By Dr. Suruchi Sood
In part two of this series, we examined what happens to children who testify about sexual abuse, including nightmares, behavioral changes, and long-lasting harm. Now, we must ask why. Why does a process designed to deliver justice often cause more harm? The answer lies in two places: inside the child’s brain and within the structure of the legal system. When these two areas interact, the damage is not accidental; it’s built in.
The Brain That Was There First
By the time a child steps into a courtroom, the abuse has often already altered the parts of the brain needed for testimony. This is not a metaphor. It is biology.
Sexual abuse floods a child’s body with stress hormones, including cortisol. These hormones damage the brain while it is still developing. They disrupt the processes by which brain cells form, connect, and mature (Teicher & Samson, 2016). One of the most affected areas is the hippocampus, which stores and retrieves memories. It is highly sensitive to cortisol, and excess levels cause harm. In 30 of 37 studies they reviewed, Teicher and Samson (2016) found that abused children had smaller or less functional memory centers than children who had not been abused. The part of the brain that helps a child remember and describe what happened is damaged by the experience itself.
The amygdala, the brain’s alarm system, is also affected. Every brain imaging study Teicher and Samson reviewed found that abused children react more strongly to threatening situations than children who were not abused (2016). In the witness box, that alarm goes off at the exact moment the child is supposed to stay calm and think clearly.
The damage also affects language itself. Childhood abuse alters the structure of key language areas in the brain, which are essential for a child to describe what happened in court (Teicher & Samson, 2016). Adolescents with PTSD from childhood sexual abuse also show reduced brain tissue in regions that help regulate emotions under pressure (Alves et al., 2024). Although research is mixed on this point, some studies suggest these children may be more vulnerable to leading or misleading questions in legal settings (Alves et al., 2024; Eisen & Goodman, 1998).
Memory Is Not a Recording
Even if abuse never changed the brain at all, trauma memory simply does not work as courts expect.
Van der Kolk and Fisler (1995) studied 46 adults with PTSD. Not one of them began with a clear account of what had happened. Each person initially experienced the trauma as scattered fragments: flashes of images, sounds, smells, bodily sensations, and waves of emotion that occurred separately and out of order. Over time, most were able to piece together a coherent story. However, five of them, all from the group who had been abused as children, never could. Even as adults, despite outside confirmation that the abuse had occurred, they still lacked a complete account. Only disconnected pieces.
There is a physical explanation for this. When traumatic memories are triggered, the part of the brain that turns experiences into words, called Broca’s area, becomes quiet. At the same time, the brain areas that process raw emotion and imagery become highly active (van der Kolk & Fisler, 1995). Under extreme stress, the brain stops organizing experiences into a coherent narrative. Instead, it stores the experience as images, sensations, and feelings, all scattered and separate (van der Kolk et al., 2001). The child is not intentionally being vague; their brain is physically unable to produce the organized account that a court requires.
Van der Kolk and Fisler describe two distinct types of memory. Traumatic memory is frozen and involuntary, meaning it cannot be recalled when needed. It is triggered by specific cues, such as a smell, a sound, or a face. Narrative memory, by contrast, is flexible. It can be organized, shortened, and shaped to fit a listener (1995). Courts require narrative memory. Trauma produces the other kind.
Children face an additional challenge beyond this. Even without trauma, children’s brains are still developing the ability to create and communicate coherent stories (van der Kolk & Fisler, 1995). A review of 11 studies involving 1,270 children found a strong link between how children experienced their traumatic memories and the severity of their symptoms, and this link persisted over time (Reed, 2022). Importantly, it is the child’s own perception that their memory is disorganized and unclear, not what an outside observer notices, that most strongly predicts their distress (McGuire et al., 2021). A child can appear calm on the outside while feeling completely lost inside.
For children with PTSD, the impact is even more profound. Trauma memories keep resurfacing, making it difficult to focus on anything else (Eisen & Goodman, 1998). Many of these children experience attention and distraction problems that closely resemble ADHD (Eisen & Goodman, 1998). Because thinking about the trauma is so painful, many children avoid it altogether. The less a memory is revisited, the more it fades and loses clarity over time (Eisen & Goodman, 1998).
Putting all of this together, the clear conclusion from Eisen and Goodman (1998) is that avoidance and distractibility make it harder to obtain a full and reliable account from a traumatized child. Stress in the interview setting worsens this: it decreases attention, disrupts thinking, and drains the effort needed to retrieve memories (Saywitz & Camparo, 1998). For a child with PTSD, the courtroom does not lessen these pressures; it triggers them.
The Institution That Wasn’t Built for Them
Set against all of this, the legal system appears less like a poor fit and more like a direct conflict.
In sexual abuse cases, the child’s account is often the only evidence available (Quas & Goodman, 2012; Fernandes et al., 2024). The entire case may hinge on the child’s ability to provide a clear, detailed, story-based account. That’s exactly what trauma makes most difficult.
Harm can begin even before a child appears in court. About one in five forensic interviews occur without standardized guidelines (Fernandes et al., 2024). Poorly conducted interviews can cause secondary victimization, defined as harm inflicted by the system itself (Fernandes et al., 2024). Campbell and colleagues (2001) describe this as victim-blaming attitudes and practices by service providers that worsen the original trauma. In a study of adult rape survivors, 52% reported that interactions with the legal system felt harmful. Both inadequate services and feeling blamed were linked to worse physical and psychological health outcomes.
Inside the courtroom, pressure mounts. Children waiting to testify are often very anxious: afraid of the unknown, afraid of retaliation, and worried they won’t be believed (Saywitz & Camparo, 1998). Legal language is usually beyond young children’s understanding. They often do not know the court rules or what the words they are supposed to use even mean (Saywitz & Camparo, 1998). Ninety percent of children who testified while facing their abuser said that was the most frightening part of the entire experience (Quas & Goodman, 2012).
The damage worsens each time a child must testify again. Children who must testify multiple times face worse outcomes, including greater avoidance, distress, and symptoms, even nearly a decade later, regardless of their condition before the case began (Quas & Goodman, 2012). Cases involving child victims usually last one to two years, with some dragging on through most of childhood. Delays keep anxiety high and slow recovery, especially for children who must testify (Quas & Goodman, 2012).
The legal system did not set out to harm children. However, it causes harm because it is based on assumptions about memory and testimony that do not apply to children who have experienced severe trauma. It interprets fragmented, non-linear memory as evidence of lying rather than as a result of trauma’s impact on the brain. It exposes children to their abusers, subjects them to aggressive questioning by authority figures, forces repeated retellings, and makes them wait years for it all to end. Each of these actions alone would be challenging for a traumatized child, but together they form a cycle of retraumatization.
Understanding why this happens doesn’t mean you have to accept that it must. Every mechanism described above points to something that could be changed: how interviews are conducted, how courtrooms treat child witnesses, and how legal professionals learn about trauma. That’s where this series goes next.
References
Alves, A. C., Leitão, M., Sani, A. I., & Moreira, D. (2024). Impact of sexual abuse on PTSD in children and adolescents: A systematic review. Social Sciences, 13(4), 189. https://doi.org/10.3390/socsci13040189
Campbell, R., Wasco, S. M., Ahrens, C. E., Sefl, T., & Barnes, H. E. (2001). Preventing the ‘second rape.’ Journal of Interpersonal Violence, 16(12), 1239–1259.
Eisen, M. L., & Goodman, G. S. (1998). Trauma, memory, and suggestibility in children. Development and Psychopathology, 10(4), 717–738. https://doi.org/10.1017/S0954579498001837
Fernandes, D., Gomes, J. P., Albuquerque, P. B., & Matos, M. (2024). Forensic interview techniques in child sexual abuse cases: A scoping review. Trauma, Violence, & Abuse, 25(2), 1382–1396. https://doi.org/10.1177/15248380231177317
McGuire, R., Hiller, R. M., Ehlers, A., Fearon, P., Meiser-Stedman, R., Leuteritz, S., & Halligan, S. L. (2021). A longitudinal investigation of children’s trauma memory characteristics and their relationship with PTSD symptoms. Research on Child and Adolescent Psychopathology, 49, 807–816. https://doi.org/10.1007/s10802-021-00773-5
Quas, J. A., & Goodman, G. S. (2012). Consequences of criminal court involvement for child victims. Psychology, Public Policy, and Law, 18(3), 392–414. https://doi.org/10.1037/a0026146
Reed, J. (2022). Trauma memory characteristics and neurocognitive performance in trauma exposed youth [Doctoral thesis, University of East Anglia]. Unpublished.
Saywitz, K., & Camparo, L. (1998). Interviewing child witnesses: A developmental perspective. Child Abuse & Neglect, 22(8), 825–843.
Teicher, M. H., & Samson, J. A. (2016). Annual research review: Enduring neurobiological effects of childhood abuse and neglect. Journal of Child Psychology and Psychiatry, 57(3), 241–266. https://doi.org/10.1111/jcpp.12507
van der Kolk, B. A., & Fisler, R. (1995). Dissociation and the fragmentary nature of traumatic memories: Overview and exploratory study. Journal of Traumatic Stress, 8(4), 505–525. https://doi.org/10.1007/BF02102887
van der Kolk, B. A., Hopper, J. W., & Osterman, J. E. (2001). Exploring the nature of traumatic memory: Combining clinical knowledge with laboratory methods. Journal of Aggression, Maltreatment & Trauma, 4(2), 9–31.