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Trauma

  1. What is trauma?
  2. Different traumatic events
  3. People affected by trauma
  4. How people respond to trauma
  5. How does trauma affect children?
    • What to look out for
    • The effects of Trauma on Learning and School
    • Tips – Children and Trauma
  6. Intervening in trauma cases
  7. Legislation
  8. How can you get help?

Trauma is when you feel fear, horror, helplessness when something violent happens to you, or you witness a violent event, in which you see someone die, or fear for your own or someone else’s life.

Trauma is the natural emotional state of an individual or family in response to a traumatic event. A traumatic event is an event/s outside the range of normal human experience where a person experiences, witnesses or is confronted with:

  • actual or threatened death
  • serious injury
  • a threat to the integrity of that person him / herself or another, and
  • where the person experienced intense feelings of fear, helplessness or horror

Trauma can be a once off / Simple Trauma – where a person is exposed to only one traumatic event or Multiple Trauma – when one is exposed to more than one type of traumatic event.  The symptoms and interventions required in this type of trauma are more complex than in once off / simple trauma.

Traumatic events may include:

  • murder
  • hijacking
  • armed robbery
  • rape
  • aggravated assault
  • kidnapping
  • motor vehicle accident
  • abuse
  • domestic violence
  • suicide
  • terminal illness
  • death
  • school or community violence
  • natural / unnatural disasters

People who are directly exposed to the traumatic event are called direct victims.  Other people can also be affected by trauma. These can be witnesses, family members and friends of the direct victim, emergency staff, counsellors, journalists and even sometimes the whole community directly exposed to the traumatic event. These are indirect victims. This is sometimes called secondary trauma.

People who experience a threatening or traumatic event usually have one of three immediate responses caused by their central nervous system: fight, flight or freeze. People either to get away from the situation, try to fight back or stop what is happening, or the person can’t do anything and feels ‘frozen’. These are normal and natural reactions for all humans (and animals), and are caused by chemicals and hormones in the brain and body.

Once the event is over the person’s body returns to normal but the feelings of being scared, terrified, horrified, and unsafe don’t go away straight away. Most people will have these feelings as well as upsetting memories and thoughts, for a while after the event.  This is called Post-Traumatic Stress Response and is very normal.

Some of the things you might experience:

  • Nightmares
  • Feeling scared a lot, especially when something reminds them of the event, or when going to the place it happened
  • Feeling like nothing is safe, or that bad things are going to keep happening
  • Not wanting to go out, be with friends, play or do other things that they used to enjoy
  • Anger
  • Guilt – the feeling that maybe they were responsible for what happened
  • Wanting to get revenge
  • Sadness
  • Hopelessness
  • Not being able to eat or sleep normally
  • Not being able to concentrate at school

When these very normal feelings, thoughts and memories don’t go away, it is called Post-Traumatic Stress Disorder (PTSD). When a person has PTSD, it means that these feelings, thoughts and memories affect their whole life, and stop them from doing the things they would normally do.

Sometimes PTSD can affect a person weeks, months or sometimes even years after the traumatic event.  Symptoms of PTSD:

  • Re-experiencing the trauma: upsetting memories, nightmares, flashbacks which may occur with sweating, pounding heart and even nausea
  • Avoidance of any reminders of the traumatic event: staying away from doing things, going to places, or even thinking about things that remind you of the traumatic event. You might even not be able to remember important parts of it. You might also feel detached from other people, feel as though you are numb inside, or lose interest in doing things you normally do
  • Increased anxiety which may cause you to not sleep very well, become irritated and angry, lose concentration, and feel constantly on guard (hypervigilance)

Other symptoms may include:

  • guilt, shame, or self-blame
  • feelings of mistrust and betrayal
  • depression or hopelessness, including suicidal thoughts, feelings, and possibly plans or attempts
  • substance abuse
  • physical aches and pains

PTSD: Symptoms, Self-Help, and Treatment Alternatives: https://www.helpguide.org/articles/ptsd-trauma/ptsd-symptoms-self-help-treatment.htm

For most children, a traumatic event is a new experience and like all new experiences, the unknown will add to the confusing and frightening circumstances surrounding this overwhelming experience. The event may significantly challenge the child’s understanding and view of the world, challenging the child’s beliefs and assumptions about the stability and safety of their world.

Very young children may not understand what happened and will be confused or even frightened by the reactions of their siblings or caregivers.

In children — especially very young children — the symptoms of PTSD can be different from adults and may include:

  • fear of being separated from their parent/caregivers
  • losing previously acquired skills (such as toilet training)
  • sleep problems and nightmares
  • compulsive or repetitive play that seems sad/serious, in which themes or aspects of the trauma are repeated and explored
  • new phobias and anxieties that seem unrelated to the trauma (such as a fear of monsters)
  • acting out the trauma through play, stories, or drawings
  • physical aches and pains with no apparent cause (these pains are real, even if caused by emotional or psychological factors)
  • irritability and aggression

What to look out for

 Preschool learners may:

  • lose recently acquired developmental milestones and may increase behaviours such as bedwetting, thumb-sucking, and regress to simpler speech
  • become clingy towards their parents and worry about their parents’ safety and return
  • become more irritable with more temper tantrums and have more difficulty calming down
  • or, become very withdrawn, subdued, or even mute after a traumatic event
  • have difficulties falling or staying asleep or have nightmares about the event or other bad dreams
  • process the event through post-traumatic play

Primary school learners may:

  • show signs of distress through physical complaints such as stomach aches, headaches, and pains
  • have a change in behaviour, such as increased irritability, aggression, and anger, or withdrawal from activities previously enjoyed
  • show inconsistent behaviour
  • show a change in school performance,have decreased attention and concentration, and more school absences
  • talk excessively and ask persistent questions about the event

High school learners may:

  • suffer from depression and anxiety
  • have suicidal thoughts, feelings, plans, or may attempt suicide
  • feel self-conscious about their emotional responses to the event
  • experience feelings of shame and guilt about the traumatic event, and may express fantasies about revenge and retribution
  • experience a radical shift in the way they think about the world (e.g. the world is a bad place)
  • begin to engage in self-destructive or high-risk, reckless behaviours
  • experience changes in their interpersonal relationships with family members, teachers, and classmates
  • show a change in their school performance, attendance, and behaviour

The Effects of Trauma on Learning and School

A traumatic event can seriously interrupt the school routine and the processes of teaching and learning. Trauma can have profound effects on a child’s ability to concentrate, participate and process the regular school day, which may lead to significant achievement gaps for these students.

  • Traumatized children are vulnerable, and educators are the critical link to intervene with sensitivity and awareness
  • Educators may not be aware that a student is learning or responding under a trauma response
  • Educators and other school staff members may misinterpret or mislabel learners’ behaviours, learning patterns, or social skills. There are usually high levels of emotional upset, potential for disruptive behaviour, or loss of student attendance. Often this leads to more negative remarks in their reports than other students
  • Traumatised children may experience barriers in several school-related areas – academic performance, classroom behaviour, and relationships, which are all essential for learning (see learning problems)

Examples of the factors which might affect academic performance include:

  • disruption of language and communication skills
  • difficulty organizing narrative material
  • comprehension of cause-and-effect relationships
  • difficulty with taking another person’s perspective
  • trouble with attending to classroom tasks
  • barriers with self-regulating or modulating emotions
  • and reduced motivation for academic engagement

Tips – children and trauma

  • just because a child doesn’t talk about a traumatic event, doesn’t mean they’re not thinking about it
  • children are often too overwhelmed to talk about the traumatic event
  • they may sense your discomfort and not want to upset you by bringing it up, or they may be too overwhelmed by their own feelings to express them
  • reassure them that it’s okay to talk about what happened, and that their feelings are normal
  • encourage the child to share their feelings
  • help the child to name their feelings
  • listen extensively
  • find out what they know, and how they understand what happened
  • start the conversations
  • If they don’t know the facts, children often fill in the parts they don’t understand by using their own imagination – sometimes these fears and fantasies can be more frightening than the facts
  • as soon as the child asks questions or seems to be thinking about the event, it’s time to have a conversation
  • know when to get outside help – Childline offers free counselling, call 0800055555
  • children as young as 4 or 5 can benefit from talking about / playing out the event
  • to open-up the conversation, you might start with questions like these: “Are you and your friends talking about what happened in Hillbrow?” “I’d be really interested in hearing about what you think. Let me know if you want to talk”

Through interventions like individual and family counselling and psycho-education, levels of trauma can be reduced, resilience in children can be built, and family relationships strengthened.

In severe cases of abuse, referrals to appropriate stakeholders will be made to investigate and where appropriate, procedures in terms of the ‘child in need of care and protection’ as per the Children’s Act (38 of 2005) or Criminal Procedure Act will follow.

In cases where PTSD is suspected one requires referral for a psychiatric assessment.

If your child or family has experienced a traumatic event, you can call Childline on 0800055555, and speak to one of our counsellors any time of the day or night. Our counsellors will be able to offer information and referrals, as well as help you set up an appointment with one of our social workers for counselling.

Make sure your children know about Childline, should they ever need help – 0800055555

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