"Non-Realisation"- Disconnection from Childhood Trauma

In his groundbreaking book, Lost Connections: Uncovering the Real Causes of Depression – and the Unexpected Solutions, British journalist Johann Hari challenges one of the most dominant narratives in modern mental health treatment: that depression is primarily caused by a chemical imbalance in the brain. This widely held belief has shaped decades of pharmaceutical treatment and public understanding, often overshadowing more human, relational, and trauma-informed perspectives on mental health.

Hari’s work isn’t just a critique, it’s a radical reframe. He introduces key causes of depression and anxiety, rooted in social, emotional, and psychological disconnection. Alongside these causes, he outlines evidence-based paths to reconnection. Notably, none of his proposed solutions involve antidepressant medications. Instead, Hari points to what so many trauma therapists, psychologists, and survivors already know: depression is often a viable adaptation and surival strategy, not necessarily a disease in and of itself. It's a call to pay attention to parts of ourselves that are hurting, neglected, or cut off.

Among the most powerful and emotionally resonant chapters in the book is where Hari lays out childhood trauma as a significant correlate of adult mental health issues. This chapter highlights the often unspoken link between adverse early experiences and later struggles with depression, anxiety, and addiction.

The ACES Study and the Hidden Link Between Childhood Trauma and Adult Mental Health

Hari introduces readers to Dr. Vincent Felitti, a physician working within the American private health system. Felitti was tasked with helping morbidly obese patients lose weight. Yet, despite some initial success with conventional weight-loss programs, many of these patients quickly regained the weight they lost. Some deteriorated emotionally after losing weight, experiencing intense depression, panic attacks, or rage. This baffled Felitti, until he started asking a revolutionary question for its time (and sadly, still often ignored in today’s health systems): What happened in the person's life that made this seemingly self-destructive pattern so persistent?

And, Felitti did something even more radical. He began listening. He asked about his patients’ personal histories including their families, their childhoods. What he uncovered was astonishing. A significant number of patients had experienced extreme childhood trauma, including physical, emotional, and sexual abuse. The excess weight was not just a health issue, it was a protective adaptation. For many, obesity created a sense of invisibility or safety. When they lost weight, they felt more exposed, more vulnerable. The parts of them that kept the weight on were protecting them in some way.

This insight led Felitti to collaborate with Dr. Robert Anda. Together, they developed the now-famous Adverse Childhood Experiences (ACE) Study, a simple yet powerful questionnaire designed to assess exposure to various forms of trauma in early life, from emotional neglect to domestic violence and abuse. The ACE Study, administered to over 17,000 participants within the Kaiser Permanente health system in San Diego, revealed staggering findings. For every additional category of adverse experience a person had in childhood, the risk of adult depression, addiction, chronic illness, and even early death increased dramatically.

In particular, emotional abuse, often invisible or minimised in both families and clinical settings was found to have an even stronger correlation with adult depression than sexual abuse. That finding alone should transform how we understand the roots of psychological suffering.

Trauma Is What Happens Inside You

Hari’s conclusion is one that trauma therapists have long understood: Depression is not simply a malfunction. It's often a perfectly logical response to past pain that has never been acknowledged, held, or healed.  In this way, trauma, especially when unrecognised, can become embedded in our nervous system and daily experience. As the famous trauma therapist, Dr Gabor Mate says, "Trauma isn't what happened to you, it's what happens inside of you..."

As a trauma-focused Clinical Psychologist, I’ve seen this time and time again. What looks like “dysfunction” on the surface often makes perfect sense when you listen deeply to someone’s story. B ehaviours like emotional withdrawal, chronic people-pleasing, rage outbursts, or addictive patterns aren’t random. They’re the individual systems' creative (and often desperate) attempt to protect us from further pain. The problem? Professionals often don’t see these behaviours as protective, instead pathologising them. People suppress or shame their past so deeply away that they genuinely believe, “My childhood was fine,” or “It didn’t affect me.”

The Cost of Non-Realisation: Why Facing Childhood Trauma Can Feel So Impossible

Hari describes his own battle with this truth. Like many people who enter therapy, he had a history of trauma, but couldn’t fully acknowledge its impact. The American trauma therapist Kathy Steele called this struggle non-realisation, or the inability (or unwillingness) to grasp significant life events as fully belonging to, or being integrated into, one’s personal story. This dissociation serves a purpose. It helps us survive when the full weight of reality feels unbearable.

Many men I work with show up in therapy saying things like:

• “I had good parents.”

• “They only hit me when I deserved it.”

• “The abuse didn’t affect me.”

• 
  

These aren’t lies. They’re protective beliefs, adaptations to overwhelming emotional realities that the child version of themselves couldn't fully metabolise. But here’s the kicker: the more entrenched these non-realisations are, the harder - and more important - the work of healing becomes. And no, trauma doesn't need to look like physical or sexual abuse to be damaging. Hari shares the example of a friend raised by a competent, well-meaning mother whose chronic negativity created a deep emotional wound. The child learned, over time, that love was conditional, that failure was shameful, that joy was unsafe. These subtle but consistent messages shape the architecture of the brain and nervous system, and they can echo into adulthood as anxiety, depression, and loneliness.

Recovery Comes from Understanding

Acknowledging trauma isn’t about blaming parents, teachers, or caregivers. As I often say to clients, “This is not a blame exercise. This is a meaning-making process.”  Most caregivers were doing the best they could with the tools they had. But denying or minimising what happened doesn’t help us heal. Healing requires truth, integration, and realisation. We must tell the truth about what happened, and not just intellectually, but emotionally. What did that event feel like at the time? What did the child need in that moment that they didn’t get? And how is that unmet need still shaping their life today?

Reconnection Is the Antidote to Disconnection

Lost Connections reframes depression not as a broken brain but as a broken connection—to others, to purpose, to meaning, no nature, and critically, to ourselves. Hari’s work affirms what many in the trauma therapy world have known for decades: our pain makes sense and our brains and minds are not working against us. Healing doesn’t come in a pill (although medications are helpful and necessary at times), it comes in relationships, in compassion, in curiosity, and in courageous truth-telling.

If you’ve ever struggled with depression, anxiety, or addiction, I highly recommend reading Hari’s book. And if some part of you wonders whether childhood trauma may be playing a role in your adult struggles, let that curiosity guide you. The path to healing begins not with blame or shame, but with listening to the parts of us that were never heard.

About the Author

Sean Cuthbert is a Clinical Psychologist, Psychology Board of Australia (PBA) Approved Supervisor, Certified IFS Therapist, and IFS-I Approved Clinical Consultant in private practice in Melbourne, online throughout Australia, and internationally. He provides 1:1 therapy for clients, and supports professionals through individual and group supervision/consultation.