What Makes an Event Traumatic for a Child?
Experiences before and after affect how severe the injury will be
Dr. Steven Berkowitz
It's important to understand that it's not the nature of the event itself that makes something traumatic. It's really the subjective experience of the child that defines whether an event is traumatic or not.
Many of us have experiences that are very upsetting. We may be disturbed, we may be unable to sleep, we may not be able to eat, we may be irritable, but we integrate it, over time, and recover. So trauma is really best understood as a failure of recovery. It's a response to an event, it's not the event itself.
There are many factors that go into whether an event is traumatic for a child.
First, there are individual factors that relate to the child's own history, her previous experiences, as well as biological vulnerabilities that we don't understand yet.
Then there are the event factors. We certainly know that close proximity, both emotional and physical, to the event are more likely to make it traumatic. For instance, rape is known to be one of the most traumatic of events, as is sexual assault.
Finally, there are also factors that occur after the event, whether a child has support from people close to her, especially her family, or whether there are additional stressors that are ongoing, and that interfere with her ability to process and recover.
So it's a very complex situation, because while we tend to think of an event as being the cause of trauma, trauma is actually a process over time. Trauma is the Greek word for injury, and so it's an experience that causes an injury to one's functioning—cognitive functioning, physiological functioning and psychological functioning.
Steven J. Berkowitz, MD, is associate professor of clinical psychiatry at the University of Pennsylvania.
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