Doctor’s Tip: Our biggest epidemic — child abuse |

Doctor’s Tip: Our biggest epidemic — child abuse

Dr. Greg Feinsinger

We seem to be living in an age of multiple epidemics: obesity, diabetes, heart disease, drug abuse, gun violence and COVID-19. In terms of human suffering, and damage to our society and economy, child abuse is arguably the biggest of them all.

At workers’ compensation medical conferences, there is usually a presentation about “delayed recovery”: Ten people suffer similar low back injuries at work, nine are pain-free in a few weeks but the 10th never gets better. We were told to always consider a history of child abuse — mental, physical or sexual — in these cases. It’s not that the pain is in these patients’ heads; it’s that childhood trauma “rewires their brains” so that they react differently to life stresses such as injuries, through no fault of their own.

“The Body Keeps The Score” is a book on the New York Times best seller list by Bessel Van Der Kolk, M.D., a Boston-based psychiatrist who started his career working with Vietnam War veterans with PTSD. He eventually went into private practice and is past president of the International Society for Traumatic Stress Studies. The title of the book refers to the fact that emotional trauma leaves a lifelong imprint not only on people’s brains, but also on their bodies. An example of the mind-body connection is that trauma victims (including those who suffer child abuse) continue to secrete high levels of harmful stress hormones for decades afterward, resulting in chronic problems such as memory and attention deficits, irritability, sleep disorders, migraine headaches, autoimmune diseases, cardiovascular disease, weakened immune systems and even cancer (stress causes inflammation, which contributes to cancer).

In his book, Van Der Kolk points out that research by the Centers for Disease Control and Prevention has found the following: “One in five Americans was sexually molested as a child; one in four was beaten by a parent to the point of a mark being left on their body; and one out of eight witnessed their mother being beaten or hit.” Over 12 million women in the U.S. have been victims of rape — more than half when they were under the age of 15. As Van Der Kolk puts it, such trauma “is not just an event that took place sometime in the past; it is also the imprint left by that experience on mind, brain and body.” Victims of child abuse “often feel sensations (such as abdominal pain) that have no obvious physical cause,” and suffer from lifelong mental illness and relationship problems.

The Adverse Childhood Experiences study was conducted by Kaiser Permanente and the CDC and involved 25,000 subjects, mostly white and middle class. High scores on the number of adverse childhood events correlated with higher workplace absenteeism, financial problems, lower lifetime income, depression, chronic pain, suicide attempts, alcoholism, heart disease, liver disease and cancer. Women who witnessed domestic violence as children were at higher risk of ending up in violent relationships; men who witnessed domestic violence as boys were seven times more apt to abuse their partners as adults.

Due to studies like Adverse Childhood Experiences, Van Der Kolk calls child abuse “our nation’s largest public health problem,” affecting not only individuals but their families, the economy and society as a whole. It is estimated that “eradicating child abuse in America would reduce the overall rate of depression by more than half, alcoholism by two-thirds and suicide, IV drug use and domestic violence by three-quarters. It would also increase workplace performance and decrease the need for incarceration.”

The National Child Traumatic Stress Network was established by Congress in 2001, and it now has 150 centers nationwide. Its mission is to educate teachers, judges, ministers, foster parents, physicians, probation officers, nurses and mental health professionals. The societal solution to preventing child abuse, in Van Der Kolk’s opinion, is to provide more help for families: “Economists have calculated that every dollar invested in high-quality home visitation, day care and preschool programs results in seven dollars of savings on welfare payments, health care costs, substance-abuse treatment and incarceration, plus higher tax revenue due to better-paying jobs.”

Van Der Kolk is not a big fan of medications for PTSD because — with the possible exception of hallucinogens (read “How to Change Your Mind, by Michael Pollin) — they help the symptoms rather than the underlying cause. Based on patient outcomes and brain-imaging studies, good results have been achieved with nonpharmaceutical treatments such as meditation, yoga, rapid eye movement (EMDR) and neurofeedback.

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email

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