Understanding Trauma and How It Affects Children
The Effects of Childhood Trauma
Two types of trauma
Shock trauma is a life threatening event or series of events such as a catastrophic accident, fire, or explosion, a violent attack or kidnapping, or being exposed to conditions of war.
Developmental or relational trauma occurs when a child is raised in a home characterized by violence (physical or sexual abuse or exposure to parent abuse), and/or a gross lack of attention to a child’s developmental needs for safety, responsive attention, and nurturance, usually due to a parent’s mental illness, addiction, or severe characterological shortcomings. Some parents are ill equipped to care for their children, as a result of their own early trauma. Developmental trauma results in a child’s social, emotional, and cognitive growth being significantly and adversely affected.
Shock Trauma and developmental trauma intersect in situations when wartime conditions persist for a long time, and where children are raised in communities in which gun violence, gang violence, racism and poverty create conditions of incapacitating fear and exposure to assault.
Both of these types of trauma cause acute psychological distress which, if not addressed, can lead to chronic states of fear and hypervigilance, or numbing and distractedness, interfering with all aspects of a person’s daily functioning. Individuals with developmental trauma are at greater risk for all manner of adverse events and when subjected to shock trauma, have particularly challenging outcomes.
Posttraumatic Stress Disorder
In some cases, trauma results in the development of Posttraumatic Stress Disorder which is characterized by intrusive memories and dreams of the traumatic events, flashbacks, wherein the traumatic events seem to be reoccurring in the present, “persistent negative emotional states including horror, anger, guilt, and shame,” “feelings of detachment from others,” “reckless or selfdestructive behaviour,” and/or the “inability to experience positive emotions such as happiness, satisfaction, or loving feelings” (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5).
Physiological Effects of Trauma
In response to a frightening event, the nervous system emits a surge of adrenalin, readying the body to brace, and fight or flee. After the threat is over, the energy produced by the adrenalin must be discharged in some way so that the body can return to a state of equilibrium. Often this takes the form of shaking, crying, or talking about the experience with others. In the case of severe or prolonged trauma, when the individual is unable to process the event or discharge the adrenalin, or where the adrenalin is continuously being emitted in response to ongoing threats, the nervous system may be quite overwhelmed, and unable to return to a state of homeostasis. This is when Posttraumatic Stress Disorder develops. The individual may become numb or frozen and unable to respond to provocations or threats in self-protective ways, may become tense, angry, and over-reactive to small threats, or may vacillate between these two states, sometimes under reacting, and sometimes over reacting.
Children growing up in fear and stress, never develop the capacity to regulate their bodies or emotions and consequently, live in a distracted, upset, and fearful state all the time. They may cry and scream in response to being denied a cookie and stare blankly when beaten, sexually assaulted, or bombed. They don’t anticipate danger, react appropriately to threats, connect with reliable others who might protect them, or have the ability to protect themselves.
At school, traumatized children often get into trouble because they misinterpret innocuous stimuli as hostile and they erupt or flee, causing enormous disruption to all.
A Sense of Helplessness and Futility
Because traumatized children can’t protect themselves and aren’t protected by their caregivers, they come to believe that life is haphazard, random, and unpredictable. Their natural instincts to recoil in fear, and cry in protest have been ignored and over ridden so often that they fail to develop any confidence in their own judgments, reactions, and responses. They aren’t sure what they feel or why, or what difference it makes. How does a child learn to plan, set goals, attend to lessons when they live in a world which is unpredictable and unsupportive, or frankly hostile? Why would he or she bother?
Memory, Consciousness and Dissociation
When children cannot escape chronic danger, and irresolvable threats, they “detach their consciousness from their ongoing painful experience” (Healing Developmental Trauma, p.121). In the short run, “dissociating” is a “life-saving mechanism” but when the “dissociative response develops into a lifestyle” it interferes with learning, adapting, and relating to other human beings (Healing Developmental Trauma, p. 147). When children and adults dissociate, they ‘go away,’ are not present, are not thinking, processing, or learning, and their experiences are not available to conscious memory. They are ‘on hold,’ in a frozen state, and the more frequently and longer periods they remain in this state, the less available they are to learn, relate, and live. They can’t learn from experience and so tend to repeat the same mistakes, encounter the same threats, meet and ‘trust’ the same ‘users and abusers’. These individuals are routinely triggered by body memories which affect them in the here and now, but rarely have the opportunity to calmly reflect on significant past events which would help them create a coherent narrative, a sense of self in the present, informed by the past. This is an essential developmental requirement for people to experience continuity, personality organization, and mental control. Experts hypothesize that individuals who dissociate are more likely to develop Posttraumatic Stress Disorder precisely because, they have difficulty attending to and processing traumatic events.
Self-Hatred
Even extremely competent adults with strong self-esteem suffer shame and self doubt after a traumatic event. They feel ashamed and diminished by their experience of helplessness and victimization, which affects their identity, sometimes permanently. Imagine the sense of shame that chronically abused children experience, believing that they deserve their cruel treatment. This is one of the reasons abused children rarely reveal what goes on at home; another reason is that their parents threaten them with abandonment, if they tell anyone. When children are sexually violated, their abuser usually tells them they are “loved”, the sexual acts are a “special secret” between them, and worse, that the child “wanted” the sexual acts. The shame and betrayal these children experience, is especially terrible.
Children who are abused and neglected develop a belief that they are unlovable, defective, and somehow deserving of the treatment they endure. They have to believe that their caregivers are reasonable beings and able to protect them, or they would collapse in fear and distress. If their caregivers routinely hurt them, it must be because they have done something wrong, have provoked the abuse, or are inherently ‘bad.’
Traumatized Children become Traumatized Adults
Children who have suffered repeated trauma need a lot of help if they are to heal and begin to engage with the world in a calm, curious, and joyful way. They need to feel safe, to develop a sense of control over their bodies and minds, and to develop trust in other human beings. When traumatized children receive no treatment or inadequate treatment, they become traumatized adults who are compromised in all areas of functioning, including the ability to parent effectively. Individuals who don’t know what it is to be safe or have their needs met, cannot keep their children safe, or meet their children’s emotional needs. Increasingly, trauma therapists around the world are employing breathing techniques, yoga, movement, and dance to help trauma survivors develop or regain confidence in their own bodies, sensations, desires, perceptions and emotions. Because trauma survivors almost always have physical symptoms and/or sleeping and eating issues, it is important that therapists work closely with the family doctor or health team.
Conclusion
The effects of childhood trauma are catastrophic and debilitating, causing enormous pain and suffering to the individual children and creating a significant strain on family, community and government resources. The outcomes for traumatized children are very poor and include, school failure, unemployment, addiction, incarceration, mental and physical illness. Treating these children should be a top priority within our national health care system.
Resources
Expanding the Playroom: School-Based Treatment for Maltreated Children, Faye Mishna, Janet Morrison, Sean Basarke, & Charlene Cook, Psychoanalytic Social Work, 19:1-2, 2012, pp. 70-90.
Healing Developmental Trauma: How Early Trauma Affects Self-Regulation, Self-Image, and the Capacity for Relationship, Laurence Heller, PhD. and Aline LaPierre, PsyD., North Atlantic Books, 2012.
Trauma and the Body: A Sensorimotor Approach to Psychotherapy, Pat Ogdan, PhD., Kekuni Minton, PhD. and Claire Pain, M.D., W.W. Norton, 2006.
The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, Bessel Van Der Kolk, M.D., Penguin Books, 2014.
Trauma and Recovery: The Aftermath of Violence From Domestic Abuse to Political Terror, Judith Herman, M.D., Basic Books, 1997.
About The Author
Janet Morrison, M.A., C. Psych Assoc. is a psychological associate in private practice and a senior lecturer at the Factor-Inwentash Faculty of Social Work, University of Toronto. Over the past 30 years she has assessed, treated and supervised treatment of children in long-term care, as well as, consulted for Children's Aid Society and group homes across Ontario.
Listen to our podcast episode on trauma: Episode 3 | How Trauma Affects Children