Years ago, when I worked at a crisis center for children, a five-year-old girl was brought in after being removed from her home due to allegations of sexual abuse at the hands of her caregivers, specifically, her mother’s boyfriend. Within days of her arrival, the counselors placed her on “watch” due to her habit of rubbing her genitals on table legs, chair legs and would attempt to rub her genitals on the legs of adult male care-workers after she demanded to sit on their laps. It became apparent that her abuser groomed her to the point of making her believe that love and affection were only evident through manipulation of her genitals through constant friction. Sexual abuse not only changed the way she interacted with the world around her, but also changed how she viewed herself in relation to her environment, the people close to her, and created sexual pathology that would take years of treatment to undo. Damage was done. It was not initially obvious, but like cancer, it was hidden, deep in the crevices of her brain, and emerged as she interacted with others.
Child maltreatment in any form is one of the leading causes of mental illness and behavioral dysfunction in children today. One study reveals that all forms of abuse account for higher rates of childhood onset psychiatric disorders (Teicher, 2016). It often goes undetected until the abuse becomes extreme to the point that someone notices changes to a child’s body or emotional state, which then authorities are called. Typically it is a third party that calls authorities and parents are then reported to Child Protective Services, in worse case scenarios, the children are then taken out of the home and placed in either a temporary shelter, group home or foster home.
Child abuse takes the shape of many forms, including but not limited to various manifestations of verbal, physical or sexual. Sadly, survivors of child abuse, in any form, have higher adult rates of overall body inflammation, metabolic syndrome, arthritis, heart disease, shortened telomeres (Teicher, 2016), which are caps at the end of each strand of DNA that protect chromosomes and effects how one ages. They are the aging clocks for our cells and represent biological age, not chronological age. Studies have indicated a strong correlation between short telomeres and how our cells age, most often shown through the immune system. (What Is A Telomere? 2018). The immune system is most affected by shortened telomeres, which reduces life expectancy (Teicher, 2016).
With that said, to determine what mechanisms are involved in creating the biophysical changes that affect overall health, researchers have looked at the connection between abuse, brain changes, and psychiatric illnesses. By looking at one of the stress sensitive parts of the brain, specifically the hippocampus, we can get a better picture of what goes on when sexual abuse occurs.
Child sexual abuse (CSA) is defined by the World Health Organization (WHO) using various descriptions that cover broad universal criteria.
1) involvement of a child in sexual activity that he or she does not fully comprehend
2) child is unable to give informed consent
3) child is not developmentally prepared and cannot give consent
4) sexual behavior towards the child that violates the laws or social taboos of society and includes children and adolescents. (Amado, 2015).
Current research shows that 1 in 4 girls and 1 in 5 boys are sexually abused before the child turns 18 years old. (Grossman-Scott, 2017). One study shows that child and adolescent sexual abuse is directly tied to higher incidence rates of major depressive disorder, dysthymia (persistent depressive disorder), generalized anxiety disorder and phobic disorders, (Amado, 2015), as well as conduct disorders (Maniglio, 2013).
One study revealed that sexual abuse stayed in the mind longer, even after victims received treatment or seemed to recover from childhood sexual trauma. For patients who sustained and recovered from a traumatic brain injury (TBI), who previously experienced childhood sexual trauma, they began experiencing reemerging memories to the point of exhibiting post-traumatic stress disorder symptoms, even after years of nonoccurrence. These symptoms included “flashbacks of the abuse, behavioral and affective disturbances, nightmares, and hyper-vigilance”.
Due to the TBI, the cognitive, affective, behavioral and sensory-motor sequences are disrupted and residual effects of childhood sexual abuse alarmingly reemerge, hindering “post-injury rehabilitation and life functioning” (Reeves, et all, 2000). The effects of childhood sexual abuse type trauma seem to stay locked in the brain of the victim longer than what is assumed, making further research on this issue crucial to help with either proper rehabilitation or better coping mechanisms.
The hippocampus has a left side and a right side. It’s a small portion of the brain within the inner folds of the bottom middle part of the brain called the temporal lobe, making up a tiny percentage of overall brain capacity. It is part of the limbic system that controls emotions, learning, and memory. It is responsible for the proper functioning of the endocrine system and is the main mechanism that controls fight or flight reactions to environmental stress.
It contains place cells that help with understanding place, geographical routes, and their associated experiences (Teicher, 2016). It is also responsible for interpreting auditory information and reaches 85% of its volume by the age of 4 (Blanco et all, 2015). The hippocampus is filled with glucocorticoid receptors that are easily damaged by too many glucocorticoids, specifically cortisol, which means if this area becomes overpopulated with its contents, it can lead to other areas to function improperly. Most importantly, when it gets overpopulated, it shrinks. An atrophied hippocampus has less overall cortisol.
Studies have proven over time (Vythilingam et all 2002, and Tiecher, 2016) the same results, that individuals who have a history of PTSD brought on by severe or repeated childhood physical and/or sexual abuse have considerably smaller hippocampus volume, most noticeably on the left side (Tiecher 2016), when they are compared to others who have no history of childhood abuse of any kind.
Psychology Today published an article titled Cortisol and PTSD in 2016. It states:
“One of the things that cortisol does in response to stress is that it helps contain the catecholamine system—it helps bring down the high levels of adrenaline that are released during fight or flight. Since we all know that adrenaline and norepinephrine are responsible for memory formation and arousal, not having enough cortisol to completely bring down the sympathetic nervous system, at the time when it is very important for a person to calm down, may partially explain the formation of traumatic memory or generalized triggers“
It’s important to note that only the left side is shown to be smaller. The right side of the hippocampus does not show signs of atrophy and is responsible for learning and non-verbal memory (Blanco et all, 2015).
However, normal right side hippocampus measurements do not equate to fully functioning, nor does it show that the right side was not affected by the abuse. One researcher (Bremner 2003), was able to show that childhood sexual abuse survivors diagnosed with PTSD as adults, who listened to accounts of their sexual abuse, showed reduced blood flow in the right side of the hippocampus (Blanco et all, 2015). This reduced blood flow is not evidenced in individuals who were not abused, proving that despite the right side being normal in size, that alone does not equate to fully functioning and healthy, validating that childhood sexual abuse somehow alters and weakens brain functioning, even if there are no noticeable signs of atrophy or deformity in certain areas.
Some studies show that women are more susceptible to having a smaller hippocampus as a result of sexual abuse trauma but that is not always the case, showing that it affects both genders. Regardless of the gender and/or frequency of the effect on either gender, a smaller hippocampus precipitated by childhood abuse has been established, with many researchers throughout the last several years coming to the same conclusion.
Interestingly, not all who have smaller hippocampus volumes due to childhood abuse will go on to develop psychopathology, proving that there are some individuals that are more resilient, either during childhood or as they aged and matured.
The effects of childhood sexual abuse do not produce obvious signs of disease or an easily diagnosed syndrome using a list of potential criteria but it does alter brain structure as well as brain function. Not all trauma affects the brain in the same way and there are “specific types of abuse that seem to target sensory systems and pathways that convey and process aversive experiences” (Teicher, 2016), and childhood sexual abuse seems to show the most significant alterations in the brain (Blanco, 2014).
It is clear that childhood sexual abuse or trauma do not end once the trauma ends. Lasting consequences are negatively seen in an individual’s cognition, behavior, and lack of psychological health (Blanco, 2014). According to many research studies, researchers are coming to the same conclusion, that is, childhood sexual abuse victims do show signs of deficits in
2) abstract reasoning
3) executive functioning.
These abuse victims also have a greater propensity to be impulsive in their behavior, have some degree of intellectual and/or verbal impairment, as well as show signs of lowered academic achievement or performance (Blanco, 2014).
Victims have also been known to engage in maladaptive coping strategies like
1) substance abuse
2) self-injury behavior
3) over and under sexualized behavior
and also show symptoms and behavior of pathology that include
1) dissociative behavior
2) aggressive behavior
3) low self-esteem or lowered self-worth (Blanco, 2014).
These pathological type behaviors and maladaptive coping strategies can be carried over into adulthood, potentially causing lifelong effects that are evidenced through “anxiety, depression, academic/occupational difficulties, unhealthy partner relationships and lastly, sexual dysfunction” (Blanco, 2014).
Recently, a prominent theologian declared in a Tweet “We will find mental health when we stop staring in the mirror and fix our eyes on the strength and beauty of God”.
Looking at the research in this article proves why the prominent theologian who wrote this Tweet was wrong and why pastors must use discernment when attempting to diagnose outside of their theological pay grade.
Personally experiencing chronic childhood trauma in the form of physical and emotional abuse, witnessing three drive-by shooting deaths before the age of 10, and being raped in my late teens, I exhibited much of the maladaptive coping skills outlined above that only exacerbated as I got older.
After my God-initiated conversion to a saving faith in Christ as an adult, the effects and consequences of my childhood trauma did not automatically erase. It was troubling for me to be “on fire for the Lord” yet not understand why I had certain negative thoughts, reacted in specific ways towards others, struggled with understanding basic concepts, became overwhelmed easily, and struggled with following through on certain tasks or goals in life. In other words…..why couldn’t I get my Christian act together?
Seeing and savoring the beauty of Christ was enough to give me peace about my life circumstances but having clear sight and valuing true beauty, whose name is Jesus, did not change the size of my hippocampus, nor did it change the other aspects of trauma that occurs in the brain as a result of childhood trauma, regardless of how much I stared at the beauty and strength of God.
Pastors or fellow Christians who fail to understand the effects of childhood trauma will do more harm than good when they attempt to counsel people to simply “have more faith” or do more outwardly spiritual behavior to prove they are indeed “Christian enough”.
Faith alone means just that. Faith. Alone.
It is our faith alone in Christ that sustains us while we live with and through the effects of the sin done to us as children or the trauma we witnessed or experienced. We do not need reminders to have more faith or stop staring in the mirror of our problems, because truth be told, even if our faith is the size of a mustard seed, Christ is there, moving mountains.
For professing Christians who have childhood trauma or sexual abuse in their histories, reading God’s Word is not just a good idea or a box to check off a Christian to do list, but rather it becomes a lifeline necessary to survive, to inhale, to exhale, to let it seep into the marrow of our souls in order to not drown because of the waves that keep throwing us against the rocks.
Verses like Psalms 46:1-3 becomes a balm.
God is our refuge and strength, a very present help in trouble. Therefore we will not fear though the earth gives way, though the mountains be moved into the heart of the sea, though its waters roar and foam, though the mountains tremble at its swelling
Charles Spurgeon, who suffered from long seasons of chronic debilitating depression wrote
“I have learned to kiss the waves that throw me up against the Rock of Ages”
Understanding that the biopsychosocial consequences of childhood trauma could very well last a lifetime, victims must learn how to kiss the waves of suffering and trauma simply and only because it is through that suffering and trauma that individuals will be continually thrown against the Rock of Ages.
Psalms 71:3 says
Be to me a rock of refuge, to which I may continually come; you have given the command to save me, for you are my rock and my fortress
You will keep the mind that is dependent on you in perfect peace,
for it is trusting in you. Trust in the Lord forever, because in the Lord, the Lord himself, is an everlasting rock
As hard as it is to hear about the evil that occurs towards children, we cannot turn a blind eye to its effects nor can we use Christian-ese platitudes when dealing with those affected by childhood abuse. Loving our neighbors well means truly understanding what they are going through as well as loving them through harder seasons of life.
Those who have ears to hear…….
Blanco, L., Nydegger, L. A., Camarillo, G., Trinidad, D. R., Schramm, E., & Ames, S. L. (2015). Neurological changes in brain structure and functions among individuals with a history of childhood sexual abuse: A review. Neuroscience & Biobehavioral Reviews, 57, 63-69. doi:10.1016/j.neubiorev.2015.07.013
Reeves, R. H., Beltzman, D., & Killu, K. (2000). Implications of traumatic brain injury for survivors of sexual abuse: A preliminary report of findings. Rehabilitation Psychology, 45(2), 205-211. doi:10.1037//0090-5522.214.171.124
Teicher, M. H., & Samson, J. A. (2016). Annual Research Review: Enduring neurobiological effects of childhood abuse and neglect. Journal of Child Psychology and Psychiatry, 57(3), 241-266. doi:10.1111/jcpp.12507
What is a Telomere? | Human Cellular Aging | TA-65 TA Sciences. (n.d.). Retrieved February 09, 2018, from https://www.tasciences.com/what-is-a-telomere/