Childhood is an interesting time in a person’s development. Many changes occur. The most obvious ones are physical. Children grow taller and their bodies develop. But underneath all that are mental changes as well. Cognitive skills develop. For example, they learn to understand cause and effect. They also learn more complex ideas like morality, managing emotions, and social skills. However, from my experience as a licensed clinical psychologist in Dubai, there are situations when something disrupts a child’s usual way of life. These can lead to childhood trauma.
What is childhood trauma?
The Diagnostic and Statistical Manual of Mental Disorders defines childhood trauma as “exposure to actual or threatened death, serious injury, or sexual violence”.1 Childhood trauma can also be called adverse childhood experiences (ACEs). This definition states the child does not need to experience traumatic situations firsthand. The trauma can be caused by learning about something that happened to another person.
Some examples of ACEs are bullying, maltreatment or abuse, and exposure to war. It is important to note that trauma is not always an intentional act. For example, a serious car accident or the death of a family member can cause a child to feel traumatized.
ACEs may be a singular event, like going through a natural disaster. They can also be persistent. Examples of these are living in an unsafe neighborhood or being bullied. All of these can have adverse effects on a child.
How does childhood trauma affect adults?
One of the first studies that explored the connection between ACEs and adult behaviors was done in 1995. The Centers for Disease Control and Prevention and Kaiser Permanente did a large-scale study and interviewed people with traumatic experiences.2 They found that there was an increase in the risk of physical health issues such as heart disease and cancer even years after the traumatic events occurred.
Physical Effects
The 1995 study was one of the first that highlighted the link between physical conditions and trauma. But it certainly was not the last. There are numerous papers that detail the physical effects on someone who went through trauma as a child.
One area of study is the effect of ACEs on brain development. Experts generally agree that stress during the early years of life can lead to disturbances in the hypothalamic-pituitary-adrenal axis (HPA axis). The HPA axis is part of the neuroendocrine system and helps regulate the response to stress. There is evidence that the HPA axis can either overperform or underperform.3 This makes it difficult to manage stress.
There is also evidence that the brain structure is affected by ACEs. Studies show that adults who were abused have a smaller hippocampus, which is the part of the brain that deals with memories.4 This can lead to difficulty retaining information and memory loss.
In 2015, there was a research paper that explored the link between childhood stress and adult health. It found that the more difficult experiences led to higher chances of chronic disease later on in life. Some of the conditions specified are asthma, heart disease, and diabetes.5
There is a consensus that ACEs lead to physical effects even after the traumatized child grows up. However, many experts note that further studies are needed. One challenge to identifying how these changes occur is that abuse usually occurs with other risk factors. For example, lack of adequate nutrition and education may also accompany abuse.
Mental Health Impact
There is a common belief that children are naturally resilient. This is true up to a certain extent. They are resilient, but they are not immune to trauma disorders. In fact, the impact on their mental health can last until adulthood. In 2019, researchers reviewed 20 years of data to see the psychological effects of trauma on adults. Some of the conditions identified are anger issues, depression, post-traumatic stress disorder (PTSD), and psychotic disorders.6
Another important aspect of childhood trauma is its impact on a person’s social skills. A person’s first brush with forming attachments is with their caregiver. In other words, they learn how to trust others because of them. However, the opposite can occur if a child learns that their caregiver is unreliable or untrustworthy. This type of trauma can set the tone for future relationships.7
How can someone deal with childhood trauma?
It is important to consider that childhood trauma has a compounding effect. According to Harvard University, the impact increases if the traumatic event keeps on recurring or the effect of the trauma is not addressed quickly. An adult who experienced ACEs should address it as soon as possible to prevent being affected further.
Therapy
There are different ways mental health professionals such as myself can help traumatized adults. One of these is through cognitive processing therapy CPT. It is a subset of cognitive behavioral therapy and was first developed to address PTSD.
The theory behind PTSD is that it happens because there is a distortion between the beliefs a person had before the traumatic event and the information they receive after. These differences are called “stuck points”. For example, a person might believe that people are trustworthy and good. But this belief might change if they experience neglect or abuse. The disconnect is called a stuck point.
Therapy will help identify those stuck points and work on examining the negative thoughts surrounding them.
Social Support
There is something ironic about experiencing trauma. ACEs can make it difficult for a person to form meaningful relationships. But, meaningful relationships are important to heal childhood trauma.8
These relationships can come in many forms. It can be familial, romantic, or even professional. The main idea behind is that the traumatized person should safe and validated as they go through the healing process.
Self-Care
Self-care is essential to improve well-being, especially when dealing with negative experiences. The National Institute of Mental Health suggests maintaining an healthy eating and sleeping schedule, exercising, and journaling to help cope with trauma.9 There can be different types of self-care, such as physical, social, and mental.
Anything that takes care of the body is physical self-care. For example, taking a walk to clear the head when stress increases is a form of self-care. Taking medication to address mental health issues is another example. On the other hand, social self-care means putting the time into cultivating close relationships with others. These relationships are known to help improve mental health.10
Finally, taking care of your mental health is a form of self-care. It can mean developing coping skills like mindfulness practices or meditation. Seeing a professional when necessary is also a part of it.
There may be different kinds of self-care. But the basis for it is remains the same. It is a conscious effort to make sure that your needs are met.
Conclusion: Childhood trauma can manifest during adulthood
It is normal for children to experience challenging situations. But there are instances when the emotions a child is subjected to are too extreme. The child can feel fearful and threatened. They can also feel grief and helplessness. These types of situations are called childhood traumas or ACEs.
People who experienced traumatic childhoods can grow up with emotional scars. As a result, they can have difficulties in regulating emotions, retaining memories, and exhibiting low social skills. They can even get physically sick. Fortunately, it is never too late to get help. Healing and recovery are possible with the right support and resources.
Cited Sources
- American Psychiatric Association . Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition Text Revision. American Psychiatric Press; Washington D.C: 2000. ↩︎
- Felitti V, Anda R, Nordenberg D. Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. American Journal of Preventative Medicine. 1998;14(4):P245-258. doi:10.1016/S0749-3797(98)00017-8 ↩︎
- Frodl, T., & O’Keane, V. (2013). How does the brain deal with cumulative stress? A review with focus on developmental stress, HPA axis function and hippocampal structure in humans. Neurobiology of Disease, 52, 24-37. ↩︎
- Hart, H., & Rubia, K. (2012). Neuroimaging of child abuse: a critical review. Frontiers in Human Neuroscience, 6, 52. ↩︎
- Gilbert LK, Breiding MJ, Merrick MT, et al. Childhood adversity and adult chronic disease: An update from ten states and the District of Columbia, 2010. Am J Prev Med. 2015;48(3):345-349. doi:10.1016/j.amepre.2014.09.006 ↩︎
- Zarse E, Neff M, Yoder R, Hulvershorn L, Chambers J, Chambers R. The adverse childhood experiences questionnaire: Two decades of research on childhood trauma as a primary cause of adult mental illness, addiction, and medical diseases. Cogent Med. 2019;6(1):1581447. doi:10.1080/2331205X.2019.1581447 ↩︎
- Huh, H.J., Kim, SY., Yu, J.J. et al. Childhood trauma and adult interpersonal relationship problems in patients with depression and anxiety disorders. Ann Gen Psychiatry 13, 26 (2014). https://doi.org/10.1186/s12991-014-0026-y ↩︎
- Freedman SA, Gilad M, Ankri Y, Roziner I, Shalev AY. Social relationship satisfaction and PTSD: which is the chicken and which is the egg? Eur J Psychotraumatol. 2015 Dec 16;6:28864. doi: 10.3402/ejpt.v6.28864. PMID: 26684986; PMCID: PMC4696463. ↩︎
- National Institute of Mental Health. Coping with traumatic events. ↩︎
- Harandi TF, Taghinasab MM, Nayeri TD. The correlation of social support with mental health: A meta-analysis. Electron Physician. 2017;9(9):5212-5222. doi:10.19082/5212 ↩︎