December 8, 2011

Psychotherapy. What’s Childhood Got to Do With It?

One of the stereotypes about counseling and psychotherapy is that you have to rehash your past and go back to your childhood. In fact many problems are not related significantly with childhood. People with very stable and happy childhoods develop problems for which they seek help later in life such as overcoming shyness, dealing with anger, anxiety or depression, coping with divorce, death or chronic pain or illness. Many people do come for psychological help who do not need to reflect significantly on their past to find strategies for the future.

Difficulty in early years can, however, have long term and far reaching effects. Often I work with people who say, “I’ve dealt with all that…I should be over this by now.” People criticize themselves for “whining” or feeling like a victim and this self-criticism often makes them feel even worse. I advocate for a different approach.

Loving and well meaning parents try hard to avoid harming their children. They avoid physical discipline and harsh punishments and they watch the language they use when they need to correct a problem behavior. Most parents will not physically abuse their children and they learn to express anger, disappointment or rebuke without damaging the child’s self-respect or trust for the parent.

But child maltreatment does occur. There is a broad spectrum of severity from mild and infrequent to horrific. It all has an impact; greater on more sensitive and vulnerable personalities, less on tougher individuals. A current focus of research has been on resilience; investigating why some children who grow up in terrible environments turn out mentally strong and healthy even in families where their siblings may develop substantial problems of violence, mental illness or substance abuse. We are trying to learn how the healthier children escaped this result.

Research is also showing us that those early experiences actually affect brain development. Two studies published this week add greater evidence of this. Research at Yale University School of Medicine found that past abuse led to a reduction of gray matter in the brains of adolescents. It did not matter whether the abuse was emotional or physical. Particular decreases in areas that regulate emotion were found in teenagers who reported emotional neglect. Another study done at University College London and also using MRI’s found similar patterns of brain activity in children exposed to family violence as the patterns that are found in combat soldiers!

What might this research mean? We do not yet have the science to say exactly what these changes represent but they seem to indicate that severe stress in childhood can have an impact on how the brain develops and this in turn may influence how we feel and behave. People who have been through traumatic experiences and the psychologists who treat them know that the impact can be far reaching.

It would be wonderful if we could, “put it behind us”, “deal with it and move on” or one of the many other trite summations of these complex experiences. I think the reality is a little different. Knowledge is power. We can learn about the effect our past has had on us and understand it better. We can discover where and how it has held us back and how it has informed the choices we made in our life. We can get better at keeping it from interfering. We can learn to live with it just as we learn to live with other disadvantages we may have in life-major ones such as a chronic illness, hearing or vision deficits, learning disabilities or minor problems such as short stature, poor common sense, short attention span, bad hair or bad skin. We don’t have to let our adversity or disability define us but we do need to accommodate it. By understanding our vulnerabilities we can make better decisions and take better care of ourselves. I don’t believe those who have suffered trauma ever truly forget it but we can learn to keep it in the background, to negotiate around it. The goal is always to make life as rich and joyful as possible. For those who experienced a harmful childhood the past may be an enemy of the present. With knowledge, perseverance and support it is an enemy we can conquer.

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