Little wonder, then, that essentially anything that a child experiences will impact which connections will get pruned or rewired and what the child's adult brain will end up look like. This is most apparent when it comes to victims of childhood abuse and neglect [1]. By exposing the young brain to a high-threat environment, it has been observed that this makes the amygdala (part of the emotional regulatory system and fight or flight mechanism) less responsive.
Along with the hippocampus (responsible for short-term memory handling), both regions thus become optimised for a high-threat, high-stress environment. While great for surviving such an environment, this adaptation makes it hard to impossible for those such affected to thrive in an environment where no such threats exist. Especially dealing with diverse, non-threatening emotions becomes exceedingly hard, with in the most extreme cases children being unable to distinguish between emotions such as sadness and anger.
Along with the hyper-vigilence and inability to regulate their emotional state, this can pose severe difficulties in the interaction with others. Since the child's brain is tuned for a high-threat environment, warnings by adults or certain actions by peers can be interpreted as a prelude to imminent danger, causing the child to display overly aggressive or aversive behaviour. In turn, this leads the former to issue sterner warnings and proceed with more aggressive forms of punishment and the like, continuing the cycle.
Abuse and symptoms
Not all types of childhood abuse are the same, obviously, and each will have a different set of common symptoms in the affected children [2]. In the case of sexual abuse victims: "Disclosure is the most obvious indication of sexual abuse. Age-inappropriate sexual behaviour or excessively sexualized behaviour might be an indicator of abuse. Indirect signs can include any of the following:"- acting out (with aggression or anger);
- withdrawal;
- regression;
- fears, phobias, and anxiety;
- sleep disturbance or nightmares;
- changes in eating habits;
- altered school performance;
- mood disturbances;
- enuresis or encopresis;
- running away;
- self-destructive behaviour; or
- antisocial behaviour (eg, lying, stealing, cruelty to animals, fire-setting)
This combines with symptoms from Box 2 in the previous link, which includes an aversion to physical contact, even with caretakers and close family, as well as low self-esteem and the feeling that one deserves anything bad that happens and any form of punishment, since obviously one is a bad person.
Adulthood
For most victims of childhood abuse and neglect the consequences persist into adulthood, where their struggle with emotions and stress responses causes many issues [3][4][5][6]. Their views of the world and other people will be more negative than average, and the difficulty in recognising positive emotions causes significant friction in the interaction with others. Many will end up in abusive relationships that imitate the original environment in which they grew up, others will exhibit risky and/or extreme sexual or otherwise self-destructive behaviour as they find themselves struggling with a low-threat environment. A number will attempt suicide.Other common issues include homelessness, substance abuse including alcohol and drugs, criminal and violent behaviour, as well as mental health issues. The latter includes depression, post-traumatic stress disorder and a range of related disorders. Finally, another major impact of childhood abuse appears to be medical, in that the affected individual will suffer more medical issues over time, likely caused both by the effects of the initial high-stress environment on the child's development immune system and the results of the later high-risk behaviour and unhealthy life style choices.
A personal note
Repressing memories of the traumatic events is apparently also quite common, even as the neurological effects do not change. This is how I was able to believe for many years that I had had a normal childhood and youth, with a caring family and a safe environment. Even as I was exhibiting many of the symptoms of child abuse during this time and well into adulthood. By being ever more confronted with my own behaviour and the reasoning behind it, it has forced me to quite literally dig into my oldest memories to put things together.A few years ago this led to the resurfacing of a recollection of being physically or sexually abused. Likely the latter as I remember lying on this surface, with two or more adults present, touching my undressed child's body. I think I must have hurt one of them as I struggled to get away. Next I remember is me running and ending up in this dark room with no way out. Then this adult male standing in the doorway and yelling at me that it's 'all my fault' before slamming the door close. Leaving the child alone in that dark room.
If it was just that apparent recollection I might have dismissed it as just a dream or fantasy, but long before this my mother would tell me that around the age of 5 I suddenly went from this open, energetic and super-friendly child to a withdrawn child, who didn't even allow their own mother to touch them, instead flinching away from any form of physical contact. Over the following years one can then track a pattern of similar symptoms that are typical of abuse as discussed earlier.
I still do not know who might have abused me, how many times or for how long it happened. I do know that a cousin of mine committed suicide after growing into a young adult because she could not live with the memories and lack of support in the family where an uncle and grandfather sexually abused her along with a number of other young girls. Especially after a legal error set the two criminals free again. Things like that are too close for comfort, and it makes one wonder about other dark secrets. Maybe even ones involving one's 5-year old self.
I'm beginning to realise that what I'm struggling with for years now are essentially the results of childhood abuse, combined with years of social rejection and bullying at school, followed by years of rejection and ridicule by doctors and psychologists regarding my intersex condition. Oh, and getting raped, sexually and psychologically abused on multiple occasions because I too fell for the lure of high-risk, abusive environments like so many of child abuse victims.
In a sense it's comforting, I guess, that I appear to be such a textbook-style case of child abuse. By realising that what's 'wrong' with me is that my brain is simply tuned for an environment which hasn't really existed since I was a child. That the way to hopefully fix this is to correct for this behaviour by being more aware of it, hopefully forcing my brain to stop living life as though there's a child rapist and murderer behind every corner. In the midst of a war zone and zombie apocalypse.
The many years of doctors and kin mistreating me the way they did has done me no service, and they will likely never relent, but there are things which I can control and fix. Together with my therapist I can dive back into what really happened, finally release that child from the dark room and show it that there can be a life after such an event. To evaluate life and other people not as a potential source of threats, but as a potential source of interesting and fun interactions and experiences.
It sounds terribly easy when I write it like that. And that's sadly the thing with cases like mine. One can cover up the literal emotional damage to one's brain with intelligence and reasoning, but in the end one is still one's brain, and just like a broken leg one cannot just wish the physical damage away. It will take time and good care to make things heal and go back to the way things were. Just like a broken leg it will however never be quite the same again.
Here's to the long road to recovery.
Maya
[1] https://pediatrics.aappublications.org/content/122/3/667
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743691/
[3] https://www.psychologytoday.com/intl/blog/somatic-psychology/201104/the-lingering-trauma-child-abuse
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117717/
[5] https://www.nap.edu/read/2117/chapter/8
[6] https://aifs.gov.au/cfca/publications/effects-child-abuse-and-neglect-adult-survivors
1 comment:
Thank you....
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