As humans, we were designed to feel—it’s central to how we experience life. And inherent to our nature is the desire to feel loved. In a fallen world, however, we exhibit this love imperfectly, both towards others and ourselves. Our words and actions can inflict irreparable damage. The resulting experience is known as trauma.
Trauma comes from an individual having experienced some form of physical, emotional or psychological harm. While everyone reacts differently to trauma, it often causes a dramatic shift in the body’s response to stress.
Childhood trauma is among the most devastating. A study conducted by the Centers for Disease Control (CDC) & Kaiser Permanente links traumatic experiences in childhood to increased likelihood for adult health issues like stroke, heart disease, and diabetes. But beyond the physical symptoms, there’s a change in the physiological makeup of a child that can lead to impaired behavioral-emotional development.
Dr. Nadine Burke Harris, a pediatrician and head of the Center for Youth Wellness in San Francisco, recently conducted a TED talk called “How Childhood Trauma Affects Health Across A Lifetime.” In it she states that trauma affects “brain development, the immune system, hormonal systems, and even the way our DNA is read and transcribed.” Along the spectrum of traumatic experiences, Harris is referring to instances of abuse or neglect. “ I’m not talking about failing a test or losing a basketball game. I am talking about threats that are so severe or pervasive that they literally get under our skin and change our physiology.”
These “threats” can include substance abuse or witnessing acts of violence. The study by CDC refers to these as Adverse Childhood Experiences (ACE). In the study, over 17,000 individuals were surveyed and confidentially asked to cite instances of ACE up until age 18. Each incident was counted toward an overall score. In the findings, the study showed that at least two-thirds of participants had at least one ACE, while 1-in-8 had a score of four or more. Moreover, there was a corresponding relationship between the ACE score and health risks, meaning the higher the score, the greater the negative outcomes.
The associated health risks are only part of the problem; the other behavioral outcomes, like substance abuse, depression and suicide point to the effects of trauma on brain development. Before recently, issues like youth violence would mainly be explained sociologically; Kids growing up in rough neighborhoods are understandably more susceptible to making riskier life choices. But Harris and others are quick to observe why experiencing trauma leads to impaired decision-making. Says Harris:
“We now understand better than we ever have before how exposure to early adversity affects the developing brains and bodies of children…It inhibits the prefrontal cortex, which is necessary for impulse control and executive function, a critical area for learning. And on MRI scans, we see measurable differences in the amygdala, the brain’s fear response center. So there are real neurologic reasons why folks exposed to high doses of adversity are more likely to engage in high-risk behavior…”
A publication from the Center on the Developing Child at Harvard distinguishes different types of stress, citing how “toxic stress” occurs when the body’s stress signals are activated for prolonged periods, usually when children may lack the family or social support structure necessary to assist with stress management. This in turn has a profound effect on brain architecture, wherein the amygdala overproduces chemical reactions while the prefrontal cortex—the brain’s decision headquarters – under-produces sufficient neural connections.
What happens when a child growing up in a trauma-filled environment lacks the support structure necessary to help manage stress? They can have difficulty functioning normally as they get older and—in some cases—react violently to stressful conditions.
Dr. Richard Dudley is a psychiatrist who works with the John F. Kennedy School of Government at Harvard University. In his writing he describes his work with a 17-year old black youth, “Andre”, that had been charged with attempted murder. Andre had never previously gotten into trouble, despite growing up in a drug infested, crime-filled neighborhood. Dudley was asked to conduct a psychiatric evaluation in which he learned that Andre had a scholarship to private school where he performed well academically.
However, Andre’s neighborhood and home life were chaotic. His mother had been through a string of abusive relationships, and he had witnessed the shooting death of his best friend at 8 years old. Dudley remarks how no one in Andre’s life was equipped to help him deal with his trauma. After the shooting, Andre’s mother yelled at him for taking the wrong route home from school, while the police that arrived on the scene that day simply pulled him away from his friend’s lifeless body, showing no sensitivity. Andre continued to experience police mistreatment as an adolescent, causing him to be fearful and mistrusting of law enforcement.
Dudley notes that police officers—in their interactions with youth like Andre—may in fact be suffering from trauma-related issues themselves that stem from childhood and may have never been properly addressed. In any case, the combination of police volatility along with witnessing violence had taken a toll on Andre’s psyche. He had only begun a carrying a gun himself after his brother had also been shot and killed, making him fearful for his own life.
In light of the science, it isn’t hard to see why inner-city violence is such a profound problem. Exposure to violence is traumatizing our youth, causing them to in turn perpetuate that violence, creating a vicious cycle. Youth 12-24 suffer more violent crime than any other segment of the population. Seventy-one percent of teens 14-17 experience assault, while thirty-two percent suffer abuse or neglect. The rates are even higher for black youth, who are three times more likely to be victims of reported child abuse or neglect and five times more likely to be victims of homicide than their white counterparts.
The approach to violence reduction is now stretching across cities, with coordinated efforts between doctors and mental health professionals, as well as law enforcement agencies and local community organizations. The CDC has published a framework (check out their facebook page) for creating awareness and dealing directly with the problem of ACE. Part of the issue in being confronted with trauma is the stigma of mental health itself. Interestingly, the initial ACE study was conducted predominantly with white, college-educated participants. This suggests that childhood trauma is incredibly common across racial and socio-economic lines. That it’s been ignored as a method for explaining inner-city violence may say a lot about how divided our experiences feel as a nation. The thread connecting us is our human nature, which seeks belonging and acceptance. Recognizing that fact may be the greatest step toward healing.