Childhood Trauma: Facing the effects

It is hard to browse the web or turn on your television these days, without coming across a heart-breaking news story. In these times of conflict and international turmoil, it can be difficult to see families in such dire situations. Often it is children who suffer the worst, and we can find ourselves asking how they will ever recover mentally or obtain some semblance of normality.

​Trauma is not always as obvious or as extreme as war and displacement. Sometimes, trauma can occur in the home or school, or as the result of a random unfortunate happening. In any case, children who have experienced trauma will inevitably require extra care and supports, and it is important to understand the associated effects and requirements.

What Is Trauma?

​Trauma refers to highly stressful events that exceed our capacity to cope. It is difficult to define what a traumatic event is, as it depends on the individual’s personal experience. Whilst some individuals may suffer long- term psychological damage from engaging in military combat for example, others adjust relatively well back into normal life. 

Childhood trauma may be defined as the child’s unique experience of an event or prolonged condition which results in:

a) An inability to healthily process the emotional experience and

b) Experiencing a threat to life, bodily integrity or mental health 

Trauma is a very broad term and incorporates “single- blow” experiences such as deaths, crimes and environmental disaster. It can also include “repeated trauma” during childhood such as abuse, violence or extreme poverty. 

Research indicates that although single-blow traumas are extremely distressing, the most serious mental health problems often arise from repeated trauma. This is because repeated trauma can often last years or even decades of a young person’s life, leaving them little time to experience the safety and stability required for psychologically healthy development.

Some psychologists argue that the most pervasive trauma is that which results from a relationship in which the victim is dependent, particularly parent- child relationships.

What Are the Results Of Childhood Trauma?

The long term- effects of trauma can be influenced by:

• The length of the traumatic experience
• The severity of the trauma (i.e. level of violence experienced)
• Availability of support following trauma

Again, not all those who experience trauma in childhood will experience long- term effects. Research has however, linked trauma in the early years to a variety symptoms and behaviours. Children who have experienced trauma may demonstrate a range of behaviours such as:

• Excessive temper and  attention seeking behaviours
• Easily startled
• Acting out in social situations
• Self- blame
• Mistrust of others
• Low self- confidence
• Separation anxiety

Physiological issues may also arise such as:

• Disrupted sleep
• Poor appetite
• Bed- wetting

Trauma is such a wide term that it is impossible to provide a full list of effects or associated behaviours, but those mentioned above are some of the most commonly recorded.
Importantly, trauma in childhood may manifest itself in later years and has been linked to Post- traumatic Stress Disorder (PTSD), addiction, psychosis and a wide range of other mental health difficulties.

In addition to emotional consequences, childhood trauma can have long- term physical consequences. The Adverse Childhood Experiences (ACE) study included 17,000 individuals. They gathered information on the participant’s childhood, including any trauma, and compared it with their medical histories. Their results showed a link between chldhood trauma and chronic illness including heart disease. It also revealed a link with risk- taking behaviours.​

Trauma Treatment For Children

There are a wide variety of treatment options available for children and adolescents who have experienced trauma.  Unfortunately however, research has invested must more effort in exploring the effect of different therapies on adults, so in some cases we have limited scientific evidence for therapeutic interventions.

Cognitive behavioural therapy (CBT) is the most common treatment choice due to scientific backing and the fact that most mental health professionals have a level of competency in CBT. Although CBT was originally developed for adults there have been attempts to adapt it for younger populations.

Multi- modality trauma treatment (MMTT) is normally conducted in school settings and uses methods that are accessible for younger populations. These include relaxation techniques and writing about the experience. It may also include some sessions where the young person is taught how to manage negative emotions such as depression and anxiety.

Another type of CBT suitable for younger people is called Trauma-Focused Cognitive Behavioural Therapy or TF-CBT. This is designed for children aged 3-18 and can involve individual sessions or sessions with a caregiver, depending on age and requirements. This involves a similar to programme to MMTT except more of it is done on an individual basis. Children are encouraged to process the trauma and learn to cope with memories or reminders. Although first developed for children who had experienced childhood sexual abuse, TF-CBT has a proven success rate with other types of distressing events.

Conclusion

​If a child has experienced trauma it is very important to handle all paths towards treatment sensitively. Forcing a child into a therapeutic situation in which they are not comfortable can do more harm than good, and the child should not be asked to face their experiences too suddenly. It may take some time for the young person to explore their traumatic experience and patience and compassion are of the utmost importance along the way. 

If you are caring for a child who has experienced trauma it is important to seek out a registered specialist who will tailor treatment to the child’s needs. Most importantly, make sure the child receives the help they require as past experiences may resurface in later years. By seeking help at an early stage later mental health problems and long-term effects may be minimized.

By:  Dr. Syras Derksen
​       Registered Psychologist

References:
Dube, S. R., Anda, R. F., Felitti, V. J., Chapman, D. P., Williamson, D. F., & Giles, W. H. (2001). Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study. Jama, 286(24), 3089-3096.

NIMH. "Effects of Complex Trauma." National Child Traumatic Stress Network. National Institutes of Health, 01 Jan. 2016. Web. 19 May 2016.