The Effects of Trauma on Children: Part 1 ~ The Origin and Types of Childhood Traumas
The kinds of experiences and conditions that can seriously hurt children are legion. For purposes of review here they are classified into three groups:
- Family Pathology
This category includes assault, robbery, rape, incest, and serious accidents. Because incest, unlike the others, tends to be a long-term problem and a manifestation of serious family pathology, it could also be considered under the section on family pathology. Bard and Sangrey (1979), identified three stages through which victims of crime tend to pass: Impact, Recoil, and Reorganization.
Victimization experiences tend to be of high intensity and short duration. Consequently, the first stage of reaction includes emotional shock symptoms such as numbness and feelings of vulnerability, helplessness, sleep disturbances and loss of appetite. The reaction to victimization would be treated the same as acute grief reaction. Other symptoms may manifest during this period. Victims often feel shame and guilt concerning their state, blaming themselves for the ordeal.
Lerner (1970) postulates “just world” theory that may account for this reaction. In brief, the theory states that it is normal to believe that the world is rational and that consequences are in accordance with justice. Thus a person who is victimized might logically conclude that he or she must have somehow deserved it.
The Effects of Sexual Abuse
Sexual abuse victims have reported depression, guilt, poor self-esteem, and feelings of inferiority in later life. Interpersonal problems such as isolation, alienation, and distrust, fear of men, transient and/or negative relationships, repeat victimization, promiscuity, and sexual dysfunction have also been associated with childhood sexual victimization.
A study, focusing upon the long-term effects of childhood sexual abuse, that was conducted by Biere and Runtz in 1985, showed significant long-term symptomatology associated with a history of sexual child abuse among non-clinical adult women. They reported that these women reported higher levels of dissociation, somatization, anxiety, and depression than did non-abused women. Briere and Runtz speculate that dissociation may initially function as a coping strategy and then later become an autonomous symptom. Anxiety and depression, they argue, appear to be conditioned or secondary learned responses to the sexual abuse, persisting into later life in a manner similar to unresolved rape trauma! In addition, they correlated abuse-related symptomatology with factors associated with the abusive incident such as perpetrator age, total number of perpetrators, use of force, parental incest, completed intercourse, and duration of abuse.
*Somatization is a tendency to experience and communicate somatic distress in response to psychosocial stress and to seek medical help for it.
Long-term symptoms are also distinguished between single-event and multiple-event (pro-longed) traumas. Research citing more obscure memories; amnesia lasting for extended periods of time following cessation of the abuse; victims experiencing difficulty expressing emotions; and self-destructiveness, among long-term childhood sexual assault victims.
Reviewing clinical studies, Green (1985) concluded that symptoms manifested by incest victims resemble those found in rape victims including fear, sleep and eating disturbances, guilt, decreased or constricted levels of general functioning, sexual problems, and irritability. Green presented three case studies of incest victims, ranging in age from 18 months to 28 years. Their symptoms included the following: Fear, startle reactions, and anxiety; Repetition, re-enactment, or flashback to the trauma; Sleep disturbance and other depressive phenomena, including excessive guilt; Self-destructiveness; Ego constriction or regression; and Explosive/*maladaptive expression of anger.
*Maladaptive behaviour is a type of behaviour that is often used to reduce one’s anxiety, but the result is dysfunctional and non-productive
The recoil stage consists of the individual’s attempts to deal emotionally with the victimizing event. Most individuals alternate between trying to go on with their lives as though the event never happened and returning periodically and almost obsessively to the event and its ramifications. The obsession phases include compensatory fantasies and planning and, often, phobic reactions. This pattern of behaviour seems to represent cognitive attempts at regaining equilibrium. They frequently experience problems of blaming.
The final stage is characterized by a return to psychological equilibrium. Obsession fear and anger become modulated, though there are occasional flashbacks or extreme agitation. While recovery depends upon many factors the victim in the reorganization phase is able to focus upon life-enhancing activities rather than simply coping.
It might be said that victimization, or any trauma, represents an overwhelming assault on the person’s sense of the world as an understandable and safe place. It shatters necessary assumptions about a safe world. Symptoms of victimization represent difficulties to make predictions about events and the estimated effects of our actions. When we are no longer able to do so, our ability to act in the world is limited. We become more fearful and less able to take the risks necessary to grow. Children are particularly affected, as their lives depend upon growth and change.
Types of Loss
Loss can be categorized into three types: Apparent losses, Losses as a part of change, and unnoticed losses.
- Apparent losses include major losses that are obvious, resulting from such events as death of a relative or friend, permanent and involuntary separation, illness, or injury.
- Losses as a part of change, can include divorce, moving, changing schools, or other significant changes in the environment. Some losses are not normally identified as such but nevertheless trigger loss responses in many people.
- Unnoticed losses can include marriage or remarriage, achievements, success, and growth. Although these changes are usually considered to be positive, they do represent the loss of an earlier lifestyle and coping pattern. Such a loss can create turmoil even though the overall life change is for the good.
The adjustment to loss requires an elaborate process whereby the subject gradually, in stages, accommodates to the changed reality. The process of bereavement has been outlined by as following the five major stages of denial, anger, bargaining, depression, and acceptance. These stages seem to apply to other losses as well.
Children under the age of 10 years have not yet developed the capacity to recognize, understand, and resolve loss. Not only are they likely to make incorrect assumptions regarding loss, but their dependent roll and lack of ability to remove themselves from unbearable situations render them vulnerable to special problems. When loss affects the family, children may develop apathy and withdrawal behaviours because their basic needs are not being met during the parents’ own grieving. Young children are not adept at limiting their helplessness (awareness) or resolving their loss (completion).
It is essential to form an understanding of the development of the concept of death in children, at different periods of their lives. See the following list for detail:
Development of Death Concepts
|Life Period||Death Concepts|
|1. Infancy||No Concept of death|
|2. Toddler||For the toddler, death has very little meaning. He/She may receive the most anxiety from the emotions of those around him/her. When a toddler’s parents and loved ones are sad, depressed, scared, or angry, he/she senses these emotions and become upset or afraid. The terms “death” or “forever” or “permanent” may not have real value to children of this age group. Even with previous experiences with death, the child may not understand the relationship between life and death. Death is not a permanent condition.|
|3. Preschool||This age group view death as temporary or reversible, as in cartoons. Death is often explained to this age group as “went to heaven.” Most children in this age group do not understand that death is permanent, that everyone and every living thing will eventually die, and that dead things do not eat, sleep, or breathe. Death should not be explained as “sleep” to prevent the possible development of a sleep disorder. The pre-school child may feel that his/her thoughts or actions have caused the death and/or sadness of those around. The pre-school child may have feelings of guilt and shame.|
|4. School-Age||School-aged children are developing a more realistic understanding of death. Although death may be personified as an angel, skeleton, or ghost, this age group is beginning to understand death as permanent, universal, and inevitable.|
|5. Adolescence||Past experiences and emotional development greatly influence an adolescent’s concept of death. Most adolescents understand the concept that death is permanent, universal, natural and inevitable. They may or may not have had past experiences with death of a family member, friend, or pet. A predominant theme in adolescence is feelings of immortality or being exempt from death.|
Normal bereavement may last a long time and be accompanied by psychological and physical distress. The grief processing includes “affective and cognitive states, coping strategies, continuing relationship with the deceased, changes in functioning, changes in relationships, and alterations in identity” (Shuchter and Zisook, 1993) .
The effects of parental death and its psychological processing are determined as well by the nature of the death itself. The extent to which the death involved trauma to the child will determine the manner in which it is grieved.
Loss is discussed in greater length in Part 2 of these posts.
3. FAMILY PATHOLOGY
The family remains a pervasive, formative force in children’s development. Functioning as the primary learning milieu for individual behaviour, the family provides the basic structure for children’s values and expectations throughout their growth toward maturity. Consequently, families that show serious disturbance provide a faulty learning environment.
The now-burgeoning family dynamics literature are summarize into four broad categories of family dysfunction that lead to a high incidence of problems in child development and later psychopathology:
- Inadequate families: These families lack the physical or psychological resources for coping with normal life stressors.
- Antisocial families: These families have values that differ greatly from their communities in that they may encourage dishonesty, deceit, or other undesirable behaviours.
- Discordant and disturbed families: These families may be characterized by fraudulent interpersonal contracts and disturbances (including fighting, gross irrationality, and enmeshment of the family in parental conflicts).
- Disrupted families: These families have inadequately adjusted to the loss of family members through death, divorce, or separation.
These four categories have been found to be associated with higher incidences of psychological disorders leading to various *maladaptive behaviours and physical illness. Several specific patterns of parental influence appear regularly in the backgrounds of children showing emotional disturbances and faulty development. The following patterns have been identified as sources therefore: Rejection, over-protection, unrealistic demands, over-permissiveness, faulty discipline, inadequate and irrational communication, and undesirable parental models.
Following an extensive review of literature relating to family life, delinquency, and crime, Wright and Wright (1995) conclude that marital discord combined with conflict and violence, parental rejection, poor monitoring and supervision, and lack of normative guidance and modelling, interact with social and community factors to produce maladaptive adolescent behaviour and, in some instances, difficulties in adulthood.
The Case of Alcoholic Families
Whether alcoholism is or is not associated with genetic predisposition, studies of alcoholic families have shown that where one member is alcoholic, a dysfunctional pattern of interaction tends to emerge, affecting the children of the family to such an extent that subsequent maladaptive behaviours may be expected.
Family systems theorists view the family as an operational system and observe that any change in the functioning of one family member is automatically followed by compensatory change in another family member. Children in alcoholic families are evolving compensatory roles in reaction to dysfunctional parenting in order to maintain family cohesiveness and equilibrium. Here we describe four such children’s roles:
- The Responsible One: the child who provides structure for him- or herself and other within the often inconsistent home environment.
- The Adjuster: the child who compliantly adapts to the inconsistencies.
- The Placater: the child who helps others, possibly in response to guilt over family dysfunction.
- The Troubled One: the child who acts out the family problems, frequently getting into explicitly maladaptive behaviours.
“The “Responsible” children carry the need to control into their adult lives and frequently end up alone or in unmeaningful relationships: “Adjuster” children tend to grow up manipulated by others, suffer from low self-esteem, and end up inviting into their lives someone who has significant problems (frequently an alcoholic); “Placaters” grow up minimizing their own needs and subjugating them to those of others; “The Troubled One” grow up to become the stereotypical juvenile delinquent who manages to find him/herself in conflict with authority figures at home, at school, and in the community. Craving attention he/she acts out his or her anger via AOD abuse, promiscuous sex, or aggressive, antisocial behaviour.
Thus the parental inconsistency, faulty communication, and learned distrust common to alcoholic families force the children to adopt coping strategies that are often maladaptive. The effects upon family dynamics of substance abuse patterns are pervasive and long-lasting.
There are several similarities among experiences of victimization, loss, and pathogenic family structure in childhood. Each appears to create sufficient stress/trauma to cause behavioural symptomatology at the time of the experience, a finding that clearly has implications for those involved in trying to help and protect them. When a crisis has occurred, sensitivity to the signs of trauma can help to determine whether or not particular children have been adversely affected by the event. These signs are discussed in detail in Part 2.
All three of the trauma conditions discussed, tend to result in similar patterns of subsequent maladaptive behaviour in adolescence or adulthood. In order to determine appropriate steps to meet the challenge of childhood crises, it is essential to know not only that an association exists between crisis and subsequent behavioural difficulties, but also why it exists and how it functions. In Part 2, we turn to this task and focus upon post-traumatic reactions in childhood.
Taken and adapted in part from: ‘Trauma in the Lives of children’ written by Kendall Johnson, PhD