We’ve all faced some type of trauma in our lives. For some, it’s an isolated event that’s quickly forgotten. For others, however, certain traumatic events leave a lasting imprint on the brain and body, shaping how we grow socially and emotionally. Trauma is an event that is perceived as threatening and leaves a person feeling helpless or hopeless. Everyone experiences trauma differently, but children are especially vulnerable.
Over two-thirds of children report going through at least one traumatic event by age 16. In the U.S., at least 1 in 7 children experience abuse or neglect every year. Each day, 14 young people lose their lives to homicide, and more than 1,300 are treated for violence-related injuries. Trauma during childhood can make learning and succeeding in school much harder. It’s also linked to greater use of health and mental health services, higher involvement in the juvenile justice system, and long-term health issues such as heart disease or diabetes.
In the following sections, Brandon Printup, Clinical Director for Behavioral Health and Counseling Services at Bobby Dodd Institute (BDI), explores different types of trauma, how to recognize it, and how to support those who’ve experienced severe events in early childhood.
Types of Trauma
Big T trauma occurs suddenly. It is intense and leads to severe psychological distress. Big T trauma includes significant events like child abuse, major loss, or physical injury.
Little t trauma refers to smaller incidents, like a dental procedure or a minor fall. However, even something seemingly minor, like a dog bite, could become a Big T trauma, depending on the person.
Hidden trauma includes systemic issues like poverty, racism, or homophobia. Witnessing violence could fall into this category or, depending on the severity, into Big T or Little t trauma.
Let’s break it down further.
Acute trauma is a single, short-term event, such as a car accident. In contrast, chronic trauma stems from prolonged exposure to high-stress situations.
A third type, complex trauma, involves varied, multiple events, often interpersonal.
It’s important to distinguish between these types of traumas and Post-Traumatic Stress Disorder (PTSD). For example, while PTSD involves a life-threatening event, chronic or complex trauma might not meet that threshold but can still profoundly affect someone.
Development plays a crucial role in understanding trauma. Erik Erikson’s stages of development highlight how identity forms from childhood through adulthood. Key milestones occur during infancy, play age, school age, adolescence, and adulthood. Trauma can cause individuals to become “stuck” at a particular developmental stage.
I once worked with a 28-year-old client whose behavior mirrored that of a toddler. After assessing her trauma history, it became clear she was emotionally stuck at the developmental stage associated with the “terrible twos.” Addressing this, required creating a safe environment, showing empathy, and guiding her through the process of development.
When we consider developmental trauma, children in foster care often experience it most severely. Identity and coping mechanisms are formed between birth and eight years old. A traumatic event during this period can hinder development, leading to long-term challenges like dysfunction, a lack of trust, empathy deficits, and difficulties with interpersonal relationships. Children are incredibly resilient and often suppress memories of trauma, which can resurface through sensory triggers or other means as they grow older. Early therapy is crucial, even if no immediate issues are evident, to address suppressed memories and prevent future challenges. Safety and connection are key.
How Does Trauma Affect the Brain?
Brain scans clearly show differences between a “normal” brain and an “abused” brain. The normal brain shows stimulation and flow, while the abused brain may have underdeveloped or inactive areas, which can impact reasoning and processing. Brain mapping can be valuable because it helps identify areas that may need attention.
Trauma impacts key parts of the brain like the prefrontal cortex that regulates rational thinking, cognition, and emotional regulation, and the amygdala (ah-MIG-dah-la) that governs fear responses and emotional processing. The amygdala is your survival mechanism. It makes rationalization difficult, as it focuses more on emotional responses. The hippocampus, responsible for memory and past experiences, tries to make sense of trauma. When it starts to shrink, it can make you feel numb and disconnected.
This is an important aspect to understand because brain function heavily impacts trauma responses. Understanding these effects helps us approach trauma with compassion and equips us to better manage its impact on ourselves and others. When a traumatic event occurs, it reduces your ability to think rationally and makes you more impulsive. It almost presents as if you have Attention Deficit Hyperactivity Disorder (ADHD).
Recognizing Trauma
Symptoms of trauma can vary but often overlap with conditions like depression or ADHD.
The symptoms of Post-Traumatic Stress Disorder (PTSD) include flashbacks, hypervigilance, avoidance, nightmares, and re-experiencing phenomena. Traumatic Brain Injury (TBI) may present with symptoms like headaches, dizziness, vomiting, sensitivity to noise, and loss of vision. Interestingly, both PTSD and TBI share common symptoms like fatigue, depression, irritability, and anxiety. This is why it’s essential to work with a trauma-informed therapist who understands how trauma manifests.
From a social-emotional perspective, trauma impacts how individuals relate to others and manage social situations. For example, some highly analytical individuals may struggle with socialization because it feels illogical to them.
Physical symptoms of trauma in adulthood can include headaches, stomach issues, chronic pain, numbness, and eating disorders. Psychological effects include anxiety, depression, and mood disturbances. Misdiagnosis is common, with conditions like bipolar disorder, borderline personality disorder, or substance abuse often being overlooked or stigmatized.
Trauma can also have severe long-term health effects, including high blood pressure, coronary artery disease, increased risk of addiction, diabetes, and chronic fatigue. Anxiety-related responses may manifest as heartburn, ulcers, or irritable bowel syndrome.
The Adverse Childhood Experiences (ACE) study from 2009, which involved about 17,000 Kaiser Permanente members, reported that 64 percent had experienced one or more adverse childhood events, like abuse or neglect. The study also highlighted strong correlations between these adverse experiences and conditions like cardiovascular disease, diabetes, hepatitis, chronic lung disease, and depression. Furthermore, it explored life expectancy impacts, noting that individuals with six or more ACEs often died 20 years earlier than their counterparts—60.6 years compared to 79.1 years on average.
Trauma responses typically include fight, flight, freeze, and sometimes fawn. Fight can manifest as aggression, trouble concentrating, irritability, anger, hyperactivity, or agitation. Flight involves withdrawal, avoidance, isolation, or escapism. Freeze leads to numbing, zoning out, daydreaming, or over-compliance. Fawn is characterized by excessive conflict avoidance or hazy thinking during stressful events.
Understanding the profound impact of trauma helps identify the symptoms and provide the proper support and intervention.
Coping with Trauma
The first and most important step is to recognize the problem and find a good diagnostician to help you explore the best treatment options. Approaches will vary significantly from person to person.
For foster children with abandonment and trust issues who display aggressive or hoarding behaviors, attachment therapy is highly effective. These behaviors often stem from control issues due to past neglect or abuse. A certified attachment therapist can address this.
Play therapy, including sand tray work and therapeutic dolls, is excellent for non-verbal children. Certified play therapists are trained to help children express themselves and process trauma non-verbally.
To encourage children, especially teenagers, to engage in therapy, make sure they feel safe to open up. A nontraditional therapist who uses creative methods like therapeutic games can help build rapport. Straight talk therapy often doesn’t work initially. A skilled therapist who understands how to engage adolescents is crucial.
Establish clear boundaries, limits, and logical consequences for those who don’t obey norms. Behavior often stems from a need for control due to past experiences. Providing structured control within safe limits helps them develop autonomy while addressing their behavior constructively.
As we age, the methods of treating past trauma change. For cognitively functional seniors, for example, reminiscence therapy can help them process past trauma. However, if cognitive decline like dementia or Alzheimer’s is present, treatment often involves medication to manage aggression or anxiety tied to traumatic memories. It’s vital to work with gerontology specialists or skilled psychologists in elderly care.
My approach is to focus on behaviors rather than diagnoses. While diagnoses provide a baseline, guided by the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), I also consider other factors. It’s crucial to look at root causes, which is why working with someone trauma-informed and trained in trauma-focused CBT is so important. This approach isn’t one-size-fits-all; it’s part of a global perspective.
