The best art reflects personal experiences and life. The author Pat Conroy is a great storyteller and artist who had a very troubled childhood. Yesterday, I mentioned the Prince of Tides in passing. Last night I watched the movie. It is a magnificent piece of art. The main character in the movie, Tom Wingo, is a largely autobiographical character for Conroy. Wingo is a largely autobiographical figure for me too. As I watched the movie, it was uncanny how closely Wingo’s childhood situation matched my own.
My father was an abusive alcoholic. He was like Dr. Jekyll and Mr. Hyde. He was out drinking most nights and when he came home at midnight that is when the rages would begin. I still remember lying in the bed consumed with anxiety and fear, knowing that the terrors would begin soon. By the time I graduated from high school, I had very little self-esteem. I went to college, and I took psychology. I went to medical school and did an acting internship in psychiatry my senior year. I did an internal medicine residency. I was still clueless about the impact of parental abuse later in life. A counselor who was a friend recommended I read Adult Children of Alcoholic Parents. I learned that these kids are never normal. They are super responsible or super irresponsible. That helped, but it was just a Band-Aid. Like Wingo, I had communication problems in marriage, and after a divorce in my late fifties, I went to a counselor who worked with me the same way the same way Dr. Lowenstein worked with Wingo in the movie. It is also remarkable how closely those experiences line up.
I finally found peace and understanding. There was a difference though and I think my therapist got it right. Wingo got it out by finally feeling the pain and sadness he had buried. My counselor told me it was entirely appropriate for me to be very angry at my father. It was really hard for me. I had killed my expression of anger as a child to protect myself. She had me read books like Alice Miller’s For Your Own Good. Finally, I understood that parental abuse is very widespread in our society.
Many individuals in the helping professions have a background like this—healthcare workers, teachers, and ministers— but they are unaware of the impact on them. From the earliest days they became little adults in the family, and they tried to help relieve the family dysfunction in any way that they could. They grow up to soon. They focus so much on the needs of others, there is a joke about them. “When they die, someone else’s life flashes before their eyes.”
Childhood stress and anxiety may increase the risk of chronic physical diseases in addition to mental illness. Consider this quote from the Journal of the American Medical Association: “the idea, based on growing evidence of the cardiovascular sequelae of early life adversity, that new interventions to reduce significant stress in early childhood may be a more appropriate strategy for preventing adult heart disease than the off-label administration of statins to school-aged children. In this article, we explore the scientific validity of the proposition that reducing significant disadvantage early in life may be a powerful strategy for reducing the population-level burden of chronic morbidity and premature death”
Now we know the mechanisms behind some of these links. Fear and stress in childhood lead to increased cortisol and adrenaline levels that persist throughout life. Cortisol activates the mineralocorticoid receptor (MR) just like aldosterone. See the location of the MR receptor in the upper right corner of the signaling diagram below. High aldosterone levels activating MR contribute to the development of every element of the metabolic syndrome. High cortisol levels leading to MR activation also contributes to depression. Primary aldosteronism is a disease with isolated high aldosterone levels that causes high blood pressure. Therefore, it helps us understand the effects of elevated aldosterone alone. Compared with other types of hypertension, patients with hyperaldosteronism have much higher rates of cardiovascular events. They also have higher rates of depression and anxiety which are improved when the aldosterone producing tumor is removed. It is all tied together.
This problem is so widespread, and our solutions are so much better that every basic psychology course in college should provide a basic understanding of these facts. Certainly, every person in training to be a teacher, minister, or healthcare worker should have a working knowledge of adverse childhood experiences and the impact on mental and physical health. The Prince of Tides could be a resource to help students and parents feel the experience of abused children so we can be more effective parents and providers ourselves. The stakes are far too high to ignore this common problem.
Bill, you are a true survivor! Let’s see how strong your heart is tomorrow. Ok?
Thank you for this personal account of the trauma you lived with in your childhood years and how it affected you in later life. I, too, lived in secret abuse as a child. I became a teacher for 35 years, filled with a desire to improve the lives of children. I also was diagnosed with major depressive disorder. Now I want to go back and read The Prince of Tides at your recommendation. Your frankness is necessary and extremely helpful.