Childhood Trauma Can Manifest Without Parents Even Knowing

Childhood trauma occurs more often than you might think and if it goes unaddressed, the potential consequences can be devastating, affecting the individual's life well into adulthood.

Nothing matters more to a parent or caregiver than their child's happiness and wellbeing. But dealing with a child who has been traumatized can be a challenging experience and often the the signs may go unnoticed.

In her book, Has Your Child Been Traumatized?, clinical psychologist Dr. Melissa Goldberg-Mintz reveals how parents can recognize the signs and symptoms of trauma in their children, while providing advice on how they can support them on their path to recovery.

Goldberg-Mintz, a childhood trauma expert who runs a private practice in Houston, Texas, and is a clinical assistant professor at Baylor College of Medicine, told Newsweek: "What I say to the majority of the families that I work with is that I get your kid for one hour a week and that's it. We can do some great work in here but what is much more impactful is what's going on at home. But here's no manual for how to parent children after they've been traumatized. So, I wrote this book for those parents to give them some guidance and reassurance."

In many cases, the parent or caregiver may be unaware that their child is suffering from trauma.

"Even in the most attuned parents, things can be missed," Goldberg-Mintz said. "A few times a year, I'll see a kid whose parent was shocked to learn the child was traumatized because things seemed so normal—their kid was continuing to earn straight As, perform well in sports, and spend time with friends. I most frequently see this when a child has a sense of shame around their trauma. They can get invested in trying to pretend like everything is fine, and their symptoms can fly under the radar."

"Most frequently, I've seen it with sexual abuse. Other types of trauma can be easier for kids to talk about, but because shame is frequently experienced by victims of sexual abuse, it can get in the way of a kid feeling comfortable enough to share their distress."

What is Trauma?

According to Goldberg-Mintz, many people misunderstand what trauma really is. Trauma is not the adverse event itself but rather the response to that event.

"An adverse event is what people actually tend to think trauma is—it can be things like a car crash, abuse or neglect, a natural disaster. Any of these sorts of things are adverse events that have the potential to traumatize. Trauma is how somebody's body responds when there isn't natural recovery."

"Two people can be exposed to the exact same event—say, two kids can be in a car crash—and one might be traumatized while the other might not."

Trauma can also arise from a series of events that some people may not consider to be very consequential.

"I'd say it's all relative. What we define as 'small' might not feel small to someone else," Goldberg-Mintz said. "One of the most straightforward examples of this is bullying. Some kids may experience taunting and name calling as simply annoying, while others may feel shattered by these insults and feel terrified to cross paths with a bully."

A Common Occurrence

All indications suggest that childhood trauma in the U.S. is common.

According to the National Institute for Children's Health Equality, around 35 million children (aged 0-17) in the country—almost half the total—have been exposed to potentially traumatizing adverse childhood experiences (ACEs).

Figures from the CDC, meanwhile, show that around 61 percent of adults surveyed across 25 states reported that they had experienced at least one type of ACE before the age of 18, and nearly one in six reported that they had experienced four or more ACEs.

Potentially traumatizing events can include witnessing or experiencing psychological, physical or sexual abuse, as well as domestic or community violence; natural disasters or terrorist acts; the loss of loved one; and serious accidents or life-threatening illnesses, among others, according to the Substance Abuse and Mental Health Services Administration.

Growing up in a home with substance use problems, mental health issues, or parental separation, can also be considered ACEs.

Trauma resulting from exposure to ACEs can have devastating consequences for the child. For example, ACEs and the stress they cause have been linked to developmental issues, chronic health problems, mental illness, substance abuse in adolescence and adulthood, problems with schooling or work, as well as higher rates of suicide and incarceration.

"So, we want to intervene," Goldberg-Mintz said. "I think some of the time that means professional help and therapy, and other times it just means skillful, caregiver support. What we don't want to do is sweep the issue under the rug and not talk about it."

Keep a Close Watch

But how can parents tell if their childhood has potentially been traumatized by an adverse event, or a series of them?

"What I tell parents to look for is just a change from baseline," Goldberg-Mintz said. "For example if your child is a great sleeper, who now is trying to avoid bedtime, or is having horrible nightmares, or not getting that restful sleep, that might be a sign. But if you had a kid who was already a horrible sleeper, it wouldn't be as alarming."

"Same as if you had a kid who ate three meals a day heartily and loved snack time but who's now saying, 'I'm not hungry,' that would be concerning. Somebody who loves socializing with friends who now prefers to stay holed up in their room is another example. These should be a red flag go for parents."

The signs of trauma may also differ with age. With younger kids, signs might include clinginess and separation anxiety, or even behavioral regression like wetting the bed, long after the kid has long mastered using the toilet properly. With older kids like teens, impulsivity can be an issue—so things like high-risk sexual behaviors, substance abuse, self-harm, among others.

When it comes to post-traumatic stress disorder (PTSD)—an anxiety condition that can develop following a traumatizing event, there are a few specific symptoms to look out for, according to Goldberg-Mintz.

These include avoidance symptoms, such as trying not to think, talk or have feelings about the adverse event, as well as avoiding certain people, places or situations.

There are also intrusive re-experiencing symptoms, so for example, having negative flashbacks and nightmares. Finally, there are arousal symptoms, for example, feeling jittery, being hyper-vigilant, having difficulty concentrating, or experiencing other negative feelings like fear, anger, shame, or guilt.

If your child has experienced or witnessed an adverse event, whether they have been traumatized or not, Goldberg-Mintz recommends keeping an extra eye on them.

Providing the child with sufficient support and assuring that they feel safe can be crucial in their recovery, as well as explaining that they should not blame themselves for events that are out of their control.

"My biggest message is always about the importance of the caregiver-child relationship in healing from trauma," she said. "If parents can foster a warm, supportive relationship with their child, where their child feels like they can turn to their caregiver in times of distress, that child will have a much easier time recovering from trauma. I truly believe connection is the best medicine we've got."

"Other practical tips would be connect your child with a good therapist if needed, and parents can do this by reaching out to the child's pediatrician or school for a list of referrals. And make sure to get your own support, because parenting a traumatized child can feel overwhelming."

Recovery Times Vary

Sometimes it's worth having a little patience after a child has been through an adverse event, Goldberg-Mintz said. Depending on the individual, some children will recover more quickly than others.

"Sometimes a kid has experienced something scary and maybe they even have a few nightmares that first week after it has happened. But often, those symptoms naturally resolve as part of the healing process. So, that's why I also caution parents not to be too alarmist. If it's short lived, that's not as concerning. If it lingers, that's another red flag," she said."

According to the clinical psychologist, what is more common than a child experiencing an adverse event themselves is hearing about one that happened in the local community, or further afield, which can still cause them to be concerned.

In these cases, Goldberg-Mintz encourages parents and caregivers to be proactive and ask kids what they have heard about the event in question, whether it be a natural disaster or violence in the local community.

"Parents so frequently are a little bit afraid to broach the topic with their kids because they think I'm gonna make them freak out about this if I bring it up. But the majority of times, it's already on your kid's mind and by showing them that you're open to talking about it, it will help them see you as someone they can talk to," she said.

Acute Distress Treatment

If you find that your child is in acute distress as a result of a traumatizing event, Goldberg-Mintz also provides some recommendations about how to deal with the situation.

"You're not going to be able to get them into a therapist immediately. So, if your child is freaking out or breaking down, the first thing to do is don't leave that child alone, unless they have said that they want space," she said. "Usually just being there with them shoulder to shoulder is going to lend a sense of support—just so they know, 'I am here with you through this.' I think that is the most powerful thing you can do."

"In my book, I also talk about some grounding and relaxation exercises that are pretty simple—things like diaphragmatic breathing, progressive muscle relaxation, and sensory-based relaxation exercises. Any of these things could help. But when your kid is really just at a 10 out of 10, your presence is going to be the biggest comfort to them."

How you approach a child who is in distress can also differ depending on their age. For example, young kids are more likely to really want the attention of a parent or caregiver in these moments. Whereas teens sometimes want to have their space.

Goldberg-Mintz said she is not a huge fan of the idea that "what doesn't kill you makes you stronger" when it comes to childhood trauma because it can set both kids and parents up for unrealistic expectations about flourishing afterwards.

"While this can happen, just as common is having a resurgence of trauma symptoms after being triggered at some point in the future," she said. "In my mind, the best thing that can happen after trauma is an enhanced caregiver-child relationship. If a caregiver can use this as an opportunity to strengthen their relationship with their child, the benefits of this will last a lifetime, including higher self-esteem and psychological resilience."