Childhood trauma is a health crisis

Trigger warning: domestic violence, rape, child physical, sexual and emotional abuse, alcoholism, suicidality.

It’s not so much that when I said “no.” two or three times he ignored me, or that when I insisted– “really, stop.”– he said he thought I was joking and continued. It’s not that I knew that I couldn’t start crying or he would enjoy it and speed up. It’s not even really that I had to kick and push him repeatedly to knock him off of me.

It’s what happened after. After I ran. The panic. The words in my head, of myself as a scared little kid. “I’m in so much trouble.” The need to get out of the house. Calculating the risk of going back into the bedroom to get my clothes; had he left the room from the other door? I wanted to hide under the desk, because to the little kid who was climbing out of the depths of my mind– frozen in time from having run so many times before– that’s what you do with no other options. Hide and pray. I knew he was going to hit me. I had stopped him from using his own property. It was my job, after all. I was his girlfriend. We lived together.

I was raised to believe that a dehumanizing lack of rights to my own body was normal and expected. I had watched my mother suffer intimate partner violence from my father, and I endured abuse and neglect from both of them. Chances are, they were carrying out the same patterns that they learned as children.

When I was a kid and things were particularly bad, I would carry a knife around at home. I knew it was only a matter of time before my father would try to kill me, too. The image of him leaning over my mother with a kitchen knife at her throat is burned into my mind. She begged me to call the police; he warned me not to. One day I would say or do something wrong, and instead of being called a dumb, good-for-nothing bitch, this time he would kill me. I planned ways to pull out and open the knife quickly. I was scared of the knife, but I was more scared of him.

I couldn’t always predict what would set him off; what would be the difference between shouted vitriol and my head being slammed into a windowsill. I once jokingly called him “silly” and he refused to speak to me for days.

My mother was essentially catatonic at home. She would stare at the TV, beer in one hand, cigarette in the other, and either silently ignore me or reply with an “mmhmm” without actually listening to what I was saying. She would sit mute while my father doled out criticisms in cruel language as though they were helpful. She was stupid. She was getting too fat. Her cooking was no good.

My father liked to remind me of how angry he was that I was a girl. He yelled at the TV about the “dumb broads” in his programs. He controlled us. We learned that, as women, it was our place to do for him. Cleaning and cooking was a woman’s job. His job was managing the money that my mother earned, while he didn’t work. I was warned not to grow up like my mother, a “whore”. As far as I could tell, simply being a woman was proof enough of being a “whore” in his book.

When my parents temporarily split up, my father treated me like a surrogate wife. He told me distressing, adult things about my mother. He made me sleep in the same bed as him, though I felt sick doing so. I remember him taking me on a cross-state drive with the intent to commit murder. He put his hand on my bare thigh as I sat in the passenger seat of the car, an eight year old in shorts. Prematurely learning my supporting role as a woman while being told that growing up into a woman was disgusting.

I finally told the guidance counselor at school that I didn’t feel safe at home, though I was terrified that my parents would find out. I was taken away and put in foster care for a year. When I returned home, despite a court order, my mother kept drinking and my father kept living with us. From then on, I lied to the social workers and told them things were fine at home. I had learned that the easiest thing to do was to deny myself and remain silent. By this age, at 12 or 13, I had come through some of my most formative years living in constant fear, in fight or flight mode. It was normal for me to shut off and simply try to survive, effects that I work to reverse even now, decades later.

Childhood trauma is an American health crisis. In a landmark study by the CDC, over 60% of people reported having had at least one Adverse Child Experience (ACE), and these experiences were strongly associated with a wide range of mental, emotional, and physical health issues. Survivors of childhood trauma are often missing crucial psychological tools to manage stressful situations and emotions. Many of us will develop depression, PTSD, anxiety disorders, or other types of mental illness, and are likely to be more sensitive, anxious, angry, and fearful than people with no history of childhood trauma.

We turn to alcohol, drugs and other self-destructive methods of coping. Sometimes, we kill ourselves. A study found that Adverse Childhood Experiences increased the risk of attempted suicide by up to 5 times. The same study found that 67% of suicide attempts among over 17,000 participants were attributable to having experienced adverse childhood events.

People with six or more ACEs have been found to die on average 20 years earlier than those who have none.

Our mental health isn’t the only thing that suffers as a result of childhood trauma. A growing body of evidence indicates that our life-long physical health is also affected. The Center for Youth Wellness found that adults who have four or more ACEs are over 4 times more likely to be diagnosed with Alzheimer’s Disease in later life, over 2 times more likely to have a stroke or chronic obstructive pulmonary disease, and almost 2 times more likely to have cancer. Experiencing child abuse has also been associated with development of asthma, autoimmune diseases and diabetes. Too often, we die early; People with six or more ACEs have been found to die on average 20 years earlier than those who have none.

Childhood trauma is also responsible for a great loss of individual potential that costs our society in productivity and economic growth. Adults with four or more ACEs are over five times more likely to suffer from depression, a disease which is the leading cause of disability for people in the US ages 15 to 44. The CDC estimates the lifetime financial cost of one year of child maltreatment cases in the United States to be $124 billion dollars, a figure which doesn’t include unreported cases or cases that couldn’t be verified.

A person with four or more ACEs is almost 12 times more likely to experience sexual violence as an adult.

There are challenges to ending this epidemic. Interpersonal violence is a trauma that is passed down from generation to generation. We repeat behaviors that we learned from our parents and caretakers; lessons about how to treat one another, particularly in close relationships. The cycle of abuse continues in far too many homes in our country. Safe Horizon, a violence prevention and victim support non-profit, reports that “one-third of abused and neglected children will grow up to abuse their own children when they become parents.” In a study of California residents, women who reported having had three violent Adverse Childhood Experiences were three and a half times more likely to experience intimate partner violence, and men with three or more ACEs were almost four times more likely to perpetrate intimate partner violence. The Center for Youth Wellness reports that a person with four or more ACEs is almost 12 times more likely to experience sexual violence as an adult.

Our culture values privacy, and this often translates into silence about uncomfortable and personal topics. Child survivors are taught, both explicitly and implicitly, to remain silent about their abuse. There are many reasons for this. Abusers often threaten their victims to keep the abuse a secret. Even if explicit threats aren’t made, disclosing abuse can be seen by the child as risky, with the potential to bring on more abuse if found out. Children learn that their bravery in talking about abuse to non-offending adults is too often met with disbelief, or even shaming. Our culture takes keeping family business private to a detrimental extreme. This emphasis on silence provides abusers an environment in which mistreatment continues, and where children and parents don’t receive the help they need.

If you think you don’t know anyone who has been affected by child abuse, think again.

I am sharing my story to give voice to children who cannot speak for themselves. I also want to give voice to the 50% of adults in the US who have experienced childhood adversity and live with its effects each day. In the state that I live in, California, over 60% of adults have experienced one ACE, and one in six have experienced four or more, with the most common ACE being emotional abuse. If you think you don’t know anyone who has been affected by child abuse, think again.

Even if we do not personally perpetrate violence against children, we participate in a society where the ground is fertilized with the seeds of interpersonal violence.

We must all think carefully about the messages we give our children, and be brave enough to introspect and work to change our own behaviors for the better. We, as a culture, are instilling values in our children that will bring harm to their generation and those that follow. The prevalence of aggressive interactions, judgemental attitudes, and skewed messages about gender roles and self-worth all act to teach children that these negative behaviors and ideas are normal and acceptable. Even if we do not personally perpetrate violence against children, we participate in a society where the ground is fertilized with the seeds of interpersonal violence. Through our complacency and silence, we are complicit in their suffering.

We have an obligation to stand up for the children who are caught in this cycle, and to have compassion for adult survivors. It is our duty to stifle our fears of “interfering” in others’ business, or let the doubt that something *might* not be going on stop us from taking action. As neighbors, friends, and family members, we must support one another. These are things we must do everyday, or be prepared to do if the situation arises:

• We must all speak up for mistreated children we see; not only those we know personally, but also any we see being abused in public. If you know the child, call your local Child Protective Services (CPS) hotline or the Childhelp hotline. Childhelp also maintains a PDF of CPS hotline numbers in each state. If you do not know the child but see abuse happening, intervene and/or call the police.
• Children disclosing abuse should be believed and made to feel as safe as possible, even if you find the actions of the adult(s) involved unbelievable. You have a responsibility to report all disclosures to the authorities. Womenwin.org has a thorough list of things to do and not do when a child discloses to you.
• We must also speak up for adults caught in violent relationships. If you see or hear what seems like a fight, intervene and ask if everyone is ok. Knock on neighbors’ doors and/or call 911 if you suspect anything. This applies to relationships involving people of all genders and sexual orientations.
• Domestic violence, rape, sexual assault, incest and other forms of interpersonal violence should only be mentioned to convey the terrible acts they describe. When we make jokes and speak casually of these tragedies, we trivialize and normalize their existence. We must be cognizant of our language and how we respond to others’ use of these words and speak up whenever they are misused.
• We must de-stigmatize mental illness, and emphasize that receiving mental health treatment is no different than going to a regular doctor. Making light of these issue reinforces the feelings of shame that discourage people from seeking help. As with misuse of terms that describe violence, we must be vigilant in speaking up when others make fun of mental illness.
• Our cultures’ ideas of masculinity and femininity perpetuate an imbalanced dynamic between men and women, which paves the way for many cases of interpersonal violence. We must not support media that reinforces the idea that women and their bodies are a commodity, or that men should be aggressive and unfeeling. As long as we surround ourselves by and raise children in a society where these messages are prevalent, gendered interpersonal violence will continue.