TWO Why Don’t Doctors Ask About Childhood Trauma?
Why don’t doctors ask about childhood trauma? The ACE (Adverse Childhood Experiences) study, and a very large body of research besides, has demonstrated beyond all reasonable dispute that if we have suffered significant childhood trauma we are at increased risk of suffering a large range of psychological problems and mental illnesses as adults.
So, if our psychological condition has been significantly contributed to by our childhood trauma, why, say, when we go to the doctor presenting with problems like severe depression or anxiety are we not asked about our childhoods as a matter of course? Surely the CAUSE of our problem has SIGNIFICANT IMPLICATIONS AS TO THE BEST WAY TO TREAT IT?
I myself saw numerous doctors and psychiatrists for years with extremely serious psychiatric difficulties, including depression requiring electroconvulsive shock therapy (ECT) and several spells in hospital. But was I ever asked about my childhood? No.
Why I was too stupid to bring the matter up, I can’t say; perhaps it’s because the expectation that patients will NOT talk about such matters is implicit within the (woefully limited) parameters of the treatment culture, which tends to concentrate on the medical model (i.e. medication and ECT) and if one’s lucky, a bit of cognitive-behavioral therapy (CBT) might be tossed into the mix.
I suppose I should be grateful that they no longer subject patients to frontal lobotomies (which, if you’re at all interested, used to be carried out by the brain surgeon/butcher inserting a small icepick type of implement into the brain through the patient’s/hapless victim’s eye socket).
Happily, some research has been conducted in this area that helps us to understand why doctors don’t ask about childhood trauma. I summarize some of the main findings below :
- many doctors are uncomfortable talking about sensitive issues surrounding childhood trauma
- doctors’ clinical training may not have prepared them to deal with issues surrounding childhood trauma
- some doctors may fear that if they bring up the subject of childhood trauma they may inadvertently ‘plant ideas’ in their patients’ minds (especially in the wake of publicity about ‘false memory syndrome).
- there is insufficient ‘in-service’ training about the effects of childhood trauma
- many doctors feel that a discussion about childhood is an inappropriate subject for initial assessments as it may make the patient feel very awkward
- studies have found when individuals are asked whether they experienced significant childhood trauma and the answer is in the affirmative, frequently they also report that this information has never been recorded on their medical records
- often individuals do not volunteer information about childhood trauma if not directly asked
- some doctors may be in denial about the significance of childhood trauma due to their own childhood histories or experiences of living in a dysfunctional family
- if the doctor knows the whole family of the patient may fear ‘stirring up trouble.’
Certainly, if I was again at the beginning of my own treatment, I would make sure that the doctor I was seeing was aware of my childhood history. Had I done so, I may have been spared a great deal of trouble!
David Hosier BSc Hons; MSc; PGDE(FAHE).