Trauma Therapy

Children and adolescents who have been traumatized can develop an intense fear regarding any reminders of the traumatic event. This fear may encourage the child to avoid any traumatic reminders and may not want to talk about what occurred. The child may become more isolated, not express his or her feelings or thoughts, and feel emotional numbing and tension.

Exhibiting one or several of these symptoms or behaviors places the child at risk of having problems at school, of isolating themselves from others, of having conflicts or lack of communication with parents and peers. These symptoms or behaviors, if left untreated, may impede the child’s normal course of development.

This stressful state can cause the child to develop symptoms such as:

A large and growing body of research indicates that toxic stress during childhood can harm the most basic levels of the nervous, endocrine, and immune systems. Changes to the brain from toxic stress can affect such things as attention, impulsive behavior, decision-making, learning, emotion, and response to stress. Children growing up under these conditions often struggle to learn and complete schooling. They are at increased risk of becoming involved in crime and violence, using alcohol or drugs, and engaging in early sexual activity, unprotected sex and suicide attempts. They are susceptible to disease, illness, and mental health challenges over their lifetime. Children growing up with toxic stress may have difficulty forming healthy and stable relationships. They may also have unstable work histories as adults and struggle with finances, family, jobs, and depression throughout life—the effects of which can be passed on to their own children.

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is an effective evidenced-based treatment for trauma. TF-CBT can help parents recognize and respond appropriately to their child’s trauma responses, while setting appropriate behavioral limits and rebuild trust and safety.

Life is full of stressful changes. Some stressful experiences can be good, such as the birth of a child, some bad, such as financial difficulties. In our everyday language we use the word trauma for many types of stressful experiences. However, traumatic experiences are unique because they specifically threaten us with serious physical injury or death. Common examples include car accidents, rape, assaults, war, fires or natural disasters. Often, traumas caused by people (e.g., violent crime) have additional psychological challenges as compared to natural disasters (e.g., floods or earthquakes). Individuals who witness such dangerous situations or their immediate aftermath may also experience traumatic reactions.

Trauma reactions commonly last for several weeks or months before people start to feel normal again. The majority of individuals report that they feel better within the first three months. On-going exposure to a threatening experience may produce more prolonged stress because of the continual reminders that the threat of danger is not over.

Life-threatening situations will produce a variety of intense and unusual stress reactions in our emotions, thoughts and actions. The most common symptoms of trauma fall into three broad areas: re-experiencing, avoidance and hyperarousal. Other emotions such as guilt, anger, and depression can also commonly occur following a trauma.

Re-experiencing: repetitive, vivid, and intrusive thoughts, images, memories, and sensations about the trauma and its consequences are hallmark symptoms and can create tremendous anxiety. Traumatic images or thoughts may intrude during the day as “flashbacks” or during sleep as nightmares. Other typical thoughts may include: believing you are in danger; believing that you should foresee and control these dangers; believing that you should have somehow been able to do more to stop the event from happening, and that your personality and future are permanently damaged.

Hyperarousal: difficulty falling or staying asleep, irritability or outbursts of anger, difficulty concentrating, being hypervigilant, a general inability to unwind and becoming easily startled are common physical symptoms of anxiety that may occur following a trauma. Panic attacks, racing heart and appetite disturbances are also common.

Avoidance: not wanting to be around reminders of the trauma. This may include avoiding some of the people, places and things that remind you of the event or were present at the time, but it can also include avoiding certain conversations, thoughts and feelings. Emotional numbing and a diminished ability to experience pleasure are typical. Some people may forget important aspects of the trauma, report being unable to have loving feelings toward others and may have less interest in carrying on with their daily lives. People may withdraw socially, begin to feel alienated and mistrustful of others and report an increase in conflicts with others. Avoidance can also take the form of strange, almost dream-like, experiences called depersonalization and derealization. You might feel unreal or disconnected from your surroundings, nearby people or your own body. Alcohol and/or other substances are another method often used to avoid traumatic feelings and memories through “self-medicating.”

When symptoms are severe enough during the first month to impair social or occupational functioning, Acute Stress Disorder (ASD) may be diagnosed. If these more immediate and disruptive patterns last beyond one month, the syndrome is called Post-Traumatic Stress Disorder (PTSD). Approximately half of those who have post-traumatic symptoms will recover within 3 months. The likelihood that you will continue to experience these symptoms beyond three months depends upon a variety of factors. For example, direct exposure to the traumatic event, the seriousness of the threat to life, amount of times trauma was experienced, a history of past trauma, psychological difficulties prior to trauma are all factors that may increase the likelihood that your symptoms will not go away on their own with time.

Cognitive Behavioral Therapy and Dialectical Behavior Therapy are evidenced-based treatments for trauma. These treatments generally aim to help people see themselves and their worlds more adaptively by modifying the distorted or unhelpful ways of thinking that have been linked to problems in emotion. The therapist helps the client view the trauma and their reactions to it in ways that are more helpful and balanced. Therapy also helps to create new relaxation behaviors and encourage a sense of empowerment, self-worth, and strength.