The Many Faces of Trauma:
Understanding Abused Children
Trauma can have many different faces. It can be a single overwhelming event or it can be repeated victimizations either later in life or beginning in early childhood. Trauma can be impersonal; natural disasters, fire, or war. It can be interpersonal: the deliberate threat or injury in the context of an interpersonal interaction (stranger rape, criminal assault, sexual harassment, combat). It can be relational; the deliberate threat or injury in the context of a relationship where the victim has some level of emotional involvement. Or it can be developmental, inflicted on infants and children unconsciously and most often without malicious intent by adult caregivers who are unaware of children’s social and emotional needs.
Regardless of the type of trauma, trauma is an experience, and ultimately it is the human brain that processes and internalizes traumatic experiences. Understanding the organization, function, and development of the human brain and brain-mediated responses to threat are the keys to understanding traumatized children and youth.
Neurons (the basic building blocks of the nervous system) form, and most migrate to their final location and then begin to differentiate in utero. Others complete their journey after birth. But all continue to differentiate until they are ready to perform their specific functions. The brain organizes and develops from the bottom up. As the brain develops from bottom to top, this process is influenced by a host of chemical signals (neurotransmitters, hormones and modulators). These signals help target cells to move, differentiate, and form synaptic connections. These crucial neural networks originate in the lower brain areas and spread up to all other parts of the developing brain. These systems are then able to communicate across multiple regions of the brain simultaneously. This guides development later in life. Impairment in the organization and functioning of these systems can result in a cascade of dysfunction from the lower regions up to all the target areas higher in the brain. Impairments during pregnancy, like maternal stress, drugs and alcohol, malnutrition, neglect, or abuse in early childhood, can all disrupt normal development.
The organization of higher parts of the brain depends upon information from the lower parts of the brain. Regulated, synchronous neural information from the lower regions of the brain allows the higher areas of the brain to organize in healthy ways. When the neural activity from the lower areas of the brain is dysregulated, asynchronous, and extreme, the higher areas will organize in an unhealthy or abnormal way.
Trauma at the hands of those closest to children and youth is viewed as being the most difficult to treat and the most impactful on the brain. Trauma between people is powerful and creates experiences that are imprinted on the brain for a lifetime. Details of the trauma may surface over a lifespan if left without proper support. The sensory system is very sensitive to bits and pieces of the world that may alert young people to the potential of a similar threat or experiences. Traumatic experiences can leave the brain in a hyper alert state and result in over-reactions to typical circumstances or the person disconnecting with the experiences in order to make them go away. In either case, the memories exist and will impact the lives of young people.
The most profound effect of early ongoing childhood trauma is the limited development of the right hemisphere of the brain. Normally, the right hemisphere processes social and emotional information. The right frontal cortex modulates emotions and responds to social cues such as facial expressions. At the same time, aggression is modulated through a right hemisphere self-regulating system that operates on an unconscious level. These systems can develop only in a secure, nurturing environment.
Neglected or abused children experience unusually high levels of arousal without opportunity for interactive repair. Early trauma not only leads to impaired development, it deprives the child of normal developmental experiences. By the time these children enter adolescence and adulthood they exhibit hostile, aggressive personalities, struggle with conventional social cues, and have difficulty reading others facial expressions. They also appear unconcerned about how their behavior affects others. Under threat or stress, they will often respond in an aggressive manner.
Depending on the type of trauma, a lack of cooperation between hemispheres can also create other symptoms:
- Somatization – unexplained physical symptoms that have no apparent cause
- Intensification of normal fears
- Depression or sadness
- Aggressive behavior or temper tantrums
- Irritability and exaggerated startle response
- Magical thinking – a continuum of symptoms that range from daydreaming to Dissociative Identity Disorder
- Problems regulating emotion and arousal
- Alterations in consciousness and memory
- Damage to self-concept and identity
- Disruptions in cognitive capacities
- Hyperactivity and attention problems
- Relationship problems
- Alterations in systems of belief
While all of this seems somewhat overwhelming, there is good news. New, healthier relationships with significant adults including therapists may be able to reverse and even undo many of the devastating effects of abuse. The advent of advanced neuroimaging technologies in the last 30 years has shown us that while natural developmental milestones and sensitive periods of enhanced neuroplasticity exist, new neurons continue to appear in parts of the brain related to new learning and that new neural networks appear and grow throughout life. Instead of our brains being the individual, isolated, self-organizing systems that neuroscientists assumed them to be, we now know that our brains are dependent on interactions with others and supportive environments for survival, growth, and well-being throughout our entire lifespan.
By being a part of their experiences, caring adults are able to activate and guide change within the brain, encouraging growth and development to facilitate new learning and better adaptation to the environment in which the child lives.
September 20, 2012
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