When does an upsetting or stressful event become a traumatic one?
Some events can be upsetting or stressful for children and young people, which may lead to short-term changes in how they feel, think and behave. Usually after the event has finished, such reactions diminish and they return to how they felt, thought and behaved before the event(s). However, if someone istraumatised by an event, it overwhelms their ability to cope and their reactions seem to last well after the event has passed.
Common reactions in children are:
- Memories or pictures of the event unexpectedly popping into the mind
- Feeling as if it is actually happening again
- Repeatedly playing or drawing about the event
- Not wanting to think or talk about it
- Avoiding anything that might remind them of the event
- Getting angry or upset more easily
- Not being able to concentrate
- Not being able to sleep
- Being more jumpy and on the look-out for danger
- Being more clingy with parents, carers or other known adults
- Physical complaints, such as stomach aches or headaches
- Temporarily losing abilities (e.g. feeding and toileting)
- Problems at school
What can be done to help?
It is quite normal for such reactions to last weeks after an event, but according to the research evidence, there are things that can be done which are likely to help children and young people recover, following the events. The research evidence is summarised in the following academic article: Hobfoll et al. (2007). Five essential elements of immediate and mid–term mass trauma intervention: empirical evidence. Psychiatry, 70(4), 283-315.
Help them to feel safe and secure
Everyone feels safer when they know what to expect, but a traumatic event may make children and young people think that nothing is predictable any more. By returning to familiar routines (or introducing them, if they were never there), and continuing with normal activities where appropriate, adults can help children and young people to feel safer sooner.
Help them to feel connected and socially supported
Sometimes children and young people start to withdraw from their friends and family following traumatic events. This may add to their sense that the event has caused a significant and lasting change to their life, it may prevent them from talking about what happened and how it has affected them, it may deny them opportunities to feel happy, and it may make them feel isolated and alone. Try to provide opportunities for connecting with people they know and trust, and try to talk openly about how they are feeling.
Help them to feel calm
Some children and young people might need help to understand that their reactions are their body’s way of trying to deal with the overwhelming event(s). Letting them know that their reactions are understandable and not unnatural may help them. Some children and young people might need help to regain control of their feelings, to teach them how to control their breathing, or to imagine being in a place where they feel calmer and safer.
Help them to feel as if they have some control
The event(s) may make them feel as if life is not only unpredictable but also completely out of their control. This might make them feel even more scared. Gradually help them to feel more in control by giving them choices and helping them to make decisions.
Help children and young people to understand what happened
Sometimes parents and carers try to protect children and young people by avoiding talking about the event in case it will upset them or make things worse. Some people hope that, by keeping quiet, children and young people will forget about the event. In fact, children and people are likely to benefit from talking about what has happened, and they may need adult help to do this.
Children and young people need a truthful, age-appropriate explanation that makes sense of the main facts. Even younger children can benefit from being given a description and explanation of what happened. Without this, they may be confused and scared or, in their desperate search for understanding, they may end up creating an explanation based on their fantasy – which may be worse – rather than on reality. For example, some children may think that it was their fault. You can help to reduce this by being clear and open.
Thinking things through with the child or young person can also help them to realise that, although bad things can happen, they don’t happen so often that we need to be scared of them all the time.
Talking is often helpful, but needs to be done carefully and sensitively at the right time for the child or young person. Try and provide opportunities, support and encouragement to help them talk about it when they are ready to, rather than forcing them. Some children and young people may want to use toys or draw pictures to help them understand what has happened.
Encourage children and young people to ask questions, and try to answer them simply and honestly. They may need to ask the same question several times as a way of coming to terms with what has happened. If they do ask questions, they are probably ready to hear the answers.
When and where to seek more help
Many children feel upset for a few weeks after a frightening event. They may show this in the ways mentioned earlier, but, over time, most become happier and more confident again. However, some children will continue to have problems several weeks after the event. If you are worried because a child or young person is very distressed, or continues to be distressed after a month or so, you could seek help from your GP. They can check your child’s health and talk to you about who else could help.
If you’re interested in the latest research and support available for those with experience of trauma, you can listen to the Anna Freud National Centre for Children and Families’ podcast on the subject. Part of the Centre’s ‘Child in Mind’ series, the podcasts are freely available on iTunes and SoundCloud.
David Trickey currently works as a Consultant Clinical Psychologist in the Trauma and Maltreatment Service at the Anna Freud National Centre for Children and Families, London (AFNCCF) and Cambridge Clinical Psychology Services.