Women’s Health Today

Kathleen Kendall-Tackett, PhD, IBCLC, FAPA looks at how you can have a bad childhood but a great life overcoming the legacy of adverse childhood experiences.

Researchers use the term Adverse Childhood Experiences (ACE) to describe the lives of some children in dysfunctional families. ACEs cover a wide range of childhood difficulties, including childhood physical, sexual and emotional abuse; child neglect; parental mental illness, substance abuse or criminal behavior; and children witnessing adult intimate partner violence.

If any of these experiences are familiar, you are in good company. In a study of 17,000 HMO (health maintenance organization) patients in San Diego, more than half had experienced at least one type of ACE. Many had experienced more than one type. Unfortunately, adverse childhood experiences increased the risk of illness including heart disease, diabetes and cancer. The more ACEs patients experienced, the more health problems they had.

Because children are resilient having a grandparent who loves you, a teacher who understands and believes in you, or a trusted friend you can confide in, may mitigate the long-term effects of early trauma, psychologists say. A difficult childhood does not have to be the blueprint for the rest of your life. And even if you did not find caring adult attention as a child, you may still overcome a bad beginning and go on to live a great life. Your first step toward healing is recognizing the ways that childhood adversity has influenced you and could be affecting you today. Once you recognize these effects, you are in a position to do something about them.

Long-term effects of childhood adversity

The effects of childhood adversity can continue well into adulthood. From hundreds of recent studies on the long-term impact of childhood abuse, we know that adverse experiences can affect men and women in five key domains of functioning. These include:

• Physiological changes
• Harmful behaviors
• Dysfunctional beliefs
• Negative social relationships
• Emotional difficulties

If you are experiencing any of the above, these issues may have developed as a way to help you cope with your life when you were a child. Unfortunately, some of these coping techniques can be harmful to you now. This listing might help you recognize some reactions you’ve had, or are having, without realizing their possible connection to your past.

Physiological changes

Over the past two decades, we have learned a lot about how traumatic experiences can influence a child’s developing body and mind. Adverse childhood experiences can interfere with:

• the quality of your sleep,
• alter your immune system, and
• make you more susceptible to memory and attention problems.

Adult survivors of childhood abuse tend to go to the doctor more often, have surgery more often, and have more chronic conditions than people who weren’t abused. Chronic pain is another commonly reported symptom among abuse survivors. Traumatic events can also lower your pain threshold, making normal sensations seem painful. Pain syndromes related to past abuse are irritable bowel syndrome, chronic pelvic pain, frequent headaches, and fibromyalgia.

Harmful behaviors

Abuse survivors are also more likely to engage in harmful behaviors, ranging from smoking to eating disorders, substance abuse, and even suicide attempts. In addition, high-risk sexual practices and sexual dysfunction are also more common in abuse survivors, particularly survivors of sexual abuse.

Dysfunctional beliefs

What you think about yourself and others can also be colored by your past experiences. Shame and self-blame are two common beliefs about self that can be affected by abuse, and these can influence how well you cope as an adult.

Self-efficacy can be influenced by adverse childhood experiences. Self-efficacy is the belief that you are competent and can do things to improve your life. Unfortunately, ACEs tend to undermine self-efficacy, and this can make you more vulnerable to depression and a range of health problems. Past abuse can also affect your beliefs about other people. Abuse survivors are more likely to be hostile and mistrusting towards others. Given their experiences, this reaction is understandable. However, mistrust and hostility can create health problems as an adult. Hostility can suppress your immune system and make you more vulnerable to illness. It can also increase your risk of heart disease and diabetes. In addition, mistrust and hostility can have a negative impact on your relationship with your partner, children and friends.

Social relationships

Adult survivors of childhood adversity may also experience difficulties in relationships with others. People who experience ACEs may be socially isolated and feel less satisfied with their current relationships than adults who were not abused. This is not true for all adversity survivors. Men and women who have stable, loving partnerships as adults often find that these relationships are quite healing. On the more extreme end, abuse survivors are at higher risk for partnering with abusive adults. In fact, some of the beliefs about self (e.g., shame and self-blame) are related to increased risk. Learning to counter and grow beyond some of those negative beliefs about yourself is often a key way to heal, and can open a path to healthy, reciprocal, non-abusive relationships with adults.

Emotional difficulties

Abuse survivors are also at risk for emotional difficulties. Of these, depression is by far the most common. Other difficulties include anxiety and posttraumatic stress disorder (PTSD). These can also be problematic because they may impact your ability to sleep, which can impact your health.

WHAT YOU CAN DO

Past abuse can influence many areas of your life. Fortunately, there is much you can do to heal. Here are suggestions about where to start.

Process your experience

In order to heal, it’s helpful if you can process events from your childhood. Professional therapy is one good way to do that. Be sure to seek out someone you like and have a rapport with. Sharing your secrets with someone can be remarkably healing in and of itself. Also, therapy can allow you to let go of distorted beliefs you may have about yourself. During your childhood, you may have internalized messages about being stupid, lazy, or dirty, and these thoughts could be influencing you today.

Much of the harm that comes from past abusive experiences is directly related to what you tell yourself about them. Another way to process traumatic events is through writing. James Pennebaker’s research demonstrates that writing can also heal. Many of the men and women in his studies went through experiences similar to yours. Once they wrote about their lives, they were able to put their traumatic pasts behind them. They experienced measurable improvements in their psychological and physical health. If you want to give journaling a try, I’d encourage you to get Pennebaker’s book, Writing to Heal (2004), since it has many specific suggestions to help you get the most out of this activity.

Get support

The process of recovery from traumatic events can take a long time. It’s helpful if you have people in your life who understand that and will give you the space to heal. Having the support of others who have gone through similar experiences can also be important. You may want to seek out a support group for adults who experienced similar childhood events.

Set some boundaries

As a child, you likely had others violate your boundaries over and over. Now that you are an adult, you may have difficulty saying no to others. This may happen with your children, your partner, or other adults. Our culture pressures most of us to do too much. But abuse survivors often feel a double portion of pressure since they may be unable to place reasonable limits on how much time and energy they give to others. Learning to set such boundaries can have a major impact on the quality of your life.

Picture your capacity for wellness

Your experience of childhood adversity has most likely had some impact on you. But what started as a difficulty can be turned into a strength. Many adult survivors have reported that eventually good came from their bad experiences. The most important thing to remember is this: your past does not have to rule your future. I’ve known many adult survivors who have not only broken the cycle of abuse and adversity, but have gone on to have rich, full lives. I’m confident that you can too.