The lasting effects of childhood trauma
From an interview on STV
Dr Gabor Maté is one of the world's leading experts on childhood trauma (see previous blog here). He spoke in June 2019 at a conference in Scotland and was interviewed after the event on STV. Here are some excerpts:
Childhood trauma can be emotional, physical, psychological. But what is the lifelong impact of having a childhood trauma?
Trauma affects how you feel about yourself. Generally the child takes things personally. When bad things happen to the child, they believe it was them who is bad. So they have a lifelong sense of shame. Trauma affects the brain development, so the brain circuits that regulate emotions, stress, body modulation, social relationships, insight, self-regulation, impulse control. These circuits physiologically are distorted in their development under conditions of trauma. And then trauma also gives a person a sense of a world where they don't belong, where they are not safe, where they are not going to find help and where they have difficulty trusting other people. Or on the other hand, they trust some people too much when they shouldn't. So this effects development in multiple ways. And these effects can be lifelong and they can lead to physiological and mental illness.
It's not inevitable. But the more trauma or the more difficult the experience, the greater the risk of these problems accruing and then cropping up in adult life. Now if a child has a traumatic experience but has a nurturing adult or a trusting mentor or a trust worthy mentor that can mitigate the trauma and promote resilience. But we can say is that the more negative experiences a child has or the less positive experiences they have, the greater the risk as adults along the whole range of health concerns.
It can happen at a really early age, as babies in the womb even?
We know enough from multiple studies internationally that when women are stressed during pregnancy, that has a negative effect on the child's brain development. It makes the child more at risk for addiction, mental health issues, behaviour problems and so on. And so really the prevention of mental health problems needs to begin at the first prenatal visit by dealing with the stresses on the woman.
The child's health truly depends on the emotional health and social support that the parent has. So in a society where, or in a situation where there's less support, more isolation and more stress on parents, you're going to get more and more troubled children, which is what we're seeing across the western world right now. All these diagnoses that we're seeing with ADHD, mental health problems amongst kids, anxiety and so on, the increasing violence, the autism problems, these are related to stress, not bad parenting. Not parents who are mean parents, parents who are loving but who are stressed and they don't get the support they need. Increasingly, we're seeing more problems burgeoning in the childhood population.
And we use this term now, adverse childhood experiences, commonly known as ACEs. How useful is it to use that term?
It's a statistical fact that you can't argue with which is that adverse childhood experiences, physical, sexual or emotional abuse, violence in a family, a parent being mentally ill, a parent being jailed, a parent being addicted, a divorce, statistically the risk for adult problems such as mental health issues, psychosis, ADHD, addiction, autoimmune disease, malignancy, go up.
Could it not stigmatise people to see that you've got ACEs and could it also not almost a self-fulfilling prophecy that if you have so many ACEs you are not going to achieve in life?
No, it's not a prophecy. What would you rather believe by the way, if you come to me as an addicted person? That you're addicted because you're a moral failure, or you're addicted because you've got this incurable genetic disease or you're addicted because you have so much pain because of your childhood experiences and if you deal with that pain, you can heal your addiction?
We actually know there's a study that showed that in a medical practice, when people are asked about their childhood experiences, there are fewer doctor's visits later on because it's just the fact of being listened to and having their experiences validated, makes them less prone to get ill. So this is not reductive and it doesn't stigmatise. It simply helps people understand their experience.
So how do we best support people then who have suffered from childhood trauma?
First of all, by not blaming them. So if you take the addicted population, which I worked with in Canada, they're stigmatised, they're ostracised, they're illegalized, they're beyond the pale. What if we saw them as people who have suffered tremendously in childhood. What if we didn't see them as derelicts or failures? What if we see them as people who have suffered and will need support to heal their suffering and then maybe they can give up their addictive habits? So this is a very hopeful perspective. It actually means we can do something as opposed to the genetic idea that addictions are due to inheritance.
You say the addiction, it's not a choice. But surely at some point it is a choice for everyone.
Have you ever met a single person in your life who woke up one morning and says, "My ambition is to become an addict. My ambition is to be an alcoholic." I don't say people have no choice. What I do say is that when people are unconscious and in tremendous pain, their range of choices is way too limited and not only that their brains are affected by those early experiences in such a way as to make those drugs highly desirable physiologically. So the idea is if we want to give people choice, genuine choice, let's give them genuine support.
Do we then blame our parents for everything that goes wrong with us then with our behaviour, our illnesses, our personality, it comes down to nature versus nurture, doesn't it?
Well, it's not versus first of all - it's nature and nurture, number one. Number two, there is no room as I said earlier in my worldview for blame, parents do their best. I did my best as a parent, but you know what? I was a trauma-affected adult. I hadn't dealt with my trauma yet. I inevitably passed on some of my trauma to my children, not because I didn't love them. It's not because they didn't do their best. It's not because my wife and I didn't have our children's best interest at heart, but our best was limited by our own degree of consciousness and our own degree of having resolved that trauma. And so it's not blaming anybody, it's just saying that trauma actually is a multigenerational. There's nobody to blame. The thing is to understand it. And if you understand this link of trauma that can be passed on, question is, what can we do to interrupt that, to break that chain?
And how can you break the chain?
By healing. By bringing healing to this generation, by looking at the factors, social, psychological, economic, emotional, physiological and environmental, that affect human beings. And by dealing with all that as effectively as we can, it also means medical policies and governmental policies that support people, that support communities, that support contact and connection between people rather than isolate people, that do not stress people. Because we know what stress does to the intestines, and to the brain and to the immune system and to the heart. And I mean there's so much we could do with this information, if we had not a bit more research, just apply what we already know or should know. We would have a much healthier system.
One of the impacts of modern capitalism is that it isolates people, it promotes the idea that people are aggressive and individualistic and selfish because of the policies that have been in practise now for close to three or four decades. Community supports have been diminished. I know in the UK and also in North America, communities are more isolated. There's less and less sense of contact with many people and as a result, what are we seeing? We're seeing more addiction, more people dying of addiction. We're seeing more mental illness. We're seeing a rise in auto-immune disease across the Western world. People are bio-psychosocial creatures, which means to say that our biology cannot be separated from our psychological and social relationships and our emotions. We're all of a piece and to be healthy, all the pieces have to be looked after.
It's just obvious that the earlier you start taking care of human beings and the more grounding you give them to be healthy, the more they will thrive and the more effective they're going to be in their lives. We need to start very early, as I said at the first prenatal visit and schools need to be informed about this stuff. The child's brain develops from in utero, begins developing in the womb and the brain development continues until your 20s which means the schools are actually in the brain development business where they should be. But how many lectures does the average teacher get on brain development and what conditions promote healthy brain development?
When you yell at a kid, when a kid acts out, when a kid behaves in ways that is not socially acceptable, it's usually because they have some kind of emotional pain that they don't know how to resolve. Now what do we do with them? We punish them. We exclude them. What does that do? Exacerbates the problem. What if the educational system was actually trauma informed, what if actually the educational system actually understood the importance of relationship in the healthy development of children's brains? Then it wouldn't be so focused on trying to control behaviours and on cramming facts. They'd be saying, "Well, what conditions do kids need for them to develop in a healthy way so they'll be curious and interested in learning and socially responsible and comfortable and confident in themselves?" These are the questions that governments should be asking, that the educational system should be asking, that the medical system should be asking. And these are totally reachable goals given our resources and our understanding.
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From an interview on STV, 26/06/2019