Coping with Trauma, Carefully

Physical 

Though most trauma impacts are psychological and emotional, they often present first as physical symptoms, Milne says. Children may experience stomach and digestive problems, bladder control problems, heart-pounding sensations, and headaches, among other symptoms.

Mental 

Mentally, trauma can manifest as avoidance, flashbacks, nightmares, a perception that the world is unsafe, anxiety (including worries about the health and safety of self and others), memory loss, difficulty concentrating, and preoccupation with death and dying, Woods says.

Emotional 

Trauma can manifest emotionally, Woods notes, as anger, terror, helplessness, sadness, guilt (“it’s my fault”), shame, loss of interest in activities, and potential suicidal feelings and actions.

Behavioural 

Common behavioural responses to traumatic events include the survival tactics of fight, flight, freeze, or appease/fawn, Milne says.

“In order to regain some of the control they lost during the traumatic event, children can sometimes engage in unhealthy behaviours that distract or numb them, such as self-harm, aggression, isolation, or substance use,” Milne says. “They may dissociate—‘zone out’—from the current situation, which can be frustrating for caregivers who do not understand that this is the body’s way of adapting to what feels like an overwhelming situation they cannot otherwise control.”

Ways to encourage open communication

Traditionally, many interventions have relied on talk therapy, such as trauma-focused cognitive behavioural therapy. “However, younger children … can be provided with other avenues such as activities and therapies based in play, arts, music, and nature; mindfulness activities such as deep breathing, yoga, and meditation; and animal-assisted interventions,” Milne says.

It’s important to find a good balance between allowing children to share how they’re feeling, while not putting too much pressure on them to talk about it often or in great detail. “This lets kids know that their parents/caregivers are understanding or trying to understand,” Woods says.

“Approach with compassion and empathy,” she says. “Reduce words or phrases that could indicate their reactions to trauma are wrong, such as ‘It’s not that big of a deal’ or ‘Get over it.’”

Woods points to Dr. Dan Siegel’s strategy of “name it to tame it” as useful. “By naming our emotions, we can start to understand and learn from them,” Woods says. “This can be a helpful strategy for children who are very dysregulated and cannot express why.”

To communicate effectively, kids may need help modulating their emotional state, and parents or caregivers must be able to do this for themselves by remaining calm and centred, Milne notes.

“Children and youth need to feel empowered to make choices and to offer their own narratives, since they did not feel they had a choice or way to express themselves during the traumatic event,” Milne says.

“Most important is how a caregiver reacts to a child who has shared their trauma; in fact, a supporting, believing, and protective reaction is the best predictor of how well a child will be able to heal from trauma, and whether they would share again if they ever experienced another traumatic event.

“It is important to know that, with appropriate support from caregivers and professionals, most children recover from trauma with time, show minimal distress, and function effectively across major life areas and developmental stages,” Milne says.