By Erica Mott, LPC
Special Clinical Initiatives Coordinator at CCGC
At some point in time,
you’ve probably heard someone use the word “trauma” to describe a situation that wasn’t exactly serious:
“I was traumatized by my last trip to the DMV…”
or, “Changing that diaper was traumatic. I’ll have nightmares for the rest of my life!”
But we know this isn’t really what trauma is….. so what is it?
Run a web search on the definition of trauma, and the results even feel vague. Take Merriam-Webster’s definition, for example:
1: a : an injury (such as a wound)…
b : a disordered psychic or behavioral state resulting from severe mental or emotional stress or physical injury
c : an emotional upset
The American Psychological Association’s definition actually includes the word “rape.” Other articles at a glance mention natural disasters, or “terrible events.”
Maybe this vagueness about the term, and about discussing trauma, has to do with people’s reluctance to address the actual traumatic events. What is your reaction to topics like child physical or sexual abuse? Neglect, or domestic violence? What happens when the conversation turns to the sad stories that too many people share about betrayal or broken families? These things often create a deeper emotional reaction, and, honestly, make a lot of people uncomfortable. As a result, we use words like “trauma” to make a joke out of no-so-traumatic experiences—I’m not criticizing, I like comedic relief as much as the next person when I’m uncomfortable! The problem is, when people are uncomfortable, they usually also avoid the source of discomfort, and we might accidentally give trauma survivors the message that their stories, experiences, and heartbreak are too much for us to bear if they choose to share it with us. In the world of trauma and trauma treatment, we know that avoidance can lead to further “mental or emotional stress,” or sometimes, Post-traumatic Stress Disorder (PTSD).
So let’s have a conversation today
(even if you just listen to…err…read what I have to say) about trauma. What does it actually look like, and what can we do to make things better for people who are suffering?
The first thing I want to tell you is experiencing a genuinely traumatic event does not guarantee the person is going to have PTSD, though the two are most certainly connected.
PTSD is a diagnosis that is given when a person experiences four key changes to their behavior and/or thoughts:
- Intrusive thoughts: This is the same as thinking about or remembering the trauma frequently. For children, especially young children, this may look like frequent, uncontrollable statements about the trauma. They may even act out the things that have happened through their play. Flashbacks also fall into this category, although they are rare. Unlike a memory, the person experiencing the flashback feels as though he or she is REALLY back in time, and to them it feels as if the traumatic event is happening again. For some children, it can be difficult to tell if they are having a flashback or a hallucination, which further complicate matters.
- Avoidance: An avoidant child will not talk about their trauma (even though they can’t stop thinking about it), or they will refuse to go near certain reminders (people, places, things that remind them of what happened). They may try to stop thinking about it by doing stuff to make themselves stop—throw themselves into school work, activities, or unsafe behaviors. Young children may tantrum to let you know there is a reminder they want to avoid.
- Changes in Thinking and Mood: Both children and teens may start to view themselves more negatively. They may feel less hopeful that they’re destined for healthy, happy lives, or blame themselves for the trauma. Their moods may become more depressed. Though it might be tempting to think that teens in this state are just suffering from “teen angst”, for a trauma survivor this feeling may be much deeper.
- Changes in Alertness or Activity Level: The child or teen can’t relax, and seems restless. They’re irritable, have trouble sleeping, can be jumpy, and seem “on-alert.” They may have trouble concentrating.
PTSD has been observed in trauma survivors across the lifespan, even in infants (Learn more by visiting ZerotoThree.org or the National Center for PTSD through the US Department of Vetern Affairs) Most people are surprised to learn that young children may not just bounce back because they’re “so young they won’t remember.” Some teenagers may struggle more than others as well, and it can be difficult to accept that there are things that are impossible to just “get over.” There are a lot of things that can impact a child’s ability to overcome traumatic events, and sometimes more help, in the form of mental health treatment, is needed.
Mental Health Services and Trauma
Fortunately, the mental health field has made tremendous progress in treating traumatic stress. There are now numerous treatments for children, from early childhood through the teen years. These treatments are called “evidenced-based practices,” which means that after being tried many times (in a clinical setting), there is a lot of evidence that the model works well for treating traumatic stress.
If your child has experienced a traumatic event, he or she may benefit from one of the following types of treatment:
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): For youth ages 3 to 18, and addresses the physical, emotional, mental, and behavioral symptoms of trauma in a structured way. Families learn about trauma and how it can impact youth, and how to target specific trauma symptoms they are struggling with. Caregivers are a big part of treatment; they work with the therapist to become a “therapeutic-extension” in the home environment to support the youth’s recovery.
- Attachment, Regulation, and Competency (ARC): For youth ages birth through 18, and is beneficial for youth who have experienced long-term, or very early in life stress or trauma, and especially kids who have experience a change in who they live with or the family that they share connections with. ARC’s main focus is to restore the parent-child connection by helping them to learn to problem-solve and manage intense feelings.
- Modular Approach to Therapy for Children with Anxiety, Depression, Conduct, or Trauma (MATCH): Where TF-CBT and ARC are first and foremost trauma models, MATCH can help with other mental health problems that may have been going on before anything traumatic happened, or that may have started as a result of the trauma. In other ways, this kind of treatment can be similar to TF-CBT. The model is intended for use with children ages 6–15.
- Child and Family Traumatic Stress Intervention (CFTSI): Designed for children ages 7 and older (an version for children 3–6 is available), CFTSI is intended to provide treatment that can prevent the onset of PTSD. CFTSI can be used within 45 days of a disclosure of abuse. CFTSI provides education and screening to determine if additional, more intensive treatment is needed.
With the exception of CFTSI, most of these treatments take a several months to just over a year to complete, but consistency and hard work at home are very important! The satisfaction surveys of families exiting the programs tell us that most of our families feel relieved: their child is doing better, and they know what to do if the symptoms creep up again.
If these services are of interest to our readers, you can learn more about Evidence Based Practices by clicking here.
If your family or a family you know could benefit from receiving trauma services, please don’t hesitate to call CCGC today at 860-643-2101 or reach us via our contact page
To end our conversation, I’d like to turn the focus to you…
…the parent, grandparent, foster parent, kinship parent, or other caregiver working with the youth in treatment. Secondary trauma can occur when one hears, or learns of, a traumatic event that happens to someone they love. Additionally, many of the caregivers we work with have had their own traumatic experiences, and having a traumatized child can sometimes bring up “stuff” the caregiver thought they had already overcome. Do not hesitate to seek treatment for yourself. I’ve often heard caregivers say, “I need to make sure my child is okay before I get help.” The truth is, you will be much better able to help your child if you are okay.
Be safe, be well, and never be afraid to seek treatment for any child in need.