The neuro-biological impact of childhood trauma

There is now a large body of research and theoretical evidence of the profound long term impact that repeated early trauma has on children’s development. The impact of pre and post-birth toxic environments, birth trauma and illness, neglect, physical and sexual abuse and multiple separations, singularly or in combination, cause impairment to traumatised children’s psychological, neurological and physiological development. In essence the brains, bodies and neurological pathways of these children become ‘hard wired’ to the expectation of trauma, an expectation that impacts the way they understand themselves, other people, especially those in a parenting role, and the meaning they give to experiences.

Experiences and the neurological brain patterning developed in the womb and in traumatised children’s earliest months and years are likely to continue to predominate their way of thinking and behaving for many years even when they are removed from the source of their traumas; e.g. by being accommodated in residential or foster care, or being adopted.

In essence, when traumatised children enter the care system the ‘internal working model’ (John Bowlby) they developed within their birth families continues to impact their understanding of new parenting figures and situations which, in turn, is expressed in their behaviour (Archer and Gordon 2013; Bowlby 1969). Alongside this, experiences in care can further impact a traumatised child’s ability to settle and start to form more secure attachments; for example, the average number of times children move between foster homes or other care placements rose from four in 2010 to five in 2011 (Richardson). This, inevitably, increases an already traumatised child’s feelings that the world is a chaotic and unpredictable place. It also means that they are unlikely to have a concept of what ‘permanence’ means.

There are three primary responses to a traumatic event: fight, flight or freeze. When faced with a traumatic incident all of these responses might be available to adults especially if the trauma is a one-off event in an otherwise relatively stable environment. For traumatised babies and young children most of these natural responses to trauma are unavailable; they are too dependent for the flight response and too powerless for the fight response.

Furthermore, children rarely enter the care system as a result of a single traumatic incident. Instead the environments in which they lived pre-placement tend to be unstable, unpredictable and chaotic. Rather than having their needs met in a predictable manner, traumatised children are likely to experience acts of commission (abuse) or omission (neglect) as random and dependent on adult rather than child needs and also in a manner over which they have no control.

As a result traumatised children’s only response might be a dissociative one, in effect a freeze response or passive fight, which allows them to switch off not only from specific traumatic incidents but also from their chaotic and unpredictable environments and from the anger, sadness and fear that might otherwise overwhelm them. Dissociation can include a switching off in a sensory way, for example children who are not able to feel pain or to differentiate feeling states (Mulder et al 1998, Perry et al, 1995).

Bessel van der Kolk with his concept that ‘the body keeps the score’ (Van der Kolk 1994) highlights that, even when traumatised children move to safe and secure homes, the feelings and sensations that underlie their dissociative responses are still there. As a result these children are often a powder keg of unacknowledged feelings, feelings that can emerge when they move to safe families where they are offered love and security. Instead of recognising the benign intentions of new carers, traumatised children may reframe these intentions as potentially abusive or neglectful (Iacoboni et al, 2005). This is not surprising. Learning about who we are and the nature of inter-personal relationships is an intersubjective experience; i.e. is dependent on the nature of parent/child relationships. ‘Learning’ that parents cannot be relied on to meet one’s needs will have a potentially long lasting impact on a child’s understanding of future intersubjective experiences (Hughes 2007).