Childhood Abuse What are the long-term effects?

Source: iStock Historical Perspective Prior to 1980, the link betweenchildhoodtrauma/abuse/neglect and adult-life issues likedepression, anxiety, andaddictionwas for the most part unacknowledged. In fact, most people, therapists included, t
Source: iStock

Historical Perspective

Prior to 1980, the link between childhood trauma/abuse/neglect and adult-life issues likedepression, anxiety, and addiction was for the most part unacknowledged. In fact, most people, therapists included, thought that as long as a child was fed and sheltered, his or her emotional and psychological development would take care of itself. The idea thatcaregiver issues (depression, anxiety, addiction, and the like) could impact a child’s development and future life just wasn’t a consideration.

In the 1980s, however, this changed, as family systems were finally taken seriously. (Research on family systems started way back in the 50s, but the work was not widely recognized or given much credence until the 80s.) As a result, for the first time it was officially recognized that that adult-life psychological symptoms and disorders could be caused by early-life family dysfunction and traumatic experiences rather than some inherent flaw or weakness in a person’s character or genetic makeup. In other words, it was finally understood that many of the people with emotional, psychological, and even behavioral issues were simply responding in a misguided way to past events. A lack of fortitude and moral fiber had nothing to do with it. So advising people to suck it up and get on with their lives, which therapists had been doing for decades – with little to no clinical success – was not the right approach.

Trauma Basics

Generally speaking, trauma is any event (real or perceived) that is physically and/or emotionally overwhelming. Trauma can occur on a one-time basis (getting mugged), a limited-time basis (experiencing a temporary health crisis), or repeatedly (ongoing childhood abuse). Some things are traumatic for just about anyone – physical and/or sexual assaults, armed combat, terrorist attacks, and the like. However, most potentially traumatic experiences are subjective in nature, meaning that one person might be highly traumatized, while another is barely fazed. For instance, a fender bender would likely be more traumatic for a mother with her kids in the car than for a professional race car driver.

One form of trauma that tends to affect pretty much everyone is childhood abuse, especially if it occurs within the family. In general, intra-family child abuse(emotional/psychological abuse, physical abuse, sexual abuse, physical neglect, emotional neglect, inconsistent parenting, and the like) is more damaging, with a wider array of later-life problems, than trauma that is more impersonal or random. This is caused by three primary factors:

  • When abuses are committed by a loved one, the abuse also involves significant betrayal.
  • Children, especially in regard to parents and other primary caregivers, are in a position of dependency and vulnerability, and cannot easily find recourse or even a sympathetic ear.
  • Abuses within the family tend to be chronic (ongoing) in nature – one incident after another.

Chronic childhood trauma is usually much more difficult to deal with than single incident trauma, because chronic traumatization creates a complex layering of emotional damage, with each layer building upon and reinforcing earlier harms. In time, chronically traumatized children learn that they cannot trust their caregiver(s), but this does not mean that their need/desire for healthy connection to the adult(s) in their life goes away. So they reach out, they get burned, and they pull away – until their childhood needs compel them to reach out yet again. So is it any wonder these individuals sometimes struggle as adults?

Case History

Jamie is a 28-year-old mortgage broker who says she is struggling in “every area of life.” In therapy, she admits that both of her parents were alcoholics. She says that when her father drank, which was daily, he was physically abusive to her mother, and she was usually forced to watch the beatings he doled out. Always, she was told that if she didn’t behave he would beat her, too. When her father wasn’t around, life wasn’t any better. Her mother yelled at her constantly, blaming her for all of the family’s problems, and sometimes she was physically abusive as well. Nowadays, as an adult, Jamie has no close friends, a string of failed relationships, crippling anxiety, and a drinking problem of her own. Deeply ashamed of her “failures” and unable to stop drinking, she is convinced that she’s worthless and crazy – with both misconceptions feeding her ever-increasing sense of shame.

Unfortunately, Jamie has no way of knowing that her adult-life problems – emotional disconnection, inability to bond, chronic and debilitating anxiety, and compulsive self-medication (numbing out via alcohol) – are not inherent failings on her part. Instead, they’re learned behaviors and coping mechanisms developed and initially implemented during her early, formative years. She is simply responding to the highly complex chronic trauma she endured and never processed as a child. So instead of seeing herself as a good person to whom bad things happened, she views herself as defective, unworthy, and most likely unfixable.

Like most childhood trauma survivors, Jamie is struggling to see the connection between her childhood abuse and her adult-life problems. Which is understandable. I mean, who wants to relive and re-feel horrible events that happened 15 or 20 years ago? Nobody, that’s who. It’s easier to suffer through present-day problems and, when thestress/anxiety/pain is too much, to simply shut down, a la severe depression, or to self-soothe (numb out) with an addictive substance or behavior.

Trauma Facts

Childhood trauma typically does more damage than adult-life incidents of trauma. In fact,research shows that kids are much more likely than adults to develop trauma-driven disorders (PTSD, depression, anxiety, addictions, and the like), particularly if the trauma is chronic and no relief or support is available.

Research also shows that children are more likely to be victimized than adults, primarily because they are developmentally immature, physically and emotionally dependent, accessible, and unable to adequately protect themselves. And in truth, victimization of children is relatively common. One study funded by the Centers for Disease Control and Prevention found that 60% of kids aged 12 to 17 had experienced at least one significantly traumatic event in the past year, including: assault without a weapon or injury (36.7%); witnessing an assault in the community (19.2%); assault with a weapon or injury (14.9); physical, psychological, or emotional abuse or neglect (10.2%); witnessing an assault in the home (9.8%); sexual victimization (6.1%); dating violence (1.4%).

Other research shows that the more times a child is traumatized, the more likely he or she is to experience adverse reactions and consequences later in life. For instance, individuals with four or more significantly traumatic experiences prior to age 18 are:

  • 1.8 times as likely to smoke cigarettes
  • 1.9 times as likely to become obese
  • 2.4 times as likely to experience ongoing anxiety
  • 2.5 times as likely to experience panic reactions
  • 3.6 times as likely to be depressed
  • 3.6 times as likely to qualify as promiscuous
  • 6.6 times as likely to engage in early-life sexual intercourse
  • 7.2 times as likely to become alcoholic
  • 11.1 times as likely to become intravenous drug users

So yeah, early-life trauma is a driving factor for adult-life anxiety disorders, depressive disorders, attachment deficit disorders, addictions, and more. For instance, Jamie, in the case history presented above, is emotionally isolated, unable to attach romantically, riddled with anxiety, drinking alcoholically, and filled with powerful and deep internal shame. All of which are common adult-life manifestations of unresolved childhood abuse.

Fixing It

The good news is that people whose adult lives have been overrun by their early-life traumatic experiences can do something about it. They don’t have to sit back and suffer in silence. And they no longer must risk having a therapist tell them, “It’s all in your head,” or, “You need to just pull yourself up by your bootstraps.” Instead, trauma can be directly addressed in a therapist’s office using any number of approaches that have proven effective.

The bad news is that trauma treatment (regardless of the specific approach utilized) requires trauma survivors to re-experience and re-feel the pain – albeit in a controlled setting, where they can process, integrate, and understand not only what happened, but how it has affected them over the years. In other words, the core of trauma treatment involves repeatedly exploring and processing traumatic experiences as a way to reduce their power.

Much of the time, this highly directed trauma work is supplemented with alternative treatments, like yoga, meditation, animal therapy, and the like, as a way to reduce stress and help the individual tolerate the pain of re-experiencing. Medications can also be used as a way to temporarily alleviate overwhelming emotional reactions.

NOTE: Medications do not cure trauma. Instead, they lessen the symptoms and their negative impact, making it easier for clients to tolerate the painful re-experiencing work of treatment.

Put simply, working through the adult-life challenges evoked by early-life trauma is often a lengthy and unpleasant process of re-experiencing past traumatic events as if they are happening in the moment, learning to recognize and accept the feelings and emotions that arise, and learning to modulate responses in a healthy way. In other words, when triggered by the memory of a past trauma, survivors learn to recognize, identify, and accept what they are feeling, to assess the reality of their situation (to understand that they are reacting to the past rather than an actual threat in the present), and to react in healthy rather than trauma-driven ways.

That said, there is no “cure” for trauma. None of us will ever be able to recapture the innocence of early childhood. But we can learn to live beyond the trauma and dysfunction we experienced. In short, what the various forms of trauma treatment can do is provide trauma survivors with a skill set they can use to reduce their trauma’s power. In all likelihood, unwanted memories of past traumas will persist to some degree or will recur occasionally even after extensive treatment, but they will not be as triggering and debilitating. Instead, they will become more like memories of normal events, and the victim is much more likely to respond in ways that are not so problematic.


Robert Weiss LCSW, CSAT-S is Senior Vice President of National Clinical Development for Elements Behavioral Health, creating and overseeing addiction and mental health treatment programs for more than a dozen high-end treatment facilities, including Promises Treatment Centers in Malibu, The Ranch in rural Tennessee, andThe Right Step in Texas. He is the author of several highly regarded books, includingSex Addiction 101: A Basic Guide to Healing from Sex, Love, and Porn Addiction. For more information please visit his website,, or follow him on Twitter,@RobWeissMSW.