Childhood PTSD: The Other Side Of America's Mental Health Crisis
PTSD Affects More Than Just Soldiers
June is PTSD Awareness month. Throughout the month, groups like the National Center for PTSD at the Veterans Administration will work to raise awareness of Post-Traumatic Stress Disorder, what it is (and what it is not), and the debillitating effects it has on people’s lives.
While most people somewhat naturally associate PTSD with soldiers who have been in combat, combat PTSD is but one type. Trauma can occur anywhere and impact literally anyone.
One particularly vulnerable demographic for trauma and incidence of PTSD is children. According to the National Center for PTSD, nearly half (43%) of all boys and girls will experience at least one trauma during childhood or adolescence. Of those experiencing at least one childhood trauma, up to 15% of girls and 6% of boys will develop symptoms of Post Traumatic Stress Disorder. For comparison, nearly 7% of veterans will develop symptoms of PTSD, with 13% of female veterans showing signs and 6-7% of male veterans developing symptoms.
In other words, roughly as many children develop symptoms of PTSD in this country as do soldiers who have been in combat.
Let that thought sink in: in this country, roughly the same numbers of children develop signs of PTSD as do soldiers in combat.
What causes PTSD in children? Obviously, exposure to traumatic events, and frequently to multiple or ongoing traumatic events:
Physical, sexual, or emotional maltreatment
Being a victim or witness to violence or crime
Serious illness or death of a close family member or friend
Natural or manmade disasters
Severe car accidents
What makes childhood PTSD particularly troubling is that many of the involved traumatic events involve the family or take place within the family setting. Physical and sexual abuse often occurs in the home, and even when the physical abuse comes in the form of bullying outside of the home, ineffective responses from parents—which can often equate to emotional neglect and maltreatment—can compound and exacerbate the trauma.
Childhood PTSD is made even more tricky to assess and to treat because many of the symptoms particularly in boys can overlap those for Attention Deficit Hyperactivity Disorder (ADHD).
One aspect of Childhood PTSD that makes it qualitatively different from other forms of trauma is that, because the traumatic events occur during the developmental years, the impacts are unavoidably life-altering. A great many maladaptive behaviors which occur during the adult years can be traced back to traumatic events during childhood and adolescence, even if the individual is not aware of the connection.
Sadly, many people fail to see the connection between their childhood trauma and their adult-life thoughts and actions. Due to such lack of understanding and association, they sometimes think of themselves and their adult-life symptoms as crazy. They simply don’t understand that their upbringing was lacking and left them without a positive sense of self or needed life skills, and their emotionally escapist behaviors are an adaptive response to what they experienced. In other words, they don’t understand that their problematic adult-life choices are a coping mechanism, typically started early in life, that is now being (maladaptively) used to deal with emotional discomfort.
While this is not the same as saying that the discrete symptoms of Childhood PTSD last a lifetime, there is no denying that childhood traumas, particularly repeated or extended traumas (e.g., physical and sexual abuse), almost unavoidably alters the trajectory of a person’s life and psycho-social development. Difficulties with interpersonal relationships, and even heightened risk for alcohol and substance abuse, are not uncommon consequences of repeated exposures to childhood traumas. The shattering of the ability to trust in childhood can have lasting impacts on the ability to form healthy relationships going forward.
When an individual experiences traumatic events as children, it can shatter our sense of safety and trust in the world. You may learn that relationships are sources of pain rather than comfort. This can lead to a fear of vulnerability and a tendency to keep others at arm’s length. You may struggle to open up, communicate our needs, or allow ourselves to depend on others. Research has shown that childhood emotional abuse is linked to insecure attachment styles in adulthood, particularly anxious or avoidant patterns. You may cling to partners out of fear of abandonment or push them away to avoid getting hurt.
To the extent these unhealthy attachment styles persist into adulthood, there is also an increased risk of being re-traumatized in adulthood, as the individual may subconsciously be drawn into dysfunctional relationships which are a replay of the earlier childhood traumas.
Are childhood traumas a contributing factor to the generational decline in mental health that has taken place in this country over the past several decades? Quite possibly. Certainly the extent that any prevalence of childhood trauma or abuse is increasing is going to contribute to an overall decline in mental and emotional health within any generational cohort.
At a minimum we may safely conclude that any individual coming out of an abusive family environment while growing up is also less likely to have mastered many of the essential life skills or learned the essential life lessons necessary to buffer their adult lives even without the added complications of PTSD and exposure to childhood traumas.
Regardless of when a person experiences trauma, however, a key determinant in their ability to move past the trauma and move back towards healthy and productive living is the presence of a strong social support network.
One of the most powerful protective factors for adult survivors is a strong support system. Surrounding oneself with caring, understanding people can provide a buffer against the long-term effects of trauma. Building a chosen family of supportive friends and mentors can be instrumental in the healing process. Having people who validate experiences, offer compassion, and provide encouragement makes a significant difference.
While there is a great deal of benefit to the support offered by other PTSD survivors, it is important also to understand that validation, compassion, and encouragement can be offered by anyone willing to meet other people where they are, and to be present in the moment with other people.
It is important to understand that the best therapies for resolving PTSD involve talking. While friends and other members of a person’s support network are not clinically trained therapists, and cannot provide the structured talk therapies available in the clinical setting, everyone has the capacity to listen, everyone has the capacity to create a safe and nurturing space where people can discuss their inner turmoil, and people grappling with trauma especially need that safe and nurturing space in which to talk.
When we listen to people, when we make them feel safe about opening up regarding their inner turmoil, we give them space to address their trauma history and move that much closer to healing. When we validate that their traumas are real, that their inner pain is real, and that they are not “broken” or made less because of their experiences, we give them hope that real healing can be had.
People may not have the same shared experiences of trauma, but to the extent that life has its share of traumas and adversity, nearly anyone has a foundation for connecting with others over their experiences of suffering.
We may not share similar experiences with others, but it is certain that we all suffer in some way, and that we are all tempted in some way. Perhaps by seeking to understand our own suffering and our own temptations we will find the wisdom to offer meaningful aid and comfort to others who are suffering and who are tempted.
We do well to remember that social support networks are networks of friends, of co-workers, and even of family members. Social support networks are not dependent upon clinics and therapists with degrees and licenses to tack on after their name. Anyone can be a part of a person’s social support network—just make the commitment to be a good friend and an active listener with that person.
The more we listen to people grappling with PTSD, the more we encourage them to talk about their traumas, and make them feel safe revealing their traumas, the closer they will come to achieving lasting inner peace and true healing.
June is PTSD Awareness Month. This is the month when many organizations—including The Houses Of Refuge Project—will be making extra effort to promote dialog and discussion about PTSD and other mental health challenges.
Yet the most important dialog and discussion about PTSD, or indeed about any mental health challenge, is the one any of us can have with someone struggling with PTSD, as well as any other mental health challenge. The best thing any of us can do to assist someone in recoverying from trauma, childhood or otherwise, is to talk to them, and especially to listen to them.
By talking, by listening, and by meeting people where they are, each of us has the capacity to build up the support networks we need to buffer the slings and arrows of outrageous fortune called “life.”
The more we can meet people with respect, with care, and with compassion, the more we can aid those who struggle. A little time and a whole lot of listening can make all the difference to those in pain.