It Won't Hurt Forever: Guiding Your Child Through Trauma

By Peter A. Levine and Maggie Kline
Issue 110 January/February 2002

Lisa cries hysterically every time the family prepares to get into the car.

Carlos, a painfully shy 15 year old, is chronically truant. "I don't want to feel scared all the time anymore," he says. "All I want is to feel normal."

Sarah reports dutifully to her second grade class on time every morning; invariably, by 11:00 a.m. she is in the nurse's office complaining of a stomachache, although no medical reason can be found for her symptoms.

Curtis, a popular, good-natured middle school student, tells his mother that he feels like kicking someone. He has no idea where this urge is coming from. Two weeks later he starts behaving aggressively toward his little brother.

The parents of three-year-old Kevin are concerned about his "autistic-like" play. He repeatedly lies on the floor, and stiffens his body, pretending he is dying and slowly coming back to life, saying, "Save me!"

What do these children have in common? Will their symptoms disappear on their own, or will they grow worse over time? Let's take a deeper look at their individual histories.

Lisa was strapped into her carseat when the family's station wagon was rear-ended. There were no physical injuries.

Carlos was intimidated for five years by an emotionally disturbed adult stepbrother.

During her first month of second grade, Sarah was told, abruptly and unexpectedly, that her parents were getting divorced and her father would be moving out.

While waiting for the school bus one morning, Curtis witnessed a drive-by shooting that left the victim dead on the sidewalk.

Kevin was delivered by emergency cesarean and had a lifesaving surgery within 24 hours of his birth.

Each of these youngsters has experienced an overwhelming life event, and, although the incident is over, each continues to experience life as if the event is still happening. These children are suffering from traumatic stress that has not gone away on its own.

Traumatic reactions can develop in anyone regardless of age. Those at greatest risk, however, are infants and children. Childhood abuse and neglect, the witnessing of violence, war, or auto accidents, and natural disasters such as earthquakes, tornadoes, fires, and floods are now being recognized as potentially traumatic. It is not surprising that witnessing a murder has affected Curtis, but symptoms can also have roots in what are generally considered more common occurrences, such as fender benders, invasive medical procedures, divorce, chronic bullying, and even falling off a bicycle. (See sidebar, "Common Causes of Childhood Trauma.")

It is important to note that events that may not be traumatizing to an adult may be overwhelming to a child. The good news is that, while the events themselves may be an inevitable part of growing up, traumatic symptoms are frequently preventable or can often be healed.

What Is Trauma?
The basis of trauma is physiological rather than psychological. Because there is no time to think when facing threat, our primary responses are instinctual. At the root of a traumatic reaction, is the 280-million-year heritage that we share with nearly every living creature on earth and that resides in what is known as the reptilian brain. When this primitive part of the brain perceives danger, it automatically activates an extraordinary amount of energy--like the adrenaline rush that allows a mother to lift a Chevrolet her child is trapped under. This, in turn, triggers a pounding heart and numerous other physical changes designed to help us defend ourselves or protect our loved ones.

The catch is that to avoid being traumatized all of that excess energy must be used up in dealing with the threat. When the energy is not discharged, it does not simply go away; instead, it stays trapped, creating the potential for traumatic symptoms. The younger the child, the fewer resources she has to protect herself, resulting in a greater amount of undischarged energy. The likelihood of future traumatic reactions is directly proportional to the amount of mobilized energy that was available to fight or flee.

Jack
Jack, an 11-year-old Boy Scout and straight-A student, had sudden-onset school phobia following a minor earthquake-actually a minor tremor by California standards. What made Jack's experience so traumatic? When he first felt the tremor, he was unable to predict the accurate level of danger; the only thing that registered in his reptilian brain was the "red flag" of threat. His nervous system responded to the perceived danger with full alert, and he continued to feel panicky well after the event.