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The Scars That Won't Heal

Thu, 2007-12-06 15:59 - Niels

THE NEUROBIOLOGY OF CHILD ABUSE

Maltreatment at an early age can have enduring negative effects on a child’s brain development and function
By Martin H. Teicher

In 1994 Boston police were shocked to discover a malnourished four-year-old locked away in a filthy Roxbury apartment, where he lived in dreadfully squalid conditions. Worse, the boy’s tiny hands were found to have been horrendously burned. It emerged that his drug-abusing mother had held the child’s hands under a steaming-hot faucet to punish him for eating her boyfriend’s food, despite her instructions not to do so. The ailing youngster had been given no medical care at all. The disturbing story quickly made national headlines. Later placed in foster care, the boy received skin grafts to help his scarred hands regain their function. But even though the victim’s physical wounds were treated, recent research findings indicate that any injuries inflicted to his developing mind may never truly heal.

Though an extreme example, the notorious case is unfortunately not all that uncommon. Every year child welfare agencies in the U.S. receive more than three million allegations of childhood abuse and neglect and collect sufficient evidence to substantiate more than a million instances.

It is hardly surprising to us that research reveals a strong link between physical, sexual and emotional mistreatment of children and the development of psychiatric problems. But in the early 1990s mental health professionals believed that emotional and social difficulties occurred mainly through psychological means. Childhood maltreatment was understood either to foster the development of intrapsychic defense mechanisms that proved to be self-defeating in adulthood or to arrest psychosocial development, leaving a “wounded child” within. Researchers thought of the damage as basically a software problem amenable to reprogramming via therapy or simply erasable through the exhortation “Get over it.”

New investigations into the consequences of early maltreatment, including work my colleagues and I have done at McLean Hospital in Belmont, Mass., and at Harvard Medical School, appear to tell a different story. Because childhood abuse occurs during the critical formative time when the brain is being physically sculpted by experience, the impact of severe stress can leave an indelible imprint on its structure and function. Such abuse, it seems, induces a cascade of molecular and neurobiological effects that irreversibly alter neural development.

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Comments

Sun, 2008-06-15 08:49 — almost_human

holy crap

this is the first time i've read about a connection between seizures and child abuse.

i have grand mal seizures very infrequently
i was abused as a child
i tend to be the opposite of a hypochondriac
i hate doctor visits

the seizures seem to come about when my body is under stress
especially when an emotional stress causes days of sleepless nights

as a result, i have to concentrate all my efforts during emotional stress on sleeping, even if it means staying 3 days in bed to derive 8 hours of sleep...
in this way, i have been able to thwart oncoming seizures, as i can now recognize the physical feelings of when i am sensitive and prone to them.
testing for epilepsy has proven inconclusive
there is no explanation for these electrical storms - until now - but something i always suspected.

i will post a story i wrote about this my first day of comp 101 (after i find it) on my blog here

it is discomforting to know your brain chemistry was probably damaged due to childhood abuse.
the physical changes manifest themselves in paralysis when confronted with situations or sensations or objects that trigger memories of abuse
it is a continual reminder of how you can't just "get over it" of your own free will
there is a tension in your body that will not dissipate

the masseuse commented they'd never felt anyone's  neck so tight before...

they call this complex ptsd, the paralysis anxiety attacks, being 'stuck' because the resolution of an event has been short-circuited in your brain, as a means to protect you from something too horrendous to deal with.  so you are forever on a treadmill, seeking resolution until someone you can trust makes you feel safe enough to go there.

i am flesh and bones, abused and violated
i wander through minefields solo
i am arrested development

Sun, 2008-06-15 13:16 — Kerry

Formal Interest

When I was recovering from my head-injury last year, hub-man was watching a  program on Sportchannel about athletes who died from repeat brain injuries.  I can't remembert the name of the show, but it featured stories about football players and boxers whose autopsies revealed massive brain damage caused by repeat concussions, and the concern was about an athlete's health and protection in contact-sports.  The irony at the time was, I couldn't discuss this show with him because I could not speak.... yet I was profoundly aware of the many times my head got smashed into things over the years.

I found an article that covers similar information about the effects repeat brain injuries have on an adult athlete. 

Numerous studies of professional boxers have shown that repeated brain injury can lead to chronic encephalopathy, termed dementia pugilistica.12, 13, 14, 15 Likewise, the autopsies of 2 former professional football players with a history multiple concussions demonstrated changes that were consistent with chronic encephalopathy.5, 6
Another investigation of retired professional football players showed a 3-fold increase of depression in players with a history of 3 or more concussions.3 Older studies of American and Australian rules football showed no effect from repetitive mild head injuries.11 However, more recent studies of collegiate football players showed an association between multiple concussions and reduced cognitive performance, prolonged recovery, and the increased likelihood of subsequent concussions.

Evidence has also been gleaned from other sports that involve head impact. Nonrandomized studies of soccer players who have had multiple minor concussions have demonstrated that these individuals performed worse on neuropsychologic tests compared with a control group.16, 17, 18, 19

Neuropsychologic testing is the standard for monitoring cognitive recovery after concussion. However, 2 studies suggest that abnormalities in visual motor and motor cortex function persist after neuropsychologic testing has normalized.8, 20 Slower recovery in patients with a second concussion was also seen.

Basic science research is also ongoing. Experiments in concussed rats demonstrated prolonged abnormalities in metabolic markers of brain activity when a second impact was administered at 3 days21, 22 This implies there may be a metabolic window of vulnerability to a second impact that leads to chronic or prolonged symptoms. Clinically useful biomarkers for brain injury are also being investigated.

Certainly, more research is needed to better understand the chronic and catastrophic effects of repetitive head injuries.  http://www.emedicine.com/sports/byname/repetitive-head-injury-syndrome.htm

It would be nice to know the concern and attention given to long-term effects of head injuries was given to children in abusive families, and not just well-paid athletes taking a beating "for their team".

Sun, 2008-06-15 15:46 — almost_human

Well, I think the article

Well, I think the article was about how emotional trauma can effect brain development.
a hidden source and a hidden result
in my case, it was sexual abuse by my father and emotional deprivation by my mother
there are definitely no physical scars - but many emotional disabilities tying up and residing in my body

maybe there needs to be studies on head trauma in conjunction with emotional trauma
it can't be a healthy combination for growing little people  

Sun, 2008-06-15 16:39 — Kerry

Safety-Measures

I think there is real treachery in the belief that emotional abuse or protective neglect does not leave physical scars.  Only the completely detached will say the mind and body do not experience the same thing.

A perfect example can be found in orphanages where the neglected children are found banging their heads on their cribs.  Why would an infant do such a terrible thing?  Draw attention... seek comfort...?  [A discussion on this can be found here:  http://www.city-data.com/forum/parenting/292084-ok-i-need-some-mommie-advice.html]   Why are so many victims of incest/sexual abuse known to beat their own breasts and bodies after exposure to certain stressful situations?  Release and relief can only be felt through pain.  In this sense, head injuries (and other acts that scar) can take place either during or after an abusive attack.  The truly manipulative abuser makes sure self-loathing felt by the victim is all that remains after the Control Game. ["There must be something wrong with me that makes this possible'"] The most dangerous child abuser is one who plants the seed of damaging-doubt, leading the child to believe "I deserve some form of punishment, from someone."

I believe physical injury is how emotional stress manifests itself.  I strongly believe you can not have one form of abuse or neglect  without any physical symptoms.  [Cause and effect work hand-in-hand that way.]  Eventually, the secrets of a person's past will reveal itself in scars throughout the body.  For some, this can be in migraines, for others it can be sexual impotency, still others it can be a drug or alcohol dependency with or without the physical scars cutting, hitting, pulling and burning leave a human body.  The scars of abuse, neglect and injury don't always have to be caused by the adult in control of the situation.

The fact that brain studies keep these two related (trauma) entities apart should say more about the mental health field and medicine's "special interests" and connections.  This is exactly why I chose to introduce an "unrelated article" to a discussion about emotional abuse.  Only the survivors can testify, "YES... there IS a cause and an effect."