In 2012, I wrote a paper for my master of fine arts degree called, “Lucy Grealy and the Importance of the Mother When Healing from Childhood Trauma.” The paper examined mother-daughter relationships as related by three women who wrote books about their childhood traumas, including Grealy, who wrote the 1994 acclaimed memoir “Autobiography of A Face.” I had decided to get my MFA primarily as a way to force myself to finish a memoir I had started five years before. And I was interested in the subject because I had experienced severe childhood trauma as a child.
When I was five, I was hit by a car while walking my bike across the street. The man who hit me was blind in his left eye and didn’t see me. My bike fell under the car, and I hung on as he continued to drive down the road for another 200 feet. When he stopped the car I was still underneath it, and my left cheek and eyelid had been torn away from my face. Over the next 15 years I underwent 20 plastic and reconstructive surgeries on my face that involved taking skin grafts from most of my body.
My memoir, Face, about this complex trauma experience and how it affected me as an adult, will be published in January, which has had me thinking a lot about how this pandemic is affecting the thousands, perhaps millions, of children and young adults living through it today. We may not see the effects of it until many years from now, but they will suffer from the same kind of traumatic stress I did. I was in my fifties when I started to realize how damaging my childhood experiences were, and it took years of therapy for me to heal from it. In fact, I’m still dealing with its effects: I have come to terms with knowing I’m a wounded child, in Jungian terms. I have only recently come to realize, too, that I’ve spent a lifetime trying to deny it.
To most outsiders—and I would bet most of my family and friends—I have been a successful woman: a writer and writing coach with several published books, a publisher and accomplished speaker and, at one time, the editorial page editor of a mid-sized city newspaper.
But I have always struggled.
Children who experience multiple and/or chronic adverse traumatic events – or complex trauma – often suffer serious social, emotional, neurological, physical and sensory development problems. If the child’s “attachment relationships,” prime among them those with her parents, are compromised, she will likely suffer a range of crippling issues. They include uncertainty about the reliability and predictability of the world, problems with boundaries, social isolation, difficulty with emotional self-regulation, chronic or pervasive depression, suicidal preoccupation, poor modulation of impulses, self-destructive behavior, substance abuse, problems focusing on and completing tasks, lack of a continuous and predictable sense of self, low self-esteem, feelings of shame and guilt, and disturbances of body image.
I see myself in many of those, though I have been very good at masking it.
In my MFA paper, I looked at Grealy’s book, and also Emily Rapp’s book Poster Child and Natalie Kusz’s Road Song. Grealy, Rapp and Kusz all experienced devastating childhood traumas. One was congenital (Rapp’s), one was due to cancer (Grealy’s), and one was caused by an accident (Kusz’s). As with all memoir, what we choose to leave out is sometimes more telling than what we choose to include. How each of the above authors’ mothers are portrayed and how the relationships are described and detailed, or not, was the focus of my exploration. Grealy wrote sparingly about her relationship with her mother, and what she wrote indicated strain between them. Even so, what Grealy did write indicated a profound sense of dependence on her mother’s emotional support – such as it was – throughout repeated surgeries early on. Similarly, Kusz and Rapp both leaned heavily on their mothers through multiple surgeries and medical setbacks. But their mothers remained present and supportive throughout their suffering and recovery, which allowed Rapp and Kusz to attain a level of self-esteem that Grealy never managed. In fact, Grealy suffered debilitating self-doubt and engaged in behaviors over time that ultimately led to her untimely death from a drug overdose at the age of 39.
Complex childhood trauma is defined as any abuse or neglect that is sustained over a long period of time, resulting in a variety of physical, emotional and mental deficiencies. I suffered physical trauma (years of painful surgeries and hospitalizations), but also the emotional toll of being teased and shamed because of my disfigured face throughout my childhood. Add to that the very complicated relationship that developed between my mother, who suffered tremendous guilt over the accident, and me, a child trying to navigate a very unwelcoming outside world. It would take me a lifetime to understand my mother’s distance and coldness toward me.
What we know for certain is that the child’s primary caretaker is the most crucial person in the potential for that child to overcome the long-term effects of traumatic stress.
Today, I worry about how this prolonged pandemic will affect many children who already struggle with either abuse and/or neglect. But also the legions of children whose entire lives have been upended by school closures and new routines. Parents, too, many of whom are working from home (or who have quit jobs, as many women have been forced to do), while at the same time taking on the tasks of teaching children who would normally have the supportive environment of a school: teachers, school-provided meals, counselors, structure. The longer this pandemic goes on, the more likely we will have many, many children struggling with the long-term effects of complex trauma.
An estimated 1 million to 3 million kids are missing from schools across the country: half a million in California, and more than 30,000 in New York public schools alone. These are students who either show up intermittently for distance learning, or have disappeared altogether. Most have likely moved, perhaps due to their parents losing jobs, or they are homeless. They are most at risk for long-term effects from the stress and trauma related to the pandemic. The strain on the social welfare system over time related to finding and providing social and mental health services to these children, and their families, will be enormous.
The only way to stave off these complications is to intervene early on with emotional and psychological support. “Psychological trauma in early childhood can have a tremendous negative impact as it can distort the infant, toddler or young child’s social, emotional, neurological, physical and sensory development. This is especially true of young children who have experienced multiple and/or chronic, adverse interpersonal traumatic events through the child’s care giving system” (“Complex Trauma in Early Childhood,” American Academy of Experts in Traumatic Stress).
The U.S. Centers for Disease Control calls toxic stress “intense adverse experiences that may be sustained over a long period of time—weeks, months or even years. … Children are unable to effectively manage this type of stress by themselves. As a result, the stress response system gets activated for a prolonged amount of time. This can lead to permanent changes in the development of the brain. The negative effects of toxic stress can be lessened with the support of caring adults. Appropriate support and intervention can help in returning the stress response system back to its normal baseline” (“The Effects of Childhood Stress on Health Across the Lifespan.”).
The National Child Traumatic Stress Network estimates the annual economic impact from childhood stress is almost $104 billion; nearly $71 billion in direct costs, which include the immediate needs of traumatized children (hospitalization, mental health care, the child welfare system and law enforcement) and $33 billion in indirect costs (long-term needs such as special education, juvenile delinquency, mental health and health care, the adult criminal justice system, and lost productivity to society).
Those are pre-pandemic figures.
Nine months in, those of us who suffered from childhood trauma are joined by untold numbers of newly traumatized kids. As a writer, I’m used to (and in many ways crave) solitude. But enough is enough. I confess this period of isolation has rattled me. My daughter, at 28, struggles with anxiety, and has been doubly traumatized by the pandemic, beginning with the loss of her job in March. How many others who are fragile are barely hanging on as this pandemic continues to pummel us?
Clearly, we face a daunting future as a society — indeed as a global community; this pandemic is not discriminatory. We need national — and international — commissions to begin to plan for the inevitable effects of traumatic stress on our children and young adults (not to mention the adults who are also suffering from depression and pandemic-related stress).
What can you do? Get involved. Talk with local school boards and educators and ask what you can do to help. Write congressional representatives and demand funding for a national commission to study and recommend funding for long-term programs nationally and in the schools.
And if you are a wounded child, join my Facebook group Beyond Childhood Trauma, where you’ll find information and resources to help. Reach out—we are here, and we understand.