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We all of us suffer childhood trauma to some degree. No one has a perfect childhood. In any case, if someone were to do so, it would not be a very satisfactory training for adult life. We have to learn to work our way through our disappointments, surmount challenges and get over the various hurts and deprivations that we may suffer. This is not to advocate that we should all wear hair shirts, nor to diminish the significance of the very real traumas that some children endure. However, it does emphasise that all life is a challenge. There is never a time when we can sit back and relax, secure in the knowledge that all our difficulties are in the past. Rather, we should get into the habit of recognising that difficult challenges are in fact opportunities for further understanding and growth. Not only should we learn from our own experience but hopefully we can learn to be more understanding and considerate towards others so that we do not perpetuate the emotional abuse and abandonment that we ourselves may have endured.

There are people who believe that eating disorders and other outlets for neurotransmission disease are primarily caused by childhood trauma. There is no evidence to support this. For example, whilst it is true that many bulimic patients have been sexually abused in childhood, it is not true that children who have been sexually abused necessarily grow up to become bulimic. The sad fact is that sexual abuse is common and only a few of the children who have been sexually abused grow up to have problems with addictive behaviour of one kind or another.

The confusion arises because, just as neurotransmission disease - with all its attendant addictive behaviours - runs in families, so does abuse and abandonment. This does not mean that abuse and abandonment are genetically inherited traits. It means that people in the active phase of their addiction tend to be totally selfcentred and abusive of others. Thus, someone who is alcoholic or otherwise addicted may abuse or abandon all his or her children equally, but only some of these children - those who inherited the genetic predisposition to neurotransmission disease - will themselves develop it in one outlet or another or, more commonly, in several at the same time. Thus, those patients who believe that their addictive behaviour was caused by abuse and abandonment in childhood should examine their own siblings - or children from other families who have been abused or abandoned - to see that very often they develop no addiction problems at all. To be sure, there is a great deal of damage done by childhood abuse and abandonment but that is a separate problem, totally distinct from whether or not one develops an addictive tendency.

I believe that the development of any specific addictive outlet is a three-stage process:

  1. The antecedent cause: the genetically inherited defect in neurotransmission in the mood centres of the brain.
  2. The contributory cause: some form of traumatic episode that awakens the need for mood-alteration.
  3. The precipitant cause: the exposure to a mood-altering substance or process
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