Sunday, October 01, 2000

Wounds That Time Won’t Heal

The Neurobiology of Child Abuse

By: Martin H. Teicher, M.D., Ph.D.

We easily understand how beating a child may damage the developing brain, but what about the all-too-common psychological abuse of children? Because the abuse was not physical, these children may be told, as adults, that they should just “get over it.”

But as developmental neuropsychiatrist Martin H. Teicher reveals, scientists are discovering some startling connections between abuse of all kinds and both permanent debilitating changes in the brain and psychiatric problems ranging from panic attacks to posttraumatic stress disorder. In these surprising physical consequences of psychological trauma, Teicher sees not only a wake-up call for our society but hope for new treatments. 

We know that the abuse or neglect of children is tragically common in America today. Nor are most of us surprised when studies point to a strong link between the physical, sexual, or psychological maltreatment of children and the development of psychiatric problems. To explain how such problems come about, many mental health professionals resort to personality theories or metaphors. Perhaps the child’s adaptive or protective mechanisms have become  counterproductive or self-defeating in the adult. Perhaps childhood abuse has arrested psychosocial development, leaving a “wounded child” within the adult.  Although such explanations may offer gen uine insight and may support patients in  therapy, too often they instead minimize  the impact of early abuse. They make it  easy to reproach the victims, to say, in so  many words, “Get over it.”  

Research on the effects of early maltreatment, including the work of my  colleagues and myself at McLean Hospital  in Belmont, Massachusetts, appears to tell  a different story: that early maltreatment,  even exclusively psychological abuse, has  enduring negative effects on brain develop ment. We see specific kinds of brain abnor malities in psychiatric patients who were  abused as children. We are also beginning  to understand how these abnormalities may  account directly for the personality traits  and other symptoms that patients manifest.  

With The Etiology of Hysteria (1896),  Sigmund Freud first introduced the topic  of childhood sexual abuse in a scientific  context. He was convinced that, as children,  many of his patients had been sexually  abused by their parents, older siblings, or other relatives. Furthermore, he claimed, based on his new analytical method, that their hysterical and neurotic symptoms could be traced directly to repressed memories of that early abuse. This hypothesis marked the birth of psychoanalysis. Freud later retreated from this theory, though, refusing to believe that childhood abuse could be as prevalent as he had initially claimed. He evolved the more complex theory that “memories” of early sexual abuse were merely repressed childhood fantasies. This theory has so swayed psychiatry for almost a century that it has largely blinded us to the frequency of real abuse in psychiatric patients’ childhoods and to the role of abuse in psychopathology.

Physical abuse of children by their parents remained a hidden problem until 1962, when C. Henry Kempe published The Battered Child Syndrome, and an avalanche of publicity led to the enactment of child abuse reporting laws. During the 1970s, case reports of sexual abuse and incest appeared with increasing frequency in medical literature. By the 1980s, scientifically valid studies of the incidence and consequences of childhood sexual abuse were being published. 

Today, episodes of serious neglect and physical abuse are featured regularly in the news, constantly reminding us of the horrifying cruelty adults inflict on children. In separate surveys in San Francisco, Los Angeles, and Canada, and of college students in New England and Texas, the percentage of women reporting sexual abuse during childhood ranged from 19 to 45. The medical literature is replete with research on this problem; clinicians, super-sensitized to it, increasingly suggest that childhood abuse lies behind a patient’s problem, even in the absence of direct evidence. Despite occasional hysteria and misuse of the diagnosis, however, the problem is all too real.

It is our hope that as we identify the specific physiological pathways by which abusive experiences alter brain development, our society will take more seriously the challenge of uprooting the violence against the children in our midst. 


Physical, sexual, and psychological trauma in childhood may lead to psychiatric difficulties that show up in childhood, adolescence, or adulthood. The victim’s anger, shame, and despair can be directed inward to spawn symptoms such as depression, anxiety, suicidal ideation, and post-traumatic stress, or directed outward as aggression, impulsiveness, delinquency, hyperactivity, and substance abuse.1

Childhood trauma may fuel a range of persistent psychiatric disorders. One is somatoform disorder (also known as psychosomatic disorder), in which patients experience physical complaints with no discernible medical cause. Another is panic disorder with agoraphobia, in which patients experience the sudden, acute onset of terror and may narrow their range of activities to avoid being outside, especially in public, in case they have an attack. 

More complex, difficult-to-treat disorders strongly associated with childhood abuse are borderline personality disorder2 and dissociative identity disorder3 Someone with borderline personality disorder characteristically sees others in black-and-white terms, first putting them on a pedestal, then vilifying them after some perceived slight or betrayal. Such people have a history of intense but unstable relationships, feel empty or unsure of their identity, often try to escape through substance abuse, and experience self-destructive impulses and suicidal thoughts. They are plagued by anger, most often directed at themselves. 

 In dissociative identity disorder, formerly called multiple personality disorder (the phenomenon behind Robert Louis Stevenson’s “Dr. Jekyll and Mr. Hyde”), at least two seemingly separate people occupy the same body at different times, each with no knowledge of the other. This can be seen as a more severe form of borderline personality disorder. In borderline personality disorder, there is one dramatically changeable personality with an intact memory, as opposed to several distinct personalities, each with an incomplete memory. People with dissociative identity disorder have two or more (on average, eight to fifteen) personalities or personality fragments that control their behavior at different times. Often there is a passive, depressed primary identity who cannot remember personal history as fully as can the other more hostile, protective, or controlling identities. 

Post-traumatic stress disorder (PTSD) afflicts some people who have undergone a traumatic event involving serious injury or a threat to life or limb. Initially identified in combat veterans, PTSD seems to result as well from natural disasters, child abuse, and other devastating experiences. People with PTSD keep re-experiencing the traumatic event in waking life or in dreams, and they actively avoid situations that might bring back memories of the trauma. They may also suffer a general numbing of their responsiveness, show diminished interest in significant activities, restrict the range of their emotions, or have feelings of detachment or estrangement from others. Finally, they may also experience increased arousal (such as difficulty falling or staying asleep), irritability or outbursts of anger, difficulty concentrating, hyper vigilance, and an exaggerated startle response.


For a century or more, scientists have hotly contested the relative importance of experience versus genetic endowment in the development of the brain and behavior. We know now that our genes provide the foundation and overall structure of our brain, but that its myriad connections are sculpted and molded by experience. Based on animal studies, scientists have long believed that early deprivation or abuse may result in neurobiological abnormalities, but until recently there has been little evidence for this in humans. 

 Then, in 1983, A. H. Green and his colleagues suggested that many abused children evidenced neurological damage, even without an apparent or reported head injury. Interestingly, although minor neurological disturbances and mild brain-wave abnormalities were more common in children who had been abused than in those who had not, Green and his colleagues did not believe that the abuse had caused them. Instead, they saw these neurological disturbances as a possible additional source of trauma, amplifying the damaging impact of an abusive environment. In 1979, R. K. Davies reported that in a sample of 22 patients involved as a child or as the younger member in an incestuous relationship, 77 percent had abnormal brain waves and 36 percent had seizures. In Davies’s interpretation, however, these children were more vulnerable to being sexually abused by family members because of their neurological handicap.

 My hypothesis is that the trauma of abuse induces a cascade of effects, including changes in hormones and neurotransmitters that mediate development of vulnerable brain regions. Testing this hypothesis in humans is difficult because abuse is not always a random act. If we observe an association between a history of abuse and the presence of a physical abnormality, the abuse may have caused that abnormality. But it is also possible that the abnormality occurred first and elevated the likelihood of abuse, or that the abnormality ran in the family and led to more frequent abusive behavior by family members or other relatives. To try to sort out these competing hypotheses, we conducted studies of analogous early stress in animals, where the potentially confusing elements can be carefully controlled. Observing parallel outcomes in animals and people has bolstered our belief that trauma causes brain damage, not the other way around. 


Our research (and that of other scientists) delineates a constellation of brain abnormalities associated with childhood abuse. There are four major components: 

Limbic irritability, manifested by markedly increased prevalence of symptoms suggestive of temporal lobe epilepsy (TLE) and by an increased incidence of clinically significant EEG (brain wave) abnormalities. 

Deficient development and differentiation of the left hemisphere, manifested throughout the cerebral cortex and the hippocampus, which is involved in memory retrieval. 

Deficient left-right hemisphere integration, indicated by marked shifts in hemispheric activity during memory recall and by underdevelopment of the middle portions of the corpus callosum, the primary pathway connecting the two hemispheres. 

Abnormal activity in the cerebellar vermis (the middle strip between the two hemispheres of the brain), which appears to play an important role in emotional and attentional balance and regulates electrical activity within the limbic system. 

Let us look briefly at the main evidence for each of these abnormalities.

Epilepsy-Like Symptoms

People with temporal lobe epilepsy (TLE)— .25 percent to .5 percent of the U.S. population—have seizures in the temporal or limbic areas of the brain. Because these areas constitute a sizable, varied part of the brain, TLE has a veritable catalog of possible symptoms, including sensory changes such as headache, tingling, numbness, dizziness, or vertigo; motor symptoms such as staring or twitching; or autonomic symptoms such as flushing, shortness of breath, nausea, or the stomach sensation of being in an elevator. TLE can cause hallucinations or illusions in any sense modality. Common visual illusions are of patterns, geometric shapes, flashing lights, or “Alice-in-Wonderlandlike” distortions of the sizes or shapes of objects. Other common hallucinations are of a ringing or buzzing sound or repetitive voice, a metallic or foul taste, an unpleasant odor, or the sensation of something crawling on or under the skin. Feelings of déjà vu (the unfamiliar feels familiar) or jamais vu (the familiar feels unfamiliar) are common, as is the sense of being watched or of mind-body dissociation—the feeling that one is watching one’s own actions as a detached observer. Emotional manifestations of temporal lobe seizures usually occur suddenly, without apparent cause, and cease as abruptly as they began; they include sadness, embarrassment, anger, explosive laughter (usually without feeling happy), serenity, and, quite often, fear.4

 TLE is difficult to diagnose because its symptoms can mimic those of other psychiatric and nonpsychiatric illnesses. The characteristic electrical discharge of TLE can be observed only in an electroencephalogram (EEG) during a seizure that is close enough to the brain’s surface to be picked up by scalp electrodes. Without this objective EEG data, a diagnosis must be based on the frequency and severity of symptoms and the ruling out of other likely causes of those symptoms.

To explore the relationship between early abuse and dysfunction of the temporolimbic system, we devised the Limbic System Checklist-33 (LSCL-33), which calibrates the frequency with which patients experience symptoms of temporolimbic seizures.5 We studied 253 adults who came to an outpatient mental health clinic for psychiatric assessment; slightly more than half reported having been abused physically, sexually, or both. Compared to patients who reported no abuse, average LSCL-33 scores were 38 percent greater in the patients with physical (but not sexual) abuse, and were 49 percent greater in the patients with sexual (but not other physical) abuse. Patients who acknowledged both physical and sexual abuse had average scores 113 percent greater than patients reporting no abuse. Males and females were similarly affected by abuse. 

As we expected, abuse before age 18, when the brain is still rapidly developing, had a greater impact on limbic irritability than later abuse. Patients physically or sexually abused after age 18 had scores not significantly different from nonabused patients. Patients with both physical and sexual abuse, however, were strongly affected regardless of when the abuse occurred, and those first abused after age 18 were almost as affected as those first abused earlier. 

Brain Wave Abnormalities

Our second study tried to ascertain whether childhood physical, sexual, or psychological abuse was associated with specific evidence of neurobiological abnormalities. We reviewed the records of 115 consecutive admissions to a child and adolescent psychiatric hospital to search for a link between different categories of abuse and evidence of abnormalities in brain-wave studies. We found clinically significant brain-wave abnormalities in 54 percent of patients with a history of early trauma but in only 27 percent of nonabused patients. Among patients who had been abused, abnormal EEG findings were observed in 43 percent of those with psychological abuse; 60 percent of the sample with a reported history of physical abuse, sexual abuse, or both; and 72 percent of the sample in which serious physical or sexual abuse had been documented. The overall prevalence of abnormal EEG studies in patients with a significant history of abuse or neglect was the same for boys and girls and for children and adolescents. 

The salient specific difference between abused and nonabused patients was in left-sided EEG abnormalities. In the nonabused group, left-sided EEG abnormalities were rare, whereas in the abused group they were much more common, and more than twice as common as right-sided abnormalities. In the psychologically abused group, all the EEG abnormalities were left-sided. 

To dig deeper into the possibility that abuse may affect development of the left hemisphere, we looked for evidence of right-left hemispheric asymmetries in the results of neuropsychological testing. We compared patients’ visual-spatial ability (predominantly controlled by the right hemisphere) to their verbal performance (predominantly controlled by the left hemisphere). In the nonabused group, left-hemisphere deficits were about twice as prevalent as right-hemisphere deficits, but in patients with physical, sexual, or psychogical abuse, left-sided deficits were more than six times as prevalent as right. In patients with a history of psychological abuse, left-hemisphere deficits were eight times as prevalent as right-sided deficits. This corroborated our hypothesis that abuse is associated with an increased prevalence of left-sided EEG abnormalities and of left-hemisphere defects in neuropsychological testing.

Problems on the Left

In order to investigate the effects of childhood trauma on development of the left hemisphere, we then used a sophisticated quantitative method of analyzing EEG that provides evidence about the brain’s structure.7 In contrast to conventional EEG, which reveals brain function, EEG coherence provided information about the nature of the brain’s wiring and circuitry. In general, abnormally high levels of EEG coherence are evidence of diminished development of the elaborate neuronal interconnections in the cortex that would process and modify the brain’s electric signals.

We used this technique to study 15 child and adolescent psychiatric inpatients who had a confirmed history of intense physical or sexual abuse compared with 15 healthy volunteers. Patients and volunteers were between 6 and 15 years of age, right-handed, and with no history of neurological disorders or abnormal intelligence. Measuring EEG coherence indicated that the left cortex of the healthy controls was more developed than the right cortex, which is consistent with what is known about the anatomy of the dominant hemisphere. The abused patients, however, were notably more developed in the right than the left cortex, even though all were right-handed. The right hemisphere of abused patients had developed as much as the right hemisphere of the controls, but their left hemispheres lagged substantially, as though arrested in their development. 

This abnormality in the cortex showed up regardless of the patient’s primary diagnosis, which could be depression, PTSD, or conduct disorder. It extended throughout the entire left hemisphere, but the temporal regions were most affected. This finding of left cortex underdevelopment is consistent with our earlier finding that abused patients had increased left-hemisphere EEG abnormalities and left-hemisphere (verbal) deficits as shown by neuropsychological testing. 

Effects on the Hippocampus

The hippocampus, located in the temporal lobe, is involved in memory and emotion. Developing very gradually, the hippocampus is one of the few parts of the brain that continues to produce new cells after birth. Cells in the hippocampus have an unusually large number of receptors that respond to the stress hormone cortisol. Since animal studies show that exposure to high levels of stress hormones like cortisol has toxic effects on the developing hippocampus, this brain region may be adversely affected by severe stress in childhood. 

J. Douglas Bremner and his colleagues at Yale Medical School compared magnetic resonance imaging (MRI) scans of 17 adult survivors of childhood physical or sexual abuse, all of whom had PTSD, with 17 healthy subjects matched for age, sex, race, handedness, years of education, body size, and years of alcohol abuse.8 The left hippocampus of abused patients with PTSD was 12 percent smaller than the hippocampus of the healthy controls, but the right hippocampus was of normal size, as were other brain regions, including the amygdala, caudate nucleus, and temporal lobe. Not surprisingly, given the role of the hippocampus in memory, these patients also had lower verbal memory scores than the nonabused group. 

Murray Stein and his colleagues also found left hippocampal abnormalities in women who had been sexually abused as children. Their left hippocampal volume was significantly reduced, but the right hippocampus was relatively unaffected. Fifteen of the 21 sexually abused women had PTSD; 15 had a dissociative disorder. They suffered a reduction in the size of the left hippocampus proportionate to the severity of their symptoms. 

These studies suggest that child abuse may alter development of the left hippocampus permanently and, in so doing, cause deficits in verbal memory and dissociative symptoms that persist into adulthood. 

Shifting from Left to Right

The left hemisphere is specialized for perceiving and expressing language, the right hemisphere for processing spatial information and also for processing and expressing negative emotions. We wondered, then, whether abused children might store their disturbing childhood memories in the right hemisphere, and whether recollecting these memories would activate the right hemisphere more than it is activated in those without such a history. 

To test this hypothesis, we measured hemispheric activity in adults during recall of a neutral memory, then during recall of an upsetting early memory.10 Those with a history of abuse appeared to use predominantly their left hemispheres when thinking about neutral memories and their right when recalling an early disturbing memory. Those in the control group had a more integrated bilateral response. 

A Deficient Pathway

Since childhood abuse (as we found) is associated with diminished right-left hemisphere integration, we wanted to know whether there was some deficiency in the primary pathway connecting the two hemispheres, the corpus collosum. We found in boys who had been abused or neglected that the middle portions of the corpus collosum were significantly smaller than in the control groups. Furthermore, in boys, neglect exerted a far greater effect than any other type of maltreatment; physical and sexual abuse exerted relatively minimal effects. In girls, however, sexual abuse was a more powerful factor, associated with a major reduction in size of the middle portions of the corpus collosum. These results were independently replicated by Michael De Bellis at the University of Pittsburgh, and the effects of early experience on the development of the corpus collosum have been confirmed by research in primates. 

Calming Irritability in the Brain

Decades ago, Harry Harlow compared monkeys raised with their mothers to monkeys raised with wire or terrycloth “surrogate mothers.” Monkeys raised with the surrogates became socially deviant and highly aggressive adults. Building on this work, other scientists discovered that these consequences were less severe if the surrogate mother swung from side to side, a type of movement that may be conveyed to the cerebellum, particularly the part called the cerebellar vermis, located at the back of the brain, just above the brain stem. Like the hippocampus, this part of the brain develops gradually and continues to create new neurons after birth. It also has an extraordinarily high density of receptors for stress hormone, so exposure to such hormones can markedly affect its development. 

New research suggests that abnormalities in the cerebellar vermis may be involved in psychiatric disorders including depression, manic-depressive illness, schizophrenia, autism, and attention-deficit/ hyperactivity disorder. We have gone from thinking of the entire cerebellum as involved only in motor coordination to believing that it plays an important role in regulating attention and emotion. The cerebellar vermis, in particular, seems to be involved in the control of epilepsy or limbic activation. Couldn’t maltreating children produce abnormalities in the cerebellar vermis that contribute to later psychiatric symptoms? 

Testing this hypothesis, we found that the vermis seems to become activated to control— and quell—electrical irritability in the limbic system. It appears less able to do this in people who have been abused. If, indeed, the vermis is important not only for postural, attentional, and emotional balance, but in compensating for and regulating emotional instability, this latter capacity may be impaired by early trauma. By contrast, stimulation of the vermis through exercise, rocking, and movement may exert additional calming effects, helping to develop the vermis. 


We know that through their effects on hormone levels, early experiences influence brain development. Fifty years ago, Seymour Levine and Victor Denenberg showed that small alterations in their environment led to lasting changes in rats’ development, behavior, and response to stress. Something as seemingly inconsequential as five minutes of human handling during a rat’s infancy produced lifelong beneficial changes. We now understand through the reserach efforts of Michael Meany and Paul Plotsky that the effects of brief handling were highly beneficial and were due to increased maternal attention. Those pups whose mothers spontaneously lick and groom them the most (about one-third in a laboratory setting) display the same benefits as the rats with the human handling. By contrast, long isolation produces stress that has a deleterious effect on brain and behavior development. 

If we assume that lots of attention, licking, and grooming are the natural state of affairs and that lower levels of attention are a form of neglect, we can use this model to explore some of the biological consequences of neglect or abuse in children. Low rates of maternal attention decrease the production of thyroid hormone by the rat pups. This, in turn, decreases serotonin in the hippocampus and affects the development of receptors for the stress hormone glucocorticoid. Since corticosterone, one of our primary stress hormones, is kept in check by a complicated feedback mechanism that depends on these same stress hormone receptors, their inadequate development increases the risk of an excessive stress hormone response to adversity. For this and certain other reasons, lack of maternal attention predisposes the animals to have a heightened level of fear and a heightened adrenaline response. Some of the consequences of this are altered metabolism and suppressed immune and inflammatory responses, neuronal irritability, and enhanced susceptibility to seizures. Still other consequences of an abnormally intense corticosterone response are reduced brain weight and DNA content, suppressed cell growth in the cerebellum and hippocampus, and interference with myelinization—the process of sheathing nerve fibers to enhance conduction of electrical impulses. 

These consequences seem consistent with inadequate development of the corpus collosum, which is a highly myelinated structure, and abnormal development of the hippocampus and cerebellum. High levels of cortisol can also hinder development of the cerebral cortex, the extent of vulnerability dependent on how rapidly the brain was growing at the time of the insult. During the years of rapid language acquisition (approximately 2-10 years of age), the left brain develops more rapidly than the right, making it more vulnerable to the effects of early maltreatment.

Finally, diminished maternal attention also appears to be associated with a lifelong decrease in production of the hormone oxytocin in the brain, and enhanced production of the stress hormone vasopressin. Recent research by Thomas Insel suggests that oxytocin is a critical factor in affiliative love and maintaining monogamous relationships. Both hormones may also help control sexual response, with vasopressin enhancing sexual arousal and oxytocin triggering climax and release. By affecting these hormones, early neglect or abuse theoretically could predispose mammals to experience enhanced sexual arousal, diminished capacity for sexual fulfillment, and deficient commitment to a single partner. 


In summary, we now know that childhood abuse is linked with excess neuronal irritability, EEG abnormalities, and symptoms suggestive of temporal lobe epilepsy. It is also associated with diminished development of the left cortex and left hippocampus, reduced size of the corpus callosum, and attenuated activity in the cerebellar vermis. We see a close fit between the effects of early stress on the brain’s transmitters—our discoveries about the negative effects of early maltreatment on brain development— and the array of psychiatric symptoms that we actually observe in abused patients.

Many disorders are associated with childhood abuse. One is depression or heightened risk for developing it. Many scientists believe that depression may be a consequence of reduced activity of the left frontal lobes. If so, the stunted development of the left hemisphere related to abuse could easily enhance the risk of developing depression. Similarly, excess electrical irritability in the limbic system, and alterations in development of receptors that modulate anxiety, set the stage for the emergence of panic disorder and increase the risk of post-traumatic stress disorder. Alterations in the neurochemistry of these areas of the brain also heighten the hormonal response to stress, producing a state of hyper vigilance and right-hemisphere activation that colors our view with negativity and suspicion. Alterations in the size of the hippocampus, along with limbic abnormalities shown on an EEG, further enhance the risk for developing dissociative symptoms and memory impairments. 

We have also found that 30 percent of children with a history of severe abuse meet the diagnostic criteria for attention-deficit/hyperactivity disorder (ADHD), although they are less hyperactive than children with classic ADHD. Very early childhood abuse appears particularly likely to be associated with emergence of ADHD-like behavior problems. Interestingly, one of the most reliable neuroanatomical findings in ADHD is reduced size of the cerebellar vermis. Some studies have also found an association between reduced size of the mid portions of the corpus callosum and emergence of ADHD-like symptoms of impulsivity. Hence, early abuse may produce brain changes that mimic key aspects of ADHD.

Our discoveries that abused patients have diminished right-left hemisphere integration and a smaller corpus callosum suggest an intriguing model for the emergence of one of psychiatry’s least understood afflictions: borderline personality disorder. With less well integrated hemispheres, borderline patients may shift rapidly from a logical and possibly overvaluing left-hemisphere state to a highly negative, critical, and emotional right hemisphere state. This seems consistent with the theory that early problems of mother-child interaction undercut the integration of right and left hemispheric function. Very inconsistent behavior of a parent (for example, sometimes loving, sometimes abusing) might generate an irreconcilable mental image in a young child. Instead of reaching an integrated view, the child would form two diametrically opposite views—storing the positive view in the left hemisphere, the negative view in the right. These mental images, and their associated positive and negative world views, may remain unintegrated, and the hemispheres remain autonomous, as the child grows up. This polarized hemispheric dominance could cause a person to see significant others as overly positive in one state and as resoundingly negative in another. Couple this with possible alterations in oxytocin- and vasopressin-mediated sexual arousal, and you see why patients with borderline personality disorder have tumultuous relationships.


I hope that new understanding of childhood abuse’s impact on the brain will lead to new ideas for treatment. The most immediate conclusion from our work, however, is the crucial need for prevention. If childhood maltreatment exerts enduring negative effects on the developing brain, fundamentally altering one’s mental capacity and personality, it may be possible to compensate for these abnormalities—to succeed in spite of them— but it is doubtful that they can actually be reversed in adulthood. 

The costs to society are enormous. Psychiatric patients who have suffered from childhood abuse or neglect are far more difficult and costly to treat than patients with a healthy childhood. Furthermore, childhood maltreatment can be an essential ingredient in the makeup of violent individuals, predisposing them to bouts of irritable aggression.

One day we will find ways to chart the progress of brain development so that we can spot early signs of stress-mediated abnormalities and monitor each patient’s progress and response to treatment. In the meantime, early intervention should be our priority. The brain is more plastic and malleable before puberty, increasing our chances of minimizing or reversing consequences of abuse. If we are right that many abuse-related changes result from a cascade of stress-mediated neuronal and hormonal responses, then we could minimize the impact of abuse by finding ways to reduce ongoing stress or suppressing an excessive stress response. 

One consequence of childhood maltreatment is limbic irritability, which tends to produce dysphoria (chronic low-level unhappiness), aggression, and violence toward oneself or others. Even into adulthood, drugs can be useful in alleviating this set of symptoms. Anticonvulsant agents can help, as can drugs that affect the serotonin system. 

Abuse also causes alterations in left-right hemisphere integration. Some research suggests that anticonvulsant drugs may facilitate the bilateral transmission of information. Left-right hemisphere integration may also improve through activities that require considerable left-right hemisphere cooperation, such as playing a musical instrument. Certain existing psychotherapies may be helpful. Cognitive-behavioral psychotherapy, which emphasizes correcting illogical, self-defeating perceptions, may work by strengthening left-hemisphere control over right-hemisphere emotions and impulses. Traditional, dynamic psychotherapy may work by enabling patients to integrate right-hemisphere emotions while maintaining left-hemisphere awareness, strengthening the connection between the two hemispheres. 

A powerful new tool for treating PTSD is eye-movement desensitization and reprocessing (EMDR), which seems to quell flashbacks and intrusive memories. A moving visual stimulus is used to produce side-to-side eye movements while a clinician guides the patient through recalling highly disturbing memories. For reasons we do not yet fully understand, patients seem able to tolerate recall during these eye movements and can more effectively integrate and process their disturbing memories. We suspect that this technique works by fostering hemispheric integration and activating the cerebellar vermis (which also coordinates eye movements), which in turn soothes the patient’s intense limbic response to the memories. 


Society reaps what it sows in nurturing its children. Whether abuse of a child is physical, psychological, or sexual, it sets off a ripple of hormonal changes that wire the child’s brain to cope with a malevolent world. It predisposes the child to have a biological basis for fear, though he may act and pretend otherwise. Early abuse molds the brain to be more irritable, impulsive, suspicious, and prone to be swamped by fight-or-flight reactions that the rational mind may be unable to control. The brain is programmed to a state of defensive adaptation, enhancing survival in a world of constant danger, but at a terrible price. To a brain so tuned, Eden itself would seem to hold its share of dangers; building a secure, stable relationship may later require virtually superhuman personal growth and transformation. 

At the extreme, the coupling of severe childhood abuse with other neuropsychiatric handicaps (for example, low intelligence, head trauma, or psychosis) is repeatedly found in cases of explosive violence. Dorothy Otnow Lewis and Jonathan Pincus have analyzed the neurological and psychiatric history of violent adolescents and adults. In one study they evaluated all 14 juveniles condemned to death in four states and found that all had suffered head injuries, most had major neurological impairment, 12 had subnormal IQ’s, 12 had been severely physically abused as children, and 5 had been sodomized by relatives. In another study, they reviewed the childhood neuropsychiatric records and family histories of incarcerated delinquents. What might have been a tip-off to those who later were arrested for murder? The future murderers were distinguished from other delinquents by psychotic symptoms, major neurological impairment, a psychotic first-degree relative, violent acts during childhood, and severe physical abuse. 

In a follow-up study of 95 formerly incarcerated juvenile delinquents, they found that the combination of intrinsic neuropsychiatric vulnerabilities and a history of childhood abuse or family violence effectively predicted which adolescents would go on to commit violent crimes. Lewis concludes that child abuse can engender all pivotal factors associated with violent behavior, namely, impulsivity, irritability, hyper vigilance, paranoia (which she interprets as an extreme version of hypervigilance), decreased judgment and verbal ability, and diminished recognition of pain in oneself (dissociation) and others. As our review shows, these factors fit closely with the enduring neurobiological consequences of abuse.

To be convicted of a crime in the United States, one supposedly must have the capacity both to know right from wrong and to control one’s behavior. Those with a history of childhood abuse may know right from wrong, but their brains may be so irritable and the connections from the logical, rational hemisphere so weak that intense negative (right-hemisphere) emotions may incapacitate their use of logic and reason to control their aggressive impulses. Is it just to hold people criminally responsible for actions that they lack the neurological capacity to control? 

 Prosecutors and pundits are quick to coin catchphrases like the “abuse excuse” to dismiss childhood trauma’s pervasive and enduring consequences for behavior. This is as unthinking as the exhortation to “get over it.” Childhood trauma is not a passing psychological slight that one can choose to ignore. Even if the abused person comes to terms with the traumatic memories and chooses (for the sake of sanity) to forgive the perpetrator, this will not reverse the neurobiological abnormalities. The only sound legal approach to a person with a history of abuse who commits a violent crime is to take into account the person’s neurobiological capacity to control his behavior. If it is irrational and hypocritical to hold a minor to the same standard of behavioral control as a mature adult, it is equally unjust to hold a traumatized and neurologically impaired adult to the same standard as one not so afflicted. Childhood abuse, age, and neurological impairments can be critical mitigating factors that a just society should not ignore. 

If we know that the roots of violence are fertilized by childhood abuse, can we make a long-term commitment to reduce violence by focusing on our children rather than our criminals? What if we set a goal of reducing the cases of childhood abuse and neglect by 50 percent a year? What if we monitored statistics on childhood abuse as avidly as we track housing starts, inflation, or baseball scores? We would have to commit ourselves, seriously, to improving access to quality day care and after-school programs. We might need to educate and support parents so they could know how to nurture their children more effectively. We certainly would need to foster better relationships among peers and siblings. 

Think of what we could save if we needed fewer prisons and fewer mental health professionals. Think of the benefits of moving one step closer to a society that everyone could experience and enjoy. 

Our brains are sculpted by our early experiences. Maltreatment is a chisel that shapes a brain to contend with strife, but at the cost of deep, enduring wounds. Childhood abuse isn’t something you “get over.” It is an evil that we must acknowledge and confront if we aim to do anything about the unchecked cycle of violence in this country.


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  6. Ito Y, Teicher MH, Glod CA, Harper D, Magnus E, Gelbard HA. Increased prevalence of electrophysiological abnormalities in children with psychological, physical, and sexual abuse. Journal of Neuropsychiatry and Clinical Neurosciences. 1993;5:401-8.
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  8. Bremner JD, Randall P, Vermetten E, et al. Magnetic resonance imaging-based measurement of hippocampal volume in posttraumatic stress disorder related to childhood physical and sexual abuse—a preliminary report. Biological Psychiatry. 1997;41:23-32.
  9. Stein MB. Hippocampal volume in women victimized by childhood sexual abuse. Psychology Medicine. 1997;27:951-9.
  10. Schiffer F, Teicher MH, Papanicolaou AC. Evoked potential evidence for right brain activity during the recall of traumatic memories. Journal of Neuropsychiatry and Clinical Neurosciences. 1995;7:169-75.


Wont heal diagnosis spot on

J. Morrison

6/18/2019 12:45:53 PM

This article answers so many questions for me. I had it easy compared to some of the posters - my abuse by my mother involved neglect and mental/emotional, only getting hit a few times that I can remember...... But what she did was me was relentless and continued non stop untill I moved away at age 46. It still happens but less often. I was so confused and hurt as.a child. None of it made sense. I was deeply damaged. I struggled in school due to problems with memorizing. In 2002 the state did full battery icognitive and psychological testing on me the results were: Borderline personality disorder ADHD without the hyper PTSD Symptoms of mild autism Split level intelligence Memory defects Damaged right left pathways And a lobe that isnt functioning at all. Sound familiar? I thought I was born this way. My spatial reasoning side exceeded the IQ score range on every section. My brother is super smart. I would have been super smart as well. I was born normal. My mom actually did this to me! Its hard to process this realisation. My biggest issue has always been that she never remembers doing anything wrong. Her mind blocks events by 6 months later..She says I'm lying. Making it up. She thinks she was a great mom. I want her to be Sorry for what she did but she never will be. My back was badly broken as a young child. but didnt know until I was 40. I have no memory of what happened. Doctor said I would not have been able to walk for a month. 6 months of pain. The injury was equal to being dropped off a one story building onto cement. 3 sets of xrays show the damage. Mom says never happened. Its a fantasy. All in my head. Someone elses xrays. She got so defensive it made me wonder if she did do something. Again - i'll never know the truth Is abusers having no memory of doing abuse normal?

Misdiagnosed and now being abused by the medical establishment

Moz Benado

6/10/2019 11:40:03 AM

I have a traumatic brain injury. My dad prevented me from being transferred to a rehab hospital. Over the years having to find a way on my own and also needing to hide my disability so no one would send me back to my family is added abuse on top of what I experienced prior to injury. However having a tbi and often not able to take of myself. The medical system does not believe me and is traumatizing me further.

Childhood Abuse

Betty J.

12/11/2018 9:59:55 AM

12/8/2018 12:40 AM Forty-Three years after I first knew that I was being abused I find this article. I am a very long way from healed but this was very eye-opening for me. I had all three types of abuse you mentioned here, which still got one. I have been searching for an answer to the problems I didn't know existed until now. I am seeing for the first time ever that I am still being emotionally abused. I hope my journey starts the healing process soon. I just wanted to say Thank You for this information.

Child abuse(1)


8/30/2018 9:30:06 PM

Ashamed to admit I am 75 and still trying to understand why I do some of the things I know I shouldn't, such as acts of outburst over minor issues, or for no reason begin crying and going back to abuses suffered. I coined a phrase, although someone before me may have also, unbeknown to me, and that phrase is "Child abuse, the invisible disability." I was somewhat relieved to see much research has been conducted regarding this issue, for no one understands the debilitating effects. People ask or wonder why when younger I acted out the way I did, would of been better if I had a leg missing, then they would understand why I walked with a limp, but how do you explain to a blind man what a sunset looks like! "Impossible!"I had head doctors looking at me when only in the second grade. I had cut school for a week, first two days missing the school bus, hanging out in an open field until the bus returned dropping kids off, then walked home, all other days playing sick. My first encounter was when at age five my dad putting a gun to my head and being wall to wall angry for knocking a model airplane off his shelf. Age eight beating me with a belt, causing a huge gash in my head, and I was laying in a pool of blood on the bedroom floor he came back with a washcloth and threw it in my face, telling me, "clean it up you son of a bitch.I began drinking when only in the fifth grade, running away from home at age ten, sleeping in the park, finding parked cars and crawling into the back seat to sleep, or in friends garages.I so dreaded when evenings came, for my mom and dad would be lit twice over after drinking from the moment he arrived home from work, would summons me into the kitchen, standing me there as he started in telling me how I was no good and never would amount to anything, and what a stupid son of a bitch I was. If I dared to say anything, the lights went out from being knocked unconscious, this occurred more times than I can remember. School and I didn't get alone to well either, was kicked out of everyone I attended starting in the seventh grade, only went as far as the eighth and left. Was shipped off to juvenile hall for being incorrigible.This occurred twice.My mother would always tell me, "we wanted you, we planned you."Talk about a contradictory statement, caused nothing but confusion in my head. I mentioned this to my grandfather, who was my step, but for me was always number one. He said, "Haven't you figured it out yet Dickie?" My name being Richard, but was affectionately called Dickie."Of course they wanted you, your dad didn't want to be drafted into the war, but you wee late and failed in your mission and they have been holding it against you ever since." Stupid me I thought! I began living on my own at age fifteen, working full time in an electronics factory after lying about my age. Had to leave that job after being injured and found out I wasn't of age. I went back home, but that was short lived, it was back to juvenile. Upon leaving J.H. I begged I not be sent back to my parents, however the law being what it was, there I was again and after only two week coming in around 10pm after being out, my parents woke up with my mom demanding the key to the house, "Why I asked." Give me the G.D. key to the house she yelled, so I handed it to her and upon doing so, she spit in my face and pushed me out the front door. I believe I have provided enough for you to see some of the abuse I endured, I could fill pages, but will leave it here. I am thankful to have found your information, as I always thought there had to be a reason why I am unable to just drop this bag of garbage on the curb and forget about it. Thank you for your work, I am hopeful society would wake up and see not all who act out are bad, matter of fact, I have met some of the best hearted people behind those tall gray walls, and cells over crowded unjustly, that's not to say I have not also met some of societies worst as well, but who can say if those were shown they were loved and valued where they might be today.If not for my grandparents who always showed me such, I would be only in one of two places, that being in prison or dead, no two ways about it. May I conclude by saying, at one time I had as many as forty three jobs in a period of eighteen months, you name it, I did it. Married at eighteen, had three boys by age twenty one. All my jobs were dead end ones, some lasting an hour some not so long, others weeks, byt those not many. Lived in the housing projects for three years, then after being placed on disability for three years after being beat up, suffering a severe head concussion,losing my drivers licenses I bought myself a used 35mm film camera and a police scanner and taught myself the rudiments of photography and started peddling my 8x10 B/W photos up and down the central cost to what ever newspapers would buy them. After two years I landed a job a daily newspaper, where I cut my teeth in the news photography business. In shot, I have worked for three newspapers, two of which I became chief news photographer/picture editor, worked for United Press International as a stringer, transmitting pictures from my home over a photo transmitter worldwide. Was a news cameraman/editor for a CBS affiliate and bureau chief for Newsreel Video out of Los Angeles, covering northen Santa barbara and San Luis Obispo Counties for all the L.A. T.V. Stations as well as CNN. Was also a cameraman for the reality T.V. Show, Bounty Hunters, "No, Not The DOG! If you would care to see some of my work you can go too Also new law in the law books on a case the California State Supreme Court ruled on and cleared for publication under discovery. Under, Bastian vs County of San Luis Obispo CHILD ABUSE, THE INVISIBLE DISABILITY

Child Abuse

Wayne Greene

7/17/2018 10:45:07 PM

Thank you for such a well written article. I was a victim of extreme physical and psychological abuse as a child. I never realized how many of my problems can be traced to those early experiences. I did not understand that without realizing it, I was doing things that were helping me to heal; music, finding spiritual meaning, community involvement, etc. And I lucked out to find loving friends at an early age who helped me overcome extreme fear and inadequacy. Now that I am at the end of my life I realize how lucky I was to partially overcome all of this and at least lead a half way normal life.

childhood trama - abuse

Lilly Smith

5/8/2018 10:45:36 AM

So what are the options for an adult working hard to overcome the patterns and impact of damage caused by this. Logically I know why and how but it is not easy to change some distrust and negative patterns when dealing with people. Forgiveness of myself and others is not easy. How do you just let it go all the negative self image, shame, worthlessness, and start to be confident without the struggle of it changing every day or minute by minute.

abused by medication since age 13 now 34 and found out I dont have any mental illness


4/16/2018 10:01:30 AM

I am dealing with alot I am finding out I have no bipolar at all I was drugged on pretty much every type of drug since I was 13 years old. 16 pills for a long time of my life. Abuse of very much taking total adantage of and I am just trying to get on with my life. My head is hurting right now getting off the meds. I am mentally good but it is bad. The abuse is bad and I don't know if I will ever be right. My parents took total advantage of me and to control of my life. Even had a doctor say I was mentally retarded and put me in DD program with the governemnt and I am fighting them in probate court. I filed abuse charges but to say the less from what I am seeing I will not ever be right.

Trying to understand why

Carol Molina

2/9/2018 11:52:29 AM

I found this article after trying to find out why I have so much anger and hatred at times for apparently no good reason. I was sexually abused by my biological father from the age of 9 to 13. I basically seem to have these what I call "uncontrollable meltdowns" every year where I think a boyfriend is out to get me, hurt me. I seem to have an uncontrollable, over reaction to the slightest thing that I interpret as betrayal. And then I am fine the next day, and don't know why I got so upset. This behavior has prevented me from having a "happy" relationship with anyone. Most times even if I repress the anger, the boyfriend has no idea that I have these thoughts of anger, betrayal, and as your article says, which I didn't realize until I read your article, that I am vilifying my boyfriends for no reason. They don't do anything, it's my reaction to things that normal people wouldn't get upset about, or it's my perceived ideas of what they might be doing to me. Im 56 now, and have had too many tumultuous relationships. I am too broken to relate to most people. I have some acquaintances, but no close friends, I am "trying" to have a relationship again, but as usual problems arise from my neurotic and angry episodes, so I withdraw and become aloof again. I'm hoping if I keep referring back to this article it well help me recognize when I'm about to go into another "episode" and how to stop it before I cause more damage to my relationship and friendships.



11/3/2017 4:46:23 PM

I am 56 year old female who experienced sexual abuse and physical abuse by a male sibling at an early age. He is 15 years older than me. I started becoming aware that my abuse was surfacing after I was diagnosed with breast cancer six years ago. Underwent bilateral mastectomy and ovary removal. During this time I could not take any hormone replacements. The spiral kept happening until presently the feelings of anger, fear, resentments come out. I am married 33 years and due to this issue being brought out I am being diagnosed as Borderline personality disorder. Also, PTSD. This state I am in is very difficult. My husband refuses to believe this ever happened. I am a liar. What I go through is very terrifying and nonsensical to others. This article is truly a message to me to find those professionals out in this world who understand this and can help with diagnosing, and not treating me as a patient who looks treatment resistant because the psych drugs don't work. I am frustrated, humiliated, ashamed and am loosing my family. I would appreciate any comments. I live in California. Thank you.

So what's the solution?


8/17/2017 10:24:30 AM

I've spent most of my life, from high school to my 50s dealing with so much of this. I've been on a variety of depression meds since my 40s, which helped when I was in the worst moment of life and constantly crying. But they haven't addressed the issue. I've been through too many relationships, very promiscuous. I've fantasized as long as I can remember. I've always been emotionally numb, I find it hard to feel anything for other people's problems. I've always been an emotional eater, very easily irritated at myself, others and even something as simple as a bad hair day. I typically feel stressed, and have a lot of anxiety at times, everything seems life or death...being late leaves me not wanting to even bother going somewhere. I cry over little things, sometimes over nothing at all. I cry when other people are crying. I can go to a stranger's funeral and burst into tears and want to run out. Confrontation leaves me shutting down, throat tightens, I try to keep from crying in front of the person, determined to avoid them from then on. I cried reading this article, and I'm crying writing this. I wasn't like this until maybe 20, and interestingly around the same time, in a heated argument with my mother, I blurted out the sexual abuse from my uncle. Her response wasn't empathetic, like a parent would usually be. Instead she defended herself as if I was accusing her of something rather than trying to finally get a mother's concern. I can't remember my life til after the age of 10, ironically, right after we moved to another state. I remember bits of the last encounter with my uncle. Years later, I spoke with my brother about it, and he said he'd wondered because, even being younger than me, he recalled some odd behavior between me and my uncle on some occasions that I don't remember anything about. I didn't really get to a point I could talk about any of this until about 40, which, when talking with a couple aunts, is when I found out I was in an elite class of abused cousins dealing with PTSD and other issues. And blood ran thicker than water. We just didn't discuss uncle ________. And for the most part, some would blame it the kids or claim we were lying. Those that did know it was happening thought he may have been molested by a neighbor when he was young. In talks with one cousin, I discovered why I behaved in a certain way, because of how he'd molested us, that I still can't remember. Her reaction to it differed from mine but she can remember the details. These lost memories have always left a hole, with therapists saying it might be better not to remember. Better than what? Losing every memory of your dad since every memory under 10 is gone? Every memory of school friends, etc.? After several therapists and talks with family, I've at least began having spurts of happy memories. It's better than years of the same nightmare every night. All this was during my parents divorce, which left it's own scars that I didn't realize til in my 40s, when I again had a blowout with my mother and in anger, I asked why she hated me so much. She quickly came back telling me how I'd rebelled at the bus station while she was leaving my dad. For years, she'd held a grudge over an 8 yo throwing a fit over losing her father. She'd spent a lifetime ignoring any of my straight A accomplishments while praising everything my brother touched, regardless of him failing school, even going against my privacy in order to to sneak him something of mine he wanted while I was asleep. After the divorce was over, we moved in with my grandparents and mom was quickly with another man, who made passes at me. He never acted on these, but would try to coax me. Three years of this before he got saved and it stopped. When I turned 18, I came to a point of nowhere to go and ended up moving in with my uncle, who was married now. I was no longer a child so figured I'd be ok...until he tried to physically rape me. That's when I first realized he may have molested others since he tried holding me down and said he'd cut my pants off just like he did ________s. Thankfully my aunt got home early. I pleaded with my parents to pick me up. Mom didn't want to. Thankfully my stepdad talked her into it. I never told them why I begged them to get me until I blurted it all out to mom a couple years later. In the midst of it all, I was born with heart defects and spent my first 5 years in and out of the hospital until they decided it was stable. That stability lasted til I was 11 and had to have open heart surgery. The end result has been a basket case. And no one has any solution other than to throw a bandaid of pills at it. Very little hope I'll get any help from these studies.

Wounds that time won't heal(3)


6/7/2017 1:05:45 PM

Thank you for this. I've been trying to research and help myself for many years. I even have a Master's in Counseling - but sadly realized I can't be my own counselor. I am officially diagnosed Attention Deficit (without the hyper part), have had an eating disorder for many years, have struggled with depression and a suicide attempt as a young adult, often rock back and forth and always have (in private), have features of autism (like the frequent need for stimming), and only recently have discovered that I'm the scapegoat in a family with a narcissistic mother and extremely abusive stepfather, which resulted in a substantial amount of abuse and trauma, and that I am only able to focus on my work if playing certain ASMR videos (of certain kinds of chewing) or after having my hair braided/curled. Of course, I have no money for therapy and even if I did there is no one qualified to work with my problems locally (I tried it with a sliding scale place locally and found that by my third session we spent half of each session reviewing her notes from sessions prior to re-familiarize with who I was and why I was I decided, never mind, I'll just figure it out on my own) ...BUT I thank those who care enough about the abused to study this material and help us. Although it may be too late for me to have a normal life (I'm 45 now, so yeah), maybe it can help others.

Wounds that won't heal(3)

Peter Burridge

5/18/2017 9:24:49 AM

Thank you for this. I've had a quick scan through and I can personally see connections to my own childhood. Things like verbal memory and dissociative symptoms are spot on. I am undergoing assessment for BPD. I was born 8 weeks prematurely weighed 2lbs. In 1954 I wan't expected to live. I spent 6 weeks in an oxygen tent with little physical contact. I believe that this, and other issues that arose, like undiagnosed ADHD and attachment disorder, was key. I also suffer Misophonia to the sound of plastic being flexed.

Wounds That Time Won't Heal(2)

Grahame King

4/21/2017 12:15:27 PM

Super article that covers all the brain abnormalities that Dr Arthur Janov has observed and written about for decades. He has been treating epileptics and ADHD cases etcetera with many successes.

Wounds That Time Won't Heal(1)

Jo Ann

1/30/2017 9:53:41 AM

As I am processing the empirical evidence of altered brain development/function offered in your study along with the associated symptomology, I am literally seeing the parade of victims in my family that suffered physical abuse, sexual abuse, and abandonment. Although each of us has developed coping mechanisms, each of us has also demonstrated a myriad of disorders both physical and psychological. This is literally the first time I have seen a neurobiological explanation for the brain alterations that can result in a lifetime of internal struggle! The portion of your article that reads "Whether abuse of a child is physical, psychological, or sexual, it sets off a ripple of hormonal changes that wire the child’s brain to cope with a malevolent world. It predisposes the child to have a biological basis for fear, though he may act and pretend otherwise. Early abuse molds the brain to be more irritable, impulsive, suspicious, and prone to be swamped by fight-or-flight reactions that the rational mind may be unable to control" rings hauntingly true! However, I do believe in the phoenix effect, in the brain's compensatory abilities, and in the hope that new techniques such as EMDR provide. Yes, absolutely, prevention and early intervention in child abuse should continue to be a primary focus. But I can also say that it seems as if there is a mighty gulf between the stakeholders in this game...I am so grateful to finally understand the basis for my hyperalert and panic disorders but do not understand why there isn't better communication of both the science and best-practice therapies. My plea is that this body of evidence would run up the flag pole to fly as the banner for all to see! This feels less like a "wound that time won't heal" when the neurobiology alterations and deficiencies are mapped out so clearly...sort of like a "You are Here" marker. I found myself almost yelling, "Well, no wonder!" If you have additional recommendations of resources, please share!


Joe Gormley

1/26/2017 10:08:43 AM

A fascinating article. However the last line of the first paragraph that is entitled Dealing With The Damage is as disheartening as the title of the piece. This is the line that would imply the improbability of the ability to reverse childhood inflicted damage in adulthood. Albeit I'm a mere layman I have great faith in the powers of neuroplasticity to repair flaws, if not directly in say modifying the size of regions of the corpus callosum but in building triggers to new pathways to address the effects of the damage.

wounds that won't heal(2)


10/23/2016 2:06:49 PM

thank you for a wonderful article. It all makes sense. Why is there so much child abuse in our soceity? Why are we so afraid to look at the truth? We need to invest heavily into prevention and treatment solutions for the victims. The offenders need to be punished. Forgiving will not heal the wounds. Self love and meditation will.

wounds that won't heal(1)


10/17/2016 9:24:15 AM

I want to thank you for this article and great information. Someone who was in these child hood situations like myself never understood why as an adult I have so much anger pent up inside me. I went to a family Dr. 15-20 yrs ago and he said i was suffering from manic depression and tried the meds with a sleeping pill for insomnia, unfortunately the hallucinations and other side effects had me flushing the pills and trying to cope on my own. I'm now 47, keep to myself as much as possible because you can't explain to people why your so angry, or crying, or silent. So thank you again, it's not all in my mind, and i don't have to feel guilty for not having a good relationship with my mother.

Wounds that won't Heal

Alex Estrada

6/9/2016 10:32:16 AM

I have not read the entire article yet, so I apologize if my comment is addressed later in the article. As a psychologist, I never understood the reasoning behind creating a technical term, like "childhood sexual abuse," for what is essentially "rape." In my opinion the term "Childhood sexual abuse" puts too much focus on the sexual aspect of rape and further stigmatizes the social view on sexuality. I am also curious to learn if consideration is taken to determine whether the trauma is caused by the childhood sexual experience or if the trauma is caused by the social reaction to how the situation is handled, addressed and resolved. So far I have not read in the article if gender plays a role in how the child receives support because boys are much more vulnerable to social trauma than girls. This is one of my reasons for believing we need to address the issue of "childhood rape" instead of "childhood sexual abuse." My point is, the field of Psychology appears to be mishandling the issue of childhood sexuality in order to meet the double-standards of a predatory society that criminalizes sex as a vehicle to commit crime. A child does not become a victim until it learns it's been victimized by an adult other than the one that initiated the abuse. This is where it becomes extremely critical to determine how "childhood sexual abuse" is defined because if the experience was positive, meaning if the child was not violently raped, then the trauma is not being caused by the abusing adult, but by the social response of the non-abusing adults. If we approach the situation from the child's perspective and not from our perception of what the child 's perspective should be, we could prevent damaging that child for the rest of it's life. The problem is, children under the age of 18 are not given the legal right to "say no" and 71% of victims are abused by a parent or guardian, yet society is afraid of strange men dressed as women using women's restrooms. Moreover, if sex were only harmful to humans, humans would be extinct. Therefore, we cannot put blame on sex alone. Unfortunately, without victims there are no patients without patients there is no funding.

Wounds That Time Wont Heal - Thank you for this article(1)


2/22/2016 9:55:35 AM

Phenomenal article and research. I am grateful to have found this article and also my introduction to this site.. And thank you commenters, I am eager to check out the video posted. I have one substantial bone to pick and that is the prevalence and continuance of the idea that cognitive disorders somehow could "cause" a child to become a victim of sexual abuse. All I can say is, nothing a child does will causes an adult abuser to molest or rape them, if they weren't already willing, looking, and capable of doing so. Not many of us. Are there sick adults who hunt for prey among children? Yes However, I don't know that they go after just any child with any cognitive disorders. I suspect child predators look for the specific pattern in the child's behavior, I've watched a documentary on a sex offender who described how he picked his victims. Has work been done to research how these cognitive disorders may be passed on? If a Mother has these brain disorders can she pass it on to her children? I feel like for fact, she can however is it through heredity or suppressed development? I suspect it will be suppressed development and often with a lifestyle pattern repeated , as I can see myself in this article, but also my Mother in a more mentally ill way. My mother repeated the pattern of her childhood, so I too was subject to infant sexual abuse by my father and my grandfather. I would hypothesis related cognitive disorders like borderline, dissociative disorder with specific brain study could be linked to the lack of development (almost like scar tissue). I even wonder if this is how EMDR has worked for me, perhaps clearing cross hemisphere pathways of communication through scar tissue?

Wounds That Time Wont Heal - Thank you for this article


2/22/2016 9:55:12 AM

Phenominal article and research. And thank you commenters. I have one bone to pick and that is the prevelence of the idea that cognitive disorders somehow "cause" child sexual abuse. All I can say is, nothing a child does will causes an adult abuser to molest or rape them. Are there sick adults who hunt for prey among children, it sounds like it. However, I don't know that they go after just any child with cognitive disorders. Also has work been done to research how these cognitive disorders may be passed on? I can see myself in this article, but also my Mother in a more mentally ill way. So perhaps if there is ANY chance these same cognitive disorders did not stem from acute childhood trauma (I would believe certain cognitive disorders.. borderline, disassociative disorder, etc with more specific brain study could be very much linked to the lack of development (almost like scar tissue).

thank you


7/27/2015 9:16:52 AM

I've been going through this. Physical and emotional then ongoing emotional abuse. I was trying so hard to understand what's wrong with me. I have had depression a long time and I am only 25. I have a hard time remembering my past. Even as a child I did so kept a journal. I found them and now I remember the worst of it. I'm just now realizing how abused I was because I would never think back to these things. This helps me better understand myself too.

Physical Brain Effects

Lindy Abbott

7/9/2015 10:22:20 AM

This is an excellent article that explains that problems that adult survivors of child abuse have are truly physical but within the BRAIN. So many times if someone cannot SEE the illness they do not believe it is really there. I appreciate the work that went into the article and look forward to sharing it with others who have been through abuse and are adapting to functioning in adulthood.

A compelling synopsis


7/6/2015 8:40:58 AM

Martin, thank you for this. I am a psychology PhD who has also been 'chasing' understanding of my adult journey following childhood events. Im sure you can appreciate how unsatisfactory normal psychiatric assessment and treatment has been for me, knowing these approaches just never seen to get close enough to the real root of my cognitive-behavioural pattern. I should add that personal counselling from a family therapist has been very effective in helping me to virtually eliminate self-distructuve behaviours and impulsivity and also psychodynamic work on 'freeing' the little boy emotionally 'stuck' as a fearful, vigilant seven year old. I have also found sertraline helpful in social settings. I had recently begun to give up and actively tell my partner I should just, "get over it" which I dislike for it's sense of defeatism. However, a counsellor this week encouraged me to read up on neurological research. I'm so glad I found this page. On one hand it obviously isn't prescribing any specific course of therapy (and rightly so) and is a lot of complex material to digest. However, for me it a) permits some comfort from understanding and b) a way to approach coping, resolution and maybe healing in a more focused way. For example, I'm just going to have more hugs! I applaud you for the moral and ethical arguments here: I personally believe psychology should be for the betterment of the individual and society. While a massive undertaking, wouldn't it be wonderful to monitor and prevent early rather than treat the consequences later! I wish you all the very best with your research and practice. Thank you again, Kindest regards G

Correlation between childhood abuse and psychological problems, addicitons

Martin Jost

1/15/2015 10:30:53 AM

I've put together a video that also shows a correlation between childhood abuse (cause) and psychological problems (anxieties, depression, PTSD, addictions ...) as this article. I'd like to share it as my artistic/poetic contribution to all people in recovery from any kind of trauma ...

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