This article discusses childhood adversity, including abuse and neglect. Please take care of yourself while reading, and pause whenever you need to.

Experiences in childhood can shape how we understand ourselves, relate to other people, respond to stress, and experience safety in our bodies. For some people, childhood provided reliable care, protection, and emotional connection. For others it involved fear, instability, neglect, loss, criticism, or responsibilities no child should have had to carry. The effects of these experiences do not necessarily disappear when childhood ends.

What are Adverse Childhood Experiences?

Adverse Childhood Experiences (ACEs) are potentially traumatic or highly stressful experiences that occur before the age of 18. The ACE framework comes from research by Felitti and colleagues in the 1990s with a largely middle-class, insured group of adults in the United States. It included emotional, physical, and sexual abuse, emotional and physical neglect, and household challenges such as violence towards a caregiver, substance misuse, serious mental illness, imprisonment, or parental separation.

These categories were developed for population research, not as a complete description of childhood trauma. Later research has widened the picture to include experiences such as:

•       bullying and social exclusion

•       racism, discrimination, or displacement

•       poverty or housing insecurity

•       the death of a parent or caregiver, or serious illness in the family

•       migration, war, or community violence

•       growing up around unpredictable conflict, or having to care for a parent or siblings

Closer to home, the Australian Child Maltreatment Study (2023) found that experiences of child maltreatment are common in Australia. What matters is not only what happened, but how the child experienced it, whether it continued over time, and whether supportive adults were available.

What does an ACE score mean?

In the traditional framework, one point is given for each category of adversity experienced, and the total is the ACE score. In large population studies, as the number of reported categories increases, so does the likelihood of certain health, psychological, behavioural, and social difficulties.

However, an ACE score is not a diagnosis or a prediction of any individual’s future. It does not tell us how often something happened, how severe or frightening it was, when it occurred, how the child understood it, whether safe and supportive relationships were present, or what strengths the person developed. Someone with a low score may have experienced one profound and enduring trauma, while someone with a higher score may have had protective relationships that supported their recovery. The score is best understood as a public-health research tool rather than a measure of personal trauma.

How can childhood adversity affect adult life?

Childhood is a time when the brain, nervous system, attachment patterns, and sense of identity are developing. When a child repeatedly experiences threat, neglect, or instability, they may adapt by becoming highly alert, shutting down, pleasing others, avoiding conflict, or disconnecting from emotion. These responses are not signs of weakness. They may have been intelligent ways of surviving an environment in which safety and care were uncertain.

In adulthood, these protective patterns may show up as:

•       anxiety or constant vigilance

•       emotional numbness or low mood

•       shame and low self-worth

•       difficulty trusting others or setting boundaries

•       perfectionism, overworking, or people-pleasing

•       feeling disconnected from the body or from emotion

At a population level, childhood adversity has also been associated with increased risks across physical health, mental health, substance use, relationships, and social wellbeing. This does not mean trauma inevitably causes a particular illness. Health is shaped by many interacting biological, psychological, relational, social, and environmental factors.

It is also worth saying that ACEs and childhood trauma are not diagnoses. Conditions such as post-traumatic stress disorder (PTSD) and complex PTSD can only be diagnosed by a qualified clinician.

Trauma is not defined only by the event

People sometimes believe their experiences were “not bad enough” to count as trauma. Trauma is not determined only by whether an event looked dramatic from the outside. It also involves how an experience affected the person’s sense of safety, connection, and agency. A child may be deeply affected by repeated experiences that adults dismiss as minor, such as:

•       being frequently criticised or humiliated

•       having emotions ignored or mocked

•       needing to monitor a caregiver’s mood

•       feeling responsible for keeping the family stable

A single overwhelming event can be traumatic, and trauma can also develop cumulatively through chronic relational experiences that leave a child feeling unsafe, unseen, or alone.

Trauma responses often begin as protection

Many adult difficulties make more sense in the context in which they developed. Hypervigilance may have helped a child anticipate danger, numbness may have protected them from feelings too overwhelming to process alone, people-pleasing may have preserved an important relationship, and dissociation may have allowed psychological escape when physical escape was impossible. These strategies can persist long after circumstances have changed. Therapy can help the nervous system and protective parts recognise that different choices may now be possible.

Childhood trauma does not determine your future

ACE research describes increased risk across groups of people. It does not determine what will happen to any one individual. Supportive relationships, community connection, cultural identity, physical safety, meaningful activity, access to healthcare, self-compassion, and effective therapy can all contribute to resilience and recovery. Resilience does not mean adversity had no effect, or that a person should have coped alone. It is the capacity for healing, adaptation, and reconnection, usually supported by safe relationships and appropriate resources.

How can therapy help?

Working with childhood trauma does not always require recounting every painful event. Trauma-informed therapy begins by establishing safety, understanding current difficulties, and building resources for emotional and nervous-system regulation. Depending on a person’s needs and readiness, therapy may support them to:

•       understand how past experiences affect present patterns, without shame

•       develop greater emotional awareness and regulation

•       reduce self-criticism and cultivate compassion

•       process unresolved traumatic memories

•       reconnect safely with the body and strengthen boundaries

At Wisdom Psychotherapy in Brunswick, Melbourne, I may draw on EMDR, Brainspotting, Emotional Freedom Techniques, Compassion-Focused Therapy, Process-Experiential Emotion-Focused Therapy, mindfulness-based somatic approaches, and IFS-informed parts work. These approaches differ in their research base: for example, trauma-focused therapies including EMDR are recommended in clinical guidelines for PTSD, while research on Brainspotting and Emotional Freedom Techniques is more limited.

The aim is not to blame the past for every current difficulty. It is to understand how experiences shaped the mind and body, appreciate the strategies that helped us survive, and create new possibilities for living with greater safety, connection, and freedom. Childhood trauma can leave lasting effects, but those effects are not the whole of who you are. With appropriate support, healing and meaningful change are possible.

If this article has brought up difficult feelings, support is available. In Australia you can call Lifeline on 13 11 14, or Blue Knot Foundation’s helpline for people affected by childhood trauma on 1300 657 380. In an emergency, call 000.

If you would like to explore whether therapy could help, you are welcome to get in touch to arrange an initial conversation.