Chronic pain and childhood trauma

Laura Kiesel

Contributor

Recently a journalist colleague of mine put out a call for quotes from those who suffer from severe premenstrual syndrome and premenstrual dysmorphic disorder (more commonly known as PMS and PMDD, respectively) who also suffered a history of childhood abuse. Her interest was piqued by a 2014 peer reviewed article that appeared in the Journal of Women’s Health linking the disorders with early onset abuse. I answered the call, having both PMS and PMDD, as well as a history of child abuse by both my stepfather and my mother.

Yet despite having both a history of abuse and several diagnoses that contribute to chronic pain, it’s only been in the past few years that I’ve become aware of the connection between the two. It wasn’t until I started writing a collection of personal essays about my youth, and researching scientific literature about childhoods like mine, that I stumbled upon the now-famous 1998 ACE study, which explored “adverse childhood experiences.” Specifically, the study surveyed 17,000 middle-income adults who had health data stretching back to their early childhoods. The ACE research indicated that the more adversities an individual experienced as a child — whether poverty, parental death or incarceration, neighborhood violence, or abuse — the more likely that person would suffer from serious physiological disorders as an adult.

Understanding the connection

While the causality between childhood adversity and adult chronic illness has yet to be fully determined, researchers now have enough knowledge about the way chronic stress impacts physiological health to make some educated guesses about their potential link. When we are threatened, our bodies have what is called a stress response, which prepares our bodies to fight or flee. However, when this response remains highly activated in a child for an extended period of time without the calming influence of a supportive parent or adult figure, toxic stress occurs and can damage crucial neural connections in the developing brain. According to Harvard’s Center on the Developing Child, the impacts of experiencing repeated incidents of toxic stress as a child “…persist far into adulthood, and lead to lifelong impairments in both physical and mental health.”

Why addressing pain and trauma should go hand in hand

The fact that childhood adversity is so intimately intertwined with adult illness does not mean that those physiological diseases experienced by adults who had traumatic childhoods are not real or valid, or that their causes are “psychosomatic.” The biological impacts of childhood adversity are not only genuine, but can be very difficult (and sometimes impossible) to completely undo.

However, it does offer hope that psychological care for those with a history of childhood trauma may help tame their overactive stress response in the present day, and in turn provide some complementary health benefits for those also dealing with physiological diseases. In my case, while processing my traumatic childhood history in psychotherapy has not automatically cured my physical ailments (and will not), it does help me relearn how to react to stress.

Pediatric health care providers and educators should understand how far into the future the effects of childhood abuse and adversity may extend. This knowledge should serve as further motivation to help children in these situations access necessary supports as quickly as possible, to guard against some of the biological changes that could make them suffer later on in life. Likewise, those who work in the mental health field with adults who suffered childhood trauma would well do to study the link between that and chronic pain and illness, so that they can better support their patients.

Comments:

  1. Emily Grace Grace

    I agree with you, there are several branches of chronic pain and one of them relates to childhood trauma. Childhood trauma leads to different psychological effects on children. This may lead to permanent chronic pain also. The reason I am saying this because I was also had also experienced the same, though I improved a lot after attending regular sessions from the doctors of Physician Partners Of America. Now I am living a normal life. The key is, we have to push it hard to treat our-self and the result will be as good as you want.

  2. Howard Schubiner MD

    Your story is very moving!
    There is hope for pain reversal when it is connected to childhood trauma.
    We just published an article demonstrating that an emotion focused therapy was superior to CBT in dramatic pain reduction in people with fibromyalgia, many of whom had childhood trauma.
    Here’s the link: https://journals.lww.com/pain/Abstract/2017/12000/Emotional_awareness_and_expression_therapy,.10.aspx
    Best wishes on your journey.
    Howard Schubiner MD

  3. Priscilla Morris M.D., M.B.A.

    I also have found a strong connenction to psychological trauma/childhood abuse and chronic pain in my pain practice. Have realized that in these cases, we often go about treatment in the entirely wrong way. I agree with Dr. Schechter and plan on reading his papers on this subject.

  4. David Schechter MD

    In my experience quite a bit of physical pain is misdiagnosed as being due to an incidental structural finding on x-ray or MRI scan. In fact quite a bit of this pain is due to prior emotional trauma, personality factors, psychological stress anxiety, fear, anger, and grief. My work begins with first diagnosing the problem correctly in reviewing those imaging tests and examining the patient carefully. Then we work on both the cognitive aspects of understanding where the pain comes from and also the emotional processing of both current and past issues. This approach is been very successful in treating over 2500 patients and I’ve published some papers on this as well.
    David Schechter MD

  5. Angela Silvernail

    This blog is exceptional! Thankyou everyone for your personal truths , while helpings others, like myself! ♡♡♡

  6. Susan

    Mickel Therapy is based on this link between chronic stress and physiological health. However, the difference is that our approach towards helping our clients with emotional issues actually is successful at treating the connected physical conditions.

  7. SkepticalSusan

    “While the causality between childhood adversity and adult chronic illness has yet to be fully determined”

    ^This.

  8. Nancy Schwartz

    Facinating blog! This makes complete sense in relation to the mindbody connection. I think this type of research could go further relating ACE adverse childhood experiences to older adult being more prone to dementia/alzhiemers disease.

  9. Daun Kauffman

    Is there a link or citation for the 2014 article in Journal of Women’s Health ?

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