Adverse Childhood Experiences or Really Bad Childhoods
In the first few paragraphs of his book “Angela’s Ashes” Frank McCourt comments: “When I look back on my childhood I wonder how I survived it all. It was, of course, a miserable childhood: the happy childhood is hardly worth your while. Worse than the ordinary miserable childhood is the miserable Irish childhood, and worse yet is the miserable Irish Catholic childhood.
People everywhere brag and whimper about the woes of their early years, but nothing can compare with the Irish version: the poverty; the shiftless loquacious alcoholic father; the pious defeated mother moaning by the fire; pompous priests; bullying schoolmasters; the English and the terrible things they did to us for eight hundred long years.”
Does a bad childhood (not only an Irish one) inevitably lead to problems in life? Not inevitably. Not everyone will demonstrate the effects of a bad childhood, but it does seem that many people do. And they do in surprising ways. We would expect a bad childhood to affect our psychological make-up and our ability to form relationships. Bad childhoods do this, but they appear to do much more than mess us up psychologically.
A very interesting group of studies, known as the ACE (adverse childhood experiences) studies have indicated that having a bad childhood can lead to numerous problems. The researchers who did the studies, divided adverse childhood experiences into the following categories: childhood sexual abuse, physical abuse, emotional abuse, neglect, substance abuse in the family, domestic violence. They did not determine the number of experiences in a category, simply the number of categories.
The researchers have demonstrated that even when controlling for lifestyle factors (such as drinking and smoking) that people who have had experiences in a number of these categories have an increased risk for physical illnesses such as diabetes, heart disease and cancer. Their risk for psychiatric illness and drug abuse also increases.
The researchers demonstrated that ACEs are extremely common – for example more than 30 percent of the group they studied indicated that they had been physically abused, almost 20 percent indicated they had been sexually abused and over 23 percent had been exposed to family alcohol abuse. This was not a group of people who had reported to mental health professionals. These were normal, everyday people who probably did not think they had too much wrong with them.
This study confirmed that adverse childhood experiences are linked to the development of depression, suicide attempts, alcoholism, drug abuse, sexual promiscuity, domestic violence, cigarette smoking, obesity, physical inactivity and sexually transmitted infections.
The more ACEs experienced, the more likely a person is to develop heart disease, cancer, strokes, diabetes, skeletal fractures and liver disease.
It appears that chronic trauma interferes with neurobiological development. Children who have experienced miserable childhoods struggle to integrate sensory, emotional and cognitive information.
There are many other studies which confirm these results. Having a bad childhood does not lead to inevitable problems, but it certainly increases your risk for them.
What are the typical emotional problems which children have who have had these experiences?
Children who have been exposed to ACEs often present with attention problems, difficulty recovering from intense emotions, they are often not aware of their own bodily experiences or find it hard to describe them. They may also experience difficulty in sleep, their appetite may be affected and they may react intensely to sounds or touch. They also often struggle to protect themselves. They may be easily distracted from goals. These children often do not feel good about themselves and may feel helpless or defective. They often find it very hard to trust adults, and may be aggressive with their friends or adults. Some of these children have a too strong need to get close to others, at times sexually.
They will often demonstrate problems at school, in the family, with their friends, and may have problems with the law. They may have health problems.
Do these problems continue into adulthood?
The area in which we see most of these problems is in the area of relationships. This is not surprising as relationship trauma will probably be triggered most severely in relationships. For both parties in these relationships it can be extremely frustrating. The person who has not had similar trauma will often struggle to understand their partner. And the person who has experienced severe interpersonal trauma as a child finds themselves behaving in inappropriate ways and feeling incapable of changing their behaviour.
They find they experience emotions such as panic at inappropriate times; they may feel abandoned in situations which other people will regard as every day. They may find that the respond to sexual advances of someone they love as though they were threatening. They may find that they experience emotions much more strongly intensely than someone who has never had ACEs. Alternatively they may struggle to experience emotions and may feel that they have none. They may struggle to stick to goals and despite their best intentions being distracted. They may struggle to trust others and may find that they lose their temper more easily than others do. They may find that they have health issues which are not always fully explained by medical science.
Can something be done about it?
Yes, psychotherapy does help. But long-standing trauma and long-term ways of functioning do not change overnight. They change in a relationship which demonstrates different ways of relating to the dysfunctional patterns were exposed to. This takes time and typically many obstacles have to be negotiated along the way.