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Coping with Trauma, Carefully

Ways to assist children’s healing

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Coping with Trauma, Carefully

Parents will do anything to keep their kids safe. Unfortunately, traumatic events can still happen. With proper supports, parents can help their children process, cope, and heal. The National Child Trauma Stress Network defines a traumatic event as the experience of a frightening, dangerous, or violent situation that poses a threat to a child’s life or their bodily integrity. Witnessing a traumatic event that threatens the life or security of a loved one can also be traumatic. Even infants and toddlers can experience traumatic stress. Reactions to trauma in kids can be wide ranging. “In most cases, it is the body and mind’s normal reaction to a very abnormal experience,” says Lindsay Woods, director of clinical services in the Multidisciplinary Assessment and Consultation Centre with the Winnipeg-based New Directions for Children, Youth, Adults and Families. “So parents may see some, many, or few symptoms of traumatic reactions after an incident or experience. Some of the symptoms may reflect adaptive attempts to cope,” says Woods. In responding to trauma, the body releases cortisol, explains Lise Milne, assistant professor in the Faculty of Social Work at the University of Regina. “Children are especially vulnerable to repeated, prolonged stress activation, as their brains and other organs in their bodies are in a critical and sensitive period of development. “This increases the risk for stress-related disease and even cognitive impairments. Though brain development occurs in utero into early adulthood, its most rapid, malleable, and vulnerable phase is in early childhood,” says Milne. As a result, exposure to traumatic events during this period can lead to changes in the brain’s architecture, which can have cascading effects from the brainstem to the prefrontal cortex of the brain, impacting our health in multiple spheres from early childhood to later life. “Fortunately, many children who experience traumatic events develop coping strategies or have supports that help to reduce the reactions,” Milne says. “For others, the effects can be long lasting.”

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The impacts of trauma

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.”

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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.’”

Starting a conversation

Woods suggests using phrases such as

  • “Whenever you are ready, I am here.”
  • “I hope you can share your feelings with me.”
  • “I notice that your body is all tensed up; are you feeling scared?”

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.

Healthy lifestyle habits to help heal

“Encouraging kids to take part in activities that help them find meaning, belonging, a sense of mastery and independence, and generosity can be helpful,” says Woods, “as can building on strengths and developing new skills.”

Examples of such activities include sports, arts, culture, community, volunteering, nature, and physical activity. “Creating routines in life can be helpful to increase a sense of safety and predictability.”

Responses to trauma-impacted children should be focused on safety and building resilience, says Milne, rather than on pathologizing their trauma-related reactions.

Benefits of breathing and meditation for kids

One of the fastest ways to deactivate stress and activate the body’s relaxation response is to help children regulate their breathing.

Rhythmic hand breathing together 

Turn one palm up to the sky, arm bent at the elbow. Guide the child to take a deep breath in as they raise their hand upward, then breathe out as they lower their arm back down, palm down.

Five-finger breathing 

Have your child spread out their fingers on one hand. Using their other index finger, have them touch the top of their thumb as they inhale. On the exhalation, move the pointer finger between the thumb and first finger. Inhale as they move to the top of the index finger; exhale to touch the space between that and the third finger, and so on. Do five deep breaths or more together.

The importance of processing trauma

When childhood trauma goes untreated, impacts can be long term. A 2020 study found that people with untreated childhood trauma had greater glucocorticoid resistance, which is associated with depression. The findings suggest that a lack of treatment for trauma could contribute to the development of depression.

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