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12 Long- And Short-Term Effects Of Child Abuse

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Updated September 29, 2023by BetterHelp

Content Warning: Please be advised, the below article might mention trauma-related topics that include abuse which could be triggering to the reader. If you or someone you love is experiencing abuse, contact theDomestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

The effects of child abuse and neglect can be serious and detrimental, both short-term and long-term. It can be important to recognize the effects of child abuse and neglect and to report possible mistreatment whenever you see it. People who have been mistreated may also face a greater risk of becoming harmful to others later in life, although many people who were once abused move on to become careful, kind, and productive part of society. If you survived childhood abuse and are still experiencing negative effects, therapy with a licensed mental health professional can be beneficial.

If you or someone you know is witnessing or experiencing any form of abuse, please know that help is available. You can call the National Domestic Violence Hotline anytime at 1-800-799-SAFE (7233). 


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You Can Overcome Adverse Childhood Experiences

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Content/Trigger Warning: Please be advised, the below article references trauma-related topics that may potentially be triggering.

Effects Of Child Abuse And Neglect: Potential Long-Term Consequences

Long-term consequences of child abuse and neglect can be physical, psychological, and behavioral. The following may occur after mistreatment:

Health Problems

While some long-term effects of child abuse and neglect can occur instantly, such as brain damage from head trauma, other effects may take months or even years to become detectable. Survivors of abuse may face a higher risk for a variety of long-term or future physical health problems, including:

  • Malnutrition
  • High blood pressure
  • Arthritis
  • Cancer
  • Bowel disease
  • Diabetes
  • Heart disease
  • Lung problems

Survivors of mistreatment and neglect may also be at risk for the effects of stunted or improper brain development. Regions of the brain, including the amygdala, which typically plays a large part in processing emotions, and the hippocampus, which can be critical for learning and memory, can be negatively affected by child abuse and neglect. However, with the help of treatment and intervention, it can be possible to help these areas of the brain recover.

Substance Use Disorders

Children of parents with substance use disorders may face a greater risk of experiencing abuse or neglect. Abuse, in turn, can increase their risk of turning to various substances as coping mechanisms when they grow older. 

One long-term study that followed survivors until they reached age 24 found that experiencing physical abuse during the first five years of life can be strongly linked to developing a substance use disorder later in life.

Juvenile Delinquency And Criminal Acts

According to research funded by the National Institute of Justice, those who are neglected or abused as children may be more likely to develop antisocial behaviors, which can include criminal acts and juvenile delinquency, and may choose to associate with others who also display these antisocial tendencies. 

Psychological And Behavioral Issues

Experiencing abuse and neglect when you’re young can also be a risk factor for developing psychiatric disorders, such as:

  • Depression
  • Anxiety
  • Post-traumatic stress disorder
  • Anorexia or bulimia
  • Behavioral disorders

Research on childhood trauma and its effects on the brain suggests that stunted or impaired brain development from abuse may play a part in the potential development of these disorders.

Impaired Cognitive Skills And Executive Functioning

Child abuse and neglect can disrupt brain development, potentially resulting in the impairment of the brain’s executive functions. These functions may include working memory, self-awareness, planning, and problem-solving. This damage can result in:

  • Learning disabilities
  • Poor grades
  • A higher chance of dropping out of school

These short-term effects can sometimes have a drastic impact on a child’s future.

Direct And Indirect Costs To Society

Abuse and neglect can have far-reaching consequences that often do not stop at the person who is or was abused. Society, as a whole, can be affected by childhood abuse.

In 2015, the Centers for Disease Control found that the total lifetime economic cost of child abuse and neglect generally added up to $428 billion. Direct costs, such as hospitalizations and foster care payments, and indirect costs, such as long-term care, like therapy and medication, factored into this total.

Child Mistreatment And Neglect: Potential Short-Term Consequences

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Depending on their age, children who experience abuse and neglect can respond to it in a variety of different ways. Preschool-aged children or toddlers may start bed-wetting and displaying signs of severe anxiety. Elementary school kids might have low grades or very few friends. Some teenagers might experiment with substances or fight with their families, though these aren’t always signs of abuse or neglect.

Depression And Anxiety

Children of any gender or age can experience depression and anxiety as a result of abuse (or unrelated to abuse). Feelings of guilt and anger may also be common, especially among adolescent survivors of abuse.

Altered Sleep Cycles

Those who are abused as children may also experience altered sleep cycles. Nightmares, sleep disturbances, and hypervigilance can contribute to their sleep problems. These symptoms typically occur in preschoolers, but can occur later in life as well, especially if PTSD or anxiety are present.

Regressive Behavior

Regressive behavior can occur when a child regresses to an earlier developmental stage emotionally, socially, or behaviorally. Wanting a bottle or pacifier after they have already been weaned off them may be one example of regressive behavior. Age regression can occur in people of all ages. 

Separation Anxiety Disorder

Preschool-aged children may develop separation anxiety disorder as a result of abuse and neglect. Symptoms of this disorder can include constantly shadowing a caretaker around the house, as well as stomachaches and dizziness in anticipation of separation.

Low Self-Esteem

People abused as children may develop low self-worth. They may internalize the abuse and believe they caused or deserve it. These feelings of incompetence and shame can carry into adulthood and become long-term effects of child abuse and neglect.

Risky Behavior

Teenagers may start to engage in unsafe sex or start misusing substances as a result of abuse or neglect from loved ones. They may also start fights in school or bully others.

Possible Signs Of Mistreatment In Children

Many people abused as children feel afraid to tell someone about the situation. This may stem from shame or confusion. It could also occur if the abuser is a parent or trusted adult. That’s why it can be so important to remain aware and alert for signs of child abuse in anyone under your care.

Common red flags of physical abuse, sexual abuse, emotional abuse, and neglect may include:

  • Unexplained injuries
  • Sexual behavior or knowledge that is inappropriate for their age
  • Depression
  • Low attendance in school
  • Poor hygiene

You may also notice disturbing behavior from the children’s parents when they are around. This can include verbal abuse, a lack of concern for their children’s well-being, and even physical abuse. While child health experts generally condemn the use of any kind of violence, some people still use corporal punishment to discipline their children. 

Types Of Child Abuse

Child abuse can take many forms. Some of them may even occur at the same time. They may include the following:

  • Physical abuse: Hitting, punching, and choking can be several examples of physical abuse. Anything that puts a child in harm’s way or that is meant to physically injure them is typically considered physical abuse.
  • Sexual abuse: Sexual abuse generally includes any form of sexual activity with a child.
  • Emotional abuse: Emotional abuse, such as verbal assault or ignoring a child, can negatively affect self-esteem and emotional well-being.
  • Neglect: Failing to provide adequate food, shelter, supervision, education, or healthcare is normally considered to be child neglect.

Prevent Child Abuse And Neglect

As a parent, you can work to prevent child abuse and neglect by ensuring that your child is always nurtured and looked after. As a friend or a relative, you can help babysit or look after children in your life and keep an eye out for any of the potential signs of abuse discussed above. 

You can also get involved in the local community by developing parenting resources at the local library, asking leaders to create services to meet the needs of different families, and volunteering at child abuse prevention programs.If you believe a child has been abused, please seek help for them immediately. You can contact the child’s doctor, the local police department, or the 24-hour Childhelp National Child Abuse Hotline at 1-800-422-4453. The National Child Abuse Hotline can give you information on support resources, emergency services, and social assistance.

A teen is sitting on a couch and looking at a cell phone screen; she has her feet up and a worried expression.
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Seeking Professional Help As An Adult Survivor Of Childhood Abuse

If you experienced abuse as a child, it may be beneficial to seek professional help so you can address any long-term effects you may be experiencing. Both in-person and online therapy can be valid options for treatment.

You may feel more comfortable trying online therapy, as you can attend sessions from home at a time that fits your schedule. When discussing vulnerable topics like abuse, it can be helpful to be in a familiar place where you feel safe and comfortable. In addition, you can choose to speak to your therapist via phone call or online chat if a video call feels too intimidating.

Although there isn’t yet much research regarding the efficacy of online therapy for adult survivors of childhood abuse, studies show that, in general, online therapy tends to be just as effective as in-person therapy. Please don’t hesitate to reach out for the help you deserve.

Takeaway

Child abuse and neglect can result in a variety of short-term and long-term consequences. In the short term, some of the effects children may experience can include depression, anxiety, altered sleep cycles, regressive behavior, and low self-esteem. In the long term, those who survived childhood abuse may experience health problems, develop substance use disorders, and live with impaired cognitive skills and executive functioning.

If you believe a child in your life is experiencing abuse, please help them by contacting the Childhelp National Child Abuse Hotline at 1-800-422-4453. Meanwhile, if you are an adult survivor of childhood abuse, you might consider reaching out for help with any long-lasting effects through in-person or online therapy.


RETRIEVED https://www.betterhelp.com/advice/abuse/12-long-and-short-term-effects-of-child-abuse/

NOTE While contacts of this page may be foreign, the overall aim of it is supporting therapy. If you can’t find what you’re after, send a message?! CARC contacts.

How Childhood Emotional Neglect Can Show Up in Our Adult Life

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By 

Wendy Rose Gould 

Published on August 18, 2023

 Medically reviewed by 

Yolanda Renteria, LPCPrint 

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Table of Contents 

While everyone may perceive neglect differently, emotional neglect in childhood generally refers to when a child doesn’t experience emotional security or support from their guardian figures. Our emotions may have been completely ignored or invalidated—purposefully or unconsciously—or we might have been explicitly shamed for expressing our feelings.

Emotional neglect is considered a form of trauma, as it can have long-lasting and profound effects on a person’s emotional and psychological well-being.

— DANIEL RINALDI, MHC

This form of neglect can occur when a caregiver is not present, but when they are present they are emotionally unavailable, if the parent is ill-equipped to handle childhood emotions, or if the parent is purposefully dismissive. 

“Emotional neglect is considered a form of trauma, as it can have long-lasting and profound effects on a person’s emotional and psychological well-being,” says therapist Daniel Rinaldi, MHC. He adds that chronic emotional neglect can shape our emotional landscape as adults by affecting our self-esteem and impacting our interpersonal relationships. 

Ongoing childhood emotional neglect is a form of child abuse and can lead to lasting trauma. This trauma can make it hard to develop a healthy relationship with others and with ourselves. We might even engage in self-sabotaging behaviors.

Therapy can teach us how to properly identify and label our emotions so that we can deal with them in a healthy way and begin to truly heal.

 Characteristics and Effects of an Uninvolved Parenting Style

How Do I Know If I Was Emotionally Neglected as a Child? 

Raising children is highly nuanced and inherently difficult; there’s no doubt that our parents or caregivers made mistakes along the way. However, chronic emotional neglect is not the norm, and its ripple effects follow us well into adulthood. 

“Emotional neglect can be hard to spot because it is not always visible—even to a professional,” says Aurisha Smolarski, LMFT, founder of Cooperative Coparenting. “It is also hard to spot because it tends to be based less on what a parent does and more on what they don’t do.” 

Smolarski says that emotional neglect can be either intentional or unintentional, or even unconscious.

Some parents emotionally neglect their children because they’re uncomfortable with emotions in general and are unsure of how to respond to the complex feelings a child experiences. 

Other parents are too overwhelmed with the stress in their own life—including struggles with addiction, work-life balance, child-rearing, and mental health issues. Smolarski also notes that parents who experienced abuse or neglect themselves may be more likely to neglect their own children.

What Are Some Examples of Childhood Emotional Neglect? 

Here are some signs of childhood emotional neglect. This isn’t an exhaustive list, but it provides a general idea of what emotional neglect looks like:

  • Punishment for expressing negative emotions like sadness, frustration, or anger (e.g., being told to go to your room or be quiet)
  • Lack of shared celebration or joy when experiencing a positive emotion like happiness or excitement (it might even present as zapping the positive emotion with a negative response)
  • Being told your feelings or experiences aren’t valid or worth further examination (example phrases might include “You’re too sensitive,” “Stop acting like a baby” or “Don’t worry about it.”)
  • Dismissed or ignored feelings because the parent is focused on themselves or another situation 
  • Withholding or not showing affection, whether it is explicitly requested or not
  • Failure to intervene or find a solution in situations when a child is under emotional stress
  • Not acknowledging difficult emotions like grief after losing a pet or embarrassment after being bullied (often because the parent struggles to recognize or process these emotions themselves)

 I Hate My Mother: What to Do When You Feel This Way

How Does Emotional Neglect in Childhood Affect Us as Adults? 

Those of us who were emotionally neglected as children often develop behavior patterns or coping mechanisms. Any of the following might be indicative of emotional neglect in childhood.

Emotional neglect can be either intentional or unintentional, or even unconscious.

Difficulty Expressing and Processing Emotions  

Childhood emotional neglect can cause us to avoid emotions all together in adulthood. We may struggle to identify our feelings or find it difficult to process big feelings.

There might also be a general sense of “numbness,” which is ultimately a form of self-protection. Smolarski adds, “They may choose to leave a relationship or situation instead of asking for something they need because that feels safer than the risk of rejection.” 

They may withdraw or isolate from social or peer groups because they feel different and because they fear being asked to talk about how they feel.

— AURISHA SMOLARSKI, LMFT

People-Pleasing Tendencies 

On the other side of the coin, Smolarski says that if we’ve been emotionally neglected as kids, we might end up becoming the “caretaker” or “burden holder” of our friends and family.

Essentially, addressing other people’s emotions and needs allows us to feel worthy, loved, needed, and good enough. This can backfire if we end up focusing so much on others that we fail to prioritize ourselves. 

 Boundaries in Relationships and Stress

We May Have a Super Hard Time Trusting Other People 

Sometimes it feels safer to put up walls so that no one else can get in and potentially hurt us. We’re simply trying to protect ourselves.

So, if we’ve experienced pain in the past we might end relationships the moment we feel threatened or avoid relationships completely.

Vulnerability and opening up to other people may feel scary too which limits the ability to connect with others. “They may withdraw or isolate from social or peer groups because they feel different and because they fear being asked to talk about how they feel,” Smolarski notes. 

She adds that some might even self-sabotage their relationships to avoid feeling abandoned, rejected, or neglected. And those who find themselves in close relationships may struggle to access or voice their own emotions, which can negatively impact the relationship. 

Our Self-Esteem May Take a Hit 

Rinaldi says that chronic childhood neglect can often cause people to have low self-worth. If our self-esteem is low, we might write off our own emotions or even let people walk all over us.

Low self-esteem may also cause struggles with self-compassion and self-love.

We May Try to Cope in Some Not-So-Healthy Ways 

In some cases, childhood emotional neglect can present with poor coping techniques as an adult. Bonnie Scott, LPC-S, founder of Mindful Kindness Counseling, says this is often because people who’ve been neglected have trouble trusting their own experience of emotions and needs. 

“They may meet those needs in maladaptive ways, like becoming codependent on people who aren’t good for them or showing people-pleasing behaviors to keep people around,” Scott says. They might also rely on drugs or alcohol to get them through a difficult emotion or become addicted to shopping, porn, online usage, risky sex, or food.

How Emotional Neglect Causes Trauma 

Rinaldi says that emotional neglect can impact someone’s life—even if it occurs only once or twice—though it is even more profound and complex when there’s a chronic pattern extended over a period of time.

Ongoing Neglect Is Child Abuse 

Ongoing emotional neglect is considered a form of child abuse. According to the U.S. Department of Health & Human Services, it’s a traumatic experience that, if severe or continued over a long period of time, can affect a child’s development.1

“Trauma can cause changes in the brain and nervous system that in turn lead to difficulty expressing emotions, lower self-esteem, shame, or guilt,” Smolarski says. “Children suffering from the trauma of neglect can have behavioral issues at home and in school and may struggle to form and maintain relationships in childhood and as adults.” 

More severe neglect can lead to substance abuse, the tendency to engage in risky behavior, and long-term mental health issues, such as depression, anxiety, and post-traumatic stress disorder (PTSD).2

 How Trauma and PTSD Impact the Brain

Healing From Childhood Emotional Neglect 

If you experienced childhood emotional neglect, know that you’re not alone. So many of us have survived this kind of abuse.

Making the effort to heal this wound is a sign of bravery, and can be done at any age.

— AURISHA SMOLARSKI, LMFT

Fortunately, healing is possible. There’s so much room for personal growth and a pathway to improved self-worth. Trust and emotional intimacy can be learned over time with patience and a strong support system. We can have and deserve fulfilling relationships.

“Remember that there is nothing wrong or bad about you or your emotions,” Smolarski says. “We all have emotions. It’s just that you didn’t have someone to reflect them back to you, to teach you that your emotions are welcome and valid, and to help you regulate them. Making the effort to heal this wound is a sign of bravery, and can be done at any age.” 

Therapy Can Help 

She adds that this process often requires professional support, such as therapy. Therapy allows us to explore past experiences, process unresolved emotions, and develop healthier coping strategies and communication skills.

In therapy, we can learn how to identify and label emotions accurately, develop self-compassion and self-acceptance, and figure out how to set and maintain healthy boundaries.

“Outside of professional settings, individuals can prioritize their emotional well-being through various self-care activities, such as engaging in activities that bring joy and fulfillment, practicing mindfulness and meditation to cultivate self-awareness, and journaling to express and process emotions,” Smolarski adds. 

 Learning Brain vs. Survival Brain: What’s the Difference?

By Wendy Rose Gould 
Wendy Rose Gould is a lifestyle reporter with over a decad

RETRIEVED https://www.verywellmind.com/childhood-emotional-neglect-in-adulthood-7568040

Taking care of yourself (or a loved one) when sexual abuse makes the headlines

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ABC Everyday 

By Grace Jennings-Edquist and Sana Qadar

Distressed woman looking at her phone with a dark storm cloud looming around her to depict how traumatic news impacts people.
For survivors of childhood sexual abuse, reading details of crimes can provoke a wide range of emotions.(ABC Everyday: Luke Tribe and Juliette Steen/Unsplash: John Tuesday)

For survivors of childhood sexual abuse, reading the details of the crimes can provoke a wide range of difficult emotions.

Some will feel vindicated and relieved that action is being taken, but anxious as the matter makes its way through the legal process, says Hetty Johnston, executive director of child protection advocacy organisation Bravehearts.

Others may be triggered by reading details of the abuse.

“For many survivors, they may have witnessed other people actually not make it to today as a result of what’s happened to them,” adds Tarja Malone, who manages the helpline at the Blue Knot Foundation, which supports adults impacted by childhood trauma.

“Sometimes there’s a lot of grief and loss for those who haven’t made it to today as a result of the abuse they’ve endured.”

If you’re feeling emotional after reading coverage of sexual abuse — or you’re supporting a loved one in that situation — there are several things these experts recommend.

Limit media

Whether it’s social media or the news, “it’s good advice for people to limit how much media they digest around this if they’re feeling triggered,” says Ms Malone.

If you’re feeling panicky or anxious, don’t feel “compelled to keep digesting information about it over and over again”.

If you or anyone you know needs help:

When you see details of child sexual abuse in the news, actively deciding not to read the details of the crime might prevent you from feeling overwhelmed, explains psychotherapist Rita Barnett, who has worked with survivors of sexual violence.

“If you do read the details, try not to picture it or use your imagination when you’re reading the words; just try to separate them as much as you can,” Ms Barnett says.

“When you have a vivid picture in your mind, it’s very hard to remove that.”

Lean on support systems 

Don’t bottle up how you’re feeling.

Reach out to friends or your counsellor, even your GP — anyone who understands your background and why this might be difficult for you.

“Speak to your friends, speak to your therapist — keep talking,” says Ms Johnston.

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“If you don’t have those kinds of supports at the moment, then calling some of the helplines available would be a really good idea,” Ms Malone says.

If talking is really difficult, Carolyn Worth from the CASA (Centres Against Sexual Assault) Forum and manager at South Eastern Centre Against Sexual Assault suggests writing down how you’re feeling.

“Some people write a letter to someone — they’re not going to send it, but they write it out and they get some structure to their thoughts in some way.”

Other people find it useful to write a journal, she adds.

Spend time on self-care

There’s plenty you can do to help yourself feel better.

It may sound simple, but keeping to a routine, getting plenty of rest and exercise, and eating regular meals can help you feel more settled.

“Don’t suddenly decide to eat a whole packet of Tim Tams, because it won’t make you feel better in the long run,” Ms Worth says.

“And don’t have eight cups of coffee, which will hype you up.”

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If you’re drawn to booze or illegal drugs, try to avoid them.

“It just makes things worse in the end; at some point, you will have to face those negative feelings.”

Instead, Ms Worth recommends making time for relaxation.

“What is it you really like doing? Is it watching first-class trash on TV? Then allow yourself to do that. Or take a bath, listen to music,” she says.

“If you’re into meditation, just sit and go and do that for a while … because we tend to do that when we’re feeling good, but not always when we really need it most.”

And if you’re stuck at work feeling emotional, take some time out for lunch or a walk. Perhaps you could ring a friend and chat.

If you’re really having trouble coping, Ms Malone suggests speaking to someone you trust at work: “Let them know you’ve received some news that’s been difficult,” and consider taking some time off.

Seek professional help if you need it

Feeling angry, sad or distressed after reading or hearing about abuse is understandable. But it’s wise to keep in mind that, if these negative feelings continue, a therapist or counsellor may help.

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Woman waiting on the platform while a train goes past depicting the difficulty of dealing with grief at work.

Read more

“If you’re still bouncing around about the same thing and you don’t feel any better at the end of a week, then ring up and make an appointment to see someone,” Ms Worth says.

“It’s bad for anyone to be that heightened for that long.”

Deal with deniers

As difficult as it is to deal with, there’s a chance you’ll encounter individuals who deny specific cases of abuse took place or blame the victims.

Unless arguing is cathartic for you, it’s probably best to walk away when you hear these comments, Ms Worth suggests.

“It’s like dealing with trolls — you’re wasting your time, you’re just giving them oxygen,” she says.

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If a loved one is struggling

The most important thing you can do for someone who’s struggling is to simply be there.

“Be there to listen and to hear their experiences, distress or anger,” Ms Malone says.

“Normalise the responses the person might be having.”

The impact of sexual harassment

Men and women who have been sexually harassed at work reflect on the short and long-term feelings of guilt and anxiety their experiences have had.

Stressed out woman leans over her computer at work

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You can also “gently talk to them about reaching out to professional support”, she adds. Consider going with them to a counsellor or being there while they ring a helpline.

It might be worth directly asking your loved one whether they’d like to discuss their feelings with you, Ms Worth suggests. Or they may prefer to simply be with you, doing something pleasant.

“It might be taking the dog to the beach, so you could do that and share with them,” Ms Worth says.

“If they want to watch something, sit with them so you’re there.”

Then, if they want to talk, you’ve made space so they can easily open up.

One more tip: “Leave the shame and the blame and all of that to the people who perpetrate the crime,” Ms Johnston says.

“Give that responsibility back to the perpetrator.”

Editor’s note: This article has been updated for legal reasons.

Posted 26 Feb 201926 Feb 2019, updated 22 Aug 201922 Aug 2019


RETRIEVED https://www.abc.net.au/everyday/how-to-cope-with-reading-traumatic-triggering-news/10849940

What is Complex PTSD?

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This form of PTSD results from repeated, prolonged trauma. Experts often use a multipronged approach to treat it. C-PTSD may be familiar to many a surviving-victim of CSA!

BY MATTHEW TULL, PHD
MEDICALLY REVIEWED BY IVY KWONG, LMFT

Complex post-traumatic stress disorder (sometimes called complex PTSD or C-PTSD) is an anxiety condition that involves many of the same symptoms of PTSD, along with other symptoms.

First recognized as a condition that affects war veterans, post-traumatic stress disorder can be caused by any number of traumatic events, such as a car accident, natural disaster, near-death experience, or other isolated acts of violence or abuse.

When the underlying trauma is repeated and ongoing, though, some mental health professionals consider it C-PTSD.

The condition has gained attention in the years since it was first described in the late 1980s. However, it is not recognized as a distinct condition in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the tool that mental health professionals use to diagnose mental health conditions.

PTSD vs. C-PTSD

PTSD and C-PTSD are a result of something deeply traumatic happening and can cause flashbacks, nightmares, and insomnia. Both conditions can also make you feel intensely afraid and unsafe even though the danger has passed. Despite these similarities, though, there are key differences, according to some experts.

The main difference is the frequency of the trauma. While PTSD is triggered by a single traumatic event, C-PTSD is caused by long-lasting trauma that continues or repeats for months, even years (commonly referred to as “complex trauma”). Another difference: C-PTSD is typically the result of childhood trauma.

The harmful effects of oppression and racism can add layers to the complex trauma—particularly if the justice system is involved.

The psychological and developmental impacts of complex trauma early in life are often more severe than a single traumatic experience—so different, in fact, that many experts believe that the PTSD diagnostic criteria don’t adequately describe the wide-ranging, long-lasting consequences of C-PTSD.

C-PTSD

● Caused by long-term, repeated trauma

● Typically arises from childhood experiences

● Often occurs in those who have endured racism and oppression

● Usually more severe than PTSD

PTSD

● Caused by a single event

● Can result from trauma experienced at any age

● Usually milder than C-PTSD

Symptoms of C-PTSD

In addition to all of the core symptoms of PTSD—reexperiencing, avoidance, and hyperarousal—C-PTSD symptoms generally also include:

DIFFICULTY CONTROLLING EMOTIONS. It’s common for someone suffering from C-PTSD to lose control over their emotions, which can manifest as explosive anger, persistent sadness, depression, and suicidal thoughts.

NEGATIVE SELF-VIEW. C-PTSD can cause a person to view themselves in a negative light. They may feel helpless, guilty, or ashamed. They often have a sense of being completely different from others.

TROUBLE WITH RELATIONSHIPS. People with C-PTSD may avoid relationships or develop unhealthy relationships because that is what they knew in the past.

DETACHMENT FROM THE TRAUMA. A person may disconnect from themselves (depersonalization) and the world around them (derealization). Some people might even forget their trauma.

LOSS OF BELIEFS AND FAITH. Another symptom can be losing core beliefs, values, religious faith, or hope in the world and other people.

All of these symptoms can be life-altering and cause significant impairment in personal, family, social, educational, occupational, or other important areas of life.

Making a Diagnosis

Although C-PTSD comes with its own set of symptoms, some believe the condition is too similar to PTSD (and other trauma-related conditions) to warrant a separate diagnosis. As a result, the DSM-5 lumps symptoms of C-PTSD together with PTSD. Therefore it isn’t officially recognized by the American Psychiatric Association.

Many mental health professionals recognize C-PTSD as a separate condition, because the traditional symptoms of PTSD do not fully capture some of the unique characteristics shown in people who experienced repeat trauma.

In 2018, the World Health Organization made the decision to include C-PTSD as its own separate diagnosis in the 11th revision of the International Statistical Classification of Diseases and Related Health Problems.

Because the condition is relatively new, doctors may make a diagnosis of PTSD instead of C-PTSD. Since there is not a specific test to determine the difference between PTSD and C-PTSD, you should keep track of the symptoms you have experienced so that you can describe them to your doctor.

Treatment for the two conditions is similar, but you may want to discuss some of your additional symptoms of complex trauma so your doctor or therapist can also address them.

C-PTSD can also share signs and symptoms with borderline personality disorder (BPD). Although BPD doesn’t always have its roots in trauma, this is often the case. In fact, some researchers and psychologists advocate for putting BPD under the umbrella of C-PTSD in future editions of the DSM to acknowledge the link to trauma, foster a better understanding of BPD, and help people with BPD face less stigma.

Identifying the Cause

C-PTSD is believed to be caused by severe, repetitive abuse over a long period of time. The abuse often occurs at vulnerable times in a person’s life—such as early childhood or adolescence—and can create lifelong challenges.

Traumatic stress can have a number of effects on the brain. Research suggests that trauma is associated with lasting changes in key areas of the brain including the amygdala, hippocampus, and prefrontal cortex.

The types of long-term traumatic events that can lead to C-PTSD include the following: child abuse, neglect, or abandonment; domestic violence; genocide; childhood soldiering; torture; and slavery.

In these types of trauma, a victim is under the control of another person and does not have the ability to easily escape.

The Latest Treatment

Because the DSM-5 does not currently provide specific diagnostic criteria for C-PTSD, it’s possible to be diagnosed with PTSD when C-PTSD may be a more accurate assessment of your symptoms. Despite the complexity and severity of the disorder, C-PTSD can be treated with many of the same strategies as PTSD, including:

Medications

Medications may help reduce symptoms of C-PTSD, such as anxiety or depression. They are especially helpful when used in combination with psychotherapy. Antidepressants including Prozac (fluoxetine), Paxil (paroxetine), and Zoloft (sertraline) are often used to treat C-PTSD.

Psychotherapy

Psychotherapy for C-PTSD focuses on identifying traumatic memories and negative thought patterns, replacing them with more realistic and positive ones, and learning to cope more adaptively to the impact of your trauma.

One type of psychotherapy that may be used to treat both PTSD and complex PTSD is known as eye movement desensitization and reprocessing (EMDR). This approach uses eye movements guided by the therapist to process and reframe traumatic memories. Over time, this process is supposed to reduce the negative feelings associated with the traumatic memory.

Coping With C-PTSD

Treatments for complex PTSD can take time, so it is important to find ways to manage and cope with the symptoms of the condition. Some strategies that may help you manage your recovery:

FIND SUPPORT. Like PTSD, C-PTSD often leads people to withdraw from friends and family. However, having a strong social support network is important for mental well-being. When you are feeling overwhelmed, angry, anxious, or fearful, reach out to a trusted friend or family member.

Research has found that writing in a journal can be helpful in managing PTSD symptoms and decreases symptoms of flashbacks, intrusive thoughts, and nightmares.

PRACTICE MINDFULNESS: C-PTSD can lead to feelings of stress, anxiety, and depression. Mindfulness is a strategy that can help you become more aware of what you are feeling in the moment and combat feelings of distress. This practice involves learning different ways to tune into your body and focus on staying in the present moment.

WRITE DOWN YOUR THOUGHTS: Research has found that writing in a journal can be a useful tool for managing PTSD symptoms; it decreases symptoms including flashbacks, intrusive thoughts, and nightmares.

Keeping a journal can be a handy way to track symptoms so that you can later discuss them with your therapist.

Support groups and self-help books can also be helpful when dealing with complex PTSD. Two recommended books that address this topic are The Body Keeps the Score by Bessel van der Kolk, MD, and Complex PTSD: From Surviving to Thriving by Pete Walker.

It can feel overwhelming if you or someone you care about has been exposed to repeated trauma and is struggling to cope. But remember that it’s important to seek help from a therapist who is experienced treating PTSD.

You might also want to contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-4357; they can provide information on support and treatment facilities in your area.

In addition, you can do a search online to locate mental health providers in your area who specialize in PTSD. The bottom line? You don’t have to go it alone.

RETRIEVED

Tull, M. (2023). What is Complex PTSD? VeryWell Publishing. Retrieved http://apple.news/ADSJf7fEbSYSaDSpkxkqhaA.

BLUE KNOT FOUNDATION
FACT SHEET: Understanding Trauma

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Fact Sheet

• The word ‘trauma’ describes events and experiences which are so stressful that they are overwhelming.
• The word ‘trauma’ also describes the impacts of the experience/s. The impacts depend on a number of factors.
• People can experience trauma at any age. Many people experience trauma across different ages.
• Trauma can happen once, or it can be repeated. Experiences of trauma are common and can have many sources.
• Trauma can affect us at the time it occurs as well as later. If we don’t receive the right support, trauma can affect us right through our life.
• We all know someone who has experienced trauma. It can be a friend, a family member, a colleague, or a client… or it can be us.
• It can be hard to recognise that a person has experienced trauma and that it is still affecting them.
• Trauma is often experienced as emotional and physical harm. It can cause fear, hopelessness and helplessness.
• Trauma interrupts the connections (‘integration’) between different aspects of the way we function.
• Trauma can stop our body systems from working together. This can affect our mental and physical health and wellbeing.

• While people who experience trauma often have similar reactions, each person and their experience is unique.
• Trauma can affect whole communities. It can also occur between and across generations, e.g. the trauma of our First Nations people.
• For our First Nations people, colonisation and policies such as the forced removal of children shattered important bonds between families and kin and damaged people’s connection to land and place.
• Many different groups of people experience high levels of trauma. This includes refugees and asylum seekers, as well as women and children. This is not to deny that many men and boys also experienced trauma.
• Certain life situations and difference can make trauma more common. People with disability of all ages experience and witness trauma more often than people without disability. LGBTQI people also experience high levels of trauma which is often due to discrimination.

Blue Knot Helpline 1300 657 380 | blueknot.org.au | 02 8920 3611 | admin@blueknot.org.au

Childhood abuse never ended for thousands of Australian adults

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PHOTO After surviving years of abuse at the hands of her family, Sarah has started a family of her own. ABC NEWS: TRACEY SHELTON

Sarah is living proof that “life after hell” is possible. 

For more than 20 years she says she endured beatings, rape and degradation at the hands of her family.

She tells of being locked in sheds, made to eat from a dog’s bowl and left tied to a tree naked and alone in the bush.

Her abusers spanned three generations and included her grandfather, father and some of her brothers. She has scars across her body.

“This is from a whipper snipper,” she says, pointing to a deep gouge of scar tissue wrapped around the back of her ankle. Higher up is another she says was caused by her father’s axe.

Family violence support services:

But Sarah survived.

Now she is speaking out in the hope of empowering others trapped in abusive situations. 

“There is life after hell, but you need to learn how to believe in yourself,” she says.

A reality for many Australian adults

As confronting as Sarah’s case may be, she is not alone. 

While most people assume child abuse ends at adulthood, it can bring control, fear and manipulation that can last a lifetime.

Incestuous abuse into adulthood affects roughly 1 in 700 Australians, according to research by psychiatrist Warwick Middleton — one of the world’s leading experts in trauma and dissociation. If that estimate is accurate, tens of thousands of Australian adults like Sarah are being abused by family members into their 20s or even up to their 50s.

PHOTO Warwick Middleton is one of the world’s leading experts in trauma and dissociation. ABCNEWS Tracey Shelton

“It’s a mechanism of ongoing conditioning that utilises every human’s innate attachment dynamics, and where fear and shame are used prominently to ensure silence — particularly shame,” says Professor Middleton, an academic at the University of Queensland and a former president of the International Society for the Study of Trauma & Dissociation.

He has personally identified almost 50 cases among his patients, yet there was no literature or studies on this kind of abuse when he began publishing his findings.

Hidden in ‘happy’ families, successful careers

Sydney criminologist Michael Salter has found similar patterns in his own research. He said cases of incest are “fairly likely” to continue into adulthood, but this extreme form of domestic abuse is unrecognised within our health and legal systems.

“It’s unlikely that these men are going to respect the age of consent,” says Mr Salter, who is an associate professor of criminology at Western Sydney University. “It doesn’t make sense that they would be saying, ‘Oh you’re 18 now so I’m not going to abuse you anymore’. We’re just not having a sensible conversation about it.”

The ABC spoke with 16 men and women who described being abused from childhood into adulthood.

They said their abusers included fathers, step-fathers, mothers, grandparents, siblings and uncles.

Medical and police reports, threatening messages and photos of the abuse supported these accounts. Some family members also confirmed their stories.

PHOTO Sarah’s father often recorded the abuse. This image is the first in a series of five she discovered in the family home.

Sarah says her father and his friends photographed some of her abuse. One image shows her beaten and bloodied with a broken sternum at five. In another photo (pictured here), she cowers as her father approaches with a clenched fist.

Most victims described their families as “well-respected” and outwardly “normal-looking”, yet for many the abuse continued well after their marriage and the birth of their own children, as they navigated successful careers. 

“You see a lot of upper-income women who are medical practitioners, barristers, physiatrists — high functioning in their day-to-day lives — being horrifically abused on the weekends by their family,” Mr Salter says.

Helen, a highly successful medical professional, says she hid sexual abuse by her father for decades.

“They didn’t see the struggle within,” she says. 

A mental ‘escape’

Professor Middleton describes abuse by a parent as “soul destroying”. In order to survive psychologically, a child will often dissociate from the abuse.

Compartmentalising memories and feelings can be an effective coping strategy for a child dependent on their abuser, says Pam Stavropoulos, head of research at the Blue Knot Foundation, a national organisation that works with the adult survivors of childhood trauma.

‘I learnt to disappear’

Like a “shattered glass”, three women discuss the myths and challenges of living with Dissociative Identity Disorder.

The extreme and long-lasting nature of ongoing abuse can result in dissociative identity disorder, which on the one hand can shield a victim from being fully aware of the extent of the abuse but can also leave them powerless to break away, Ms Stavropoulos says.

Claire*, 33, describes her dissociation as both her greatest ally and her worst enemy.

“You feel like you’ve keep it so secret that you’ve fooled the world and you’ve fooled yourself,” she says.

In her family, women — her mother and grandmother — have been the primary physical and sexual abusers and she says some of her abuse is ongoing.

“In a way you have freedom, but at the same time you are trapped in a nightmare,” she says.

‘It’s like he’s melted into my flesh’

For many, the attachment to an abuser can be so strong, they lose their own sense of identity.

Kitty, who was abused by her father for more than five decades until his recent death, says she did everything her family said to try to win their love.

“I thought I was some kind of monster because I still love my father,” she says. “It’s like he’s melted into my flesh. I can feel him. He is always here.”

Raquel’s rage grew from her family’s dark past

Four years into my relationship with my new partner, I realised I was continuing a cycle of abuse. I am a survivor of family sexual abuse who was raised by a child molesterer, and I was releasing my rage on the closest person to me, writes Raquel O’Brien.

Mr Salter says the conditioning is difficult to undo, and often leaves a victim vulnerable to “opportunistic abuse” and violent relationships.

“If the primary deep emotional bond that you forge is in the context of pain and fear then that is how you know that you matter,” he says. “It’s how you know that you are being seen by someone.”

Many of those the ABC spoke with were also abused by neighbours or within the church or school system. Others married violent men.

“They don’t have the boundaries that people normally develop,” Mr Salter says, adding that parental abuse could leave them “completely blind to obvious dodgy behaviour because that’s what’s normal for them”.

‘You believe they own your body’

Professor Middleton said premature exposure to sex confuses the mind and the body and leaves a child vulnerable to involuntary sexual responses that perpetrators will frequently manipulate to fuel a sense of shame, convincing them they “want” or “enjoy” the abuse.

For Emma*, violent sexual assaults and beatings at home began when she was five and are continuing more than 40 years later.

“When you are naked, beaten, humiliated and showing physical signs of arousal, it really messes with your head. It messes with your sexuality,” she says.

“Your sense of what is OK and what isn’t becomes really confused. You come to believe that they literally own you and own your body. That you don’t deserve better than this.”

A medical report viewed by ABC shows Emma required a blood transfusion last month after sustaining significant internal tissue damage from a sharp object. The report stated Emma had a history of “multiple similar assaults”.

She said medical staff do want you to get help and sometimes offered to call police.

“What they don’t understand is that for me police are not necessarily a safe option,” she says.

As a teenager she had tried to report to the police, but was sent back home to face the consequences.

She said a “lack of understanding about the dynamics of abuse and the effects of trauma” mean victims rarely get the response and help they need.

While Emma has been unable to escape the abuse, she has made many sacrifices to shelter her children from it. But they still suffer emotionally, she says.

“It makes it hard for anyone who cares about you having to watch you hurt over and over again.”

Incest after marriage and kids

For Graham, it was devastating to find out his wife Cheryl* was being sexually abused by both her parents 10 years into their marriage.

“I had no idea it was going on,” he says, of the abuse that continued even after the birth of their children. “The fight between wanting to kill [her father] and knowing it’s wrong wasn’t fun. I don’t think people know what stress is unless they’ve been faced with something like that.”

With Graham’s support, the family cut contact with his in-laws. He says the fallout of this abuse ripples through society impacting everyone around both the abused and the abuser.

Mr Salter urges anyone suffering abuse to reach out for help, and for those around them to be supportive and non-judgemental.

“You can get out — don’t take no for an answer. Keep fighting until you find someone who is going to help you keep fighting,” he says.

A new life

Sarah met Professor Middleton after a suicide attempt at 14, but it took many years for her to trust and accept that things could change.

“I just couldn’t grasp I was free. It didn’t matter what anyone did,” she says. 

“I still felt overall that my family was in control of me and at any moment they could kill me.”

Through therapy with Professor Middleton — who she spoke of as the only father figure she has ever known — and the support of her friends and partner, Sarah finally broke away from her abusive family to start a new life of her own.

“You need people to help you through it. In the same way that it took other people to cause you the pain, it takes new people to replace them and help you give yourself another go,” she says.

“If I can give hope to one other person out there, then all my years of pain will not have been for nothing.”

*name changed to protect identity

https://mobile.abc.net.au/news/2018-09-01/family-sex-abuse-survivor-took-rage-out-on-partner/10155992