Trauma is one of the most popular topics discussed since the rise of mental health awareness in the last few years. Once only associated with war veterans and sexual assault survivors, trauma is now understood to be highly nuanced, come in many different forms, and affect several more individuals than previously assumed. According to the National Council for Mental Wellbeing, 70% of U.S. adults experience at least one traumatic event in their lives – that is roughly 223.4 million people.
Depending on context, trauma describes a deeply distressing or disturbing experience, or the emotional response and consequences of such an event. It can be something that happened to us directly, or it can be something that happened to someone close to us. When we think of trauma, major events like natural disasters, death of loved ones, or acts of violence are often the first examples to come to mind. These larger, more immediately apparent traumatic events are often informally referred to as “Capital T” or “Big T” trauma. Still, an accumulation of smaller, more everyday experiences can also be traumatic. This form of trauma is often informally called “Little T” trauma, and common examples include growing up in a chaotic or dysfunctional home, experiencing financial worries, and feeling like a social outcast. In this blog, we’ll focus on understanding how past experiences can still affect us today by exploring childhood trauma and its potential long-term impact.
Identifying Childhood Trauma
As the name suggests, childhood trauma broadly refers to deeply distressing, frightening, and/or dangerous events that individuals’ experience(d) at any point between birth and 18 years old. Childhood trauma can come in several different forms, but some of the first that come to mind are “Big T” examples, such as:
- Emotional abuse. Characterized by patterns of behavior that damage a child’s self-worth or emotional well-being. This can include name-calling, threats, shaming, and rejection.
- Physical abuse. Any non-accidental physical force used against a child for purposes of punishment or control. This can include hitting, shaking, burning, or scalding.
- Sexual abuse. Any sexual act committed against a child for purposes of gratification or financial gain. This can include fondling, penetration, and forcible sodomy.
- Neglect. The failure to provide for a child’s basic emotional and physical needs, which can include food, clothing, shelter, medical care, connectedness, and supervision.
“Little” Does Not Mean None
“Big T” examples of childhood trauma often get the most press, but that doesn’t mean “Little T” trauma can’t have profound, long-term effects as well. One of the most common examples of “Little T” childhood trauma individuals experience is growing up in a home that lacked violence or overt abuse, but was still chaotic and/or dysfunctional. Examples of this could be a home in which parents frequently argued, conflict rarely ended in compromise, guilt was weaponized, etc. As the first example of family dynamics, homes such as these often don’t seem abnormal or traumatizing to the individuals who were raised in them. For several, it is not until later in life that they begin to realize the interpersonal dynamics they learned from their family of origin may have been dysfunctional, and furthermore, may continue to impact the way they navigate interpersonal situations in their current life.
For more information about families of origin and their great potential for long-term impact, check out this Instagram live with Remedy’s founder, Dr. Kirsten Thompson, and a colleague, Dr. Karla P. Arriaran!
The Impact of Past Trauma
Every age and life stage is important, but none in the same way as childhood. By conventional Western standards, the years between birth and age 18 are when an individual develops from a helpless infant to a capable adult. It is not only when we learn to walk, speak, and interact with others – it is also when our brains establish lasting concepts of trust, care, and security. Experiencing distressing events during childhood can have profound, long-term effects.
We’ve discussed in past blogs how chronic stress and anxiety can be damaging to the body and brain, and the concept is similar with the long-term impact of childhood trauma. If it goes unresolved, trauma experienced in childhood can persist in the body and manifest in ways that negatively affect an individual’s nervous, endocrine, and immune systems, as well as their attention, behavior, decision-making, and stress response throughout the rest of their life.
Post-Traumatic Stress Disorder (PTSD)
For some, unresolved trauma may develop into full-blown post-traumatic stress disorder (PTSD) – a mental illness that may occur in those who experienced or witnessed a traumatic event. PTSD is often categorized into four main groups: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. The disorder’s presentation can vary between people, but common symptoms of PTSD include nightmares, flashbacks, social isolation, self-blame, guilt, anhedonia, fear, anger outbursts, and changes in sleeping patterns. Of course, not all who experience traumatic events – one or several – develop PTSD. There are still several other ways unresolved trauma can impact a person later in life.
Attachment & Relationships
Thanks to mental health advocates and content creators, the pipeline of experiencing childhood trauma to developing a less-than-secure attachment is perhaps the most popular long-term impact of childhood trauma. As previously mentioned, childhood is when we do the majority of conceptualizing trust, care, and security. Experiencing traumatic events during childhood can disrupt the establishment of healthy understandings of those concepts, which can result in unconsciously engaging in, and contributing to, tumultuous relationships (familial, friendship, romantic, etc.) for the rest of our lives if not addressed.
Attachment style is a term that refers to the way we relate to others in our close relationships, and it is largely established by the very first relationship we established with our primary caregiver(s) in early childhood. There are four main attachment styles: secure, anxious, avoidant, and disorganized. People with a secure attachment style feel safe and secure in their relationships, trusting that people will be there for them when they need them. People with an anxious attachment style often feel insecure and needy in their relationships, constantly worrying that people will leave them. People with an avoidant attachment style often find emotional intimacy uncomfortable so they may intentionally or unintentionally push others away or sabotage a situation to avoid the discomfort altogether. Finally, those with a disorganized attachment style are often inconsistent in the way they respond to others, as they may have a mix of characteristics from the previous three attachment styles.
Unsurprisingly, those who experienced childhood trauma – and therefore likely established unhealthy understandings of trust, care, and security – are more likely to develop an anxious, avoidant, or disorganized attachment styles. As a result, those who experienced trauma in childhood often also experience challenges with developing and maintaining close relationships in the future if they don’t work through those unhealthy conceptualizations later in life.
Adverse Childhood Experiences (ACEs)
We can’t complete our discussion on the impact of childhood trauma without talking about ACEs, or adverse childhood experiences. As we briefly touched on in our last blog, ACEs are potentially traumatic events that occur in childhood (0-18 years). They are broadly categorized into three groups – abuse, neglect, and household challenges – then further divided into multiple subcategories, such as emotional abuse, physical neglect, and parental separation or divorce. ACEs have been a significant topic of interest in health research since the CDC-Kaiser ACE Study began in the late 1990s. Since then, an abundance of evidence from the ongoing ACE study, as well as several others that followed, have revealed the profound influence ACEs seem to have on individuals’ physical and mental health – among other things – in the future.
In short, the greater number of ACEs an individual has experienced, the greater their risk for a variety of negative mental and physical health outcomes in the future. In fact, at least 5 of the top 10 leading causes of death are associated with ACEs. Ample research has linked ACEs to an increased risk of developing chronic disease and behavioral challenges, including obesity, autoimmune diseases, depression, and alcoholism. Individuals who experienced multiple ACEs are also more likely to underperform academically, be unemployed, and develop high-risk health behaviors like smoking and other drug use.
Unfortunately, ACEs are common and the effects can accumulate over time. According to CDC data, 61% of adults reported experiencing at least one ACE and 16% – about 1 in 6 – reported having experienced four or more ACEs. To further stress the significant long-term impact of ACEs, the CDC estimates that preventing ACEs could reduce the number of adults with depression by as much as 21 million (-44%), cases of heart disease by 1.9 million (-13%), and cases of obesity by 2.5 million (-2%). Ultimately, ACE prevention has the potential to significantly reduce chronic conditions, risk behaviors, socioeconomic challenges, and leading causes of death in the United States.
According to the National Child Traumatic Stress Network (NCTSN), the immediate impact and lasting effects of childhood trauma largely depend on a number of factors, including the child’s developmental stage, support system, and how frequently the trauma is experienced. If you suspect that a child in your life is experiencing any form of trauma, it’s important to reach out for help because it can make a difference. As we’ve discussed in this blog, trauma can have lasting effects on an individual’s mental and physical health, interpersonal skills, SES, etc., so getting them the support they need can be pivotal in helping them lead a healthy, happy life.