How Children Heal from Trauma

by Aletha Solter, Ph.D.

Please see Aletha Solter's book, Healing Your Traumatized Child,
for more information about this approach and a list of scientific references.

 

Podcast interview with Aletha Solter about her book, Healing Your Traumatized Child

 

Video interview with Aletha Solter about her book, Healing Your Traumatized Child

 

Children around the world are being traumatized every day. They are exposed to terrorism, war, natural disasters, abuse, accidents, painful medical procedures, and many additional traumas at home or at school. Even with loving and attentive parents, children encounter frightening and painful experiences that are beyond the parents' control.

This article summarizes the Aware Parenting approach to emotional healing. It is based on two assumptions: children know instinctively how to recover from trauma; and parents can play an important role in facilitating their children's natural recovery processes. Please note, however, that this article is not intended to replace professional advice or treatment.

Trauma therapy for adults

Some of the early trauma therapies for adults encouraged intense emotional reactions. For example, combat veterans with PTSD were told to talk about their war experiences or were exposed to the sights and sounds of war. Some veterans benefited from these exposure therapy sessions and became desensitized to trauma triggers. However, others felt re-traumatized and their symptoms worsened.

Trauma survivors react in two different ways when they feel triggered but not safe. Some explode with rage or aggression (fight or flight), while others become numb and frozen in terror (dissociation). In these extreme states, our autonomic nervous system is doing what it evolved to do in order to enhance survival during a life-threatening situation (or when we think itís happening again). Fight or flight (hyperarousal) helps us defend ourselves or escape, and dissociation conserves energy while dulling physical and emotional pain.

Therapists learned from these early approaches that people can become overwhelmed by trauma triggers when they donít feel safe and when the triggers are too similar to the original trauma. Many trauma-informed therapists for adults now use a gentler, more gradual approach so people will not become overwhelmed by painful memories, body sensations, and emotions. The term "revisiting trauma" has replaced the former term, "reliving trauma." Therapy typically begins with techniques to ensure that clients feel safe and firmly grounded in the present. These approaches are like gently peeling away the layers of an onion.

Differences between adults and children

The basic principles for healing from trauma are the same at all ages. However, most adults have decades of accumulated stress, unhealed trauma, and emotional suppression, so it makes sense to proceed gradually. Young children, however, donít have much accumulated stress or unhealed trauma, so they can heal more quickly. They can also heal through certain forms of play which are not typical adult activities.

Another difference is that therapeutic interventions for adults usually consist of special sessions separate from everyday activities, while Aware Parenting focuses on childrenís ability to heal from trauma in the context of daily life with loving parents. The assumption is that children strive for emotional health, know how to heal, and will do so spontaneously when they feel safe.

The Aware Parenting approach also recognizes that there may be situations where children would benefit from sessions with trained therapists, especially following severe trauma or when the parents themselves are the source of trauma (as in cases of parental abuse or neglect).

How children heal from trauma

Frightening or threatening experiences all cause terror, but not all of them result in post-traumatic symptoms. Traumatic events cause problems later on only if 1) the child felt unprotected and helpless because his attempts to get help, escape, or defend himself failed, and 2) he had no opportunity to process the trauma immediately afterwards because he did not receive the support he needed.

Healing from trauma is like completing unfinished business. Children need to perform the survival mechanisms that were ineffective during the event and complete the healing that was blocked afterwards. This means that they benefit from revisiting traumatic memories while feeling both protected and powerful. Memories are not static. Every time we recall an event from the past, we change our memory of it, so these new experiences allow children to replace painful memories with more pleasant ones.

Babies and young children cannot escape or defend themselves during a traumatic event. Their main survival mechanism is to express their outrage while making frantic efforts to defend themselves (fight or flight). When that doesnít bring support or prevent the trauma (as during a painful medical procedure), their other natural survival strategy is to become calm and numb (dissociation).

Children can recover later on by crying while feeling safe and protected. In addition to its communication function, crying is also a stress-release mechanism, so if they are allowed to cry in arms as long as needed, they will complete the natural stress/relaxation process that failed to occur immediately after the trauma.

Children can counteract feelings of helplessness by performing the natural survival movements which were ineffective during the original trauma, and these active body movements use the energy mobilized for fight or flight. For example, babies whose mothers experienced a very long labor typically kick their legs vigorously while crying, and this relieves the frustration and powerlessness they felt during the birth process. Childrenís active arm and leg movements during temper tantrums serve a similar function.

Specific kinds of play can also counteract powerlessness and help children recover; for example, attacking the parent who lets the child feel powerful in a playful pillow fight. Laughter, like crying, is a natural stress-release mechanism, so itís always beneficial. Playing hide-and-seek with the parents can help a child recover from separation trauma, and re-enacting a traumatic experience through symbolic play can also be helpful, especially if the child can symbolically change the outcome.

While revisiting the trauma during these activities, children release stress, and their memory of the trauma becomes associated with feelings of safety, power, mastery, and completion (instead of feelings of danger and helplessness). These experiences reprogram their brain to think that the trauma has been successfully confronted and overcome, and their nervous system no longer overreacts to trauma triggers. This is the essence of effective desensitization without re-traumatization.

When children get "stuck" with big feelings

Children know intuitively how to heal, and they often choose to revisit trauma when they feel safe, either through play or by making use of minor pretexts to cry. Sometimes, however, they get stuck with big feelings. Some become hyperactive and aggressive (hyperarousal), while others become calm but withdrawn (dissociation). In both situations, the children feel disconnected from themselves and from others.

As mentioned above, children need to revisit traumas while feeling safe. In Aware Parenting this is called the balance of attention. When children become stuck with big feelings, itís possible that they are not feeling safe. A first step is to create connection and safety, but this may not be sufficient. Some children may need help to revisit a trauma, because they purposely avoid situations that trigger traumatic memories, and this can interfere with their lives. We need to intervene when childrenís trauma-related phobia or avoidance prevents them from eating, sleeping, defecating, or learning; or from accepting necessary caregiving routines (being dressed, diapered, or bathed).

When necessary, we can gently trigger the trauma (perhaps through play or specific kinds of touch) while ensuring that the child feels safe. A toddler who was born by vacuum extraction might strongly resist wearing a hat in cold weather and persist in removing it. Parents can help him revisit his birth trauma (and cure his hat phobia) by suggesting a playful activity with his hat. For example, they could place the hat repeatedly on their child's head and express mock surprise each time when he removes it, pretending that they can't understand why the hat is no longer on his head. Any activity with the hat which brings laughter will help the child release feelings of anxiety and powerlessness caused by his birth trauma.

Avoiding re-traumatization

Trauma triggers should always be used with caution. Children can become overwhelmed (re-traumatized) if they donít feel safe and if a trauma trigger is too similar to the original trauma (just as combat veterans become overwhelmed if the triggers resemble a real war too closely). Forcing the child in the previous example to wear a hat might be too similar to his traumatic birth, and he could react by becoming aggressive (hyperarousal) or by sucking his thumb (dissociation).

Sometimes children encounter overwhelming trauma triggers during everyday life. A child who has been attacked and bitten by a dog may show extreme panic whenever a dog approaches, because the situation is too similar to the original trauma. He will feel safer when he is further away from the dog. The goal is to reduce the feeling of imminent threat. When he feels safe in his parent's arms, he might choose to cry at that time. He would also benefit from symbolic play later on with a toy dog.

There is a huge difference between therapeutic crying and the fight or flight response. Crying or raging with a parent's loving attention is not a symptom of re-traumatization or hyperarousal. The crying-in-arms approach with babies can help them recover from past trauma (such as a difficult birth or a medical intervention) or from a day full of new stimulation, frustrations, and mini-traumas. Likewise, a healthy tantrum (without violence or destructiveness) can help a toddler or older child recover from trauma or an accumulation of stress.

When we listen to children and trust them to express emotions in ways that their bodies are designed to do, we will not re-traumatize them. If a mother stops using a pacifier (dummy) each time her baby cries, but holds him in her arms while offering empathy, this is neither a new trauma nor a trauma trigger. The childís crying is no longer being suppressed, and he is free to activate his natural biological healing processes. There is no evidence that crying in arms is stressful for babies or that crying damages the brain (although being left to cry alone can be traumatic).

Should parents ever try to calm children down?

Confusion between therapeutic crying and the fight or flight response (hyperarousal), combined with the misleading idea that babies and young children canít "self-regulate," has led many parents to think that they should calm their crying children down. However, children are born knowing how to recover, and they stop crying on their own when they are done. The disadvantage of calming them down (through soothing activities or distractions) is that we put them into a state of mild dissociation and create habits of emotional suppression. Also, the immediate effect is usually only temporary, and the childís calm state "wears off" after a few hours. When children continue to cry after all immediate needs are met, they benefit from physical closeness, love, empathy, and reassurance that we are willing to listen and accept their entire range of emotions.

Further confusion comes from popular calming techniques for adults, such as deep breathing, meditation, chanting, or yoga. These activities can help us calm us down when we are in a state of hyperarousal caused by stress or trauma triggers. As with calming techniques for children, however, the beneficial effects are usually only temporary, and we may need to repeat these practices on a daily basis to cope with life and maintain homeostasis. These practices can help us relax and even reduce the need for psychiatric medication, alcohol, or drugs. However, they can also put us into a state of mild dissociation and block genuine emotional healing.

We all want babies and children to be happy and relaxed, but itís not helpful to strive directly for calmness while bypassing the important healing work that may need to happen first. If unhealed trauma were a rotten wooden floor in need of repair, then calming children down without allowing them to express their emotions would be like covering the floor with thin plastic. The plastic coating would look nice and new, but it would soon wear off and reveal the rotten wood below. Therefore, we need to resist the temptation to calm children down prematurely.

There are a few situations where it might be necessary to calm a crying child down (if the crying continues after all needs are met): the child has a medical condition which makes crying a health risk; the crying could cause an adult to harm the child; and the crying is disturbing other people in a confined space such as an airplane. Also, if a child is being aggressive or destructive while crying or raging, we need to intervene lovingly to keep everyone safe. However, it's not necessary to stop the crying itself.

Summary and conclusion

Our role as parents is to help children feel safe, recognize their attempts to heal, and trust their natural healing processes. In Aware Parenting, we donít "regulate" childrenís emotions, and we avoid the use of that term. Instead, we accept and listen to childrenís emotions, no matter how intense they are. The goal is not to calm down childrenís nervous system, but to reprogram their brain with new experiences during which they are allowed to be active and emotionally expressive. Healing occurs when children can revisit the original trauma while feeling safe, release the emotions, move their bodies, and transform their memories. After these experiences, children become deeply relaxed, and their nervous system becomes less reactive without anybody ever trying to calm them down.

 

differences between calming techniques and healing techniques

 

About Aletha Solter

Aletha Solter, PhD, is a developmental psychologist, international speaker, consultant, and founder of the Aware Parenting Institute. Her books have been translated into many languages, and she is recognized internationally as an expert on attachment, trauma, and non-punitive discipline.

Aware Parenting is a philosophy of child-rearing that has the potential to change the world. Based on cutting-edge research and insights in child development, Aware Parenting questions most traditional assumptions about raising children, and proposes a new approach that can profoundly shift a parent's relationship with his or her child. Parents who follow this approach raise children who are bright, compassionate, competent, nonviolent, and drug free.

For more information about helping children heal from trauma, see Aletha Solter's book, Healing Your Traumatized Child: A Parent's Guide to Children's Natural Recovery Processes.

Healing Your Traumatized Child

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This page was last updated on October 7, 2022. Copyright © 2021 ro 2022 by Aletha Solter. All rights reserved. No part of this article may be reproduced or transmitted in any form or by any means, electronic or mechanical (including copying to other web sites, and including translations), without written permission from Aletha Solter.

Warning/Disclaimer: The information in this article is not intended to be used as a substitute for professional advice or treatment. When children display emotional, behavioral, or medical problems of any kind, parents are strongly advised to seek competent professional advice and treatment. Some of the suggestions in this article may be inappropriate for children suffering from certain emotional, behavioral, or physical problems. Aletha Solter, The Aware Parenting Institute, and Shining Star Press shall have neither liability nor responsibility to any person or entity with respect to any damage caused, or alleged to be caused, directly or indirectly by the information contained in this article.