Childhood Trauma Essay

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Childhood Trauma And Its Impact On The Brain

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The nature versus nurture debate in human development is longstanding with many

opposing viewpoints - Childhood Trauma Essay introduction. However, numerous studies have confirmed that the maturation and development of the brain has a “reciprocal relationship with the environment” (Wilson, Hansen & Li, 2001). With the brain developing at its fastest rate in childhood, it is especially impressionable to early life experiences. If those experiences include repeated trauma of abuse or neglect, optimal brain development and function is threatened. Chronic activation of a child’s stress response system affects neurochemical dysregulation, contributing to dissociation and depression.

The brain develops in a sequential manner, starting with the brainstem, growing upwards

and outwards towards the frontal cortex. As a child grows, her interactions with the world translate into neurochemical reactions within the brain. With the brainstem and limbic regions at their most impressionable, early childhood traumas induce exaggerated neurochemical reactions within them, establishing a negative trajectory that influences future brain development. In regards to childhood trauma and brain maturation, Perry (2006) discussed a potentially significant impact; as the brain is “use-dependent” (p.29), its repeated response to trauma could over-develop certain brain regions, while other regions atrophy.

For example, when a child experiences fear, a blend of interacting hormonal and neural systems react, preparing the mind and body to protect itself against threat. In some instances, the

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brain releases a natural heroin-like substance known as endogenous opioids. The opioids manufacture a protective distancing from trauma by producing a calm and pain-free state (Perry, 2006). This state, called ‘dissociation’ prepares the body for harm by slowing down the heart rate and breathing. In extreme cases of dissociation, like Amber’s (Perry, 2006), the stress response system’s overstimulation essentially delivered an overdose of endogenous opioids. As a result, Amber’s body was thrown into an unconscious state, including shallow breathing and very low blood pressure. The dose of opioids could have proven lethal had not medical professionals intervened. Additionally, Perry (2006) spoke of Ted, a teenager who grew up watching his father abuse his mother.

Witnessing the abuse caused extreme stress in Ted; the stress solicited a repetitive neurochemical response, leading to dissociation. Like Amber, his stress response system became ‘sensitized’, and in turn, it took smaller amounts of stress to activate a full-blown response. When Ted experienced a smell or sound, anything that he associated with the abuse, his stress response system reacted in equal proportion to how it had responded when Ted was actually witnessing the abuse. The response led to an inflated release of endogenous opioids, causing Ted to faint. While most consider dissociative responses problematic, for some, the dissociative state provides relief of unmanageable stress.

Self-mutilation, or ‘cutting’ is one way to induce the dissociative state. The act of cutting (creating shallow cuts in the skin) instigates the release of brain opioids, and for those who are accustomed to dissociation as a means of escaping stress, it reactivates a familiar form of coping despite the intrinsic dysfunction of the cutting behavior. Perry added, “the experience is far more likely to be perceived as pleasurable and attractive to those who have a sensitized dissociative response from previous trauma and are in emotional pain” (2006, p.189). Dissociation is one response to trauma; another is depression.

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Depression is among the top psychological disorders, and studies confirm its causal association with stress. The prominent symptoms of depression are low mood, sleep and appetite disturbances, and diminished interest in daily activities. Carr continued, “Major depression is an episodic disorder characterized by major depressive episodes and intervening periods of normal mood” (2007, p.3). Early life trauma is considered a significant precursor of depression (LaNoue,

Graeber, Hernandez, Warner & Helitzer, 2010).

Childhood trauma affects many brain systems. The stress response system and its cosystems pay the greatest toll when a child experiences chronic threat. Taking a closer look at the functions of the HPA axis and the steroid hormone, cortisol, aid in identifying the precursors to depression. Hyperactivity of the hypothalamic–pituitary–adrenal (HPA) axis in depression was a vital discovery in psychoneuroendocrinology (Heim, Newport, Mletzko, Miller & Nemeroff, 2008). Heim et al., stated, “The HPA axis represents the major neuroendocrine stress response system designed to maintain stability and health” (2008, p.694).

Unfortunately, when a child is subjected to repeated trauma, dysregulation of the HPA axis occurs. Studies also found that cortisol, a multifunctional steroid produced in the adrenal gland, reinforced the body’s ability to cope in the face of danger. In situations of chronic threat, a condition called ‘hypercortisolism’ (persistently high cortisol levels) can lead to an array of harmful psychological side effects, including depression. Its as if the brain is “marinated in fear” (Perry, 2006, p.64). When a child is exposed to the repetitive trauma of abuse or neglect, and her stress response system is provoked to perform beyond its state of homeostasis for prolonged periods, she often dips into the dark realm of depression.

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Learning about the effects of childhood trauma made my heart ache with empathy and sadnes. It seemed so unfair that an innocent child could suffer at the hands of an abuser, with no power to defend against atrocities, like the ones I read about in Dr. Bruce Perry’s book, The Boy Who Was Raised As a Dog (2006). Everything in me that fights to protect the innocent was ignited. I found myself feeling angry with the people I read about, who committed acts of abuse and neglect on the children in Dr. Perry’s cases. Equally, I felt tremendous compassion, like in Leon’s case (Perry, 2006), where his mother was ill equipped to take care of him; for how much she and Leon suffered without the additional support that extended family had provided when Leon’s older brother was born.

Additionally, researching the effects of trauma on neurochemical functioning elicited a mix of emotions. While I experienced a level of satisfaction in forming a better understanding of the neurochemical affects on brain function and how they are influenced by trauma, I was saddened to realize its causal relationship to dissociation and depression, and the tremendous impact it can make on children’s lives. The toll that is paid by maltreated children is astounding. I cried when I read about how Justin suffered from the neglect of his grandfather (Perry, 2006). To accept that a child could fail to walk, talk, or know how to interact with other human beings as a direct result of neglect was difficult, at best. The apparent ignorance and lack of maliciousness on Jason’s grandfather’s part only exacerbated my contrasting feelings.

My greatest relief came from reading Dr. Perry’s (2006) insights, and how he employed a thoughtful, knowledge-based, and intuitive approach to healing the abused and neglected children he met. I was reassured by his examples; he affirmed my intrinsic belief in the healing power of compassion, attention, and love.

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I appreciate the knowledge I’ve gained by producing this paper on childhood trauma and its affect on brain development. Applying this knowledge to my practice will be critical in helping traumatized children. When a child enters my office for treatment, assessing her background will be of equal importance to the assessment of her caregivers’ history. This will help to identify any underlying causal influences to the child’s condition and future wellbeing.

Creating a safe environment will be a top priority when working with traumatized children as their daily lives have been so profoundly disrupted by abuse and neglect. Perry stated, “Without love, children literally won’t grow (2006, p.92). Perry’s (2006) ‘neurosequential approach’ is brilliant and seems fundamental in addressing children’s needs -“needs that reflect the age at which they’d missed important stimuli or had been traumatized, not their current chronological age” (Perry, 2006, p. 138).

To address the functioning of less mature regions of the brain, treatment will include steadying the more mature regions of which the less mature rely upon. The aim will be to augment neurobiological homeostasis by providing patterned, repetitive therapies, targeting developmental needs that date to the age at which the child experienced the trauma.

With children exhibiting dissociative disorders, it will be necessary to address the dysregulation of endogenous opioids, as well as any existing sensitization to their original trauma. It is important to note that dissociative responses often appear similar to attention deficit disorder (ADD); dissociated children seem to be daydreaming or ‘spaced-out’ (Perry, 2006, p.51). More, now than ever before, I’m grasping how neurochemical imbalances can lead to maladies like dissociation and depression, and how critical it is to address those imbalances with a blend of science, timely intervention, and compassion.

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References

Carr,
A.
(2008).
Depression in young people: Description, assessment and evidence-­‐based treatment.
Developmental
Neurorehabilitation,
11(1),
3-­‐15.

Heim, C., Jeffrey Newport, D., Mletzko, T., Miller, A. H., & Nemeroff, (2008). The link between childhood trauma and depression: Insights from HPA axis studies in humans. Psychoneuroendocrinology, 33, 693-710. doi: 10.1016/j.psyneuen.2008.03.008 LaNoue, M., Graeber, D., Hernandez, B., Warner, T., & Helitzer, D. (2012). Direct and indirect effects of childhood adversity on adult depression. Community Mental Health Journal, 48(2), 187-192. doi: 10.1007/s10597-010-9369-2

Perry, B.D. (2006). The boy who was raised as a dog: What traumatized children can teach us about loss, love and healing. USA: Basic Books Wilson, K., R., Hansen, D., J., & Li, M. (2011). The traumatic stress response in child maltreatment and resultant neuropsychological effects. Aggression & Violent Behavior, 16(2), 87-97. doi: http://dx.doi.org/10.1016/j.avb.2010.12.007

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