How Child Sexual Abuse Impacts the Developing Brain 

(part 1 in a 5 part series)

We all know that sexual abuse has lasting effects on the person who was abused. This often shows up as chronic feelings of low self-esteem, shame, anxiety, depression, and more. But what is not talked about as much is how sexual abuse, especially sexual abuse that begins during those critical first 5 years of life, actually changes the developing brain. 

During the first five years the brain and its core features are developing at a rapid pace. Billions of connections (neural activity) are being made. These connections are made up of stimuli that comes from the outside world, physiological responses that are constantly happening internally, as well as memories. Memories which are made up of our past experiences and catalogued in our brains and subsequently stored also in our body. 

Our experiences include the two drives that we all have as human beings. That is, the instinctual inherit drive for self protection (the Stress Response System) and our drive for love/connection (attachment). When we take a moment to digest the impacts of sexual abuse, what we notice is that our two basic core drives are being attacked. It’s no wonder that sexual abuse, whether single incident or chronic, has such drastic impacts on the survivor. 

An Overview of How Our Brains Develop

Our brains develop in a sequential use dependent manner. Starting with the most basic foundational block, the brainstem. The brainstem begins developing while we are in the womb. It represents our connection to our basic physiology. The neuronal connections in the brainstem transmit messages between the brain and different parts of the body. By the time we are born and within those first weeks our physiological responses or drives become hardwired-meaning they are difficult to change.

Next on the developmental hierarchy and is actually the top part of the brainstem is the diencephalon. The diencephalon is responsible for transmitting sensory information (information from the 5 senses) to different brain regions, connects the endocrine system with the nervous system, and works with the limbic system. The diencephalon also begins developing in utero but it does most of its hard work during that first year, when the baby is growing rapidly both physically and cognitively. 

Also during this crucial time is the development of the limbic system. We know it as the emotional center of the brain but it also does a lot more. The limbic system is also responsible for storing memories and managing our arousal levels. It is here where our basic drives, attachment (love) and self protection (fight-flight freeze or the Stress Response System) meet. Our limbic systems are constantly developing, but just like the other areas during this first 5 years and like the Cortex, it doesn’t meet full maturation until well into ones 20’s. The limbic system goes through big bursts of development both during the first five years and then again during adolescence. 

Finally, we have our Cortex. Our cortex is the top most part of our brains and is typically what we use to manage our more basic impulses. It is also responsible for critical thinking, problem solving, meaning making, and it houses our core beliefs about ourselves and others. The cortex is the largest part and the most easy to change. Our cortex is constantly developing and it also takes the longest to fully develop,  which happens typically by age 25 for females and 26 for males. 

Although discussed separately, these key areas of the brain are intricately connected. They work together to make us who we are.

Attachment is Fundamental to Our Developing Brains

In the safety and security of our home, with loving and safe adults, our nervous systems feel a sense of calm which allows for key developmental blocks to be set and subsequent ones to be built upon that foundation.

The development of our brains is aided by our attachment relationships with our primary caregivers. Primary caregivers can be a mother, father, grandmother, uncle, aunt, family friend, etc. What they have in common is that they are the responsible for the love and care of the baby.

Attachment or our need to both feel and express love, is a core drive that we are all wired for. This bond begins while a woman is pregnant, as the baby responds to the touch of the belly, the hormones that get released (cortisol-the stress hormone, oxytocin the “love” hormones, etc), and the sounds they continuously hear from the outside world (most notably the mothers voice but also others who are in the environment). 

Once the baby is born they have a lot more stimuli, both internally and externally, that they  respond too. Sometimes all of this stimuli is too much and the baby becomes overwhelmed. This may trigger the stress response system but the attachment connection is the buffer that helps alleviate the stress. This distress is experienced in those early weeks and months as core physiological functions that are out of balance (hunger, tiredness, temperature, etc) and only as the baby grows and develops manifest into more. 

The sign of distress that a baby communicates to it’s caregivers is through crying. When the adult comes and attunes to that distress, alleviating it, this creates an association between crying, distress, and the primary caregiver coming to alleviate that distress by taking care of their baseline physiological needs (feeding, rocking, cuddling, soothing words, gentle touch, etc). With repeated interactions like this, connections in the brain are made and memories are formed. A pattern of repetitive and expected behavior that a child learns to depend on. This becomes the foundation of the beliefs about the people in their lives and later can extend to beliefs about people in general.

This process of learning and association occurs even in home environments where the baby is constantly stressed and overwhelmed, but instead of having a foundation built on the safety of the attachment system and all that goes with it you have one that is built upon the chronic activation of the stress response system with inconsistent or little positive attachment to buffer. What gets strengthened in these instances is the mechanisms involved with the stress response system or easier put a baby who is wired to constantly conscious be prepared for danger. 

Stress Response System is Fundamental to Our Survival

The stress response system is our innate drive for self protection that we are all born with. When we become overwhelmed by perceived threats in our environments, the stress response system gets activated and a cascade of other biological functions get deployed to help us survive said threat. Primarily activated by feeling fear, it responds based on our  past experiences as well as our arousal levels. 

When activated there are 3 primary behaviors we might engage in. We might go directly to one and stay there or move through all 3, it just depends on a lot of factors that happen at a split level and largely unconscious awareness (but we can bring it into our awareness). Also know as the fight-flight-freeze response, what is described here in our natural drive to escape danger, pain, harm, or potential death using the method that is deemed most efficient given the situation. 

Both fight and flight are movement based and are characterized by an increase in adrenaline to our extremities (legs and arms), increase hear rate, and an expansion of vision as we look for the best way out of said threat. On the other hand the freeze response is immobilizing and is characterized by the release of endorphins (to dull pain), a decrease in heart rate, a narrowing of vision, and when severe enough disconnection between mind and body (dissociation). 

Our first real activation of the stress response system happens in the process of labor. Prior to this, while in utero, as babies we were automatically provided with what we needed (in typical development). Mom ate, we ate. Temperature was stable, the amniotic sac was at 99.7 degrees Fahrenheit. We had stimuli in the form of constant physical movement, as well as touch/pressure on the stomach, and sounds from the outside world. It was all stable and constant (again in a typical development). But once out in the world things tend to be a little different. 

No longer are things stable in the same way and thus those little systems must adjust. This occurs in the confines of the attachment relationship and these small doses of stress (waiting to be feed as opposed to constantly having food available for example) are developmentally appropriate and increase a babies resiliency. They are not fear based as in the case of trauma and thus they are not trauma reactions. 

How Sexual Abuse Impacts the Developing Brain 

Our psycho-sexual development is part of our limbic system, and is thus part of our basic physiology. Toddlers and prepubescent children often stumble upon sex through the form of masturbation, by accident, on their own, and it very typically becomes a method of self soothing because it feels good rather than a sexual release in a way that adults might conceptualize sex. In these instances it’s up to parents and caregivers to talk with kids about their bodies, privacy, and the like, to help them develop positive associations around sexuality that they can carry through puberty and beyond. Furthermore, even for toddlers and children who do not stumble into masturbation, they are still very curious about their bodies and others bodies. They ask questions and want answers, just like they do with many other things in their lives. 

Abusers: parents, caregivers, older children, etc, use children’s normal curiosity around bodies and sex to prey upon the children in their lives. The coercion abusers use to sexually abuse children, triggers the victim/survivor’s stress response system as their body goes into self protection mode. They capitalize and manipulate the trust of the child that they have earned through their relationship to get their own sexual needs met, while harming the child. In this way they are not only activating and reactivating the child’s stress response system (and thus strengthening those neuronal pathways used for survival) but they are also taking away the very thing a child needs to thrive and build resiliency, the attachment relationship (human to human connection). 

When the abuser is the parent or other primary caregiver then the actual attachment foundation is fractured as well, as this core drive for love, affection, and connection is confusingly tied in with fear, anxiety, and pain. It’s bad enough when the abuser is a family friend or another child who doesn’t play a central role in care taking of the child, but when the abuser is actually someone responsible for the day to day nurturing of the child you are stripping away something so fundamental in the development of that child.

The subsequent developmental building blocks, as a result if these early traumas, will be survivor based. Spawned by heightened anxiety and fear, the child is hyper aware of their environment (hypervigilance). They are constantly looking for threats and are more susceptible to changes in another person’s tone of voice, proximity to others, touch, etc. With all the attention being diverted towards looking for threats, as well as both the external and internal stimuli associated with threats, its no wonder these children have trouble in school. 

They often have trouble sustaining attention and focus as they are constantly scanning their environment. Survivors also have trouble remembering things as once they are triggered they might go into a dissociative state and miss chunks of time and thus information. For other children their fight or flight mechanism is triggered when the teacher raises their voice (even if it is at another student) and they are running out of the classroom or arguing with the teacher (which will often get them out of the classroom). In this instance they are not only missing class but they are label “difficult” and the teacher and other school personnel treat them differently. This is another example of how attachment or connection is disrupted.  There are just so many ways that child sexual abuse and the associated trauma responses and attachment wounds can be disruptive to typical development. 

Conclusion:

Child sexual abuse is a huge problem that really needs to be discussed more. Not only so we are aware of how pervasive it is and how we can protect our children but also so we can help survivors not feel so alone. To help them understand why they behave the way they do and what they can do to change this. 

In the next couple blogs I’m going to dive deep into child sexual abuse and how it impacts each group of humans, from toddlers, to children, to teens, and even adults. My hope is to help you not only see the signs of abuse but also recognize the subtle ways that a survivor behaves as a result. In the end I want to help normalize the survivors experience while also giving them tools to help change their behaviors and heal so they can feel more control and in love with themselves. 

If you are a survivor of sexual abuse and want help with how to heal and “move on” then contact me to schedule your first session so you can get started today!

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