How does childhood trauma impact on brain development and health?
Trauma affects brain development. This in turn can negatively affect many systems of the body. This includes psychological AND physical health. The greater the severity and duration of childhood trauma `the more severe are the psychological and physical health consequences’ (Middleton W., in Blue Knot Foundation, 2012). People who have experienced complex childhood trauma often have multiple diagnoses. This can happen without workers identifying or acknowledging their underlying trauma. This can pathologise the person and their experiences. It can also traumatise them all over again (re-traumatise). It can also be ineffective (Jennings, 2004; Fallot & Harris, 2009).
What are the impacts of childhood trauma on physical health?
Adults who have experienced childhood trauma are more likely to visit the doctor for physical problems more often (Draper et al., 2007). New understandings in neuroscience show that ongoing stress or trauma affects the structure and function of the developing brain. It also affects it chemically, releasing stress hormones over time. High levels of stress hormones can create inflammation. Inflammation can in turn create disease. Child abuse survivors are at increased risk of illness, hospitalisations, surgery and accidents.
What are the impacts of childhood trauma on cognitive function?
It is important for the right and left brain to work together. Childhood trauma can interrupt the connection between left and right brain processes. High levels of stress can change the levels of activation in the brain. This can vary from hyper-arousal to hypo-arousal, repeatedly, over time. These variations can impact on thinking, concentration, focus and memory. They can also be associated with dissociation.
How can childhood trauma affect behaviour?
Many children who have experienced repeated childhood trauma live in a state of hyper-arousal or ‘hypervigilance’. They often also live in fear; they are anxious about what will happen next. This ‘normal’ response to ongoing threat can make some of their behaviour challenging.
Some are diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), truancy and aggression. Many children with these diagnoses have complex childhood trauma histories. However their behaviours make sense in the context of trauma.
The Adverse Childhood Experiences (ACE) study shows that coping strategies are protective at first i.e. being constantly on guard to defend against danger. However they often become less protective over time. They can also threaten the adult’s emotional and physical health. For example, living in a state of hyper-vigilance is experienced as ongoing anxiety, insomnia or difficulty relaxing. This can be exhausting.
Although coping strategies can become less constructive over time they are ‘strengths’ which helped a child survive. It is very important to acknowledge that. Treatments often try to stop behaviours without considering their function. It is important to honour these behaviours and understand them in the context of trauma, while fostering alternatives.
How can childhood trauma affect emotional and mental health?
Children learn how to soothe themselves and manage big feelings (affect regulate) when they live in safe environments with caregivers, who are attuned to their needs. Children growing up in unsafe environments are more likely to develop anxiety and depression (Fergusson & Mullen, 2007). Children as well as adults who have grown up in unsafe situations can be impulsive, passive and overly compliant. They can also be hypervigilant, easily startled (hyper-aroused) and/or numb and shutdown (hypo-aroused). Many can use substances and other ‘coping mechanisms to try and manage, numb or avoid painful feelings.
Ninety percent of people presenting to public mental health services have experienced sexual, physical or psychological trauma (Cusack et al., 2006). Two out of three patients presenting to emergency, inpatient or outpatient mental health services have experienced childhood physical or sexual abuse (Read et al., 2005). Research has found that childhood trauma and abuse makes it more likely to have depression, anxiety disorders, addictions or personality disorders (Spila al., 2008) eating disorders, sexual disorders and suicidal behaviour (Draper et al., 2007). A recent study found that almost 76% of adults reporting child physical abuse and neglect have been diagnosed with at least one psychiatric disorder in their lifetime and nearly 50% have been diagnosed with three or more psychiatric disorders (Harper et al., 2007).
How does childhood trauma affect relationships and social interactions?
A young child’s world revolves around their parents or primary care-givers. Caregivers ideally provide safety, security, love, understanding, nurture and support. Interpersonal trauma in childhood interrupts secure attachment. That’s because trauma violates the child’s boundaries. This means they are not safe or respected. This can be especially damaging with primary caregivers. As a result the child, and the adult they become, can find it difficult to trust. Sometimes they can trust too easily.
When the primary relationship is one of betrayal, the child develops a negative set of beliefs. This often means they struggle with other attachments throughout life. Many survivors experience conflicted relationships and chaotic lifestyles. They often have trouble forming adult intimate relationships, as their reactions threaten to, and do, disrupt close relationships (Henderson, 2006).
Many survivors struggle with their identity, with their core sense of self and their self-esteem. Some survivors find it difficult to learn and complete their education. Or to hold down a job which matches their natural abilities. With these impacts many survivors struggle to find a sense of purpose and a meaningful role in society.
Many survivors experience frequent crises e.g. job disappointments, relocations, failed relationships and financial setbacks. This is because of the many chaotic ups and downs. This can prevent them from establishing any regularity, predictability and consistency. Many survivors function in ‘crisis mode’. This reflects their biological responses to repeated trauma. This can be exhausting and dispiriting and contribute to feelings of helplessness and hopelessness.
How can childhood trauma affect our sense of meaning?
Having been hurt by another person/people and having to live ‘on guard’ or ‘dissociated’ can create a sense of surviving in the here and now. This can affect the ability to dream about the future. To hope and to develop ambitions. Many survivors believe that people and life are not trustworthy or ‘just’, and that life is worth very little. Making meaning of terrible experiences is a challenge and a hallmark of healing. Being abused in faith-based communities can particularly tarnish concepts of God and create additional confusion.
An Australian study by (Draper et al., 2007) found that child abuse survivors are:
· almost two and a half times as likely to have poor mental health outcomes,
· four times more likely to be unhappy even in much later life
· more likely to have poor physical health.
· at risk of having three or more medical diseases
· at higher risk of broken relationships
· likely to have less social support
· more likely to live alone
· more likely to show suicidal behaviour
· more likely to smoke, use substances
· more likely to be physically inactive