effects of childhood trauma
The infographic below illustrates different types of child abuse together with some of the effects of such abuse :
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effects of child abuse
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Childhood Trauma: The Link with Alcoholism.
Childhood Trauma And Alcoholism
When childhood trauma remains unresolved (i.e. it has not yet been worked through and processed with the help of psychotherapy), alcoholism may result (together, frequently, with aggressive behaviour).
Indeed, it has been suggested that unresolved traumatic events are actually the MAIN CAUSE of alcoholism in later life. The trauma may have its roots in:
– the child having been rejected by the parent/s
– too much responsibility having been placed upon the child
As would be expected, it has also been found that adult risk of both alcoholism and depression increases the greater the number of traumatic events experienced and the greater their intensity.
Children who grow up in alcoholic households have also been found to be at greater risk of becoming alcoholics themselves in adulthood, but this appears to be due to the fact that, as children with alcoholic parent/s, they are more likely to have experienced traumatic events than children of non-alcoholic parents, rather than due to them modelling their own behaviour regarding drinking alcohol upon that of their parent/s.
Furthermore, the more traumatic events experienced during childhood (of a physical, emotional or sexual nature), the more intensely symptoms of ANGER are likely to present themselves later on.
In research studies on childhood trauma, the degree of trauma experienced (and it is obviously not possible to quantify this with absolute precision) is often measured using the CHILDHOOD TRAUMA QUESTIONNAIRE (Fink et al., 1995) which identifies EMOTIONAL INJURIES and PARENTAL NEGLECT experienced during childhood and adolesence.
PSYCHODYNAMIC THEORIES view alcholism as A MEANS OF COPING WITH ANXIETY.
Studies suggest that an alcoholic adult is about ten times more likely to have experienced physical violence as a child and about twenty times more likely to have experienced sexual abuse. Lack of peace in the family during childhood is also much more frequently reported by adults suffering from alcoholism, as are: EMOTIONAL ABUSE, NEGLECT, SEPARATION AND LOSS, INADEQUATE (eg distant) RELATIONSHIPS and LACK OF PARENTAL AFFECTION.
IMPLICATIONS FOR THE TREATMENT OF ADULT ALCOHOLICS:
Psychotherapy to help the individual suffering from alcoholism resolve his/her childhood trauma may improve treatment outcomes and reduce the likelihood of relapse. Further research is being conducted to help to confirm this.
ALCOHOL DEPENDENCE :
There is no precise definition of ‘alcohol dependence’, but it is generally agreed between experts that it usually includes the following features:
– a pattern of daily drinking
– being aware of a compulsion to drink alcohol
– changes in tolerance to the amount of alcohol that can be consumed (in the first stage, tolerance increases,but, eventually, tolerance actually reduces again)
– frequent symptoms of withdrawal from alcohol (commonly referred to as a ‘hangover). Symptoms of this may include : nervousness, shaking, tenseness, agitation (or feeling ‘jittery’ and ‘on edge’), feelings of tension, feelings of sickness/nausea
– finding relief from some or all of the above symptoms by consuming more alcohol
– during any periods of abstinance, finding that the features of dependence on alcohol soon re-emerge
It should be noted that individuals who are considered to have become dependent on alcohol may not have all of the symptoms noted above; however, the more symptoms one possesses, the more seriously dependent upon alcohol one is likely to be. The intensity of these symptoms of alcohol dependence will also vary considerably between individuals.
The cycle below represents the common experience of the highly dependent drinker :
STRATEGIES FOR THE REDUCTION OF ONE’S ALCOHOL INTAKE :
– cut out at least some drinking sessions (eg lunchtime drinking) and, ideally, find something else to occupy the time to act as a distraction (such as actually eating lunch!)
– during drinking sessions, alternate between soft drinks and alcoholic drinks
– avoid drinking environments / the company of people who may pressure you to drink, during periods that you have decided to stay alcohol-free
– if people who are likely to encourage you to drink cannot be avoided, plan how you will resist their influence
– add generous amounts of non-alcoholic mixers to alcoholic drinks where possible, but drink at same speed as you would if the alcohol were less diluted (or slower!)
– avoid falling into social traps that tend to encourage drinking, such as participating in a large, hard-drinking group of people who are buying ’rounds’ for one another where a ‘group mentality’ is likely to predominate
Alcohol, to put it starkly, can destroy lives (see chart below), so, if you feel you have a serious problem, it is strongly advisable to seek professional guidance and support.
RESOURCES :
David Hosier BSc Hons; MSc; PGDE(FAHE).
David Hosier BSc Hons; MSc; PGDE(FAHE)
Childhood Trauma and Self-Harm : How it can be Addressed.
Three key elements to reducing our risk of harming ourselves are:
1) distracting our thoughts away from self-harm.
2) reducing the intensity of our emotional arousal to levels which we are able to manage.
3) dealing with internal critical ‘voices’ (i.e. thought processes).
However, as self-harming is often deeply ingrained, we cannot expect instantaneous results. It needs working at.
Let’s look at each of the 3 elements in turn:
1) DISTRACTION: these can be very simple things such as listening to music, watching a movie, going for a walk or a run, reading, calling a friend, browsing the internet, doing something creative like art or craft (e.g. making a collage), taking a bath, and keeping a journal or diary (including writing down our feelings).
2) REDUCING THE INTENSITY OF OUR EMOTIONAL AROUSAL: one way to do this is to get the painful emotion out. Again, there are simple ways to accomplish this. They include: going for a run, punching a punch bag (or even a pillow), writing a letter to, for example, our parents (without actually sending it), writing out our feelings in a journal, calling a crisis line, going to an online chatline/support group and sharing our feelings, writing poetry about how we feel, playing moving music/crying.
RELEASING ANGER SAFELY:
Sometimes our anger can overwhelm us, so it is important to be able to discharge it in a safe way. Those of us who have experienced childhood trauma have very frequently been taught to blame ourselves. This can result in remaining angry at ‘the child within us’. It is therefore necessary to realize:
a) this child did nothing wrong and does not deserve our anger.
b) the anger needs to be appropriately and safely redirected at those who caused our childhood trauma (in a way which is not destructive to ourselves or them).
c) FEELING angry is not the same as EXPRESSING anger, so does no harm: so we don’t need to fear these angry feelings.
d)we need to stop repressing or misdirecting our anger (at those who do not deserve it – known as DISPLACEMENT in psychodynamic theory) as this can lead to it becoming obsessive.
e) we need to learn to express our anger safely, appropriately and positively. For example, writing a letter we have no intention of sending in order to release our pent up feelings, taking up Judo or a martial art, role playing with a friend or counsellor (saying to him/her what we would like to say to those who caused our childhood trauma).
SOME DOs AND DON’Ts RELATED TO ANGER:
DO:
A acknowledge anger
N nip it in the bud
G get help for your anger if necessary (eg anger management classes)
E express anger constructively
R release anger appropriately and let it go
DON’T:
A avoid it
N numb it with food/ illicit drugs/alcohol etc
G grin and grit your teeth (ie suppress it as it will just ‘fester’)
E explode
R rationalize it (ie explain it away)
3) DEALING WITH OUR INTERNAL CRITICAL ‘VOICES’: growing up with negative parents leaves many of us with a lot of negative messages running around our heads – we may have had horrible things said about us so often that we have INTERNALIZED them (i.e. come to see them as true so they form the basis of our self-concept and self-hatred). As adults, we first need to acknowledge that we have these self-lacerating thoughts. This is because the attempt to ignore them can paradoxically make them all the more intense and tenacious.
We may come to notice triggers for these thoughts. For example, if someone is just slightly off-hand with us we may feel we must be a horrible person who everyone will always reject as a matter of course. The root of this may be that we were rejected by one or both of our parents. Being able to trace our self-critical thoughts back to their roots in such a way, and, therefore, understand their triggers, can reduce their intensity of them quite considerably.
In order to retrain the way we think about ourselves, it is helpful, every time we have a negative thought about ourselves, to replace it with a positive one. It can be helpful, too, to write those positive messages down and to keep them somewhere they can easily be retrieved so that we can, on occasion, read through them. It is even possible to make an audio file of them and listen to them occasionally.
As time goes on, it is necessary to let our self-critical messages go and to stop emotionally tormenting ourselves – instead, we need to treat ourselves with compassion.
When individuals come to the point that they are ready to stop hurting themselves with self-critical messages, some make a kind of ritual out of it such as writing down all the negative thoughts they used to have about themselves on a piece of paper and then burning it or tearing it up and throwing it away.
In summary, then, we need to realize that we have absolutely nothing whatsoever to gain, for either ourselves or others, by constantly emotionally torturing ourselves. It is necessary, instead, to start treating ourselves with the love and compassion which may well have been denied us in childhood. We can give ourselves the love and compassion the child within us deserves.
David Hosier. BSc (Hons); MSc; PGDE(FAHE).
Childhood Trauma And Self-Harm.
Childhood Trauma And Self-Harm
Many research studies (eg Arnold, 1995) have demonstrated a link between having been abused as a child and self-harm. In one study,84% of individuals who self-harmed reported that childhood trauma had contributed to their condition.
WHAT IS SELF-HARM?
The following are examples:
-skin cutting
-skin burning
-compulsive skin picking
-self-hitting
-self-biting
-hair pulling
-interfering with wound healing
-swallowing foreign objects
-pulling off nails
Whilst it sounds counter-intuitive, self-harm is fundamentally a COPING MECHANISM born out of trauma and a profound sense of powerlessness.
‘PAIN-EXCHANGE’.
Self-harm has been described as a kind of ‘pain-exchange’. This means invisible, extreme emotional pain is converted into visible, physical wounds. After a period of self-injury individuals report feeling calmer and more able to cope. Self-injuring causes the brain to release ‘natural pain killers’ which may have the twin effect of diminishing psychological pain. A further theory is that, due to an individual’s self-loathing (see later in the post), self-injury acts as a form of self-punishment which the individual consciously or unconsciously believes s/he deserves.
Typically, people who self-harm are emotionally fragile and highly sensitive to rejection.
INDIRECT SELF-HARM.
Not all self-harm is direct. Indirect methods include:
-substance misuse
-gambling
-extreme risk taking
-anorexia/bulimia
-staying in an abusive relationship
With these, the damage is not immediate, but, rather, they are physically and/or psychologically damaging over the long-term.
TYPES OF CHILDHOOD TRAUMA ASSOCIATED WITH SELF-HARM.
The following have been found to be associated with self-harm:
-physical/sexual/emotional abuse
-loss of primary care giver (eg through divorce)
-having ’emotionally absent’ parent/s
-growing up in a chaotic family (eg due to parental mental health problems)
-being raised in the care system
–role reversal in child-parent relationship (eg child acting as a disturbed parent’s counselor)
Furthermore, many who self-harm have NEGATIVE CORE BELIEFS such as the following:
-I am bad/evil
-I am worth nothing
-I shouldn’t have been born
-I’m never good enough
-I don’t deserve to be happy
-I’m unlovable
-I’m inferior
-I don’t fit in anywhere
-there’s something wrong with me
Such beliefs lead to: SELF-LOATHING and EXTREME LOW SELF-ESTEEM. This in turn leads to emotional distress which can trigger acts of self-harm such as those illustrated in this post. My next post will look at ways we can minimize our risk of self-harming.
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David Hosier BSc(Hons); MSc; PGDE(FAHE).
Childhood Trauma: The Statistics
The following statistics relate to the UK. However, it should be pointed out that childhood trauma and abuse tends to be under-reported and under-recorded so the figures presented should only be taken as a guide. The statistics were gained by interviews with a large sample of young adults.
– a quarter of young adults were severely maltreated in childhood
– at present, there are approx. 50,000 children officially deemed to be at risk.
-approx. 15% of young adults have been severely maltreated by a parent or guardian during childhood
PHYSICAL ABUSE :
-just over 10% of young adults experienced violence by an adult during childhood.
NEGLECT :
– in family settings, this is the most common form of child abuse
– approx. 15% of young adults experienced neglect during their childhood
– approx. 10% of young adults experienced SEVERE neglect during childhood.
SEXUAL ABUSE :
– about one quarter of young adults experienced sexual abuse during childhood ( either by peer/s or adult/s).
– about 10% 0f children in the 11-17 year old age group have experienced sexual abuse in the last year
EMOTIONAL ABUSE :
– approx. 7% of young adults have experienced emotional abuse during childhood.
EXPOSURE TO DOMESTIC VIOLENCE :
– about one quarter of young adults experienced domestic violence between adults during their childhoods
Finally, it is worth pointing out again that due to both cover-ups and sometimes reluctance to report incidents these figures could be underestimates.
Because the statistics derive from young adults in the UK, it is likely that they give a fairly up-to-date picture of the situation.
David Hosier. BSc Hons; MSc; PGDE(FAHE).
Serotonin And Childhood Trauma
As we have seen from other articles that I have previously published on this site, neurological problems resulting from childhood trauma can be reversed, and it is to the research into this exciting and fast developing area of study that I now turn.
Studies have shown that because SEROTONIN (a chemical, also known as a neurotransmitter, in the brain) can become depleted by childhood trauma, ANTI-DEPRESSANTS (for example, Setraline) which increase the availability of serotonin in the brain can help to REVERSE the harmful effects of childhood trauma on it.
However, the beneficial effects of anti-depressant treatment is greatly increased if, in addition, the childhood trauma survivor’s ENVIRONMENT is also significantly improved, providing as many positive experiences as possible. Indeed, positive experiences can BENEFICIALLY AFFECT BRAIN CHEMISTRY (for example, by increasing the availability of serotonin and other important neurotransmitters in the brain), just as anti-depressants can.
So: brain chemistry can be affected by environmental factors, as well as by medication.
Because survivors of childhood trauma often FEEL OVERWHELMED BY THEIR EMOTIONS, studies have been conducted which also show that activities that discharge these emotions in a creative or constructive manner can also change brain chemistry for the better. Examples include drawing, painting, writing or undertaking what are called TRAUMA RELEASE EXERCISES.
In addition to human studies, there have also been some studies on animals. There is now a growing body of evidence that new experiences can regenerate animals’ brain cells. Studies in this area are likely to be conducted on humans in the near future.
Because many of these studies are new, their implications have not yet been fully taken advantage of in the construction of treatment programs. Indeed, it is estimated that fewer than 10% of childhood trauma survivors are receiving appropriate therapeutic interventions.
The exciting conclusion that we are able to draw from all of the above is that there is now good evidence that even if the brain has undergone neurological damage as a result of childhood trauma, this CAN BE REVERSED due to the fact that THE BRAIN CONTINUES TO CHANGE THROUGHOUT LIFE.
David Hosier BSc Hons; MSc; PGDE(FAHE).
Cognitive Behavioral Therapy: Challenging Our Negative Thoughts.
Challenging Negative Thoughts :
This article examines how we can use cognitive behavioral therapy to challenge our negative thoughts.
When we have negative thoughts, it is important to ask ourselves:
‘What is the evidence to support this negative thought/belief?’ OFTEN, WILL WILL FIND THERE IS VERY LITTLE OR AT LEAST NOT THE COMPELLING EVIDENCE WE’D ORIGINALLY SUPPOSED.
It is important for us to get into the habit of challenging negative thoughts in this way because very often the negative thoughts come to us automatically (due to entrenched negative thinking patterns caused in large part by our traumatic childhoods) without us analyzing them and examining them to see if they are actually valid.
So, to repeat, we need to try to get into the habit of CHALLENGING OUR NEGATIVE THOUGHTS AND ASKING OURSELVES IF THERE REALLY IS PROPER EVIDENCE TO SUPPORT THEM.
A SUGGESTED EXERCISE FOR CHALLENGING NEGATIVE THOUGHTS :
1) Think of two or three negative thoughts that you have experienced lately.
2) Ask yourself what evidence you have to support them.
3) Ask yourself how strong this evidence actually is.
4) Now think of evidence AGAINST THE NEGATIVE THOUGHT.
Step 4 above is very important.This is because when we are depressed and have negative thoughts we tend to focus on the (often flimsy) evidence which supports them BUT IGNORE ALL THE EVIDENCE AGAINST THEM (in other words, we give ourselves an ‘unfair hearing’ and , in effect, are prejudiced against ourselves). This is sometimes referred to as CONFIRMATION BIAS.
Challenging our negative thoughts and FINDING EVIDENCE TO REFUTE THEM is a very important part of CBT. It is, therefore, worth us putting in effort to search hard for evidence which weakens or invalidates our automatic negative thoughts/beliefs.
ALTERNATIVE THOUGHTS:
When we have successfully challenged our negative thoughts, and found, by reviewing the evidence, reason not to hold them anymore, it is useful to replace them by MORE REALISTIC APPROPRIATE THOUGHTS.
One way to get into the habit of this is to spend a little time occasionally writing down our automatic negative thoughts. Then, for each thought, we can write beside it:
1) Evidence in support of the negative thought.
2) Evidence against the negative thought.
3) In the light of the analysis carried out above in steps 1 and 2, replace it with a more realistic, valid and positive thought. Here is an example:
Negative Thought: I failed my exam which means I’m stupid and will never get the job I wanted or any other.
1) Evidence in support of negative thought:
‘after a lot of revision, I still didn’t pass.‘
2) Evidence against negative thought:
‘I only failed by a couple of per cent and was affected by my nerves – failing one exam does not make me stupid’.
3) Alternative, more valid, realistic and positive thought:
‘I can retake the exam and still get the job. Even if I don’t get my first choice of job, that does not mean there won’t be other jobs I can get, and they may turn out to be better.’
Getting into the habit of occasionally writing down negative thoughts, challenging them, and coming up with more positive alternative thoughts will help to ‘reprogram’ the brain not to just passively accept the automatic negative thoughts which come to us without subjecting them to scrutiny and challenging their validity.
Ten Steps To Overcoming Negative Thinking.
David Hosier BScHons; MSc; PGDE(FAHE).
