Fighting Words

The Link Between Childhood Trauma and Addiction

Family separation is traumatic, and traumatic experiences can launch a predisposition to addiction or mental illness into an actual disorder.

Maia Szalavitz

Maia Szalavitz

Alex Edelman/AFP/Getty Images

My father was only a toddler when his father was ripped from his family and conscripted into the Hungarian army; he was just five or six when the Nazis came for his town’s Jews.

First, he, his mother, and even-younger sister were caged with dozens of others in a freezing former factory. They were actually on the train to Auschwitz—packed in like cattle, without windows, food, or bathroom facilities—when liberation finally came.

My dad was so traumatized afterwards that when he entered first grade, his teachers thought he was intellectually disabled. In his teens, he made it to America and had a family and a career as a chemist—but he spent most of his life profoundly depressed.

And I have spent much of mine trying to understand the effects of childhood trauma as it echoes across generations. When I was in college, I became addicted to cocaine and heroin—only after I recovered did I learn that what I had experienced prior to that was depression and then work my way back to my family history. I eventually co-authored two books with Bruce D. Perry, a leading child trauma expert, who recently appeared on “60 Minutes” to discuss the lasting effects of early life stress with Oprah.

Not surprisingly, I was extremely troubled to learn that Americans have been tearing apart immigrant families—putting little children in cages, not allowing them to comfort each other with hugs. The potential damage of this alone is hard to overstate, regardless of whether any further cruelty is inflicted. Between May 5 and June 9, 2018, more than 2,300 children were separated from their parents or caregivers after crossing the southern border into the US. (On Wednesday, President Trump signed an Executive Order to end family separation but it’s unclear what will happen to the families already broken up.)

An early inkling of the harm done by denying children the primal bond of parental care can be seen in a study that was, ironically, conducted in the 1940s by an Austrian doctor, René Spitz. While we don’t know how long these immigrant children will be in institutional settings like “shelters” without their parents or even foster parents, we do know that such places are harmful, especially for those under five.

Indeed, as far back as the 1940s, physicians had long known that babies raised in hospitals or other institutions without the loving, specific care of one or two parents had incredibly high mortality rates. Experts believed that this was due to infection—so they made the infants’ rooms extremely sterile, leaving them alone in bare cribs surrounded by sheets.

Spitz suspected that something else was going on. He thought that the babies were dying because—without being the center of someone’s world, without being cuddled or fussed over by the same family day and night—they weren’t getting enough love, stimulation, and physical nurture for normal development. He compared two groups of children: babies raised in the typical sterile room by shifts of nurses and those whose mothers were incarcerated, but allowed to keep their infants with them.

The differences were obvious quickly: for one, 37 percent of the hospital babies died before turning two, while none of the prison babies who had their moms with them did. Second, the hospital babies were smaller and more listless—and only two out of 26 could walk or talk like typical children do at that age.

Moreover, research conducted in the 2000s found that children reared even in pleasant and well-staffed institutions in Romania simply didn’t thrive: They were more than twice as likely to have mental illness during childhood, compared to those randomized to foster care, for one.

They were also smaller, less happy, have more attention and behavior problems and their IQs were significantly lower, a condition that worsens with each month spent without parents. (While the ethics of randomizing babies to orphanages versus foster care were already questionable when this study was done, the researchers did it only to prove to the Romanian government that its existing orphanages were doing harm and adoption was encouraged even in the orphanage group).

This is why infant orphanages no longer exist in the United States and most developed countries: Early-life institutionalization can clearly do permanent, lifelong harm. It just isn’t possible to provide the physical and emotional nurturing that a family can in an institutional setting with staff doing shift work and caring for numerous children.

During early childhood, your parents are literally in control of your stress system: Young babies cannot self-regulate or calm themselves and it takes thousands repetitions of being soothed and comforted by the same few people over and over for this to be learned. Strangers cannot provide the relief that mom or dad does: The system is wired by oxytocin and the brain’s own opioids to respond only to the deep familiarity of a specific person’s loving touch.

This means that separation is traumatic—it not only causes stress in and of itself, it prevents the child from accessing her only means of relieving it. Uncertainty about whether a parent will return, lack of contact with other loved ones, and a feeling of helplessness all exacerbate this type of trauma. And of course, immigrant families seeking asylum are generally already fleeing from prior traumatic experience like violence, hunger, and extreme poverty.

Worse, traumatic experience is often the means by which a predisposition to addiction and/or mental illness becomes an actual disorder. There are many genes which do no harm, and may even be helpful, if a child isn’t exposed to severe stress. Research shows that the higher the number of what are known as “adverse childhood experiences” (ACEs), the longer the exposure to them, and the more different types of trauma involved, the greater a person’s risk of addiction and poor mental health. For example, having four or more ACEs increases the odds that a person will inject drugs by a factor of more than seven, compared to experiencing just one ACE.

Indeed, higher numbers of ACEs are not only linked with psychiatric and behavior disorders, they are also associated with higher risks of heart disease, stroke, obesity, type II diabetes, and many cancers. Though many children, thankfully, are resilient to trauma, unnecessarily adding to a child’s ACE burden is extremely risky.

And the harm done doesn’t only damage a single generation: What was done to my father had a huge effect on me both psychologically and, possibly, on the genes of my cells themselves.

While my dad was obviously a loving father, I was also hurt by his depression when I was a child: I interpreted his sadness as a reflection of my inability to be good enough, not as his inability to feel joy. And some studies show that certain genetic markers are altered in Holocaust survivors and these changes are passed down to their children. While it isn’t exactly clear what these changes mean, they affect whether specific stress-related genes are turned on or off—and this influences risk for conditions like post-traumatic stress disorder (PTSD).

Of course, I can’t say for sure how either of these factors affected my development of depression and addiction. However, I do know that it is inhumane to needlessly take children from their parents—and that it carries risks far beyond those that are immediately obvious.

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