Our childhood stays with us throughout our lives. We know this intuitively, from the shiver that can accompany memories of an upsetting event from our early years even into adulthood. But it is also true in a much deeper way.
The Adverse Childhood Experience (Ace) study, carried out in the US in the 1990s, found that children exposed to serious neglect, abuse or household dysfunction were at significantly greater risk of a litany of poor health and social outcomes, ranging from heart disease, liver disease and sexually transmitted diseases to depression, suicide attempts and intimate partner violence. Most starkly, people with a high score on the Ace scale died on average nearly 20 years earlier [pdf] than their counterparts who reported no childhood adversity.
This is not just a case of traumatic events leading to unhealthy behaviours leading to poor health outcomes. There is a growing body of evidence that suggests the impact of toxic stress on the developing brain has the potential to transform the way we view health problems.
Toxic stress is the term used to describe the prolonged physiological arousal that occurs when people find themselves in a threatening situation for an extended period of time. When that threatening situation is an abusive or neglectful home, and when the period of time coincides with a person’s formative years, the effects can change how the body’s organs function and drastically alter the course of a life. It has even been suggested that many poor health and social outcomes in adulthood are really developmental disorders with their roots in childhood, not simply the result of poor health choices in adulthood.
If the right questions are not being asked, we cannot expect to find the right answers
This represents a radical shift in the way we see and treat health and social issues. Our healthcare system tends to treat presenting symptoms rather than root causes. Clinicians tend to ask: what is wrong with this person? Now there is an emerging movement that advocates a “trauma-informed” approach, asking instead: what happened to this person?
Take attention deficit hyperactivity disorder (ADHD). The symptoms of ADHD can bear a remarkable similarity to the effects of childhood trauma, which include hypervigilance and an inability to focus, and could be caused by the heightened physiological arousal associated with toxic stress. Yet there is concerning evidence that children who have experienced trauma are more likely to receive a diagnosis of ADHD than post-traumatic stress disorder. If the right questions are not being asked, we cannot expect to find the right answers.
So what is the solution? Resilience has been shown to mitigate the lifetime impact of childhood adversity, but resilience relies on connection with others – nobody can be resilient without support. Early neglect, abuse and family disruption are about lack of connection, broken connection or loss of connection. At Body & Soul we aim to build the resilience of people of all ages by fostering a restorative, healing connection within a supportive and loving community of members, volunteers, staff and professionals.
Our approach is designed to mirror the holistic care that, in an ideal world, everyone would receive in childhood. When our members come to the centre, we provide them with a nutritious, home-cooked meal, which they share in a warm, social environment. They have access to one-to-one and group psychotherapy. They can book in for massages, shiatsu and reflexology. They can see a casework team if they are having practical difficulties with things like housing or benefits. They are encouraged to attend workshops on the importance of physical health and nutrition, as well as training courses on employability. They are invited to explore their feelings through music, dance and poetry. Nurturing these connections mitigates some of the physical, emotional and psychological effects of a childhood spent in a state of uncertainty, fear and physiological arousal. Over time, our members develop the resilience they need to withstand life’s challenges.
Screening for adverse childhood experiences in primary care is feasible, but ultimately primary care clinicians can only refer patients to services that exist. If money continues to be channelled into the treatment of symptoms at the expense of investigating root causes, people’s lives will continue to be defined by their childhood experiences.
What we need is for funders, both statutory and independent, to see beyond the symptoms, and recognise the healing power of human connection, particularly when that connection was missing in childhood. Failure to do so risks consigning those who have experienced adversity in childhood to a future of psychological hardship, relentless medication and an early death.
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A supportive, loving community can help heal neglected children | Emma Colyer
