PTSD, or Post Traumatic Stress Disorder, is an accepted diagnosis that is used in cases where people had a traumatic event happen in adulthood (like taking part in a violent battle, or having a car accident).
The symptoms include flashbacks, anxiety, depression, insomnia, social withdrawal and explosive emotions, among other things.
Another, second of PTSD is Complex PTSD (or CPTSD) which is caused by chronic, ongoing exposure to emotional or physical trauma, such as living through a war, being in an abusive relationship, or growing up neglected or abused.
It’s this variant of CPTSD I call “Childhood PTSD,” because most people intuitively understand what it means.
Childhood PTSD is only now finding its way into diagnostic manuals, but it tends to follow a common pattern that can be observed and measured, and is now a huge area of research and advocacy worldwide. The biggest and most impactful study so far is probably The ACE Study, which has become an accepted (if imperfect) way to measure the scope of a person’s early trauma, and to predict how it may affect them throughout life.
The study of the impact of “adverse childhood experiences” (ACEs) began when physician researchers Vincent Felitti of Kaiser Permanente and Robert Anda of the U.S. Centers for Disease Control interviewed hundreds of study participants about their history of trauma.
Felitti and Anda created a survey that asks about ten traumatic experiences that can happen in childhood. Respondents gave themselves one point for each experience on the list they checked as a “yes.”
So a person’s ACE score is somewhere between zero and ten.
The ten adverse childhood experiences, or ACEs include:
- Physical abuse
- Sexual abuse
- Emotional abuse
- Physical neglect
- Emotional neglect
- Mother treated violently
- Household substance abuse
- Household mental illness
- Parental separation or divorce
- Incarcerated household member
There are many other experiences that could be included, like the death of a parent, or being bullied in school, or being desperately poor, or a living as a refugee, just to name a few.
You can take this into consideration when you take the test.
The researchers found that the higher your ACE score, the higher the probability that you’ll experience certain problems in your life. Many of these are well known, such as depression, anxiety, smoking and other addictions, eating disorders, violent behavior, or being in a violent relationship.
But the study showed other correlations that were quite surprising.
Higher ACE scores increase the likelihood of cognitive difficulties including ADHD, memory problems and learning disabilities. They’re linked with heart disease, obesity, diabetes, migraines, cancer, autoimmune diseases like multiple sclerosis, thyroid disorders, chronic fatigue, rheumatoid arthritis reproductive disorders like endometriosis and pelvic inflammatory disease, gastrointestinal disorders, fibromyalgia and chronic pain, chronic lung disease and stroke.
This was big news — that trauma in childhood can play a significant role in behavioral and physiological problems in adults. And what this means is that learning to heal Childhood PTSD is one of the most important things we can do as people, and as a society.
How Does Early Trauma Cause Childhood PTSD?
“Trauma” is what we experienced as kids when the bad things were happening. When you’re a baby or small child, trauma is particularly toxic for your brain, and causes developmental changes. Emotional neglect can be even worse for your brain than physical abused (another unexpected recent finding).
For healthy brain development, a child needs the parent to be connected with them, to make eye contact and talk to them, to respond to their feelings and their accomplishments.
If parents are dead, gone, drunk, high, obsessed with a partner, depressed or otherwise not paying attention, their child may learn to dissociate (it kind of means “to check out”), or grow frequently “dysregulated” in terms of the brain, nervous system or emotions. Traumatized children may also grow up with a limited capacity to connect with people, pay attention or learn.
These brain changes have consequences for physical health. A traumatized child may have headaches and stomach troubles, but as he or she grows to adulthood, even more serious problems can show up. It’s not well understood yet how or why, but the health, emotional and cognitive problems associated with Childhood PTSD are all related to nervous system dysregulation.
Are the Symptoms of CPTSD Different than PTSD?
Trauma is also at play in PTSD. In the case of combat veterans, for example, they come back from war experiences and might find themselves anxious, depressed, or having trouble sleeping, connecting with people or dealing with the bad memories. They might have “flashbacks,” where they remember something or dream about it, and forget for a moment that this is now, and the old trauma is not actually happening. Their body is reacting as if it is happening now, with heart pounding, adrenaline pumping, and other stress hormones...pushing their bodies into a stressful overdrive. If the reaction keeps happening, it can wear them down. Combat vets with PTSD have a high rate of drinking, using drugs and even suicide.
Those of us who had traumatic childhoods may develop Complex PTSD, or CPTSD, which can be similar to adult-onset PTSD, but it’s not the same thing.
There are two specific symptoms that mark CPTSD:
- Emotional Flashbacks: Unlike specific memories of events, emotional flashbacks involve strong negative emotions that don’t seem on the surface connected to anything happening in present time. A person will be overwhelmed (for small reasons or no reasons) with an overwhelming sense of sadness, rage, terror or frustration. It can happen when you wake up, for example, or when someone criticizes you, or gives you a present. You are not reliving some childhood experience consciously — you know that you are here in present time. But your emotions respond as if your original childhood trauma is happening again.
- Dysregulation: Childhood trauma is associated with a tendency to become dysregulated, not just emotionally but neurologically. Everyone gets dysregulated sometimes, and most of us eventually re-regulate. But people with Childhood PTSD may spend more time in a dysregulated state and have difficulty re-regulating. You might feel numbness in your hands or mouth, get lost while driving, or find yourself unable to finish a sentence. Dysregulation can also lead to illness, learning difficulties and emotional overreactions. When you’re dysregulated, part of your brain is actually shut down (an old response to unbearable stress when your brain was developing). Without your full brain working, you are not fully yourself. So you may seem to have too much or too little emotion, and say things you don’t really mean (they seem true in the moment, but only because you’re operating with half a brain!).
Four Discoveries That Inform My Approach to Healing Symptoms of CPTSD :
- Recent research has shown that abuse, neglect and other trauma cause brain changes in children. This damage, in turn, can cause cognitive impairment, emotional problems and chronic disease. Though much of the damage can be reversed, it’s important to be aware of how these events can have such a broad impact on every part of our lives.
- Focusing on your childhood traumas will not, by itself, produce recovery. While taking stock of what happened is a useful first step, putting attention on bad things can actually retraumatize you, and in the retraumatized state, it can be impossible to reason, remember or integrate information. This is one of the main reasons that talk therapy doesn’t work very well for trauma, and why other methods of recovery are necessary. Focusing on childhood can also emphasize blame, which ultimately keeps you trapped.
- Learning to regulate your emotions makes change possible. The problem is not so much the memories, but the unregulated emotions they trigger. In these hyper-emotional states we are prone to (and even crave) destructive behaviors. The sooner we can recognize that this “flooding” is happening, the sooner we can interrupt the flood. We can do this with quick interventions, like stepping away, refraining from speaking, breathing deeply, writing our fears and resentments on paper, or counting to ten — or ongoing practices like daily writing, meditation, exercise and connecting with like-minded others.
- Instead of talking about it, taking action and making strong decisions about your life is the most powerful way to change your health, your thinking, and your behavior. Granted, past trauma can have a big impact on your functioning today, and messed-up families can pass on some dysfunctional beliefs and habits. But your past can’t change and your family is unlikely to change. It is you and only you who can change your life, and everything now depends on your willingness to take action.
Anna Runkle
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