How Childhood Trauma Can Physically Damage The Developing Brain

To read Part One of my eBook How Childhood Trauma Can Physically Damage The Developing Brain (And How These Effects Can Be Reversed) scroll down.









PART 1 :


1) Introduction

2) The Prefrontal Cortex

3) Three Key Components Of The Limbic System

●       The Amygdala

●       The Hippocampus

●       The Thalamus

4) Other Limbic Regions

5) The Insula

6) Right Hemisphere

7) The BrainBody Connection

8) Brain inflammation



PART 2 :



9) Lack Of Emotional Security

10) Poverty

11) Constant Humiliation

12) Domestic Violence

13) Anger

14) Emotional Neglect

15) Guilt

16) Lack Of Love


PART 3 :



17) Risk-Taking And Decision Making

18) Memory 

19) Control Of Emotions

20) Inability To Articulate Severely Traumatic Experiences

21) Eye Contact 

22) Risk Of Developing Complex PTSD

23) Risk Of Developing Narcissistic Personality Disorder

24) Risk Of Developing Borderline Personality Disorder

25) Constant Fearfulness

26) Structural Dissociation


PART 4 :


27) SelfDirected Neuroplasticity

28) Seven Key Elements That Aid Brain Repair

29) Repairing The Amygdala

30) Repairing The Prefrontal Cortex

31) Raising Endorphin Levels

32) Raising Serotonin Levels

33) Raising Oxytocin Levels

34) Meditation And The Electrical Brain

35) Unlocking And Rewiring The Brain

36) Dialectical Behavior Therapy

37) Compassion Focused Therapy (CFT)

38) Cognitive Behavioral Therapy

39) Treatment For Depression

40) Right Brain Therapy

41) Trauma Informed Yoga





APPENDIX 1 : Childhood Trauma And Borderline Personality Disorder (BPD).


APPENDIX 2 : Childhood Trauma And Complex Posttraumatic Stress Disorder (Complex PTSD).


APPENDIX 3 : Dissociation.


APPENDIX 4 : Childhood Trauma And Psychosis.


APPENDIX 5 : Childhood Trauma And Avoidant Personality Disorder.


APPENDIX 6 : The Fight / Flight Response.


APPENDIX 7 : Anhedonia


APPENDIX 8 : Childhood Trauma And Obsessive Compulsive Disorder (OCD)


APPENDIX 9 : Electroconvulsive Shock Therapy And My Experience Of It.






Recently, there have been various cutting-edge studies into how severe and protracted childhood trauma can potentially damage the developing physical brain and harmfully disrupt its chemical balance.


Such damage can, in turn, have devastating effects upon the cognitive (e.g. learning and memory), behavioural, social and emotional functioning of the individual affected.


As an indication of the scale of the problem, it has been estimated that about 75% of children in the care system could have suffered such adverse effects on the physical brain following their particular traumas.


Studies have found that prolonged and severe stress (sometimes referred to as ‘toxic stress’) in early life can adversely affect the production of chemicals (also known as neurotransmitters) in the brain.


Two important neurotransmitters which may be affected are :


a) CORTISOL (which regulates stress)


b) SEROTONIN (which is closely tied to mood and behaviour)


(We will look at how levels of cortisol and serotonin can be naturally raised in the brain n Part 4.)


Dysfunction of these chemicals may lead, respectively, to:


a) an impaired ability to cope with stress in later life.


b) an increased risk, in later life, of suffering severe, clinical depression and an impaired ability to suppress aggressive and violent impulses.


Furthermore, some individuals, as a result of their childhood trauma, may develop conditions such as borderline personality disorder (see Appendix 1), other personality disorders, complex posttraumatic stress disorder (see Appendix 2) and other serious, psychiatric condition.


Indeed, research involving brain scans suggest that sufferers of BPD (one of the psychiatric conditions most closely linked to childhood trauma which I discuss at length in another one of my books : Childhood Trauma And Its Link To Borderline Personality Disorder) can have abnormalities in the following brain areas :


●       The prefrontal cortex

●       the limbic system (including the amygdala, the hippocampus and the thalamus, the anterior cingulate, the subgenual cingulate, the ventral striatum)

●       mammillary body

●       the hypothalamus

●       the olfactory cortex

●       the cingulate gyrus

●       the fornix





This brain region :

  • modulates feelings of fear associated with a threat (e.g. calms us down if a raised alarm turns out to be a false alarm).


●       controls the intensity of our emotions (so we are neither inappropriately under-emotionally aroused nor inappropriately over-emotionally aroused).


●       helps us to plan future


●       helps us control impulsive, ‘knee-jerk’ reactions.


●       helps us to become mentally attuned to others and to empathize with them


●       provides us with a moral awareness and ethical framework


●       provides us with insight into the workings of our own minds


●       helps us behave rationally


●       helps us to think logically


●       helps us maintain a healthy balance between hyperarousal (too much arousal) and hypoarousal (too little arousal)


●       is involved in expression of the personality.


●       Is involved in conscious control of social behaviour.


●       Is involved in speech / writing.


●     Is involved in purposeful (as opposed to instinctive) behaviour


Even in emotionally and mentally ‘healthy’ individuals, the prefrontal cortex does not become fully developed until the age of about 25 years; this is a major reason why the behaviour of someone aged, say, eighteen, is often more erratic and ill-considered than that of a person aged, for example, twenty-six years. (It follows from this that a strong argument can be put forward that Courts of Law should take into account the underdevelopment of the prefrontal cortex in younger adults when considering sentences for this age group.)


Also, crucially, the development of the prefrontal cortex is particularly sensitive to the emotional and psychological environment in which we grow up.


Indeed, if one has suffered protracted and severe trauma when growing up, the prefrontal cortex (specifically, the ventromedial prefrontal cortex)  may not physically develop to its usual size, and, therefore, in adulthood, be of a smaller volume than average.


This can inhibit the functions listed above to varying degrees (depending upon the degree to which the development of the brain region has been damaged).


In particular, the individual affected in this way may develop hypersensitivity to stressful stimuli, an inability to calm him/herself down when experiencing stress (sometimes described by psychologists as an inability to self-regulate emotions) and abnormally high levels of fear and anxiety.


Extreme fear responses and high levels of anxiety are particularly likely to occur when an individual, who has incurred damage to the prefrontal cortex due to childhood trauma, experiences a stressful event or situation which triggers memories (on either a conscious or unconscious level) of the traumatic event/events.






If we have suffered severe and chronic childhood trauma, there is also a high risk that an area of our brain called the limbic system may have incurred developmental damage which can severely affect how we feel and behave as adults.


The limbic system is a region of our brain that experiences emotional reactions to information relayed by our five senses: taste, touch, vision, smell and hearing.


Our emotional reactions are strongly shaped by the memories stored in the limbic system connected to past experiences associated with these senses.


To provide a simple example: if our ancestors heard the roar of a lion behind them because this sound is associated (from past experience) in the limbic system with danger, they would react with fear and run away.


It can be seen, therefore, that the function of the limbic system clearly has survival value, which is why modern-day humans have inherited it.


Three key components of the limbic system (briefly referred to earlier) that I will focus on and which are particularly relevant when we are considering the effects of childhood trauma on the brain are as follows :


A) the amygdala (see below)

B) the hippocampus (see below)

C) the thalamus (see below)


If, as children, our limbic system was repeatedly activated by threatening and frightening experiences then its development may have been disrupted.


This may mean that it becomes HYPERSENSITIVE AND OVER-REACTIVE to a perceived threat.


Importantly, the limbic system may cause us to over-react to perceived threats that we only perceive on an unconscious level.


For example, if someone in authority speaks to us in a manner that, on an unconscious level, reminds us of how an abusive parent used to speak to us, we might become extremely anxious, frightened or aggressive (aggression here would represent an unconscious drive to defend ourselves).




The amygdala is the brain region that responds to fear, threat and danger and is involved with the storage of the emotional content of memories.


If a child experiences frequent fear due to childhood abuse the amygdala becomes overwhelmed by the need to process too much information (which is both overwhelming and complex).


This can damage it in two main ways :


a) the amygdala becomes overactive and remains constantly ‘stuck on red alert’, leading the individual to feel constantly anxious and fearful, even at times when there is no need to feel this way, objectively speaking. (An oversensitive amygdala is also thought to be a major feature of borderline personality disorder.)


b) the amygdala shuts down as a way of protecting the individual from intolerable feelings of being in danger, which can have the effect of leaving the him/her feeling numb, empty, emotionally dead and dissociated (see Appendix 3).


Drissen et al. (2000) found that those who had suffered severe childhood trauma had amygdalae which were 16% smaller in terms of volume than those who had not experienced significant trau


One of the main, and most problematic, symptoms that those with borderline personality disorder (BPD) and complex posttraumatic stress disorder (which, as we saw earlier, are two conditions linked to childhood trauma) suffer from is the experiencing of disproportionately intense emotional responses when under stress and an inability to control such responses or to efficiently recover and calm down once such tempestuous emotions have been aroused. This very serious symptom is also often referred to as (as already mentioned) emotional dysregulation.


The main theory as to why such problems managing emotions occur is that damage has been done to the amygdala in early life due to chronic trauma.


This chronic trauma causes the amygdala to be overloaded and overwhelmed by emotions such as fear and anxiety during early development causing a long term malfunction which can extend well into adulthood or even endure for the BPD / complex PTSD sufferer’s entire lifespan (in the absence of effective therapy).


The damage done to the development of the amygdala means that, as adults, when under stress, BPD / complex PTSD sufferers are frequently likely to experience what is sometimes referred to as an emotional hijack an amygdala hijack.


When external stimuli are sufficiently stressful, the amygdala ‘shuts down’ the prefrontal cortex (as we have already seen, functions of the prefrontal cortex include  planning, decision making and intellectual abilities).


In this way, when a certain threshold of stress is passed (and this threshold is far lower in BPD sufferers / complex PTSD sufferers than the average person’s) the amygdala (responsible for generating emotions, particularly negative emotions such as anxiety, fear and aggression) essentially ‘takes over’ and ‘overrides’ the prefrontal cortex.


As such, the prefrontal cortex ‘goes offline,’ leaving the BPD / complex PTSD sufferer flooded with negative emotional responses and unable to reason, by logic or rational thought processes, his/her way out of them.


When the amygdala is ‘hijacked’ in this way, there are three main signs. These are :


1) An intense emotional reaction to the event (or external stimuli).


2) The onset of this intense emotional reaction is sudden.


3) It is not until the BPD sufferer has calmed down and the prefrontal cortex comes ‘back online’  (which takes far longer for him/her than it would for the average person) that s/he realizes his/her response (whilst under ‘amygdala hijacking’) was inappropriate, often giving rise to feelings of embarrassment and shame.


Drissen et al. (2000) found that those who had suffered severe childhood trauma had, on average, amygdalae which were 16% smaller than those who had not experienced significant trauma.





The hippocampus is the part of the brain responsible for long-term storage of memories. If trauma is severe, the consequential production by the body of stress hormones can have a toxic effect upon this brain area, reducing its capacity by as much as 25℅.



Drissen et al. (2000) found that those who had suffered severe childhood trauma  HIPPOCAMPI that were, on average, 8% smaller in terms of volume than those who had not experienced significant childhood trauma.



The thalamus is the part of the brain that assesses all incoming sensory data (i.e. information from sound, vision, touch,  smell and taste) and then sends this information on to the appropriate, higher region of the brain for further analysis.


If a child constantly experiences trauma (for example, by frequently witnessing domestic violence perpetrated by a drunken father) the child’s thalamus can become so overwhelmed by the intensity and quantity of sense data it needs to process that it is no longer able to process it properly. This can lead to the child’s memories of trauma becoming very fragmented.


Another effect of the thalamus being overloaded with traumatic sensory data is to shut down the cortex, resulting in impairment of rational thinking processes.


Also, due to the shutting down of the cortex, many of the traumatic experiences are stored without awareness (so that they become unconscious memories).


Further research by Shore (2001) has shown that the brain’s right hemisphere (see below), which has deep connections into the limbic and autonomic nervous systems, is impaired in terms of its ability to regulate these systems properly;  leading to profound difficulties managing stress  in those who had suffered serious childhood trauma.




Other regions of the limbic system that may be adversely affected by childhood trauma are :


A) the anterior cingulate (see below)

B) the subgenual cingulate  (see below)

C) the ventral striatum (see below)



Its functions include :


– decision making

– heart rate

– blood pressure

– impulse control

– emotions




Its functions include :


– sleep

– appetite

– anxiety

– mood

– memory

– self-esteem

– transporting serotonin

– our experience of depression




Its functions include :


– decision making

– emotional regulation (the control of emotions)

– the extinction of conditioned responses




Poor decision making ; poor control of social behaviour ; impaired ability to think rationally ; poor planning for the future ; dysfunctional personality ; increased physiological response to stress ; poor impulse control ; poor emotional control ; insomnia ; changes in appetite ; severe anxiety ; mood instability ; low self-esteem ; impairment of the brain’s ability to make effective use of serotonin leading to clinical depression ; changes in appetite ; emotionally charged memories leading to flashbacks, nightmares, intrusive thoughts, panic attacks ; feelings of being under constant threat, fear, terror and extreme vulnerability.




The insula is a small region of the brain’s cerebral cortex ; its precise function is not fully understood but it is hypothesized to play a significant role in :

●       generating our conscious self-awareness of our emotions.

●       interoceptive processing (this refers to the degree to which we are paying attention to the sensory information generated by our bodies).

●       how the above 2 functions interact to generate our perception of the present moment.

●       pain

●       love

●       addiction.




A study conducted at the Stanford University School of Medicine involved 59 participants who were aged between 9- years-old and 17-years-old.


These 59 participants comprised 2 groups :


GROUP 1 (The Traumatized Group) : This group comprised 30 young people (16 males and 14 females).


Of these 30 participants, 5 had been exposed to one traumatic stressor in childhood, whilst the other 25 had been exposed to two or more traumatic stressors or to ongoing / chronic traumatic stress during childhood.


All 30 participants of this group had exhibited symptoms of posttraumatic stress disorder (PTSD).

GROUP 2 : (The Non-Traumatized Group) : This group was the ‘control’ group and comprised the remaining 29 participants.


None of the 29 participants in this group exhibited symptoms of posttraumatic stress disorder (PTSD).




The brains of all 59 participants were scanned using a technique known as structural magnetic resonance imaging (sMRI).




In the NON-TRAUMATIZED GROUP (GROUP 2) there was found to be NO DIFFERENCE in the structure of the insulae when the males were compared to the females.




In the TRAUMATIZED GROUP (GROUP 1) there WAS FOUND TO BE A DIFFERENCE in the structure of the insulae when the males were compared to the females. The difference was as follows :




b) Girls in the TRAUMATIZED GROUP (GROUP 1) had insulae of a LESSER VOLUME AND SURFACE AREA than the girls in the NON-TRAUMATIZED GROUP (GROUP 2).




We are able to draw two main inferences based upon the above observations ; these are :


a) the experience of significant childhood trauma adversely affects the structural development of the insula.


b) the way in which the experience of significant childhood trauma adversely affects the structural development of the insula. differs between boys and girls.




The above findings imply that because the effects of traumatic stress on the brain appear to differ between males and females, the type of treatment provided for individuals with PTSD need to take into account their sex.





Research by Shore (2001) has shown that the brain’s right hemisphere, which has deep connections into the limbic and autonomic nervous systems, is impaired, leading to profound difficulties managing stress in those who had suffered serious childhood trauma.


The brain is split into two hemispheres (or halves) referred to, simply enough, as the left hemisphere and the right hemisphere


In terms of their functions, the LEFT HEMISPHERE is associated with :


●       logical and analytical thought processes

●       reasoning

●       language (including written language)

●       mathematics / numerical skills


whilst the RIGHT HEMISPHERE is associated with :


●       intuitive thought processes

●       creativity/appreciation of art/appreciation of music

●       holistic thought

●       insight

●       imagination

●       empathetic feelings with others

●       emotions and emotional attachment to others

●       feelings of trust

●       ‘reading’ the emotional state of others from their facial expressions

●       self-awareness



The above lists of functions derive from the work of Sperry (a Nobel Prize Winner) in the 1960s. However, recent research suggests that whilst LATERALIZATION (the tendency to employ one area of the brain more than others with respect to certain functions) is a genuine phenomenon, the popular idea that people can be simply split into two groups (so-called left brain-dominant individuals versus right brain-dominant individuals) appears to be a myth.


Furthermore, a recent study conducted at Utah University suggests many functions previously believed to be mainly associated with a particular hemisphere may, in fact, actually involve the opposite hemisphere as well to a greater degree than many originally believed.


Notwithstanding this recent confusion, it is still the case that therapy which concentrates upon many of the functions listed in the FUNCTIONS ASSOCIATED WITH THE RIGHT BRAIN column above may be particularly helpful for those of us who have been unfortunate enough to have suffered from severe childhood trauma. This is because many of these functions are found to be impaired childhood trauma survivors (especially emotional attachment to others and the ability to trust). 




Allan Schore, in particular, argues for the importance of ‘right-brain’ psychotherapy.


Schore devised Affect Regulation Theory which incorporates the idea of how early life ‘affective interactions of attachment’ (in particular, the quality of our early-life emotional bond with our primary caregiver, usually the mother) physically affects the development of our brain.


The quality of the bond depends upon the quality of the emotional communication between the (usually) mother and the infant. This communication includes :


●       voice rhythms

●       voice inflexions

●       mutual gaze

●       bodily interactions (e.g. holding, stroking etc.)


When this communication between the primary caregiver and infant is healthily synchronized, the infant experiences a positive state of affect and arousal.


However, when the infant experiences negative arousal, the synchronicity is temporarily lost until the primary caregiver is able re-establish it, soothe the young child, and ameliorate his/her (i.e. the aforementioned young child’s) distress.


If the primary caregiver interacts with the infant in ways that inspire infantile distress (e.g. too little physical contact, rejection. unpredictability, the transmission of anxiety etc.) this will cause the young child’s autonomic nervous system to become dysregulated.


And, furthermore, if such dysfunctional interactions occur frequently enough, and over a long enough period, the physical development of his/her (i.e. the young child’s) right / emotional brain will be adversely affected.




Schore argues that emotional communication between the primary carer and the young child is strongly founded in RIGHT BRAIN TO RIGHT BRAIN interaction (i.e. how the right brain of the primary carer communicates with the right brain of the young child).


And, as the young child goes through life, both soothing and stressful emotionally interactive experiences with others become indelibly woven (encoded) into his / her brain’s rich tapestry and this process gives rise to (unconscious) internalized, mental working models of attachment that reside in the brain’s right hemisphere.


In other words, the quality of our relationship with our primary caregiver as we grow up physically affects the brain’s development and this, in turn, affects how we act, feel and behave in connection with our relationships with others in later life – attachment trauma can, therefore, be considered to be a phenomenon closely interconnected with right brain hemisphere development and functionality.




Schore, therefore, infers that those of us who have been affected by childhood trauma and have, as a result, incurred attachment trauma, require therapy that taps into the way in which the right brain works.

According to Schore, therefore, the therapist should concentrate on core skills and techniques which include :


●       empathy

●       regulating his / her own (i.e. the therapist’s) affect

●       ability to communicate non-verbally and to be sensitive to non-verbal communications from the client/patient (including very tiny changes in the client’s / patient’s facial expressions, intonation etc.)

●       immediate awareness of his / her own (i.e. the therapist’s) subjective and intersubjective experience.


Schore emphasizes that the above-listed skills/techniques provide an indispensable and essential foundation to the therapy without which other skills/techniques are likely to be ineffective for helping the individual affected by attachment trauma.


His theory is based on research into neuroscience and infant development.





Perhaps the best-known study on the effects of childhood trauma on the individual is the ACE (Adverse Childhood Experiences) study conducted by Felitti and Robert Anda in the 1990s.


The study involved a survey of 17,337 volunteers (approximately half of whom were female) to ascertain whether there was a link between the experience of childhood trauma and the development, in later life, of emotional, behavioural and physical problems.


In summary, the study found that (on average) the greater the individual’s experience of childhood trauma, the more likely, on average, s/he was to develop the emotional, behavioural and physical problems in later life that I referred to above.


It is now known that these mental and physical problems experienced in later life by individuals who have suffered significant and ongoing childhood trauma are intrinsically interlinked due to the intimate relationship between the brain and the body. This intimate relationship is illustrated by the recent research study described below :


Recent research conducted at the University of Virginia School of Medicine found that (a hitherto undiscovered) ‘brain-body pathway’ exists linking the brain,  via the lymphatic vessels, to the body’s immune system (prior to this discovery, it was assumed that the brain was isolated from the body’s immune system). This newly discovered pathway transports immune cells around the body and helps to detoxify it.


A central effect on children of suffering significant and protracted childhood trauma is that the ongoing, severe stress that they are forced to endure leads to the production of excessive quantities of damaging and inflammatory chemicals (Bierhaus et al., 2003).


It is now known that because of the existence of this newly discovered ‘brain-body pathway’, these harmful chemicals are distributed throughout the entire human biological system, thus adversely affecting both mind and body and, accordingly, leading to both mental (e.g. anxiety and depression) and physical problems (e.g. high blood pressure and heart disease).


Indeed, research shows that those who have experienced severe and protracted childhood trauma are, on average, likely to die significantly earlier than individuals who were fortunate enough not to live through such early life traumatic experiences.






One mechanism through which the brain may be damaged is thought to be inflammation.


Research on the brain carried out by McCarthy suggests that if a child is subjected to significant, chronic stress, particularly when the cause of this stress is unpredictable (e.g. due to a hostile, abusive, unstable parent prone to random explosions of terrifying rage), s/he may develop brain inflammation.


This is a recent finding – until not long ago, the prevailing wisdom was that brain inflammation could only be caused by physical damage to the brain, not psychological damage; however, this latter theory has now been discredited.


It now appears that when a child is exposed to the type of chronic stress described above, the action of vital cells in his/her brain (called microglial cells) is disrupted, leading them to go haywire and run amock; it is thought that when their action is disrupted in this manner they start to destroy other neurons (brain cells) that, prior to their destruction, were beneficial to the brain.


Research suggests that the main neurons that the microglial cells destroy are those involved in reasoning and impulse control. Therefore, of course, it follows that, due to the adverse action of microglial cells caused by chronic stress, the individual’s ability to control his/her impulses, and to reason, will be impaired.


These rogue microglial cells are also believed to reduce the volume of both grey and white matter in the brain, leading to anxiety, depression and even psychosis (see Appendix 4).


And, as if this weren’t bad enough, they also seem to inhibit regeneration of neurons (brain cells) in the part of the brain known as the hippocampus (see above) ; this, too, is liable to contribute yet further to mental illness


One relevant research study involved rats being exposed to chronic stress. This resulted, as the researches intended, in the microglial cells in the rats’ brains being damaged (as too, we have seen from the above, occurs in humans). As a consequence of this damage, the rats began behaving in a highly stressed manner. However, when the researchers reintroduced healthy microglial cells into their brains, the rats’ observable stressed behaviour was ameliorated.


This finding provides hope that, in the future, we may be able to extrapolate from this experiment and relieve human stress-related problems, where applicable, in a similar manner.


Also, meditation, properly done, has been scientifically proven to reduce inflammation.






About David Hosier BSc Hons; MSc; PGDE(FAHE)

Psychologist, researcher and educationalist.

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