Last week I shared my favourite quotes from “The Problem With Forever”. So today I want to take a closer look at one of the quotes at the very end as well as look at the impact childhood abuse can have on one’s mental health, in this case, social anxiety.
Let’s first take a look at the statistics of child abuse:
Childhood abuse statistics
According to the American Psychological Association, child abuse is harm caused to a child by a parent or caregiver. “This harm may be physical (violence), sexual (violation or exploitation), psychological (causing emotional distress), or neglect (failure to provide needed care)” (APA, 2022). When a child is abused they experience so called “adverse childhood experiences” (ACEs). In a widely popular study Dr. Vince Felitti and Dr. Bob Anda asked 13,494 adults about their exposure to adverse childhood experiences. The categories they studied were physical, emotional or sexual abuse, physical or emotional neglect as well as parental mental illness, substance abuse, incarceration, parental separation or divorce and domestic violence. After collecting the participants’ responses, the researchers correrlated each individual ACE-score with measures of adult risk behavior, health status, and disease. The results were striking:
“More than half of the population (67 %) reported at least one, and one-fourth reported ≥2 categories of childhood exposures.” (Felitti et al., 1998). What they found as well is that there was an interaction between the ACE-score and health outcomes, which means, the higher the ACE-score, the worser the health outcomes. The fatal consequences do not only include PTSD, higher risks of depression or suicidality, but also severe physical hazards: “A person with an ACE-score of seven or more had triple the lifetime risk of lung cancer and 3,5 times the risk of ischemic heart disease” (Nadine Burke Harris, 2015). This is due to the fact that these adverse childhood experiences have a tremendous effect on the human brain and body. Areas like the nucleus accumbens (the reward center of our brain) or the prefrontal cortex (responsible for executive functioning) can be severely inhibited. Researchers even found measurable differences in the amygdala, the brain’s fear response system. These changes in the human brain can explain how physical diseases as well as mental disorders can develop in children who have experienced child abuse. One type of anxiety that can develop is social anxiety.
Social anxiety
The ICD-11 defines social anxiety disorder as a “marked and excessive fear or anxiety that consistently occurs in one or more social situations such as social interactions […], doing something while feeling observed […], or performing in front of others […]” (ICD 11, 2022). Very often, this disorder is mistaken for shyness. But people who have social anxiety aren’t shy in the traditional sense; they are afraid of being judged by others. These people suffer from intense fear and anxiety when it comes to social interactions and the possible judgement by others. Symptoms, which vary from person to person, may include worry about being judged by others, worry about embarrassing oneself, avoidance of common social situations, anxiety in anticipation of a feared event or expectation of the worst possible outcome from a negative experience (Mayo Clinic, 2022). Those affected may also have a low sense of self-esteem and suffer from dysfunctional thoughts, i.e. “I am dumb and awkward and others will notice it right away”. In terms of causes, there are many possibilities on how a person can develop social anxiety. Anxiety may run in the family or the person concerned has an hyperactive amygdala, which leads to a heightened fear in social situations. However, like mentioned above, social anxiety can also be developed through negative experiences, childhood abuse being one of them.
This can be seen in Mallorys story: She has experienced severe abuse and emotional neglect through her former foster parents, especially Mr. Henry and his aggressive behaviour. This has left a deep mark on her. Because of her past trauma, she has learned to stay silent and keep out of the way of other people. The reader gets to know Mallory as a rather quiet person who doesn’t talk a lot. Under the surface, she is afraid of being judged by others since she has never learned how to speak her opinion and speak up for herself. Because she hasn’t known what it is like to be free of the fear, she worries that she will feel like this forever and never leave her past behind. But thanks to her friend Rider, who has many times taken the physical abuse for Mallory in the past from their foster parents, Mallory now learns that she can face her fears and love herself as she is. They understand each other so well because they have went through the worst together and now both suffer from PTSD. They both deal with it differently but share a deep connection because of it. As their bond deepens after they see each other again, Rider tells her that even though she is quiet, this doesn’t take away from her great personality. It is something that she can work at. Receiving the support from Rider, her now loving foster parents and her best friend Ainsley, Mallory comes to a final conclusion at the end of the novel.
“All I needed to remember when I felt like not trying is that that feeling wouldn’t last forever”
“The Problem With Forever” (Jennifer L. Armentrout)
This quote shows to me that no matter how strong your fear is, it doesn’t have to define you. Even if you have gone through a difficult past or an event where you have been abused or treated badly, you aren’t broken. It may have partly gotten you to where you are today, but it doesn’t define or control you. I can only imagine how hard it is to deal with it, but by taking the first step to becoming aware of it, you have already won. I remember watching the two short films “Removed” and “Remember My Story” a few years ago which also tell the story of a girl who has grown up in an abusive home. The films show in a raw and honest way how the little girl tries to find her place in the world who took more from her than it gave. At the end of the second film, her foster mother gives her an important advice: “Right in the middle of all that spinning, you can let that tornado rip apart your heart or you choose how you let what has happened to you affect you.” (Remember My Story, 2015). Your individual tornado might look invincible to you, but you can learn how to survive in it. No one can decide what your future looks like or who you become. Only you can. It is okay to feel lost and confused about the past and have fear of the future. But there is absolutely no shame in asking for help. Therapy will teach you not only acceptance of yourself, but most importantly give you the tools how to work through your individual fears and make the most out of your life. To say it with the words of my favourite artist: “Fear won’t go away, but I can keep it at bay” (“Six” – Sleeping At Last); you can’t erase the past and the fear asociated with it, but you can use what has happened to you and transform it into something beautiful. For likeminded people, but most importantly, for yourself.
Title picture:
Delevingne, C., 2021. Art Illustration Art Social Anxiety Disorder. [online] Illustration of Many Recent Choices. URL: https://biz-at-it.blogspot.com/2020/10/art-illustration-art-social-anxiety.html
References:
– APA Dictionary of Psychology. (2022). Retrieved 3 September 2022, from https://dictionary.apa.org/child-abuse
– Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study. American journal of preventive medicine, 14(4), 245-258.
– ICD-11 criteria for Social anxiety disorder 6B04. (2022). Retrieved 3 September 2022, from https://www.mrcpsych.uk/2022/05/icd-11criteria-for-social-anxiety.html
– Burke Harris, N. (2015). How childhood trauma affects health across a lifetime [Video]. Retrieved from https://www.youtube.com/watch?v=95ovIJ3dsNk
– Armentrout, J. (2016). The problem with forever. Some screts go to deep for words. Harlequinn Teen
– Matanick, N., & Matanick, C. (2015). Remember My Story [Video]. Retrieved from https://www.youtube.com/watch?v=I1fGmEa6WnY
The Deeper Meaning 