What are Adverse Childhood Experiences?


Adverse childhood experiences (ACEs) encompass various forms of physical and emotional abuse, neglect, and household dysfunction experienced in childhood.

ACEs have been linked to premature death as well as to various health conditions, including those of mental disorders. Toxic stress linked to childhood maltreatment is related to a number of neurological changes in the structure of the brain and its function. The Adverse Childhood Experiences Study, published in 1998, was the first large scale study to look at the relationship between ten categories of adversity in childhood and health outcomes in adulthood. Subsequent research is beginning to identify specific biomarkers associated with different kinds of ACEs.

Long Term Effects

According to the Centre for Youth Wellness website:

“Exposure without a positive buffer, such as a nurturing parent or caregiver, can lead to a Toxic Stress Response in children, which can, in turn, lead to health problems like asthma, poor growth and frequent infections, as well as learning difficulties and behavioral issues. In the long term, exposure to ACEs can also lead to serious health conditions like heart disease, stroke, and cancer later in life.”

Adverse childhood experiences can alter the structural development of neural networks and the biochemistry of neuroendocrine systems (i.e. how the brain regulates the hormonal activity in the body) and may have long-term effects on the body, including speeding up the processes of disease and aging and compromising immune systems.

Adverse childhood experiences are equal to various stresses, and a serious adversity is defined as a trauma. The World Health Organisation (WHO) recognises that prolonged stress in childhood can have life-long implications for the development of many diseases. Moreover, ACEs can disrupt early brain development leading to the possible development of several disorders. WHO has designed a screening questionnaire to be used internationally in order to list adverse effects, and relate them to future developments.

The effects of ACEs goes beyond health and risk taking behaviours with studies reporting that people with high ACEs scores showed less trust in government COVID-19 information and polices.

Health Outcomes in Adulthood

Physical Health

ACEs have been linked to numerous negative health and lifestyle issues into adulthood across multiple countries and regions including the United States, the European Union, South Africa, and Asia. Across all these groups researchers have reported seeing the adoption of higher rates of unhealthy lifestyle behaviour including sexual risk taking, smoking, heavy drinking, and obesity. The associations between these lifestyle issues and ACEs shows a dose response relationship with people having four or more ACEs have significantly more of these lifestyle problems. Physical health problems arise in people with ACEs with a similar dose response relationship. Chronic illnesses such as asthma, arthritis, cardiovascular disease, cancer, diabetes, stroke, and migraines show increased symptom severity in step was exposure to ACEs.

Mental Health

Mental health issues have been well know in the face of childhood trauma. Exposure to ACEs is no different with multiple mental health conditions found to have a dose response relationship with symptom severity and prevalence – including depression, attention-deficit hyperactivity disorder (ADHD), anxiety, suicidality, bipolar disorder and schizophrenia.

Special Populations

Additionally, epigenetic transmission may occur due to stress during pregnancy or during interactions between mother and newborns. Maternal stress, depression, and exposure to partner violence have all been shown to have epigenetic effects on infants.

Implementing Practices

Globally knowledge about the prevalence and consequences of adverse childhood experiences has shifted policy makers and mental health practitioners towards increasing, trauma-informed and resilience-building practices. This work has been over 20 years in the making bringing together research are implemented in communities, education settings, public health departments, social services, faith-based organisations and criminal justice.


As knowledge about the prevalence and consequences of ACEs increases, more communities seek to integrate trauma-informed and resilience-building practices into their agencies and systems. Indigenous populations show similar patterns of mental and physical health challenges as other minority groups. Interventions have been developed in American Indian tribal communities and have demonstrated that social support and cultural involvement can ameliorate the negative physical health effects of ACEs.

There is a paucity of empirical research documenting the experiences of communities who have attempted to implement information about ACEs and trauma-informed practice into widespread public action. The Matlin et al. (2019) article on Pottstown, Pennsylvania’s process demonstrated the challenges associated with community implementation. The Pottstown Trauma-Informed Community Connection (PTICC) initiative evolved from a series of prior collectives that all had similar goals of creating community resilience in order to prevent and treat ACEs. Over the course of the two-year study, over 230 individuals from nearly 100 organisations attended one training offered by the PTICC, raising the number of engaged public sectors from 2 to 14. Participation in training and events was fairly steady and this was largely due to community networking.

However, the PTICC faced several challenges similar to those predicted by the Building Community Resilience model. These barriers included availability of resources over time, competition for power within the group, and the lack of systemic change needed to support long-term goals. Still, Pottstown has built a trauma-informed community foundation and offers lessons to other communities who have similar goals: start with a dedicated small team, identify community connectors, secure long-term financial backing, and conduct data-informed evaluations throughout.

Other community examples exist, such as Tarpon Springs, Florida which became the first trauma-informed community in 2011. Trauma-informed initiatives in Tarpon Springs include trauma-awareness training for the local housing authority, changes in programs for ex-offenders, and new approaches to educating students with learning difficulties.


ACEs exposure is widespread globally, one study from the National Survey of Children’s Health in the United States reported that approximately 68% of children 0-17 years old had experienced one or more ACEs. The impact of ACEs on children can manifest in difficulties focusing, self regulating, trusting others, and can lead to negative cognitive effects. One study found that a child with 4 or more ACEs was 32 times more likely to be labelled with a behavioural or cognitive problem than a child with no ACEs. Another study by the Area Health Education Centre of Washington State University found that students with at least three ACEs are three times as likely to experience academic failure, six times as likely to have behavioural problems, and five times as likely to have attendance problems. The trauma-informed school movement aims to train teachers and staff to help children self-regulate, and to help families that are having problems that result in children’s normal response to trauma. It also seeks to provide behavioural consequences that will not re-traumatize a child.

Trauma-informed education refers to the specific use of knowledge about trauma and its expression to modify support for children to improve their developmental success. The National Child Traumatic Stress Network (NCTSN) describes a trauma-informed school system as a place where school community members work to provide trauma awareness, knowledge and skills to respond to potentially negative outcomes following traumatic stress. The NCTSN published a study that discussed the ARC (attachment, regulation and competency) model, which other researchers have based their subsequent studies of trauma-informed education practices on. Trauma-sensitive or trauma-informed schooling has become increasingly popular in Washington, Massachusetts, and California in the last 10 years.

Social Services

Social service providers – including welfare systems, housing authorities, homeless shelters, and domestic violence centres – are adopting trauma-informed approaches that help to prevent ACEs or minimize their impact. Utilising tools that screen for trauma can help a social service worker direct their clients to interventions that meet their specific needs. Trauma-informed practices can also help social service providers look at how trauma impacts the whole family.

Trauma-informed approaches can improve child welfare services by:

  • Openly discussing trauma; and
  • Addressing parental trauma.

The New Hampshire Division for Children Youth and Families (DCYF) is taking a trauma-informed approach to their foster care services by educating staff about childhood trauma, screening children entering foster care for trauma, using trauma-informed language to mitigate further traumatisation, mentoring birth parents and involving them in collaborative parenting, and training foster parents to be trauma-informed.

Housing authorities are also becoming trauma-informed. Supportive housing can sometimes recreate control and power dynamics associated with clients’ early trauma. This can be reduced through trauma-informed practices, such as training staff to be respectful of clients’ space by scheduling appointments and not letting themselves into clients’ private spaces, and also understanding that an aggressive response may be trauma-related coping strategies. Up to 50% of people with housing insecurity experienced at least four ACEs.

Health Care Services

Screening for or talking about ACEs with parents and children can help to foster healthy physical and psychological development and can help doctors understand the circumstances that children and their parents are facing. By screening for ACEs in children, paediatric doctors and nurses can better understand behavioural problems. Some doctors have questioned whether some behaviours resulting in ADHD diagnoses are in fact reactions to trauma. Children who have experienced four or more ACEs are three times as likely to take ADHD medication when compared with children with less than four ACEs. Screening parents for their ACEs allows doctors to provide the appropriate support to parents who have experienced trauma, helping them to build resilience, foster attachment with their children, and prevent a family cycle of ACEs.

Public Health

Objections to screening for ACEs include the lack of randomised controlled trials that show that such measures can be used to actually improve health outcomes, the scale collapses items and has limited item coverage, there are no standard protocols for how to use the information gathered, and that revisiting negative childhood experiences could be emotionally traumatic. Other obstacles to adoption include that the technique is not taught in medical schools, is not billable, and the nature of the conversation makes some doctors personally uncomfortable. Some public health centres see ACEs as an important way (especially for mothers and children) to target health interventions for individuals during sensitive periods of development early in their life, or even in utero.

Resilience and Resources

Resilience is the ability to adapt or cope in the face of significant adversity and threats such as health problems, stressors experienced in the workplace or home. Resiliency can moderate the relationship of the effects of ACEs and health problem in adulthood. Being able use emotion regulation resources such as cognitive reappraisal and mindfulness people are able to protect themselves from the potential negative effects of stressors, these skills can be taught to people but people living with ACEs score lower on measures of resilience and emotion regulation.

Resilience and access to other resources are protective factors against the effects of exposure to ACEs. Increasing resilience in children can help provide a buffer for those who have been exposed to trauma and have a higher ACE score. People and children who have fostered resiliency have the skills and abilities to embrace behaviours that can foster growth. In childhood, resiliency and attachment security can be fostered from having a caring adult in a child’s life.

Adverse Childhood Experiences Study

The Adverse Childhood Experiences Study (ACE Study) is a research study conducted by the US health maintenance organisation Kaiser Permanente and the Centres for Disease Control and Prevention that was originally published in the American Journal of Preventive Medicine. Participants were recruited to the study between 1995 and 1997 and have since been in long-term follow up for health outcomes. The study has demonstrated an association of ACEs with health and social problems across the lifespan. The study has produced many scientific articles and conference and workshop presentations that examine ACEs.

In the 1980s, the dropout rate of participants at Kaiser Permanente’s obesity clinic in San Diego, California, was about 50%; despite all of the dropouts successfully losing weight under the program. Vincent Felitti, head of Kaiser Permanente’s Department of Preventive Medicine in San Diego, conducted interviews with people who had left the programme, and discovered that a majority of 286 people he interviewed had experienced childhood sexual abuse. The interview findings suggested to Felitti that weight gain might be a coping mechanism for depression, anxiety, and fear.

Felitti and Robert Anda from the Centres for Disease Control and Prevention (CDC) went on to survey childhood trauma experiences of over 17,000 Kaiser Permanente patient volunteers. The 17,337 participants were volunteers from approximately 26,000 consecutive Kaiser Permanente members. About half were female; 74.8% were white; the average age was 57; 75.2% had attended college; all had jobs and good health care, because they were members of the Kaiser health maintenance organisation. Participants were asked about different types of adverse childhood experiences that had been identified in earlier research literature:

  • Physical abuse.
  • Sexual abuse.
  • Emotional abuse.
  • Physical neglect.
  • Emotional neglect.
  • Exposure to domestic violence.
  • Household substance abuse.
  • Household mental illness.
  • Parental separation or divorce.
  • Incarcerated household member.


According to the United States’ Substance Abuse and Mental Health Services Administration, the ACE study found that:

  • Adverse childhood experiences are common.
    • For example, 28% of study participants reported physical abuse and 21% reported sexual abuse.
    • Many also reported experiencing a divorce or parental separation, or having a parent with a mental and/or substance use disorder.
  • Adverse childhood experiences often occur together.
    • Almost 40% of the original sample reported two or more ACEs and 12.5% experienced four or more.
    • Because ACEs occur in clusters, many subsequent studies have examined the cumulative effects of ACEs rather than the individual effects of each.
  • Adverse childhood experiences have a dose-response relationship with many health problems.
    • As researchers followed participants over time, they discovered that a person’s cumulative ACEs score has a strong, graded relationship to numerous health, social, and behavioural problems throughout their lifespan, including substance use disorders.
    • Furthermore, many problems related to ACEs tend to be comorbid, or co-occurring.
ACE Pyramid
The ACE Pyramid represents the conceptual framework for the ACE Study, which has uncovered how adverse childhood experiences are strongly related to various risk factors for disease throughout the lifespan, according to the CDC.

About two-thirds of individuals reported at least one adverse childhood experience; 87% of individuals who reported one ACE reported at least one additional ACE. The number of ACEs was strongly associated with adulthood high-risk health behaviours such as smoking, alcohol and drug abuse, promiscuity, and severe obesity, and correlated with ill-health including depression, heart disease, cancer, chronic lung disease and shortened lifespan. Compared to an ACE score of zero, having four adverse childhood experiences was associated with a seven-fold (700%) increase in alcoholism, a doubling of risk of being diagnosed with cancer, and a four-fold increase in emphysema; an ACE score above six was associated with a 30-fold (3000%) increase in attempted suicide.

The ACE study’s results suggest that maltreatment and household dysfunction in childhood contribute to health problems decades later. These include chronic diseases – such as heart disease, cancer, stroke, and diabetes – that are the most common causes of death and disability in the United States. These findings are important because they provided a link between the effects of child maltreatment and negative effects later in life which had not been established as clearly before this study.

Subsequent Surveys

The ACE Study has produced more than 50 articles that look at the prevalence and consequences of ACEs. It has been influential in several areas. Subsequent studies have confirmed the high frequency of adverse childhood experiences.

The original study questions have been used to develop a 10-item screening questionnaire. Numerous subsequent surveys have confirmed that adverse childhood experiences are frequent.

The Behavioural Risk Factor Surveillance System (BRFSS) which is ran by the CDC, is an annual survey conducted in waves by groups of individual state and territory health departments.. An expanded ACE survey instrument was included in several US states found each state. Adverse childhood experiences were even more frequent in studies in urban Philadelphia and in a survey of young mothers (mostly younger than 19). Surveys of adverse childhood experiences have been conducted in multiple EU member countries.

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What is Repressed Memory?


Repressed memory is a controversial, and largely scientifically discredited, claim that memories for traumatic events may be stored in the unconscious mind and blocked from normal conscious recall.

Refer to Recovered Memory Therapy and Memory Inhibition.

As originally postulated by Sigmund Freud, repressed memory theory claims that although an individual may be unable to recall the memory, it may still affect the individual through subconscious influences on behaviour and emotional responding.

Despite widespread belief in the phenomenon of repressed memories among laypersons and clinical psychologists, most research psychologists who study the psychology of memory dispute that repression ever occurs at all. While some psychologists claim that repressed memories can be recovered through psychotherapy (or may be recovered spontaneously, years or even decades after the event, when the repressed memory is triggered by a particular smell, taste, or other identifier related to the lost memory), experts in the psychology of memory argue that, rather than promoting the recovery of a real repressed memory, psychotherapy is more likely to contribute to the creation of false memories. According to the American Psychological Association, it is not possible to distinguish repressed memories from false ones without corroborating evidence.

In part because of the intense controversies that arose surrounding the concepts of repressed and recovered memories, many clinical psychologists stopped using those terms and instead adopted the term dissociative amnesia to refer to the purported processes whereby memories for traumatic events become inaccessible, and the term dissociative amnesia can be found in the DSM-V, where it is defined as an “inability to recall autobiographical information. This amnesia may be localised (i.e. an event or period of time), selective (i.e. a specific aspect of an event), or generalised (i.e. identity and life history).” The change in terminology, however, has not made belief in the phenomenon any less problematic according to experts in the field of memory. As Richard J. McNally, Professor and Director of Clinical Training in the Department of Psychology at Harvard University, has written:

“The notion that traumatic events can be repressed and later recovered is the most pernicious bit of folklore ever to infect psychology and psychiatry. It has provided the theoretical basis for ‘recovered memory therapy’ — the worst catastrophe to befall the mental health field since the lobotomy era.”

Brief History

The concept of repressed memory originated with Sigmund Freud in his 1896 essay Zur Ätiologie der Hysterie (“On the etiology of hysteria”). One of the studies published in his essay involved a young woman by the name of Anna O. Among her many ailments, she suffered from stiff paralysis on the right side of her body. Freud stated her symptoms to be attached to psychological traumas. The painful memories had separated from her consciousness and brought harm to her body. Freud used hypnosis to treat Anna O. She is reported to have gained slight mobility on her right side


Case Studies

Psychiatrist David Corwin has claimed that one of his cases provides evidence for the reality of repressed memories. This case involved a patient (the Jane Doe case) who, according to Corwin, had been seriously abused by her mother, had recalled the abuse at age six during therapy with Corwin, then eleven years later was unable to recall the abuse before memories of the abuse returned to her mind again during therapy. An investigation of the case by Elizabeth Loftus and Melvin Guyer, however, raised serious questions about many of the central details of the case as reported by Corwin, including whether or not Jane Doe was abused by her mother at all, suggesting that this may be a case of false memory for childhood abuse with the memory “created” during suggestive therapy at the time that Doe was six. Loftus and Guyer also found evidence that, following her initial “recall” of the abuse during therapy at age six, Doe had talked about the abuse during the eleven years in between the sessions of therapy, indicating that even if abuse had really occurred, memory for the abuse had not been repressed. More generally, in addition to the problem of false memories, this case highlights the critical dependence of repression-claims cases on the ability of individuals to recall whether or not they had previously been able to recall a traumatic event; as McNally has noted, people are notoriously poor at making that kind of judgement.

An argument that has been made against the validity of the phenomenon of repressed memories is that there is little (if any) discussion in the historical literature prior to the 1800s of phenomena that would qualify as examples of memory repression or dissociative amnesia. In response to Harrison Pope’s 2006 claim that no such examples exist, Ross Cheit, a political scientist at Brown University, cited the case of Nina, a 1786 opera by the French composer Nicolas Dalayrac, in which the heroine, having forgotten that she saw her lover apparently killed in a duel, waits for him daily. Pope claims that even this single fictional description does not clearly meet all criteria for evidence of memory repression, as opposed to other phenomena of normal memory.

Despite the claims by proponents of the reality of memory repression that any evidence of the forgetting of a seemingly traumatic event qualifies as evidence of repression, research indicates that memories of child sexual abuse and other traumatic incidents may sometimes be forgotten through normal mechanisms of memory. Evidence of the spontaneous recovery of traumatic memories has been shown, and recovered memories of traumatic childhood abuse have been corroborated; however, forgetting trauma does not necessarily imply that the trauma was repressed. One situation in which the seeming forgetting, and later recovery, of a “traumatic” experience is particularly likely to occur is when the experience was not interpreted as traumatic when it first occurred, but then, later in life, was reinterpreted as an instance of early trauma.

A review by Alan Sheflin and Daniel Brown in 1996 found 25 previous studies of the subject of amnesia of childhood sexual abuse. All 25 “demonstrated amnesia in a subpopulation”, including more recent studies with random sampling and prospective designs. On the other hand, in a 1998 editorial in the British Medical Journal Harrison Pope wrote that “on critical examination, the scientific evidence for repression crumbles.” He continued, “asking individuals if they ‘remember whether they forgot’ is of dubious validity. Furthermore, in most retrospective studies corroboration of the traumatic event was either absent or fell below reasonable scientific standards.”


Memories can be accurate, but they are not always accurate. For example, eyewitness testimony even of relatively recent dramatic events is notoriously unreliable. Memories of events are a mix of fact overlaid with emotions, mingled with interpretation and “filled in” with imaginings. Skepticism regarding the validity of a memory as factual detail is warranted. For example, one study where victims of documented child abuse were re-interviewed many years later as adults, 38% of the women denied any memory of the abuse.

Various manipulations are considered to be able to implant false memories (sometimes called “pseudomemories”). Psychologist Elizabeth Loftus has noted that some of the techniques that some therapists use in order to supposedly help the patients recover memories of early trauma (including such techniques as age regression, guided visualisation, trance writing, dream work, body work, and hypnosis) are particularly likely to contribute to the creation of false or pseudo memories. Such therapy-created memories can be quite compelling for those who develop them, and can include details that make them seem credible to others. In a now classic experiment by Loftus (widely known as the “Lost in the Mall” study), participants were given a booklet containing three accounts of real childhood events written by family members and a fourth account of a wholly fictitious event of being lost in a shopping mall. A quarter of the subjects reported remembering the fictitious event, and elaborated on it with extensive circumstantial detail. This experiment inspired many others, and in one of these, Porter et al. convinced about half of the participants that they had survived a vicious animal attack in childhood.

Critics of these experimental studies have questioned whether their findings generalise to memories for real-world trauma or to what occurs in psychotherapeutic contexts. However, when memories are “recovered” after long periods of amnesia, particularly when extraordinary means were used to secure the recovery of memory, it is now widely (but not universally) accepted that the memories have a high likelihood of being false, i.e. “memories” of incidents that had not actually occurred. It is thus recognised by professional organisations that a risk of implanting false memories is associated with some similar types of therapy. The American Psychological Association advises:

“…most leaders in the field agree that although it is a rare occurrence, a memory of early childhood abuse that has been forgotten can be remembered later; however, these leaders also agree that it is possible to construct convincing pseudomemories for events that never occurred.”

Not all therapists agree that false memories are a major risk of psychotherapy and they argue that this idea overstates the data and is untested. Several studies have reported high percentages of the corroboration of recovered memories, and some authors have claimed that among sceptics of idea of recovered memory there is a “tendency to conceal or omit evidence of corroboration” of recovered memories.

A difficult issue for the field is that there is no evidence that reliable discriminations can be made between true and false memories. Some believe that memories “recovered” under hypnosis are particularly likely to be false. According to The Council on Scientific Affairs for the American Medical Association, recollections obtained during hypnosis can involve confabulations and pseudomemories and appear to be less reliable than nonhypnotic recall. Brown et al. estimate that 3 to 5% of laboratory subjects are vulnerable to post-event misinformation suggestions. They state that 5-8% of the general population is the range of high-hypnotisability. 25% of those in this range are vulnerable to suggestion of pseudomemories for peripheral details, which can rise to 80% with a combination of other social influence factors. They conclude that the rates of memory errors run 0-5% in adult studies, 3-5% in children’s studies and that the rates of false allegations of child abuse allegations run 4-8% in the general population.


Those who argue in favour of the validity of the phenomenon of repressed memory have identified three mechanisms of normal memory that may explain how memory repression may occur: retrieval inhibition, motivated forgetting, and state-dependent remembering.

Retrieval Inhibition

Retrieval inhibition refers to a memory phenomenon where remembering some information causes forgetting of other information. Anderson and Green have argued that for a linkage between this phenomenon and memory repression; according to this view, the simple decision to not think about a traumatic event, coupled with active remembering of other related experiences (or less traumatic elements of the traumatic experience) may make memories for the traumatic experience itself less accessible to conscious awareness. However, two problems with this viewpoint have been raised: (1) the evidence for the basic phenomenon itself has not consistently replicated, and (2) the phenomenon does not meet all criteria that must be met to support memory repression theory, particularly the lack of evidence that this form of forgetting is particularly likely to occur in the case of traumatic experiences.

Motivated Forgetting

The motivated forgetting phenomenon, which is also sometimes referred to as intentional or directed forgetting, refers to forgetting which is initiated by a conscious goal to forget particular information. In the classic intentional forgetting paradigm, participants are shown a list of words, but are instructed to remember certain words while forgetting others. Later, when tested on their memory for all of the words, recall and recognition is typically worse for the deliberately forgotten words. A problem for viewing motivated forgetting as a mechanism of memory repression is that there is no evidence that the intentionally forgotten information becomes, first, inaccessible and then, later, retrievable (as required by memory repression theory).

State-Dependent Remembering

The term state-dependent remembering refers to the evidence that memory retrieval is most efficient when an individual is in the same state of consciousness as they were when the memory was formed. Based upon her research with rats, Radulovic has argued that memories for highly stressful traumatic experiences may be stored in different neural networks than is the case with memories for non-stressful experiences, and that memories for the stressful experiences may then be inaccessible until the organism’s brain is in a neurological state similar to the one that occurred when the stressful experience first occurred. At present, however, there is no evidence that what Radulovic found with rats occurs in the memory systems of humans, and it is not clear that human memories for traumatic experiences are typically “recovered” by placing the individual back in the mental state that was experienced during the original trauma.


Amnesia is partial or complete loss of memory that goes beyond mere forgetting. Often it is temporary and involves only part of a person’s experience. Amnesia is often caused by an injury to the brain, for instance after a blow to the head, and sometimes by psychological trauma. Anterograde amnesia is a failure to remember new experiences that occur after damage to the brain; retrograde amnesia is the loss of memories of events that occurred before a trauma or injury. Dissociative amnesia is defined in the DSM-5 as the “inability to recall autobiographical information” that is

  • “traumatic or stressful in nature”;
  • “inconsistent with ordinary forgetting”;
  • “successfully stored”;
  • involves a period of time when the patient is unable to recall the experience;
  • Is not caused by a substance or neurological condition; and
  • Is “always potentially reversible”.

McNally and others have noted that this definition is essentially the same as the defining characteristics of memory repression, and that all of the reasons for questioning the reality of memory repression apply equally well to claims regarding dissociative amnesia.

Effects of Trauma on Memory

The essence of the theory of memory repression is that it is memories for traumatic experiences that are particularly likely to become unavailable to conscious awareness, even while continuing to exist at an unconscious level. A prominent more specific theory of memory repression, “Betrayal Trauma Theory”, proposes that memories for childhood abuse are the most likely to be repressed because of the intense emotional trauma produced by being abused by someone the child is dependent on for emotional and physical support; in such situations, according to this theory, dissociative amnesia is an adaptive response because it permits a relationship with the powerful abuser (whom the child is dependent upon) to continue in some form.

Psychiatrist Bessel van der Kolk divided the effects of traumas on memory functions into four sets:

  • Traumatic amnesia; this involves the loss of memories of traumatic experiences. The younger the subject and the longer the traumatic event is, the greater the chance of significant amnesia. He stated that subsequent retrieval of memories after traumatic amnesia is well documented in the literature, with documented examples following natural disasters and accidents, in combat soldiers, in victims of kidnapping, torture and concentration camp experiences, in victims of physical and sexual abuse, and in people who have committed murder.
  • Global memory impairment; this makes it difficult for subjects to construct an accurate account of their present and past history. “The combination of lack of autobiographical memory, continued dissociation and of meaning schemes that include victimization, helplessness and betrayal, is likely to make these individuals vulnerable to suggestion and to the construction of explanations for their trauma-related affects that may bear little relationship to the actual realities of their lives”.
  • Dissociative processes; this refers to memories being stored as fragments and not as unitary wholes.
  • Traumatic memories’ sensorimotor organization. Not being able to integrate traumatic memories seems to be linked to posttraumatic stress disorder (PTSD).

According to van der Kolk, memories of highly significant events are usually accurate and stable over time; aspects of traumatic experiences appear to get stuck in the mind, unaltered by time passing or experiences that may follow. The imprints of traumatic experiences appear to be different from those of nontraumatic events, perhaps because of alterations in attentional focusing or the fact that extreme emotional arousal interferes with memory. van der Kolk and Fisler’s hypothesis is that under extreme stress, the memory categorisation system based in the hippocampus fails, with these memories kept as emotional and sensory states. When these traces are remembered and put into a personal narrative, they are subject to being condensed, contaminated and embellished upon.

A significant problem for trauma theories of memory repression is the lack of evidence with humans that failures of recall of traumatic experiences result from anything other than normal processes of memory that apply equally well to memories for traumatic and non-traumatic events. In addition, it is clear that, rather than being pushed out of consciousness, the difficulty with traumatic memories for most people is their inability to forget the traumatic event and the tendency for memories of the traumatic experience to intrude upon consciousness in problematic ways.

Evidence from psychological research suggests that most traumatic memories are well remembered over long periods of time. Autobiographical memories appraised as highly negative are remembered with a high degree of accuracy and detail. This observation is in line with psychological understanding of human memory, which explains that highly salient and distinctive events – common characteristics of negative traumatic experiences – are remembered well. When experiencing highly emotional, stressful events, physiological and neurological responses, such as those involving the limbic system, specifically the amygdala and hippocampus, lead to more consolidated memories. Evidence shows that stress enhances memory for aspects and details directly related to the stressful event. Furthermore, behavioural and cognitive memory-enhancing responses, such as rehearsing or revisiting a memory in one’s mind are also more likely when memories are highly emotional. When compared to positive events, memory for negative, traumatic experiences are more accurate, coherent, vivid, and detailed, and this trend persists over time. This sample of what is a vast body of evidence calls into question how it is possible that traumatic memories, which are typically remembered exceptionally well, might also be associated with patterns of extreme forgetting.

The high quality remembering for traumatic events is not just a lab-based finding but has also been observed in real-life experiences, such as among survivors of child sexual abuse and war-related atrocities. For example, researchers who studied memory accuracy in child sexual abuse survivors 12 to 21 years after the event(s) ended found that the severity of PTSD was positively correlated with the degree of memory accuracy. Further, all persons who identified the child sexual abuse as the most traumatic event of their life, displayed highly accurate memory for the event. Similarly, in a study of World War II survivors, researchers found that participants who scored higher on posttraumatic stress reactions had war memories that were more coherent, personally consequential, and more rehearsed. The researchers concluded that highly distressing events can lead to subjectively clearer memories that are highly accessible.

Legal Status

Serious issues arise when recovered but false memories result in public allegations; false complaints carry serious consequences for the accused. A special type of false allegation, false memory syndrome, arises typically within therapy, when people report the “recovery” of childhood memories of previously unknown abuse. The influence of practitioners’ beliefs and practices in the eliciting of false “memories” and of false complaints has come under particular criticism.

Some criminal cases have been based on a witness’s testimony of recovered repressed memories, often of alleged childhood sexual abuse. In some jurisdictions, the statute of limitations for child abuse cases has been extended to accommodate the phenomena of repressed memories as well as other factors. The repressed memory concept came into wider public awareness in the 1980s and 1990s followed by a reduction of public attention after a series of scandals, lawsuits, and license revocations.

A US District Court accepted repressed memories as admissible evidence in a specific case. Dalenberg argues that the evidence shows that recovered memory cases should be allowed to be prosecuted in court.

The apparent willingness of courts to credit the recovered memories of complainants but not the absence of memories by defendants has been commented on: “It seems apparent that the courts need better guidelines around the issue of dissociative amnesia in both populations.”

In 1995, the Ninth Circuit Court of Appeals ruled, in Franklin v. Duncan and Franklin v. Fox, Murray et al. (312 F3d. 423, see also 884 FSupp 1435, N.D. Calif.), that repressed memory is not admissible as evidence in a legal action because of its unreliability, inconsistency, unscientific nature, tendency to be therapeutically induced evidence, and subject to influence by hearsay and suggestibility. The court overturned the conviction of a man accused of murdering a nine-year-old girl purely based upon the evidence of a 21-year-old repressed memory by a lone witness, who also held a complex personal grudge against the defendant.

In a 1996 ruling, a US District Court allowed repressed memories entered into evidence in court cases. Jennifer Freyd writes that Ross E. Cheit’s case of suddenly remembered sexual abuse is one of the most well-documented cases available for the public to see. Cheit prevailed in two lawsuits, located five additional victims and tape-recorded a confession.

On 16 December 2005, the Irish Court of Criminal Appeal issued a certificate confirming a Miscarriage of Justice to a former nun, Nora Wall whose 1999 conviction for child rape was partly based on repressed-memory evidence. The judgement stated that:

There was no scientific evidence of any sort adduced to explain the phenomenon of “flashbacks” and/or “retrieved memory”, nor was the applicant in any position to meet such a case in the absence of prior notification thereof.

On 16 August 2010 the United States Second Circuit Court of Appeals in a case reversed the conviction that relied on claimed victim memories of childhood abuse stating that “The record here suggests a “reasonable likelihood” that Jesse Friedman was wrongfully convicted. The “new and material evidence” in this case is the post-conviction consensus within the social science community that suggestive memory recovery tactics can create false memories” (p.27 FRIEDMAN v. REHAL Docket No. 08-0297). The ruling goes on to order all previous convictions and plea bargains relying in repressed memories using common memory recovered techniques be reviewed.

Recovered Memory Therapy

The term “recovered memory therapy” refers to the use of a range of psychotherapy methods that involve guiding the patient’s attempts to recall memories of abuse that had previously been forgotten. The term “recovered memory therapy” is not listed in DSM-V nor is recovered memory therapy recommended by mainstream ethical and professional mental health associations. Critics of recovered memory therapy note that that the therapy can create false memories through its use of powerful suggestion techniques. It has also been found that patients who retract their claims – after deciding their recovered memories are false – may suffer PTSD due to the trauma of illusory memories.


The Working Group on Investigation of Memories of Child Abuse of the American Psychological Association reached five key conclusions:

  1. Controversies regarding adult recollections should not be allowed to obscure the fact that child sexual abuse is a complex and pervasive problem in America that has historically gone unacknowledged;
  2. Most people who were sexually abused as children remember all or part of what happened to them;
  3. It is possible for memories of abuse that have been forgotten for a long time to be remembered;
  4. It is also possible to construct convincing pseudo-memories for events that never occurred; and
  5. There are gaps in our knowledge about the processes that lead to accurate and inaccurate recollections of childhood abuse.

What is the Term: ‘Kick the Cat’?


Kick the cat (or kick the dog) is a metaphor used to describe how a relatively high-ranking person in an organisation or family displaces (see below) their frustrations by abusing a lower-ranking person, who may in turn take it out on their own subordinate.


In psychology, displacement is an unconscious defence mechanism whereby the mind substitutes either a new aim or a new object for goals felt in their original form to be dangerous or unacceptable.

Origin of the Idiom

The term has been used at least since the 19th century. According to author John Bradshaw, humans were far more cruel to cats at that time, to the extent that kicking one was not perceived to be unusual and hence entered the language as a popular idiom.

The concept was reinforced in British culture by a scene in the Blackadder episode Nob and Nobility in which Edmund Blackadder kicks the cat when annoyed, and the cat bites the mouse, and the mouse bites Baldrick.

In current usage, the name envisions a scenario where an angry or frustrated employee comes home from work looking for some way to take out his anger, but the only thing present is the cat. He physically abuses it as a means of relieving his frustration, despite the cat playing no part in causing it.

Workplace or Family Dynamics

Kicking the cat is commonly used to describe the behaviour of staff abusing co-workers or subordinates as a mechanism to relieve stress. This behaviour can result in a chain reaction, where a higher-ranking member of the company abuses their subordinate, who takes it out on their own subordinate, and so on down the line. This domino effect can also be seen in family dynamics, where the father yells at the mother who yells at the older child who yells at the younger child who yells at the pet.

Blaming others can lead to kicking the dog where individuals in a hierarchy blame their immediate subordinate, and this propagates down a hierarchy until the lowest rung (the “dog”). A 2009 experimental study has shown that blaming can be contagious even for uninvolved onlookers.

Psychological Theories

According to Psychology Today, “Anger and frustration in one part of life can lead us to lash out at innocent people (or pets) in another.” The technical term for this kind of behaviour is “displaced aggression”.

Kicking the cat is looked upon unfavourably and viewed as a sign of poor anger management. According to author Steve Sonderman, “Men funnel 90 percent of their emotions through anger” and may “kick the cat” as a substitute for grief, anxiety or other emotions. Psychology author Raj Persaud suggests that people “kick the cat” as a means of catharsis because they fear expressing their full emotions to the peers and colleagues.