Nursery World - Trauma: Part 1

In the first of a two-part series, Caroline Vollans advises practitioners on how to support children who have experienced trauma

Different children can have different emotional reactions to the same experience (see Case study) PHOTO Adobe Stock

Trauma is a commonly used term these days. Whether an experience is ordinarily unpleasant or truly horrific, we might refer to it as a trauma. A child who is upset may be described as experiencing trauma, or a member of staff caught up in a road-rage incident may say they are traumatised by it.

While each of these might well be true, they also might not be.

When training as a psychoanalyst, I was struck to learn that ‘what is experienced as trauma by one person may not be by the next’. Until then I understood that if an event was dreadful or shocking then it was traumatic.

But what might feel ‘dreadful or shocking’ to me may not for the next person. It is my perception, my take on the world. In the most abject of circumstances, some individuals, though marked by their situation, are not traumatised. Others most certainly are.

The concept of trauma is complicated. Responding to it and treating it is equally complicated. We must tread carefully.

WHAT IS TRAUMA?

There isn’t one precise working definition or understanding of trauma. Notwithstanding this, most psychologists and therapists will agree on its fundamental aspects.

The psychoanalyst Sigmund Freud defined trauma as an emotional wound or shock stemming from infancy that has a lasting effect. This psychological injury is caused by an experience that was too overwhelming for the child to cope with. For instance, if the child is suddenly separated from their primary caregiver, it may be too much for them. Future separations may not be just sad but devastating.

The Anna Freud Centre defines trauma as an emotional response to an event that is deeply frightening or distressing. It occurs when a person is so overwhelmed by emotions, such as fear or anxiety, that they can’t make sense of their experience. These emotions remain with the person and can influence the way they feel and react in the future. For instance, a loud noise might remind them of a previous experience such as a car accident or bomb. This will cause them to experience it as scarier and more overwhelming than it would ‘normally’ be.

Alexandra Langley is a psychoanalyst working with young children. She thinks of trauma as, ‘When a person is psychically overwhelmed. They are unable to process, to think or to feel.’She adds, ‘It is like their sense of existence is obliterated.’

In terms of working with trauma, Langley says, ‘The aim is for the person to construct a narrative around their experience. This will give it a place in their personal history.’ She adds a caveat, ‘Importantly, this will only happen when they are ready, and at their own pace.’

Langley says more about her work, ‘The therapist’s position is to acknowledge what the child says. The words are like building blocks from which the child can start constructing their story block by block. If they are using wordless play or gestures, the therapist witnesses what they are expressing and cautiously tries to verbalise it for them. Over time the child’s narrative will help prevent them from being consumed by their trauma: putting it into words makes it less potent.’

Common to these interpretations of trauma is that it is an overwhelming experience that is beyond the child’s capacity to deal with. They will need professional input.

This is very different from the more everyday upset and distress.

TRAUMA AND TALKING ABOUT IT

It is generally understood that talking about our distress makes it become less troublesome. This is not always the case.

Walter Michel, the psychologist who famously found that four-year-olds who could delay the gratification of eating a marshmallow went on to achieve more than their peers who could not, has important things to say about trauma.

Michel makes it clear that talking about trauma can make it worse. That is not to say he advocates the stiff upper lip or bottling things up – far from it. Michel’s point is that some ways of working with trauma are beneficial and some are harmful. Talking about trauma can fall into either of these categories.

Talking can help us process an experience to make it manageable, more liveable.

Through speaking with someone else, an individual can gain some distance from their distress, have some control over it (rather than it over them). Putting an experience into words helps locate their trauma in the past instead of living it as though it is still happening.

Talking can be a means of retraumatising ourselves, reliving the trauma.

Conversely, talking can serve to feed the trauma. The person may get more into their traumatic experience. This will inscribe it further. It is rather like scratching a bite or scab: if you continue to scratch, it’s not likely to heal.

Helping people, including children, to process trauma is highly specialised work. Trained professionals use specific approaches to assess and respond to it. Michel reiterates, however, that even among such highly trained experts, it is not an exact science.

There is no guarantee that talking something through will always work.

WORKING WITH CHILDREN

The key thing to know is that trauma and its treatment are delicate matters. Identifying whether a child is traumatised or more simply upset can be difficult as the symptoms may overlap.

These indicators may help us distinguish between the two:

Duration and intensity of the child’s reactions. Traumatic reactions tend to be more intense and prolonged than more regular upset: the distress persists, and the child is inconsolable.
Physical symptoms. Trauma can manifest in the body. For instance, headaches, stomach aches, or changes in eating, sleeping and toileting patterns.
Changes in behaviour. Significant changes include withdrawal, aggression, regression or persistent anger or fearfulness.

If a practitioner is concerned, they should discuss their concerns with their manager and with the parents. They might advise the parent to make an appointment with their GP, or make a referral for a specialist intervention.

Finally, if we are to respect trauma as a psychological state with considerable effects on a person’s life, it is important to have a good understanding of it and use it aptly. Otherwise, we do a disservice to those suffering from it, living with it.

It is not uncommon to dilute the severity of psychological concepts. Many of us will, for instance, have misused the term depression: ‘I’m so depressed – they’ve changed my flight time.’ Though such things may be said lightly, they can also make light of a serious and complex condition. This article just touches on exploring the potentially life-changing concept of trauma. We all have more to learn, including specialists in the field.

CASE STUDY: Two siblings

Three-year-old L found much of nursery life a strain. He was unable to concentrate for very long, easily upset, struggled with relationships, and had periods of shutting down. His brother, who was a year older, didn’t present with any of these symptoms.

The head teacher’s opinion was that L, the ‘difficult child’, had been spoilt and needed discipline. The head saw two brothers growing up in a loving family. They had the same family life and same sorts of experiences of the wider world. So, why was one was ‘doing well’ and the other not well at all?

Each person’s experience of the world around them, starting with their primary caregivers, is unique. Two children growing up in the same family will have different experiences of their parents. Psychoanalysis teaches us that, in this sense, no two children have the same parents.

For Freud, though the early childhood experiences of siblings may appear to be the same (or very similar), each sibling will perceive them differently. An occurrence in their childhood may, then, have a traumatic effect on one but not on the other. L was affected by something, or his perception of something, but his brother was not.

As soon as we stop to think about it, it makes sense. Why wouldn’t the responses of two individuals (to the same event) be very different?