Quick summary: A global health expert and survivor describes the importance of adult childhood trauma victims seeking mental health and therapeutic resources for improved health outcomes and overall quality of life in adulthood. She explains that the consequences of a high-stress home environment in childhood can have long-term adverse consequences that impact a survivor’s physical, mental, and emotional stability over a lifetime. Mental health interventions, even in adulthood, can have substantial health benefits towards healing childhood trauma. For clinicians, primary care providers play an integral role in recognising the signs of childhood maltreatment in their patients. These providers are a vital frontline surveillance resource in ensuring adult patients are appropriately identified, triaged, and receive the necessary care for recovery.
The enduring effects of childhood trauma can have long-term adverse mental and physical health consequences in adulthood. When a child lacks adequate safety, security, stability, and emotional protection in their home environment it can have serious negative affects on relationships and attachment styles later in life. Parents are the child’s first attachment figures. Children learn how to cultivate interpersonal relationships, trust, and emotional regulation from their parents. When children encounter emotional neglect, rejection, physical, mental, or verbal abuse from their initial attachment figures these traumas become hindrances in adult life.
Further, these experiences negatively affect the child’s ability to securely attach with friends, family, and partners later in life. As adults, the wounded inner child is unable to foster safe relationships and regulate a central nervous system that signals closeness translates to danger. Thus, it is vital for survivors of childhood trauma to seek the necessary mental health resources for recovery and long-term healing.
Long-term health impact of childhood maltreatment
According to the World Health Organization (WHO), 6 in 10 children aged five years or less experience physical or psychological harm from their parents or primary caregivers globally. More disconcerting, 1 in 5 women and 1 in 7 men report being victims of sexual abuse as children. Children are among humanity’s most vulnerable groups because they are dependent upon their adult caregivers and unable to protect themselves. When a developing child experiences any type of abuse it disrupts normal biological development and function. Children that experience trauma also have an increased risk of developing posttraumatic stress disorder, anxiety, cancer, depression, chronic illness and disease. Early exposure to stress, particularly inordinate levels observed in victims of childhood abuse, causes the body’s stress response system to develop abnormally. The adult survivor of childhood abuse may respond to everyday stressors in a disproportionate manner. These responses present themselves as panic attacks, heightened or irrational emotional responses, or total detachment. Such maladaptive responses substantially reduce the quality of life in adulthood and impair their ability to foster healthy relationships.
For example, an adult that suffered severe emotional neglect from one or both of their parents in childhood may develop an avoidant attachment style. This type of attachment style results in the avoidant partner running away from the relationship when they begin to experience deeper feelings because in childhood they were taught emotional dependency is unsafe. Absent the appropriate mental health resources, the adult survivor of childhood trauma finds themselves in a continuous cycle of difficulty with interpersonal relationships, romantic relationships, unhealthy attachment, or isolation. Once the adult survivor becomes aware of these residual effects, they can begin the process of healing. No matter the age, it is never too late to seek the required resources for recovery and promoting safety in adult life.
Adult mental health interventions for childhood maltreatment
Therapeutic interventions such as cognitive behavioural therapy assist patients in identifying the sources of pain and negative thoughts while providing approaches to change harmful thought patterns. Other approaches might include dialectical behavior therapy, eye movement desensitization and reprocessing, or group therapy. Some patients find group therapy particularly helpful, as they are able to find community with people that have similar lived experiences. Survivors of childhood trauma often feel alone and finding community through healing can be empowering for trauma survivors. Therapy also provides survivors positive validation. It affirms that the abuse they suffered as children was not their fault and validates their worthiness of care and love; even when their childhood environments communicated the opposite. This sort of validation is essential in retooling how abuse victims perceive themselves in the world, establish boundaries with others, and pursue safe and stable relationships.
How primary care providers support maltreatment survivors
Primary care providers possess a unique role in the health care continuum to identify adult patients that are survivors of childhood trauma. A quick mental health screening questionnaire can assist care providers in determining if a patient is encountering difficulty functioning in daily life due to childhood maltreatment. The Adverse Childhood Experiences (ACEs) Screening in Primary Care for Adults protocol offers clinicians a baseline practice for managing patients that are suffering from the lingering effects of childhood maltreatment. A large body of evidence links ACEs scores to several adult mental and physical health problems. The ACEs primary care screening framework provides clinicians a toolkit for enhanced detection methods, interpretation, and management of ACEs related health complications in adult patients.
Despite the widely accepted body of evidence that links ACEs to long-term health impacts later in life, there is still a substantial gap in adopting this research into clinical practice. Clinicians, particularly primary care practitioners, must apply ACEs screening measures in daily practice to ensure adult survivors suffering from childhood trauma are not overlooked and referred to appropriate specialists for targeted care. Research on childhood maltreatment has shown us that survivors have an increased risk for mood disorders, substance-use disorders, suicide, and complications functioning normally in daily life. Adult ACEs patients deserve proper care and to be seen in clinical settings so that they can finally receive the care resources for recovery.
As a survivor of childhood abuse, I battled severe anxiety as a child and during my college years. Once I recognized the issue and sought therapy, I acquired the tools to map the disorder to childhood trauma. My life became calmer. I was able to process external stimuli without scanning for threat, emotional distress, and fear of harm. Therapy helped me identify the tools needed to cultivate safe environments and relationships. As the child protector in my home, adult psychotherapy helped me to understand I also deserved safety and protection. That revelation was transformative for me. I began to understand the criticality of maintaining boundaries and that no one, not even family, had the right to violate them or cause me harm. As an adult, I knew the trauma was not my fault nor was it my shame to carry. However, healing from the trauma was a journey and my primary health care providers played a key role in that recovery.
Survivors of childhood trauma deserve healing and to live a life free from the cycles of abuse that caged them as children. Further, the people that care for survivors and provide safe relationships deserve the same from them as well. The first step on that path to healing requires locating proper health care that supports holistic well-being, defining an identity separate from the trauma, reclaiming sovereignty, and taking the journey to becoming whole.
Dr Ashley S. Glosson is an infectious diseases scientist, global health expert, and author of the memoir “Blood Orphan“. She holds degrees from Northeastern University, New York Medical College, and A.T. Still University, and advocates for women’s and community health initiatives.
