Last week, I attended the 30th annual International Trauma Conference in Boston. Several thousand mental health clinicians from around the world attended. It was sponsored by Dr. Bessel Van der Kolk, one of the world’s foremost researchers and clinicians in developmental trauma. He wrote an excellent book, “The Body Keeps the Score,” which I highly recommend.
In the last 10 years, the field of neuroscience has blossomed. With new imaging techniques, we can better map the brain and see how it works in real time. We are beginning to understand some basic processes. Even so, we have a long way to go.
Sadly, we know that despite our best intentions, 12.6% of the population experienced four or more adverse childhood experiences. These can include witnessing domestic violence, abuse, neglect and divorce, or a family member with mental illness, substance abuse, suicidal thoughts or who was jailed. With four of these events, a child is far more likely to experience health and emotional distress as an adult. The consequences of early-childhood adverse experiences can have a devastating impact on an adult’s health.
Why? The brain, primitive at birth, is exquisitely sensitive in its early development. As the infant encounters the world, the brain develops and establishes pathways and connections that are informed by experience, not just by DNA. Brain structures that regulate our response to the world react differently when encountering sustained stressors. The developing brain prepares itself for a hostile world by overreacting to potential threats, and can be continually bathed in stress hormones. The brain wires itself for danger and unpredictability. It becomes dysregulated and disorganized, constantly on the lookout for danger.
As a psychologist, I often administer the Adverse Childhood Experiences questionnaire to my patients. Many of them have these challenging experiences as children, with some having six or more of these events. Indeed, some researchers have found that adversity experienced in the first two months of life can have profound effects on our neurobiology, and set a painful life path for children.
While these new findings are unsettling, they are also hopeful. Through reconstructive experience, we can strengthen and forge healthy neural connections that bring new organization to our brains and bodies. Body-mind approaches such as yoga, tai chi, meditation and mindfulness practices can teach us how to calm a fear-driven brain. Counseling can help us learn how to use the thinking, evaluating and decision-making part of our brain to interact differently with the world around us and to make healthier choices. Medications can help us function better in daily life.
While human beings are vulnerable, we are also resilient. Our brains can slowly but surely respond to new, healthy experiences. We can heal.
While there are many new approaches for helping adults and children who have experienced trauma, the important message from last week’s conference is the importance of prevention and early intervention. Parents who come from generations of abuse themselves need help and support to raise their children. We need to provide families with help to deal with substance abuse and domestic violence.
What are we learning? The age-old debate over nature versus nurture is far more complex than we ever imagined. Genetics do not necessarily predict a preordained future. There is much room for influencing how these genes express themselves in the world that we create together.
Paul Schoenfeld is a psychologist at The Everett Clinic. His Family Talk blog can be found at www.everettclinic.com/family-talk-blog.