Trauma in Children and Adolescents

By Julie DeFalco, LCSW and Clinical Director of Child & Adolescent Services

One may ask, how can multiple children be in the same situation, even the same family, and one have trauma and one not? It’s not only the event but how the event was experienced that makes it traumatic. If a child feels unsafe for an extended period, or scared or hurt without having soothing or consolation, the event is experienced as a trauma. Two children who are each bit by a dog may have distinctly different experiences of that event. One child may have been taken care of by a parent or teacher immediately following and recognized the event was over and they were safe, thus adaptively processing the event. The other may have been alone with no one to quickly help them. The longer that child remains in a panicked or fearful state, the more likely the event gets “stuck” in the mind as raw emotional data and becomes a trauma.

A traumatic reaction in a child can sometimes look like misbehavior or, the opposite, ideal behavior. Our natural response to imminent danger is typically one of three things: fight, flight or freeze. Depending on where the child is on the fight-flight-freeze continuum, their behaviors will vary. Sometimes kids are brought in for therapy to work on behavioral concerns or anger management. These children may be in the fight response to trauma. A child with a flight response will commonly appear anxious or withdrawn. The freeze trauma response in kids can be easily overlooked, since this child may present as cooperative and quiet, even successful in various areas (e.g. school). These seemingly benign behaviors can be a sign of excessive people-pleasing as the child is trying to avoid any conflict that may create panic for them.

When helping a child or teen who has experienced trauma, we need to respect that these defenses (fight-flight-freeze) are normal protective responses to scary situations. Children must feel safe and secure to allow themselves to let down their defenses and work through the pain underneath. Offering reassurance that the situation was not the child’s fault can help deter the common reaction of self-blame. Parents and other adults can offer safety and security by providing nurturing and appropriate affection as well as structure and consistency. We can be available to listen without pressuring the child to talk in detail about the event. A helpful tool to use is the concept of a “remote control” for telling the story, so the child can pause, fast forward, etc. as desired. A wonderful resource for all parents is the book, The Whole-Brain Child by Daniel J. Siegel and Tina Payne Bryson. A qualified therapist can be another excellent resource.

Julie DeFalco MSW, LCSW

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