Scared Sick. The Role of Childhood Trauma in Adult Disease



By Robin Karr-Morse, assisted by Meredith S Wiley

Review by Anna Luise Kirkengen, MD, PhD

Spring 2012 - Volume 16 Number 2

A Book I Would Have Liked to Have Written

Family therapist Robin Karr-Morse, assisted by Meredith S Wiley, presents a condensate of knowledge from a wide, new, and multidisciplinary field in medicine comprising a multitude of translational research and documentations. The field is "multihyphened," so to say, as it has gradually emerged during the last two decades by linking psychology—neurology—endocrinology—immunology, in short psychoneuroimmunology, and the neurosciences including neuroradiology, genetics and, quite recently, epigenetics.

Its essence is the interplay between human biology and personal biography, in other words the impact of personal experience on this person's physiology, the lived body. This phenomenological term accounts for the fact that human bodies are not purely biological organisms or entities void of history and experience, but rather informed by embodied life and lived experience, in other words inscribed bodies.1

Karr-Morse and Wiley refer to a steadily growing body of knowledge and international literature and report from dialogues with some of the most experienced, leading, and—quite often—pioneering scholars in this field, as for example Bessel van der Kolk, Bruce Sperry, Allan Schore, Daniel Siegel, Bruce McEwen, Robert Anda, Vincent Felitti, and Robert Scaer. These scholars do not only represent a variety of disciplines but also combinations of experimental and epidemiologic research and clinical practice. Despite their different points of departure, these scientists have come to contribute to a converging and ever more solidly documented message: childhood trauma affects health. Having been deathly frightened early in life means, highly probably, falling sick later, if no appropriate "buffers" or protective measures are available.

Deathly scared children, when left to themselves (which means left by relevant others), are not only existentially shaken but also epistemologically disturbed. This means: their very framework, the ground from where to interpret and understand the world, is that of shattered trust and of permanent fear, alarm, alertness or—utmost problematic—chronic powerlessness.

To be in the world as permanently alerted or profoundly powerless is not a thought or an emotion. It is a fear-full, pain-full, violated being. Such states of being are toxic because they tax the body's adaptability, straining the flexible interplay in and between the central nervous, hormonal, and immune systems.2 Here is the entrance to complex, chronic sickness and premature death.3

This is what Karr-Morse and Wiley write about, and they do so in a language and style that renders the really demanding, scientific "stuff" they deal with comprehensible for every reader. This is indeed impressive.

Are there no drawbacks? Almost none, although two objections can be made. First, the authors have omitted the fascinating documentation that the telomeres, the tips of our chromosomes, are also affected by overwhelming adversities, implying an experiential effect on genetic level. Next, the authors refer to currently available therapies for, or therapeutic approaches to, the long-term impact of childhood trauma. But all approaches mentioned are, by necessity, inappropriate for the matter at hand since the most crucial consequence of the converging knowledge implies that the very foundation of biomedicine, the theory of bodily matter as different and separate from the mind, has been invalidated and must be revised.

This theory, constituting the divide between somatic and psychiatric medicine and rendering the human body a separate entity, has been overruled by now and needs to be transcended. The knowledge offered in the present book indicates, literally, that mind matters. Consequently, a new theory is urgently called for, namely a theory appraising that human bodies are embodied in time-space, and that human beings are relational and social. This implies that every person, from conception to death, is embedded in relationships and systems of socioculturally constituted values and meaning, informing every level of being, from the metaphysical to the genetic with a transgenerational impact. This is an important and practical book for physicians.

1.    Kirkengen AL. Inscribed Bodies. Dordrecht: Kluwer Academic Publishers; 2001.
2.    Shonkoff JP, Boyce WT, McEwen BS. Neuroscience, molecular biology, and the childhood roots of health disparities: building a new framework for health promotion and disease prevention. JAMA 2009 Jun 3;301(21):2252-9.
3.    Felitti VJ, Anda RF. The relationship of adverse childhood experiences to adult medical disease, psychiatric disorders and sexual behavior: implications for healthcare. In: Lanius RA, Vermetten E, Pain C (eds). The impact of early life trauma on health and disease. The hidden epidemic. Cambridge: Cambridge University Press; 2010.


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