How Emotional Abuse in Childhood Changes the Brain

Childhood emotional abuse and neglect can result in permanent changes to the developing human brain. These changes in brain structure appear to be significant enough to potentially cause psychological and emotional problems in adulthood, such as psychological disorders and substance misuse.

Around 14% of Americans report experiencing emotional abuse or neglect during their childhood. Emotional abuse can include:

• Insulting, name-calling, or swearing at a child
• Threatening to physically harm the child
• Terrorizing or otherwise making the child feel afraid

Emotional neglect involves failing to meet a child's emotional needs. This can include failing to:

• Believe in the child
• Create a close-knit family
  
• Make the child feel special or important
• Provide support
• Want the child to be successful
  

How Abuse Alters Brain Structure

As children grow, their brains undergo periods of rapid development. Negative experiences can disrupt those developmental periods, leading to changes in the brain later on.

Research supports this idea and suggests that the timing and duration of childhood abuse can impact the way it affects those children later in life. Abuse that occurs early in childhood for a prolonged period of time, for example, can lead to particularly negative outcomes.

Dr. Martin Teicher and his colleagues at McLean Hospital, Harvard Medical School, and Northeastern University studied the relationship between abuse and brain structure by using magnetic resonance imaging (MRI) technology to identify measured changes in brain structure among young adults who had experienced childhood abuse or neglect.

They found clear differences in nine brain regions between those who had experienced childhood trauma and those who had not. The most obvious changes were in the brain regions that help balance emotions and impulses, as well as self-aware thinking. The study's results indicate that people who have been through childhood abuse or neglect do have an increased risk of developing mental health issues later on.

Effects on Brain Structure

Childhood abuse and neglect can have several negative effects on how the brain develops. Some of these are:

• Decreased size of the corpus callosum, which integrates cortical functioning—motor, sensory, and cognitive performances—between the hemispheres
• Decreased size of the hippocampus, which is important in learning and memory
• Dysfunction at different levels of the hypothalamic-pituitary-adrenal (HPA) axis, which is involved in the stress response
• Less volume in the prefrontal cortex, which affects behavior, emotional balance, and perception
• Overactivity in the amygdala, which is responsible for processing emotions and determining reactions to potentially stressful or dangerous situations
• Reduced volume of the cerebellum, which can affect motor skills and coordination

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Effects on Behavior, Emotions, and Social Function

Because childhood abuse, neglect, and trauma change brain structure and chemical function, maltreatment can also affect the way children behave, regulate emotions, and function socially. These potential effects include:

• Being constantly on alert and unable to relax, no matter the situation
• Feeling fearful most or all of the time
• Finding social situations more challenging
• Learning deficits
• Not hitting developmental milestones in a timely fashion
• A tendency to develop a mental health condition
• A weakened ability to process positive feedback

These effects can continue to cause issues in adulthood if they're not addressed. Adults who experienced maltreatment during childhood may have trouble with interpersonal relationships—or they may avoid them altogether.

These outcomes could be related to attachment theory, or the idea that our early relationships with caregivers influence the way we relate to people later on in life. Emotional abuse and neglect don't allow for a secure attachment to form between a child and caregiver, which causes distress for the child and influences the way they see themselves and others.

Adults who went through childhood emotional abuse or neglect may also experience:

• Emotional dysregulation
• Feelings of hopelessness
• Low self-esteem
• Negative automatic thoughts
• Problems coping with stressors

Treatment

Through treatment, it is possible to address the effects of childhood emotional abuse and neglect. Treatment in these cases is highly individual since maltreatment can take many forms and each person's response to it may differ.

Any form of treatment would likely include therapy and, depending on whether or not any other mental health conditions are present, may include medication as well. Brain plasticity is at its peak during early childhood, meaning early intervention is the best way to recover from changes in the brain caused by stress and trauma. Although the adult brain continues to have plasticity, it requires more effort and time to re-establish healthy neural connections. Some effective forms of therapy for children and adults are:

• Attachment and Biobehavioral Catchup (ABC): Partnering with parents and teaching them to re-interpret their children's behavior and respond to them sensitively. Creating a safe and positive interaction between the parent and the child fosters a secure attachment and healthy brain development. This results in children who can learn to self-regulate their own emotions and behaviors.
• Exposure therapy: Exposure therapy involves interacting with something that typically provokes fear while slowly learning to remain calm. This form of therapy may improve neural connections between several regions in the brain.
• Family therapy: Family therapy is a psychological treatment intended to improve relationships within the entire family and create a better, more supportive home environment. This type of treatment may improve HPA axis functioning and lead to a healthier stress response. 
• Mindfulness-based approaches: Mindfulness-based therapy focuses on helping people develop a sense of awareness of their thoughts and feelings so they can understand them and better regulate them. These approaches may help improve resiliency against stress by benefiting several brain regions and improving neural connections.
• Play therapy: Play therapy can help a child process and express emotions in a safe environment. Using toys, games, and crafts can help a child get comfortable and may use play to act out or express their emotions and learn to regulate their behavior while adopting healthier coping mechanisms.
• Trauma-focused cognitive behavioral therapy (TF-CBT): TF-CBT focuses on helping people learn new coping skills, restructure negative or unhelpful thoughts, regulate their moods, and overcome trauma by crafting a trauma narrative. This form of therapy may help reduce overactivity in the amygdala.

A Word From Verywell

Emotional abuse and neglect are linked with structural and functional changes in the brain of a child that can affect their well-being for years to come. Depending on the severity and duration of the abuse, and other factors, a neglected or abused child may develop cognitive impairments, behavioral problems, and emotional dysregulation, as well as challenges in developing healthy social relationships.

Early intervention and support can help reverse some of the damage that happened in the young developing brain. Without intervention, the child is at higher risk for developing mental health problems, personality disorders, and substance abuse in the future.

It is also important to increase education and awareness for new parents to help them understand their child’s needs and how to respond appropriately and sensitively. Some parents have endured abuse themselves and may need additional support from parenting coaches and psychotherapy, to stop the cycle of intergenerational abuse.