In the "Cahoga Lake" episode of the TV series Loot, Nicholas, an actor, struggles to cry on cue for a role he got. When his friend, Howard, attempts to help him by asking him about any childhood trauma, Nicholas insists that it was “very normal”.
“You know, there was no screaming, no fighting, no crying, no hugging, no I-love-you's, no touching, no birthdays, no holidays. It was a nice, normal life.”
As Howard acknowledged, much darker than anticipated. It sheds a funny-but-serious light on how the things from childhood that we don’t recall, or just believe to be "normal", may influence our present.
What is trauma?
The American Psychological Association defines trauma as the lasting “emotional response to a terrible event like an accident, rape, or natural disaster”. The Centre for Addiction and Mental Health notes that traumatic events “can harm a person’s sense of safety, sense of self, and ability to regulate emotions and navigate relationships”.
People at some points in their lives will face awful events, such as the loss of a loved one. It’s important to note that trauma is a very normal reaction to abnormal events. According to the Institute for Advanced Psychiatry, not everyone who experiences trauma will develop PTSD. However, there may be instances where reactions are so severe that a person’s daily functioning and wellbeing are disrupted.
For more information on signs of post-traumatic distress and PTSD symptoms, I often refer folks to Mayo Clinic’s article on PTSD.
How might this show up in adulthood?
I occasionally will have adult clients who are aware of their childhood trauma, the impact of their past on their present, and their need for therapeutic support. However, I also have clients who display PTSD-like symptoms, but there is not (yet) a clear connection between this and their childhood.
The Institute for Advanced Psychiatry has some great information on how this might appear in adulthood. Some signs that I’ve observed in my own clients include:
Attachment difficulties, especially anxious or avoidant attachment styles, which can strain relationships
Self-regulation issues, such as anger, anxiety depression, or withdrawal
Flashbacks and/or nightmares
Physical health issues, such as chronic pain, headaches, or nausea
Statements to look out for
Blanks in the memory from 2.5 to 7 years of age are normal given that our hippocampal region (the part of the brain thought to be responsible for memory formation) is still developing. When I hear that first memories can only be recalled until much later than what is considered normal, I consider it a flag for potential childhood trauma.
Some sample phrases to look out for include:
“I don’t really remember much of my childhood.”
“My earliest memory was when I was 13-years-old.”
“Nothing bad EVER happened to me as a kid.” (This may be true, but typically people can identify one or a few adverse events, such as a family death, a sudden move, bullying, etc.)
“I was told I was very mature for my age.” (May indicate having to grow up too quickly out of necessity.)
Other considerations
Please note that these statements, and others similar to these statements, should not be considered as the only criteria when exploring potential childhood trauma and/or a diagnosis of PTSD.
We also need to rule out underlying physical concerns, such as head injuries, vitamin deficiencies, or other medical illnesses that only a medical doctor may diagnose. It also helps to use multiple measurements to explore other symptoms that may indicate trauma, such as the PCL-5 (PTSD Checklist).
Finally, it’s very important to note that PTSD symptoms often overlap with other disorders that may be coexisting or explaining someone’s presentation. For example, if you are diagnosed with either PTSD or ADHD, you are more likely to be diagnosed with both disorders.
Comments