PSYCHOLOGICAL TRAUMA

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Emotional Trauma in Children and Adults

•  By Peggy Thurman

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Emotional component of patient care how we
deal with it
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Many children receiving medical care have
experienced some trauma
Carol, age 9
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Hospitalization Trauma

• limited parental contact
• three stages  protest, despair, detachment
• feelings of abandonment, depression,
  hopelessness, lack of trust
• child returns home changed

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Personal Story
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Policy now changed
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Effects of trauma can be healed held in body
- physiological

• Focus conscious mind on bodily states
• Children resilient and malleable, but can be
  overwhelmed and traumatized
• Some traumas may need professional help sexual
  abuse, exposure to violence

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Events that can be traumatizing to children more
than to adults

• Attack by animal
• Natural disasters
• Auto, bike accidents
• Medical procedures

• Separation from parents
• High fever life-threatening illness
• Loss death of family member
• Near drowning

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Child often feels responsible for trauma and that
theyre being punished
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Symptoms

• Withdrawal
• Fearfulness
• Irritability
• Shyness
• Emotional outbursts
• Aggression to other children
• Hurting animals

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Symptoms

• Trouble sleeping thrashing nightmares
• Starting fights
• Exaggerated startle reactions
• Regression to other behaviors bed wetting
  thumb sucking
• Avoidant behaviors
• Physical symptoms tummy ache headaches
  fever vomiting diarrhea

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Parents may feel guilt, shame, helplessness
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SHAME
Perfection
Procrastination

• Compulsions

Rage
Unhealthy Relationships
Addition
Suicide
Depression
Control
Victimization
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Biological trauma reaction

• Reptilian brain
• Must discharge energy
• If not discharged, child left with residuals of
  traumatization
• Can be discharged several ways

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How to help child rebound / heal

• First, caregiver take a moment to assess own
  feelings like O2 mask in airplane
• Second, pick up child
• After child is calmed listen to child let
  them know its okay it wasnt their fault
• Adults presence most important reassure child
  has done nothing wrong
• Child may play/act out experience

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Healing the effects of trauma

• Process through bodily sensations or directed
  play
• Trauma is about being stuck need to move it
  along
• Can use drawings, stories, play to elicit
  movement
• Important to help them connect with their
  creative process
• Can co-create a new story

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How should I help myself and my family?

• Give yourself time to heal.
• Ask for support from people who care about you
• Find out about local support groups
• Engage in healthy behaviors
• Establish or reestablish routines
• Avoid major life decisions
• Become knowledgeable about what to expect

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Exercise
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References

• Peter Levine, Ph.D.,   It Wont Hurt Forever - 
  2001
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• Robert Karen, Ph.D., Becoming Attached 1998
• American Psychological Association, Managing
  Traumatic Stress www.apa.org/practice/traumacti
  cstress.html

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