child abuse and brain damage
Friday July 18, 2008
Dear Alice Miller,
probably you are already informed about this, but gladly I would like to point out the research that these last years is done in Harvard on child abuse and brain damage. In 2000 professor Martin Teicher already published an article in which he states 4 abnormalities that result from abuse in the first 4 years of a child’s life. (www.mclean.harvard.edu/PublicAffairs/20001214_child_abuse.htm)
1) Disruption of the limbic system (‘the emotional brain’). Disturbances in electrical impulses as limbic nerve cells communicate, associated with more self-destructive behavior and aggression.
2) Arrested development of the left hemisphere. May contribute to the development of depression and increase the risk of memory impairments.
3) Deficient integration between the left and right hemispheres. Can result in dramatic shifts in mood or personality.
4) Increased vermal activity. The cerebellar vermis helps to maintain emotional balance, but trauma may impair this ability.
‘Based on these studies, the McLean team (Harvard medical school) theorizes that the stress caused by child abuse and neglect may also trigger the release of some hormones and neurotransmitters while inhibiting others, in effect remolding the brain so that the individual is “wired” to respond to a hostile environment.’
Now this may have been known for a longer time now, – although for me it is very informative to hear they can even locate the parts in the brain that get damaged – and people may have read your chapter on brain damage in The Truth Will Set You Free (‘Barriers in the mind’) but the following research is perhaps less well known, because it underlines the fact that not only physical and sexual abuse, but also neglect and verbal aggression lead to severe brain damage. The idea that words cannot hurt is simply proven wrong (an idea that my body knows to be wrong, but it still helps to have this confirmed by ‘science’.). I quote from ‘Child abuse hurts the brain’ (2003, www.news.harvard.edu/gazette/2003/05.22/01-brain.html)
‘Teicher plans to look for such abnormalities in others who have been verbally abused and in those who witness violence at home. He and his colleagues have already found evidence of anxiety, depression, and brain differences in a study of 554 college students exposed to loud yelling, screaming, and belittling remarks directed at them. The latter include remarks like “You’re stupid,” “You’ll never amount to anything,” and “Why can’t you be more like your cousin?” From this study, Teicher concludes that “exposure to verbal aggression may have effects as powerful as physical or nonfamilial sexual abuse.”’
In a different article on this research ‘Verbal abuse hurts as much as sexual abuse’: (http://www.news.harvard.edu/gazette/2007/04.26/05-abuse.html)
‘Verbal abuse, the researchers found, had as great an effect as physical or nondomestic sexual mistreatment. Verbal aggression alone turns out to be a particularly strong risk factor for depression, anger-hostility, and dissociation disorders. The latter involve cutting off a particular mental function from the rest of the mind. In one type of dissociation, the person can’t recall part of his or her personal history. Other types involve hallucinations, feeling unreal or unstable, unconsciously converting painful emotions into physical symptoms, and multiple personalities.
As yet unpublished research by Teicher shows that, indeed, exposure to verbal abuse does affect certain areas of the brain. These areas are associated with changes in verbal IQ and symptoms of depression, dissociation, and anxiety.’
And Teicher stresses the importance of early intervention:
‘Teicher advises the earliest possible assessment, monitoring, treatment, and protection from further abuse. “The younger a child, the more plastic is his or her brain, and the greater the chance of diminishing negative changes in structure or function,” he says. Researchers at McLean right at this moment are writing a proposal for a grant to study how reversible the effect of abuse might be.’
Indeed, these findings have been valued as highly important by Harvard University as well, since in 2006 they have established a new ‘Center on the Developing Child’, which main purpose is to make policy with these recent (neuroscientific) findings on child abuse. In an interview with head of the center Jack Shonkoff the similarities between the theory of Alice Miller and this new research are very striking to me. It underlines the devastating effects of abuse – in every form – on the developing brain, leading to depression and substance abuse – this multiform abuse being categorized as ‘toxic stress’, which is in my opinion the neurological equivalent of ‘poisonous pedagogy’, since it contains not only the stress created by beatings or incest, but also verbal assault and emotional neglect. It also points to the importance of ‘supportive relationships’, the quality of the relations the child has with important people in his surroundings (‘enlightened witnesses’) and even suggests a link between childhood trauma and adulthood physical diseases, like cancer. I quote from a short news article in December 2007, ‘Experts discuss lifelong impact of early childhood adversity’: (www.hsph.harvard.edu/now/20071207/adversity.html)
‘In addition, said Shonkoff, epidemiological studies have suggested an association between early-life trauma and later physical diseases such as hypertension, heart disease, obesity, stroke, and some forms of cancer.’
‘If stress is particularly high, prolonged, or recurrent in the early years, children who are not buffered by supportive relationships may end up with a permanently lower threshold for activating their stress response system, explained Shonkoff, meaning that these individuals will experience stress more readily than their peers throughout their lives. It is a compelling hypothesis that this lower threshold is one reason why some adults are more likely to have diabetes, hypertension, or myocardial infarction, he added.’
Although the link is not made between the denial of the abuse and the illnesses of the body, I still find it exciting that they have established a connection between childhood trauma and adulthood diseases. For most people find the claim that cancer is not (only) a genetic defect or simply bad luck, but perhaps related to repressed memories and emotional stress, completely outrageous.
More importantly, they are intent on changing American policy concerning child abuse and its solutions. Listen how Shonkoff addresses the problems in such an alarming way that I find very encouraging, in this lecture at the annual meeting of the American Association for the Advancement of Science, in February 2008. (http://harvardscience.harvard.edu/culture-society/articles/early-childhood-stress-affects-developing-brain). His opening statement leaves no ambiguity of the damage done to children and the urgency of this problem.
‘It is now clear that creating a sustained, reliable, compassionate and widespread system that cares for tiny children born into troubled families is needed in this nation, said Jack P. Shonkoff, Director of the Center on the Developing Child at Harvard University.’
He explicitly mentions that there are no ‘magic bullets’ that can cure these problems, in this way implicitly attacking America’s reliance on the psycho pharmaceutical industry and their antidepressants, and underlining the urgency of direct public and social intervention.
‘(…) decades of research have shown that bad experiences in stressful homes breed lifelong problems in vulnerable children. If action isn’t taken in the first few months and years of life, children can be harmed irreparably and are unlikely to recover.
‘These conclusions, Shonkoff said, “are rock-solid. Brains are built over time. At birth they already have most of their cells, but very little of the circuitry (the wire-like connections) has been built. This happens from the bottom up,” with more fundamental circuits connected first, then more advanced circuits are built depending, in part, on the infant’s experiences.
“This is the critical period,” essentially the first four years, as “the circuits come in on a very strict schedule. And how these circuits get established is highly influenced by experience. It never goes back to re-wire,” he said. “If it builds healthy circuits, you’re all set. But any faults are built-in for life. So it’s an interaction between the genes and experience” the leads to a mature brain. A good home can make a huge difference.’
Since I have greatly benefitted form the work of Alice Miller, I do not and simply cannot agree with the pessimistic conclusion that once the damage is done, there is no re-wiring possible. (In an earlier interview Shonkoff claims that it is not at all impossible to change the brain later on, only much more difficult the older you get – so perhaps this exaggeration is strategic). But I am very much encouraged by his unambiguous statements and the urgency of his tone that depression is not (only) genetic, that the brains of children are highly affected by the way parents behave, not only by beatings or rape, but also by lack of care, respect and understanding, that by result the brain of the adult is still wired for an extremely hostile environment and thereby suffers from panic, fear and anxiety, that there is a connection between these trauma’s and later diseases, and that the solution to this is not a pill, but a long emotional learning process that takes a lot of time, understanding, and sensitivity.
I particularly like this remark:
‘Shonkoff lamented, too, that speaking to government policy-makers has been essentially fruitless. “There is no sympathy for studying stress. People think it’s character-building, it makes you stronger. Nobody cares about stress,” even though it’s now clear that early neglect has negative neurological impact on the developing brain and leads to lifelong deficits.’
This is something I have come up against a lot lately. Since discovering Alice Miller’s work I have made a lot of progression, acknowledging my truth and confronting my abusers (my story is published here, 30 April, ‘Born into heroin’), but what perhaps shocks me the most is the lack of understanding and sympathy from some people in my environment. I have been in therapy for not even a year now, and people, friends, family, many of them seem to say: ‘Hey, it’s been a year now, aren’t you done delving yet? What good is it? Can’t you just move on and leave it behind?’
Shonkoff is right on the mark when he says that people tend to think depression or anxiety can be solved by character-building. When I hear the word character I get the shivers, because it tells so clearly how these people murder their own child within, with ‘character’, how they whip them into shape, create ‘strong’ persons, which to them is the true sign of adulthood: to kill your childish feelings and move on. There is a Dutch movie called ‘Character’, which is about a father who opposes his son’s life and career in every way, because he wants to give him character: ‘’I’ll strangle him for nine tenths, and the one tenth I leave him will make him strong.’
I have tried in discussions with friends and family, but I cannot really convince these people of the progression I make by confronting my unique childhood history, of releasing anger, of acknowledging all the crimes against the child, both of the most obvious abuse as well as of the subtlest cruelty, of the de-idealization of your parents which comes with deep grief, and of the joy of finding back the little boy I once was. At times I feel so isolated, weary of the walls I come upon, that I fall back into panic, guilt and eventually depression again, when I start doubting my history, putting the abuse ‘into perspective’ and trying to ‘move on’. Sometimes I find myself even blaming the fact that I found the work of Alice Miller, wishing to be blind again, so I would not have to fight so hard for a little understanding and sympathy of some people I consider close to me. To them Miller is just another therapy, among many other solutions, like yoga, meditation, medication, or sport, or even activities like walking on the beach and cycle in the woods, or eventually simply getting back to work, doing ‘something’, just get a purpose in life. Of course this proves how widespread the poisonous pedagogy is, but that’s why I am so excited to see that Harvard-scientists have discovered things that back the findings of Alice Miller. At the least it makes it easier for me to reciprocate when people try to deny my problems. Reference to empirical research costs less energy than an empathic conversation, energy I need for the extremely difficult work to confront my history, stand up against my abusers and ‘re-wire’ my brain through a long emotional process. Let’s just hope that this research can help to turn the public opinion on child abuse, and perhaps even policy in the end, if the wisdom and practical experiences of a lifelong therapist and the stories of thousands of people like you find at this website, to my frustration, cannot enough.
IS (the Netherlands)
P.S. Here’s a long interview with Jack Shonkoff (www.childrenofthecode.org/interviews/shonkoff.htm) in which he stresses that ‘the active ingredient in the environment that’s having an influence on development is the quality of the relationships that children have with the important people in their lives. That’s what it’s all about’. A healthy brain needs a healthy home!
For those who prefer Powerpoint and diagrams: http://www.wca4kids.org/wca_drshonkoff_mar2006.htm
AM: Thank you so much for your important letter. Unfortunately, I could not open any of the links you offered. Can you send us the interview with Shonkoff in your mail? The problem with all these discoveries (Martin Teicher already published about his research 20 years ago, Bruce Perry and others too) is that the scientists are rarely interested in and hardly informed about the dynamic of child abuse, nor do they try to know the ways of overcoming therapeutically the consequences of early abuse by questioning their own abusing parents. They may only know the traditional, psychoanalytically oriented treatments that are indeed ineffective. But fortunately they can show what has been denied before, that the mistreatment of children damages them for life. The damage for their mind that I describe as barriers in the mind still does not yet seem clear to them. They don’t seem to realize that to claim discipline from the beginning of the child’s life is exactly the EFFECT of the DAMAGED BRAIN caused by spanking babies and small children. However, it is so obvious. Maybe you will once want to write about your own experience using the research others have done and showing concretely how you found your way of overcoming the terrible abuse you were suffering already before you were born. Good luck for your therapy!