Abuse And Neglect: How Broken Children Become Broken Women

Abuse and neglect in childhood can lead to trauma (psychological injury). Over time, trauma can cause the overactivation of the fear center in the brain, causing chronic stress, emotional challenges, difficulty concentrating, panic, and/or physical symptoms like chronic pain. Some adults who’ve survived childhood abuse and neglect find that they experience a reduced sense of self-worth, and they may experience guilt, shame, dissociation, difficulty connecting with others, emotional instability, anxiety, and posttraumatic stress disorder (PTSD). In addition to self-help strategies, trauma-informed therapy can help child abuse and neglect survivors heal.

What is childhood abuse?

Child abuse is any intentional harm to a child who is under 18. It’s a serious public health issue that can include one or more of the following: 

• Emotional Abuse: Abuse intended to harm self-worth, cause fear, or otherwise disrupt the well-being of a child. It may include things like name-calling, isolation, making hurtful comments, or rejection. 
• Physical Abuse: This type of child abuse occurs when a child is physically harmed, intended to be physically harmed, or put in a position where they may be physically harmed by someone else. 
• Neglect: Neglect occurs when basic food, shelter, water, clean living conditions, education, affection, supervision, and/or medical needs are not met. 
• Medical Abuse: When a child needs medical attention and falsified information is provided (that puts the child at risk of harm or unneeded medical care), it can constitute medical abuse. 
• Sexual Abuse: Child sexual abuse occurs when a sexual activity occurs with a child. Child sexual abuse includes both sexual contact and noncontact that is sexual in nature. 

According to federal law, listed on the Child Welfare Information Gateway, child abuse and neglect is: 

"Any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse or exploitation," or "An act or failure to act which presents an imminent risk of serious harm."

The link between abuse and trauma 

Abuse and trauma are different, but closely related, terms. Abuse or neglect occurs when intentional harm is caused through action or inaction, whereas trauma is an enduring harmful emotional response from abuse or other events that cause distress. 

While the types of childhood abuse, neglect, and mistreatment described above can lead to trauma, they don’t always. According to one study on family violence, around 15-30% of children exposed to physical abuse develop trauma that meets the diagnostic criteria for post-traumatic stress disorder (PTSD) at some point in their life. Trauma can also develop after exposure to traumatic events not related to childhood abuse, such as natural disasters, domestic violence, or witnessing violence outside the home.  

The likelihood of abuse leading to trauma is influenced by additional risk factors: 

• Developmental level
• Ethnicity
• Cultural factors 
• Ability to maintain agency during abuse
• Resources available
• Duration of abuse 
• Number of instances of abuse 

Childhood trauma can change the way the brain functions, making it overactive to perceived threats, and contributing to long-standing feelings of shame, powerlessness, helplessness, rumination, and chronic fear. When trauma does not go away or gets worse, it may develop into posttraumatic stress disorder (PTSD). 

How childhood abuse impacts adults

Maladaptive coping mechanisms

In addition to changing the way the brain responds to stressors, many people who experience childhood trauma utilize maladaptive coping mechanisms to rationalize trauma or numb emotions: 

Substance use

Substances, like alcohol or drugs, can temporarily relieve stress, anxiety, sleep disturbances, and painful memories stemming from trauma. However, the temporary numbing of symptoms does not address underlying causes, and it can lead to substance use disorders (formerly called substance abuse disorders). 

Avoidance

Many trauma survivors rely on emotional avoidance to escape from reminders of trauma, and disturbing feelings, thoughts, and memories. Individuals who rely on avoidance may experience emotional numbness, dissociation, and symptoms of depression. Avoidance is a predictor of the development of PTSD, and it may lead to substance use. 

Self-blame

This coping mechanism is thought to develop in response to the experience of powerlessness during child abuse, possibly to maintain a sense of control. Many survivors of childhood trauma utilize shame and guilt to rationalize their mistreatment. Particularly in the case of abuse perpetrated by caregivers, children are often dependent upon them and rationalize the trauma by blaming themselves. 

Self-destructive behaviors

Many people who experience childhood trauma adopt behaviors that can cause mental or physical harm. In addition to substance overuse, examples of self-destructive behaviors include binge eating, harmful self-talk, self-injury (such as cutting or skin-picking), pushing people away through aggressive behavior, procrastination, suicide attempts, or risky sexual behaviors. 

Denial

The memories and emotions associated with a traumatic event can be difficult to confront. Trauma denial is a common coping mechanism, as it can separate people from their abuse. However, burying, hiding, or otherwise avoiding trauma denies reality and makes it difficult to resolve. 

Social withdrawal

Trauma survivors often experience anxiety, fear, isolation, or anger in social situations. Many people remove themselves from social support and interactions to avoid these feelings, though it can lead to loneliness, reduced support, and depression. 

Insecure attachment styles

John Bowlby, MD, developed attachment theory in the 1950’s, which theorized that parental relationships in childhood influence relationships into adulthood. To assess attachment styles in children, the responses of infants when they are separated and subsequently reunited with their parent are assessed. According to this theory, there are four primary attachment styles: 

Secure attachment

According to the American Psychological Association, infants with secure attachment will be confident when their parent is present, somewhat distressed when they leave, and then quickly reestablish contact and confidence once they return. In adulthood, this type of attachment constitutes healthy relationships with others and healthy self-esteem.

Ambivalent/anxious-preoccupied attachment

In this case, infants may display a desire to reunite with their parent after separation, while resisting close contact with them. Adults with this attachment style find it challenging to trust others or get close emotionally out of fear that their partner may leave.  

Avoidant attachment

In childhood, infants with avoidant attachment styles do not want to return to their parent when reunited after separation. Instead, they will avoid or ignore the parent. In adulthood, this type of insecure attachment is characterized by not letting people get close, being dismissive, or avoiding intimacy out of fear of abandonment. 

Disorganized attachment

In infants, this type of attachment is characterized by inconsistent behaviors during reunion with a parent. Disorganized attachment often develops when parents do not respond appropriately to their children’s distress signals. Adults with this attachment style may be inconsistent in their relationships, display difficulty with emotional regulation, and put barriers between themselves and close relationships.  

According to a 2016 study, survivors of childhood abuse are most likely to have an insecure attachment style (ambivalent, avoidant, or disorganized), whereas children who have not experienced trauma are much more likely to display secure attachment. 

Psychiatric disorders 

Survivors of childhood trauma are more likely to be diagnosed with a psychiatric disorder later in life. Common diagnoses include posttraumatic stress disorder, adjustment disorders, substance use disorder, depressive disorders, and anxiety disorders. One study found that adults who experienced trauma were 1.3 times more likely to be diagnosed with a psychiatric disorder later in life.  

What can you do

While survivors of childhood trauma often experience challenges with low self-esteem, trust, and shame, there are many effective things you can do to take agency and empower your own healing.

Yoga 

Practices such as yoga, mindfulness, meditation, and Pilates can be effective ways to reconnect with your body and reduce stress. A 2018 study found that trauma-informed yoga helped adult women with PTSD related to childhood trauma regulate volatile emotions, improve ability to process emotions, and increase the feeling of safety and ease within the body. Additionally, yoga sessions developed a stronger sense of agency, stronger connections with others, greater self-acceptance, and a sense of calm. 

Deep breathing exercises

A 2023 study published in Nature found that breathwork can have some ability to reduce stress and improve mental health. However, the researchers emphasized that this practice is best used in combination with other approaches. 

Massage therapy

One study found that massage therapy, given in two 30-minute sessions per week, was able to reduce symptoms of depression and anxiety in women who experienced sexual abuse. A more recent study published in Frontiers in Psychology found that massage therapy, tai-chi, dance/movement therapy, reflexology, functional relaxation, and acupuncture all reduced stress, depression, anxiety, and chronic pain, with massage therapy demonstrating the most robust evidence of effectiveness. 

Read an informative book

There are many books written by licensed professionals in the field of psychology to help people understand, process, and heal from trauma and child maltreatment. One of the most popular books on trauma is The Body Keeps The Score by Bessel Van Der Kolk, M.D., which is a New York Times bestseller. 

Connect with others 

Trauma survivors may find it difficult to connect with others. Group therapy or support groups can help survivors feel seen, understood, and supported and provide a safe place for vulnerability exposure. In other words, they provide a place to feel safe feeling vulnerable and exposing your experiences. Additionally, support groups can help survivors learn new coping skills from each other. Research shows that group therapy can be as effective as individual therapy for some people. 

Groups are sometimes specific or certain types of traumas, age groups, gender, or psychiatric disorders, and they often include various psychotherapy approaches such as: cognitive behavioral therapy (CBT), interpersonal group therapy (IPT), and mind-body skills group therapy. 

Talk with a professional

Trauma can be painful and difficult to address productively without the help of a professional. Trauma-focused cognitive behavioral therapy (CBT) is recommended by the APA to address traumatic memories, feelings, and emotions. During trauma-focused CBT sessions, therapists help clients address and challenge harmful automatic thoughts related to trauma and provide a safe space for emotional processing. 

If you’d feel more comfortable attending therapy sessions from your own home, you may want to try online trauma-focused CBT from a platform like Regain. A 2017 study found that online CBT can effectively address symptoms of PTSD, depression, generalized anxiety disorder, panic disorder, obsessive compulsive disorder, adjustment disorder, phobias, and chronic pain. 

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Takeaway

Childhood abuse can be traumatic, which can have long-lasting effects into adulthood. For example, many survivors develop unhealthy coping mechanisms to rationalize or avoid the pain of their trauma, such as substance use, self-blame, avoidance, self-destructive behaviors, social withdrawal, or denial. 

There are many self-care strategies you can utilize to help you connect with your body and practice self-acceptance, including yoga, deep breathing, and self-education, however many people benefit from the help of a licensed professional. Online therapy can effectively reduce symptoms of psychiatric disorders associated with trauma.