Early trauma, including child abuse and neglect create enormous problems for the victims. Among these are fundamental changes in brain development. The deprivation of severely neglected infants and children can be so damaging to the brain that it simply fails to grow in size at a normal rate, resulting in a brain size and a head size that are much smaller than is appropriate for a child’s age.
Nurturing and safety in infancy unlock certain genes that create self-soothing and self-regulating chemical receptors in the brain. These receptors cause the body to quickly turn of cortisal production after a stressful event. The result of such nurturance is a child and later an adult who recovers quickly from stress and is able to avoid many of the diseases and mental disorders of high stress.
For a very simple, interactive explanation of this process, see the University of Utah’s website on epigenetics http://learn.genetics.utah.edu/content/epigenetics/
In addition, certain critical governing neural networks that extend throughout the brain in a healthy individual must begin their development in the brainstem, and then gradually grow upward to progressively more complex regions of the brain. If, as a result of child abuse or neglect, this does not happen, a survivor of child abuse will have great difficulty with self regulation, impulse control, physiological calming, and attention. The result? Erratic behavior, including anger outbursts, inability to focus, mood swings, anxiety, depression, reckless or dangerous behavior, failure to follow through on goals or tasks, and hyperactivity.
The ACE (Adverse Childhood Experiences) studies offer a stark picture of the effects of childhood trauma on adult quality (and length) of life. The ACE studies show the following correlations:
- Unresolved trauma doubles or triples the risk of major metabolic illnesses and health problems:
- For a person with 4 or more categories of ACE trauma, (compared to a person with none) the chances of
- stroke increases 140%,
- ischemic heart disease increases 120%,
- any cancer increases 90%,
- chronic bronchitis increases 290 %,
- diabetes increases 60 %,
- obesity increases 60 %,
- broken bones increases 60 %,
There is also an increase in autoimmune diseases: For a person with more than 2 ACES (compared to a person with none) there is
- 80 % more myasthenia gravis,
- 100 % increase in rheumatoid diseases,
- 70 % increase in idiopathic myocarditis
- Frequent Headaches: more than doubles (2.1) with five or more ACES
- Psychotropic Medication triples with 5 or more ACES
- An ACE Score of at least 7 [categories, not incidents] increased the likelihood of childhood/adolescent suicide attempts 51-fold and adult suicide attempts 30-fold
- Five-fold increase in hallucinations with 7 or more ACES
- Number of ACE categories steadily increased risk of depression, 3-5 fold
Even more dramatic is the increase in addiction. The probability of addiction for a person with 4 or more traumas (compared to 0) shows that
- Alcoholism increases to 640 %
- Illegal injected drug use increases 930%
- Obesity increases 60%
- Promiscuity increases 220%
- Sexually Transmitted Diseases 150 %
- Smoking increases 180 % with 5 or more ACES
- For a male with 6 or more childhood traumas, the chances of injected illegal drug use increases 3900%
These correlations are extremely significant. The ACE studies are not a minor body of research. Conducted by Robert F. Anda, MD, of the Center for Disease Control, and Vincent J. Felitti, MD of Kaiser Permanente, they are the largest studies ever done to correlate childhood trauma with adult illness. To date there are 58 articles articles an publications about the ACE s tudies, many in presitious, peer-reviewd journals such as the Journal of Affective disorders, the American Journal of Preventive Medicine, JAMA, Child Abuse and Neglect, Psychological Medicine and others. To view the articles about the ACE studies, go to http://www.cdc.gov/ace/index.htm
Typically children with trauma symptoms have been variously diagnosed and misdiagnosed as having attention deficit disorder, conduct disorder, oppositional defiant disorder, mood disorders, anxiety disorders, and “childhood” bipolar disorder. All of these labels do nothing to identify the abuse and neglect that are the root cause of the problem and do not lead to trauma therapy interventions that repair the brain’s regulation systems.
In fact, a huge problem in current psychiatric treatment involves the use of antipsychotic drugs for the treatment of children with trauma. This use of antipsychotics drugs on children is not approved by the FDA, is not supported by research, and creates many serious side effects including suicide risk, loss of ability to feel pleasure, weight gain, permanent movement disorders, and a greatly increased risk of diabetis. Pharmaceutical companies have aggressively pushed these drugs onto psychiatrists for use with children. Thousands of lawsuits have resulted, and the pharmaceutical companies have been fined the largest prescription drug-related fines in US history, with criminal penalties as well in some cases. However, these antipsychotics are so profitable that the illegal marketing and off-label prescribing continues to affect increasing number of US children. More details can be found in the following articles:
Some of the nation’s top child trauma therapy researchers, led by international experts Bruce Perry and Bessel Van Der Kolk (both psychiatrists) have been working for the last thirty years to discover what is damaged in the traumatized brain, and how to actually repair it, rather than mask it with medication
Their research, along with a wealth of new information from brain imaging, has created a trauma therapy approach that stimulates the gradually development of the appropriate neural networks, from the brainstem up, even in older children and adult survivors of child abuse and neglect.
The new trauma therapy, called “Neurosequential Model of Therapeutics” or NMT, requires much more than one hour a week, however much of the work is simple and does not require a therapist. It can be done at home, as long as it is overseen and guided by a clinician who understands the sequencing of tasks needed at each stage.
For example, at the brainstem level, the necessary neural networks need to be stimulated by touch and by physical activities involving balance, posture, rhythm, breathing and motion. Appropriate therapeutic activities thus include yoga, tai chi, rhythmic dance, music, drumming, breathing exercises, horseback riding, and massage.
As the networks of self-regulation begin to improve, the therapist can then add activities that focus more on hand to eye coordination, social interactions, understanding and experiencing emotions, learning trust and teamwork, and watching social cues and body language.
The last stage of this developmentally-sequenced trauma therapy is to learn cognitive skills such as mindfullness, positive thought patterns, self-worth, goals, motivation, and attention. These skills, which are much of the substance of traditional cognitive-behavioral therapy, cannot be effectively mastered at the first stage, but they are essential in the final stage of therapy.
Dr. Bruce Perry has developed a sophisticated system of brain mapping of v various aptiudes and developmental skills. This brain mapping enables the trauma therapy practitioner to evaluate the level of brain development in a survivor of child abuse, and to then choose the level of intervention that is most likely to be helpful.
Using this system, Dr. Perry, Dr. Van Der Kolk and others have achieved a level of emotional and functional repair in survivors of child abuse and neglect that was not previously believed possible.
Unfortunately, this trauma therapy approach is not yet widespread, partly because of entrenched conventions and insurance protocols that pay only for older traditional therapies and medications. This appropach is unfortunate. Not only is the essential brain sequency negelcted, but in many cases the medications that are being prescribed actually prevent the brain of a childhood trauma survivor from building the essential neural networks of healing.
For those who want to understand and embrace the neurosequential approach to trauma therapy, Dr. Bruce Perry offers distance training at a very reasonable cost to therapists who want to learn the Neurosequential Model of Therapeutics. Clinicians attend ten 90 minute seminars, one a week, to complete the training, and can do this via phone or skype. For more information go to childtrauma.org.
Bessel Van Der Kolk has been actively raising research funds to create a new diagnostic category, “developmental trauma disorder” and to establish a diagnostic system that will recognize the trauma core of many other disorders, and thus direct survivors and caregivers towards appropriate therapies that actually repair the brain.
Childhood trauma is by far the biggest health problem in our nation. According to the ACE studies, more than half of US adults have experienced childhood trauma, and this trauma doubles and triples the risk of most major health problems. In addition, childhood trauma multiplies the rate of addiction, depression, anxiety and suicide attempts, in some cases as much as thirty or forty-fold. To unlock trauma is to unlock our future.
If you would like to be involved, please consider contributing to these pioneers in healing. You may also spread the word by liking, sharing, linking to or emailing out this page and video program.
To go to the website of Bruce Perry’s Child Trauma Academy, go to http://childtrauma.org.
To read Dr. Bruce Perry’s recent article on NMT, published in the Journal of Loss and Trauma, go to http://michfed.org/wp-content/uploads/2009/11/TraumaLoss_BDP_Final_7_09.pdf
To view Bruce Perry’s powerpoint slides showing brain mapping, go to https://childtrauma.org/images/stories/docs/nmt_core_slides_2011.pdf
To go to Bessel Van Der Kolk’s Trauma Center, go to http://traumacenter.org.
A one hour radio presentation, with a great deal more detail about neuro-science based trauma therapy was presented live on Healing Talk Radio in February, 2012. Please click on the play arrow below.