A guide for children about understanding and managing trauma, by Greater Manchester Resilience Hub.
Looking after yourself following a trauma
You may be reading this because you, or someone you care about, have been involved in a traumatic situation.
Being involved in a trauma can have a big impact on you and it is common to find life harder than before. This often settles down after a few weeks, but sometimes it can take longer.
This guide will help you understand why you find it hard after a trauma and suggest ideas you can use to help you begin to feel better.
What you can do if you are finding it difficult
If you are struggling, talk to an adult you trust. They could get involved with the ideas in this guide and support you to find help.
You can read the whole guide or pick the sections that are the most relevant to you. Come back to it whenever you need a reminder.
A trauma is an unexpected situation where you have felt helpless, or afraid for the safety of yourself or someone you love. You don’t have to have been there or even to have seen it to be affected.
There are many different types of traumas such as; a car accident, a burglary, severe bullying or an attack. Traumatic situations usually come out of the blue and may be something you have never experienced before.
Often people think they, or someone they love, are going to die or be seriously hurt.
Trauma affects people in different ways, at different times. There is no right or wrong way to think or feel. Some of the things people describe are;
- nightmares and/or struggling to sleep
- upsetting thoughts
- memories and pictures of the event popping up when you don’t want them to
- feeling as though it is happening all over again
- feeling anxious, jumpy and on edge
- having panic attacks or physical sensations, like dizziness, heart racing
- becoming upset at reminders
- being more worried about bad things happening
- finding it difficult to cope with everyday stresses
- feeling scared to go out
- finding it hard to be away from loved ones or wanting to be with them more
- wanting to spend more time alone
- feeling sad and irritable
- having difficulty concentrating
- feeling guilty for what you did or didn’t do and how you are feeling now
- feeling like things will never get better
- feeling nothing or feeling numb.
Trauma reactions are often invisible. Sometimes you think you should be able to get over a trauma quickly and you can become annoyed and embarrassed about how you feel and cope.
When frightening situations happen, the world can feel like a very different and scary place. Some things may have changed, and it takes time to come to terms with this.
Struggling after a trauma is not a sign of weakness, it is okay to not be okay.
During a trauma your brain switches to survival mode and stops processing everything that is happening around you.
Afterwards this leaves chunks of information that are jumbled up and that don’t behave as you would expect.
The memories are not properly organised or linked to a specific time in your brain’s filing system, so it doesn’t realise it is in the past.
When you are reminded about the trauma you may feel just as scared as you did at the time.
Sometimes memories or chunks of information pop into your minds when you don’t want them to. The memory can also stop at the worst part, have bits missing or be in lots of broken pieces. Like a jigsaw puzzle that has been tipped out of the box.
Because the memories are not filed away, your brain thinks you are still in danger and keeps you on high alert. This can make you react to even the smallest worries.
You may also try hard not to think about it by avoiding reminders and situations that make you anxious. This makes it even harder for your brain to file the memories away and can stop you learning that you are safe.
It is important to remind yourself that you are safe and that the trauma is in the past but that it is also okay to have strong thoughts and feelings about what has happened.
Here are some things you can do to help yourself begin to feel better;
- Look after yourself - eat well, get enough sleep and do a small amount of exercise every day
- Take pressure off yourself where you can – does your room have to be tidy, can you get some time off homework?
- Get back to doing things you used to do. Talk to the adults around you about what will make it easier to go back to school, college, hobbies and any worries you have about this
- Remind yourself that it is in the past – put a picture on your phone of something good you have done since, something you are looking forward to or an inspirational quote
- Do things that make you feel safe - make your bedroom nice, have things around you that make you feel secure and spend time with people (or pets)
- Stay away from social media and the news if this is upsetting
- Don’t worry if you feel scared - it does not mean you are in danger now
- Help your brain to make sense of what happened - talking about the event (when you want to with a person you trust), or writing this down can help.
Other people may be able to help fill in missing information for you. However, it is also okay to say you don’t want to talk about it if people ask you questions.
There are lots of suggestions throughout this guide that you can use to help yourself feel better. You may need to use different ones at different times.
Matching the type of help to how you are feeling is important - use strong things when you are really struggling and more soothing ones when you are less stressed.
When you have tried them - and have chosen the ones you find useful - putting them all together in one place will make it easier to remember what they are.
Making a resilience box to keep them in can also be a helpful activity in itself. Choose a container, like a shoe box or a pencil case. Decorate it with things that you like – pick your favourite colours, pictures, quotes and stickers or gems.
As you find things that help, you can put a reminder or the actual thing in your box.
A good item to put in your box is a sensory plan. Using your five senses to calm your body and mind can be very effective.
You can put the plan or the objects you choose in your box and you could also have things to carry around with you. Find smells, images, sounds, tastes and textures that make you feel relaxed and safe.
Here are some ideas you could try:
Touch
- Pictures of family
- Friends and pets
- Favourite holiday
- Glitter bottles
- Lava lamps
- Positive quotes
Taste
- Chocolate
- Sour sweets
- Popping candy
- Hot chocolate
- Herbal teas
Sight
- Pictures of family
- Friends and pets
- Favourite holiday
- Glitter bottles
- Lava lamps
- Positive quotes
Sound
- Favourite music
- Background noise (rain, waves, birds)
- Meditation soundtracks
Smell
- Favourite perfume or aftershave
- Fresh coffee in a café
- Scented objects
- Diffusers
You can also put reminders that you are safe in your box. For example;
- get people to write messages to you
- find quotes you like and print them off or write them out
- print off photographs of your favourite memories or places.
Write down some ideas of what you could put in your resilience box.
After a trauma people often describe feeling low and fed up.
Things may have changed, you might have bad thoughts and memories, everything may feel harder and good things may seem far away. You may also feel disconnected from friends and like you have had to grow up too quickly.
You may notice you are doing things like;
- Crying
- shouting and being irritable
- feeling less or more hungry
- finding it hard to sleep or sleeping more
- not going out with your friends
- staying in your bedroom
- feeling really tired
- finding it hard to concentrate
- taking less care of yourself
- feeling like you can’t be bothered anymore
Looking after yourself, keeping in touch with other people, doing small, nice things every day and exercising will all help. Even if you only feel a bit better for a while, it is more helpful than being sad all day.
Tell someone how you feel, help them understand that you are not just being grumpy and ask them to help you. Talking to an adult you feel comfortable with is especially important if you are worried you are really low or if you feel you can’t keep yourself safe.
What you can do to help yourself feel better
When people feel sad and low they often don’t feel like doing things they used to enjoy.
However, if you stop doing things you can end up feeling even more alone, more tired, have more time for upsetting thoughts and cause yourself problems – this can make you feel even worse.
It is helpful to turn this around by planning things in every day, however small. Exercise, spending time with others and doing things that make you feel good will improve your mood, help you feel close to people and remind you that life goes on.
You could include things like;
- Watching your favourite programme, reading a good book, listening to a playlist
- Going to the gym, playing sports, dancing or taking the dog for a walk
- Inviting friends round
- Shopping
- Baking a cake and eating it
- Playing a video game with friends
- Using your favourite shower gel or bubble bath, painting your nails or using a face mask
- Spending time with your family or pets.
Keep an eye out for things that you have been doing that might be making you feel worse, like spending lots of time alone in your bedroom. Think about what you can do that would be better for you.
Keep a note of every small step you achieve, so you can see how far you have come.
Plan the week ahead, put the plan somewhere you will look at it and stick to it, however you feel at the time. Get ideas from your family and friends and ask them to encourage you.
Set yourself small achievable challenges to help you feel like you are moving forward. Don’t worry if there are things that seem too hard now and remember to reward yourself when you stick to your plan!
After a trauma your brain tries to keep you safe by assuming lots of things are dangerous. When it notices things that might be harmful it prepares you for the worst, which makes you feel anxious and on edge.
Triggers are things that remind you of the trauma and make it pop into your head or set your danger alarm off. Triggers can be noises, smells, someone mentioning it, reminders in the media, going past the scene, a poem in English or many other things.
Sometimes it is not clear what the trigger is. If you get really scared for no clear reason or if a memory of the trauma pops into your head it can be helpful to work out what might have been happening directly before it – understanding what your triggers are can make them seem less scary and can help you manage them better.
However, completely avoiding reminders will not be helpful in the long term and can lead to more problems.
Memories of a trauma can also seem to have a mind of their own. Because they are not filed away properly they can pop back up easily, especially when triggered by a reminder. They are often in pieces and in the wrong order. This is the information - emotions, sights, sounds, smells, tastes or physical sensations - from the time the trauma was happening.
Sometimes they don’t even seem recognisable. These often make people feel scared and can make it feel like it is happening all over again. When the pieces pop up they are called ‘flashbacks’.
If trauma memories are not processed properly they will feel like they are happening all over again when they pop up. They will also be stronger and more emotional than other memories.
Memories can also come back in disjointed pieces making you feel unsettled and confused. Your brain may not realise the trauma is in the past, so when you are reminded of it your body acts to keep you safe, intentionally putting you on high alert.
This can make you feel like there is something to be scared of.
Remembering is your brain’s way of trying to make sense of the information that it couldn’t process at the time.
Although avoiding reminders and pushing upsetting memories away seems like a helpful thing to do, this actually stops the processing and means it is more likely to bother you.
Trying to ride out the flashback or memory and then reminding yourself you are safe will be more helpful in the long term.
There are things you can do to ‘ground’ yourself and remind yourself you are safe. These can be helpful if you are struggling with flashbacks and upsetting memories.
Try to refocus your attention back into the present, rather than pushing the thoughts away or dwelling on them. Try out the different ideas and use the ones you find most helpful, you could also make up your own.
- Tell yourself that it is in the past and that this feeling and memory will fade again - remind yourself what day it is, where you are and what you are doing
- Think about what is happening now – name one thing you can hear, smell, taste, touch and see
- Describe what you can see as if you were explaining it to an alien – how would you describe a chair?
- Connect your body with the world around you – put your hand on a cold or rough surface, drink a cold or fizzy drink, eat a sour sweet, take your socks off and feel the floor
- Focus on your body - move about, shake your arms and legs, rub your arms
- Look at a picture on your phone of something positive – remind yourself where you were, who you were with, how you were feeling
- Think about something else – count backwards in 3s from 100, sing the rainbow, think of a name for every letter of the alphabet.
You could also use your sensory plan, or other ideas, from your resilience box.
Sleep is important as it helps us make sense of what we have experienced through the day and re-energises our brains and bodies.
Following a trauma, it is common for sleep to become disrupted. This may be because you are experiencing upsetting thoughts and memories when you try to fall asleep.
Sometimes you may feel like your brain just won’t switch off, you might also have nightmares or become anxious and panicky in your sleep, which then wakes you up.
Nightmares could include parts of the trauma, other bad things that you worry might happen or a sense of threat.
Nightmares can be scary and upsetting, but they are your brain trying to make sense of information while you sleep.
What can help with sleep
Following a trauma everywhere can feel unsafe. It can help to make your bedroom feel as safe as possible. Think about;
- The temperature (not too warm)
- soft lighting (like nightlights or fairy lights)
- having your favourite objects by your bed using things that feel nice (like onesies and blankets)
- relaxing sounds and nice smells (like a pillow spray)
You can also use ideas from your resilience box.
Following a trauma some people like to do things to make them feel safe such as putting your head under the bed covers, having the door open or sleeping with a soft light on.
However sometimes these things lead to other behaviours like; checking doors and windows are locked, saying goodnight a set way or sleeping in a parent or carer’s bed every night.
This is understandable, but by doing these things you actually stay more focused on your worries and never learn that you would have been safe anyway.
Try to slowly reduce these things at bedtime and any other time of the day you notice you are doing them.
A calm bedtime routine can also help you wind down and feel safe before going to sleep. This could include:
- A bath/shower with a relaxing smell
- Reading/listening to music
- A warm drink
- Relaxation time.
What you can do if you have a nightmare
Nightmares are especially common after a trauma. Although they are scary it is helpful to remind yourself that you are safe, and it was just a dream.
You could wake someone up, keep things by your bed that makes you feel safe or use sensory soothing items from your resilience box.
Often thinking about something else will help you forget the nightmare and go back to sleep. If the same nightmare about the trauma happens repeatedly it may be useful to seek additional help.
After a trauma it is common to feel more anxious and on edge. Anxiety sensations can feel horrible but they can’t hurt you.
Anxiety is actually your brain’s way of trying to help you. When your brain notices danger it sets off an ‘alarm’ to try and keep you safe. After a trauma your danger alarm becomes more sensitive and is more easily activated.
When the alarm is sounded our bodies are very clever – they can change in a split second to keep us safe from danger. This response is called the ‘fight, flight and freeze response’.
Cavemen had this response and so do animals. This response works well and has meant that the human race has thrived.
The fight, flight and freeze response
Imagine walking down a road. You feel relaxed and happy, the sun is shining, you are humming a little tune and everything is good...
Suddenly a huge cow comes hurtling out of a gate straight at you. It is mooing loudly and long streams of drool hanging from its huge mouth. It misses you…but only just.
How do you feel? Think about what would be going on inside your body if you just miss being squashed by this massive beast?
What happens to your body
You might notice some of the following happen to you:
- Your breathing becomes loud and fast, but it feels difficult to take a breath
- Your heart starts racing
- Your stomach clenches in fear and you might have butterflies or feel sick
- You can only think about the danger
- Your legs shake and feel like jelly
- You feel like you need the toilet
- You get hot and sweaty
- Your mouth dries up and you get a lump in your throat
- You feel dizzy or light headed.
The cow didn’t actually hurt you but your body prepared itself, just in case.
When your body thinks there might be danger need for action, it changes to make itself faster, stronger and fitter (fight and flight), or to make you very small and still, so the danger passes you by (freeze).
It does this by releasing chemicals, including adrenaline - this is a short acting power surge to help you deal with the danger.
When our bodies get it wrong
Our brain wants to keep us alive so it keeps a look out for danger and if it spots a threat it acts to keep us safe. Sometimes it mistakes situations or thoughts about bad things happening as dangerous and can set off its danger alarm too early - suddenly you are pumped up and ready for action.
Because there’s no real danger the physical feelings seem stronger, you notice them more and you can end up mistaking them for a sign that you are really in danger.
You can also get side effects from the physical changes that can make you feel even more anxious such as: blurred vision, being unable to concentrate and feeling unreal.
When the sensations get really strong, without any real danger present, this is called a panic attack.
The ideas that have already been described in this guide can help when you are anxious, however there are other things you can try too.
Breathing
When we anticipate danger our breathing changes, it becomes quicker and we breathe in more to get oxygen into our blood.
However, we then don’t breathe out properly, so don’t get rid of the carbon dioxide we have breathed in and this can leave us feeling out of breath and dizzy.
Slowing your breathing down and making sure you breathe from deep down in your stomach will help. Remember – breathing out is as important as breathing in!
Some ideas to help with this might be:
- Calming breathing – use your phone edges (or anything rectangular) to breathe in along the short side and breathe out along the long side. Keep repeating this slowly for as long as you need to. Run you finger along the edge as you do it to help you stay in the here and now
- Bubble breathing – imagine you are blowing up bubble gum as you breathe. Breath in and then blow the bubble up, right from your stomach. Practice getting it bigger and bigger each time you breathe out
- Counting your breaths – breathe in and out slowly, starting with counting to 1 and then increase it by one more count each time you breathe. See how high you can count to
You could also download a breathing app and use it regularly.
Relaxing your muscles
- Relaxing your muscles one by one will also help you feel calmer. Start with your toes – screw them up as tight as you can and then relax them. You can do this with each part of your body in turn, slowly moving from your toes to your head.
- Shaking out your muscles can also help. Get up, move around and shake out your arms and legs.
Imagining a calm and safe place
Creating a calm and safe place you can visit in your mind can be useful when you are feeling anxious or stressed. This can be used without people noticing what you are doing.
To practice, find somewhere quiet where you won’t be disturbed. Make sure you are warm and comfortable. Focus on your breathing and take some deep breaths in and out.
- Imagine a place where you feel peaceful and happy. This can be real or imaginary. You might want hold something that reminds you of it (e.g. a pebble from a beach).
- Close your eyes. Notice the things around you in your mind, what can you see? Is it indoors or outdoors? If there is a window, what can you see through it.
- Think about what you can hear. Are there sounds close to you or can you hear things in the distance? What are the sounds like?
- How does it feel? Is it warm and cosy or is it cool and fresh? What can you feel below your feet?
- Think about what you are doing in your place. Are you sitting, lying down or perhaps walking?
- Spend some time in your place. Think of a key reminder, so you can easily get back there – is it a name, an image, a smell?
- When you have spent enough time there, take some more deep breathes, imagine breathing out stress and tension and breathing in calmness and relaxation. Then open your eyes slowly and gradually remind yourself of where you are.
- Practice your safe place regularly until it becomes easy to imagine. You can then use this whenever you need to feel calm or safe.
Lots of people describe having upsetting thoughts and worries after a trauma. These could be memories, guilt at what you did or didn’t do, or worries about bad things that have happened or might happen - they could be about anything.
Difficult thoughts and worries can take up a lot of space in your head and can leave you feeling anxious and exhausted.
It is important to remember that everybody has unpleasant and unwanted thoughts and images that pop into their minds. These thoughts do not mean anything. They are just bits of random ‘junk’ that bob into your head from time to time. They only have power if you take them seriously.
Managing upsetting thoughts and worries
Instead of battling with them, or spending ages thinking about them, it is more helpful to let thoughts just come and go.
Imagine a dog coming up to you, if you give it attention or feed it it will stay or keep coming back. So don’t have a conversation with your thoughts or worries as this gives them power.
However don’t push them away either, as this can make them come back stronger and bigger. However bad they are they will go away by themselves, if you let them (if you ignore the dog it will eventually get bored and go away). Just let them be and pay more attention to what you are supposed to be doing.
Although it is common to worry after a traumatic situation, if you spend a lot of time thinking about things it can make you feel more anxious.
Catching yourself worrying is the first step to managing this. Look for clues such as using the phrase ‘what if’. If you can catch yourself as you start worrying then you can choose a more helpful way to respond.
You could use the grounding or sensory ideas from earlier to help you refocus on what you would prefer to be doing. One of the ways to manage a worry is to decide if you really need to be engaging with it – will worrying about it get you anywhere or will it make you feel worse? Is it true or does it just feel true? Even if it is true can you do anything about it, will spending time thinking about it solve the problem?
Writing worries down and then coming back to them later on can help. You can spend time each night sorting them into those that are real (and can be resolved) and those that are just a possibility (or can’t be solved). Doing this every night will help you to recognise patterns and decide which ones you actually want to spend time thinking about.
If you can’t decide whether the thought or worry is worth spending time on, ask yourself these questions:
- Is it my problem?
- Can I do anything about it?
- Will it help if I keep thinking about it?
- What would you say to your best friend if they had the same worry, what would they say to you?
- Is this your danger alarm being overly sensitive?
- Is it as big a problem as you think it is?
- Will it matter in 10 years’ time?
While talking about things can be helpful, sometimes you can find yourself talking about them too much or seeking repeated reassurance from other people. This is not helpful in the long term as it actually keeps you focused on your worries.
If you do need to do something about a worry then plan it and do it - don’t put it off and worry about it!
After a trauma it can feel like life has changed and that things you used to manage now make you feel anxious. Setting yourself small achievable goals can help you feel like you are moving forwards.
Sometimes situations you used to manage now cause anxiety, this could be busy areas at school, public transport or being alone at home. Because your danger alarm is on high alert it will take some time and practice to reset it.
Avoiding anxiety provoking situations stops anxiety in the short-term. However, it means you never reset your alarm, so you will stay scared.
The most helpful way to resolve this is to gradually face your fears. This will help you learn that things are often not as dangerous as they feel. This will also begin to reset your alarm system so that it no longer puts you on high alert.
However, it takes time and effort as it is easier to set your alarm system than reset it. Doing this in gradual steps can make it easier. Think of it like climbing a ladder, make sure you begin with something that is manageable, don’t go for the hardest thing first.
Keep a record of what you have achieved and make sure you reward yourself.
You can write down your 'steps to success' to plan your tasks and next things you want to do. If it is too hard then try making your steps smaller or start with something easier. If it is too easy then make your steps bigger!
Sometimes it can take a long time to begin to feel better and there are often bumps along the way.
You can feel fine for a while and then feel worse later on, especially if there are other difficult things happening in your life.
It can be hard to remember how far you have come, especially if you have been challenging yourself. Revisiting the ideas in this guide and asking for support from people you trust will be helpful if you are having a difficult time.
Keeping a diary of the steps you have achieved will also help you remember the progress you have made.
It can be hard to see when things might get better, so be kind to yourself and look after yourself as you take each step. Often people look back a long time afterwards and reflect on how far they have come.
If things feel really difficult or don’t seem to be getting better, there are services that can help you.
You might benefit from extra help if the following are making things difficult at home, with your friends or at school or college:
- Putting a lot of effort into not thinking about things
- Having upsetting memories or nightmares
- Easily reminded about what happened
- Feeling very anxious or low
- Feeling jumpy, irritable or on high alert a lot of the time
- Not able to do the things you would like to be able to do.
Where you can get help
Your school nurse, pastoral lead, or GP can direct you to the right service.
If you are under 16 most services will be provided by Child and Adolescent Mental Health Services (CAMHS).
If you are over 16 the local NHS talking therapies service will be able to help and you will often be able to refer yourself.
When you go for an assessment, you will meet someone who can help you understand what is going on.
You will not have to discuss the trauma in detail – but it is helpful to talk about how it has affected you and your life, how the memories are behaving and how you would feel if you did have to think about it.
The person you see will help you work out why you might not be feeling better and what the best treatment will be.
If you need more help with trauma memories and/or managing low mood and anxiety, trauma-focused cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR) are often the most helpful.
It is important school or college know that you have been involved in something traumatic. You could ask an adult to do this for you.
Going back to school or college can be daunting, however there are things that can be put in place to make it easier such as:
- Having a named person for support
- Reducing pressure (e.g. homework)
- Planning for difficult times of the day, like busy corridors and lunch queues
- Thinking about how to answer awkward questions
- Giving you a space to have time out and a time out card
- Telling you about any fire alarms or lockdowns
- Letting your teachers know so they can warn you if difficult topics are going to come up in lessons
- Planning for exams, like having a seat near the door or in a quiet room.
It is important that this continues for as long as you need it, although gradually getting back into lessons and on top of homework will be better in the long term.
There will be times when you are reminded more about what has happened, such as:
- anniversaries
- police investigations
- media reports
It understandable if this brings back memories or nightmares, or if it makes you feel upset and anxious for a while.
Things you can do to help:
- Reduce your time on social media
- Unfollow pages that might include upsetting information
- Talk to people you feel comfortable with
- Plan nice things to do each day
- Make time for yourself to relax
- Use strategies you have found helpful in the past
- Plan ahead for significant dates, such as birthdays or anniversaries.
Important things to remember:
- Trauma affects everyone in different ways at different times - there is no one right way to think or feel.
- People recover at different speeds and there can be bumps along the way - but you will get there.
- Try different strategies, make a resilience box and put your favourite strategies in it.
- Use the support around you, ask people for help.
- Unprocessed memories can lead to flashbacks and nightmares – it is important to remember that right here, right now, you are safe.
- If you feel low create a plan of positive activities and stick to it.
- Remember anxiety can’t hurt you, it is your body trying to keep you safe, but it can get it wrong and there may not be any actual danger.
- Choose which thoughts and worries you want to engage with and don’t have a conversation with the rest.
- Face your fears step by step, keep a record of how far you have come and reward yourself for trying.
- Seek more help if things aren’t getting any better.
Visit our helplines page for details of helpful phone numbers you can call, including NHS 111, Papyrus, Young Minds, Childline and Samaritans.
You can download a copy of this guide, which has helpful worksheets for you to print and fill in.