From Survival to Connection: Supporting Adult Survivors of Adverse Childhood Experiences

Recently, I received a message from a podcast listener requesting a special episode addressed to people who live with and/or love someone with CPTSD. His message highlighted the importance of education related to complex trauma for both survivors and those who love them.

Not all people living with CPTSD have a history of childhood trauma, but those who do may struggle relationally because of learned coping mechanisms that served to connect to caregivers in childhood (e.g. perfectionism, people pleasing). Our very first venture in life is connecting with our caregivers; therefore, it is important to understand that children will adopt and repeat behaviors they perceive as aligning with their caregivers.

Such behaviors can and often do cause relational issues in adulthood, as many survivors of childhood trauma do not recognize their behaviors as anything more than how they accomplished that connection in childhood. Many times, these relational issues are explained by attachment styles, but rarely are relational issues connected to learned behaviors related to a lack of safety and choice in childhood.

Those of us with a history of childhood trauma may lose adult relationships because those behaviors that connected to caregivers in childhood are ineffective in healthy adult relationships. My friend Lauren Starnes explained it like this:

“behaviors that served to connect you in childhood serve to disconnect you in adulthood”.

Perhaps the saddest part of childhood trauma is its potential to affect people across their lifespan. Suffering often continues into adulthood and is played out in fractured and lost relationships. Nobody is at fault, really. Usually, loved ones (especially a spouse) are operating with a knowledge deficit.

Knowledge is powerful, and understanding how childhood trauma affects humans has the potential to support survivors of childhood trauma and those who love them. Additionally, trauma survivors are not without responsibility and that is sometimes a hard truth, but healing comes with learning. Knowledge provides safety and autonomy–something those of us with a history of trauma know little about.

But as adult survivors, we can choose to learn and alter ineffective coping, we can choose power, we can learn and we can change. We have a choice now. The work is hard, but it is worth it.

“When you know better, you do better” Maya Angelou

Perhaps one of the most liberating experiences as a survivor of an abusive childhood came when I finally understood the effects of childhood trauma. It wasn’t until I began advocating for survivors that I learned about Adverse Childhood Experiences.

I felt validated and suddenly able to extend grace and compassion for my behaviors that hurt the people I loved. I understood that, given my experiences with abuse and neglect, I was simply doing the best I could with behaviors I had created to survive and connect. There were parts of me that weren’t convinced that I had an abusive childhood, but learning about Adverse Childhood Experiences altered my life and gave my pain a name.

Adverse Childhood Experiences is measured by a questionnaire (10 questions) that probes for abuse (emotional, sexual, physical) and/or neglect (emotional, physical). Also included are separation factors such as severe mental illness in the home (resulting in hospitalization or completed suicide); substance abuse; or imprisonment of a family member. The ACE questionnaire was developed by Kaiser Permanente and the Centers for Disease Control in the 1990s. Originally created as a weight loss study, researchers found a connection between childhood trauma and physical manifestations that caused participants to drop out of the study. Since many survivors of childhood trauma are high utilizers of the health care system (Hargreaves et al., 2019), the ACE study could be foundational to our understanding (and DSM adaptation) of CPTSD.In the meantime, an understanding of maladaptive behaviors that may be present in survivors of childhood trauma could support survivors.

Those who have a history of Adverse Childhood Experiences need social support, but often maladaptive behaviors serve to disconnect them from people. Until survivors recognize these behaviors, they cannot address them. After many fractured relationships, I realized I had work to do including learning healthy ways to connect to my friends and family. For me, two prominent behaviors caused irreparable fractures in important relationships—people pleasing and perfectionism.

People-pleasing can manifest in many ways, but perhaps the most prominent is the inability to say no to others.

Amenability as a child connected me to caregivers, and I learned early to always agree to any plan and never to resist. While this did connect me to my mom in childhood, in adulthood it has served to separate me from people.

For example, when making plans with others, I did not have the language or the ability to simply say “no thank you, that doesn’t work for me,” so I cancelled more plans than I kept. After a while, friends and family stopped asking me to make plans with them. This led to loneliness, shame, and despair.

Once I learned that I simply wanted people to be happy with me and to accept me, I understood that people-pleasing was not the way to deeply connect with them.

Now, when something is asked of me, I do not answer on the spot. My standard is “let me get back to you”—because I know I almost always don’t want to go with that plan. Taking a moment to think allows me to choose to respect the time and energy of my friends and family while also giving me the choice to make a decision based on interpersonal factors (time, energy, desire). Both can be true; I can respect their time and energy, and I can choose to say no–without fear of separation from them.

The key to recovering from people-pleasing is to choose wisely who you allow into your inner circle.

Be careful about anyone whose presence in your life depends on how many times your will is bent to theirs. For those living with a spouse, it is important to invite them to join you on your healing journey. And if people-pleasing is a behavior you use to connect with others, consider having honest conversations with those in your circle. Recruit them to help you. Ask them to stay connected to you even if you don’t accept those dinner plans.

For those of you who love people pleasers, don’t hesitate to go deeper when making plans or when submitting a request to them; their default may always be to make themselves amenable to you.

When the people pleaser behavior is present, gently guide them back to connection with you that is not based on their amenability to your plan.

I still struggle with people pleasing, but I have a solid core of people who remind me that their connection to me has nothing to do with my performance, but rather who I am as a human being. These relationships have served to heal me more than anything I learned in a classroom or a counselor’s office. These people exist, I promise.

The opposite is true, though. Be careful about keeping people in your life whose connection to you depends on your performance. Sometimes this means separating from family members; this can feel brutal, but sometimes it is necessary for your healing. Ask me how I know…

Perfectionism is a common maladaptive coping mechanism that is a result of childhood trauma (Smith et al., 2019). This maladaptive coping mechanism, often adopted in childhood, is particularly difficult because perfectionism can equate to vocational and economic success.

However, perfectionism can cause problems in adult relationships because perfectionists also hold others to high standards. The perfectionist can be judgmental of others, particularly when others don’t meet perfect standards. I learned that perfect grades connected me to my mom, something I deeply desired, and as long as I can remember, I never accepted less than 100% in my academic pursuits.

This became painfully clear to me when I submitted my dissertation to my chair. When she requested a minor revision, and I was unable to accept the revisions as minor and deemed the entire document (245 pages) a failure.

During a subsequent counseling session, I realized that it was never about being perfect; it was about being securely attached to my dissertation chair, whom I highly respected. It was a valuable lesson for me and one that I am still learning.

I am learning that I am not perfect, and I am learning that my friends and family are not perfect. I am learning that we grow together and that life is messy, and that mistakes will be made.

Sometimes I sit in imperfection just to demonstrate that imperfection will not kill me. Those imperfections have nothing to do with my value as a human being.

Perfectionism may have served its purpose in childhood, but it will destroy our ability to maintain strong relationships in adulthood. Learning to accept imperfections may always be a struggle, but I am grateful for supportive people around me who remind me that I am valuable even if I never accomplish a single thing in this life. That is true of you too, my fellow survivor.

You do not need to be perfect to be loved; you just need to be you to be loved. For those of you who love survivors of adverse childhood experiences we need you to extend care and compassion, and maybe even congratulations when we stop trying to be perfect for you to accept us.

Keep reminding us that you love us because we are imperfectly human.

Dear Survivor: you can rest now. You are accepted. You are SEEN. You are KNOWN. You are HEARD. You are VALUED, JUST as you are. Dear loved ones, it is important that you get help too. Don’t give up, keep fighting for us.

Remember, nobody did that for us when we were most vulnerable. The best news? There is help, there is hope. There are armies of people who want to stand in the gap for you. I am honored to be one of them.

Sources:

Hargreaves, M. K., Mouton, C. P., Liu, J., Zhou, Y. E., & Blot, W. J. (2019). Adverse childhood experiences and health care utilization in a low-income population. Journal of Health Care for the Poor and Underserved, 30(2), 749–767. https://doi.org/10.1353/hpu.2019.0054

Smith, M. M., Saklofske, D. H., Yan, G., & Sherry, S. B. (2019).
Adverse childhood experiences and multidimensional perfectionism in young adults. Personality and Individual Differences, 146, 53–57. https://doi.org/10.1016/j.paid.2019.03.042

Photo Credit: Unsplash

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