What is trauma?

Trauma, a term borrowed from ancient Greek, was at first used in surgery to denote a violent injury from an external cause that breached the body's integrity. Traumatism is used occasionally as a synonym, and occasionally refers to any condition resulting from trauma. The term eventually made its way into common usage, in a psychological sense.

What are traumatic life experiences?

Almost everyone has been through a stressful event in his or her life. When the event, or series of events, causes a lot of stress it is called a traumatic event. Traumatic events may have an impact on people who have directly experienced these events or who may have seen the event either firsthand or on television. A person’s normal coping efforts are challenged if they experience trauma in their life. If the traumatic event is very severe i.e. death, injury or bloody scenes children are at a greater risk of developing psychological problems.

For children a traumatic event can be when they witness or experience sexual and physical abuse, loss of a loved one (parent or friend), animal bites, severe burns, natural disasters (e.g. floods, tornadoes, hurricanes, etc.) or medical procedures. Similarly witnessing or experiencing violent crimes either in media or in a real life situation (e.g., kidnapping and school shootings), suicide bombing, physical attack, rape, or murder of a parent or vehicle accidents such as car and plane crashes, can be very traumatic for children.

A stressful event is most likely to be traumatic if:

• It happened unexpectedly.
• The child was unprepared for it.
• The child felt powerless to prevent it.
• It happened persistently.
• It happened at an early age.

What are the typical trauma reactions in children?

Every child reacts differently and may not react the way their parents or caregivers expect. Sometimes, negative reactions continue weeks or even months after the event. There is a wide range of responses to catastrophic events. Some children and teenagers experience temporary worries and fears that are forgotten quickly. Others experience long-term problems such as fear, irritability, depression, withdrawal, anger, haunting memories, regressive behavior (acting younger than their actual age) etc.

Children who have had traumatic experiences may have difficulty in sleeping or are more likely to have nightmares. They may avoid activities, situations, thoughts, or conversations that may be related to the traumatic events. They may not want to be with people as much as before. They may avoid school, have trouble with schoolwork, or feel unable to pay attention. They may not want to play as much, avoid certain kinds of play, or lose interest in things they once enjoyed. They may be sad or seem to have less emotion or feel guilty about things they did or did not do related to the traumatic experience. Here is a list of some common reactions or symptoms that are exhibited in children who have undergone a traumatic event.

• Withdrawal – such as loss of interest in activities, loss of confidence, not wanting to talk or regressing to more ‘babyish’ ways of behaving.
• Preoccupation – need to relive the experience: for example, through repetitive play or drawings. The child may be overly concerned about the possibility of future such events or may have nightmares.
• Anxiety – such as problems with concentrating or paying attention, clingy behaviour, separation anxiety, sleep problems and irritable behaviour.
• Physical symptoms – such as headaches, stomach aches, stammering and bed wetting.
• Sleep problems – such as not wanting to go to bed at night or have difficulty going to sleep, staying asleep, staying in their own bed etc. 
• Behaviour change – such as becoming more clingy, demanding or difficult, or having temper tantrums.
• Changes in their relationships with siblings, such as becoming more competitive or aggressive.
• Deteriorating school performance – such as drop out, failure or repetition of grades.
  

What You Can Do for Your Child?

Most children and adolescents, if given support, will recover almost completely from the fear and anxiety caused by a traumatic experience within a few weeks. However, some children and adolescents need more help, perhaps over a longer period of time in order to heal. Grief over the loss of a loved one or experience related to trauma may take months to resolve, and may be reawakened by reminders such as media reports or the anniversary of a death etc.

Talk about the event

• The most important thing to do in such a situation is to listen to your child and to take their concerns and feelings seriously. Children may not be good at expressing their thoughts, so it’s important to pay attention to their behavior and whatever they are trying to communicate to you through their actions and attitudes.
• Let your child know that you would like to hear about how things are for them.
• Tell your child about what happened in a way that is appropriate to their level of understanding and without going into frightening and lurid detail. Use language they understand. If you keep information from them, they will fill in the blanks using their experience, available information and their imagination which may make them more frightened.
• Reassure your child that the event is over and they are safe (but only if this is the case). You may have to reassure them over and over again.
• Make sure your child hasn’t jumped to any wrong conclusions. For example, younger children may think that tragedies are their fault because they were naughty or thought bad things about someone.
• Talk about the event as a family. Allow everyone to have their say, including children. This helps everyone to overcome isolation, to understand each other and to feel supported and heard.
• Talk to your child about how people may react to distress. Tell them their feelings are normal in these circumstances and reassure them that they will gradually feel better.