Childhood Trauma RecoveryOver 750 free articles by psychologist and childhood trauma survivor David Hosier MSc on effects of childhood trauma on mental health, therapies, self-help and related topics
A study conducted by Santavirta et al., (Uppsala University) and published in the journal of JAMA Psychiatry.sought to answer the question as to whether the adverse effects of childhood trauma could alter a person’s genes and, if so, whether these genetic changes could be passed on to the next generation in a damaging way.
The study involved examing the medical records of 3000 children of Finnish people who, as children, were evacuated during World War 2 to Sweden. Many were under the age of 5 years and were required to learn Swedish; all were placed with Swedish foster families. The medical records of these 3000 children of former evacuees were compared with the medical records of children of parents who were NOT evacuated as children.
FINDINGS FROM THE STUDY:
Children of parents who were evacuated during WW2 were found to have quadruple the risk of developing serious mental health conditions compared to children of the non-evacuated.
Children of mothers who were, as children, evacuated during WW2 were found to be at an elevated risk of being hospitalized for a mental health condition. However, no such elevated risk was found to be associated with children of fathers.
INTERPRETATION OF THESE FINDINGS:
The researchers who conducted the study suggested that it was probable that these findings were due to the childhood trauma experienced by those who had been evacuated as young individuals altering their gene expression (technically known as epigenetic alterations) which were subsequently inherited by their offspring, making them more susceptible to developing problems with their mental health.
However, the researchers also conceded that children of parents who were evacuated during WW2 may also have been at greater risk of developing poor mental health because the childhood trauma experienced by their parents impaired there ability to parent effectively.
Furthermore, more research will be needed in the future to help cast light upon the finding that children of formerly evacuated mothers were at greater risk of being hospitalized with a mental health condition whilst this was not found to be the case in relation to children of formerly evacuated fathers.
EVIDENCE FROM ANIMAL STUDY:
In an animal study (Franklin et al., 2010) investigating if high levels of stress in early life experienced by animals can adversely affect future generations, mice were subjected to chronic and unpredictable stress (by being separated from their mothers) for the first fortnight of their lives). As adults, these ‘traumatized’ mice, as would be expected, were found to have developed depressive symptoms.
However, it was also found that the offspring of the male, ‘traumatized’ mice also developed depressive symptoms, despite the fact that they were raised in a normal manner. The conclusion drawn by the researchers was that the third generation mice must, therefore, have inherited their depressive symptoms via the process of epigenetic transmission.
CONCLUSION:
Such research suggests that the effects of trauma can be passed on to future generations via epigenetic transmission both in animals and humans; however, research in this sphere of study is in the early stages, and more will be needed in the future.
A DEFINITION OF EPIGENETICS:the study of how alterations in how genes express themselves (e.g., as a result of early life trauma) can be inherited by the next generation. However, it should be noted that the underlying DNA structure of these affected genes is not changed (i.e., there is a change in phenotype, not genotype).
Childhood trauma, if it is severe enough, has a profoundly adverse effect on how we think and how we process information.
In order to explain why this happens, it is first helpful to recap how the brain is organized. In simple terms, we can split the brain into three parts: the brain stem, the limbic system, and the neocortex. The functions of these three parts of the brain are as follows:
THE BRAIN STEM: The brain stem consists of the midbrain, pons, and medulla oblongata. It is the most primitive part of the brain and controls essential bodily functions such as swallowing, blood pressure, and heart rate.
THE LIMBIC SYSTEM: The limbic system is involved in emotion, motivation, memory, and learning. It also controls the brain’s ‘alarm system’ (i.e., its fight/flight response).
THE NEOCORTEX: The neocortex is involved in the brain’s higher functions, such as reasoning, language, and logic.
Now, regarding the above brain components, let’s compare and contrast how the brain processes information under normal circumstances with how it processes information related to traumatic experiences.
THE NORMAL WAY IN WHICH THE BRAIN PROCESSES INFORMATION:
Under normal circumstances, the brain receives information and processes it via the limbic system to determine its emotional content and then passes it on to the neocortex where it can be logically analyzed and reflected upon in order to produce a rational response.
THE WAY IN WHICH THE BRAIN PROCESSES INFORMATION RELATING TO TRAUMATIC EXPERIENCES:
However, when the brain receives traumatic information, because it could potentially mean we are in danger, the brain needs to process it as quickly as possible so that we can respond with the utmost alacrity, thus improving our chances of avoiding harm. In these situations, then, when a lightening-quick response is called for, there is no time for the luxury of allowing the neocortex to leisurely analyze and reflect upon the traumatic/threatening information received until it can determine the appropriate response.
Instead, the brain takes emergency action and processes the traumatic information quickly via the brain stem and the limbic system, bypassing the neocortex and, thus, allowing an instant, reflexive reaction. A simple example of when the brain might process information in such a way would be that of a person out for a walk who sees what s/he (mistakenly) takes to be a snake in the grass (though it is, in fact, just a piece of rope). In such a circumstance, s/he is likely reflexively to flinch and immediately step-away. This happens because the limbic system, working on an emotional level, has detected possible danger (emotional response: FEAR) and activated the ‘fight/flight’ state.
It is only when the neocortex comes back online and the person can logically analyze the situation that s/he realizes that what s/he initially took to be a snake is, in fact, a harmless length of dark, green rope. To reiterate: the reason the neocortex does not take part in the initial assessment as to whether the snake-like object is dangerous or not is that it would take up too much time (after all, if it is a snake it could be poisonous and strike at any second); an immediate response is called for, working on the principle of ‘better safe than sorry.’
WHAT HAPPENS WHEN WE HAVE TO LIVE IN A STATE OF CONSTANT FEAR AND ANXIETY?
Of course, we can swiftly recover from a minor incident like the one just described above However, if we have existed in a situation (e.g., living with an unpredictably violent, alcoholic father when we were a child) whereby we lived in a perpetual state of fear and anxious uncertainty, the type of information processing just described above (involving mistaking a rope for a snake) becomes increasingly REINFORCED and ENTRENCHED.
Thus, we come perpetually to respond to stimuli via an analysis of information by the emotionally driven limbic system, bypassing the rational analysis that the neocortex would typically supply. This, in short, makes us highly vulnerable to behaving in ways that, objectively speaking, may look deeply IRRATIONAL.
Indeed, eventually, this form of emergency, instant, fear-driven information processing (sometimes referred to as the traumatic neurological response), instead of only operating very occasionally when needed, becomes the brain’s DEFAULT METHOD of information processing and habitual. And, because of this, the brain becomes stuck in a state of constant read alert, leading us to feel constantly on edge and under threat as well as to be continually prone to vastly over-reacting to even the most minor (objectively speaking) of stressors and our whole lives can feel as if they have been subsumed into a kind of living nightmare in which everything seems a threat and potential source of danger – it is as if we have lost control of our thought processes which, in a very real neurological sense, we have.
FRAGMENTARY, UNPROCESSED MEMORIES STORED IN THE SOMATOSENSORY PART OF THE BRAIN LEADING TO UNCONTROLLED THOUGHTS IN THE FORM OF FLASHBACKS, INTRUSIVE MEMORIES AND NIGHTMARES:
Traumatic experiences overwhelm our arousal system, which prevents them from being processed immediately and as a coherent whole. Instead, they are mentally absorbed in a fragmentary way and stored in the somatosensory part of the brain to be processed and made sense of at a later date. Such fragmented memories, therefore, remain unprocessed and unhealed.
It is these unprocessed, unhealed and fragmentary pieces of information stored in the somatosensory part of the brain that gives rise to uncontrolled thoughts which manifest themselves in the form of flashbacks, intrusive memories, obsessive ruminations, and nightmares; such psychological phenomena are likely to be triggered by any stimuli that even vaguely reminds us of our original traumatic experiences (often on an unconscious level) and, whilst deeply unpleasant, represent the brain’s attempt to process our unresolved experiences properly.
However, despite such regret and shame, many, too, find themselves trapped in a perpetual cycle of repeating such self-defeating, ‘acting out’ behaviours, often at a very high cost to themselves and those who trigger their trauma-related feelings (e.g. feelings of rejection). In this way, the traumatized individual seems powerless to learn from experience and past mistakes, as if driven by unconscious psychological forces beyond their control (which, without effective therapy, may indeed be the case).
THE ROLE OF FAULTY MEMORY PROCESSING :
Such apparent helplessness to learn from experience is, however, much easier to understand when we consider how the severely traumatized individual’s memory processing abilities may have been negatively affected by his/her traumatic past.
To be more specific, trauma can impair brain and memory function in a variety of different ways, including adversely affecting the functionality of a part of the brain known as the hippocampus (indeed, research has shown that those who experience severe, long-lasting trauma in childhood can develop SHRUNKEN HIPPOCAMPI due to the chronic over-stimulation of the body’s stress hormones which have, in excess concentrations, a toxic effect upon the brain and other bodily organs)
Such impairment of brain and memory function, in turn, leads to DIFFICULTIES IN TRANSFERRING MEMORIES FROM SHORT-TERM STORAGE TO LONG-TERM STORAGE and, furthermore, interferes with the brain’s ability to process and make rational sense of information. Episodic memories (memories of past personal experiences that occurred at a particular time and place) may not be properly processed which prevents a corresponding semantic memory (a form of long-term memory essential for the use and understanding of concepts and language) from being formed, making it hard for the individual to use knowledge (which, in normal circumstances, would have been gleaned from the episodic memory and have made it available to be subjected to rational analysis)) to inform and beneficially adjust future behaviour.
DISSOCIATION:
Studies also show that memory function is impaired due to the tendency of traumatized individuals, especially those suffering from complex PTSD and BDP, to dissociate when ‘acting out’ as a result of a trauma-related feeling triggered.
Both of the above (i.e.impaired memory processing ability due to organic damage and dissociation) impact on learning ability which, in turn, then, help to explain why traumatized individuals find it hard to learn from experience, particularly in the context of interpersonal conflict that mirrors early-life traumatic experiences and results in dissociated, ‘acting-out’ type behaviour). Furthermore, such individuals may also suffer from depression which is itself known to impair learning, memory and cognitive processing abilities.
Impaired memory, learning and cognitive processing ability, of course, can also interfere with other crucial areas of life, such as academic and occupational performance.
THERAPY:
Therapies that reduce stressand increase emotional resiliencecan help people who have been affected in this way and there exists some evidence that antidepressants can increase hippocampal volume (N.B. Always consult an appropriately qualified expert before deciding whether or not to take antidepressants).
I have described in several other articles that I have published on this site that if we were treated during our childhood by our parents / primary caretakers in an abusive fashion (e.g. made to feel worthless, unlovable, unwanted, inadequate, fundamentally flawed etc.) we are likely to internalize a very negative view of ourselves and, without appropriate therapy, go through life having to endure profound and pervasive feelings of shame that can severely impair our quality of life by making us feel unwanted wherever we go and of less worth than others (Pattison).
PHYSIOLOGICAL RESONSES TO SHAME :
In physiological terms, we respond to shame a similar fashion to how we respond to feelings of fear, danger and threat. In evolutionary terms, this response has come about because the perception of shame is linked to the fear of social rejection and ostracization which could, literally, threaten our distant ancestors’ ability to survive ; therefore, to be rejected from the group could be fatal.
In the modern day, of course, social rejection and ostracization is unlikely to prove fatal (unless, of course, it drives us to suicide) but our nervous systems still respond to perceived shame as it did for our ancestors i.e. feelings of shame are equated with being in danger and, as a consequence, the SYMPATHETIC NERVOUS SYSTEM IS ACTIVATED AND WE ENTER THE FIGHT / FLIGHT / FREEZE STATE.
In this state, the body is biologically prepared to deal with danger by either PHYSICALLY FIGHTING or RUNNING AWAY. However, as I have said, this response evolved to help our ancestors and is seldom appropriate in relation to modern day shame-inducing scenarios so, instead of physically fighting, we may become extremely angry and verbally aggressive (although in extreme cases a person might become physically violent) or hide ourselves away (e,g, by not leaving the house, avoiding peopleetc. – in extreme cases, a person might move to another town, country or, if things are particularly bad, perhaps, continent). This feeling of wanting to hide and escape is encapsulated fairly well by the expression : ‘I just wanted the ground to open up and swallow me’ and, of course, by actions such as covering one’s face with one’s hands or averting one’s gaze away from others / looking down at the ground. To reiterate, all these shame responses are directly linked to the activation of our sympathetic nervous system and the potential danger to which our brains are alerted.
However, our most common response to shame is the FREEZE response (which involves part of the nervous system shutting down) because we can’t properly metabolize our feelings of shame via the fight or flight responses. This freeze response can give rise to various unpleasant symptoms such as dissociation, derealization and depersonalization. In this state we feel trapped, powerless and completely unable to help ourselves or change our situation. It can also deprive us of our ability to think clearly which Nathanson refers to as ‘cognitive shock’ – cognitive shock is a state of panic involving a desperate need to hide from or conceal our shame and stops us from being able to think in a rational way or to exercise moral reasoning (Nathason).
To reiterate : all three reactions to shame, i.e. fight, flight and freeze, are physiological repercussions to being in ‘survival mode’ due to perceived danger. When we are in ‘survival mode’, because all our mental and physiological resources are focused on, in effect, ‘keeping ourselves alive,’ it is almost impossible for us to feel empathy for others.
Shame pervades our very sense of identitymaking us feel intrinsically worthless as a person, Furthermore, we are highly liable to ‘feeling ashamed of feeling ashamed‘, creating a viscious cycle whereby shame feeds off shame. (You may wish to read more about this in my previously published article about a phenomenon known as THE SHAME LOOP.)
Because being conscious of our own shame can be exquisitely painful, we sometimes repress it (i.e. block it out of conscious awareness) and protect ourselves from its poisonouis effects by employing psychological defense mechanisms. According to Nathanson, four such defenses we use against shame are :
There is also research existing to suggest that chronic shame can lead to :
alcoholism
addictions
eating disorders
narcissistic rage leading to violence and antisocial behavior
stress
anxiety
depression
weight gain
And, research suggests, because chronic shame is such a powerfully negative emotion, it can increase the level of stress an individual experiences leading to increases in the body of the stress hormone cortisolwhich, in turn, can impair both cardiovascular health and the immune system.
Stress can be defined as ‘a state of mental or emotional strain or tension resulting from adverse or demanding circumstances’ and is, of course, an inevitable part of life. Whilst we often complain about stress due to the fact that too much of it can have damaging or even catastrophic effects upon our wellbeing, the right amount of stress is necessary and normal and this is true both in adulthood and childhood.
As children, exposure to a certain amount of stress is necessary and facilitates healthy development. The physiological effects of stress include an increased heart rate, increased blood pressure, increased production of stress hormones (e.g. cortisol) and inctreased rate of breathing to more effectively deliver oxygen to the muscles to prepare us for ‘fight or flight.’
As long as the stress we experience as children is not too great and, crucially, we are provided with sufficient support from our significant relationships with others (primarily in the form of emotional support from our primary caregiver) we are able to cope with it (and, in physiological terms, our bodily functions such as heart rate etc. are able to return to normal and do not incur damage to our nervous systems).
However, if the stress to which we are exposed is too overwhelming, and we are not provided with sufficient support, the cumulative effects of stress and the accompanying physiological impact on our bodies can have seriously damaging effects, including upon the physical development of the brain, potentially resulting in life-long emotional, behavioral, cognitive and social consequences.
THREE TYPES OF STRESS : POSITIVE, TOLERABLE AND TOXIC :
One way of thinking about stress, due to the very differing effects it can have upon us, is to view it as fitting into one of three possible categories which are listed below :
POSITIVE STRESS
TOLERABLE STRESS
TOXIC STRESS
Let’s look at each of these three categories of stress in turn :
POSITIVE STRESS AND ITS EFFECTS :
The physiological effect of positive stress is a short lasting accelaration of pulse rate and slight increase in levels of stress hormones such as cortisol. Experiencing positive stress is an indispensible part of normal and healthy child development and an examples of situations which might give rise to such stress are a well-managed first day at school or a rudimentary dental check-up.
TOLERABLE STRESS AND ITS EFFECTS :
This type of stress induces a higher and longer lasting level of physiological arousal and the event giving rise to this reaction may go on for some time. Examples include grief resulting from the loss of a loved one or a natural disaster. However, in relation to such stress, it is necessary that the child has good emotional support and that the increased level of physiological response is not too long lasting / chronic if enduring damage to the brain and other bodily organs is to be avoided.
A study carried out by Lanius et al. involved trauma survivors having their brain activity measured (using fMRI machines) whilst being read a script that described the trauma that they had experienced.
As alluded to in the opening paragraph, it was found that their brains reacted in 2 ways which I briefly describe below :
THE ‘FLOOD’ RESPONSE :
Individuals who became flooded and re-experienced their traumatic experience showed reduced activity in the parts of the brain (the rostral anterior cingulate and medial prefrontal cortex) that dampen down emotions like fear. Therefore, these brain regions’ ability to dampen down the individual’s feelings of fright and terror were impaired (thus allowing these unwelcome sensations to run amok and create a state of hyper-arousal, including flashbacks and intrusive memories).
Correspondingly, these individuals also showed increased activity in the amygdala (a region of the brain associated with feelings of fear) and the right anterior insula (a region of the brain associated with awareness of body states). These responses, too, led to elevated feelings of fright and terror as well as an intensified experiencing of the bodily sensations that accompany such feelings.
2) THE DISSOCIATIVE RESPONSE :
Individuals displaying the dissociative response showed the opposite brain reactions. In other words, the brain regions that dampen down feelings like fear became MORE active thus reducing feelings of fear. Whilst this might sound good, the problem is that when individuals respond in this dissociative fashion, their emotions are ‘turned down’ too much, leading to feelings of emotional numbness / emotional deadness.
Which Of These Two Responses Was The Most Common?
It was found that 70% of participants showed the FLOODING response and 30% showed the DISSOCIATIVE RESPONSE. However, further research needs to be conducted to determine what proportion of individuals predominantly react to trauma by displaying either the flooding or dissociative response and what proportion react to trauma by displaying both responses (i.e. oscillating between the two). It is currently believed that most individuals respond in the latter manner (i.e. by oscillating between states of feeling flooded and states of feeling dissociated).
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A study conducted by Santavirta et al., (Uppsala University) and published in the journal of JAMA Psychiatry.sought to answer the question as to whether the adverse effects of childhood trauma could alter a person’s genes and, if so, whether these genetic changes could be passed on to the next generation in a damaging way.
