What is PTSD?
Not everyone who experiences trauma develops PTSD (Post Traumatic Stress Disorder) and not everyone who has been diagnosed with PTSD has seen something frightening. Trauma is basically defined as seeing, experiencing, or being aware of one or more events that overwhelm the person’s natural ability to cope. When we think of PTSD, we often think of war veterans, natural disasters, community violence, or accidents such as automobile wrecks. However, PTSD can manifest as a result of repeated exposure of seemingly “typical” experiences when viewed in isolation-for example, bullying or lack
of attentiveness from a caregiver when in distress. Childhood neglect or abuse can cause the development of PTSD and may only become problematic for the person as they age and engage in complex relationships with others. Many people recover from the initial acute stress symptoms after a traumatic event. However, some do not and their body and brain adapt to the frightening event by attempting to protect from further harm. The problem is that the brain begins to perceive harmless situations as potentially threatening and sends the person into protection mode (fight or flight response) when it is not necessary to do so. As you can imagine, this can cause difficulty in a person’s ability to function in any aspect of life, particularly relationships with themselves and others.
How is PTSD Different in Children?
When children experience trauma, their ability to recover is often largely dependent on securely attached relationships with caregivers. Children who are unable to protect themselves or are unprotected (or even abused) by those who are trusted to care for them, they may become overwhelmed by the physical and emotional experiences.
Even when their attachment figures work hard to keep children safe, scary and dangerous things still happen. Consider the effects of school shootings or the death of a parent. Complex trauma occurs when a child suffers multiple or persistent traumas that are often interpersonal and invasive in nature. When the child experiences symptoms that impact their daily lives, it might be time to seek help.
Trauma can affect a child of any age. Even trauma experienced as an infant can impact the child severely enough to manifest in various ways as the child grows. How a child’s symptoms present differs from child to child depending on experience, age, length of trauma, temperament, developmental level, and other factors.
Children can be reminded of the traumatic event (either consciously or subconsciously) by thoughts, feelings, sensations, sensory information, people, places, or anniversaries. Understanding the child’s response in context to the trauma and addressing the trauma is important in ongoing adjustment and healing.
Often children are misdiagnosed with mental disorders such as Attention Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder, and Oppositional Defiant Disorder when trauma may be the more appropriate explanation. When this happens, the child may be labeled as “defiant”, “difficult”, or “hyperactive”. Children with trauma are often misunderstood and unnecessarily medicated. The National Child Traumatic Stress
Network is an excellent resource on child trauma. You can learn more on their website here.
PTSD is the most widely diagnosed mental illness for children who have experienced trauma. However, oddly enough, most children with trauma do not actually meet the diagnosis criteria. There simply isn’t a diagnosis that matches the complex emotional, physical, psychological, and developmental picture that frequently presents as a result and cause of trauma. According to one of the leaders in the field of child trauma, Bessel van der Kolk, MD, “Because children’s brains are still developing, trauma has a much more pervasive and long-range influence on their self-concept, on their sense of the world and on their ability to regulate themselves” (find source here). Children often experience trauma in the context of relationships, which is often the case in childhood abuse and neglect. These traumas change the neurochemistry of brain, resulting in developmental impairment.
A group of the world’s leading researchers in child trauma is now proposing a diagnosis called “developmental trauma disorder”, or DTD, to more clearly define what children experience and how they experience it. A diagnosis that encompasses the experiences of traumatized children drives treatment that is more appropriate and sensitive to the attachment, play, physical, and social-emotional needs of children.
For adults, a variety of treatments have proved effective for the treatment of trauma. These therapies include exposure therapy, cognitive therapy/psychotherapy, and Eye Movement Desensitization and Reprocessing (EMDR), often in conjunction with body oriented therapies such as yoga, mindfulness, and meditation.
I am trained to provide Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and EMDR and often incorporate aspects of body-mind work and exposure therapy as adjuncts. I believe the body and mind are inter-connected and both must be honored as part of the healing process. Part of treating trauma is connecting the body and the mind (which often become disconnected with trauma) and becoming the “commander of your ship”, so to speak. You will learn that you can regain control over your body’s responses and retrain your brain to respond in a new way to old stimuli. To discover more about how I use EMDR to treat trauma, click here.
For children, EMDR can be combined with a relationship/attachment based
dyadic method of treatment to utilize the power of corrective relationships in healing trauma. I am trained as a Child Parent Psychotherapist, an evidenced based therapy for the treatment of trauma for children birth to five years and their caregivers. I primarily use this type of therapy when working with children with complex trauma, including children in foster care, when a stable, healthy and nurturing caregiver is available. To find more information on Child Parent Psychotherapy for you and your child, click here.