People casually talk about ‘being traumatised’ by missing their favourite television show or by misplacing their car keys. Although these events can be upsetting, the definition of trauma is much more than a minor upset or being distressed for a short period of time. People often think that trauma is an unexpected, horrific event that is relatively rare, affecting only a few unlucky individuals. However, many people are affected by trauma to some degree, at one time or another during their life.
A traumatic event is an incident that is so frightening it overwhelms a person’s ability to cope. Any coping skills a person may have had are weakened and they feel utterly helpless and hopeless. It is as if a person’s legs have been knocked from under them.
Traumatic events involve situations where a person’s life has been threatened or severe injury has occurred such as a car accident, a bad fall, a hospital operation, a natural disaster like a flood, fire or cyclone, or being the victim or witness of violence such as physical and sexual abuse. Trauma can be a one-off event as well as ongoing events.
The effects of trauma may be immediate or take some time to appear. Trauma that involves events between people, such as a child being abused by someone they know, is more likely to have a longer lasting effect than the result of events such as a flood or car accident.
Traumatic events overwhelm, challenge and question people’s expectations of their safety and how their world works.
Different types of trauma
One way to understand trauma is to break the events into different types:
Simple trauma is a single event that lasts a short time and involves a one-off crisis. Most simple traumas are unexpected and generally people in the community respond in a supportive and helpful way. The causes tend to come from impersonal events such as car accidents, house fires, cyclones and floods.
Complex trauma involves threats and violence between people. It generally involves a number of events and lasts longer than simple trauma. Often people who experience complex trauma feel unsupported, isolated and blamed, with a sense of shame and stigma. Examples of complex trauma include child abuse, bullying, family violence, rape, war and imprisonment.
Developmental trauma is when children are exposed to longstanding or repeated traumatic events. When this occurs it reduces the development of the ‘thinking part’ of a child’s brain and limits the way they can manage their feelings and behaviour, affecting a child’s ability to develop to their full potential. Developmental trauma includes incidents when children are neglected, abused or experience ongoing conflict between their parents and carers. The impact of complex trauma can lead to developmental trauma.
How to help children who have experienced trauma
There are a number of ways parents, carers and staff can respond to help children recover from a traumatic event.
Talk to children about the traumatic event
When a child brings up the traumatic event take their lead and enter into a discussion. If children pick up that the adults around them don’t feel comfortable about talking about events, they will be reluctant to bring it up. Children do not benefit from ‘not thinking about it’ or ‘putting it out of their minds’. In the long run this can make the child’s recovery more difficult.
It is important to keep sharing thoughts and feelings and to give children an opportunity to ask questions. It is also important for adults to be as honest and clear as possible about the traumatic event. Children who are not given details or explanations about traumatic events often make up stories in their head to try to understand what has happened. Use language young children can understand and give basic facts. Just as for adults, children often find the unknown is more frightening than the reality.
Some of the ways to talk with children about traumatic event include:
- calmly listening to a child’s repeated retellings of events
- letting a child express their feelings through play, such as physically re-enacting the trauma
- helping a child identify their feelings such as drawing the way they feel and naming these feelings.
Provide consistent and predictable routines
Changes to their routines and their environment can be frightening to children who have been traumatised. They are very sensitive to changes in routines, transitions, surprises, unstructured social situations and new situations. Letting children know about changes in routine in advance and why it is happening helps children manage their fears (eg a new person visiting the home, going to see the doctor).
Most children respond well to structured environments with clear goals, timelines and activities. Keeping familiar routines, having trusted people around, predictable routines and familiar places reduces unnecessary stress and helps children feel safe.
Some of the ways to do this are:
- Having regular routines around sleeping, eating, playtimes.
- Telling children about what is coming up next and give them details of what to expect.
- Being sensitive when moving from one task or place to another, such as ending playtime or getting ready for bed.
Tuning in and being responsive to children
Children who have experienced traumatic events often need help to tune into the way they are feeling. When parents, carers and staff take the time to listen, talk and play they may find children start to tell or show how they are feeling. Providing children with time and space lets them know you are available and care about them.
It takes time to understand how to respond to a child’s needs and there can often be ups and downs before parents, carers and staff work out the best ways to support a child. It is helpful to keep in mind a child’s behaviour may be a response to the traumatic event rather than just ‘naughty’ or ‘difficult’ behaviour. It is common for a child to temporarily go backwards in their behaviour or become ‘clingy’ and dependent. This is one of the ways children try to manage their experiences.
Some of the ways to do this are:
- Observing the behaviours and feelings of a child and the ways you have responded and what was most helpful in case of future difficulties.
- Creating a ‘relaxation’ space with familiar and comforting toys and objects children can use when they are having a difficult time.
- Having quiet time such as reading a story about feelings together.
- Trying different types of play that focus on expressing feelings (eg drawing, playing with playdough, dress-ups and physical games such as trampolines).
- Helping children understand their feelings by using reflecting statements (eg ‘you look sad/angry right now, I wonder if you need some help?’).
Managing your own reactions
It is important to acknowledge and manage the feelings that parents, carers and staff have when they are caring for children who have experienced traumatic events. Adults can become physically and emotionally worn out and may feel overwhelmed by the child’s trauma and their reactions to it. This can lead to a traumatic stress of their own, often called secondary trauma. The signs are similar to those caused by the direct experience of trauma, although less intense.
There are a number of ways for adults to reduce their own stress and maintain awareness so they continue to be effective when offering support to children who have experienced traumatic events.
Some of the ways to do this are:
- Taking time to calm yourself when you have a strong emotional response. This may mean walking away from a situation for a few minutes or handing over to another carer or staff member if possible.
- Planning ahead with a range of possibilities in case difficult situations occur.
- Remembering to find ways to look after yourself, even if it is hard to find time or you feel other things are more important. Taking time out helps adults be more available to children when they need support.
- Using supports available to you within your relationships (e.g., family, friends, colleagues).
- Identifying a supportive person to talk to about your experiences. This might be your family doctor or another health professional.
Living or working with traumatised children can be demanding - be aware of your own responses and seek support when you need it.