I have heard it said that all life experiences help you to be a better GP, and I feel that it is the challenging experiences that have helped me the most. Adopting my children 4 years ago has caused a major shift in my understanding of my patients. Like most children removed from their birth family in the UK, my children have experienced multiple traumas. Their subsequent grief and trauma-related behaviours have helped me find a new level of empathy for my patients.
IMPACT OF NEGATIVE EXPERIENCES IN CHILDHOOD ON ADULTHOOD
Since having my children I have found that one of my most useful history taking techniques is a simple question: ‘how was your childhood?’. I use it when talking to patients about anxiety, depression, addiction, relationship problems, and difficulties with their own children’s behaviour. It has also proved valuable when exploring medically unexplained symptoms with patients. Initially I feared causing offense with such a direct question but many of my patients have revealed stories of alcohol addiction and abuse, domestic violence, rejection, and sometimes physical and sexual abuse. Some patients reveal shocking violence from their past with little emotion or realisation of the impact it could be having on them now.
I hope that if asked openly people can move past it quickly if they don’t have much to say about it or if they are not ready to talk. If you don’t routinely ask this question or similar, I think you would be surprised by the responses you will receive.
Research into Adverse Childhood Experiences (ACEs), such as those described above, has found that is a correlation between adverse experiences in childhood and the risk in adulthood of a range of conditions, from cardiovascular disease and stroke to addiction and suicide.1 Fractures in the relationship between a child and their mother, father, or primary care giver can impact on childhood development and the ability to form relationships as adults. The emotional disconnection can also lead to people having difficulty regulating their emotions and feeling empathy for others.
Understanding this on a deeper level has helped me understand the behaviours of my patients, as well as my children. Their sometimes chaotic and self-destructive behaviour can be frustrating to deal with but I find having empathy for how and why patients might behave the way that they do can lessen this frustration. Childhood trauma can impact a whole lifetime, so while I don’t have the solutions, I think an understanding about it can help GPs connect better with their patients.
- © British Journal of General Practice 2021
