“More than 160,000 children suffer sexual violence each year in France” alerts Dr. Salmona, psychiatrist specializing in the management of trauma. How do you know if you suffered a childhood trauma? What are the consequences in adulthood? How to overcome it?
Childhood trauma is particularly difficult to detect since they concern a very vulnerable population. Indeed, minors are dependent on their legal representatives (parents, guardians, etc.). “About 61% of adults surveyed said they had experienced at least one type of childhood trauma before the age of 18, and nearly 1 in 6 said they had experienced four or more types“according to the Centers for Disease Control and Prevention (CDC). “In France, we have very few figures and no direct victimization survey among children, but from those carried out among adults who report childhood violence suffered, we can estimate that each year, at least 160,000 children suffer sexual violence, 400,000 children are exposed to domestic violence and every five days a child is killed within his family“Reports Dr. Muriel Salmona, psychiatrist and specialist in the management of traumatic events. What is childhood trauma? How do you know if you suffered a childhood trauma? What are the consequences trauma from childhood to adulthood? How to overcome it?
What is a trauma?
“Trauma is the result of a event which is recognized by all as particularly generating suffering, fear, danger” says Dr. Salmona, psychiatrist. Traumatic situations include life-threatening events, natural disasters, witnessing a sudden death, brutal situationall the violent situations that we can undergo etc.
What are the different types of childhood trauma?
Childhood traumas are categorized under the termnegative childhood experiences (or ACE) by the CDC. In other words, they are potentially traumatic events that occur between birth and age 17. It includes in particular:
- them violence (verbal, physical, psychological and sexual)
- them gross negligence
- exposure to physical and/or psychological domestic violence (blows, shouting, insults)
- exposure to a brutal death
- Iexposure to addiction grave from a parent (alcohol, drugs)
- exposure to a parent who is in jail
- them psychiatric illnesses heavy from one of the parents
According to a survey published in 2016, worldwide, one child in four has suffered physical violence, one girl in five and one boy in thirteen sexual violence, one child in three psychological violence reports the World Health Organization (WHO). “84% of child victims of violence are never protected or recognized“ reports Dr. Salmona.
People who have experienced intra-familial or sexual trauma in childhood are often dissociatedbecause they remain in contact with their attackers and often continue to suffer further violence, they are people who are emotionally disconnected. They seem not to react to events, they have significant discomfort without understanding where it comes from, images in the head similar to hallucinations without identifying their origin. “The person seems indifferent. The victims feel that something is “wrong” but do not connect it to anything. Generally, patients consult for suffering such as depression and when asked the question of violence in childhood, they spontaneously answer that no, there was none. To the extent that, they mention acts of child abuse but adding sentences such as “it doesn’t matter or it was my fault”. The discourse of the aggressor prevails and they don’t realize gravity because the emotion is dissociated“explains Dr. Salmona.
Is it possible to forget a childhood trauma?
Amnesia linked to traumatic dissociation and the emotional anesthesia it brings is one of the issues to be addressed in childhood trauma. “Amnesia is at the origin of a exceptional tolerance of violence or even of an “oblivion” of these since memory is disconnected from emotions. As long as we remain dissociated, we can “forget” for years what happened since the event is not emotionally accessible” emphasizes Dr. Salmona. But the psychiatrist specifies that “not having access to the event does not mean that the victim is not impacted by the trauma. On the contrary. From birth, the child is completely impacted by the violence to which he is exposed. Abusers sometimes believe a child won’t remember anything, especially if they have a disability, but that’s not true.“.
“To access the memory of the trauma, the first step is to to be out of danger, protected and no longer exposed to the context and the aggressor“ immediately answers the specialist. This situation is all the more difficult in the context of intra-family violence. This is why memories often resurface in old age. Treatment by a psychotherapist trained in trauma processes traumatic memory and allows the victim to access the traumatic event.
What are the consequences of childhood trauma in adulthood?
“Early exposure to violence has been recognized as the leading cause of early mortality and morbidity in adulthood” warns Dr. Salmona. Having suffered violence in childhood increases the risk in adulthood:
- to commit suicide or attempt suicide
- to be alcoholic, drug addict, smoker
- to be obese
- to have risky behaviors
- to suffer from depression
- to have a early pregnancy
- to find oneself in a situation of precariousness, marginalization or prostitution
- to suffer further violence or to commit violence
“For a girl, having suffered physical and sexual violence multiplies by 16 the risk of being subjected to it again in adulthood. For a boy, this multiplies by 14 the risk of committing violence in adulthood“says Dr. Salmona. There is a correlation between childhood trauma and many psychiatric, cardiovascular, endocrine and gynecological disorders, with some autoimmune and neurological diseases, sexually transmitted infections, cancers, osteoarthritis, chronic pain, etc It is likely that the adult’s level of pain tolerance is deregulated. “For example, in the event of a foot fracture, it is possible that the adult does not go to consult because he does not have the same relationship to pain as the others.” indicates our interlocutor. “In professional life, they will tend to accept very high-risk situations. A female reporter who suffered from incest in her childhood would systematically end up in the most at-risk areas” illustrates Dr. Salmona again. From the moment when a child has suffered 4 forms of negative experiences (ACE) and that he is not taken care of, they determine his mental health and physics 50 years later. “If the child has suffered 5, his life expectancy reduced by 20 years compared to the average“alerts the psychiatrist.
► “For a traumatic exposure, the risk of settling psychotraumatic disorders is of 24%. For child physical abuse (as a victim or witness), the risk increases to 50-60% and during sexual violence or acts of childhood barbarism, it is more than 80%“. The symptoms of post-traumatic stress include in particular traumatic memory, phobic and obsessive disorders etc In order to survive the emotional load, and in particular because of the effects of traumatic memory, these people will put in place survival strategies through avoidance behaviors, dissociative strategies to anesthetize (addictive behavior, endangerment, eating disorders, etc.). “These strategies which are desperate attempts at self-treatment are very detrimental to their health, and their quality of life, they increase their vulnerability and the risk of suffering further violence, they are rarely reported to violence by health professionals, and they are very unjustly blamed“reports Dr. Salmona.
► The impact is not only physical and psychological, but also neurobiological. “The cognitive development of the child is deteriorated with disorders of attention, memory, concentration. We note an impact on the endocrine system and growth difficulties. These attacks leave cerebral sequelae visible by MRI, with a decrease in the activity and volume of certain structures and for others a hyperactivityas well as a impaired dendritic connections and functioning of memory circuits and emotional responses“explains the psychiatrist.
We can really reduce the impact of trauma at any time, from the moment we intervene. It should be noted that neurological damage is reversible (by neurogenesis and neuroplasticity) with treatment. The faster the treatment, the more damage to adult life can be avoided, but it can be done and be effective at any time in life. The first thing to do is to protect the person from the violent or stressful situation.
“Give them very specific information about how trauma works, what it isdecrypt it and link it to malaise, restore coherence and readability is the second step. The more the event and its consequences become comprehensible thanks to specialized psychotherapy by trained professionals, the more the memory will integrate into the brain, i.e. go from traumatic to autobiographical and the less the victims are at risk of falling into addictive and endangering behavior” develops our interlocutor. Therapeutic education represents 50% of the treatment. To alleviate symptoms such as stress, one can resort toEMDR or hypnosis. Prevention is essential when it comes to children. “We have formed a booklet tools and explanations of violence and resulting trauma for children“adds the specialist. The psychiatrist recalls the importance of protecting children from all forms of violence including the so-called ordinary educational violence and the importance of detect violence and other childhood trauma as soon as possible to be able to process them.
Thank you to Dr Muriel Salmona, psychiatrist specialized in the management of traumatic events and President of the association Traumatic memory and victimology.