“Not all wounds are visible, and not all scars are on the skin.”
Every other day, we hear about the devastating effects of child abuse in the media, reinforcing the importance of tackling childhood trauma. While physical and sexual violence are widely acknowledged as forms of trauma, less obvious types of adversity can have equally profound, long-lasting impacts on a child’s development.
Childhood trauma encompasses experiences that inflict significant emotional and psychological damage during a child’s developmental years. Unlike typical setbacks, such as failing a test or having a disagreement with a friend, the consequences of trauma can follow a person throughout their life.
To tackle childhood trauma, it’s crucial to first recognise how these early experiences shape our thoughts, behaviors, and emotions—often in ways that aren’t immediately visible.
What is childhood trauma?
One key framework for understanding childhood trauma is the Adverse Childhood Experiences (ACEs) model, developed by the Centers for Disease Control and Prevention (CDC).
ACEs cover a variety of potentially traumatic events occurring before the age of 18, including:
- Experiencing violence, abuse, or neglect.
- Witnessing violence in the home or community.
- Having a family member attempt or die by suicide.
- Growing up in a household with
– Substance use problems.
– Mental health problems.
– Instability due to parental separation.
– Instability due to household members being in jail or prison. - Not having enough food to eat
- Experiencing homelessness or unstable housing
- Experiencing discrimination
The ACEs score helps us understand the extent of childhood trauma by tallying these experiences, with scores ranging from 0 to 10.
While a higher ACEs score can be associated with increased risks for mental health and chronic conditions, it’s not a definitive predictor of future outcomes. Instead, it’s an indicator of potential risk that can be addressed through effective interventions, support, and resilience-building strategies.
Childhood trauma in Singapore
The occurrence of Adverse Childhood Experiences (ACEs) is strikingly high. For example, a study by the CDC and Kaiser Permanente discovered that about 64% of participants had experienced at least one ACE, with 12.5% encountering four or more.
In Singapore, a 2020 study found that 63.9% had experienced ACEs over their lifetime, with emotional neglect being notably more prevalent than physical neglect. Additionally, a 2024 study by the Institute of Mental Health (IMH) and KK Women’s and Children’s Hospital (KKH) estimated that ACEs cost the country approximately S$1.18 billion annually in terms of absenteeism, reduced productivity, and healthcare expenses.
These figures highlight the broad impact of ACEs and underscore the importance of addressing and mitigating their effects.
Do I have childhood trauma?
Figuring out whether you’ve experienced childhood trauma can be complex. For example, while one child might view harsh discipline as a tough lesson and move on, another might experience lasting fear and anxiety.
So, what separates an unpleasant experience from a traumatic event?
Typically, an unpleasant experience doesn’t occupy much mental space for long, but a traumatic event can trap us in the “fight, flight, or freeze” mode. This affects our daily lives, interactions with others, and overall functioning.
A child who fails a test may feel briefly upset but can move on and improve. In contrast, a child who is caned whenever they receive a poor grade may remain hypervigilant, even in safe environments like school. This can hinder their ability to focus in class, form relationships with peers, and maintain overall well-being.
Compared to an unpleasant experience, a traumatic event also impacts our sense of self and how we make sense of the world to a greater extent.
Imagine this child has grown up to become a working professional. After their team is impacted by a recent company layoff, their peers may feel discouraged but still maintain hope for future success. In contrast, they begin to see themselves as unworthy and perceive the world as harsh and unforgiving.
In short, what makes an event traumatic is how it is experienced and the lasting effects it creates. With that said, these factors can vary based on individual characteristics, such as temperament, personal history, and available support.
So, how do you know if you’ve been affected by childhood trauma? Reflecting on how past experiences influence your present-day thoughts, emotions, and behaviours is a good starting point.
How childhood trauma manifests in adulthood
Our experiences as children, especially those that are distressing or overwhelming, significantly shape our sense of self, relationships, and world view. Although we might not immediately link our adult challenges to childhood events, the effects of child trauma often persist in subtle ways throughout our lives.
- Emotional: Survivors of childhood trauma may struggle with lingering feelings of anxiety, depression, or low self-esteem. For example, a child who grew up in an abusive environment might internalise the belief that they are unworthy of love or safety, leading to a profound sense of inadequacy or self-loathing in adulthood.
- Physical: The constant state of fight-or-flight triggered by trauma can strain the body’s immune system and overall health. Research indicates that individuals with higher ACEs scores are more prone to health issues such as heart disease, autoimmune disorders, and chronic pain.
- Behavioural: Childhood trauma can lead to the development of harmful coping mechanisms. Adults may turn to substance abuse, disordered eating, or other risky behaviours as ways to manage overwhelming emotions or numb the pain stemming from unresolved trauma.
- Cognitive: The brain, especially during childhood, is highly sensitive to stress, and repeated traumatic experiences can disrupt its development, resulting in difficulties with information processing, emotional regulation, and stress response.
Childhood trauma often manifests in two key areas of our adult lives: personal relationships and professional environments.
- Personal: An individual who grew up with emotional neglect or frequent abuse may understand “safety” in relationships differently from those who had more supportive childhoods. If they grew up in constant conflict, they might find a stable relationship unsettling and potentially seek out familiar, albeit dysfunctional, patterns of behaviour.
- Professional: An individual who was frequently criticised for their academic performance in school might internalise these negative labels and carry them into their professional lives. As a result, they may view mistakes as a reflection of their worth rather than as opportunities for growth and learning.
Do I need counselling/psychotherapy?
Childhood trauma can lead to Post-Traumatic Stress Disorder (PTSD) in some cases, but not all. Even when the symptoms of childhood trauma do not meet the criteria for PTSD, they can still have a profound impact on a person’s mental health. For example, they may experience persistent anxiety, depression, or relationship difficulties, without necessarily having the flashbacks or hyperarousal associated with PTSD.
Whether or not PTSD symptoms are present, survivors of childhood trauma can greatly benefit from counseling or psychotherapy, especially if certain memories:
- Trigger intense emotional reactions
- Cause distress in your relationships
- Impact your daily functioning
While some may wonder if there’s a “right” time to seek help, especially when the traumatic event occurred years ago, we encourage you to reach out if it continues to affect your wellbeing.
What can I expect from my sessions?
Counselling offers a supportive space to address and heal from childhood trauma, and therapeutic approaches such as Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) can be particularly effective.
Cognitive Behavioural Therapy (CBT)
CBT is based on the idea that our thoughts, feelings, and behaviours are interconnected. By changing unhelpful thought patterns, we can alleviate negative emotions and act constructively in challenging situations.
When addressing childhood trauma with CBT, your clinician will explore how emotions arise, the behaviours that follow, and strategies for regulating these emotions. You will also examine the origins of coping mechanisms and work on fostering a healthier sense of self.
A key component of CBT is Exposure and Response Prevention (ERP). For example, if you tend to avoid authority figures at work due to childhood trauma, your clinician may guide you to gradually confront and process these triggers in a safe environment. This approach helps diminish the power of traumatic memories and reduces avoidance behaviours, allowing for more effective interactions with supervisors.
Eye Movement Desensitisation and Reprocessing (EMDR)
Designed specifically for trauma treatment, EMDR helps individuals reprocess distressing memories so they become less disruptive and more manageable.
In EMDR, your clinician will first help you build “resources” and teach grounding techniques to establish a solid foundation. Once this groundwork is in place, they will use bilateral stimulation, which typically involves guided eye movements. Tracking your clinician’s fingers (or a visual cue) while recalling traumatic memories helps reprocess the memories and reduce their emotional impact, thereby integrating neutral or positive beliefs about the memory.
Ultimately, the effectiveness of counseling depends on a person-centered approach. With survivors of childhood trauma, clinicians typically combine different approaches to create a personalised treatment plan that meets the individual’s unique experiences and needs.
Address childhood trauma at Intellect Clinic
It’s common for survivors of childhood trauma to blame themselves for being stuck in their past experiences. However, if we had the choice, we would never want our past to define us. The feeling of safety is a biological response, not something we can control or fault ourselves for. You’re not weak—you’re simply human.
While we can’t change our pasts, we have the power to shape our future. If you’re ready to begin your journey of healing and personal growth, our clinicians are here to support you every step of the way.
50-minute sessions with our counsellors and clinical psychologists are priced at $160 and $240 (Singapore dollars) respectively, and we offer appointments at our clinics in Marina One, Tanjong Pagar, Woodleigh, and Tembeling.
Reach out to us today for an appointment in the same week.
