By Dr. Georgia Fourlas, LCSW, LISAC, CSAT-S Dr. Georgia Fourlas, LCSW, LISAC, CSAT-S Clinical Director of Workshops, Rio Retreat Center at The Meadows

The Meadows specializes in treating trauma. Abuse is one form of trauma. Childhood trauma in adults that occurred because of child abuse is often overlooked as a core issue when people enter treatment for addictions or other mental health disorders. Sometimes people minimize what they experienced as children, deny that they were abused, or believe that it happened so long ago that they are (or that they should be) “over it” or no longer relevant.

What Is Child Abuse?  

What is child abuse? There are many definitions out there, and most answers to the question are quite complex. The Meadows uses Senior Fellow Pia Mellody’s simple yet broad definition: child abuse is any action or inaction by a parent or other major caregiver less than nurturing or experienced as shaming by a child. 

This is my favorite definition since it doesn’t minimize based on intent. It allows for the child’s experience of the action or inaction to be the primary defining factor. It also eliminates issues around what was “acceptable” in society at any given time. Just because something was accepted in society, it doesn’t mean that it was healthy or okay. Society makes many mistakes.

While this isn’t even close to being an exhaustive list, here are some examples of child abuse (adapted from Pia Mellody’s book, Facing Codependence):

Physical Abuse:

• Hitting, kicking, punching, pinching, burning, etc.
• Failure to provide adequate physical needs (food, shelter, clothing, medical, etc.)
• Lack of appropriate physical nurturing (too much or not enough)
• Forced to watch or listen to someone else being abused

Emotional Abuse:

• Failure to provide emotional nurturing (ignoring, neglecting, abandoning, etc.)
• Refusing to allow a child to express their feelings (“stop crying or I will give you something to cry about,” “get over it already”, etc.)
• Demonstration of improper expression of feelings by caregivers (yelling, belittling, sarcasm, ridiculing, demeaning, raging, silent rage, side-ways anger, guilting, etc.)
• Overindulging or overprotecting⦁ No accountability or limits set
• Emotional isolation or forced to keep unhealthy secrets

Sexual Abuse:

• Any sexual contact between an adult and a child (or two children with a power differential such as age difference or more than three years) including, but not limited to, sexual intercourse, oral sex, anal sex, touching of genitals, or other private areas
• Poor sexual boundaries with children (not monitoring exposure, objectification, rigid or uncontained sexual attitudes, inappropriate sexual talk in front of children, etc.)
• Failure to protect a child from sexual abuse when the risk is known or should reasonably be known (a family member who has been accused of sexually abusing a child is permitted to babysit)
• Lack of sexual information, too much sexual information or sexual misinformation given to children

Intellectual Abuse:

• Attacking or shaming a child’s thought process
• Ridiculing for being “too smart” or “not smart enough”
• Failure to provide education
• Failure to support a child with a learning disability or who is gifted
• Demanding perfection
• Over-controlling or forcing religious beliefs
• Hypocrisy
• Failure to provide spiritual nurturing
• Any abuse by a spiritual leader
• Using spirituality to instill fear
• Occult or radical religious practices

Peer or Social Abuse:

• Bullying or being teased by siblings or other peers

Why Does It Still Matter in Adulthood?

Trauma impacts the brain. Children have brains that aren’t fully developed. When children are abused, their brains are forced to develop in a stressed or dysregulated state. This can lead to a lifetime of challenges with self-regulation. The effects of child neglect in adulthood can lead to an increased likelihood of unhealthy relationship patterns, addictions, anxiety, depression, obesity, suicide attempts, chronic health issues, and sexually transmitted diseases.  

That list could just as quickly begin with, “People most frequently seek treatment for…”.  While most people are motivated to therapy or treatment for symptoms, the best treatment also addresses the underlying and historical issues that pre-date the symptoms. Symptoms of childhood trauma in adulthood are often a result of a person’s maladaptive attempts to cope with stress and dysregulation. When underlying issues aren’t addressed, symptoms may return, or new symptoms may surface to replace the treated ones.

Long-Term Effects of Child Abuse 

Child abuse can have physical, psychological, behavioral, and societal well-being. The child’s age, type of abuse, relationship to the abuser, and severity and duration of the abuse can influence the long-term effects of child abuse. These child abuse effects can make people feel confused and have a lack of trust in others throughout adulthood.

Depression

Depression is a long-term effect of child abuse because many children blame themselves for their abuse, thinking it’s their fault. Studies have found that abuse or neglect is connected to most depression cases and suicide attempts in women. 

Anxiety

Anxiety, characterized by constant worrying, is another common long-term effect of child abuse. People who experience child abuse don’t trust themselves or their environment. These intense feelings of anxiety often transcend throughout adulthood. 

Relationship Issues

The long-term effects of childhood trauma and abuse are often characterized by low self-esteem and relationship issues. Victims of abuse think they caused their abuse. In turn, their guilt makes them question who they are and what they stand for. As a result, they carry this perspective into intimate adult relationships, leading to poor decisions, such as staying in unhealthy or abusive relationships. 

Unhealthy Behaviors

Because child abuse can cause anxiety and depression, it can also lead to unhealthy physical behaviors, including eating disorders, alcoholism, drug abuse, violence, and even crime. 

Physical Health Problems    

Immediate physical harms of child abuse include broken bones, bruises, impaired brain development, and abusive head trauma, leading to long-term health consequences due to the childhood neglect. As a result, victims of child abuse are at a higher risk of heart disease, pulmonary disease, high blood pressure, diabetes, asthma, liver disease, and obesity. Child abuse can also lead to a higher risk of unintended pregnancies and intimate partner violence.

Do I Need to Seek Treatment?

Some people need to seek inpatient or intensive outpatient treatment when their symptoms of childhood trauma in adulthood are so disruptive to their lives that day-to-day functioning is impaired. Some people require less intensive treatment but still want something specialized and focused on dealing with their core issues and childhood trauma in adulthood. 

The Meadows and its sister programs offer highly individualized treatment services that encompass trauma and related mental health conditions on many different levels. Childhood trauma in adults can be addressed at all of The Meadows’ programs. Survivors is The Meadows signature workshop and an essential component of its inpatient treatment programs. It’s an intensive workshop focused on addressing childhood trauma. The Survivors workshop is also offered as a stand-alone intensive for people who don’t need long-term treatment.  

Rio Retreat Center at The Meadows provides a five-day Survivors workshop for anyone interested and who meets the criteria for admission. For more information on enrolling in a Survivors workshop experience or any treatment programs, please call our intake department at 1-(800)-244-4949.

April is National Child Abuse Prevention Month. Learn more here.