Post-traumatic Stress in Survivors of Childhood Abuse

The ordinary human response to danger is a complex, integrated system of reactions, encompassing both body and mind. Threat initially arouses the sympathetic nervous systems, causing the person in danger to feel an adrenaline rush and go into a state of alert. In addition, threat may alter ordinary perceptions: people in danger are often able to disregard hunger, fatigue, or pain. Finally, threat evokes intense feelings of fear and anger. These changes in arousal, attention, perception, and emotion are normal, adaptive reactions. They mobilize one to act and preserve a sense of trust in one’s power to be able to cope with the threat and survive.

Chronic childhood abuse is different. The abuse takes place in a familial climate of pervasive terror in which much needed ordinary relationships have been profoundly disrupted. Survivors describe a characteristic pattern of complete control enforced by means of violence and the threat of withholding of love, capricious enforcement of petty rules, intermittent rewards, and destruction of all competing relationships through isolation, secrecy, and betrayal.

The child in an abusive environment is faced with a formidable task of adaptation. She must find a way to preserve a sense of trust in people who are untrustworthy; safety in a situation that is unsafe; control in a situation that is terrifying and unpredictable; and a sense of power in a situation of helplessness.

Traumatic reactions occur when action is of no avail. When neither resistance nor escape is possible, the child’s system of self-defense becomes overwhelmed and disorganized. Each component of the natural response to danger, having lost its utility, persists in an altered and exaggerated state long after the actual danger is over.

Childhood traumatic events produce profound and lasting changes in physiological arousal, emotion, cognition, and memory. The survivor may experience intense emotion but without clear memory of the event, or may remember everything in detail but without emotion. She may find herself in a constant state of vigilance, irritability, and anxiety without knowing why.

After a traumatic experience, the child’s system of self-preservation seems to go on permanent alert, as if the danger might return in any moment. She may relive the event as though it were continually recurring in the present or may feel a perpetual sense of hopelessness. These are some of the symptoms of post-traumatic stress.

Excerpted from Trauma and Recovery: The Aftermath of Violence–From Domestic Abuse to Political Terror by Judith Herman, M.D.
Copyright 1992, 1997 by Basic Books.