Trauma, Signs, Symptoms and Support

You might not think this is trauma

You might be here because something happened, a hospital stay, a frightening event, a loss. Or you might be here for another reason entirely, your child’s sleep has fallen apart, they seem more anxious or angry than usual. Or even, school has become a real struggle, and none of it quite makes sense. If that’s you, it’s worth knowing trauma doesn’t always look like what people expect. Many parents I see never connect what they’re witnessing to the word trauma at all, until we look at it together.

Trauma: Signs, Symptoms and Support

Trauma leaves a mark. Not always visibly, not always immediately, but in the body, the nervous system, and the way a child comes to understand themselves and the world around them.

I have spent over twenty six years working with traumatised children and families across CAMHS and private practice. In recent years my work has focused increasingly on medical trauma and birth trauma, areas where specialist support is hard to find and where families often carry something significant, largely alone.

A definition of Trauma

Trauma occurs when a child feels intensely threatened by something they experience or witness, and their capacity to cope is overwhelmed. It is not defined by the event itself but by the impact on the child’s nervous system. Two children can experience the same event and respond very differently, depending on their age, their temperament, their attachment history, and the support around them.

The Bristol, North Somerset and South Gloucestershire Trauma-Informed Practice Framework, developed with the NHS and local partners, describes trauma similarly, as arising from an event, or series of events, experienced as harmful or life-threatening, with effects that can genuinely limit someone’s ability to function and find wellbeing, sometimes for a very long time afterwards. It’s a definition I recognise constantly in my own work. Trauma isn’t really about what happened, it’s about what happens inside a child because of what happened, it lives in the nervous system, not just in memory.

Research into Adverse Childhood Experiences, known as ACEs, has shown that children exposed to multiple traumas are significantly more likely to experience serious physical and mental health difficulties in adulthood. Early support makes an enormous difference.

What trauma can look like

Children will not come to you and say they are traumatised. They will show you through their behaviour, their bodies, and the ways they relate to the people around them.

What trauma can look like

Some children want to be with you constantly, unable to let you out of their sight. Others do the opposite and withdraw in ways that feel unfamiliar. Behaviour may become more irritable, more reactive, or harder to reach. School can become a struggle, not because of ability but because a nervous system still scanning for threat cannot settle into learning. Forming or trusting relationships may feel difficult. A child may seem younger than their years, or show an exaggerated response to things that would not usually bother them.

The wider signs recognised across trauma-informed practice more broadly are wide-ranging, and worth knowing, since trauma can present in ways that don’t always look like what you’d expect: withdrawal or isolation, difficulties sleeping, trouble recognising or managing emotions, nightmares, low self-esteem, shame or self-blame, anger or irritability, poor concentration, anxiety, hypervigilance, and real difficulty forming trusting relationships. It’s a genuinely wide picture, and that breadth is exactly why trauma is so often misread as something else entirely, defiance, poor behaviour, simple anxiety, when the root is something deeper.

Children will not come to you and say they are traumatised. They will show you through their behaviour, their bodies, and the ways they relate to the people around them.

Physical symptoms are common. Headaches, stomach aches, and other complaints that have no clear medical cause make complete sense when you understand that the body holds what the mind cannot yet process. And sleep is almost always disrupted. A nervous system that has been overwhelmed finds it genuinely hard to feel safe enough to let go into rest.

You can read more about supporting children with sleep in my free guide When Darkness Comes.

Different Types of Trauma

It’s worth knowing that trauma doesn’t come in just one shape. Local trauma-informed services recognise several distinct forms: single-event trauma, a one-off frightening experience like an accident; complex trauma, repeated experiences of abuse or adversity, often over time; developmental trauma, harm experienced at a young age within a caregiving relationship specifically, which affects attachment and brain development directly; and intergenerational trauma, difficult experiences and their emotional weight passed down across generations. There are further forms too, community trauma, cultural trauma, and secondary or vicarious trauma among them, all reminders that trauma rarely sits in isolation, it’s often layered, and interconnected with other experiences in a child’s or family’s life.

Medical trauma

This is an area I work with a lot in my private practice,

Medical trauma occurs when a child’s experience of illness, injury, pain, or medical procedures overwhelms their capacity to cope. It does not require a dramatic event. A frightening procedure, an unexpected diagnosis, a stay in hospital, repeated medical interventions, all of these can leave a significant mark on a child’s nervous system, particularly when they are young and do not have the language or the understanding to make sense of what is happening to them.

Trauma is held in the body. A child who has experienced medical trauma may develop anxiety around anything that feels medical, become intensely fearful of pain or needles, struggle with separation, or display signs of hypervigilance and emotional dysregulation that seem disconnected from their current circumstances. Often parents describe a child who changed after a medical event.

Traumatic grief

Many children adjust well to the death of a family member or close person. For others the grief becomes complicated, interfering with daily life and making it hard to access positive memories or move forward. This is sometimes called childhood traumatic grief and it benefits from specialist support.

Complex or developmental trauma

This occurs when a child has been exposed to ongoing adversity, stress, or neglect in their early caregiving environment. Most traumatised children will not develop PTSD. Instead they are at risk for complex difficulties with emotional regulation, relationships, and physical health that can persist without the right support. These children often reenact their trauma through behaviour in ways that can be hard to understand without that context. Beacon House have a genuinely excellent website full of resources for developmental trauma, click here.

Harm and safeguarding

If you are concerned about abuse, the following organisations offer information, guidance, and support:

NSPCC for all forms of child abuse including physical, emotional, and sexual abuse.

Women’s Aid for domestic abuse support for women and children.

Interested in working with me

I work with children, young people, and their parents using trauma informed, nervous system focused approaches. For younger children this includes play therapy and the World technique, which uses a sand tray and miniature figures to help children process difficult feelings without needing words. For older children and teenagers I offer talking therapy adapted to where they are and what they need.

I also work with parents individually, helping you understand what your child is carrying, process your own experience of trauma, and find ways to support your child that feel manageable alongside everything else you are holding.

And I offer training and consultation for professionals working with traumatised children and families.

If you would like to find out more, please do get in touch via my contact page.

Free resources

Understanding Your Child’s Guard Dog Brain

Holding in the Storm

When Darkness Comes

All free to download.

References

BNSSG Trauma-Informed Practice Framework (2024). Bristol, North Somerset and South Gloucestershire.

And if you would like occasional guidance and support straight to your inbox, you are very welcome to join my newsletter.

With warmth,
Catherine