How the legacy of childhood trauma can be eased

Francis McMonagle reflects on a trauma summit in Belfast where experts highlighted the long-term damage of early traumatic experiences

A group of physiotherapists with an interest in mental health attended a recent International Trauma Summit in Belfast. More than 1,200 delegates heard world experts talk about the huge impact trauma can have on all aspects of our health.

Perhaps most interesting from a physiotherapy point of view was Dr Gabor Mate, who discussed the potential impact of adverse childhood experiences (ACEs) on health in adulthood. Studies have shown ACEs increase a person’s risk of a range of chronic illnesses and ultimately early death. ACEs can also cause disrupted neurodevelopment, leading to social, emotional and cognitive impairments. These can often result in coping strategies such as smoking and alcohol or drug misuse, with all the knock-on negative effects.

Recent research showed that Belfast has the highest levels of avoidable deaths in the UK. The causes are multifactorial but work carried out by clinicians within a sectarian interface in North Belfast has demonstrated the trauma of The Troubles, superimposed on ACEs, can produce a complex post traumatic stress disorder. This may manifest in chronic disease. Consistent with this premise, chronic disease registers for Northern Ireland show that North Belfast tops the list for 11 out of 14 chronic diseases including COPD, heart disease, rheumatoid arthritis and mental health. While the causes are varied we must recognise the significant role that trauma plays in all aspects of health.

Physiotherapists working in multidisciplinary teams in pain management and trauma are integral to the effective treatment and management of such complex presentations, and there are gaps in training at all levels. Recently, however, the role of physiotherapy in mental health was added to the undergraduate syllabus at Ulster University. And postgraduate training in mental health has been introduced into commissioning plans.  These are positive steps and we hope to see more as the research showing the links between physical and mental health grows. As part of this we have recently formed a regional special interest group for physiotherapists in mental health and trauma.

  • Francis McMonagle is a specialist musculoskeletal physiotherapist

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