Anxiety is a common human experience. We experience anxiety as a part of our evolutionary danger response, which then trickles into normal events such as big presentations and first dates. However, clinical anxiety, defined as any anxiety that becomes chronic and interferes in daily life, is a disruption of our regular functioning. These persistent and intense worries can develop at any point in life, triggered by a variety of factors. One of the biggest contributing factors to the onset of clinical anxiety is trauma.
Trauma
Therapists colloquially differentiate between types of trauma using the terms “Big T” and “little T” trauma. “Big T” trauma refers to events largely recognized by most people as devastating. Events such as bombings, sexual assault, or car crashes all fall under the Big T definition. “Little t” trauma, then, refers to the more subjective or nuanced experiences that could traumatize. This includes having an incarcerated or drug-addicted parent, or even bullying. We know that these experiences can be deeply affecting, as much, or even more so than one-off traumas. All these traumas change how we navigate the world and ourselves. When our coping strategies are unable to address these traumas after a period of time, Post-Traumatic Stress Disorder can develop.
Diagnostically, a person can only have PTSD if they have been exposed to Big T traumas like death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence in some way. This exposure can be direct or distanced, including witnessing the event, being a first responder to the event, or hearing that it happened to a person close to you. Symptoms of PTSD include mood changes like anxiety, flashbacks, intrusive thoughts about the event, nightmares, and avoiding reminders of the event.
However, we know that the little t traumas can change our lives as well. These little t traumas contribute to a type of PTSD called Complex PTSD, also called C-PTSD. Complex Post-Traumatic Stress Disorder is especially connected to childhood due to its interpersonal, chronic, and deeply-ingrained nature. The feelings of distress that occur when a person experiences C-PTSD then become trauma and fundamentally change who that person becomes. It feels like a part of who they are, accepted as a truth without question or examination of context. Many people who experience C-PTSD will try to minimize the traumatic nature of their childhoods due to how personal it feels. Symptoms include typical PTSD symptoms such as nightmares and hypervigilance, but also includes feeling distrustful of the world, feeling worthless, or that no one could ever understand what happened to you or what it is like to be you.
The Biology of Trauma
Trauma can affect several areas of the brain that are involved in regulating emotions and stress responses. The amygdala, for example, is a part of the brain that plays a key role in processing emotional information and responding to perceived threats. Scientists sometimes call the amygdala our “lizard brain.” It is the oldest part of the brain responsible for response and fear perception. When we are in survival mode, this area of the brain is responsible for the freeze response. In individuals with PTSD, the amygdala may become overactive, leading to a heightened response to stress and anxiety-provoking stimuli.
The hippocampus is the next area of the brain that is affected by trauma. This part of the brain developed after the amygdala, and is called the “monkey brain.” The hippocampus is involved in memory formation and retrieval. In individuals with PTSD, the hippocampus may become smaller, leading to difficulties with memory and an increased sensitivity to stressful or traumatic stimuli. The survival mode behaviors associated with the hippocampus are fighting and fleeing.
The prefrontal cortex is also deeply affected by trauma. This part of the brain is our most recently developed area and as such, it is sometimes called the “human brain.” The survival mode behavior associated with this part of the brain is the fawn response, where a person uses flattery and persuasion to neutralize the threat. The prefrontal cortex is responsible for regulating emotional responses and inhibiting impulsive behavior. In individuals with PTSD, the prefrontal cortex may become less active, leading to difficulty controlling emotional responses and coping with stress.
Beyond structural areas of the brain affected by trauma, changes in neurotransmitter systems, such as the serotonin and dopamine systems, may also play a role in the development of PTSD-related anxiety. Neurotransmitters are chemicals that act as a communication system for the brain. These neurotransmitters are involved in regulating mood and reward processing, and disruptions in their functioning can contribute to symptoms of anxiety and depression.
How Childhood Trauma Manifests into Anxiety
Childhood trauma translates into anxiety though a number of ways. There are the biological changes that occur due to exposure to trauma (with a Big T) and repeated little t traumas, but we are unaware of these changes until we notice physical symptoms. These physical symptoms can include PTSD or C-PTSD, but can include illness or body changes. Girls who experienced early childhood trauma were likely to experience the development of reproductive disorders such as PCOS. Others who experience early trauma and anxiety can develop Irritable Bowel Syndrome or chronic pain. These changes may also look like interpersonal changes. One may notice changes in relationship dynamics or social engagement. However, some of us may not even realize traumatic effects on our lives until many years after they occur. This is also extremely common.
Abandonment, Attachment, and Childhood Trauma
Abandonment is perceived very early in childhood. This, of course, can refer to physical abandonment, where a baby is left on a doorstep to fend for itself or children who go hungry for days because there isn’t a parent around to feed them. However, abandonment can also refer to children who have physical needs met, new school clothes every year, expensive extracurricular activities, and parents who sit with them every night for dinner. These children may even have abundant upbringings with luxuries some could not imagine. Instead of physical abandonment, these children are likely experiencing emotional abandonment, which the brain is just as adept at perceiving. Emotional abandonment and physical abandonment can be equally impactful.
There is an extremely popular study where baby monkeys were offered a wire frame mother figure who fed them regularly or a soft, terry cloth mother figure who was inconsistent with feeding but warm and comforting. The baby monkeys sought out comfort over food. This study introduced researchers to the idea of the comforting caregiver, which then led to countless studies around attachment.
Attachment theory posits that the way we navigate the world is a response to the way our caregivers interacted with us as babies and toddlers. If we have a secure relationship with at least one primary caregiver, the theory maintains, then we will be able to cope with the world and relationships much better than if we maintained an insecure relationship with our caregivers. Securely attached relationships with caregivers include attunement, or the idea that the other person completely understands our needs and emotions. Not every caregiver will be entirely perfect for every interaction, but a general positive perception of that caregiver and their attempts to maintain a secure relationship keeps the relationship secure. Please note that those with secure attachments may still experience clinical anxiety with diagnoses such as Generalized Anxiety Disorder or Panic Disorder. However, that clinical anxiety is not due to relational trauma.
For those who experience insecure attachments with caregivers, navigating the world is much more difficult because there was no perceived safe base to return to. Some caregivers were inconsistent in being warm. Some caregivers were totally absent, while some caregivers were a chaotic mix of both fear and comfort. Generally speaking, these types of responses to children develop into three specific insecure types of attachment. A person who sees the world through an insecurely-attached lens will tend to look for signs of rejection, much like they experienced as children who sought comfort from their caregiver. Seeking out the rejection is a defense against what seems inevitable. Parents often unconsciously pass insecure attachment on to their children as they try to soothe their own insecurities.
The child whose caregiver produced fear and comfort tends to develop into a person with disorganized attachment. This person desperately desires intimacy and warmth but denies it and hates their desire for it. This discrepancy creates anxiety and deep feelings of unworthiness due to the ongoing need for love while grappling with self-hate.
The child with the absent caregiver learns to manage the world all alone. This child grows into a person with avoidant attachment. This attachment style is marked by a lone wolf mentality. The person does not want help, they deny any need for intimacy, and are incredibly put-off by shows of emotion. Their anxieties develop from constant suppression of emotions, but may also come from trying to avoid other people’s feelings. If a person with avoidant attachment is asked to make adjustments or to deeply empathize, it may trigger deep feelings of anxiety, as it may feel like tip-toeing through a minefield.
The child with an inconsistent caregiver is most likely to identify with anxious attachment. Those with anxious attachment are known for being clingy. They feel a constant need for attention and reassurance that they are still worthy of love and effort. A person with anxious attachment struggles with boundaries, and this is where their anxieties develop. For a person with anxious attachment, any space between themselves and a loved one is a threat. This is the complete opposite of a person with avoidant attachment, who finds closeness to be a threat. Those with anxious attachment are also extremely sensitive to perceived threats to the security of a relationship and will take great lengths to get reassurance from their loved one again.
Effects of the Overbearing Parent
The overbearing and cold parent is often well-intentioned in their desire to create an outstanding kid. However, along the line this can get mangled and tangled into producing an unhappy child. The unhappy child will eventually meet a fork in the road when they start to desire independence and the freedom to develop their own identity. Some children will act out, becoming a perpetual pain until they grow out of their rebellion. Parents usually hope to avoid this if they can, as it requires constant monitoring, low trust, and high stress. Instead, they’d prefer a child who keeps operating as usual.
However, this normal operation is an illusion. If the child is truly unhappy, feeling as if they must guard their feelings, meet strict standards, expect harsh punishments for minor infractions, or place their parent’s feelings above their own, the child is merely a duck panic-paddling under a seemingly calm pond. These children experience hypervigilance and learn to tune themselves very deeply into their parents’ habits, feelings, and behaviors, yet still act calm on the outside. These children also push down and repress, constantly testing their thresholds for discomfort. Parents do not realize that the silent child is often anxious, deeply afraid of a misstep. This fear is traumatic. The child feels unsafe and may turn to unhealthy coping mechanisms. Many, many children have feelings of suicide around this time because their anxiety and their home lives feel like a complex trap.
Treating Childhood Trauma
Childhood trauma can have lasting effects on mental health and wellbeing, with one of the most common outcomes of trauma being anxiety. Fortunately, there are many steps that can be taken to treat childhood trauma and anxiety. Here are some tips to consider:
- Seek professional help: One of the most important things to do if you or a loved one is struggling with childhood trauma and anxiety is to seek professional help. This may involve working with a therapist or counselor who specializes in trauma and anxiety, or discussing medication options with a doctor or psychiatrist.
- Practice mindfulness: Mindfulness practices, such as meditation or deep breathing, can help to calm the mind and reduce anxiety. Regular practice can help to rewire the brain and reduce the impact of childhood trauma.
- Build a support network: Building a support network of trusted friends and family members can provide a safe space to discuss and process trauma. Be sure that this support system is truly safe. Consider avoiding attachment figures like parents or older siblings who were responsible for the onset of the trauma. Support groups can also be a valuable resource for those who have experienced childhood trauma.
- Exercise: Exercise can be a great way to reduce stress and anxiety, as well as improve overall physical health. Consider taking up a regular exercise routine, such as walking, yoga, or weight lifting. Be mindful of the stress-release aspects of this movement. Do not engage in exercise that makes you feel emotionally bad or lowers your self-esteem on a chronic basis.
- Try exposure therapy: Exposure therapy involves gradually exposing individuals to situations that trigger anxiety in a safe and controlled environment. This can help to desensitize individuals to the triggers and reduce anxiety over time. Please, only engage in exposure therapy with the guidance of a trained professional, especially if you are extremely vulnerable to intense emotional reactions.
- Consider medication: In some cases, medication may be prescribed to help manage anxiety symptoms. Some medications target anxiety and daily functioning, while others focus on symptoms of panic attacks. This should always be done under the supervision of a medical professional.
- Practice self-care: Self-care practices, such as taking a warm bath or reading a book, can help to reduce stress and anxiety. It is important to prioritize self-care as part of any daily routine, as well as part of a treatment plan for childhood trauma and anxiety.
- Avoid alcohol and drugs: Alcohol and drugs can exacerbate anxiety symptoms and should be avoided. This is a default coping mechanism for many people who struggle with childhood trauma and anxiety, but may quickly slip into something dangerous. If you are struggling with addiction, seek professional help.
- Feel your feelings: It can be tempting to avoid or redirect difficult emotions, but keeping emotions suppressed only reinforces feelings of disconnect and anxiety. Releasing these emotions can include crying or hitting a pillow. If you find it difficult to release or express your emotions, consult with a therapist or counselor.
- Be patient: Healing from childhood trauma and anxiety takes time and patience. It is important to be kind to yourself and to celebrate small victories along the way. It took years for you to develop into the person that you are today. It is okay if you stumble or struggle a few times on your healing journey.
