Do I Actually Have Childhood Trauma? A Therapist’s Guide to Recognizing, Understanding, and Beginning to Heal
Do I Actually Have Childhood Trauma? A Therapist’s Guide to Recognizing, Understanding, and Beginning to Heal
Whether you’ve walked into therapy naming your trauma or you’re quietly wondering, “Does what happened to me even count?” — you’re not alone. This guide to childhood trauma therapy explores what trauma really is, the most common wounds I see in my practice, and how healing is possible.
Sometimes clients come to therapy naming their trauma, stating they have complex post-traumatic stress disorder, and other times clients say, “I don’t know if I would call it trauma.”
And for me, I am not too concerned with what we call it. We can call it a wound, a hurt, a harm — and that works for me. What matters more than what we call it is how it’s impacting us today and how we relate to it. Before we get to that, let’s talk about a couple of different ideas around the word trauma in case that helps bring you any clarity.
What Is Childhood Trauma? Rethinking the Definition
Trauma expert Dr. Gabor Maté states that “trauma is not what happened to you, it’s what happened inside of you as a result.” This is usually where my mind goes when someone is questioning whether or not an experience would qualify as “trauma.” My curiosity is always around, regardless of whether or not we call it trauma: how did that situation or event leave you, impact you, change you? How did you interpret it? What beliefs about yourself or the world did it cause? Did it alter the way you see or relate to your body or others? These are the questions that can lead us on a path towards recovery.
The ACE Scale: Adverse Childhood Events and Your Health
Instead of the word trauma, sometimes I like to use the phrase “adverse events.” This comes from what we refer to as the ACE scale in therapy, which is a 10-question screening. It asks if 10 different adverse events happened to you before the age of 18. The theory is, the higher the score, the more likely you may have physical and/or mental health symptoms as an adult. It was created as a tool to help practitioners look beyond symptom management and instead explore possible underlying factors causing the symptoms. These adverse events can become EMDR targets in therapy. There is also a religious adverse event questionnaire that can be used to explore harm from spiritual communities.
The Childhood Wounds I Most Often See in My Office
Trauma can be described as “something that happened that should not have happened” or “something that did not happen that should have happened.” The experiences below fall into one of these categories.
Emotional Neglect
This could be described as caregivers who are unaware, disinterested, or unable to care for their kids’ emotional world. Things that should have happened, did not happen — asking how your day was, making space for your anger, sadness, or joy, expressing curiosity about your inner world. This harm can be harder to point to because it is the absence of something, and therefore it can be harder for us to grasp, name, and validate.
This is an important part of healing: to put words to what we needed as a child and begin to practice providing that to our younger and adult self. I often hear clients describe this experience as being alone in their rooms as their safe place. A client taught me the phrase “living room kids” versus “bedroom kids” — and typically these are “bedroom kids” who felt alone, carrying a lot, with no release valve outside of themselves. Often, these kids grow up to be adults who strive to be good, who are peacemakers, avoid conflict, people-pleasers, and are cut off from their own emotions, wants, and desires.
When we receive some emotional attunement but not consistently, this can contribute to an anxious attachment style. When we receive none of the emotional attunement, this can contribute to an avoidant attachment style. Our attachment desires do not go away in adulthood and continue to surface, especially in our primary relationships.
Because I often work with those who have a history of spiritual trauma, some of this emotional neglect has threads in religious communities as well. This could look like caregivers being encouraged by religious leaders to dismiss their child’s emotions, keep them quiet, and expect them to behave like little adults.
Childhood Sexual Abuse
It’s estimated that 1 in 4 girls in the US are sexually abused before the age of 18, likely closer to 1 in 3 worldwide. That statistic really guts me. 1 in 3–4. How can this happen to 25–33% of girls? The stats for boys are about 1 in 6 in the US and 1 in 5 worldwide. What strikes me is how common this experience can be and yet how little we hear about it. Honoring anyone’s desire to disclose or not is paramount to helping people claim their voice, choice, and agency — which is so important in recovery from trauma in general, and especially sexual trauma.
Childhood sexual abuse seems to carry, at times, an element of confusion and doubt about the occurrence: “Did it really happen? Am I remembering it correctly?” I can personally relate to this experience, and it took “believing the little one in me” to find a path towards recovery. I want to shout: if you are experiencing symptoms related to childhood sexual abuse, there are ways to shift how much it impacts your daily life.
To highlight connections to spiritual trauma — in systems that perpetuate patriarchy, they can create contexts where sexual abuse and assault are more likely to occur. If a girl can’t trust her body, can’t say no, has to see the man as spiritual authority, or is taught to see her body as bad or existing only for a man’s pleasure — how can these dynamics not play a role in removing a female’s autonomy over her own body?
Emotional Harm
The third harm I’d like to highlight is emotional harm. Most often, I see this described by clients as a caregiver using fear and threats to attempt to control a child’s behavior. This can look like screaming, threatening to do something scary to the child or something they love, or criticizing a child. These are typically chronic behaviors on the caregiver’s part, with no repair on the other end. They are patterns in the relationship between the child and caregiver.
A child interprets these moments as either “I am bad” (self-blame) or “I can’t trust myself” (self-doubt). Why? Because for a child’s survival, they cannot view their caregivers as wrong or bad — it threatens their sense of safety. So instead they point the finger at themselves. Kids have to have a caregiver to survive; they are completely dependent, so they hold onto a sense of goodness in their caregivers. If they can blame themselves, it gives them a sense of something they can control: their own behavior. When our caregivers are the ones who scare us, this can contribute to a disorganized attachment style.
This is why repair is so critical in caregiving: “That was mama’s mistake. I’m still learning how to manage my emotions; it was not about you or your fault. You are so good. Next time I want to take a break and step outside. I love you so much.”
These experiences can leave us disconnected from ourselves, our emotions, our body, and our sense of goodness. And we know that many systems benefit when we don’t think we are good enough. So what if we started acting as if — believing and claiming, now, in this moment — that we are okay as we are? That it was never a debate to be had.
To me, this looks like building an attachment to self. Getting to know and honoring our internal world: our longings, thoughts, and intuition.
A Practice for Healing Childhood Trauma: Building Attachment to Self
I once attended a training on perinatal loss, and the facilitator encouraged us to use “attachment-based language” with our clients. I wonder if you could use these phrases toward yourself, with some compassionate self-touch, to continue building your attachment to self.
This can look like placing your hands on your heart, cheek, or thighs — then repeating aloud, slowly:
“I am here for you”
“You matter to me”
“You belong here”
“I’m glad you are here”
“I want to be a safe place for you”
You could also consider holding a younger picture of yourself and repeating these phrases toward younger you as a way to reparent yourself and offer the support you may have needed at the time. Consider how you can incorporate or tweak these phrases with your own children as well, through words and actions.
Frequently Asked Questions About Childhood Trauma Therapy
How do I know if I have childhood trauma?
Childhood trauma doesn’t always look like a single dramatic event. Emotional neglect, inconsistent caregiving, chronic criticism, or witnessing harmful dynamics can all leave lasting imprints. If you notice patterns of self-doubt, people-pleasing, difficulty with emotions, or troubled relationships, it may be worth exploring with a therapist who specializes in childhood trauma therapy.
What is the difference between “Big T” and “Small T” trauma?
“Big T” trauma refers to overwhelming, life-threatening events such as abuse or disasters. “Small T” trauma refers to events that are distressing but not life-threatening — such as emotional neglect, chronic criticism, or loss. Both types can have real, lasting effects on your mental health and are valid reasons to seek support.
What is the ACE scale and how is it used in therapy?
The Adverse Childhood Experiences (ACE) questionnaire is a 10-question screening tool that measures exposure to adverse events before age 18. Higher ACE scores are linked to increased risk for physical and mental health challenges in adulthood. In therapy, it helps identify underlying factors contributing to current symptoms and can guide treatment, including EMDR therapy.
What is EMDR and can it help with childhood trauma?
Eye Movement Desensitization and Reprocessing (EMDR) is a research-supported therapy that helps people process and heal from traumatic memories. It is widely used in childhood trauma therapy and can reduce the emotional charge of past experiences, allowing clients to move forward with greater ease.
Can childhood trauma affect my adult relationships?
Yes. Attachment patterns formed in childhood — whether anxious, avoidant, or disorganized — often resurface in adult romantic relationships. Childhood trauma therapy can help you understand and shift these patterns so you can build more secure, fulfilling connections.
Ready to Begin Healing?
If any of this resonates with you, know that healing is possible. You don’t have to have a name for what happened to start the work. Whether it was something that should never have occurred, or something that never happened but should have, your experience deserves care and attention. Childhood trauma therapy offers a path toward reclaiming your sense of self, your emotions, and your relationships.