Adverse Childhood Experiences: How Early Life Patterns Affect Our Health

Written by Roland Bal

I met with Art O'Malley to talk about the long-term effects of early life trauma on our physical and mental health. Art is originally trained as a Psychiatrist, with a specialty in working with children and adolescents, and from there on expanded his approach with Somatic Experiencing, Sensory-motor Psychotherapy, and EMDR. He is also the founder of the B.A.R.T model (Bilateral Affective Reprocessing Trauma) and author of The Art of Bart.

Art and I both see the importance of using a somatic and cognitive approach to trauma — what is also called a top-down and bottom-up approach. We started with a wide topic so we have just skimmed part of some of the essences of the topic, namely: the brain and nervous system responses after trauma, what works as to approaches to working with trauma, the narrative of the story and using constructive imagination to reintegrate missing parts, safety, resistances, and the necessity to leave one's personal agenda and be present to working with and honor resistances, honesty and a willingness to work. To name a few.

How Adverse Childhood Experiences Wire the Nervous System

Trauma, the word itself, is quite stigmatized and marginalized. In the public domain, we are not really aware of how much it impacts us — especially when it happens in early life. Birth in itself can be quite complicated. Early life diseases like meningitis. Loss of a parent or a sibling. These are the more common early life traumas that can happen to us, and even there, we do not see the ramifications on a long-term scale of what they do to our physical and mental health.

And then we have what society more readily considers trauma: severe neglect or abuse, sexual abuse, beatings, growing up with a depressed or alcoholic or drug-dependent parent. All of this affects us very deeply in our nervous system. In an early life stage, the limbic structure, the brainstem, the amygdala, the thalamus — they get this strong wiring of going into fight, flight, and freeze mode. And then we keep running on that for the rest of our lives if we do not find help to break out of it.

This is just from a nervous system perspective. But from there, the emotions are involved as well — the hyper and hypo reflexes, the endocrine system. And from there, how it affects our organs and the way we function. The link between nervous system reflexes, the endocrine system, our emotions, and then how all of that impacts our organ systems is what makes adverse childhood experiences so far-reaching in their consequences.

Disrupted Developmental Stages and the Shrinking Cortex

As Art explained in our conversation, there are critical developmental windows that, when disrupted, play on right into adult life. From zero to one, we have trust versus mistrust. From one to about two and a half, autonomy versus shame and doubt. If those stages are disrupted by adverse childhood experiences, the effects do not simply fade — they become embedded in how a person relates to themselves and to others for decades.

What is particularly striking is what happens to brain development under chronic stress. A baby's head is about 50% of adult size at birth and grows to 90% by age five. That shaping of the brain, the emotions, the cortex — it is very much dependent on the parent-child interaction and the scaffolding of the developing brain. When that scaffolding is absent or replaced by threat, the amygdala and brainstem responses are kept constantly in fight or flight. And the cortex — the part responsible for language, communication, imagination, and rational thought — can actually shrink because it is not getting nurtured.

You can either make the amygdala and those brainstem responses constantly in fight or flight, or you can actually shrink the cortex, because it's not getting nurtured.

This is the inverted development that adverse childhood experiences create. Too much energy invested in survival structures, not enough fuel left for the higher functions — nervous system regulation, clear communication, and the ability to relate to others with any sense of safety.

Pre-Verbal Trauma and Why Talk Therapy Is Often Not Enough

One of the most important points that came up in our conversation is the concept of pre-verbal trauma — adverse experiences that happen before the age of five, where the body stores the information but the cortex does not register it as a narrative story. The child cannot name what is happening. There are no words yet. But the nervous system records every detail: the sensations, the felt sense of danger, the absence of safety.

This is why so many people find that years of talk therapy do not reach what is driving their symptoms. You cannot narrate your way out of something that was encoded before language was available. The body holds the archive, and that is where the work needs to happen — through sensation, breath, movement, and the gradual rebuilding of the nervous system's capacity to tolerate what was once overwhelming.

This is where the somatic and cognitive approach working together becomes essential. You need the cognitive part — our thought capacity — to create a healthy framework for addressing trauma and to not fall back into old patterns. And you need the somatic part to work through the emotional residue that is stored within the body and nervous system. One without the other leaves the work incomplete.

Art and I go deeper into all of this in the full podcast — including how constructive imagination can reintegrate missing parts of the narrative, the role of resistance in the healing process, and why working at the edge of your window of tolerance is where real change happens.

Listen to the full conversation:

Reenactment, Resistance, and Working Through Adverse Childhood Experiences

It takes significant commitment to work through adverse childhood experiences and early life trauma. Those who are willing and ready to work need to keep this in mind. It is also important to keep healthy expectations. You cannot get rid of or forget about what happened to you. You can heal the wound, but the scar — most likely — will remain.

One of the patterns that makes recovery so difficult is reenactment. A mother who was abused as a child may freeze when her own baby plays with a toy that reminds her of the room where the abuse happened. Until her own trauma is addressed, she cannot effectively parent — not because she does not love her child, but because her nervous system is still responding to a threat that existed decades ago. This is how adverse childhood experiences pass from one generation to the next — not through intention, but through unresolved nervous system patterns.

And then there is the resistance to healing itself. We form a kind of familiarity with our suffering. The structures of fight, flight, and freeze — however painful — are within the known. To move out of that means to move away from a pattern we are used to and start growing into a larger part of ourselves. There is real hesitancy there. The devil you know feels safer than the devil you do not know. This resistance is not a character flaw. It is the nervous system clinging to what is familiar, even when what is familiar is destructive.

What is often more important than the expectation that you will not suffer anymore is having the right tools and resilience to recover faster from triggers — to widen your window of tolerance so that you are not constantly flipping between hyperarousal and shutdown, but can stay present long enough for the old patterns to begin loosening their grip.