What Does Emotional Medical Trauma Look Like?

“My son refused to lift his shirt. He fought all of us trying to help him—trying to give him the medicine and care his body needed. I felt guilty and anxious and sad, not only that I felt like I couldn’t help my son, but that I didn’t even know how.”—Melissa J. Hogan, parent and co-author of Afraid of the Doctor: Every Parent’s Guide for Preventing and Managing Medical Trauma

Millions of people experience medical trauma symptoms every year. As described by Hogan, medical trauma can affect kids and parents. Yet, many people don’t know what medical trauma is and might have a hard time understanding why they feel the way that they do or what to do about it.

The National Child Traumatic Stress Network defines medical trauma as “a set of psychological and physiological responses of children and their families to pain, injury, serious illness, medical procedures, and invasive or frightening treatment experiences” (NCTSN, 2020). In other words, medical trauma is the emotional response to medical diagnoses or medical treatments. This emotional response can include body responses as well such as sweating, feeling nauseous, racing heart, or increases in blood pressure.

To be considered “trauma” rather than an expected response, the reaction needs to be intense such that it either causes the individual (child, parent, family member) a lot of distress or it interferes with medical care or life in some way (for example, refusing to go to the doctor or take medication; being unable to sleep the night before a shot; having stomach pain due to fears or worries that prevents school attendance).

What are the symptoms of medical trauma?

Just like more typical posttraumatic stress disorder (PTSD) symptoms (American Psychiatric Association, 2013), there are four primary categories of symptoms that often emerge for medical trauma: avoidance, re-experiencing, hyperarousal, and changes in mood or cognition. Different individuals show different symptoms, sometimes even when they have the same experience or are in the same family.

A few examples of common ways these symptoms appear include the following:

• Avoidance: Not making eye contact with medical professionals, skipping medical appointments (or attempting to skip them), not wanting to talk or think about anything related to the medical condition or care, avoiding treatments.
• Re-experiencing: Flashbacks about the diagnosis or injury event or a part of medical care, thoughts about the medical condition popping up suddenly, repeated conservations about the medical conditions/care, thoughts repeating over and over again, acting out parts of medical care in play or drawing pictures.
• Hyper-arousal: Jumpiness, difficulty sleeping, difficulty concentrating, elevated blood pressure.
• Changes in mood/cognition: Increased overall depression or anxiety, increased negative thoughts, increased thoughts or feelings that the world is unsafe.

Who gets medical trauma?

Anyone can experience medical trauma. In fact, approximately 30 percent of children with medical conditions and their parents have challenging medical trauma symptoms (Price et al., 2016). Some individuals can develop medical trauma reactions from a single medical experience (for example, a time when they became very frightened about a shot or blood draw) or a frightening injury while others might develop reactions while undergoing ongoing medical care (for example, cancer treatment or diabetes management).

What do I do about medical trauma?

There are lots of effective strategies that you can try if your child or you are experiencing medical trauma.

If you’ve noticed symptoms of medical trauma in your child or yourself, start with talking with your or your child’s doctor. The doctor can help you decide whether you can start trying some strategies to address the symptoms on your own or whether you or your child may benefit from support from a mental health provider. Mental health treatments such as cognitive-behavioral therapy or trauma-focused cognitive behavioral therapy can be particularly helpful.

Here are some resources that provide ideas about what you can do to navigate medical trauma symptoms:

• Afraid of the Doctor: Every Parent’s Guide for Preventing and Managing Medical Trauma
• The Cellie Coping Kit
• After the Injury (Children's Hospital of Philadelphia)
• Health Care Toolbox

The ideas in this blog post and resources are not a replacement for mental health care. If you are worried about your own or child’s behaviors or emotions, reach out to your doctor for help.