Dear Therapist:

Hi, my two-year-old child was recently exposed to something very traumatic. At least it was something that would be very traumatic for an adult. I am uncomfortable going into all the details but it involved a serious injury to someone right in from of her, with a large medical response etc. I am wondering if a child that young can be "traumatized" and what would be the signs in a child so young that they needed help? What kind of help is even available to a child that young and how does it work? Thank you for your time.

Response:

Your opening sentence refers to something that was very traumatic. This appears to be a universal assertion—that the event to which your child was exposed would be universally traumatic. However, you follow up with a perceptive mention of the fact that it would be traumatic for an adult. I would alter that sentence to state that it would be traumatic for you.

You recognize that a two-year-old child might experience a traumatic event differently than would an adult. However, every person experiences traumatic events differently. In fact, we all experience every event differently. And we all experience life differently. We all have different fears, and we all have different personalities. There is a reciprocal relationship between these and other individual characteristics.

Consider someone with a particular personality and specific fears, insecurities, background, trauma, emotional response, and responses of others. This person is “primed” to react a certain way to certain types of traumatic events. A different person with a completely different set of personality factors might react quite differently. We could assert that one person was traumatized, while the other was not.

This opens the door to discussion of the definition of “trauma.” What makes something traumatic? Is there a universal definition or is it individualized? You ask whether a young child can be traumatized. The question is really: Will this particular child be traumatized?

The first thing to consider is the fact that your two-year-old child is an individual. Despite their young age, they have had the chance to develop an individual personality. Additionally, there is a reciprocal relationship between internal factors (fears, insecurities, emotional responses, etc.) and external factors, like others’ responses.

Often, our fears cause us to actually cause the feared event to come true. This is despite all we do to turn the tide in the other direction. Ironically, this effort to avert the feared outcome is often the greatest contributor to causing this outcome. This process is known as a self-fulfilling prophecy.

Consider a parent and young child walking in the park. They encounter a large dog. The parent is startled. Believing that their reaction may cause the child to develop a fear of dogs, the parent says, “Dogs are our friends. When they bark, they’re saying ‘hi,’ and when they chase you, they want to play.” For one child, this may be the correct response. Perhaps the child began to cry upon seeing the dog, and continues to be afraid of dogs days later. Another child, however, may never have been afraid; they may have been delighted at the sight of a dog leaping up. The parent, however, projected their fear onto the child, assuming that they were also afraid. Discussing the fact that dogs are our friends may cause the child to wonder why the parent feels the need to reassure them, leading to a previously non-existent fear.

Of course, this is an oversimplification of the self-fulfilling prophecy process, but it is important to understand the concept. While I don’t know your child, recognize that to a large degree it is our responses as adults that can cause consternation in young children. Young children are very ego-centric. Since the world revolves around them, it can be very difficult for them to conceptualize the idea that a threat to others can translate to a threat to them.

As adults, when someone close to us dies it can lead to thoughts of our own mortality. For children, however, this typically does not occur unless there are other factors at work. In many cases these factors work on an unconscious level. A child may become afraid of dogs simply because the parent is giving them subliminal messages to the effect that dogs are scary. They often have no idea what it is about dogs that is scary. (This is the reason that phobias tend to generalize to things seemingly unrelated to the original fear.)

So, how can you determine whether your child has been “traumatized,” to the extent that they require professional help? At the risk of seeming blasé, perhaps the best response would be to ignore the incident unless you have reason to believe that your child has been traumatized. Of course, if there is an indication that they have been traumatized—like unexplained crying, bedwetting, outbursts, or other unusual actions—you should seek help. The sooner that appropriate assistance is rendered, the less risk there is of any trauma becoming prolonged.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

  Woodmere, NY

  adjunct professor at Touro College

  Graduate School of Social Work

  author of Self-Esteem: A Primer

  www.ylcsw.com / 516-218-4200

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