Seven Levels of Trauma Impact

Trauma can profoundly affect children's development. In an article highlighted on the website Zero to Three (National Center for Infants, Toddlers, and Families), Dr. Theodore Gaensbauer discusses the "Developmental and Therapeutic Aspects of Treating Infants and Toddlers Who Have Witnessed Violence." Dr. Gaensbauer's framework for understanding how trauma affects children has even wider significance, applying to older children and to those affected by other forms of trauma as well. This framework may be helpful for training new therapists, helping parents understand the ripple effects of trauma, and explaining the crucial need for sexual abuse prevention to policy makers.

In this article, Dr. Gaensbauer uses the example of "Kevin," who witnessed his father being stabbed. To make this framework more useful for our purposes, I will give the example of "Hannah," a five-year-old who was sexually abused by her mother's boyfriend, Seth, when she was three and four. (This is a composite example, not an actual case.)

Level One

Posttraumatic symptoms, which "likely have a strong biological basis," such as re-experiencing, avoidance of reminders, numbing of general responsiveness, and increased arousal. For example, Hannah refuses to sit on the couch in the family room, where much of the abuse took place. She is also "jumpy" and anxious, and responds with irritability to minor conflict.

Level Two

Feelings and meanings "connected to the particular circumstances of the trauma, such as depression, feelings of responsibility or guilt, or the search for omens…" Hannah was told by Seth that she was a bad girl and no one would believe her, and (despite having been told otherwise), she often believes the abuse was her fault.

Level Three

"Disruption in developmental issues being worked on at the time that the trauma took place." Hannah was beginning to play more independently at age three, but now she is very demanding of her mother's presence and doesn't like to go into her room or the fenced back yard alone.

Level Four

"Disruption in subsequent developmental phases" with ongoing posttraumatic symptoms and themes. Hannah was happy and excited to start preschool (before the abuse began), but now she is clingy and nervous about going to kindergarten, and she sometimes masturbates in class.

Level Five

"Effects of the child's symptoms and behaviors on interactions with others." Hannah is preoccupied with fears and themes of threats. Her kindergarten classmates are uncomfortable with some of the scary images she talks about, and she can be unpredictably angry and threatening with them.

Level Six

"The independent impact of trauma on other family members, independent of the child's reactions." Hannah's mother, Cindy, felt that her life fell apart when she learned of the abuse. Cindy was physically abused by Hannah's father, and when she met Seth, she saw him as a "real gentleman" and "a knight in shining armor." Cindy became very depressed when the abuse came to light, and her depression made it difficult for her to respond to Hannah's needs.

Level Seven

"The extent to which a trauma may bring up memories and feelings related to previous traumas." Hannah had witnessed her father's abusive behavior toward her mother, and later on, the threats made by Seth to ensure her silence about the abuse reactivated her sense of fear and lack of safety, even though she didn't have clear memories of the earlier trauma.

Gaensbauer offers a vivid description of how young children carry traumatic memories with them, with powerful feelings that may be triggered by present-day events. He says, "These enduring sensory-motor/affective representations and their 'here and now' immediacy are thus not just disorganizing in nature, but instead come to play an organizing role in the child's development, coloring and distorting many subsequent experiences." Very young children may be so affected by negative experiences that their very identity is wrapped up in and distorted by trauma reactions. It is critical that they experience "islands of safety" where they can move forward with healthy development.

Helping nonoffending parents to cope effectively with their own reactions and respond in a positive and supportive manner to their children are some of the most important ways in which advocates and therapists can promote "islands of safety" for children who have been sexually abused. When a parent can be calm and supportive, the child can begin to rebuild a sense of safety and trust. In conjunction with therapy, if needed, young children can benefit from a safe emotional environment so they can heal and move forward in the important developmental tasks of childhood.