to seek professional help. Many people have misconceptions when it comes to adults affected by childhood trauma. Here are 3 common misconceptions related to childhood trauma;
- An individual who was abused and/or neglected as a child will abuse and/or neglect their own children
- Abused and neglected children will become deviant adults, and
- The effect of abuse and/or neglect are irreparable, and the adult won’t live a full life of recovery.
This is false! Overcoming childhood trauma in adults is possible through therapy. The first step to healing is finding a childhood trauma therapist who can help navigate the individual through the trauma and/or neglect. Therapy for childhood trauma is typically provided in an outpatient setting through group and/or individual therapy.
Treatments for Overcoming Childhood Trauma
Dealing with childhood trauma is a complex but necessary process. Through therapy, adults can overcome childhood trauma. They can raise happy and healthy families, be productive citizens, and have a fulfilling life.
Cognitive Processing Trauma Therapy (CPT)
Cognitive processing therapy is a specialized type of cognitive trauma healing therapy used to treat patients with post-traumatic stress disorder (PTSD).
A typical 12-session period has been shown to reduce trauma in veterans, sexual assault victims, and children who have experienced abuse or trauma.
The main focus of CPT is to recontextualize and help rationalize the traumatic events experienced by the victim.
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
Trauma-focused cognitive behavioral therapy is a type of psychotherapy provides trauma healing.
Specifically focused on trauma, that helps patients change destructive patterns such as negative emotional, behavioral, and thought patterns into positive solutions through the use of awareness and cognitive responses.
Clinicians have found success using TF-CBT in children, adolescents, and traumatized adults in 8-25 period sessions.
Eye Movement Desensitization and Reprocessing (EMDR)
Eye movement desensitization and reprocessing therapy is form psychotherapy in which a subject will recall traumatic memories while moving their eyes from side to side in a rhythmic pattern. This treatment has shown success in decreasing negative effects associated with PTSD. EMDR typically lasts for 6-12 sessions.
Narrative Exposure Therapy (NET)
Narrative exposure therapy aims to treat individuals with complex and multiple incident trauma.
NET involves a chronologically laying a patient’s life out and putting into context the events of their life at both positive and traumatic points.
The goal of NET to help the patient refine and understand traumatic events by putting one’s life events into context. NET is a short-term therapy typically ranging from 4-10 sessions.
Prolonged Exposure Therapy
Prolonged exposure therapy, sometimes referred to as flooding, is a type of behavioral cognitive therapy in which a patient is exposed to traumatic memories to help them understand and rationalize those events. Prolonged exposure therapy has had decades of success with patients suffering from PTSD related depression, panic attacks, and anxiety. Sessions typically last 15 weeks or longer.
Healing childhood trauma in adults is a daunting and difficult task but it is possible through therapy. Luckily, continuing research and developments in the field are revealing more effective ways of treating trauma. In particular, EMDR therapy is a newly emerging form of therapy that has had substantial success in treating PTSD.
EMDR is unique in that rather than discussing and reliving the trauma, its focus is on the emotions associated with that trauma in conjunction with bilateral sensory input. Every person reacts to trauma in different ways. For a better understanding of treating trauma, contact a professional therapist for a trauma diagnosis.
Don’t let trauma dictate your life, there are multiple Highland Springs Specialty Clinic locations in Utah that specialize in diagnosing and treating childhood trauma. Our renowned therapists are committed to helping you and your loved ones!
Learn more about our trauma therapy program here, or call us today to speak with a specialist.
Dr. Thatcher, DO, CMRO, works with the Valley Behavioral Health’s Director of Nursing providing supervision and oversight of medical operations for over 70 medical staff members and medical issues in over 70 clinics and facilities in Utah, Boise Idaho, and Phoenix Arizona.
His major medical initiatives include telehealth, integrated care, medication-assisted treatment, and substance abuse services, forensics services, and seamless integration of jail/prison/mental health court & drug court/probation/parole services with behavioral health and substance abuse treatment, ValleyLab blood and urine drug testing, data analytics to drive better outcomes & computerized automation of standardized measurement tools, and Brainsway Deep Transcranial Magnetic Stimulation clinic.
Signs You May Be Dealing With Lingering Effects of Childhood Trauma
The incidence of childhood trauma in the United States is eye-opening — more than two-thirds of children report at least one traumatic event by the age of 16. From bullying to abuse, trauma is an unfortunate part of growing up for many children, and the effects can very much carry over into adulthood.
To help make peace with a tumultuous past, Dr. Diana Ghelber and our team at the Institute for Advanced Psychiatry, offer a wide range of mental health services. Our goal is to help you reconcile past traumatic events so that you can move forward and pursue a happy and healthy life.
To get started, it’s important to recognize the signs that a past childhood trauma may still be haunting you, so we thought we’d review some of the more common warning flags here.
One of the first things to understand about childhood trauma is that there’s no set cause-and-effect relationship. There are many different types of trauma and each person’s reaction to the event depends upon a host of factors, such as whether you were able to “process” the event with the right support systems.
To give you a better idea about what constitutes trauma, here are some of the more common events:
- Childhood sexual or physical abuse
- Witnessing domestic violence
- Community or school violence
- Natural disasters
- Loss of a loved one
- Serious illness or accident
Again, it’s important to note that these are just common examples of trauma — your experiences may not reflect any of the events on this list, but it was still traumatic for you.
Signs of childhood trauma
There are many different ways in which the lingering effects of childhood trauma can influence your adulthood, including:
Post-traumatic stress disorder
While many people are aware of post-traumatic stress disorder (PTSD), which stems from unresolved trauma, this is a very specific mental health issue that doesn’t develop in everyone who experiences trauma. In fact, only 3% to 15% of girls and 1% to 6% of boys experience PTSD after a traumatic experience.
That said, some of the signs of PTSD include:
- Reliving the event (flashbacks or nightmares)
- Problems with trust
- Self-destructive or risky behaviors
If any of these apply to you as an adult for no reason that you can think of, there is some cause for concern as you may be dealing with unresolved PTSD from your childhood.
Attachment and relationships
Another warning flag of childhood trauma that carries over into adulthood are problems forming attachments and relationships. For example, if your childhood trauma was caused by a loved one or caregiver, you may learn to mistrust adults. This mistrust can carry over into your adulthood and affect your ability to form relationships with others.
Or, perhaps you consistently form unhealthy relationships with bad people since that is what you know from your childhood (a victim of child abuse may marry an abusive spouse, for example).
Whatever the case, if you struggle with forming healthy relationships with your peers, this may be a sign of unresolved childhood trauma.
Emotional regulation and responses
Another side effect of childhood trauma may be problems regulating your emotions. There are many ways in which this problem can manifest itself, including:
- Uncontrollable anger
- An inability to express your emotions
Again, these are just some examples, and you may experience different issues when it comes to regulating your emotional health.
While childhood trauma can directly affect your mental and emotional health, it can also influence your physical health, For example, studies show that kids who were subjected to abuse were more at risk for serious health issues, including:
- Coronary artery disease
Suicide attempts are also shown to be considerably higher among adults who experienced childhood trauma.
If any of these descriptions ring true for you, we urge you to come see us so that we can release the hold that childhood trauma still has on your life. To get started, contact one of our offices in Granbury or Fort Worth, Texas, to set up a consultation.
TMS for Major Depression: What to Expect
You’ve tried medications and therapy for your depression, with little success. Before you become too discouraged, there is another way through transcranial magnetic stimulation, or TMS therapy. Here’s how it works.
4 Conditions Ketamine Infusions Treat
Ketamine made headlines when it was approved by the FDA a couple of years ago for treatment-resistant depression. We’re also experiencing success with other mental health issues, as well.
Can You Have Anxiety and Depression at the Same Time?
While anxiety and depression are two very separate diagnoses, the fact is that nearly half of those diagnosed with depression are also diagnosed with an anxiety disorder. Here’s a look at a few of the reasons why the two may be connected.
When to Consider TMS Therapy for OCD
More than two million adults in the United States struggle with obsessive-compulsive disorder (OCD), which can overshadow their lives in meaningful ways. To take back control of your life, explore how TMS therapy can help.
Which Type of Depression Do I Have?
The word “depression” is a catchall term for several types of the mood disorder, so it’s helpful to better understand what you may be experiencing. Here, we explore the more common forms of depression.
4 Ways PTSD Can Impact Your Daily Life
Millions of people experience ongoing psychological distress due to post-traumatic stress disorder, which impacts their lives in very serious ways. Here we explore four of the more common.
Childhood Trauma’s Lasting Effects on Mental and Physical Health
Traumaticevents don’t always leave physical scars, but they often leave emotional andpsychological ones. Those imprints can affect a child’s mental and physicalhealth for years to come — and even into adulthood.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Psychologist Kate Eshleman, PsyD, says that often, children can move on from traumatic events and thrive. But they may need a helping hand. “There are things parents and caregivers can do to support a child after trauma.”
Understanding adversechildhood experiences
Childhealth experts often talk about adverse childhood experiences (sometimes calledACEs) — traumatic events in a child’s life.
SomeACEs are clearly terrifying — such as abuse, witnessing extreme violence or survivinga natural disaster.
Butkids see the world differently than adults do and can experience distress fromthings that might not seem so scary to grown-ups, says Dr. Eshleman. Events chronic bullying at school, the death of a family member or divorce canalso traumatize a child.
“Parentsshould be mindful that even though an event might not seem traumatic to them,it may have been traumatic for their child,” she says.
Lingering effects of stress:risk factors
Manychildren who experience an adverse event don’t have long-lasting effects.Still, some factors increase the chance of later problems, Dr. Eshlemansays:
Traumacan leave a stamp at any age. But children who experience an adverse eventbefore the age of 8 may be particularly vulnerable.
Level of trauma
Noteveryone experiences trauma the same way. Some kids can bounce back from majorstressors while others are more affected by things that, on the surface, seemless severe. Overall, the more extreme the trauma, the higher the risk forlasting difficulty.
Duration of trauma
Chronicor repeated exposure to adverse events increases the risk of lasting healthproblems. Children who witness repeated violence in an unsafe neighborhood, orthose who are abused, are more ly to have long-term problems than a childwho experiences a one-time event, such as a car crash.
Effects of childhood trauma
Pasttraumas can stay with a child — and even affect their physical health. Childrenwho experience traumatic events have a greater chance of developing healthconditions, including:
Thereare two main ways that trauma can cause those lingering effects, Dr. Eshlemanexplains:
“Thebody responds to emotional stress in much the same way it responds to physicalstress,” Dr. Eshleman says.
Elevated proteins: After physical head injuries suchas concussions, levels of a protein called S100B can spike in the brain.Researchers found similarly high levels of this protein in children who hadexperienced emotional trauma. S100B is associated with potentially damaginginflammation in the brain.
High levels of stress hormones: Stress affects the bodyfrom head to toe. When something scary happens, stress hormones set your heartracing and make you break into a cold sweat. But if those hormones stayelevated for a long time, they can cause inflammation in the body and lead tolasting health problems. “The stress response can wear on our bodies,” Dr.Eshleman says.
“Sometimes,significant stress or trauma can lead to mental health disorders, such as anxietyand depression,” says Dr. Eshleman. And people with untreated mental healthproblems are:
- At increased risk for disease.
- Less ly to make healthy choices, seeing the doctor regularly or eating well.
- More ly to turn to unhealthy coping mechanisms, such as drinking and smoking.
Support and treatment forchildhood trauma
If you’re caring for a child who has survived trauma, you might be feeling overwhelmed by all the possible outcomes. It’s worth repeating: Those outcomes aren’t inevitable. As a caregiver, you can take steps to reduce the risks for your child:
Hear what your child issaying
“Sometimes,adults minimize the significance of a traumatic event such as bullying,” Dr.Eshleman says. You may be trying to help your child by taking the “it’s not sobad” approach.
Buttrauma might make your child shut down — when you want them to let you in.Validate your child’s experience. Let them know that you understand how hardthe experience was and that you’re there to help.
Watch for clues
It’s not always easy for children to explain what they’re thinking. After a distressing event, look for changes in behavior. These can be clues that your child is having a difficult time. Some common changes to watch for include:
- Eating more or less than usual.
- Sleep changes, including having trouble sleeping or needing more sleep than usual.
- Regression (such as a potty-trained preschooler having accidents again, or a toddler who slept through the night now waking frequently).
- Irritability and grumpiness.
- Clinginess and separation anxiety — especially in younger kids.
Talk it out
“Encourageopportunities for discussion and allow kids to express their thoughts andfeelings,” says Dr. Eshleman.
Ask for help
Mentalhealth professionals can use tools such as trauma-focused treatments to helpchildren recover from trauma. Not sure where to start? Dr. Eshleman recommendstalking to your pediatrician for recommendations.
Take care of yourself
Ifyour child has been through a trauma, there’s a good chance the experience wasstressful for you as well. “Make sure you’re getting the support you need andengaging in healthy behaviors. If you’re having difficulty coping, seek helpfor yourself, too,” says Dr. Eshleman.
Adults: It’s not too late todeal with childhood trauma
Doesthis all sound a little too familiar? Not everyone gets the support they needin childhood. You may recognize that your own ACEs dealt you a bad hand. Andyou might still be dealing with the emotional and physical consequences.
Help is available at any age. “There are a variety of therapies that are very effective at treating anxiety, depression and PTSD,” Dr. Eshleman says. “It’s never too late to work with a mental health professional.”
Supporting adults who have experienced trauma or abuse in childhood
Supporting adults who have experienced trauma or abuse in childhood Supporting adults who have experienced trauma or abuse in childhood
This month we discuss complex post-traumatic stress disorder (PTSD) with Priory Hospital North London Consultant Psychiatrist, Dr Liam Parsonage. We explore the links that this condition has to childhood trauma or abuse, and the importance of supporting adults who have developed mental health challenges due to these experiences.
Research has shown that children who experience early childhood trauma, abuse or neglect are more ly to go on to develop profound and long-lasting mental health problems in adulthood, such as ‘complex PTSD’. This differs from ‘PTSD’ which is more typically associated with a single traumatic incident or set of traumatic events.
The risk of developing complex PTSD is greater if trauma or abuse is repetitive and prolonged, involves harm or abandonment by care givers and if it occurs at a developmentally vulnerable age such as early childhood or adolescence, which are critical periods of brain development.
Why does this happen?
We spoke to Dr Parsonage about the ‘fight, flight or freeze response’:
- The amygdala, part of the limbic system, is the brain’s ‘smoke detector’ and emotional memory centre. The amygdala is triggered if it senses any kind of threat or danger and causes the brain stem to react instinctively and activate the fight, flight or freeze response. This causes an increase in heart rate, breathing rate and muscle tension
- The ‘thinking part of the brain’ (the neocortex), becomes less active and shuts down. At times of danger, we become overwhelmed by feelings and impulses and we don’t think about or contextualise our experiences – we simply react to the danger rather than thinking about it
- This evolutionary response to danger takes the fast route via the amygdala, rather than the longer thinking route via the cortex, which has aided our survival
- After the danger has passed, the normal response is for the thinking brain to then react, regulate responses, plan, problem solve, and allow arousal levels to return to baseline
- The amygdala is over-sensitive and the capacity of the thinking brain is reduced in individuals who have been exposed to trauma in childhood and develop complex PTSD
- Memories have not been processed and fully integrated into autobiographical memory and they remain stuck in implicit (feeling) memory
- Flashbacks and re-living of the trauma occur because the amygdala has kicked in and the hippocampus has gone ‘offline’ and is unable to contextualise the memory in the moment. Traumatic memories are therefore ‘re-experienced’ rather than ‘remembered’
The neurological systems that process emotions are significantly compromised in individuals who have experienced chronic childhood trauma:
- Chronic stress reduces the size and functioning in the area of the brain that processes memory
- The amygdala is overstimulated and is in constant overdrive
- High levels of cortisol make it harder to learn and block memories forming
- The brains of people with complex PTSD show an enhanced sensitivity to threat and are usually in a chronic state of ‘red alert’
What are the symptoms of complex PTSD to look out for?
Trauma survivors can present with a wide range of problems and symptoms ranging from physical, psychological and maladaptive coping strategies and may report any of the following:
- Re-experiencing or re-living unwanted memories as flashbacks or nightmares
- Hyper-arousal: problems with sleep, irritability, anger, anxiety, hyper-alertness, exaggerated startle response
- Hypo-arousal: feeling numb or cut off, feeling detached from others, dissociating, feeling flat or empty
- Emotional dysregulation
- Negative self-concept
- Relationship difficulties
- Avoiding thinking or talking about trauma related topics
- Abuse of alcohol or abuse of substances to avoid and numb their feelings
- Engaging in self-harm or having suicidal thoughts
When to consider the diagnosis of complex PTSD
People who have complex PTSD often present with co-morbid psychiatric conditions and patients will often not disclose that they have experienced a trauma in their childhood and therefore present with another mental health or physical health problem, relationship or behavioural problems.
It is also worthwhile considering complex PTSD when a patient presents with symptoms that don’t fit the usual pattern of depression or anxiety or don’t respond to the usual treatments.
Other conditions patients with complex PTSD might present with include:
- Major depression
- Anxiety disorders
- Substance abuse disorders
- Eating disorders
- Dissociative disorders
- Borderline personality disorder (BPD)
- Chronic pain and other health problems
How can a GP help?
- Build a trusting therapeutic relationship
- Don’t push to talk about the details of trauma as this can re-traumatise the patient and leave the patient feeling vulnerable and destabilised
- Don’t over-estimate the patient’s capacity to tolerate emotions and encourage them to engage in treatment to develop skills to manage their intense emotions
- Psycho-education regarding the effects of childhood trauma on the brain can help the patient understand why they feel such intense emotions
- Normalise and give hope
Provide them with practical techniques to build emotional stability. These can include:
- Grounding techniques
- Breathing strategies
- Trigger awareness
- Sleep hygiene
- Understanding anger
Educate the patient on the neurobiology of trauma
It can be helpful to explain the neurobiology of trauma to patients to help them understand why they have such intense reactions to everyday experiences which don’t affect others in the same way.
Tell them about the three complex sections of the brain
- The brainstem – involved with instinctive responses, controlling bodily functions such as heart rate, and breathing
- The limbic system – involved in non-verbal emotional experience, feelings and ‘gut’ memories, and traumatic memory
- The neocortex – involved with reasoning, problem-solving, verbal expression, and memory for events and facts
Refer them to a specialist for further treatment
Most people who have complex PTSD will need specialist intervention to confirm the diagnosis, manage risk, formulate an appropriate treatment plan and gain access to talking therapies.
What are the best treatments for those with complex PTSD?
Trauma-focused cognitive behavioural therapy (CBT)
Trauma-focused CBT is an evidenced-based, NICE recommended talking therapy which has been developed from CBT to specifically help people who have experienced trauma. The recommendation is 8 to 12 individual weekly sessions for an hour with the same therapist each week.
Eye movement desensitisation and re-processing (EMDR)
EMDR is another NICE recommended treatment for people who have experienced trauma and often re-live the events as nightmares and flashbacks.
EMDR involves recalling the traumatic event whilst making rhythmic eye movements similar to the eye movements we make whilst we sleep and are processing memories.
This helps the brain to process the traumatic experiences and reduce the emotional content so that rather than re-living the experience, the experience becomes a memory, so that distressing symptoms associated with the traumatic event are reduced.
Five-day trauma programme
The five-day trauma programme is offered at Priory locations in the UK and is Pia Mellody’s Post Induction Therapy (PIT) – a method that is widely used in the USA.
The PIT approach utilises an eclectic mix of therapy and treatment models, bringing together elements of psychoanalysis, gestalt therapy (gestalt helps people to focus on their immediate thoughts, feelings and behaviours and to better understand the way they relate to others), family systems therapy, transactional analysis therapy and rational emotive therapy.
By using educational and experiential processes, the programme helps patients to identify and address their childhood trauma and family-of-origin issues. Once these issues are identified, patients are able to explore ways to deal with the emotions that accompany their past traumatic events, and how to resolve the resulting grief and distress.
Medications are not the key to treatment of complex PTSD but should be used to target specific symptoms, for example antidepressants for low mood, or mood stabilisers for mood instability.
Can't find what you're looking for?