Verbal Abuse: Words Can Hurt

Emotional abuse is perhaps the least understood type of abuse.  In the field of trauma it is sometimes thought of as a “little t” trauma. Many people minimize its importance or the damage it does. Think of the familiar adage: “Sticks and stones may break my bones, but words will never hurt me”.  In my practice, however, I see every day the lasting and severe impact of childhood emotional abuse. I want to share with you a research study that supports this.

I am including an abstract of a study looking at the impact of one type of emotional abuse, parental verbal abuse, on the child’s developing brain. My understanding of conclusion of this study is that childhood exposure to ongoing verbal abuse by parents has been found to have an adverse impact on the child’s developing brain even when no other type of abuse or trauma has occurred. The impact seems to be similar to witnessing domestic violence as a child or being sexually abused by someone outside the immediate family.

The parts of the brain that are impacted are related to language processing and areas that are effected in those who experience dissociation, depression and anxiety. What does this mean? Perhaps it can help us understand why emotional/verbal abuse alone can lead to the development of the type of symptoms we associate with complex PTSD. I hope that studies like this can help illustrate how serious emotional abuse really is.

The abstract is below. Or read an interview with the main investigator, Martin Teicher, MD, Ph.D:

For now, however, the most important message of this work may be the awareness that parental verbal abuse is damaging. “People hear that spanking is bad, so they stop doing that and become more verbally abusive,” said Teicher. “It turns out, that may be worse.”

Abstract: Preliminary Evidence for White Matter Tract Abnormalities in Young Adults Exposed to Parental Verbal Abuse

Background:

Psychiatric sequelae of exposure to parental verbal abuse (PVA) appear to be comparable with that of nonfamilial sexual abuse and witnessing domestic violence. Diffusion tensor imaging (DTI) was used to ascertain whether PVA was associated with abnormalities in white matter (WM) tract integrity.

Methods:

1271 healthy young adults were screened for exposure to childhood adversity. Diffusion tensor imaging was collected on 16 unmedicated subjects with history of high-level exposure to PVA but no other form of maltreatment (4 male/12 female subjects, mean age 21.9 +/- 2.4 years) and 16 healthy control subjects (5 male/11 female subjects, 21.0 +/- 1.6 years). Group differences in fractional anisotropy (FA), covaried by parental education and income, were assessed using tract-based spatial statistics (TBSS).

Results:

Three WM tract regions had significantly reduced FA: 1) arcuate fasciculus in left superior temporal gyrus, 2) cingulum bundle by the posterior tail of the left hippocampus, and 3) the left body of the fornix. Fractional anisotropy in these areas was strongly associated with average PVA scores (rs = -.701, -.801, -.524, respectively) and levels of maternal verbal abuse. Across groups, FA in region 1 correlated with verbal IQ and verbal comprehension index. Fractional anisotropy in region 2 was inversely associated with ratings of depression, dissociation, and limbic irritability. Fractional anisotropy in region 3 was inversely correlated with ratings of somatization and anxiety.

Conclusions:

Exposure to PVA may be associated with alteration in the integrity of neural pathways with implications for language development and psychopathology.

Jeewook Choi, Bumseok Jeong, Michael L. Rohan, Ann M. Polcari, Martin H. Teicher, Preliminary Evidence for White Matter Tract Abnormalities in Young Adults Exposed to Parental Verbal Abuse, Biological Psychiatry, Volume 65, Issue 3, Epigenetic Mechanisms in Psychiatry, 1 February 2009, Pages 227-234, ISSN 0006-3223, DOI: 10.1016/j.biopsych.2008.06.022.

Kathleen Young, Psy.D.