Abuse Harms Your Mind—and Your Body

If you’ve ever suffered physical, sexual or emotional abuse, you might think that psychological scars are the only long-lasting damage. But that couldn’t be further from the truth.

A lingering threat: Volumes of scientific evidence show that these negative experiences also increase risk for chronic disease and early death…even when the incidents occurred several years earlier.

THE SHOCKING STATISTICS

The veil of secrecy regarding abuse has slowly lifted as more people have recently opened up about their past. With sexual abuse, in particular, recent allegations lodged against film producer Harvey Weinstein, actor and comedian Bill Cosby and others have prompted a renewed interest in the harmful effects of such experiences—whether the victim is a child or an adult.

Even though sexual abuse in adulthood has been linked to physical health problems, such as headaches, digestive disorders and other chronic ailments, the most extensive research has focused on the long-term effects when mistreatment occurs during childhood.

Landmark investigation: The Adverse Childhood Experiences (ACE) Study, a massive collaborative research project cosponsored by the Centers for Disease Control and Prevention, looked at the backgrounds of 17,000 adults, beginning in 1995 at Kaiser Permanente in San Diego. With more than 20 years of follow-up, the study offers crucial insights into the physical effects of abuse and mistreatment.

In the original research, two-thirds of the study’s middle-class participants reported at least one incident of childhood trauma or neglect. More specifically, 28% reported physical abuse…and 21% said they were abused sexually. More than one in five people reported three or more categories of adverse childhood experiences, or ACEs. (To determine your own ACE score, see below.)

THE HEALTH RISKS ARE REAL

The ACE Study determined that the more of these experiences a person has suffered, the higher his/her risk is for a range of mental and physical health conditions.

For example, compared with participants who did not experience any abuses or mistreatment, those who reported four categories of adverse childhood experiences were twice as likely to be diagnosed with lung cancer and/or depression as adults. They also had a fourfold increase in chronic lung disease, such as chronic obstructive pulmonary disease (COPD), and a sevenfold increase in alcoholism. A person with six or more categories of ACEs had their life expectancy shortened by nearly 20 years.

WHY PHYSICAL HEALTH SUFFERS

It’s easy to imagine how trauma would affect a person’s mental health. But why would it also impact physical health? Long-term research has identified such factors as…

• Coping mechanisms. Trauma victims are more likely to use self-soothing habits, such as smoking, drinking, overeating and drug abuse, which are helpful in the short term but are known risk factors in the long term for many chronic health problems.

• Complex brain-mediated effects. Chronic stress due to ACEs can distort the function of brain networks, resulting in immune system suppression, which in turn can lead to a variety of diseases. In addition, it causes the release of pro-inflammatory chemicals that are responsible for additional diseases such as heart disease, pulmonary fibrosis, etc.

WHAT HELPS MOST

If you experienced trauma as a child, it is never too late to get help to reverse or at least moderate the negative physical and/or emotional effects of ACEs. The strategies below, which tend to yield positive results more quickly than psychotherapy and/or antidepressants, are likely to also be helpful for those who experienced trauma as an adult…

• Tell a trusted person. People who have experienced childhood trauma often carry the secret into adulthood. Victims of abuse feel shame and assume that they did something wrong to deserve the abuse. By simply telling someone, and having that person continue to accept you, the shame dissipates.

• Try eye movement desensitization and reprocessing (EMDR). The American Psychiatric Association recognizes this therapy as an effective treatment for trauma. Studies have found that trauma victims no longer had signs of post-traumatic stress disorder after as few as three, 90-minute EMDR sessions.

How it works: During EMDR, a clinician asks the patient to hold a traumatic memory in mind while the therapist moves one or two fingers from side to side, or diagonally, in front of the patient’s eyes. This guides the eyes to move as they do during the rapid eye movement (REM) sleep phase, during which the most active dreaming occurs. Dreaming can help process trauma and move it to long-term memory, enabling the patient to feel as if it is now resolved and only in the past.

The therapist repeats the process multiple times as needed, until the distress related to the targeted memory is gone and a positive belief replaces it. For example, a rape victim shifts from feeling horror and self-disgust to feeling empowered—I survived it and I am strong.

To find an EMDR clinician near you, visit the website of the EMDR Institute at EMDR.com. Check with your health insurer to see if your policy covers the treatment.

• Consider clinical hypnosis. This method helps patients identify past events or experiences that are causing problems. With hypnotherapy, a trained practitioner uses imagery and presents ideas or suggestions during a state of concentrated attention that helps bring about desired changes in thinking.

To find a certified hypnosis professional in your area, visit the website of the American Society of Clinical Hypnosis at ASCH.net. Check with your health insurer to see if clinical hypnosis is covered.

HOW TRAUMATIC WAS YOUR CHILDHOOD?

For each of the following questions, give yourself one point for ­every “yes” answer. During your first 18 years of life… 

1. Did a parent or other adult in the household often swear at you, insult you, put you down or humiliate you? Or act in a way that made you afraid that you might be physically hurt?

2. Did a parent or other adult in the household often push, grab, slap or throw something at you? Or ever hit you so hard that you had marks or were injured?

3. Did an adult or person at least five years older than you ever touch or fondle you or have you touch his/her body in a sexual way? Or try to or actually have oral, anal or vaginal sex with you?

4. Did you often feel that no one in your family loved you or thought you were important or special? Or that your family didn’t look out for one another, feel close to one another or support one another?

5. Did you often feel that you didn’t have enough to eat, had to wear dirty clothes and had no one to protect you? Or that your parents were too drunk or high to take care of you or take you to the doctor if you needed it?

6. Were your parents ever separated or divorced?

7. Was your mother or stepmother often pushed, grabbed or slapped? Or did she often have something thrown at her? Or was she sometimes or often kicked, bitten, hit with a fist or hit with something hard? Or ever repeatedly hit for at least a few minutes or threatened with a gun or knife?

8. Did you live with anyone who was a problem drinker or an alcoholic or who used street drugs?

9. Was a household member depressed or mentally ill, or did a household member attempt suicide? 

10. Did a household member go to prison?

Takeaway: If you score a four or higher, tell your doctor about your history of abuse and follow the recommendations in the main article. If these steps don’t help, consult a trained therapist.