Post No.: 0569
Maltreatment can affect a child’s brain and behaviours in maladaptive ways, as was alluded to in Post No.: 0562…
Firstly, maltreated children may find difficulty in building trusting relationships with others because of their personal history of experiencing how other people have let them down. They might say they prefer being alone, whether in school or beyond – saying, “You can’t trust other people anyway” or, “They’re out to harm me.” An ‘if I look after number one then everything’s fine’ strategy can be a short-term adaptation, as a learnt defence mechanism against distrust or rejection – perhaps due to experiencing abusive or absent parents – but will be maladaptive in the long-term because strong social relationships are important for one’s well-being, career, intimate/romantic relationships and other significant life outcomes.
They may consequently lack an effective support system of friends and family members they feel they can trust when they need to talk with someone whenever anything is troubling them. They might even have a negative view of intimate, as well as platonic, relationships in the future. They might become distant with others and in turn over-reliant on just themselves, or alternatively cling too hard onto someone for the fear of re-experiencing neglect or abandonment.
Children also learn by copying, hence poor role models, a lack of healthy coping mechanisms and experiencing a lack of positive relationships when young can mean that their social and communication skills won’t be as well developed – leading to difficulties when interacting with and forming close bonds with other people, which in turn raises the risk of being rejected and ostracised by their peers. Their social interactions might be awkward, they might misread social situations, and they might not understand what a normal, healthy relationship should be like. They might be quiet and extremely introverted people who suffer things in silence, or they might alternatively develop antisocial behaviours, which could hurt others and push others away, and thus reinforce their loneliness.
Other people might struggle to understand a maltreated person’s history hence fail to empathise with their trauma, or they might understand it but fear re-triggering their trauma by saying or doing something wrong, and for this reason stay away from or break off relationships with them because they don’t want a friend or partner with that sort of ‘baggage’.
Adolescents who shrug their shoulders and say they don’t care in a defensive manner usually do care, but this maladaptive attitude is a defence mechanism against a world that appears to conspire against them. If an individual truly didn’t care then they wouldn’t feel so down. So we need to investigate between the lines and not just take a person’s word for it whenever they say, “I’m fine” or, “I don’t care.”
Building a trusting relationship with a young person who has experienced maltreatment is thus a key foundation of any therapeutic or supportive intervention. Trust in one’s primary caregiver – be it a mother, father, foster carer or whoever – is vital for building resilience in other relationships. If a child cannot trust his/her primary caregiver then it’ll be more difficult for him/her to learn to trust in any other relationships.
Primary caregivers are usually able to provide a child’s physical needs but may not be equipped to provide their emotional needs – therefore foster or adoptive caregivers also need support, and need to learn to be more understanding of abused or neglected children (who are most likely going to be the types of children being fostered or adopted). It’s not enough for a parent or foster carer to just keep a child physically alive through food, water and shelter – their emotional and mental well-being needs must be met too. Woof.
It should be needless to say that a child should be settled in a place of positive, nurturing, supportive, safe and secure care where they feel loved. (There are unfortunately a minority of cases where abuse occurs whilst children are in care.) Feeling connected to others – whether with one other person or a wider community – is a common protective factor that helps people to survive, and hopefully thrive, after violent or difficult childhoods. Caring relationships are crucial for everyone’s well-being.
But it’s more complex than thinking that love is enough to make people better. A maltreated child mightn’t know how to respond to affection, so might push back. They might feel unworthy of love because that’s been directly or indirectly drilled into them. This doesn’t mean that affection is unwanted or worthless but it presents a challenge for any caregivers who didn’t expect this. It’s more about what you do than what you say – and treating them with respect is the most critical thing, especially for teenagers, because that’s the thing that nobody has given them before. This means listening, validating their perspective, not shouting, and setting clear and consistent expectations of behaviour and boundaries that have a positive regard for the young person. So praise and reward desired behaviours instead of punishing undesired behaviours (this could even be in the form of a financial incentive, like giving them a bonus allowance if they tell you where they are whenever they go out).
A foster or adoptive parent will need to show patience, perseverance and continuity by being there for them no matter what they say or do, which may be a tough challenge since the child may be distrusting and thus aggressive. This might be a test to see if you stay, or leave like the other caregivers in their life did before them. The fruits of this labour may only bloom many years later. Fostering can be difficult but highly rewarding.
Secondly, the lack of consistent and trusting relationships and/or the lack of safe and stable environments can lead to developing maladaptive negative expectations and beliefs about others in general. The world and other people may seem frightening and confusing to them. They might have a greater difficulty in properly and confidently reading the emotions of others, which might lead to misunderstanding an adult’s facial expressions and intentions as threatening when they’re actually neutral or ambiguous.
Young people with violent physical maltreatment experiences tend to detect angry faces more readily and quickly. At a neural level, they show greater activity in brain regions linked to threat, such as the amygdala and insula, and a greater anticipation of physical sensations such as pain. This may be advantageous in a hostile environment but will be maladaptive and problematic when the child is in a safe environment, such as hopefully in school. This is a maladaptive result of being constantly in a state of hypervigilance, or high alert, for living in an environment where they face/faced daily threats – perhaps from an abusive caregiver. The same pattern of brain activation has been observed in soldiers after they’ve been deployed in combat, and those with anxiety disorders.
The rapid and instinctive ‘fight, flight or freeze’ response evolved to respond to perceived threats – to help prepare us to handle and survive dangerous situations. We’re not usually consciously aware of the reaction arising when it does but it can lead to fast and impulsive, rather than well-thought-out, reactions. These reactions can thus be maladaptive in the wrong contexts and hinder a person’s ability to build and maintain healthy relationships with others.
An abused child might have learnt to freeze or stay quiet after realising that he/she would get hit even harder and for longer if he/she didn’t stay quiet when threatened by his/her violent father. He/she might have instead learnt that running away and hiding was the response that worked best. Or a neglected child might have learnt that fighting, being loud or otherwise aggressively reacting would gain him/her some attention from his/her disconnected mother. These responses could then become the learned default response to any kind of stress or trial they face in life. And because of the hypervigilance and the general distrust of others – maltreated children experience more stress than non-maltreated children in social situations and react as if threatened too frequently. In turn, other people might find it difficult to connect with someone who stays quietly reserved, hides or is always belligerent.
So this hypervigilance can help a child to spot dangers such as a violent caregiver, thus it keeps the child safe in a hostile environment, but in the bigger-picture they might misperceive innocent people as threats (which might even make them more susceptible to voting for conservative nationalist policies even though they might be poor), get defensive or get into fights too easily, find it hard to focus on their schoolwork hence their learning suffers, find it harder to trust the intent of others or get emotionally close with anybody, not want to share their deepest feelings or thoughts with anybody else, and rather be alone – which all impacts all kinds of relationships. Hence once again, a child’s brain can adapt to a hostile and unpredictable environment in ways that may be adaptive in the short-term but maladaptive in the long-term, and ultimately increase their loneliness and risk of developing mental health problems.
We don’t learn effectively when in this state either – we’re more focused and tunnel-visioned on surviving and self-preservation (which can come across as selfish behaviour to others) rather than on being open-minded, receptive to learning or creative. This negatively impacts upon their academic progress, grades and future employment prospects.
Thirdly, those who’ve experienced early childhood adversity can often only recall the events of their own life (autobiographical memories) in an over-general or vague way. For instance, when asked to recall a happy event, they may point out one time they were on holiday but not any specific moment when on that holiday easily. Some people are good at telling detailed anecdotes about their life but these people struggle. It’s not so much forgetting as over-generalising one’s history. Neuroimaging research shows that, compared to those who don’t experience adversity, young people who experience adversity use different brain regions when recalling autobiographical memories, suggesting that they’re being processed and remembered differently. This ‘overgeneral autobiographical memory’ (OGM) is also associated with, and predictive of, depression and PTSD too.
Not remembering a lot of detail about really traumatic times could be the brain’s way of protecting us from being overwhelmed by the negative memories? If so, it’s another case of how the brain can adapt in ways that are beneficial for coping in traumatic environments but might be maladaptive overall, for happy memories become vague too. Well actually, negative memories are privileged and are more prominent than positive memories – children who are exposed to personal violence show greater activity in the brain regions linked to threat detection when recalling negative memories, and less activity in the brain regions involved in memory detail during positive memories.
Also, compared to their non-maltreated peers, they can feel more excluded and ostracised. At a neural level, there’s reduced brain activation in, and connectivity between, areas associated with the regulation of negative experiences, like the dorsal anterior cingulate cortex and dorsolateral prefrontal cortex. So this hypersensitivity to negative social cues could extend to more subtle forms of social threat, such as rejection, too. Rejections, of all kinds, are felt much more strongly, which can lead to depression and further social distrust. This would highlight how the risk factors compound – fortune and misfortune sadly don’t ‘even out’ in people’s lives but naturally reinforce and amplify. This again hinders their ability to form supportive relationships, and these difficulties frequently extend into adulthood and will affect the quality of their interpersonal relationships as adults. All of these factors could be contributory reasons why they become more vulnerable to mental health issues when older.
Woof. So there are at least a few ways in which a child’s developing brain adjusts to living in an abusive or neglectful environment. But whilst these adaptations may aid their survival in such environments, they may be maladaptive in other environments and in the long-term.