Factor 4: Trauma

Think That Trauma Doesn’t Affect You? Think Again

• living with parents who were judgmental and harsh, not warm and accepting
• living with parents who ignored you, rejected you or did not respond to your emotions or were inconsistent and irrational when disciplining
• living in a chaotic household with yelling and arguing
• lack of attachment or bond to caregivers
• verbally abusive, rejecting, critical, or shaming parenting styles
• living with parents who were depressed, anxious, or narcissistic and self-absorbed
• substance abusing parents
• neglect, poverty, or chaotic home environments
• frequent moves
• witnessing or experiencing physical or verbal abuse
• experiencing emotional neglect
• witnessing or experiencing sexual abuse
• witnessing or experiencing domestic violence
• loss of either or both parents due to divorce, abandonment or death
• inconsistent involvement by parents
• foster care or adoption
• living in a crime-ridden neighborhood
• poverty and insecurity
• exposure to crime or family member in jail
• family member with mental illness
• early medical problems or hospitalizations
• exposure to excessive violence in media
• accidents, natural disasters, fires
• witnessing war, suicide or murder

Landmark Study

Trauma is one of the most widely recognized external sources of emotional difficulty, especially following the Adverse Childhood Experiences Study (ACES) in the mid-1990s. In this landmark epidemiological research study, the Kaiser Permanente health maintenance organization, along with the Centers for Disease Control and Prevention, surveyed 17,000 adult healthcare patients. They were asked 10 questions about their childhood experiences with physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, whether their mother was treated violently, household substance abuse, household mental illness, parental separation or divorce, or if a household member had been incarcerated.

The ACES study found that 1 in 11 middle-class adults had experienced 6 or more of these events, an exposure level far higher than had been anticipated. And of those who had 6 or more events, the resulting emotional, behavioral, and health consequences were staggering. These traumatized people were 4,600 percent more likely to become IV drug users. They were 30 times more likely to attempt suicide. Not only was their emotional functioning fragile, but their physical health was far more likely to involve chronic disease states largely as a result of high-risk behaviors, such as smoking, drug use, promiscuity, and over-eating. Stressed out people tend to adopt coping mechanisms, such as addictions or unhealthy emotional states, to manage their emotions.

The Effects of Trauma

During follow-up longitudinal studies, highly traumatized study participants were found to have had a life expectancy that was 20 years shorter than those who had not experienced such high levels of trauma. The unrelieved stress of living with the emotional damage of trauma causes chronic effects on the central nervous system, releasing pro-inflammatory biochemicals and suppressing the immune system.

Fearful responses learned in childhood are especially powerful, because they couple the sense of terror with a sense of helplessness, leading a child to believe he or she is unable to respond to frightening situations. This sense of powerlessness can continue into adulthood, resulting in depression, anxiety and panic attacks.

Peter A. Levine, PhD, has written extensively on the effects of trauma on humans, including in his excellent book, In An Unspoken Voice: How the Body Releases Trauma and Restores Goodness:

“The younger, the more developmentally immature or insecurely attached the victim is, the more likely it is that he or she will respond to stress, threat and danger with paralysis rather than active struggle. People who lack solid early attachment bonding to a primary caregiver, and therefore lack a foundation of safety, are much more vulnerable to being victimized and traumatized and are more likely to develop the entrenched symptoms of shame, dissociation and depression.”¹

Childhood traumas, even just judgmental parents, can lead a person to have:

• feelings that one is powerless to protect oneself
• feelings that the world and relationships are frightening and unsafe
• feelings that caregivers are not there to protect you

The result can be:

• a high need for reassurance and connection to others coupled with a fear of trusting others, which can be confusing and emotionally draining
• low self-worth leading to a strong need for external approval or a distancing from emotional connection
• hyper-vigilance for any signs of being rejected
• high levels of perfectionism and self-criticism
• difficulty handling criticism, shame, and embarrassment
• lashing out in anger and blame toward others or “lashing in” in self-blame
• isolating and avoiding social contact
• seeing emotional threats where there are none (negativity bias)
• fear-based “black-and-white” thinking, catastrophic thinking

A sense of dependence and insecurity can lead to feeling helpless and at the mercy of others. Couple this with feelings of inadequacy and it is a perfect recipe for being chronically fearful.

Self-Worth and Rejection

For many people, it does not take a full-blown trauma, such as abuse, to develop the “superhighway” of connections in the emotional brain. Parents and our culture may inadvertently teach a child that she is not worthy of love and acceptance.

Children need to feel accepted, loved and protected physically and emotionally by parents. Harsh, critical parents who focus only on enforcing compliance with behaviors inadvertently teach a child that she is not worthy of love and acceptance. Without secure attachment to a caregiver, children often grow up with impaired emotional development. They may develop insecurities, shame and fears that they will not be approved of by others.

They may then learn to be very self-blaming, perfectionistic and self-critical as a way of trying to earn that approval.

If a person learns to be very self-critical, these constant messages of shame (“I’m not worthy”) can make a person hyper-vigilant or on guard for signs of being rejected by others.

These internal negative thoughts about the self can trigger the fear response in the brain and body. So self-rejection can lead to the same response in our body and brain as the fear of being stalked by a tiger!
The resulting feelings of shame can be acted out as

• anger (rage at others)
• depression (rage at the self)
• perfectionism and anxiety.

Developmental traumas are more damaging than random events, such as crimes or hurricanes, because this trauma is personal — someone (often a family member) chose to hurt you. Someone who should be providing security and comfort is instead harming you. This produces strong emotions of fear, but also shame, in the context of feeling psychologically alone and helpless. Feeling invisible while in great distress is what is so deeply hurtful.

In contrast, strong attachment bonds signal that someone will be there for us when we are in distress and will provide emotional healing.

Chronic Trauma

The most common cause of chronic trauma is a negative parenting style, such as parents who are harsh, judgmental, verbally abusive, permissive, anxious, easily agitated, overly focused on behaviors, or under-focused on responding to a child’s emotional states.

Children learn that perhaps:

• parents are a source of judgment, shame and rejection
• parents are the source of or do not protect the child from fear-provoking situations or people
• parents are self-absorbed, seeking comfort for their own emotional or physical needs
• parents do not respond with emotional attunement to the child when he or she is fearful
• a child is helpless in the face of threat because of the natural dependency on parents.

Paul Gilbert summarizes how this experience can lead to fear of criticism in an adult:

“Imagine a child’s parent is often angry and calls them stupid. The child experiences the parent as threatening and dangerous, there will be arousal of panic/fearful emotions within the child, and these emotions will be associated with the words the parent uses (e.g. ‘stupid’). Note too that the child cannot just run away or escape, so in that moment the child may feel trapped and that no one will rescue them.

Another key emotion that follows on from the sense of ‘no rescue’ is feeling very alone. Fear, a sense of entrapment and aloneness are all emotional experiences being programmed into the child’s brain. If this happens repeatedly that programming will become more fixed.

So what do you think happens later in life when the child, who is now an adult, is criticised? (sic) They may well have a flush of these difficult emotions — that sense of shame, feelings of entrapment and aloneness/no rescue. These feelings may be overwhelming and complex. These are like body memories with feelings flushing through the person because of their original experiences. To cope with theses complex feelings the person might react in an angry way or withdraw, or even self-harm, but we can see that that is not their fault.”²

Harshly critical parents who over-focus on behavioral compliance often try to gain a child’s compliance with the use of judgment or shame, or with threats of abandonment or rejection. A child learns to judge, criticize, and essentially reject herself in an attempt to find acceptance and love.

In terms of self-acceptance, the problem with rejecting, unemotional or neglectful parenting is simply this: If parents are not nice to you, how do you learn to be nice to yourself? And if you cannot be nice to yourself, how do you learn to be nice to others? How do you learn to trust that others can be nice to you? How do you learn to trust that you can be nice to yourself?

Essentially the entire social world may appear to be an emotionally threatening place — even the relationship you have with yourself.

And if developmental trauma teaches a child that even his own emotions are threatening, he learns to shut down to his physical, emotional and intuitive experiences. He learns to over-think, leading to worry and stress. And he learns to under-feel, leading to an inability to generate pro-social emotions for himself or others.

How Trauma Affects Relationships

This pattern is most notable clinically in couples and families, because a clinician can witness the lack of kindness between members. Most couples and families appear for therapy with relationship issues because they do not behave generously, thoughtfully and compassionately toward others. Some even express outright that they do not have an ability to experience feelings for others.

I would suggest this is a major indicator that they also lack these skills in relation to themselves. A lack of compassion toward others is a major indicator of lack of self-compassion. Inability to recognize emotional states in others indicates a lack of this ability toward oneself as well.

The source of this lack of pro-social skills is often parents who failed to provide appropriate emotional attunement and responsiveness, especially during the key attachment period of ages birth to three.

There is also the unfortunate conundrum trauma survivors face: They find it difficult to connect to others, since physical and emotional closeness triggers a sense of danger. Yet common sense and research tell us that feeling loved and connected to other supportive family and friends helps heal trauma.
Read more on Bessel van der Kolk’s writings.

Effects of Childhood Trauma

Researchers have extensively proven that trauma in childhood causes several significant effects:

• Adverse childhood experiences can alter the structural development of neural networks and the biochemistry of neuroendocrine systems.³ The brainstem, or lower parts of the brain, are the more-primitive aspects of the organ and control survival-oriented body functions, such as breathing. The midbrain is involved more in social and emotional reactions, while the upper brain or cortex is most active in executive functions, such as thoughtful problem solving. The cortex is essential for regulating impulsivity, reactivity, and emotionality. Inputs from the body’s sensory organs generally come into the lower brain, then move up toward the cortex. Anything, such as trauma, that compromises the development of the cortex limits the ability of the brain to regulate responses such as impulsivity, and may lead to poor decision making, poor emotional control, and poor social skills. People need a fully developed cortex to mindfully take charge of the necessary, but unruly, lower brain.⁴
• Stress can cause long-lasting changes in the brain that contribute to vulnerability to emotional and behavioral problems. One study in rats found that long-term stress seems to reduce the number of neurons and increase myelin production in the brain.⁵ Stress turned stem cells into oligodendrocytes, which produce the myelin or grey matter in the brain and reduced the number of stem cells that became neurons. People who have post-traumatic stress disorder have higher levels of grey matter in comparison to white matter in the brain. The study indicates that the amygdala and hippocampus may be better connected in those who are stressed, meaning that the fear response is faster. To make things worse, the connections to the thinking part of the brain, the prefrontal cortex, were reduced. Therefore, the reactive, impulsive operations in the brain would be heightened, and the rational, inhibitory pathways diminished. The authors postulate that this may provide the biological underpinnings of “mental disorders.”
• Stressful experiences in childhood sensitize the brain and nervous system to threats. Traumatized individuals learn to “live in the limbic system,” or emotional brain, and do not learn to engage the cortex to manage emotions, such as fear. They lack the ability to be calm or stay calm. Essentially, their set-point for anxiety is set too high. The hyper-aroused brain is then more easily hijacked by the threat response, even in adulthood, when an experience may be interpreted as more stressful than it really is.
• Because children developmentally lack the cognitive capacity and experience to manage strong emotions, childhood trauma victims learn patterns of emotional over-reactivity to threat. This response is a normal, self-protective response by a child whose cortex is not fully developed, is in an acute or chronic fear-provoking situation, and lacks adult support to care for his or her emotional state.
• Threats of social or emotional rejection or abandonment will appear especially fear provoking.
• Traumas that involve lack of attachment to caregivers, shame-based parenting, or neglect are especially likely to lead to a sense of low self-worth and shame. Neglect and abuse victims believe that if parents did not protect them from or even caused abuse, then the child is not worthy of love and acceptance.

Neurobiological Research Has Shown That Internal Messages of Shame Trigger the Threat Response

Trauma researcher Bessel van der Kolk, MD, found many psychological results of childhood trauma, including:⁶

1. affect dysregulation: angry, upset, nervous
2. inability to concentrate
3. negative self-image
4. poor impulse control
5. aggression/risk taking

If we consider the threat response, it is clear that a person who is in “fight-or-flight” on a continual basis is going to have more difficulty regulating emotions. He will react more impulsively with fear responses, including “fighting” with anger or aggression, or will merely be nervous and upset. Fear also makes it difficult to concentrate due to hyper-vigilance.

For many people, trauma is a shameful experience that leads to self-blaming beliefs that the incident was the victim’s fault. Negative self-image also is a way to attempt to protect oneself from further harm or blame.

Quite simply, trauma turns up the volume on many normal, adaptive human cognitive processes, emotions, and behaviors. Even lack of self-acceptance can be traced to trauma.

Trauma and attachment trauma sensitizes our natural human alarm system that signals social exclusion. Those who have been harmed, neglected or rejected by others will be especially attuned for that rejection in the future.

Resources

• Take the ACES Assessment
• Detailed article on the ACE Study
• Levine, P.A. (2010) In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. Berkeley, CA: North Atlantic Books
• van der Kolk, B., (2014) The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma, New York: Penguin (An excellent summary at: The Science of How Our Minds and Our Bodies Converge in the Healing of Trauma)
• A good article on trauma, attachment and how it affects parenting: Dr. Gabor Maté & Full-Potential Parenting, Even When It Is Hard
  • ¹Levine, P.A. (2010) In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. Berkeley, CA: North Atlantic Books, p. 60↩
  • ²Gilbert, P. (2010) Training Our Minds in, with, and for Compassion: An Introduction to Concepts and Compassion-Focused Exercises. (Available at www.compassionfocusedtherapy.com), p. 14↩
  • ³Anda, R.F.; Felitti, V.J.; Bremner, J.D.; et al. (April 2006). “The enduring effects of abuse and related adverse experiences in childhood”. European Archives of Psychiatry and Clinical Neuroscience 256 (3): 174–186. doi:10.1007/s00406-005-0624-4. PMC 3232061. PMID 16311898.↩
  • ⁴https://www.youtube.com/watch?v=uOsgDkeH52o↩
  • ⁵Chetty, S., Friedman, A.R., Taravosh-Lahn, K., Kirby, E.D., Mirescu, C. ,Guo, F., et al (2014) Stress and glucocorticoids promoted oligodendrogenesis in the adult hippocampus. Molecular Psychiatry 19, 1275-1283, Dec 2014, doi:10.1038/mp.2013.190↩
  • ⁶van der Kolk, B. (2005) Psychiatric Annals, pp. 401-408 http://www.traumacenter.org/products/Developmental_Trauma_Disorder.pdf↩