A blog by Araminta Jonsson

A baby boy was played a CD of 8 nursery rhymes every time he was taken anywhere in the car aged between 6 and 18 months. When he was about 18 months old the CD started skipping and was too scratched to play any more. The little boy never got to listen to those nursery rhymes again and his parents never gave it a second thought. That is until one day, aged about three and a half, the little boy started singing one of the more obscure nursery rhymes from his CD. Fairly sure that he hadn’t heard this particular song since he was 18 months old, his parents were amazed that he was able to remember the words and tune so well.

The relevance of this story is to emphasise just how much young children, even as young as six months old, are able to take in, process and retain. Able, even 18 months later, to repeat verbatim something they had heard before they even had the cognitive ability to talk. In light of this story, this article aims to explore what the long-lasting effects of trauma, especially prolonged trauma, experienced in childhood could be.

When you think of the word trauma you often think of serious physical wounds, or perhaps a car crash. PTSD is more often than not associated with veterans returning from war ravaged countries. However, it’s important not to forget the young children who grow up in their own micro version of a war torn country. Those that live in dysfunctional families, adoptees taken into care, neglected, mistreated or abandoned children. Children who have been victims of any sort of physical, emotional or sexual abuse. All of these children suffer not physical, but psychological wounds at a time when their brains are still developing. When young children undergo prolonged periods of toxic stress caused, not only by the instances previously mentioned, but also by unintentional relational emotional trauma that can happen on a daily basis through "wrong parenting" or "poor parenting" or "misinformed parenting”, permanent changes can take place in their brains. ‘As trauma expert Bessel van Der Kolk, author of The Body Keeps the Score notes, 'our brains can literally be rewired for fear when it comes to childhood abuse.[1]

Young children are ill equipped to deal with prolonged amounts of stress. ‘The ability to manage stress is controlled by brain circuits and hormone systems that are activated early in life. When a child feels threatened, hormones are released and they circulate throughout the body. Prolonged exposure to stress hormones can impact the brain and impair functioning in a variety of ways.[2]

  • The area of the brain which controls the fight or flight response, mood and emotional regulation (the amygdala), becomes enlarged and hyperactive after trauma. A hyperactive amygdala will result in a person become extremely hyper vigilant to possibilities of any future threat.
  • Prolonged, toxic stress or trauma can ‘impair the connection of brain circuits and, in the extreme, result in the development of a smaller brain.[3]
  • When experiencing trauma the body is flooded with the stress hormone, cortisol. ‘Sustained high levels of cortisol can damage the hippocampus, an area of the brain responsible for learning and memory. These cognitive deficits can continue into adulthood.[4]
  • Trauma can also lower the functionality of the prefrontal cortex which is where our decision making and judgement take place. When this area has been inhibited by traumatic experiences in childhood, it can affect our ability to regulate emotional responses. This effect can continue through to adulthood.

Studies have confirmed that parental verbal aggression has an impact on key areas of the brain related to learning, memory, decision-making and emotional regulation.[5] Today we know that adverse childhood experiences can have a severe impact on various things including impulse control - lacking impulse control increases our likelihood of substance abuse, hypervigilence - keeping us constantly on the look out for threat which can develop into anxiety related disorders and they also leave us ‘exposed to a plethora of health problems in adulthood.[6]

A defining study that looked at just how much what we experience in childhood really does impact our life long mental and physical health trajectory was the collaborative study between the Centres for Disease Control and Prevention (CDC) and Kaiser Permanente’s Health Appraisal Clinic in San Diego. They aptly named the research the ACE study and it was one of the largest studies of its kind. It looked at over 17,000 middle-class American adults and was able to demonstrate the link between specific childhood stressors and trauma and adult health problems. All those who took part were asked to answer a questionnaire providing intimate information around their childhood and family situations. ‘Researchers were particularly interested in participants’ exposure to the following ten ACEs:[7]

Abuse

  • Emotional
  • Physical
  • Sexual

Neglect

  • Emotional
  • Physical

Household Dysfunction

  • Mother treated violently
  • Household substance abuse
  • Household mental illness
  • Parental separation or divorce
  • Incarcerated household member

The questionnaire asked a question on each of the 10 categories listed above. 10 questions in all. The study showed that the standard number of ACEs in this cohort was 2 out of 10, those questioned whilst in addiction treatment centres scored on average over 6 out of 10, which suggested that addicts have generally been exposed to over 3 times more adverse child experiences than your average person. In an unpublished study by Christophe Sauerwein, carried out at the Priory North London Hospital in 2015, he saw not only the link between addiction and ACEs, but also that the number of ACEs experienced directly correlated with the number of different addictions you have. In other words complex Emotional-PTSD leads to a complex response such as developing multiple, intertwined addictions. Felitti used the ACE study to further highlight the link between addiction and ACEs noting that there was a 500% increased risk of a person developing alcoholism if they had experienced 6 or more ACEs compared to if they hadn’t experienced any. There was also a shocking 4600% increase in the likelihood of a male child with an ACE score of 6 or more becoming an injecting drug user compared to a child scoring zero.

Peter Levine stresses in his 2007 book, “Trauma through a child’s eyes” that trauma is “the most avoided, ignored, belittled, denied, misunderstood, and untreated cause of human suffering". Yet unprocessed trauma can lead to increased mental health difficulties during adulthood and other social problems such as drug use, school failure and anti-social behaviour. It can also contribute to various physical health issues such as, chronic obstructive pulmonary disease, ischemic heart disease and liver disease.

The original story that started this blog demonstrated a child’s propensity to retain and re-enact/repeat information learned at a very early age in his development, in much the same way negative experiences will leave an indelible mark on the extremely malleable brains and psyches of our young children. ‘Without proper intervention, support, validation and protective factors, this form of violence has the potential to shift the course of one’s life-course trajectory.[8] In short, early childhood experiences cast tremendously long shadows.