Are You Suffering In Silence? The Impact of Childhood Abuse

Jennifer, a 40-year-old wife, paraprofessional and mother of two, came to see me struggling with anxiety, panic attacks, mood instability and difficulty with relationships. She would have angry outbursts at her children and then feel terribly guilty. Jennifer was anxious all the time and would have panic attacks that sent her to the ER. Jennifer’s husband was supportive but was losing patience with her mood swings. She felt inadequate at work, was jealous of coworkers and viewed any constructive feedback as criticism. She came to treatment to find out “what was wrong with her” with the hope of fixing it. This is common among survivors of childhood abuse and attachment wounding.

The impact of childhood abuse

Jennifer grew up with both parents in the home and two siblings. Her family lived in poverty due to her father’s alcoholism and job losses. She was physically abused and at the age of 9 was sexually abused by her father. Both parents were physically present in the home, but they were emotionally absent. Jennifer’s parents divorced and Jennifer and her younger siblings would have to go stay with their father on weekends. After Jennifer was sexually abused, she became protective of her younger siblings, which caused conflict between her and her parents leading to more physical abuse. During her teen years Jennifer became promiscuous and in young adulthood she cheated on boyfriends and would break up with them, which she carried a lot of shame about. She thought she was “bad” and “damaged”.

Jennifer’s story is unique but the difficulties she experienced are not. Childhood abuse is more prevalent than we think. According to the CDC, “At least 1 in 7 children have experienced child abuse or neglect in the past year in the United States. This is likely an underestimate because many cases are unreported. In 2020, 1,750 children died of abuse and neglect in the United States.”(https://www.cdc.gov/violenceprevention/childabuseandneglect/fastfact.html)That means that of seven children you come in contact with one of them has been abused. Over the long term, children who are abused and/or neglected are at an increased risk for experiencing future victimization, substance abuse, sexually transmitted infections, delayed brain development, lower educational attainment, and limited employment opportunities.

Chronic abuse typically results in chronic stress. Chronic stress is when the brain and body's fight or flight response is activated too often or for too long. When a child is in fight or flight mode, they are using the mammalian part of the brain, which means the learning part of their brain is turned off. This prevents the brain from developing normally and increases the risk for problems like complex post-traumatic stress (CPTS) and executive functioning difficulties.

Complex post-traumatic stress develops as a result of repeated incidents of abuse starting early in childhood and continuing throughout development, typically perpetrated by a primary caregiver or someone with whom the child is dependent. Symptoms of complex post-traumatic stress include social and interpersonal avoidance (avoiding relationships), feeling distance or cut off from others, feelings of worthlessness and guilt, identify confusion, believing yourself to be contaminated or bad, having feelings which are easily hurt, anger/temper outbursts, anxiety, depression, suicidal thoughts, lack of trust in self, and dissociation.

Often times one will present with executive functioning difficulties as well and may be diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Some of the symptoms of executive functioning difficulties include forgetfulness, poor time management and scheduling, trouble with organization, easily distracted, poor focus, poor concentration and working memory problems. In school these kids become labeled as having ADHD although some, especially girls, go unidentified. Girls tend to internalize their distress more due to adhering to societal and cultural norms and typically experience anxiety, low-self-esteem, frustration, and low self-worth. I believe this is one of the reasons that rates of Attention Deficit Hyperactivity Disorder (ADHD) diagnosis’ in children and adults has increased substantially in the last several years. The question is, is it a diagnosable disorder or is it the long lasting effects of childhood trauma.

What is attachment wounding?

Attachment wounding is the result of what didn’t happen for you in relation to primary care givers. Attachment wounding is the result of not getting emotional needs met throughout childhood and adolescent development. As children we have emotional needs which include validation, reassurance, encouragement, being listened to, comforted, having good limits, help solving problems, positive attention, unconditional love, respectful communication, help with grieving losses, being taught life skills and identifying emotions. We also have safety needs which include having a safe place to play and explore, feeling safe with caregivers and feeling protected. If our emotional needs were met about 70% of the time and there was no abuse or violence in the home, we have a higher chance of developing a secure attachment to our caregivers and the skills needed to function well in life. When our needs are not consistently met, we can develop an insecure attachment and lack of important life skills, which increases risk for social, occupational and emotional difficulties.

Attachment style determines how safe and secure we feel in relationships. It also impacts the pattern or way in which we interact with others. Insecure attachment to caregivers leads to feeling insecure in relationships throughout the life span. Attachment style isn’t fixed and can vary with different people. Some people develop an avoidant/dismissive insecure style of relating to others and some develop an anxious style of relating and most people fluctuate between the two. For example, you can feel safe and secure in your relationship with your partner and, also, feel insecure in peer relationships.

If you were abused by a primary caregiver, as a child you were faced with an unsolvable dilemma, the most important person in your life that you depended on for food, shelter, clothing, safety, love and protection was the same person hurting you. This is overwhelming for a child’s undeveloped brain and causes immense distress. Most children develop dissociation, a splitting of consciousness, to survive and go on with daily life. Dissociation in childhood typically persists into adulthood.

What Jennifer came to learn through trauma counseling was that there wasn’t anything wrong with her. She learned to make sense of what happened to her and how it impacted her development and ways of relating to others. Through Jennifer’s treatment she became more accepting and understanding of herself. She developed self-compassion which increased her empathy and compassion for others. Jennifer stopped having panic attacks and used coping tools to manage times when she felt anxious. Her relationships with her kids improved and she felt more secure and independent in her relationship with her husband. Jennifer improved her peer/coworker relationships and was even recognized as an outstanding employee. She no longer feared her boss but came to respect him.

Jennifer is a fictional character based on a combination of actual people.