Adverse Childhood Experiences

Girl on Track

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Adverse childhood experiences (ACEs) have a long-term impact on an individual’s functioning. Currently, there is an abundance of research that examines how abuse, neglect, poverty, and growing up in chaotic and unpredictable homes can impact one’s psychological and physical health – even long after the abuse and chaos have ended. However, childhood ACEs can also impact a person’s exposure to re-victimization throughout the life span.

This post will focus on survivors of child sexual abuse (CSA). Survivors of CSA are two times more likely to experience re-victimization as an adult and are four times at greater risk of experiencing adult sexual assault. Re-victimization has been attributed to symptoms of dissociation and/or hyper-arousal diagnosed with post-traumatic stress syndrome. The latter two responses of dissociation and hyper-arousal are the same mechanisms associated with a women’s vulnerability to re-victimization. The defense mechanism of dissociation that is used to protect oneself against the overwhelming physical and emotional effects of child sexual abuse are the same mechanisms that allow for continued re-victimization.

As an adult, when faced with cues in the environment and/or interactions with others that resemble the past-traumatic event, the current situation may again elicit the defense of dissociation. This dissociative state which protected the defenseless little girl does not serve the same protective functions as an adult. Instead, it leaves a woman unable to identify real and impending danger in the environment and prevents her from taking appropriate precautionary action, making her and her children vulnerable to the possibility of danger and being re-victimized.

Similarly, women who were sexually abused as children often take a subordinate and compliant position in their relationships. Compliant and passive behaviors were many times used to protect herself as a child by not escalating the abuse by the perpetrator. As an adult, this pattern of relating to people can thwart her abilities to act assertively, leaving her powerless and without the necessary skills of setting limits and boundaries to protect herself and employ protective actions. In addition, appeasing others to avoid conflicts leaves her at risk of denying and silencing her own feelings and needs. Often, perpetrators seek out mothers who are submissive because they can easily be taken advantage of and exploited. Low self-esteem, faulty judgments, and unhealthy boundaries make these mothers and their children susceptible to further victimization.

On the other end of the continuum, mothers diagnosed with PTSD may have hyper-aroused physiological states causing them to be vigilant, easily provoked, and inept at maintaining a sense of calm under stress. Their bodies are primed to respond to potential threats and they may over-react to benign encounters and situations that remind them of the trauma. From a hyper-aroused position, these individuals misinterpret and respond to environmental and interpersonal cues with a high degree of emotional intensity. Their interactions with others are governed by strong feelings and misperceived threats rather than intellect and logic. Highly charged reactive behaviors can antagonize others and result in occurrences of verbal and/or physical aggression, thus reinforcing their position of victim and need to maintain a defended stance towards others.

Chronic hyper-aroused states are physically and emotionally draining and overtime can diminish one’s ability to sustain attention and focus, make rational and effective decisions, and discern between real and imagined threats. This reduces the individual’s ability to respond effectively to real threats, leaving them vulnerable to re-victimization.

Women with a history of child sexual abuse may misuse alcohol and drugs to alleviate and numb feelings and emerging memories linked to their past abuse. However, substance use also interferes with women’s ability to discern risk and potentially dangerous situations, thereby diminishing her ability to protect herself against perpetrators. Substance use increases a woman’s risks of re-victimization and is connected to higher rates of physical and sexual assault.

A number of studies have shown that some survivors may have been able to function as children and successfully navigate through the developmental tasks of childhood. However, it is not until they are re-victimized as an adult that their resilient qualities erode and they begin to suffer from mental health symptoms. Re-victimization in adulthood predisposes and/or exacerbates mental health concerns including symptoms of post-traumatic stress disorder, depression, anxiety, substance use, and suicidal ideation. Increased symptomatology resulting from re-victimization further compromises and impedes a woman’s functioning and compromises her mothering capacities and her ability to care for her children.