Dr. Matthew Kerr, Psychologist at The Royal, spoke about Childhood Trauma and it's long term effects on your mental health.

1. An Unwanted Legacy:
Long-term effects of chronic
childhood trauma
Matthew Kerr, Ph.D. C.Psych.
October 5, 2013

2. Where we are headed…
• What is trauma?
• How common is childhood trauma?
• Why is chronic childhood trauma so damaging?
• What is the lasting impact of these experiences?
• What do I do about it?

3. What is trauma?
Psychological Trauma:
“…the unique individual experience, associated with an
event or enduring conditions, in which the individual’s
ability to integrate affective experience is overwhelmed
or the individual experiences a threat to life or bodily
integrity…”
(Pearlman & Saakvitne, 1995)

4. What is trauma?
• PTSD Criterion A (DSM-5)
– “Exposure to actual or threatened death, serious injury, or
sexual violence in one of the following ways:”
• Direct experience, witnessing, learning about, repeated or
extreme exposure to aversive details
• Post Traumatic Stress Disorder (PTSD) Symptoms
• Intrusion (re-experiencing)
• Avoidance
• Hyperarousal
• Negative alterations in thoughts and mood

5. What is trauma?
Chronic Developmental Trauma
– Repeated psychological trauma from very early
childhood to pre/early adolescence
– Also experienced by the child:
• unhealthy parenting
• lack of security
• Poor caretaking
• aka Complex Trauma

6. How common is it?
• National (U.S.) Comorbidity Study –
Replication (2010)
• Surveyed 3019 women and 2673 men
• Inquired about numerous adverse life
experiences prior to age 13
• Rape – 5.9%
• Sexual assault/molestation – 9.8%
• Any sexual violence – 13.1%
• Any assaultive violence – 25.5%

7. How common is it?
• Canadian Incidence Study of Reported Child Abuse
and Neglect (CIS):
– In 2003, an estimated 235,315 child maltreatment
investigations were conducted in Canada (3.8%)
– About 1.9% of Canadian children age 15 and under
experienced substantiated childhood abuse
– Many cases are never reported.
• 5.1% of those with history of childhood physical abuse
• 8.7% with a history of childhood sexual abuse (MacMillan, Jamieson, &
Walsh, 2003)

8. How common is it?
• The impact of chronic developmental
traumatization poses a significant public
health risk
“Dealing with the effects of trauma is a health-
care priority; it is as serious as any major
medical illness” (US Surgeon General, 1999)

9. Why is chronic childhood trauma so
damaging?

10. Why is chronic childhood trauma so
damaging?
• Often this trauma involves:
• Contextual factors
• A betrayal of trust
• Inadequate parenting
• Disrupted neurophysiological and social development
• 50 to 75%+ of children experiencing complex and chronic
trauma will develop PTSD (and other difficulties) in
adulthood
• Compared to 18-25% of those traumatized as adults
• As the number of adverse childhood experiences
increases, so does the risk for various psychological and
medical disorders

12. Why is chronic childhood trauma so
damaging?
• Neurophysiological development
– Over development of the survival brain at the
expense of the learning brain
– Stress response system
• Reduces immune system activity
• Interferes with more complex brain function
– Learning, making conscious judgements, planning
– Particularly sensitive periods are around age 2 and
late pre-adolescence/early adolescence

13. Why is chronic childhood trauma so
damaging?

14. Why is chronic childhood trauma
so damaging?
• Relational development
– Attachment Theory (John
Bowlby)
• Stable/predictable
caregivers = stable
patterns of relating in
child
• Inconsistent parents or
those who cause
pain/trauma yield a
disorganized attachment
style in child

15. What is the lasting impact of these
experiences?
• Disrupted psychobiological/Interpersonal functioning
in the following domains:
– Emotion and impulse regulation
– Biological self-regulation
– Attention or consciousness
– Perception of perpetrators (and/or dangerous others)
– Self-perception
– Capacity for relationships (Trust)

16. What is the lasting impact of these
experiences?
• Self-blame, felt sense of being
bad/defective/evil/deserved what happened
• Fear of strong emotion (especially anger)
• Fear that one is like their abuser
• See world as a dangerous place

17. What is the lasting impact of these
experiences?
• Mental Health
– Depression
– Anxiety
– Psychosis
– Substance use/abuse
– Eating disorders
– Personality disorders
– Dissociative
symptoms/disorders &
Somatoform disorders
– Suicidality and/or self-injury
• Physical Health
– Coronary artery disease
– Liver disease
– Chronic obstructive
pulmonary disease
– Autoimmune disease
– Chronic pain
– Overutilization of emergency
medicine / underutilization of
routine healthcare

18. What do I do about it?
• Get more education about trauma and its impact
• See web resource list
• Know that the trauma is/was not your fault
• Trauma-related symptoms are treatable
• See community resource list
• Tell your (mental) health care provider
• Advocate for yourself

19. What do I do about it?
• Trauma-based psychotherapy
– 3 stages:
• Stabilization
• Processing of Traumatic Memories
• (Re-) Integration
– Often movement back-and-forth between first two stages
– Gradual exposure to sharing of traumatic material

20. Community resources (free or low fee)
Centre for Treatment of Sexual Abuse and Childhood Trauma
www.centrefortreatment.com
Family Services of Ottawa http://familyservicesottawa.org
Sexual Assault Support Centre of Ottawa www.sascottawa.org
Ottawa Rape Crisis Centre www.orcc.net
Catholic Family Services of Ottawa www.cfsottawa.ca
Jewish Family Services of Ottawa
www.jfsottawa.com/TheCounsellingGroup/site
(list not exhaustive)

21. Web resources
• http://www.sidran.org/sub.cfm?sectionID=4
• http://www.trauma-pages.com/trauma.php
• http://www.istss.org/ForthePublic.htm
• http://www.nimh.nih.gov/health/publications/post-
traumatic-stress-disorder-ptsd/nimh_ptsd_booklet.pdf
• http://www.cmha.ca/mental_health/post-traumatic-stress-
disorder/#.UaOOE9Ksg6Y
• http://www.nami.org/factsheets/ptsd_factsheet.pdf
• http://www.isst-d.org/default.asp?contentID=13

22. Discussion and Questions?