Agitation and Threat Responses in Children With Trauma

For children with a history of trauma, agitation can be particularly challenging, as their brain's threat response system becomes hyperactive, leading to heightened sensitivity and reduced emotional regulation. As a result, these children may struggle to communicate their feelings effectively and may react disproportionately to seemingly minor triggers, their brains primed to detect and respond to potential threats based on past traumatic experiences.

Helping Children Navigate Agitation and Trauma

Dusty Oregon Trail path carved into prairie, tall grass rippling, rain clouds looming on horizon, foreshadowing pioneer hardships.<br>
Agitation, closely related to anger, is a state of heightened emotional and physiological arousal characterized by feelings of irritability, restlessness, and tension. In children, agitation can manifest as difficulty sitting still, fidgeting, pacing, or engaging in impulsive behaviors. They may also experience a rapid heart rate, sweating, and a sense of being on edge or easily provoked.

When a child with a history of trauma becomes agitated, their brain's threat response system, particularly the amygdala, becomes hyperactive. This can lead to a heightened sensitivity to perceived threats and a reduced ability to regulate emotions. The child's prefrontal cortex, responsible for rational thinking and impulse control, may be less active, making it harder for them to calm down and respond appropriately. As a result, agitation in children with trauma histories may manifest as emotional outbursts, aggression, defiance, or withdrawal. They may struggle to communicate their feelings effectively and may react disproportionately to seemingly minor triggers, as their brain is primed to detect and respond to potential threats based on their past traumatic experiences.

Navigating Childhood Agitation: A Journey of Healing and Resilience

A close-up of clenched fists and angry teen girl's face amid dusty trail backlight, conveying inner turmoil on Oregon Trail.<br>
When a child from a difficult background appears agitated, they may be experiencing a range of intense and overwhelming emotions stemming from their past traumatic experiences. This agitation is like the wagon encountering rough terrain on the journey to healing, causing the contents of the wagon to shift and rattle, and making the journey more challenging and uncomfortable for the child.

From the perspective of the Wheels of Well-being, the child's sense of safety and stability may feel threatened, as the agitation can trigger memories of past traumatic events when their physical or emotional safety was compromised. The child may struggle to feel loved and accepted in the moment, as their emotional distress can overshadow their sense of connection and belonging. Their identity and value may also be shaken, as the intensity of their emotions can lead to feelings of shame, guilt, or worthlessness.

The child's Grounded Experiences, both positive and negative, can influence their response to agitation. Traumatic memories and learned coping mechanisms may be triggered, leading to heightened emotional reactivity and difficulty regulating their emotions. The weight of these experiences can feel like a heavy burden, making it harder for the child to maintain their balance and move forward on their healing journey.

Outside Obstacles, such as stressful life events, conflicts in relationships, or reminders of past trauma, can contribute to the child's agitation. These challenges can feel like steep hills or rocky paths, requiring extra effort and support to navigate. The child may feel overwhelmed and alone in facing these obstacles, further exacerbating their distress.

In these moments, the support of the child's Advocates and Nurturing Network is crucial. Just as the oxen must work together to pull the wagon up a steep incline, the child's support system must come together to provide the extra care, reassurance, and guidance needed to help the child through this rough patch. This may involve offering emotional support, co-regulation strategies, and reminders of the child's strengths and progress.

The Advocates' role is to create a safe and supportive environment where the child can express and process their emotions without fear of judgment or rejection. This may involve providing a calm, soothing presence, validating the child's feelings, and offering reassurance and comfort. The Advocates can also help the child identify and practice coping strategies to manage their agitation, such as deep breathing, grounding techniques, or engaging in calming activities.

The Nurturing Network can also play a vital role in supporting the child during times of agitation. By offering a sense of connection, belonging, and shared experience, the network can help the child feel less alone and more supported in their struggles. The network can also provide practical assistance, such as respite care or resources for stress management, to help alleviate some of the pressure on the child and their immediate caregivers.

As the child works through their agitation with the support of their Advocates and Nurturing Network, they may begin to develop new coping skills and resilience. They may learn to identify and express their emotions in healthier ways, to seek support when needed, and to find comfort and strength in their relationships. These new experiences and skills can help to lighten the load of their past traumas, making it easier for them to navigate the ups and downs of their healing journey.

Over time, the experience of being supported and cared for during times of agitation can help to strengthen the child's Wheels of Well-being. They may begin to internalize a sense of safety and trust in their relationships, feel more deeply loved and accepted for who they are, and develop a stronger sense of identity and self-worth. These inner resources can provide a solid foundation for the child's ongoing growth and healing, helping them to weather future storms and continue moving forward on their journey to wholeness.

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Related Anger

The Story of feeling Agitated

The Restless Trail: A Child's Agitated Journey West

Young girl with furrowed brow, pursed lips, clenched fists, pacing uneasily beside wagon on dusty trail, showing inner turmoil.<br>
Polly couldn't stop fidgeting as she sat on the hard wooden bench of the wagon. Her skin felt prickly, like ants were crawling all over her body. She clenched and unclenched her small fists, her fingernails digging into her palms. No matter how she positioned herself, she couldn't get comfortable.

It had been hours since the wagon train stopped to make camp for the night. Polly's parents were busy setting up their tent and building a fire to cook dinner. Her little brother Tommy was off playing with some of the other children. But Polly couldn't bring herself to join them. She felt wound up as tight as a coiled spring, ready to burst at any moment.

Nothing seemed to soothe her restlessness and irritation. The constant jostling and creaking of the wagon all day long had grated on her nerves. The sun beating down made her skin hot and sticky with sweat. Dust from the trail coated her clothes and face. She longed to wash it all away but there likely wouldn't be an opportunity to bathe for days.

Polly's stomach churned as her mind raced with agitating thoughts. She hated having to leave her friends and home behind. Starting over in Oregon territory filled her with dread and uncertainty. What if something bad happened to her family on this dangerous journey? What if they didn't find a good place to settle? What if they struggled terribly to survive?

Her parents had assured her that everything would work out for the best. They said this was an adventure and an opportunity for a fresh start. But Polly remained unconvinced. All she felt was uneasiness gnawing deep in her gut.

Clenching her jaw, Polly suddenly jumped down from the wagon, landing hard and kicking up a cloud of dust. She started pacing back and forth in an attempt to release some of her pent-up tension. She muttered angrily to herself, cursing the whole notion of this fool-hearted Oregon Trail. Her hands shook as she gestured wildly.

Just then, her mother glanced over, a look of concern on her weathered face. "Polly dear, are you quite alright?" she called out. "Why don't you come sit by the fire and have some cornbread?"

"I don't want any stupid cornbread!" Polly snapped, instantly regretting her harsh tone but unable to rein in her foul mood. "Just leave me be!"

With that, she turned on her heel and stomped off toward the edge of camp, her mind and body still simmering with an unrelenting sense of agitation she couldn't seem to escape. She hoped somehow the wide open spaces of the frontier would ease her troubled soul. But for now, Polly remained mired in distress, as unsettled as the vast untamed wilderness that stretched out before her.

The Story Explained Through the Wagon Method

Nurturing the Trail-Worn Soul: Polly's Journey Through Agitation and Healing

Dry prairie grass, wagon ruts, tiny wildflowers, lone grasshopper on brittle blade in harsh sun on desolate Oregon Trail frontier.<br>
Polly's agitation can be understood through the lens of the Wagon Method as a reflection of the intense and overwhelming emotions she is experiencing due to her past traumatic experiences and the challenges of her current circumstances. Her agitation is like the wagon encountering rough terrain on the journey to healing, causing the contents of the wagon (her Grounded Experiences) to shift and rattle, making the journey more uncomfortable and distressing.

From the perspective of her Wheels of Well-being, Polly's sense of safety and stability feels threatened by the uncertainty and upheaval of leaving her home and friends behind to embark on the Oregon Trail. The unfamiliar and harsh conditions of the journey trigger memories of past traumatic events when her physical and emotional safety was compromised, further exacerbating her agitation.

Polly may struggle to feel loved and accepted in the moment, as her emotional distress overshadows her sense of connection and belonging. The intensity of her agitation and anger towards her family's decision to move can lead to feelings of isolation and disconnection. Her identity and value are also shaken, as the overwhelming nature of her emotions may lead to feelings of shame, worthlessness, or powerlessness.

Polly's Grounded Experiences, both positive and negative, influence her reaction to the stresses of the journey. Traumatic memories of loss, instability, or danger may be triggered by the challenges and uncertainties she now faces, leading to heightened emotional reactivity and difficulty regulating her emotions. The weight of these past experiences burdens her like heavy cargo, making it harder for her to maintain her balance and move forward.

Outside Obstacles, such as the discomforts and deprivations of trail life, the strain of adjusting to new routines and expectations, and the lack of privacy or space to process her emotions, further contribute to Polly's agitation. These challenges can feel like steep hills or rocky paths that require extra effort and support to navigate. Polly may feel overwhelmed and alone in facing these obstacles, compounding her distress.

In these moments of agitation, the support of Polly's Advocates (her parents) and her Nurturing Network (her brother and the wagon train community) is vital. Just as the oxen must work together to pull the wagon up a steep incline, Polly's support system must come together to provide the extra care, reassurance, and guidance she needs to weather this rough patch.

Polly's parents can create a safe and supportive environment for her to express and process her emotions without judgment or punishment. By responding to her outbursts with patience, validation, and empathy, they can help her feel seen, heard, and understood. They can offer comfort through physical affection or soothing words, and guide her in practicing coping strategies like deep breathing or engaging in calming activities.

Polly's brother and the other children in the wagon train community can also play an important role by offering companionship, distraction, and a sense of shared experience. By inviting Polly to play games, share stories, or explore their surroundings together, they can help lift her spirits and foster a sense of connection and belonging. The adult members of the community can also provide practical support and a listening ear, reminding Polly that she is cared for and not alone in her struggles.

As Polly experiences the steadfast support of her Advocates and Nurturing Network, she may begin to develop new coping skills and emotional resilience. She may learn to identify and express her emotions in healthier ways, seek comfort and reassurance when needed, and find moments of joy and wonder even amidst the challenges of the trail. These new experiences and skills can help lighten the load of her past traumas, making it easier for her to weather the ups and downs of her healing journey.

With time and consistent support, Polly's agitation will begin to ease as her Wheels of Well-being are strengthened. She may internalize a deeper sense of safety and trust in her relationships, feel more securely loved and accepted for who she is, and develop a stronger sense of identity and self-worth. These inner resources will provide a solid foundation for her ongoing growth and healing, allowing her to face future challenges with greater resilience and hope.

Though Polly's healing journey is not a straightforward or easy one, with the unwavering support of her Advocates and Nurturing Network, she will continue to grow and thrive. Her story of overcoming adversity through the power of love, connection, and community will become a beacon of hope and resilience for all those who travel alongside her on the winding path to healing and wholeness.

Supporting Research and Sources


  • Barzman, D. H., Brackenbury, L., Sonnier, L., Schnell, B., Cassedy, A., Salisbury, S., Sorter, M., & Mossman, D. (2011). Brief Rating of Aggression by Children and Adolescents (BRACHA): Development of a tool for assessing risk of inpatients' aggressive behavior. The Journal of the American Academy of Psychiatry and the Law, 39(2), 170-179.

  • Dvir, Y., Ford, J. D., Hill, M., & Frazier, J. A. (2014). Childhood maltreatment, emotional dysregulation, and psychiatric comorbidities. Harvard Review of Psychiatry, 22(3), 149-161.

  • Lindenmayer, J. P. (2000). The pathophysiology of agitation. The Journal of Clinical Psychiatry, 61 Suppl 14, 5-10.

  • McLaughlin, K. A., Colich, N. L., Rodman, A. M., & Weissman, D. G. (2020). Mechanisms linking childhood trauma exposure and psychopathology: A transdiagnostic model of risk and resilience. BMC Medicine, 18(1), 96.

  • Thomason, M. E., & Marusak, H. A. (2017). Toward understanding the impact of trauma on the early developing human brain. Neuroscience, 342, 55-67.

  • Bath, H. (2015). The three pillars of trauma-informed care. Reclaiming Children and Youth, 23(4), 5-11.

  • Cohen, J. A., Mannarino, A. P., & Deblinger, E. (2017). Treating trauma and traumatic grief in children and adolescents (2nd ed.). The Guilford Press.

  • Masten, A. S. (2015). Ordinary magic: Resilience in development. The Guilford Press.

  • Perry, B. D., & Szalavitz, M. (2017). The boy who was raised as a dog: And other stories from a child psychiatrist's notebook--What traumatized children can teach us about loss, love, and healing (2nd ed.). Basic Books.

  • Siegel, D. J., & Bryson, T. P. (2012). The whole-brain child: 12 revolutionary strategies to nurture your child's developing mind. Bantam Books.