Understanding Trauma: What You Can Do to Help Children


We say that a person has experienced or witnessed a trauma when they have been exposed to an unexpected event that seriously threatened, injured, or killed someone.  (American Psychiatric Association, 2013).  A traumatic event can evoke feelings of helplessness, horror, and fear in children and teens. 

Understanding how these elements affect us is our first step, so let’s begin with helplessness.  Trauma victims need to regain control; empowering them is one of our first goals.  For example, pediatric nurses offer young patients choices whenever possible: “You can look or close your eyes.”  “You can keep your stuffed animal with you, if you want.” 

Fear is a natural reaction to the shock one experiences during a trauma.  Again, each person will respond according to experiences, age, cognitive abilities, and emotional maturity.  It’s important to remember that the experience of trauma is individual; what may terrify one child may be manageable for another.  These disparities often confuse parents attempting to console siblings whose behavioral and emotional reactions require different supports.

Typical Responses to Trauma

Those who experience trauma usually have one or more emotional, physical, behavioral, or cognitive reactions.  These reactions echo the essential elements of the traumatic experience, as you can see below.  In our work, we often see the behaviors listed below as youth attempt to manage or cope with shock, helplessness, and fear.

Shock

  • Upset with changes in routine
  • Wanting more frequent communications with others; seeking news updates
  • Asking questions repeatedly to get information about what is about to happen
  • Dependent on routines at school, work, and at home
  • Moodiness
  • Anger
  • Absentmindedness, inability to concentrate

Helplessness

  • Need to control what happens
  • Irritable when not given choices or power in decisions
  • “Bossy” with family and friends
  • Critical of others; judgmental; argumentative
  • Stubborn; insistent on having own way
  • Inflexible; narrowed focus on self
  • Showing off, overly confident
  • Risk-taking behaviors

Fear

  • Poor appetite; nervous eating
  • Frightened by: darkness, monsters, strangers, “bad guys,” reminders of the event
  • Using alcohol and other drugs to calm one’s fears
  • Anxious when separated from parents or caregivers
  • Sleep disturbance
  • Fearful of going to school or work
  • Concerned about own health and that of loved ones
  • Nervous; hypervigilant (easily startled)
  • Less willing to try unpredictable social situations or new experiences, including academic assignments and tests, sports competitions, public performances
  • Demanding reassurance and attention

Other typical signs of stress include general anxiety, guilt, withdrawal from others, and not wanting to engage in favorite activities (known as anhedonia).

Mental health specialists describe two stress-related disorders: Acute Stress Disorder and Post-Traumatic Stress Disorder, or PTSD (American Psychiatric Association, Diagnostic and Statistical Manual-V, 2013).  While it is helpful to have a general understanding of these two disorders, one should not “medicalize” a person’s reactions to stress, unless their reaction is impairing their daily life.  This could make them feel that something is wrong with them, or that they have somehow failed.  On the other hand, acknowledging stress reactions is helpful to trauma victims, who often respond, “Oh, so I am not the only one who feels this way.  That makes me feel better.” 

Stress is a part of the human condition.  Heightened stress reactions are normal among those who have just experienced or witnessed a horrible and sudden event that left them feeling helpless and fearful.  While a few individuals will require specialized help when symptoms do not diminish over time, most find great comfort and strength in those friends and family members closest to them. Short handouts for parents and community caregivers are available free at www.projectreassure.pitt.edu.


Mary Margaret Kerr, Professor of Psychology in Education, and Professor of Psychiatry at the University of Pittsburgh, has lectured extensively on crisis response and is the author of School Crisis Prevention and Intervention now in its second edition. Today, Kerr and her team work closely with two 9/11 memorials and have published innovative research on children’s experiences when they visit or live near sites commemorating mass trauma. 


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