PTSD — or Post Traumatic Stress Disorder is a real diagnosis usually used for cases where people had a traumatic event happen in adulthood (like taking part in a violent battle, or having a car accident). The symptoms include flashbacks, anxiety, depression, insomnia, social withdrawal and explosive emotions, among other things.
Another, second of PTSD is Complex PTSD (or C-PTSD) which is caused by chronic exposure to emotional or physical trauma, such as living through a war, being in an abusive relationship, or growing up in traumatic conditions, which is what this blog is about. The diagnosis is not 100% clear, so for now let’s call this kind “Childhood PTSD.” There is a LOT of research going on right now in this area. The biggest and most impactful is probably The ACE Study, which has kind of become the standard measurement of childhood crappiness.
The ACE Study
the Ace Study began in the mid-1990s, when physician researchers Vincent Felitti of Kaiser Permanente and the Robert Anda of U.S. Centers for Disease Control interviewed hundreds of study participants about their history of adverse childhood experiences” known as the “ACE” Study.
Felitti and Anda created a survey (you can see it and take the survey here) that asks about each of these experiences; respondents gave themselves one point for each experience on the list they checked as a yes. So a person’s ACE score is somewhere between zero and ten.
The ten adverse childhood experiences, or ACEs include:
- Physical abuse
- Sexual abuse
- Emotional abuse
- Physical neglect
- Emotional neglect
- Mother treated violently
- Household substance abuse
- Household mental illness
- Parental separation or divorce
- Incarcerated household member
(There are probably many other experiences that ought to be included, like the death of a parent, or being bullied in school, or being desperately poor, or a refugee — you can take this into consideration when you take the test.)
The “T” Word
Another, shorter word for adverse experiences is “trauma,” “childhood trauma” or “developmental trauma.” I almost hate to say all these words, because they make me feel so damaged and doomed, but it may help you get a more realistic sense of the causes and possible solutions for the problems you have today.
Trauma is what we experienced as kids when the Adverse Childhood Experiences were happening. When you’re a baby or small child, trauma is particularly toxic for your brain, and causes developmental changes. Believe it or not, being neglected can be even worse for your brain than being abused. For healthy brain development, a child needs the parent to be connected with them, to make eye contact and talk to them, to respond to their feelings and their accomplishments. If parents are dead, gone, drunk, high, obsessed with a boyfriend, depressed or otherwise not paying attention to the child, the child may learn to dissociate (it kind of means “to check out”), and may grow up with a limited capacity to connect with people, pay attention or learn.
These brain changes also have consequences for physical health. A traumatized child may have headaches and stomach troubles, but as she grows to adulthood, even more serious problems can show up — depression, addictions, eating disorders, migraines, gastrointestinal disorders, autoimmune diseases, diabetes, heart disease, lung disease and even cancer.
It’s not well understood yet how exactly trauma leads to to these chronic health problems, but there is no doubt that, the more adverse experiences a person had as a kid, the higher their risk of these health problems.
Trauma also at play in Post Traumatic Stress Disorder, or PTSD. In the case of combat veterans, for example, they come back from terrible war experiences, and they may be anxious, depressed, and have trouble sleeping, connecting with people or dealing with the bad memories. They get “flashbacks,” where they remember something or dream about it, and forget for a moment that this is now, and the old trauma is not actually happening. Their body is reacting as if it IS happening, with heart pounding, adrenaline pumping, and other stress hormones pushing their bodies into a stressful overdrive. If the reaction keeps happening, it can wear them down. Combat vets with PTSD have a high rate of drinking, doing drugs and even suicide.
Those of us who had traumatic childhoods may develop Complex PTSD, or C-PTSD, which may not be the same as adult-onset PTSD. There are two specific symptoms that mark C-PTSD:
Emotional Flashbacks: Unlike specific memories of events, emotional flashbacks involve strong negative emotions. A person will be flooded, for small reasons or no reasons, with an overwhelming sense of sadness, rage, terror or frustration. It can happen when you wake up, for example, or when someone criticizes you, or gives you a present. You are not reliving some childhood experience consciously — you know that you are here in present time. But the emotions don’t know it and are reacting like you did during the original trauma.
Dissociation: There is a kind of full-on dissociation that people get, like where they can’t remember who they are, or they feel like they’re not in their body. But more common is a subtler version where you just space out. You might feel numbness in your hands or mouth, get lost while driving, or find yourself unable to finish a sentence. If it happens with an emotional flashback and you’re upset or angry, your emotions might first flare (flashback) and then go very flat and emotionless (dissociation).
When you’re dissociated part of your brain is actually shut down (an old response to unbearable stress when your brain was developing. Without your full brain working, you are not fully yourself. So you may seem to have too little emotion, and say things you don’t really mean (they seem true in the moment, but only because you’re operating with half a brain!).
Four Things to Remember
- Recent research has shown that abuse, neglect and other traumas cause brain changes in children. This damage, in turn, can cause cognitive impairment, emotional problems and chronic disease. Though much of the damage can be reversed, it’s important to be aware of how these events can have such a broad impact on every part of our lives.
- Focusing on your childhood traumas will not, by itself, produce recovery. While taking stock of what happened is a useful first step, putting attention on bad things can actually retraumatize you, and in the retraumatized state, it can be impossible to reason, remember or integrate information. This is one of the main reasons that talk therapy doesn’t work very well for trauma, and why other methods of recovery are necessary. Focusing on childhood can also emphasize blame, which ultimately keeps you trapped
- Learning to regulate your emotions makes change possible. The problem is not so much the memories, but the unregulated emotions they trigger. In these hyper-emotional states we are prone to (and even crave) destructive behaviors. The sooner we can recognize that this “flooding” is happening, the sooner we can interrupt the flood. We can do this with quick interventions, like stepping away, refraining from speaking, breathing deeply, writing our fears and resentments on paper, or counting to ten — or ongoing practices like daily writing, meditation, exercise and connecting with like-minded others.
- Instead of talking about it, taking action and making strong decisions about your life is the most powerful way to change your health, your thinking, and your behavior. Granted, past trauma can have a big impact on your functioning today, and messed-up families can pass on some dysfunctional beliefs and habits. But your past can’t change and your family is unlikely to change. It is you and only you who can change your life, and everything now depends on your willingness to take action.
By the way…
Are you ready to accelerate your recovery from past trauma? I’m pleased to announce my new course, “Healing Childhood PTSD” , is open for registration. It’s a self-paced course with 32 videos about how PTSD happens, what it does to us, and how ordinary people can begin healing and connecting again, whether or not they have access to professional help. You can learn more and register here.