Trauma is not limited to domestic or sexual violence. We live in a world prone to floods, hurricanes, and earthquakes, not to mention other sorts of natural disasters. Without warning, people die or are injured every day in cars on our nation's streets and highways.
Despite wonderful technological advances in medicine, people still experience life-threatening medical conditions and painful procedures. The media provides us with a picture of escalating community violence, drug abuse, and other dangers. Even from an adult perspective, the world can be a very frightening place!
Seeing the World Through a Child's Eyes
Over the next day or so, as you think of it, imagine the world through a child's eyes. What otherwise benign sights or events might be frightening if you were a child? Consider the evening news. What message would children receive about the world they live in if they saw the same news item that you are viewing?
If you are at a loss for a relevant news clip, consider the following Associated Press item, dated March 9, 2000:
MIAMI -- A woman has been charged with attempted murder after her 15-year-old daughter told authorities the woman doused her with gasoline and set her on fire because she didn't like the girl's boyfriend.
Miami-Dade Police also charged Maria Tarrago on Monday with aggravated child abuse and great bodily harm and arson resulting in injury. Her daughter was burned over 23 percent of her body.
The girl has been hospitalized since the Dec. 6 fire and unable to communicate until recently, police spokesman Pete Andreu said. On Monday, she told her story to the father of her roommate at Jackson Memorial Hospital's Rehabilitation Center.
Police said Wednesday that Tarrago, a maid from El Salvador, was upset because her daughter was seeing a boy she disapproved of. The fire occurred in the apartment Tarrago shared with her daughter and son.
Realizing what she had done, police said, Tarrago and her boyfriend extinguished the fire and rushed the girl to Miami Children's Hospital.
At the time, Tarrago told officials the fire had been an accident.
Tarrago's daughter is now in good condition, Jackson spokeswoman Rosa Gonzalez said, although it is not known when she will be released. She is in state custody.
Adults listening to the news report are horrified. But imagine what a child might think after hearing such a frightening news report. Though the child may not ask you anything about what she has heard, she will have a whole host of questions: What does it mean to be set on fire? Will that girl be okay? What will happen to the mother? How could a mother set her own daughter on fire? Could this happen to me?
Childhood Trauma Increases Risks in Adulthood
People who have experienced traumatic events in childhood are at increased risk for a host of other problems, impacting all domains of functioning. Impaired emotional, social, cognitive, and physiological functioning can result from adverse childhood events.
Social problems of traumatized children can manifest in teenage pregnancy, adolescent drug abuse, school failure, victimization, and anti-social behavior. Victims of childhood trauma can suffer from neuropsychiatric conditions, such as post-traumatic stress disorder, dissociative disorders, and conduct disorders.
Medical problems such as heart disease and asthma can also be directly attributed to childhood trauma in some cases. Childhood trauma has even been linked to increased risk for cigarette smoking:
Researchers from Kaiser Permanente in California studied data on 9,215 patients in health maintenance organizations. They questioned patients about their smoking habits and exposure to the following events: being emotionally, sexually, and/or physically abused; having a battered mother; divorce or separation of parents; growing up around substance abuse; or growing up with a mentally ill or incarcerated household member.
Kids exposed to five or more of the eight types of negative childhood experiences were 5.4 times more likely to begin smoking by age 14 or 15 than kids who did not have such negative experiences. And children with negative experiences were twice as likely to be a current smoker and nearly three times more likely to be a heavy smoker than children who were not exposed to negative events. (This study appeared in the November 3, 1999, issue of the Journal of the American Medical Association.)
The escalating cycles of abuse and neglect of our children seen in some of our urban and rural communities can, in turn, become a major contributor to many other social problems. Some would consider the deterioration of public education, the proliferation of urban violence, and an alarming rate of social disintegration all as direct results of childhood trauma.
Dissociation and PTSD
Here are two more terms to define before we move forward:
Dissociation is the mental process of disengaging from the stimuli in the external environment and attending to inner stimuli. This is a graded mental process that ranges from normative daydreaming to pathological disturbances. Dissociation may include exclusive focus on an inner fantasy world, loss of identity, disorientation, perceptual disturbances, or even disruptions in identity.
Post-Traumatic Stress Disorder (PTSD) is a neuropsychiatric disorder that may develop following a traumatic event. Symptoms of PTSD can include changes in emotional, behavioral, and physiological functioning. It is characterized by three key sets of symptoms: 1) re-experiencing and re-enactment, 2) avoidance, and 3) physiological hyper-reactivity. In later lessons we will learn more about each of these three symptom clusters.