Trauma describes an event that would be considered unusually distressful to most people. A traumatic event is more overwhelming than events that are normally expected to occur within a lifetime. Most traumatic events are life threatening. When children experience traumatic events, it is important that they obtain therapy to help process the occurrence. Without treatment, the effects of the trauma are likely to last far into their adulthood.
One-episode trauma differs from repeated trauma in the symptoms it engenders. Single-episode trauma results from an unexpected and sudden episode, such as a car crash or a hurricane. Repeated trauma occurs when a child is exposed to ongoing negative events, such as long-standing child abuse or life in a war zone.
The effects of a one-time trauma are diagnosed by psychiatrists as Type 1 Post Traumatic Stress Disorder, or PTSD Type 1. Children who have experienced a one-time trauma typically retain vivid intrusive memories of the event. The memories appear at any time, seemingly unprovoked, and they interfere with the child's daily life.
PTSD Type 1 usually comprises nightmares and a strong startle response. Children with the diagnosis can be hypervigilant, as if waiting for another trauma to occur. Their attempt to gain control over the event might lead to a fixation on concern as to why it happened to them, and how the event could have been avoided.
The feeling of lacking control can cause children to become depressed and empty. They can grow pessimistic about the future and express nihilistic thoughts. Some children also develop visual hallucinations after a single-event trauma, actually believing that they see threatening objects in their environment.
Children who are exposed to repeated trauma can develop PTSD Type 2 disorder. Chronic trauma is characteristic of life in a violent neighborhood or war zone. Children who are subjected to repeated sexual or physical abuse are also prone to PTSD Type 2.
PTSD Type 2 comprises many of the same symptoms as PTSD Type 1, with the addition of other troubling signs. Children with this disorder usually develop a constant sense of dread, anticipating another traumatic episode. Their feelings tend to be confused and poorly defined. Their moods can quickly switch from fearful, to sad, to angry. Many develop a sense of detachment, an out-of-body sensation, in order to cope with their extreme pain. Emotional numbness is typical of victims of repeated trauma.
Immediately following a trauma, children will usually have a brief period of denial and impassiveness. During this time, they will try to stop thinking about the traumatic experience. As the child tries to adapt to the new reality of the trauma and the associated loss, internal changes are likely to occur. Numbing of feelings is an effort to reduce the pain. Repeatedly thinking about the trauma can represent the child's effort to gain mastery or control over the experience. Dissociation, or psychically distancing oneself from one's environment, can deaden the pain, but can negatively affect a child's development. Developing a belief in signs and omens can help the child regain a sense of control, but will not help resolve ongoing grief.
Repeated abuse often produces anger and rage in children. The rage can be focused outwardly, manifesting in tantrums and violence, or inwardly, displayed as suicidal gestures or self-mutilation. Abuse victims might over-identify with the aggressor, assuming an aggressive and victimizing stance in relationships with other children. At the other end of the range, children who are exposed to repeated abuse might develop a passive posture, exposing themselves to further victimization and abuse.
Trauma irrevocably interferes with children's development. It breaks the senses of trust and invincibility that are implicit in childhood. Trauma can create a multitude of mental disorders, such as conduct disorder, depression, panic disorder and obsessive-compulsive disorder. As adults, victims of childhood trauma are likely to feel pessimistic, which negatively influences their careers and relationships. Child victims of trauma often develop into adults with violent behavior, substance abuse, self-mutilation and suicidal tendencies.
Families and educators of traumatized children should respond with early intervention. Giving support and understanding directly after the event can limit the effects of the trauma. Individual psychotherapy helps the child accept and move beyond the traumatic incident. Play therapy allows children to reenact the trauma in a safe environment, gaining a feeling of control over the occurrence. It also allows them a safe place to talk about their feelings. The goal is to have the child view the traumatic event as a matter of the past, lacking the ability to control his or her destiny.
In some circumstances, children with PTSD require psychotropic medication to mitigate the strength of their symptoms. Antidepressants and anti-anxiety medications might be prescribed by a psychiatrist.