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Trauma experienced in has a special ability to wound, especially when it includes emotional, physical or or neglect. The fallout echoes through the years and causes negative consequences, such as higher risks of , , bipolar disorder, , , behavioral problems, and health problems such as heart disease. One study that followed hundreds of adolescents over time found that 80 percent of individuals who had been abused as children met the criteria for at least one disorder at age 21.

A troubled childhood can also lead a person to and drug use as a way to numb the pain or, conversely, to feel something. Studies estimate that up to two-thirds of patients in substance use treatment have childhood histories of sexual, emotional, or physical abuse. There is much to overcome with a troubled childhood, but help is available, and a thorough understanding of what hinders healing can aid the recovery process.

Here are 8 primary reasons why freedom from childhood trauma is difficult:

The traumatized person may be slow to realize the source of their pain. Children have no frame of reference when experiences occur, so they come to see their reality as normal, especially if their caregivers are the source of their distress. Often, it is only much later—when exposed to healthier families or when raising children of their own—that they see how damaging their childhood was. Unfortunately, the longer a person waits to get help, the tougher it becomes to heal. (If you’ve experienced childhood trauma and wonder where you fall on the spectrum, a test provided as part of the Adverse Childhood Experiences study can provide insight as well as gauge your risk of developing related health problems.) Co-occurring issues can mask the true problem. Those who use drugs or alcohol to deal with the pain of childhood trauma may become so focused on dealing with their —what is essentially a symptom of the trauma—that they never discover its source. Unless that’s done, however, they are likely to keep cycling in and out of recovery. There’s another complication to trauma-based addiction: Fellow addicts sometimes provide the sense of family missing from a person’s life. The damage may also be biological. Scientists now know that childhood trauma can alter brain structure and change how certain are expressed. In a 2012 Brown University study, childhood trauma such as abuse or the loss of a parent was found to alter the programming of genes that regulate , boosting the risk of developing issues such as anxiety and depression. Trauma-induced brain changes, according to a 2013 study, have been linked to a diminished ability to moderate negative impulses. Childhood trauma can also affect the brain’s neurotransmitters, boosting the reward felt when drugs or alcohol are used—and making dependence more likely. These new understandings highlight the difficulties of overcoming childhood trauma, but they are also leading the way to targeted therapies and medications. Overcoming the past may mean remembering it. Some find the concept of revisiting the past too painful. Others may be willing but find it impossible to sort out the jumble of childhood impressions. Often all that remains is a floating sense of anxiety. Pain becomes tough to eliminate when its source cannot be pinpointed. Closure can be elusive. Oftentimes, getting those responsible for trauma to accept responsibility for their role in a painful past is impossible. They may no longer be alive by the time the traumatized person comes to understand the source of their distress or feel ready to address it. It can be tough to accept that an abuser will never be held accountable for his or her actions, or that there is no hope of ever developing a healthier relationship. Answers may be sought in others rather than themselves. Often a person attempts to find in others what was missing from their life in an attempt to fix the past. Or they may become an approval-seeker who will go to any lengths to keep the peace or earn the love of others. Rather than valuing their own needs, they spend their energy trying to become worthy of others’ affection, often enduring further abuse in the process. Emotions may be closed off. In some cases, caring becomes too dangerous for the child, so they numb themselves to feeling. This not only damages their ability to build healthy relationships, but it also complicates later attempts to access the emotions needed for healing. It can be hard to silence the inner voices. Children buy into all the things they are told about themselves. If those things are negative—that they are worthless, lazy, stupid, ugly, a failure, or will never measure up to a —it can leave them feeling both unworthy of a better life and powerless to change.

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While each of these scenarios challenges healing, none precludes it. For many, treatment and therapy can dramatically improve quality of life—among them, techniques such as , which can change negative thought patterns, and Eye Movement and Reprocessing (EMDR), a form of that can help a person retrieve, process, and resolve past traumas.

Additional techniques and medications are on the horizon as research increases our understanding of trauma’s effects on the mind and body. We may one day, for example, be able to simply block bad memories associated with trauma, research suggests.

Also encouraging is that researchers and therapists are coming to understand that there is a small silver lining to negative experiences: They can sometimes boost . Carrying an ugly burden from the past can weigh a person down, but it can also make them stronger.

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