Wednesday, December 22, 2010

What is Childhood Trauma?

I have always viewed my childhood as 'traumatic' ... not just as a memory but even when the situations where actually happening to me as a young child. I always knew that what was happening wasn't normal, that I was in survival mode, and that I would have some issues to deal with when all the dust settled. I distinctively remember at 12 years old upon the moment of calling the police on my parents for a 'domestic disturbance' (they were physically fighting each other at the front door) that I was thinking, "Deep-six-ing everything in order to get past the moment will result in something coming out later." I could feel in the pit of my stomach, in the depth of my being, that I was getting eaten up by the stress, the drama, and the trauma. I knew that brushing it all aside and moving forward without truly addressing what happened would later haunt my brother and me.

So, for years, I went about life during my parents' long, drawn-out, and viscous divorce which encompassed custody battles, possession wars, and using us kids as pawns (Parental Alienation Syndrome). My parents remarried very shortly (within a year) after the divorce to 'ready made' families, so my brother and I were thrust into these 'ready made' families without having comprehended or adjusted to my parents actually being separated and divorced. The 'ready made' families immediately had riffs, battles, and conflicts, making life even more strained and stressed.

Although my mother will deny that our up-bringing has any effect on our adult life (read Blaming Parents for Our Past), nearly every researcher agrees that early childhood traumas lie at the root of most long-term depression & anxiety, and many emotional and psychological illnesses. Severe traumas can even alter the very chemistry and physiology of the brain itself. I have continually stated that I feel as if my brother's life as a dysfunctional adult is part-and-parcel of his upbringing. My mother and Dad both think that he is solely responsible for his mental state, lack of ability to manage his life, and his depression, lack of motivation, & more.

I wasn't left unscarred from my childhood either. I have battled insomnia during peak times of childhood trauma. I have battled anxiety through out my life, waiting for the next bomb to explode in my family. I have sought acceptance and attention from my parents that I will never achieve in receiving. I have searched, researched, dug, and sought understanding of my past, with which my parents have never assisted (my mother is irrational when speaking of the past, and my Dad 'doesn't remember' because he 'doesn't want to', which neither helps when trying to gain peace with the past).

So what exactly constitutes childhood trauma? Did I actually experience childhood trauma? A seminal 1992 American Academy of Pediatrics (AAP) report defines childhood abuse as "a repeated pattern of damaging interactions between parent(s) [or, presumably, other significant adults] and child that becomes typical of the relationship." In addition to physical, sexual and verbal abuse, this can include anything that causes the child to feel worthless, unlovable, insecure, and even endangered, or as if his only value lies in meeting someone else's needs.

Examples cited in the report include:
  • "belittling, degrading or ridiculing a child; making him or her feel unsafe [including threat of abandonment]; failing to express affection, caring and love; neglecting mental health, medical or educational needs."
  • The AAP also includes parental divorce in the list of potentially harmful events which can traumatize a child.
  • Moving home frequently is traumatic for a child (it has been linked to suicide in older children)
  • Disruptive home life, including having to adapt to a parent's remarriage and being part of a new blended family (perhaps several in the course of childhood).

Given the information above, my brother and I indeed experienced childhood trauma, namely (1) the repeated pattern of damaging interactions with my parents, (2) parental divorce, and (3) 'disruptive home life' with having to adapt to a parent's remarriage and being part of a new blended family (two in the course of our childhoods). The results are also blatantly clear with my brother who is very depressed and suffers anxiety with panic attacks.

Not only can these childhood traumas cause depression, anxiety, PTSD, ADD/ADHD, but researchers at the CDC have also found that a traumatic childhood can take 20-years off of one's life. The study, which appeared in the November 2009 issue of the American Journal of Preventive Medicine, is the latest in the ongoing 14-year-old Adverse Childhood Experiences Study. The study involved 17,337 adults who became members of Kaiser Permanente, a health care maintenance organization in San Diego, between 1995 and 1997. After visiting a primary care facility at the HMO, they voluntarily filled out a standard medical questionnaire that included questions about their childhood. The questionnaire asked them about 10 types of child trauma:
  • Three types of abuse (sexual, physical and emotional).
  • Two types of neglect (physical and emotional).
  • Five types of family dysfunction (having a mother who was treated violently, a household member who’s an alcoholic or drug user, who’s been imprisoned, or diagnosed with mental illness, or parents who are separated or divorced).
The researchers found that people with six or more of these types of trauma died nearly 20 years earlier on average than those without — 60.6 years versus 79.1 years. In this particular research, neglect was not included. So, a person who has been emotionally abused, physically neglected and grew up with an alcoholic father who beat up his wife would have an ACE score of 4. The significance of the study is that it supports the previous research — that child trauma is an important public health issue, stated David Brown of the CDC.

Research also shows that if a person has one risk factor, he or she usually has another. So, the researchers asked: if risk factors for disease, disability and early mortality aren’t randomly distributed, what influences their adoption or development? In parallel research, the neuroscience community has found that that trauma alters the function and development of children’s brains and nervous systems. Epigeneticists, who study how a person’s experiences turn their genes off and on, have found that trauma can turn on genes that manufacture the chemical stressors that affect the brain.

Traumatized children become hyper-vigilant, edgy, and impulsive with hot tempers. They are unable to focus on their schoolwork, unable to sit still, and regard social interactions as threats. These behaviors can get them in trouble or suspended, and that can lead to engaging in risky behaviors, such as smoking, drinking too much alcohol, workaholism, eating too much, etc., which can affect their health. Each of those descriptors fits what happened to my brother: hyper-vigilant, edgy, impulsive, hot tempered, unable to focus on schoolwork, couldn't sit still, and engaged in risky behavior (smoking, drinking).

I still believe that one's personality and genetic make-up have a huge effect on who you develop into as a person. Your perspective in life which leads to how you handle your surroundings, thus your stress levels, greatly impacts your health. I recent dove into that topic of Nature vs Nurture And considering that my brother and I both came from the same parents, with the same childhood trauma, and over the same duration, but we both turned out drastically different gives an indication of personality's effect. Regardless of how we turned out as adults and regardless of my mother's and Dad's perceptions of my brother / my childhoods, we did indeed experience childhood trauma: my brother from 7 years old and onward, and for me from 9 years old and onward.

Monday, December 13, 2010

Surviving Childhood Trauma | Nature versus Nurture

So the other day, I read this piece titled "Children Learn What They Live" which lead into an interesting contemplation about Nature vs Nurture regarding how well an individual adjusts as an adult after a abusive / traumatic childhood. So, what does Nature versus Nurture actually mean? This is an essential issue in developmental psychology and describes the association between innateness and environmental influence in terms of the different aspect of development. This is frequently termed as “nature versus nurture” or nativism versus empiricism. A nativist’s view of development is one that is innate, meaning it is dictated by a person’s genes. From an empiricist perspective, development is acquired through an interaction with the environment. First, here's the piece:

If children live with criticism, they learn to condemn.
If children live with hostility, they learn to fight.
If children live with fear, they learn to be apprehensive.
If children live with pity, they learn to feel sorry for themselves.
If children live with ridicule, they learn to feel shy.
If children live with jealousy, they learn to feel envy.
If children live with shame, they learn to feel guilty.
If children live with encouragement, they learn confidence.
If children live with tolerance, they learn patience.
If children live with praise, they learn appreciation.
If children live with acceptance, they learn to love.
If children live with approval, they learn to like themselves.
If children live with recognition, they learn it is good to have a goal.
If children live with sharing, they learn generosity.
If children live with honesty, they learn truthfulness.
If children live with fairness, they learn justice.
If children live with kindness and consideration, they learn respect.
If children live with security, they learn to have faith in themselves and in those about them.
If children live with friendliness, they learn the world is a nice place in which to live.
Copyright © 1972 by Dorothy Law Nolte

A small discussion that proceed on a social networking site between myself & my friend who is also a mother where you can clearly see the viewpoint fluctuate from nurture versus nature:
  • me: Key words are tolerance, encouragement, praise, fairness, security, approval, acceptance, and friendship. May I also add: support (which goes along with encouragement above) and love as additional key words.
  • friend: So true and a great reminder of what we provide as an environment to our children makes them the people they will become.
  • me: My mother always said that the stuff kids endure during childhood does not have a bearing on who we are as adults. She said that we have a choice as an adult to be whoever, which to an extent is true; however, I do believe that an unhealthy environment has long-term consequences on who we are as people and how we deal with the world around us.
  • friend: I do have to agree with your mother also. My childhood was not the best and if I lived by the statistics I should be an abusive alcoholic. But thank goodness I chose in my life to be a much different person. So with that being said you could also say that an environment can have extreme result the other way. We can nurture all we want but in the end our children will decide what type of person they wish to be.
  • me: I know of people who came from the same parental / childhood experiences (nurture) and both turned out different. Personality (nature) plays a huge part in the equation, just as you said.
My friend's first comment reflects how nurture influences a child's upbringing whereas her second comment supports how nature takes over in who we are. After this little thread of communication, I started to think once again about the effects of both nurture and nature. Do children learn what they live or live what / who they are? First of all, I think Nature versus Nurture is much to simplistic thinking to what molds a person into who he / she is. I also think that both Nature and Nurture are influential as you can read in my post Blaming Parents for Our Past

How my brother and I have adjusted as adults after having the same upbringing is an interesting little case study. We were raised by the same parents but have starkly different lives. Our parents, an NPD Dad and a BPD mother who had a nasty divorce when I was 12 y/o and my brother 10 y/o, have been conditional with their love, selfish parents, and wielding of guilt. We were latch-key kids, thrust into ready-made families when our parents re-married shortly after their divorce, and basically left to fend on our own as our parents engaged in their new lives with their new spouses. Both parents were very selfish, focusing deeply on their own lives rather than raising their children. Both parents also placed the children into situations where they expect us to chose one parent over the other. Our mother was continuously emotionally abusive and our Dad was continuously selfish, pushing us aside on a whim.

As far as my personality and my brother's: I am optimistic, happy, and motivated; my brother is pessimistic, depressed, and highly unmotivated-- these traits could be seen from an early age. I have always been a high-achiever, one who aims to please, and an organized perfectionist. My brother? The complete opposite.

So where have our lives led us?
  • I have a Masters degree; my brother didn't graduate from high-school.
  • I lived independently as a single business woman until my mid-30's when I eventually got married and had a child.
  • My brother on the other hand has never lived independently, married young, divorced young, has had four children, and is still struggling to manage his life.
My personality definitely supported me through the abusive, challenging, and tough years. My self-confidence, optimism, and motivation kept me focused on getting an education, realizing the situations were created by my parents (not me), and that life will change (and I can make that change happen). Certainly I was affected by my parents selfishness (I have always sought their approval and love), guilt trips (I have had to overcome feelings of guilt throughout my life, especially inflicted by my parents), anxiety (worry and fear of what they were going to pull out of their hat of tricks next-- what situation will be created that I am the fault of?), and defensiveness (immediately being defensive when my Dad would come at me, which I found out I treated situations outside of my relationship with my Dad the same).

My brother, on the other hand, has always exhibited anger issues, depression, lack of motivation, and a defeatist attitude. Compound this personality with self-absorbed parents and traumatic experiences at a very young age, and this child who was seeking approval, attention, and unconditional love from his parents, spiraled further down into a bad spot. He should have had intensive therapy from a young age but he didn't. Then add the trauma of his parents divorce and the emotional torment of Parental Alienation Syndrome, and you have a nasty mix of bad nature and bad nurture.

I had many talks with my mother about my brother, which she gets very defensive saying she did all she could for him when he was a child. My main point to her is that he desperately needed stability and therapy. Her response is always that the stuff my brother endured in his childhood should not have any bearing on who he is as an adult-- that who he is as an adult is his choice. Well, in my opinion, the situation is not that simple. My brother needed medical attention as a child and didn't get it. The medical attention (therapy) would have provided tools and mechanisms that my brother could have used to manage his life and deal with the idiosyncrasies of family life and more. Additionally, both my Dad and my mother did not offer unconditional love and support for my brother during his teenage years. Rather they cast him aside when his behavior became too tough to handle.

So, on one side you have the biology (nature) of the child: personality, genetic psychological disorders, emotional disorders, and drugs / alcohol effects from the mother's pregnancy. On the other side, you have children effected by nature: emotional & physical abuse, divorce, Parental Alienation Syndrome, being latch-key kids, parents with personality disorders / alcoholism / addictions, and more.
  • A child could have positive nature with negative nurture and turn out okay (me).
  • Or you could have a child with negative nature with negative nurture and turn out not okay (my brother).
Or you could have negative nature with positive nurture and turn out not okay as seen in the case with California case: a few years ago a case in California was a headliner and was profiled on the show "60 Minutes". A teenage boy was adopted as a baby, and his adoptive family was very loving and stable by all accounts. The boy had a happy and normal childhood but, unfortunately, when he was 18 y/o he snapped. He raped and murdered a 7 y/o girl, which completely shocked his adoptive parents. From background research into the boy's biological family, his parents suffered from schizophrenia and other severe psychological disorders. The adoption agency hid this from the adoptive parents. Even the boy admitted in an interview that his upbringing or his parents was optimal and that he just had something wrong with him. He blamed himself 100% for the crime.

Some psychologists agree that Nature and Nurture are both major influences to behavior development. Psychologist Robert Plomin said, "But the genetic influence on traits and behaviors is only partial: Genetics account, on average, for half of the variance of most traits. That means the environment accounts for the rest." Nurturing and our environment can alter the effect of our nature (our genes we inherited) if the influence is strong enough. Nature and Nurture mingle and influence traits of everyone. Our genes are important because what we have inherited is essentially the basis of what kind of person we are, but the environment can alter and develop a person even more.

In my opinion, without positive nature (meaning the child is negatively effected by nature), enduring and coming out okay after negative nurture is going to be a very challenge battle. However, if the child has a positive nature, developing into a productive and well-adjusted adult is less of a challenge. And as you saw in the example of the adopted boy in California, nature has a significant impact even if the nurture was positive.

With as much as my parents think that my brother can just make a choice to turn his life around, I believe his mental illness combined with post-traumatic-stress-disorder from the childhood trauma make managing his own life virtually impossible. And on the flip side, people are always asking me how I came out so well-adjusted, happy, and positive after all the trama I have been through with my parents, and I always answer that I have been happy since birth... and that I thank God for allowing me to know I was not responsible for my parents' actions.