The entire series in January will be focusing on how trauma-informed care can help adults overcome the effects of adverse childhood experiences (ACEs).
However, to understand the process of healing, we must first explore what happens to the brains of traumatized children, and how neuroplasticity and mindfulness aid us in healing.
Childhood Trauma, Who is Affected?
According to a report published in 2012 by the National Center for Mental Health Promotion and Youth Violence, 60% of adults report they experienced trauma in their childhood.
In yet another report published by the National Center for Mental Health Promotion and Youth Violence, the traumatic experiences children endure are many and varied. Sexual, emotional and mental violence plus neglect are the abuses generally thought of as being the causes of complex post-traumatic stress disorder. However, there are other events children experience which can cause them to develop CPTSD symptoms.
Exposure to and the witness of violence against others, living in a war zone or neighborhood with constant violence and living through a natural disaster are also adverse childhood experiences.
The results from being exposed to ACEs is long and tragic. According to a paper published in 2016 by Child and Adolescent Psychiatry and Mental Health (Bielas, Barra, et al., 2016), the mental health disorders most closely associated with adverse childhood experiences are as follows:
- Post-traumatic stress disorder
- Anxiety and anxiety disorders
- Suicidal behaviors
- Antisocial behavior
- Dissociative Disorders
- Borderline personality disorder
The list above is only partial, having not room enough in this article to incorporate the other mental and physical consequences later in adulthood from adverse childhood experiences.
ACEs, and the Developing Brain
Traumatic experiences do not just harm a child emotionally; they also harm their developing brain. Experiencing child abuse early in life can dramatically change the number of neurons in the brain and can decrease the ability of the neuron to communicate with one another.
In a book written by Pablo Nepomnaschy and Mark Flynn on page 373, there is a discussion of why structures in the brains of young children are so severely affected. The changes are caused by constant exposure to the developing brain to the stress hormone cortisol. Cortisol, sent from the amygdala when it recognizes a threat, readies our bodies for the fight/flight/freeze response.
When subjected to adverse childhood experiences, cortisol is continually pumped into the bodies of children and the child’s brain chemistry never returns to baseline. Cortisol is poisonous to developing brains causing damage to vital brain structures that are unalterably changed for life.
Unfortunately, the amygdala and hippocampus are affected the most, and these structures are responsible for our ability to control our emotions and our memory.
The Changes from ACEs to the Amygdala and Hippocampus
When humans become frightened, a complex cascade of events occurs in the brain and body.
The fear response begins in the amygdala, a small almond-shaped section of nervous tissue that is located deep within the brain. The amygdala is responsible for emotions and remembering danger so we can avoid it in the future.
This tiny structure is the first part of our brain to recognize danger, and when it does, it produces cortisol. The amygdala alerts the body to the danger and readies it for the flight, flight or freeze responses.
The hippocampus is a small seahorse-shaped structure that is also located deep inside our brain. This structure plays a vital role in memory formation and storage.
Several papers have been written noting the significant changes in the size of the amygdalae and hippocampi of people living with dissociative identity disorder (DID) which is linked closely to complex post-traumatic stress disorder (CPTSD). This paper offers the following conclusion:
“Hippocampal volume was 19.2% smaller and amygdalar volume was 31.6% smaller in the patients with DID, compared to the healthy/ neurotypical subjects. The ratio of hippocampal volume to amygdalar volume was significantly different between groups [as compared to healthy/ neurotypical subjects in the study] .”
The reason for mentioning how ACEs change these two structures is because they are directly related to the formation of CPTSD and its symptoms.
A smaller amygdala alters how our ability to react to danger, as we may perceive danger where there is none. Our body reacts viscerally based only on a smell, sight or sound which throws our body into fight/flight/freeze. We also may experience flashbacks and panic attacks.
Also, because our hippocampus is smaller, our ability to recognize what we are hearing, seeing or smelling today is mixed up with what we experienced in the past. For instance, we might hear firecrackers and then flashback to the time when we were children and witnessed gun violence.
There is research showing that other regions of the brain, including the corpus callosum, are damaged also, which makes treating complex post-traumatic stress disorder complicated.
The Effect of Synaptic Pruning and Adverse Childhood Experiences
Adverse childhood experiences dramatically change the connections between and the number of neurons in the developing brain. These neuronal changes can change our personalities and perceptions because pruning rids the brain of synapses that are not needed.
Which synapses we rid ourselves of is based on our experiences, and ACEs hijack our experience-based pruning. The loss of the brain cells which should have been used in developing healthy connections to others leaves us emotionally scarred and with deficits in our world view.
During early childhood, new skills are picked up quickly because we are born with over 100 trillion brain cells which are anxious to absorb information from our environment and our experiences.
The learning of language is one good example of how our minds can learn and how that time is limited.
When babies are born, they do not distinguish between languages nor the accents within them. Our inability to distinguish languages and accents is automatic, as we are hardwired in utero to listen to those around us. At birth, we cannot tell one language from another.
Children who are born into bilingual households learn both languages at the same time at the same rate as those born into monolingual homes. However, if children are not exposed to language by their caregivers, the synapses we are born with which develop our ability to speak are pruned away and lost forever.
A horrible example of how we lose a vital skill through synaptic pruning is the story of Genie (not her real name). Genie is an American feral child who was the victim of severe neglect and had been kept in total isolation from 20 months until she was thirteen-years-old.
When the authorities found her, she was incapable of uttering a single word. Specialists tried to teach her how to speak, but she has only been able to learn nouns and form rudimentary sentences.
The reason she could not learn a language is that her brain had pruned away the synapses necessary for acquiring language.
Thankfully, synaptic pruning is a normal part of brain health and is not a limitation to most neural plasticity.
What is Neuroplasticity?
Until the 1960s, mental health professionals and researchers believed that once we reach adulthood, our brains do not change. It was thought that after early adulthood what we had at that time regarding brain structure and size was permanent.
A book The Brain that Changes Itself: Stories of Personal Triumph From the Frontiers of Brain Science written by Norman Doidge, there is a possible explanation for these erroneous beliefs.
Norman Doidge wrote about the ancient belief that the brain could not grow and change and how these beliefs came from observations that people with brain damage often couldn’t recover. Physicians were unable to see the activities that occur microscopically in the brain, and this limitation kept researchers focusing on early childhood changes and not on what happens in adulthood.
However, modern research shows that the brain is not static after early adulthood, but a vibrant and changing organ which changes as we encounter new experiences.
Neuroplasticity is the term researchers gave to the way brain cells (neurons) grow and change because they are malleable (plastic).
Neurons change regularly and are shaped by our experiences. This helps adults learn, adapt, and remember. Every time we experience something new, a new neural pathway forms, and if repeated, reinforces and strengthens the connections between brain cells.
So, neuroplasticity happens throughout our lives based on our experiences which either strengthen or weaken our neural connections. What we don’t use will be pruned away. However, there is a way neuroplasticity can be harnessed to successfully mitigate the effects of adverse childhood experiences on our adult lives.
Just What is Mindfulness?
Mindfulness does not have one definitive definition. However, the best answer is that mindfulness aids us in paying attention in a non-judgemental fashion to all our thoughts and actions, without focusing unnecessarily on faults and flaws.
Mindfulness is also a technique anyone can learn and involves making a special effort to notice what is happening around you in the now. This skill can help us to:
- Become more self-aware
- Feel calmer and less stressed
- Feel able to make choices in responding to our thoughts and feelings
- Cope with intrusive thoughts
Another term for mindfulness, first coined by Daniel J. Siegel and the MARC at UCLA, is mindful awareness. By using intentional, directed focus and paying close attention to the “now” one becomes aware of intrusive thoughts allowing for changes to thought patterns.
By paying more attention to the present moment, we can lower the stress hormones which are responsible for the hyperarousal which accompanies CPTSD. When these chemicals in our bodies decrease, we become less anxious, and we can better incorporate new ideas and new ways of thinking about ourselves.
Mindfulness and Neuroplasticity
Neuroplasticity is our greatest ally when it comes to healing from complex trauma.
A training post made in the Journal of Trauma Nursing, published in June 2018, offered a breakdown of how mindfulness changes the brain. They record that researchers have been studying via magnetic resonance imaging (MRI), how mindfulness causes new neuro-pathways to form.
Mindfulness changes how we process incoming signals from the environment and helps to desensitize our reactions to them. If one practices mindfulness regularly, eventually our hyperattentive amygdalae will calm and we will no longer have the classic complex post-traumatic stress disorder response to triggers.
There are results from other research that found people who practice mindfulness make new neural connections between important prefrontal brain structures, which not only stabilizes arousal to stimuli but also reduces harmful risk-taking.
Through practicing mindfulness, one can learn to remain in the present. Our brains will make new neuro-pathways through mindfulness which will allow us to remember the calm we find through it, and thus reduce our anxiety. We learn how to be less hypervigilant, and for our mind to be less reactive to triggers than we once were.
While adverse childhood experiences change our brains in unalterable ways, this does not mean new neuropathways cannot be formed to help us live well. By using mindfulness techniques, neuroplasticity allows us to create new habits and therefore a new life, despite the lingering effects of the events which caused us to form complex post-traumatic stress disorder.
Next week we will examine resiliency building and how it can help us travel down the road less taken to healing.