Understanding Childhood Trauma
Trauma is a term defined as an emotional wound or shock that creates substantial, lasting damage to an individual’s psychological development, often leading to neurosis.
All children experience some stressful events. Early childhood trauma generally refers to traumatic experiences that happen to children aged 0-6. Since infants and young children may react differently than older children, and may not be able to verbalize their reactions to threatening or dangerous events, there is an assumption that young age protects children from the impact of traumatic experiences. However, young children are affected by traumatic events, even though they may not understand what has occurred.
Current research suggests that young children, and even infants, may be affected by events that threaten their safety or the safety of their parents/caregivers, and their symptoms have been well documented. These traumas can result from intentional violence—such as child physical or sexual abuse – domestic violence, natural disaster, accidents, or war. Young children also may experience traumatic stress in response to painful medical procedures or the sudden loss of a parent/caregiver.
Trauma for an adoptee begins at the moment of separation from a birthmother. Whether adopted from birth or later in life, all adopted children have experienced some degree of trauma. Until recently, the full impact of trauma on adopted children has not been fully understood. Since infants do not see themselves as a separate entity, it is believed they see themselves as part of the person they physically attached and bonded to for 40 weeks. When separated, infants may naturally feel they have lost part of themselves. When an adoptee is separated from a birthmother, extensive trauma is experienced. The trauma will not be remembered, but it will stay in the subconscious as it was lived. Any event from infancy can and will stay with an individual through life.
Traumatic events have a profound sensory impact on young children. Since they are less able to anticipate danger or know how to keep themselves safe, young children are more vulnerable to the effects of exposure to trauma. For example, when young children witness traumatic events, they may blame themselves or their parents for not preventing it or for not being able to change its outcome. These misconceptions of reality compound the negative impact of traumatic effects on children's development.
In today’s society, a significant number of children are exposed to traumatic life events before age 16. For example, in the US, estimated rates of witnessing community violence range from 39% to 85%, estimated rates of victimization up to 66%, and exposure to sexual abuse estimated range between 25% to 43%. Rates of children’s exposure to disasters are lower than for other traumatic events, but when disasters strike, large proportions of young people are affected, with rates varying by region and type of disaster. Children and adolescents have likely comprised a substantial proportion of the nearly 2.5 billion people affected worldwide by disasters in the past decade.
Race and ethnicity, poverty status, and gender also affect children’s risk of exposure to trauma. For example, significantly more boys than girls are exposed to traumatic events in the context of community violence, and serious injury disproportionately affects boys, children living in poverty, and Native youths.
Symptoms and behaviours of childhood trauma
As with older children, young children experience both behavioral and physiological symptoms associated with trauma. Unlike older children, young children cannot express their feelings in words, but their behaviors provide important clues about how they are affected.
Children aged 3-6:
Many of the reactions displayed by children and adolescents who have been exposed to traumatic events are similar or identical to behaviors that mental health professionals see on a daily basis in their practice.
Functioning in the family, peer group, or school may also be affected as a result of these symptoms. Therefore, when working with children who show these types of reactions, a careful assessment of possible exposure to trauma must be conducted.
There are two basic types of psychological trauma: one-episode or single-blow psychic trauma, which results from a single, sudden, and unexpected event such as a rape, a bad car accident, or a devastating tornado; and repeated trauma, which develops from long-term, repeated events, such as sexual or physical abuse. Each type has characteristic signs.
One-episode trauma or single-blow trauma
Also called Type I post-traumatic stress disorder (PTSD), produces a number of characteristic symptoms that include:
Also called Type II PTSD is trauma that is repeated and occurs in children who have been abused often and for a long time. Chronic trauma is also common in children who have been reared in violent neighborhoods or war zones. Increasingly it is found in children who witness violence in the home or in their communities.
Many of the same symptoms that accompany Type I or single-episode trauma occur, as well as additional ones with Type-II. Since the trauma is repeated or prolonged, a child will develop a sickening anticipation and dread of another episode. After being repeatedly brutalized, children may have a confusing combination of feelings, at times angry and sad, at others fearful. These children often appear detached and seem to have no feelings. This emotional numbness is a hallmark of this type of trauma.
Identifying the Signs
Immediately following any kind of traumatic event, children commonly experience brief and usually limited denial and emotional numbness. They will often try to stop thinking about the traumatic experience. Children who suffer through repeated traumatic horrors develop and use a variety of psychological mechanisms to cope. They include:
Other signs common to children who suffer post-traumatic stress disorder include:
Theoretically, adopted children have experienced being unwanted before they were born. In addition, they may have experienced the loss of the mutual and deeply satisfying mother-infant bond. This experience can affect them in more than one-way, including:
Tragically, trauma destroys the natural sense of invincibility and trust basic to normal childhood. This ruins the children’s confidence about the future and can lead to limited expectations. Childhood trauma darkens the child’s vision of the future as well as attitudes about people.
Managing childhood trauma
Over time, most children show resilience in the aftermath of traumatic experiences. This is especially true of single-incident exposure. Children who have been exposed to multiple traumas, have a past history of anxiety problems, or have experienced family adversity are at higher risk posttraumatic stress disorder (PTSD). Despite exposure to traumatic events and experiencing short-term distress, most children and adolescents recover or return to their previous levels of functioning after several weeks or months and resume normal development. This resilience typically results in a reduction in both psychological distress and physiological arousal.
Early intervention in childhood psychological trauma is critical. Families that offer support, understand, and provide a sense of safety as close to the time of the traumatic event as possible can effectively limit the effects of trauma on children. Your child’s doctor may also recommend consulting a child and adolescent psychiatrist or other mental health professionals for evaluation and treatment.
Therapy that allows children to talk about the trauma or integrate it into play may help in moving beyond the pain to better cope.
Play therapy - Psychotherapy in which children are encouraged to use actions and play materials to express emotions, thoughts, and fantasies – allows younger children to reenact the traumatic event in a safe environment, moving gradually to verbal expression. For example, drawing the scene of the event may help children start talking about the trauma.
Therapy may make it easier for children to describe their feelings. In time, they may be able to understand their symptoms, behavior, and characteristic ways of dealing with the trauma. Furthermore, talk and play eventually give children the opportunity to look at the traumatic event in context and to gain perspective. Gradually, children are helped to see the event as an encapsulated experience, a personal tragedy that occurred at a moment in time, rather than as a fate that determines and controls the rest of her life.
Occasionally, medication is prescribed to treat symptoms of post-traumatic or acute stress disorder. Among the medications that might be prescribed are anti-depressants such as imipramine (Tofranil), and nortriptyline (Pamelor), and anxiety-reducing agents like clonazepam (Klonopin) or lorazepam (Ativan).
Mental health professionals have an important role in facilitating the recovery of children, adolescents, and families when traumatic events occur. For instance, they can provide consultation to other professionals (in schools, health care settings, spiritual settings, and other service systems) about responding to trauma-exposed children, adolescents, and families. Mental health professionals can also support the whole family, provide education about trauma reactions and hope for full recovery, advocate for trauma-focused treatment for those who do not make a full recovery.
Trauma for an adopted child is very common. They have already been removed from at least one caregiver, and maybe several others before they enter their adoptive families. While some children have suffered a traumatic family situation prior to being adopted, the process of adoption in itself is enough change, stress and turmoil for anyone, especially a child. How you handle this delicate situation as a parent, will contribute to their mental and emotional development.
Before any potential adoptive parent thinks about adopting an older child, domestic or international, you must remember that a child is not a purchased object, nor a financial investment. The responsibility will likely be the most difficult one you have ever have in your life. If you have not carefully done your research, and established much support from friends, family, health services, and the community, then it is best to consider other options.
There are many methods and support tools to help build foundation of love and stability for childhood trauma. Talk to your child’s doctor about finding supports and resources in your area or community or work with a family specialist to build a healthy platform for your child’s development
Helpful links or resources for childhood trauma
Center on the Developing Child - http://developingchild.harvard.edu/
Child Witness to Violence, Boston Medical Centre - http://www.childwitnesstoviolence.org/
Twenty Things Adopted Kids Wish Their Parents Knew - http://www.amazon.ca/Twenty-Things-Adopted-Adoptive-Parents/dp/044050838X
Cope with Life Article - http://www.copewithlife.ca/adoption/trauma-for-the-adopted-child/
The Post Institute - http://www.postinstitute.com
National Child Traumatic Stress Network - http://www.nctsn.org/trauma-types
American Psychological Association -http://www.apa.org/pi/families/resources/children-trauma-update.aspx
Starr Training - https://www.starr.org/training/tlc
Center on Trauma and Children - http://www.uky.edu/CTAC/