The Effects of Child Abuse

and Its Role in Alcoholism

and Addiction



The effects of child abuse have profound physiological, spiritual, emotional, and social consequences that are carried with the victim for the rest of their lives. There are more than three million reports of child abuse and neglect each year, and that's only the cases being reported. Most child abuse goes unreported.



That means there is a staggering amount of abuse taking place in our society. Child abuse continues to be overlooked and minimized in our culture because there is still a pervading dysfunctional and destructive belief that it is acceptable to use physical violence, verbal aggression and exploitation in the process of child rearing, which originated in and continues to be encouraged within religion. Additionally, most of society fails to recognize the depth of damage that is incurred.



It's no secret that one of the most common effects of child abuse are that most abused children grow up to be alcoholics or addicts, and most alcoholics and addicts have had an abusive childhood, and science now reveals that there is a biochemical reason this occurs. It used to be believed that the scars of child abuse were exhibited only in the psychosocial arena or through the development of defense mechanisms that become maladaptive and self-defeating in adulthood; and that in itself is detrimental enough, however, scientific findings now tell us that it is much deeper and more serious than even this.

Child Abuse Alters Brain Chemistry



Earlier, the effects of child abuse were thought to be similar to a software problem that could be reprogrammed, where as now neurobiology tells us it is more like a "hard wiring." Because child abuse and neglect takes place during a crucial period of brain development, neurobiology now reveals that trauma such as physical, emotional and sexual abuse and neglect have a profound impact on the structure, function and chemistry of the brain that may result in irreversible damage.



Neuroscientist, Dr. Martin Teicher, associate professor of psychiatry at Harvard and director of the Biopsychiatry Research Program in Belmont, has found in his studies that abused children have abnormal brain wave patterns. He tells us that the more severe the abuse is, the more powerful the impact on the brain function will be. The relationship that the child has with the abuser is also important. Abuse perpetrated by a family member is more detrimental than abuse perpetrated by a clergy member or babysitter.



Teicher and other neuroscientists have found that abuse damages important brain structures like the cortex, which is related to rational thinking. Some of the most dramatic damage is seen in the limbic system. The limbic system is the "primitive midbrain region that regulates memory and emotion." It contains two deep lying brain structures, the amygdala and hippocampus.



The hippocampus determines what information coming in will be stored in the long-term memory. It is essential for processing emotions and memories and is the control center for most of the body's hormonal systems. Trauma to the hippocampus also results in memory loss, which may explain why many abused children forget their abuse soon after it happens.



While the amygdala's primary job is to "filter and interpret incoming sensory information in the context of the individual's survival and emotional need and then help initiate the proper response." The amygdala assists us in being able to take quick action when facing a dangerous or threatening situation such as jumping out of the path of an oncoming semi. Ongoing abuse causes the amygdala to alert us to danger even when a threat does not exist. Neuroscientist, Dr. Bruce Perry, says, "A maladaptive amygdala makes an abused child recoil in fear at the drop of a hat."



The hippocampus and amygdala are found to be smaller in abused individuals. Additionally, both of these areas of the brain are crucial for learning. An association has also been found in that the greater the reduction in size of the hippocampus, the more severe the dissociative symptoms will be exhibited.



Dr. Teicher also tells us that these changes in the brain take place in an attempt to adapt to an unsafe environment and ensure evolutionary survival. He even goes as far as to include sexual promiscuity, which is frequently seen in abused woman, as one of these adaptations. Although these changes are effective in the short term, in the long term they result in a variety of detrimental physiological, behavioral, cognitive, social and psychological consequences that may be permanent.



Damage to these important brain structures results in a variety of psychological and physiological symptoms like post traumatic stress disorder (PTSD), dissociative identity disorders (multiple personality disorder), antisocial behavior, borderline personality disorder, irrational fear, aggression, increased risk of suicide, sexual promiscuity, impaired ability to concentrate and learn, and self-destructive behaviors.



Now here's an extremely crucial component in the effects of child abuse that relates to the neurotransmitter connection we've been discussing throughout this site. All this damage to brain function and structure is also associated with serious changes in brain chemistry. When a child is exposed to continuous and overwhelming stress early in life, such as abuse, it alters the production and release of their stress-regulating hormones like cortisol and essential neurotransmitters that are involved in the addiction process, like epinephrine, dopamine, serotonin and GABA. Survivors of abuse typically have lower than normal levels of important neurotransmitters like serotonin and dopamine, and GABA receptors are altered.



When a child lives with ongoing traumatic stress like abuse, the brain stimulates the release of high levels of neurotransmitters and stress hormones. Since the abuse is ongoing, their brain is releasing these neurotransmitters in excessive amounts on a continuous basis, which ultimately causes great damage. If you read my understanding alcohol addiction page you'll learn that when neurotransmitters are stimulated excessively, over time as this continues, the neurotransmitter receptors become unresponsive or "desensitized" and eventually the brain no longer produces and releases adequate levels of neurotransmitters for the brain to function properly; thus the abused child becomes an adult who suffers with anxiety, depression, mood disorders, hyperactivity, cravings for carbohydrates, alcohol or drugs as well as impaired attention span, etc.



The abused child is used to having high levels of those crucial neurotransmitters involved in the addiction process and are conditioned to engage in other behaviors that will keep them released. So they eat sugar, smoke cigarettes, drink caffeine, and get into alcohol and drugs to maintain those levels. Since these substances only boost the neurotransmitters temporarily, they continually need more. Essentially, abused children are biochemically set up to become an addict.

In addition to that, when we're under stress, this releases sugar into the blood stream. So, that means the child living with abuse is having sugar pumped into their system pretty much all the time. Thus, this sets them up for Candida overgrowth, sugar addiction, hypoglycemia, adrenal exhaustion, insulin resistance, weight gain, and all the other health problems associated with excess sugar.



Additionally, these excessively high levels of neurotransmitters and stress hormones also damage and inhibit the growth of neurons in the brain. When the stress persists for a long time, the neurons shrink in size and will even die. Neurons are cells that send and receive electro-chemical signals to and from the brain and nervous system. Neurotransmitters are the chemical messengers used in this process. The neurons are also where the neurotransmitter receptors reside. Without an adequate supply of neurons, neurotransmitters cannot be released or received properly. Communication from the brain to the nervous system and other parts of the body malfunctions.



Here again we have the all-important issue of the reward pathway and those crucial neurotransmitters dopamine, serotonin and GABA that lead to addiction. Why do so many abused children grow up to be addicts and alcoholics? Because their neurotransmitters have been damaged, depleted and put out of whack by the abuse. Malfunctioning neurotransmitters result in feelings of depression, anxiety, fatigue, irritability, hyperactivity, fear, PTSD, cravings for food, alcohol and drugs and much more.



The brain of adult survivors of abuse is like a laptop that's been dropped on the floor. Their internal wiring is all over the place. Chemical messengers aren't produced in sufficient numbers or they produce too many, they aren't connecting properly, and they miscommunicate. Abused children grow into adults who have neurotransmitters that have gone haywire and results in a variety of uncomfortable, sometimes crippling physiological and psychological symptoms. They attempt to balance out, calm down or rev up the neurochemicals in the brain with drugs and alcohol.

hat's really interesting about these scientific findings is that researchers have discovered that if intervention takes place, some damage to the brain can be reversed. For example, it is believed by leading physicians treating psychological trauma that "positive experiences that contradict a traumatized child's negative expectations are critical to helping the brain to readjust itself." For example, "just saying to a child that you are sorry the event happened changes brain chemistry." If a child is removed from the abusive environment and provided with a loving and nurturing environment, then some healing may occur and the effects of child abuse may be minimized or reversed.



Unfortunately, this is not usually the scenario with child abuse and neglect. Most children do not get rescued from child abuse. They must endure it for a lifetime, and in order to adapt to this hostile environment, the brain is altered and they develop coping mechanisms that become maladaptive in adult life and then engage in their own destructive behaviors such as alcohol and drug addiction and relationships with abusive people. Although it is now believed that brain changes can take place even in adulthood, the more time that passes between the actual abuse and the initiation of intervention, the more deep-rooted the neurological damage will be.



To make matters worse, people who have been abused tend to develop a variety of self-defeating beliefs about themselves and the world. They view bad events in a self-blaming way, which undermines self-esteem and encourages depression and helplessness. Unfortunately, it is believed that this type of thinking may have a negative impact on brain chemistry as well, and thus sets them up in another vicious cycle of interfering in neurotransmitter functioning even more, which only amplifies and perpetuates the negative thinking pattern.

Child Abuse Impairs the Endocrine System and the Stress Response System



As we discussed above, the excessive and continuous release of stress hormones is one of the primary effects of child abuse and it is associated with a variety of negative effects on the body and mind. Another one of the main systems impacted by the excessive and continuous release of stress hormones is the stress response system of the body.



The primary system involved in the body's stress response system is known as the HPA axis, which involves a complex interaction between the hypothalamus, pituitary and adrenal glands. It is responsible for controlling essentially all the body's hormones, nervous system activity, storage and expenditure of energy, as well as regulating the immune system, controlling reactions to stress and a variety of other body processes like digestion, mood and emotions, and sexuality.



When you're under stress, the hypothalamus releases a hormone called corticotrophin-releasing factor (CRF), which then flows through your pituitary gland and stimulates the release of adrenocoricotrophic hormone (ACTH), which then stimulates the adrenal glands to release cortisol. This process makes you alert and gives you the energy needed to deal with the stressful event.



In a normal circumstance, once the threat (the stressful event) passes, then the hormones recede. However, in the case of child abuse, the threat never passes, therefore, the HPA axis never stops releasing hormones and eventually burns itself out, resulting in a hypothalamus, pituitary and adrenal glands that don't function adequately.

also important to note here that several neurotransmitters like dopamine, serotonin and norepinephrine are needed for regulating the HPA axis and, as we discussed above, these neurotransmitters are first being excessively stimulated and then not being produced and released sufficiently so this leaves the HPA axis even more vulnerable to malfunction.



A malfunctioning HPA axis is associated with a variety of psychological and physical symptoms like panic attacks, chronic anxiety, insomnia, PTSD, ADHD, depression, chronic fatigue syndrome, fibromyalgia, irritable bowel syndrome and alcoholism.

Dr. Putnam, another leading researcher in the effects of child abuse, tells us that in fearful circumstances like abuse, stress floods the brain with cortisol repetitively and excessively. Over time this repetition damages the brain and the adrenal glands. In an attempt to adapt to this situation, the brain then lowers the threshold at which cortisol is produced to a dramatically lower level; however, the system remains in a hypersensitive state. This results in a variety of psychological and physiological symptoms such as those seen with post-traumatic stress disorder.



When we are under attack or threatened, cortisol redistributes the energy in our body, but excessively high levels lead to high levels of fear and anxiety. Cortisol also damages the hippocampus, which as we learned is detrimental to memory and cognition, and may damage or alter the hormonal system. Severe damage to the hippocampus is believed to lead to dissociation, and in extreme cases result in dissociative identity disorder, also known as multiple personality disorder.



Dr. Bruce Perry explains that typically when we're exposed to acute stress, the neurophysiological changes are rapid and reversible; however, when the exposure to the stressful situation is ongoing and intense, as it is in child abuse and neglect, the changes are not reversible. The stress response system of the body becomes "sensitized." It now reacts to stressful situations in a much more sensitive manner. It is believed that this phenomenon is similar to the changes that take place in neurotransmitter receptors like that seen in sensitization to cocaine. These changes result in symptoms like hypervigilance, increased startle response, affective disorders, anxiety and PTSD.

A child living with child abuse is in a constant state of fight or flight. Their adrenal glands never get a break as their body is continually releasing high levels of stress hormones like cortisol. This often leads to adrenal exhaustion, or at the very least, depleted or malfunctioning adrenal glands. The adrenal glands are no longer able to perform their jobs as needed for the body and brain to function optimally. The adrenal glands have a crucial role in maintaining blood sugar, producing hormones, managing stress and fatigue, and many other important body functions that can result in cravings for alcohol.



When the adrenals are exhausted, they no longer produce enough cortisol. Cortisol is crucial for many body functions like glucose metabolism and blood sugar maintenance, regulating blood pressure, immune function, and inflammatory response. When there isn't sufficient cortisol in the body, the individual is susceptible to autoimmune disorders, chronic pain syndromes, chronic fatigue, asthma, allergies and more. Again in an attempt to self-medicate the many symptoms that occur as a result of malfunctioning adrenal glands, the abused individual often reaches for drugs and alcohol.

Factors that Affect Degree of Trauma



It is believed by neuroscientists that a variety of factors such as the nature of the trauma, the degree to which body integrity is threatened and the family support system after the trauma has a great impact on the how severe the effects of child abuse will be, the level of neurological damage and the extent of symptoms that an abused individual may experience. Someone who endures a life-threatening abusive situation, or one that is highly degrading, is likely to exhibit more neurological damage than abuse that occurs in a less threatening more benign setting. Alternatively, if the abused individual receives support and validation from other family members after the abuse, they are likely to be less traumatized than the individual who is dealing with a family that denies, represses or hides the abuse, or blames the abused.

The age in which the abuse occurs also seems to influence which set of symptoms the abused person presents with, because different areas of the brain are developing at different ages. It is believed that abuse that occurs before the age of four may result in different symptoms than those exhibited in children who are abused later in childhood. This explains why there's such a wide variety of symptoms found in abused individuals and why some people exhibit more symptoms than others.

Unfortunately, for those who've been abused their entire life beginning in infancy and ending when they leave home as a young adult, the damage is pretty extensive and may include the whole gamut of possible symptoms.

I have only touched the surface here on the extent of the neurological damage that occurs as a result of child abuse and neglect. Volumes have been written and the depth of this issue is staggering; thus it is beyond the scope of this site to cover all the effects of child abuse in detail. I have given you an overview and what this tells us is that all the so-called psychological symptoms like anxiety, depression, fear, irritability, mood disorders, fatigue, etc., that are so typical for survivors of child abuse and neglect are actually physiological in nature. This also illustrates how deeply intertwined the mind and the body really are.

Effects of Child Abuse on Personality, Identity and Sense of Self



However, the effects of child abuse and neglect also create a variety of problems in the social, emotional and spiritual arenas that can and often do lead to drug or alcohol addiction. These areas have been covered pretty extensively in the self-help field and, therefore, there is no need to go into them in great detail again here. My goal at this time is to call attention to the brain chemistry aspect and highlight a few other important areas.

Child abuse in any form violates a child at their core. It shatters their personality, identity and spirit, which results in a confused and fragmented sense of self. It is the ultimate act of betrayal and abandonment that wounds and scars every fiber of their being. Nothing is left unscathed and this trauma is carried with them for a lifetime. This should be of grave concern to all of us, because these damaged children grow up into adults who teach our children, administer law enforcement, minister to our families and run our governments, etc.

Children who were abused grow into teens and adults that feel flawed, inferior, worthless, hopeless, inadequate, dirty, overwhelmed with deep shame, depressed, anxious, extreme loneliness, helpless and afraid. They have low self-esteem and self-worth, aggression or anger control issues, feel like a failure, are severely lacking in coping and social skills, and have difficulty with intimacy and relationships. They are often unconsciously drawn to partners with similar characteristics as their parents and then reenact the abuse over and over. They experience a constant state of internal deprivation with deep feelings of loss, isolation and emptiness.

It is no wonder that so many victims of abuse turn to drugs and alcohol to feel better. When you don't feel good about yourself there's no motivation to do what's healthy for your body and mind. It seems inevitable they would reach for relief and artificial stimulation through drugs, alcohol, sugar, caffeine, cigarettes, etc.

With so many issues working against them, survivors of abuse literally don't feel capable of functioning in the world. Alcohol and drugs are used as a coping mechanism. It gives them courage when they're afraid; company when they are lonely; a false sense of control and power, which was taken away from them in childhood; it reduces the dysphoria; and anesthetizes the emotional pain. It is also used to keep memories of the abuse from surfacing.

When you don't feel loved, nurtured, connected and worthwhile, this too has a very powerful negative impact on neurotransmitters. Being nurtured is a necessary component to thrive and provides healthy stimulation to neurotransmitters. So although these particular effects of child abuse that we're speaking of at the moment are emotional and spiritual, they are deeply interconnected with the physiological and perpetuate the vicious cycle of damage to brain chemistry.

Additionally, when the survivor of abuse becomes involved in the use and abuse of drugs and alcohol, they usually engage in behaviors that violate their morals and values. This results in deeper feelings of shame, guilt and confusion, which drives them even further into alcohol and drug use to cover up these feelings.

Addicted survivors of abuse who don't address the effects of child abuse and neglect on their adult life are at high risk of relapse or bouncing back and forth between different addictions. When an alcoholic or addict gets sober, all these feelings and memories they've been repressing and "numbing out" come rushing into consciousness. Just because you get sober does not mean you magically develop self-esteem and stop feeling worthless, ashamed, and inadequate, etc. On the contrary, with drugs and alcohol out of the picture, all these negative feelings are magnified. It takes time and work.

Additionally, they don't suddenly know how to handle their anger, practice assertiveness, build healthy intimate relationships or develop effective social skills. They may still blow up when they get angry, can't function in social situations, don't know how to get their needs met and avoid intimate relationships. These things must be learned. Even when survivors of abuse are no longer under the influence of drugs and alcohol, they may still engage in behaviors that are confusing and violate their conducts of behavior with acts like promiscuity or relationships with abusive people. They can't understand why and this incites more feelings of shame and guilt, which may lead to a drink in an attempt to cope.

Since their identity was shattered, never fully developed and/or is deeply attached to their drug and alcohol abuse, when they get sober, they don't really know who they are or how to fit into this world. They feel more fragmented, disconnected and lost, which results in lots of confusion. To have successful recovery with sobriety, there must be a successful recovery of self.

Recovering from Childhood Abuse



So in summary, the main point I'm trying to highlight here is that although it is essential to address the biochemical aspects of alcoholism and balance neurotransmitters, even if you make a lot of progress in healing your biochemistry, the lingering effects of child abuse and neglect can still have the power to sabotage recovery if they too are not addressed.

If a survivor of abuse does not gain awareness and understanding of their abuse issues after they get sober, then they will remain in the grips of the trauma and its aftershock. It is the unconscious factors operating in the background that leave them at risk of relapse.

On the other hand, as I can testify by my own life, I was working very hard on my abuse issues, doing everything humanly possible to stay sober and still struggling. I was making great progress with sobriety, but something was missing. That missing piece was the biochemistry and neurotransmitter aspect and it wasn't until I included that in my treatment plan that I was able to get over the hump. Both are crucial for successful long-term recovery.

Since we know the profound impact that child abuse and neglect has on brain chemistry, it is also my belief that when you engage in behaviors like counseling, workshops, groups, seminars and books that help you heal your child abuse that the validation, support and understanding that accompanies these activities is not only beneficial on the emotional level but it also helps balance out the neurotransmitters and heal brain trauma as well.

I know in my own experience as I became enlightened about the effects of child abuse it was so mind-boggling and powerful it felt like brain cells and neurotransmitters were firing so strongly in my head it was as if my brain was rearranging itself. The information was staggering and innovative in my mind because I had never heard it before and it changed my life completely.

Although it took me many years to make significant healing in this area, the fact that I had awareness was what empowered me and eliminated the abuse as a risk factor for relapse. With awareness came understanding for myself and my behaviors, with understanding came forgiveness of myself and motivation to work on my issues. Awareness and understanding also began to lift the veil of shame and with that came a sense of freedom and the ability to develop a healthier identity.

When I would read a book about adult survivors of abuse or attend a workshop, I identified so deeply that it was as if the book or workshops were written specifically about me. Another lightbulb came on and I was astounded to learn that there was an explanation for all the craziness in my life. Suddenly, my entire life made sense and this information alone was incredibly healing.

If you would like to read about my life and how I recovered from both alcoholism and child abuse, to achieve more than 25 years of craving-free sobriety, you can find my story in my book Get Sober Stay Sober: The Truth About Alcoholism. Everything on this page is excepted directly from the book.

Another issue for the survivor of abuse, if they are entering traditional treatment for addiction or AA, is that many of the methods used are counterproductive. Angry, forceful confrontations that are frequently used to break denial can push those with abusive backgrounds further into resistance, because they feel they're being violated again. The whole powerlessness concept is threatening because they were unable to control what was done to them as a child so it's terrifying to think they have no power as an adult. The structure and tone of treatment and AA tends to be punitive, shaming, rigid and blaming, which resembles the atmosphere they grew up in. Traditional treatment methods often make the survivor of abuse feel revictimized.

Considering the fact that the majority of people entering treatment for addiction have been abused, this gives us another clear indication as to why traditional treatment is not successful for so many people. It is my opinion that those survivors who do feel comfortable in AA and traditional treatment do so because, as we learned earlier, one of the most common effects of child abuse leaves survivors of abuse unconsciously drawn to situations and people that simulate their dysfunctional family system. It's familiar to them. On some level they feel comfortable in AA and yet on another level it incites great internal conflict. That was the case for me and the longer I stayed sober and the deeper I worked on my childhood abuse issues, the more uncomfortable I became with certain aspects of AA. Treatment for alcoholism and drug addiction needs to empower the individual and that is not the case with AA and mainstream rehabilitation centers.

It's also important to note here that although we're talking specifically about the effects of child abuse and neglect, that any high-stress, traumatic event in life has the potential to alter and damage the body's stress response system and brain chemistry. Other events like natural disasters, kidnapping, civilians in war or those engaging in combat, prisoners of war, a car wreck, plane wreck, a terrorist attack, chronic health conditions, domestic violence, unhealthy relationships or other similar scenarios where someone is in crises, traumatized and unable to escape or forced to live with ongoing stress could have the same results and make one vulnerable to addiction.

References

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Briere, John N. Child Abuse Trauma: Theory and Treatment of the Lasting Effects. Sage Publications, Inc., 1992.

Kendall, Josh. “How Child Abuse and Neglect Damage the Brain.” The Boston Globe, 2002.

Mukerjee, Madhusree. Hidden Scars: “Sexual and Other Abuse May Alter a Brain Region.” Scientific American (1995).

Bremner, J. Douglas, M.D. Does Stress Damage the Brain: Understanding Trauma Related Disorders from a Neurological Perspective. W.W. Norton & Company, 2002.

Kirmayer, Laurence J., Robert Lemelson, and Mark Barad, eds. Understanding Trauma: Integrating Biological, Clinical, and Cultural Perspectives. Reprint ed. Cambridge University Press, 2008.

ScienceDaily. "Low Levels of Neurotransmitter Serotonin May Perpetuate Child Abuse Across Generations." ScienceDaily, 2006.

Perry, Bruce D., M.D., Ph.D. “Neurobiological Sequelae of Childhood Trauma: Post-traumatic Stress Disorders in Children.” Child Trauma Academy. http://www.childtrauma.org/

Middleton-Moz, Jane. Children of Trauma: Rediscovering Your Discarded Self. HCI, 1989.

Herman, Judith. Trauma and Recovery. Basic Books, 1992.

Wadsworth, R., Spampneto, A.M., & Halbrook, B.M. “The Role of Sexual Trauma in the Treatment of Chemically Dependent Women: Addressing the Relapse Issue.” Journal of Counseling and Development 73 (1995): 401-6.

Blume, E. Sue. Secret Survivors: Uncovering Incest and its Aftereffects in Women. Ballantine Books, 1991.