The Lingering Impact of Childhood Trauma
Many of us have heard about tree rings that appear as concentric circles on a tree stump. They not only tell us the age of the tree but also provide evidence of the weather conditions that occurred during each year of the tree’s life. The color of the rings can even indicate in what season growth occurred. Lighter-colored tree rings represent wood that grew in the spring and early summer, while the dark rings represent growth that occurred in the late summer and fall. The wider rings indicate warm, wet years; the thinner rings show when it was cold and dry. Under stressful conditions, such as a drought, the tree may have hardly grown at all.
Like a tree, human beings need the right conditions to grow physically, psychologically, and emotionally, especially during critical stages of development. Babies and children require certain needs to be met to mature properly; trauma will stunt normal development. But unlike trees, with human beings, it isn’t always easily visible when traumatic or stressful conditions embed themselves and create lasting scars.
Those developmental hurdles may or may not be noticeable during a child’s development, and often will surface later during the individual’s adult years. That is why when people seek mental health care providers ask questions about their past to gain an understanding of their formative years.
Understanding an individual’s history as they were growing up, including their relationship with their parents or caregivers, often helps define who they are today. This approach to understanding a child’s level of security is known as attachment theory. Developed in the mid-1950s, the theory centers around the idea that the level of responsiveness to the needs of a child is primarily responsible for forming an individual’s lasting sense of security within their world.
That sense of security depends upon a child’s ability to rely on their caregiver for food and comfort. Children with a secure attachment history from infancy tend to develop stronger self-esteem. They are also more self-reliant as they grow older. Studies have shown that these children are more independent, do better in school, and have more successful social relationships. They also experience less depression and anxiety.[1] Consequently, failure to form secure attachments early on often results in a negative impact on behavior in later childhood and throughout life.
Adverse Childhood Experiences Create a Lifetime of Challenges
Significant developmental interruptions in a child’s life are considered a unique category of trauma known as Adverse Childhood Experiences. The acronym, ACEs, are typically defined as potentially traumatic events that occurred in childhood (ages 0-17) that may include witnessing or directly experiencing violence, abuse, or neglect, most notably within the home or collectively within their community.
The Centers for Disease Control and Prevention (CDC) and Kaiser Permanente conducted the ACEs study from 1995-1997, during which time data was collected from over 17,000 individuals in Southern California about their childhood experiences and current health status and behaviors. From this groundbreaking study, it was determined that 2/3 of all participants reported at least one ACE and over 20% experienced three or more ACEs during the first 18 years of life.
The questions revolved around the instances of:
Abuse – emotional, physical, or sexual
Household challenges in form of violence, substance abuse, mental illness, parental separation, or divorce; or an incarcerated household member
Emotional or physical neglect
Individual survey scores were tallied to reveal a sum of the different categories. It was discovered that there were lasting impacts from instances of early adversity events in both health and life opportunities. Throughout the years, a multitude of follow-up studies has reinforced these findings, revealing a strong link between ACEs and an individual’s health and well-being. Most recently, a study in the fall of 2022, found that ACEs greatly impact physical conditions such as obesity, chronic pain, and migraines and that the most prominent association are mental disorders such as post-traumatic stress disorder (PTSD), substance abuse, and depression.[2]
There’s such a strong correlation between ACEs and a multitude of health conditions that the CDC estimates that up to 21 million cases of depression, 1.9 million cases of heart disease, and up to 2.5 million cases of obesity could be completely eliminated by preventing future ACEs.[3] Additionally, poor lifestyle, choices like smoking or heavy drinking, and socioeconomic challenges, such as lack of formal education, or being unemployed have all been linked to ACEs.
Yet people don’t usually make the connection between the traumas they experienced as a child with the circumstances they are facing years later. Deciding not to finish high school. Choosing to be a heavy smoker. Engaging in risky behavior. How do those choices stem from a childhood fraught with food insecurity or fear of violence when you were seven years old? The connection is there. Consider that statistics show that individuals with six or more ACEs on average die nearly twenty years earlier than those without ACEs.[4]
In addition, the more ACEs someone has experienced, the greater the likelihood of serious physical and mental health challenges. For every reported type of abuse experienced in childhood, a participant's risk for post-traumatic stress disorder jumped by nearly 50%. Subsequently, each cumulative trauma increased the risk of making a suicide attempt by 33%.[5]
While the ACEs study is an evaluation that provides a general baseline to understand the impact of childhood trauma, traumatic experiences feel differently for each individual. In some cases, certain milestone events may trigger feelings of trauma without warning. For instance, when a parent has a child approaching the age they were when they experienced the trauma themselves, he/she may suddenly experience symptoms. An example is a client who was sexually assaulted at age 14. When her child reached that same age, some of that trauma response resurfaced and brought her back to those painful experiences.
Healing From Trauma Starts with Awareness
Clearly, people who suffered the pain of multiple ACEs continue to suffer dire consequences as life goes on. We see in our practice the overlap of mental and physical health symptoms, like irritable bowel syndrome or other chronic diseases, such as heart disease, or high blood pressure. Awareness that an adverse experience from their past may be the culprit helps people recognize that there is an underlying cause and can help motivate them to seek help. After the Kaiser-CDC ACEs study, a self-test was created to help people measure for themselves how much childhood trauma they experienced.
Curious about your ACE score? Take it now!
Self-screening can be helpful in opening someone's eyes to recognize that ACEs can potentially put them at more risk for serious health conditions than they ever realized. That knowledge is the first step in guiding treatment decisions and interventions. It’s easy for individuals to become discouraged if they have a high ACEs score but understanding that there are a variety of pathways to recovery can help them realize that their past does not have to dictate their quality of life going forward.
Approaching Treatment
Starting treatment can help individuals untether themselves from the anchor of trauma. While for some, traumas can heal on their own over time, more often than not, they endure and negatively impact someone’s quality of life long-term, keeping them from reaching their full potential. There is a possibility that the effects of trauma may continue indefinitely and even worsen which is why long-lasting healing may require professional treatment.
Full disclosure: therapy takes time and requires effort! There is also a potential threat of re-igniting painful trauma symptoms. However, the benefit to keep top of mind is that there is also great potential for life-changing healing.
Recovery from trauma requires an individual’s readiness to create the conditions that promote healing. To set expectations, I let my clients know that recovery is a highly individualized process that takes place over time. It is far from instant. It also can be very painful, and like that saying about opening old wounds, it often means being ready to revisit things that may be long buried. Preparing to delve into an individual’s trauma history may first require stabilization techniques to help clients cope with and manage the intense emotions that therapy can surface. Things like medication adjustment, grounding techniques, breathing practices, and nervous system regulation can ready individuals for the deeper dive that is necessary for effective trauma work.
When dealing with a painful past it is a very human response for individuals to find ways to cope. However, when coping is based on unhealthy choices and habits, they are far from desirable long-term solutions and can only complicate matters. An individual who is abusing substances or has developed a reliance on a risky gambling habit as a distraction, for instance, needs support in finding more adaptive, healthier ways of healing and coping. If they're not in a place where they can implement those strategies, then we work with them to provide ways to support their distress, improve their tolerance, and regulate their emotions to ready them to do the work that treatment requires.
Our approach with clients begins by gently inquiring about their concerns – what is bringing them into treatment? What are their goals? These broad-brush strokes allow clients to guide the initial discussion to ensure they feel heard and that we are on the right path to making sure that their needs are being met. It also provides a good starting place to establish their psychological and emotional state, and what their priorities are. That opening dialogue is enlightening and helpful to understand how they view what they are experiencing. Next, understanding their early childhood experiences, memories, developmental history, and family dynamics helps provide insight as to what life was like for them growing up, and helps determine any trauma history.
With a focus to meet clients where they are in their journey, childhood trauma is not only essential to address for a long, healthy, and productive life, but when approached gently and with an experienced and compassionate therapeutic partner, we believe there’s no obstacle too big to overcome to not live your best life.
[1] Childhood Trauma Impairs Both Physical and Mental Health | Psychology Today
[2] vs-1105-aces-H.pdf (cdc.gov) [3] What are Adverse Childhood Experiences? (stopabusecampaign.org)
[4] Childhood Trauma Impairs Both Physical and Mental Health | Psychology Today
[5] https://www.verywellmind.com/what-is-attachment-theory-2795337