The Biology of Soul Murder
Fear can harm a child's brain. Is it reversible?
Many of the brain abnormalities seen in abused and neglected children are localized in the brain's left hemisphere, where language and logical thought are processed. Martin Teicher, a psychiatrist at McLean Hospital in Belmont, Mass., compared recordings of brain electrical activity in abused and normal children. His finding: In abused kids, the left hemisphere has fewer nerve-cell connections between different areas. The electrical traces also revealed that tiny seizures, similar to those of epileptics, crackled through various sectors of abused children's brains. Children with the most abnormal recordings were the most likely to be self-destructive or aggressive.
Scanning for danger. Abused children also show a variety of other disturbances in physiology, thinking and behavior. Many have elevated resting heart rates, temperature and blood pressure. Hypervigilance is common. Abused kids continually scan their surroundings for danger and overinterpret the actions of others: An innocent playground bump may be seen as a direct threat. And as many as half of children from some violent neighborhoods show symptoms of Attention Deficit Hyperactivity Disorder (ADHD), compared with about 6 percent of the general population.
"Children who are aroused [from fear] can't take in cognitive information," says Perry. "They're too busy watching the teacher for threatening gestures, and not listening to what she's saying." Such behavior makes sense, given the constant threats in the child's world. His brain has become exquisitely tuned to emotional and physical cues from other people. At the same time, he may be failing to develop problem solving and language skills. Perry has found that in a group of neglected children, the cortex, or thinking part of the brain, is 20 percent smaller on average than in a control group.
Studies now indicate that abused and neglected children run a high risk of developing mental illnesses. Since 1987, National Institute of Mental Health child psychiatrist Frank Putnam has tracked 90 sexually abused girls, comparing them to a control group who were not abused. The abused girls were more likely to evidence depression and suicide attempts, and many showed the beginnings of PTSD, including anxiety attacks and abnormal levels of cortisol, which are also seen in combat veterans. Putnam also found a decline in the abused girls' IQ over time. Saddest of all, the abused girls are rated by their teachers as not very likable. "That's tragic," says Putnam, "because the one place where they might find some support is at school."
Indeed, for some children, a loving adult can serve as a powerful antidote to abuse and neglect. Infants and young children normally learn from a comforting caretaker how to soothe themselves, thereby regulating their stress response and cortisol levels. Researchers now believe loving relationships also can help older children reset their response to stress when it has been derailed by abuse. Says Gunnar: "We don't know when the door to the brain's plasticity closes."
Unfortunately, loving damaged children can be tough. One minute they are hostile, the next withdrawn. In class, they escape their feelings by daydreaming. When the teacher confronts them, they retreat even further. Then, says Perry, "the teacher touches the kid. When you touch them, that's incredibly threatening, and the child has a tantrum."
The growing understanding of what's going on in an abused and neglected child's brain has begun to yield new treatments. In addition to psychotherapy, Perry gives some of his young patients clonidine, a drug that helps check the fight-or-flight response. Clonidine, and other drugs that interfere with the release of cortisol, may decrease the chances a child will go on to develop PTSD. Perry also hands out devices that allow teachers and foster parents to monitor a child's heart rate from a distance, so they can refrain from making demands on him when he's frightened.
For every child who finds help at a clinic like Perry's, there are dozens who fall through the cracks. Only a fraction of the millions of children who are mistreated each year receive the kind of help that can reverse the underlying physiological changes they suffer. Ultimately, says McLean's Teicher, failing these kids may be shortsighted. They are less likely to live up to their economic potential, and more likely to wind up in prison, on drugs or in psychiatric units, he says. "The cost on society of having a child who has gone through abuse is enormous."