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Transcript
About The Author.
David Hosier MSc is a psychologist who was educated at Goldsmith's College, University of London. He has
worked as a lecturer, researcher and teacher. His own experience of severe childhood trauma, and its effect
on him, strongly motivate his study of the subject. He is also the founder of the successful website and blog
childhoodtraumarecovery.com.
He currently lives in Brighton, UK.
THE DEVASTATING EFFECTS OF CHILDHOOD TRAUMA
Copyright 2014 David Hosier MSc
Second Edition.
childhoodtraumarecovery.com publications.
THE DEVASTATING EFFECTS OF CHILDHOOD TRAUMA
CONTENTS
What is Childhood Trauma?
What Kinds of Problems does Childhood Trauma Cause? Part 1.
What Kinds of Problems does Childhood Trauma Cause? Part 2: Traumatic Memories
Childhood Trauma: Recovery.
How Childhood Trauma can Affect View of Self. Part 1.
How Childhood Trauma can Affect View of Self. Part 2.
Childhood Trauma: An Analysis of Blame.
Coping Mechanisms for Survivors of Childhood Trauma
Overcoming Relationship Difficulties Caused by Childhood Trauma
How to Manage Anger Resulting from Childhood Trauma.
Neurological Effects: How Childhood Trauma can Damage the Developing Physical Brain
How Neurological Problems Relating to Childhood Trauma can be Addressed
The Effect of Childhood Trauma on Genes and Susceptibility to Depression.
Childhood Trauma: The Statistics
A Closer Look at the Theory of Repression of Traumatic Memories.
Childhood Trauma and Self-harm.
The Association Between Childhood Trauma and Borderline Personality Disorder (BPD). . .
How Adult Children can Manage Their Relationship with Parents who have Borderline Personality Disorder
(BPD).
Borderline Personality Disorder and Reasons for Low Self-Esteem.
Childhood Trauma: The Link with Future Violence. Part One.
Childhood Trauma: The Link with Future Violence. Part Two.
Childhood Trauma: The Link with Alcoholism.
Childhood Trauma: The Link with Future Gambling.
How Adult Children can Manage their Relationship with Parents who have Borderline Personality Disorder
(BPD). Part 2.
How Childhood Trauma can Reduce Life Expectancy by 19 Years.
Types of Relationship Problems the Individual may Experience as a Result of Childhood Trauma.
Effects of Childhood Trauma: The Interaction between Nature and Nurture.
Childhood Trauma: What Experiments on Causes of Aggression in Rats Tell Us
Childhood Trauma, Borderline Personality Disorder (BPD) and Dissociation
Childhood Trauma: Famous People who Experienced It. Kurt Cobain
Childhood Trauma: How the Child’s View of Their Own ’Badness’ is Perpetuated. .
Childhood Trauma: Complex Post-Traumatic Stress Disorder (with Questionnaire).
Childhood Trauma: Damage Done by Breakdown of Maternal Bond.
Childhood Trauma: Its Relationship to Psychopathy.
Childhood Trauma: The Five Main Personality Disorders.
Childhood Trauma: Mental Illness and Responses to Stigma.
Self-Test Questionnaires for 10 Psychological Conditions Linked to Childhood Trauma
Childhood Trauma: Its Link to Adult Anxiety.
Possible Traumatic Consequences Faced by Gifted Children.
Why We Worry.
A Closer Examination of The Effects of Childhood Trauma.
Childhood Trauma: Does ’Multiple-Personality Disorder’ Exist?
A Closer Examination of The Effects of Childhood Trauma. Part 2
Childhood Trauma Leading to Excessive Need for Approval.
Latest Research Leads to New List Of Main Borderline Personality Disorder (BPD) Symptoms: The List
Childhood Trauma : Defense Mechanisms Resulting from Stress.
A Closer Look at the Link Between Childhood Experiences and BP
..
The Vicious Cycle of Adult Problems Stemming from Childhood Trauma
Childhood Trauma : Its Link to Later Psychosis.
How Is a Personality Disorder Defined?
What Studies on ’Unloved’ Rats Tell us about Effects of Childhood Trauma
How Borderline Personality Symptoms Reinforce Each Other.
Childhood Trauma : Its Link to Narcissistic Disorder
Emotional Abuse and The Law
Effects of Parental Favouritism
Emotional Abuse and the Law
How Does PTSD Develop?
The Mother Prone to Explosive Rage.
.
Childhood Trauma Leading to ’The Jumping to Conclusions’ Bias
The Effect of Growing Up with Personality Disordered Mother on Suicidal Behaviour
The Link Between Childhood Trauma and Future Suicide Attempts
Childhood Trauma : The Effects of Bullying
Intermittent Explosive Disorder (I.E.M.) and Childhood Trauma.
Borderline Personality Disorder Tests.
Personality Disorder Clusters
High Conflict Personality (HCP) Link to Child Trauma
Mental Health and Criminal Law - Introduction
Child Trauma and Obsessive-Compulsive Disorder (OCD)
Those Bullied as Children More Likely to Commit Crime as Adults.
Child Trauma and Obsessive-Compulsive Disorder (OCD) . Part 2.
Effects of Severe and Long-Lasting (Chronic) Trauma.
Effects of Lack of Emotional Security in Childhood.
Effects on Sexuality of Childhood Trauma
Adverse Effects on Physical Health of Childhood Trauma
Childhood Trauma and Major Depressive Disorder
Posttraumatic Growth - How Trauma can Positively Transform Us
Top 10 Most Common Thoughts of Those with PTSD.
Was I a Disturbed Child? .
Childhood Trauma : Avoidant Personality Disorder (APD). Part 1
Avoidant Personality Disorder (APD). Part 2 - Causes
Avoidant Personality Disorder (APD). Part 3 - Treatments.
Patterns of Behaviour Stemming from Childhood Trauma
Patterns of Behaviour Stemming from Childhood Trauma. Part 2.
Effects of Mothers with Borderline Personality Disorder on Children
Defining Emotional Abuse
Four Types of Borderline Mother
The Five Main Routes Through Which Childhood Trauma Harms Us-Part 1
The Five Main Routes Through Which Childhood Trauma Harms Us-Part 2
Post Traumatic Stress Disorder (PTSD) Test.
Why Is Emotional Abuse So Harmful?
The Damaging Effects of Physical Abuse
Possible Effects of Divorce on Children
Arrested Psychological Development and Age Regression
Neglect as a Form of Emotional Abuse
The Use of Religion as a Weapon of Abuse
Childhood Trauma Leading to Anhedonia (Inability to Experience Pleasure)
The Link Between Childhood Trauma and Chronic Fatigue Syndrom
Possible Damaging Behaviours of the Borderline Personality Disordered Parent
Effects of the Narcissistic Mother. Part 1.
Effects of the Narcissistic Mother. Part 2.
Emotional Torture? When Parents Put Kids in a Psychological Double-Bind.
Highly Dysfunctional Families and Borderline Personality Disorder (BPD)
Childhood Fame : The Downside
The Dysfunctional Family’s Scapegoat.
Human Stress : Why We Should Envy Gazelles
Fifteen Types of Depression.
On Being Suicidal (or Why I carried a Rope in a Bag around London for 3 Months) . . . . . . . .
List of Life Events Categorized According to Their Stressfulness.
Physical Symptoms of Stress and How to Reduce Them
Why a Mother’s Influence is so Powerful.
Repressed Memories : The Need for Further Research
Childhood Trauma Linked to Homosexuality. So What?
Effect of Early Trauma on Brain’s Right Hemisphere Development.
Fifteen Emotional Symptoms of Stress
Trauma, Depression and Learned Helplessness
Childhood Trauma and Obsessive Love Disorder
Signs of Borderline Personality Disorder in Adolescence
Borderline Personality : Difference in Symptoms Between Men and Women
Finding Optimism and Positive Moods : The Neuroscience.
Borderline Personality Disorder (BPD) : Latest Facts and Figures
Childhood Trauma and Anorexia
What is Childhood Trauma?
There is no one, absolute and precise definition of childhood trauma. However, experts in the field of its study
generally agree that an individual’s traumatic experience will be related to one or more of the following three
types of abuse:
1) Emotional abuse
2) Physical abuse
3) Sexual abuse
In the past it was generally agreed amongst clinicians that sexual abuse had the most significant adverse
impact on the child’s subsequent development. However, it is important to point out that more up-to-date
research shows emotional and physical abuse can be just as damaging (some children will experience a
combination of two or more of the three types).
The exact nature of the abuse will be inextricably intertwined with the developmental problems which emerge
in the individual as a result of it.
Neglect.
There is a problem, though, with the categorization method. This is because the three individual categories
do not tend to take account of neglect. Neglect may involve a parent or carer doing nothing to intervene to
prevent the child from being abused by someone else, or a parent burdening a young child with their own
psychological problems which the child is not old or mature enough to cope with. A parent or carer might
neglect a child knowingly or unknowingly.
How Common is Child Abuse? It is difficult to know the true figures as childhood abuse is often covered up or
unreported. Also, accurate figures are hindered by the fact childhood abuse cannot be precisely defined.
However, current estimates in the UK suggest about 12 % of children experience physical abuse and 11 %
experience sexual abuse.
So if you have been abused as a child, you are far from alone.
Personal Meaning.
Whilst it is impossible to precisely define child abuse, what is important is the PERSONAL MEANING the
sufferer ATTACHES to it. In other words, recognizing the problems a person has developed as a result of the
abuse and providing therapy to help the individual deal with those problems is more important than precisely
defining the traumatic experience which caused the problems, and arguing about whether it technically
qualifies as abuse or not.
What Kinds of Problems does Childhood Trauma Cause? Part 1.
One thing from research is clear: the experience of childhood trauma makes it more likely the individual will
suffer problems as an adult. Abuse does not, though, necessarily lead to severe problems, but makes a
person more VULNERABLE to them in later life.
THE MORE SEVERE AND REPEATED THE ABUSE THE MORE LIKELY THE INDIVIDUAL WILL
DEVELOP PROBLEMS LATER.
However, if the child also has good experiences in childhood this can serve to build up RESILIENCE,
diminishing the negative effects of abuse.
For resilience to develop, it is particularly important that the child does not blame him or herself for the abuse.
COMMON PROBLEMS RESULTING FROM ABUSE IN CHILDHOOD:
guilt and shamedepression, hopelessness, helplessness alcohol and drug misuse
eating disorders
self-harm eg. cutting self, attempting suicide lack of confidencesocial withdrawal
poor anger management
difficulty trusting others
being drawn into further abusive relationships
NEGATIVE BELIEF SYSTEM.
Survivors of childhood abuse are much more likely to hold an array of negative beliefs. Their view of
themselves and their general outlook tend to be negative. British Psychologist Professor Jehu summarized
the kinds of negative beliefs held:
BELIEFS ABOUT SELF:
I am unusual I am bad
I am worthless I am to blame
BELIEFS ABOUT OTHERS:
Others are untrustworthy Others will reject me
BELIEFS ABOUT THE FUTURE:
The future is hopeless
THE EFFECTS OF ABUSE ON THINKING PROCESSES:
Research on this has led to two main findings:
1) Those who have been abused tend to DETACH (or ’space out’) more than the average person. This is
known as DISSOCIATION. It can involve cutting off from emotions or feeling ’unreal’. Sometimes, if the
original trauma was especially adverse and distressing, it might be REPRESSED (’blanked out’ from
memory).
Survivors are sometimes driven by their pain to INTENTIONALLY dissociate by:
drinking alcohol
smoking
using drugs
binge eating
self-injuring /gambling
2) Survivors of abuse are much more sensitive to abuse-related triggers. This is a kind of defense
mechanism: by being hyper-alert to possible danger, the person is more able to protect him or herself.
However, if as an adult there is much lower risk, this oversensitivity can severely interfere with the person’s
quality of life.
What Kinds of Problems does Childhood Trauma Cause? Part 2: Traumatic Memories
Remembering traumatic events is in some ways beneficial. For example, it allows us to review the experience
and learn from it. Also, by replaying the event/s, its/their emotional charge is diminished.
However, sometimes the process breaks down and the memories remain powerful and frightening.
Sometimes they seem to appear at random, and at other times they can be TRIGGERED by a particular
event such as a film with a scene that shows a person suffering from a similar trauma to that suffered by the
person watching it.
Traumatic memories can manifest themselves in any of the 3 ways listed below:
FLASHBACKS
INTRUSIVE MEMORIES
NIGHTMARES
1) FLASHBACKS
These are often intense, vivid and frightening. They can be difficult to control, especially at night.
Sometimes a flashback may be very detailed, but at other times it may be a more nebulous ’sense’ of the
trauma.
Sometimes the person experiencing the flashback feels that they are going mad or are about to completely
lose control, but THIS IS NOT THE CASE.
2) INTRUSIVE MEMORIES
These are more likely to occur when the mind is not occupied. They are more a recollection of the event
rather than a reliving of it. When they do intrude, they can be painful. Often, the more we try to banish them
from memory the more tenaciously they maintain their grip.
3)NIGHTMARES
These can replay the traumatic events in a similar way to how they originally happened or occur as distorted
REPRESENTATIONS of the event.
HOW RELIABLE ARE MEMORIES OF TRAUMATIC EVENTS?
There used to be concern that some memories of trauma may be false memories. However, the latest
research suggests that memories of trauma tend to be quite accurate but may be distorted or embellished.
However, false memories CAN occasionally occur. This is most likely to happen when someone we trust,
such as a therapist, keeps suggesting some trauma (eg sexual abuse) must have happened.
It is important to remember, though, that parents or carers will sometimes DENY or DOWNPLAY and
MINIMIZE our traumatic experiences due to a sense of their own guilt. In other words, they may claim our
traumatic memories are false when in fact they are not.
REPRESSION
Very traumatic memories may sometimes be REPRESSED (buried in the unconscious with no conscious
access to them). In other words, we may forget that a trauma has happened. As I suggested in PART 1, this
is a defense mechanism. Sometimes the buried memories can be brought back into consciousness (eg
through psychotherapy) so that the brain may be allowed to process and work through the memories allowing
a recovery process to get underway.
Childhood Trauma: Recovery.
Research shows those who suffer childhood trauma CAN and DO recover.
Making significant changes in life can be a very daunting prospect, but those who do it in order to aid their
own recovery very often find the hard work most rewarding.
Some people find making the necessary changes difficult, whereas others find it enjoyable.
THE DECISION TO CHANGE
Change does not occur instantly. Psychologists have identified the following stages building up to change:
1) not even thinking about it
2) thinking about it
3) planning it
4) starting to do it
5) maintaining the effort to continue doing it
THE RECOVERY PROCESS
Each individual’s progress in recovery is unique, but, generally, the more support the trauma survivor has, the
quicker the recovery is likely to occur.
Often recovery is not a steady progression upwards - there are usually ups and downs (eg two steps
forward...one step back...two steps forward etc) but the OVERALL TREND is upwards (if you imagine
recovery being represented on the vertical axis of a graph and time by the horizontal). Therefore, it is
important not to become disheartened by set-backs along the recovery path. These are normal.
Sometimes, one can even feel one at first is getting worse (usually if traumas, long dormant, are being
processed by the mind in a detailed manner for the first time). However, once the trauma has been properly
consciously reprocessed, although this is often painful, it enables the trauma survivor to work through what
happened and to form a new, far more positive, understanding of him/herself.
Once the trauma has been reworked (ie understanding what happened and how it has affected the survivor’s
development) he or she can start to develop a more positive and compassionate view of him/herself (for
example, realizing that the abuse was not their fault can relieve strong feelings of guilt and self-criticism).
Once the reworking phase has been passed through, improvement tends to become more consistent and
more rapid.
How Childhood Trauma can Affect View of Self. Part 1.
Our ENVIRONMENT has a large influence on how our personalities develop. For example, children brought
up in a loving and secure environment are much more likely to become relatively content and self-confident
adults.
On the other hand, a child who has suffered abuse and neglect may develop into an adult lacking
self-confidence and prone to anxiety, depression and other serious difficulties.
Also, if a child has had an unstable parent or carer who has been unpredictable and has given mixed
messages, they may develop into an adult who is fearful of abandoment. As a result, he/she may:
1. cling to close relationships
2. avoid close relationships
and, quite often:
a confusing combination of the two.
This can make maintaining close relationships very problematic.
Children are ’programmed’ to learn from adults (for evolutionary reasons) so if the adult carer has been
abusive and critical the child may well grow up FALSELY BELIEVING that he/she is bad, stupid, unloveable
and worthless. Also, trusting others may become very difficult as the individual’s experience during childhood
was to be badly let down BY THE VERY PERSON/S WHO WERE SUPPOSED TO CARE FOR THEM AND
PROTECT THEM.
The more stresses and traumas a child has, the more likely it is that he/she will develop into a pessimistic,
anxious, depressed adult who believes things are hopeless and cannot improve.
It should be pointed out, though, that if a child suffers abuse but also has significant positive support in other
areas of his/her life during childhood, this can make the individual more RESILIENT to the negative effects of
the trauma.
It is also important to note that if a person has suffered trauma and as a result has a negative view of
themselves, the future and the world in general (sometimes referred to as the ’depressive cognitive triad’).
How Childhood Trauma can Affect View of Self. Part 2.
DEVELOPMENT OF BELIEF SYSTEMS IN CHILDHOOD:
We develop our most fundamental belief systems in childhood. If a child is brought up with love, ffection and
security s/he tends to build up positive beliefs. For example:
- people should not treat me badly
- I am a decent and likeable person
- I have rights
- I deserve respect
However, negative belief systems often develop in children who have been abused. For example:
- people cannot be trusted
- I am vulnerable
- I am worthless
- everyone is out to get me
- I am intrinsically unloveable
These negative beliefs often feel very true, but most of the time they are very inaccurate. JUST BECAUSE
WE FEEL OUR BELIEFS ARE TRUE, IT IN NO WAY LOGICALLY FOLLOWS THAT THEY ARE.
In effect, then, childhood abuse can cause us to become PREJUDICED AGAINST OURSELVES we see
ourselves through a kind of distorting, black filter.
SELF-FULFILLING PROPHECY:
Negative, prejudiced self-beliefs are dangerous as they may become a self-fulfilling prophecy. For example:
- someone who thinks s/he will always fail may, as a result, not try to achieve anything and therefore not
succeed in the way s/he in fact had the potential to do (if only s/he had believed in her/himself).
- someone who believes s/he is unloveable (when in reality this is untrue) may never attempt to form close
relationships thus remaining unnecessarily lonely and isolated.
In summary, childhood EXPERIENCES form OUR FUNDAMENTAL BELIEF SYSTEMS. This in turn affects:
- our mood
- our behaviour
- our relationships
This negative belief system can become deeply entrenched. It is therefore necessary to ’re-program’ our
belief systems and I shall be examining in later articles.
Childhood Trauma: An Analysis of Blame.
When we are children, if someone treats us badly, we attempt to understand why. But in trying to understand,
the child’s logic is very often flawed and s/he falsely deduces s/he is to blame for it. The child’s flawed logic
may flow similarly to this:
’Someone is hurting me...punishment only happens to bad children...that means I must be bad...therefore I
am to blame for this happening...it is my own fault, there’s something wrong with me.’ THIS CAN OCCUR ON
AN INSIDUOUS, UNCONSCIOUS LEVEL.
For this reason, many individuals who have survived trauma spend their adult lives feeling deeply guilty.
Often, too, the individual will feel deeply unworthy and may be filled with a strong sense of self-loathing.
It is important to realize such feelings have been ’programmed’ in through the abuse and are absolutely not a
true and accurate reflection of the person who suffers them.
THE NECESSITY TO STOP BLAMING ONESELF:
Although stopping blaming oneself is a very important step and obviously extremely beneficial to one’s sense
of self-worth and peace of mind, it can be difficult and challenging. For example, one may have led a life
without looking for joy, success or close relationships because ONE FELT ONE DIDN’T DESERVE SUCH
THINGS. Seeing things in a new way, and the realization one isn’t a bad person or to blame for the childhood
trauma and had , in fact, every right to live an enjoyable life, may cause the individual to feel overwhelmed by
a sense of GRIEF for all the wasted years.
Another possibility is that the realization one isn’t to blame will sometimes cause this blame, sometimes in a
very intense way, to be turned on those who are perceived to be responsible (such as carers or parents).
Letting go of self-blame, then, whilst necessary, can in itself be stressful. However, coping mechanisms can
be employed to help alleviate such stress. It is to this I will turn in my next article.
Coping Mechanisms for Survivors of Childhood Trauma.
In my last article, I mentioned it might be useful to look at some coping mechanisms one may wish to make
use of in the recovery stage from childhood trauma and it is to some of these that I now turn.
There are two main types of coping mechanisms:
1) Those which are helpful in the short-term, but unhealthy in the long-term.
2) Those which are useful in the long-term (but can take more effort and discipline).
Examples of the first include: drinking too much, use of illicit drugs, gambling, over-eating and taking anger
out on others (and, almost always, later regretting it).
Examples of the second are: going for a walk, talking things over with a friend, having a relaxing bath or
listening to music.
It should be pointed out that the strategies in the first category tend to leave the person with a lower sense of
self-worth over time whereas the opposite tends to be the case with the kinds of strategies mentioned in the
second category.
The key is to gradually reduce the use of the coping strategies in category one and gradually increase the
use of the coping strategies in category two. This can take time.
BREATHING EXERCISES:
Another coping strategy is very simple but very effective (when I first learned this one I was dubious that
something so simple could help and was surprised when it did) is to learn ’controlled breathing’.
Under stress, we tend to HYPERVENTILATE (this refers to the type of breathing which is rapid and shallow)
which has the physiological (and indeed psychological) effect of making us feel much more anxious.
CONTROLLED BREATHING, on the other hand (breathing DEEPLY, GENTLY and EVENLY THROUGH
THE NOSE) has the physiological (and, again, psychological) effect of calming us down. It is recommended
by experts that with controlled breathing we should take 8-10 breaths per minute (breathing in AND out
equates to ONE breath). With pratise, this skill can become automatic.
FORMING SUPPORTIVE RELATIONSHIPS: Survivors of childhood trauma often find it difficult to form
lasting relationships in adulthood (sometimes related to anger-management issues, volatility, inability to trust
others and other problems). However, those who can form such relationships tend to have a much better
outcome.
My next article will look at ways to help overcome difficulties in building and sustaining relationships.
Overcoming Relationship Difficulties Caused by Childhood Trauma
It has already been stated that as survivors of childhood trauma we often find it very difficult to trust others.
We may avoid close relationships in order to avoid the possibility of being hurt.
Whilst this can allow us to feel safe from harm, it can also lead to extreme loneliness.
Research shows that without good social support the childhood trauma survivor is much more likely to suffer
emotional problems. Having just one person to confide in, though, can help to SIGNIFICANTLY ALLEVIATE
emotional distress.
Because of our negative experiences in childhood, we might often have NEGATIVE BIASES in our thinking
when it comes to considering relationships. These are sometimes based on FEAR.
Below are some examples of negative biases we might have when thinking about relationships.
1) everyone has always hurt me, therefore this person will too; I won’t try to form a close relationship with
him/her.
2) he/she has let me down. That means he/she will always let me down and is completely untrustworthy.
3) there’s no way I’m going to the party - they’ll be lots of people I don’t know and it’s certain they’ll all hate
me.
HOWEVER, in all three examples it is likely our beliefs are erroneous and based on a negative thinking bias
caused by our childhood experiences. Below are some ways it would be reasonable for us to mentally
challenge our beliefs held in the three above examples.
1) I am OVERGENERALIZING. My past experiences don’t mean everyone in the future is bound to always
hurt me.
2) He/she is usually good to me; therefore there might be a perfectly reasonable explanation why he/she
seems to have let me down on this particular occasion.
3) I’m being far too harsh on myself - I may be lacking some confidence at the moment but this does not
mean people will hate me. Anyway, I can work on ways to gradually rebuild my confidence.
Indeed, there is a therapy called COGNITIVE-BEHAVIOURAL THERAPY which helps people to get into the
habit of challenging their habitual, unhelpful, negative thinking patterns in a similar way to how I’ve illustrated
above. I will look at this in more detail in later posts, but, in the meantime, there are many very good books
and ebooks on cognitive-behavioural therapy from online bookstores such as Google Books and Kindle.
DEVELOPING SOCIAL SKILLS:
One way to do this is to observe others who already possess good social skills - the type of things they do
may include:
-smiling reasonably often
-using a reasonable amount of eye contact
-giving genuine compliments (but not overdoing it)
-using the other person’s name when talking to them (but, again, not overdoing it)
Others that can be observed to help develop social skills may include friends, strangers or even characters
from TV or cinema. It can be of particular benefit to observe how others deal with difficult situations.
Finally, it is worth mentioning that when developing social skills, it is best to build up gradually, rather than to
throw ourselves immediately into an especially challenging social event.
How to Manage Anger Resulting from Childhood Trauma. Part 1.
Anger is not a bad thing if it is APPROPRIATELY EXPRESSED.
As we begin to realize that what was done to us as children was wrong, anger often emerges (especially
when we start to understand all the ramifications of how we have subsequently been affected by it).
Repressing anger (’bottling it up’) is often painful and stressful. We can also get to the point when we can
contain it no longer and this might result in it being MISDIRECTED (expressed against the wrong person) or
in it being expressed in a DESTRUCTIVE and DAMAGING way (to both ourselves and those we interact
with).
It is much better if anger is MANAGED and only expressed in a manner which is beneficial.
For some, expressing anger gives rise to a feeling of power, the power that was denied us in childhood, and
can therefore feel that by expressing this anger we are in some way protecting ourselves or taking back
’control’ (though, almost always, uncontrolled outbursts of anger backfire very unpleasantly). The adrenaline
associated with such anger can sometimes lead to it being expressed in a very intense way. Whilst this may
be understandable, then, such expressions of anger ULTIMATELY HARM THE PERSON EXPRESSING IT.
THREE CATEGORIES OF ANGER:
1) PRIMARY ANGER.
This is anger which is REASONABLE given what has occurred - it is directly related to what has happened
and is not influenced by extraneous factors.
2) SECONDARY ANGER.
The psychologist Aaron Beck, during the 1980s, defined this type of anger as RESULTING FROM FEAR or
HURT. WE USE IT TO TRY TO PROTECT OURSELVES AGAINST FURTHER TRAUMA. This type of anger
can be EXPLOSIVE and feel as if IT IS ’TAKING US OVER’. It may occur in response to:
- perceived rejection
- a perceived slight
- a perceived threat
All of the above may trigger memories, consciously or unconsciously, of the original trauma; this can explain
the (seemingly) disproportionate intensity of the reaction.
3) PAST ANGER.
This refers to anger we are currently feeling but which STEMS FROM THE PAST. When it is TRIGGERED
BY CURRENT EVENTS, the anger we express, similar to the anger illustrated in 2 above, can be
disproportionate (to the current event). For example, we may see a mother in the street screaming
aggressively at her child which in turn triggers memories of how we ourselves were treated in childhood.
Neurological Effects: How Childhood Trauma can Damage the Developing Physical Brain.
Recently, there have been various cutting-edge studies into the neurological effects of child abuse and child
neglect- in other words, how childhood trauma has been shown to damage the developing physical brain.
It has been shown that BEHAVIOURAL PROBLEMS, following childhood trauma, can be scientifically traced
back in origin to damage, caused by child abuse, neglect etc., to both the brain’s PHYSICAL STRUCTURE
and its CHEMISTRY. As well as behavioural problems resulting from this damage, it has also been shown to
impair the sufferer’s ability to LEARN.
Indeed, it has been estimated that about 75 % of children in the care system could have suffered such
adverse effects on the physical brain following their particular traumas.
THE POSITIVE NEWS
This is all very depressing; however, there is also good news: the damage that the brain has suffered is NOT
ALWAYS PERMANENT. If therapeutic interventions are made, especially when the brain is still developing
during childhood, the brain is able, to some extent (due to its plasticity), to rewire itself in such a way that
development can return much closer to the norm than it would have done without such intervention. The
intervention needs to include the child being given a loving, secure, stable and supportive environment.
In general, the more protracted and intense the childhood trauma, the more serious the damaging effects on
the physical brain will have been.
WHICH BRAIN REGIONS ARE AFFECTED?
Severe and prolonged childhood trauma has been demonstrated to potentially damage:
a) THE CORTEX (the function of the cortex is to facilitate RATIONAL THINKING).
b) THE HIPPOCAMPUS (the function of the hippocampus is, in part, to facilitate the REGULATION of our
EMOTIONS).
Given that these regions of the brain are sometimes damaged by childhood trauma, and given the function of
these regions, we need hardly be surprised that if we have suffered childhood trauma we might find ourselves
behaving IRRATIONALLY at times and finding it very difficult to CONTROL OUR EMOTIONS.
Indeed, in one study it was found those who had suffered childhood trauma were much more likely to have:
a) an underdeveloped cortex
b) a smaller hippocampus
Further studies have found that another brain area, the AMYGDALA (which also has a very prevalent role in
regulating our emotions) becomes OVERSENSITIVE and OVERACTIVE in those who have suffered
childhood trauma. As a result, it will often signal extreme danger - putting us constantly on ’red-alert’, as it
were - even when, in objective terms, there is no, or very little, danger threatening us. Our fear response,
then, operates on a hair-trigger.
HOW BRAIN CHEMISTRY IS AFFECTED BY CHILDHOOD TRAUMA: Studies have also found that
prolonged and severe STRESS in early life can also affect the production of chemicals (also known as
neurotransmitters) in the brain. For example:
a) CORTISOL (which regulates stress)
b) SEROTONIN (which is closely tied to MOOD and BEHAVIOUR)
Dysfunction of these chemicals leads, respectively, to:
a) us becoming far more susceptible and far more likely to be adversely affected by stress
b) us becoming far more prone to severe, CLINICAL DEPRESSION and much more prone than normal to
IMPULSIVE VIOLENCE/AGGRESSION.
My next article will look at how these problems may be addressed, and, in best case scenarios, reversed.
How Neurological Problems Relating to Childhood Trauma can be Addressed.
As I said in my previous article, neurological problems resulting from childhood trauma can be reversed, and
it is to the research into this exciting and fast developing area of study that I now turn.
Studies have shown that because SEROTONIN (a chemical, also known as a neurotransmitter, in the brain)
can become depleted by childhood trauma, ANTI-DEPRESSANTS (eg. setraline) which increase the
availability of serotonin in the brain can help to REVERSE the harmful effects of childhood trauma on it.
However, the beneficial effects of anti-depressant treatment is greatly increased if, in addition, the childhood
trauma survivor’s ENVIRONMENT is also significantly improved, providing as many positive experiences as
possible. Indeed, positive experiences can BENEFICIALLY AFFECT BRAIN CHEMISTRY (eg. by increasing
the availability of serotonin and other important neurotransmitters in the brain), just as anti-depressants can.
So: brain chemistry can be affected by environmental factors, as well as by medication. Because survivors of
childhood trauma often FEEL OVERWHELMED BY THEIR EMOTIONS, studies have been conducted which
also show that activities that discharge these emotions in a creative or constructive manner can also change
brain chemistry for the better. Examples include drawing, painting, writing or even undertaking exercises such
as hitting a punch bag at the gym.
In addition to human studies, there have also been some studies on animals. There is now a growing body of
evidence that new experiences can regenerate animals’ brain cells. Studies in this area are likely to be
conducted on humans in the near future.
Because many of these studies are new, their implications have not yet been fully taken advantage of in the
construction of treatment programs. Indeed, it is estimated that fewer than 10 % of childhood trauma
survivors are receiving appropriate therapeutic interventions.
The exciting conclusion that we are able to draw from all of the above is that there is now good evidence that
even if the brain has undergone neurological damage as a result of childhood trauma, this CAN BE
REVERSED due to the fact that THE BRAIN CONTINUES TO CHANGE THROUGHOUT LIFE.
The Effect of Childhood Trauma on Genes and Susceptibility to Depression.
ENVIRONMENTAL EFFECTS ON DNA.
Recent studies have shown that childhood trauma can actually change the structure of DNA in the person
who has suffered it and consequently alter how these genes work (it has been known for some time that how
genes express themselves is influenced by their interaction with the environment).
Animal studies support this finding: in rats it has been shown that QUALITY OF MATERNAL CARE HAS A
LARGE EFFECT ON GENES RESPONSIBLE FOR THE STRESS RESPONSE IN OFFSPRING:
POOR MATERNAL CARE = ADVERSE EFFECT ON GENES OF OFFSPRING = HIGH SUSCEPTIBILITY
TO STRESS IN OFFSPRING.
Indeed, there is a growing body of evidence that psychological abuse of children has BIOLOGICAL effects.
Research suggests that the effects of abuse on the child’s DNA lowers their resistance to stress. This effect
can persist throughout life and increases the suicide risk of the individual.
It is thought that trauma/abuse in early childhood (before the age of six) can have a particularly damaging
effect on the DNA which controls the individual’s stress response.
(For those that are interested, environment affects DNA (and thus how it expresses itself) by punctuating it
with what are technically known as EPIGENETIC MARKERS. It follows from this that the function of DNA is
not permanently fixed from birth, but can be altered by its interaction with the environment).
The good news is, however, that the adverse effects on DNA caused by childhood trauma can be reversed in
adult life by appropriate interventions. Key to these are the replacement of the traumatic environment with
one which is supportive, loving, stable, safe and relatively stress-free. This is because just as traumatic
environments can leave harmful epigenetic marks, good environments, over time, can reverse this effect.
CHILDHOOD TRAUMA, GENES AND DEPRESSION.
Just as trauma can affect genes, pre-existing genes can affect the impact trauma is likely to have on us; it is,
to this extent, a two-way street then. It has already been stated in previous posts how exposure to trauma in
childhood can lead to psychological problems such as clinical depression; studies now show that the risk
becomes even greater if the sufferer of childhood trauma has a particular genetic make-up making him or her
more vulnerable to the effects of stress:
So: children who are genetically predisposed to being particularly vulnerable to stress will typically be more
adversely affected by the childhood trauma than those children who do not have the genetic vulnerability.
THIS HELPS TO EXPLAIN WHY TWO CHILDREN WHO SUFFER SIMILAR TRAUMA MAY BE AFFECTED
QUITE DIFFERENTLY FROM ONE ANOTHER.
Further study has shown that the children with the particular genetic variation are MORE SENSITIVE TO
THE ENVIRONMENT AROUND THEM (they process emotional information differently) than children without
the variation. The genes involved are responsible for the production of SEROTONIN (a chemical affecting
mood, also known as a neurotransmitter) in the brain.
DISCORD BETWEEN PARENTS and NEGLECT (again, especially if the child is under six) have specifically
been linked to the child developing HIGH EMOTIONAL SENSITIVITY and a greater susceptibility to stress.
Again, if the child has the genetic variation making him or her particularly vulnerable, the adverse effects of
the discord or neglect will be increase such vulnerability.
The research producing such findings as illustrated above is still in a relatively early stage and future
research is likely to help clarify the complex interactions between our genes and how childhood trauma
affects us.
Childhood Trauma: The Statistics
The following statistics relate to the UK. However, it should be pointed out that childhood trauma and abuse
tends to be under-reported and under-recorded so the figures presented should only be taken as a guide.
The statistics were gained by interviews with a large sample of young adults.
- a quarter of young adults were severely maltreated in childhood
- at present, there are approx. 50,000 children officially deemed to be at risk.
-approx. 15 % of young adults have been severely maltreated by a parent or guardian during childhood
PHYSICAL ABUSE.
-just over 10 % of young adults experienced violence by an adult during childhood.
NEGLECT.
- in family settings, this is the most common form of child abuse
- approx. 15 % of young adults experienced neglect during their childhood
- approx. 10 % of young adults experienced SEVERE neglect during childhood.
SEXUAL ABUSE.
- about one quarter of young adults experienced sexual abuse during childhood ( either by peer/s or adult/s).
- about 10 % 0f children in the 11-17 year old age group have experienced sexual abuse in the last year
EMOTIONAL ABUSE.
- approx. 7 % of young adults have experienced emotional abuse during childhood.
EXPOSURE TO DOMESTIC VIOLENCE.
- about one quarter of young adults experienced domestic violence between adults during their childhoods
Finally, it is worth pointing out again that due to both cover-ups and sometimes reluctance to report incidents
these figures could be underestimates.
A Closer Look at the Theory of Repression of Traumatic Memories.
Most of us are familiar with the idea that people who have experienced severe traumas sometimes
REPRESS the memory of them (ie. bury them deep in the unconscious where they cannot be consciously
recalled). This is thought to be an automatic process (ie. not under conscious control) which operates as a
defense mechanism. Freud thought that such repressed memories festered in the unconscious, causing
neurotic symptoms or hysteria, and that they needed to be brought back into consciousness and worked
through in order for healing to take place.
Psychologists refer to the inability to recall traumatic events DISSOCIATIVE AMNESIA.
Many have claimed that repression of traumatic memories is very common. For example, one therapist,
Renee Frederickson (1992), claimed: ’millions of people have blocked out frightening episodes of abuse,
years of their lives, or their entire childhood.’ Indeed, today, many psychotherapists regard uncovering
repressed memories as vital to the treatment of their patients.
But what does the research indicate?
Loftus (1993) found that most people seemed to have no trouble recalling traumatic events, up to, and
including, the Holocaust. Indeed, such memories disturbed many in the form of FLASHBACKS.
The scientific community has also become increasingly aware that the ’memory recovery’ procedures some
psychotherapists use, such as hypnosis, can generate false memories of traumatic events, due, often, to a
combination of SUGGESTION and LEADING QUESTIONS. So, patients can be encouraged to ’recall’
something that, in fact, never actually happened. Indeed, so powerful can the effect be that the patient may
truly believe the ’recalled’ event happened, despite documentary evidence disproving it.
HOWEVER, NOT ALL RECOVERED MEMORIES (EVEN AFTER DECADES) ARE FALSE (eg. Schooter et
al. 1997) SO RECOVERED MEMORIES OF TRAUMA SHOULD BE TAKEN SERIOUSLY AND CERTAINLY
NOT DISMISSED. Instead, corroborating evidence should ideally be sought.
Childhood Trauma and Self-harm. Part 1.
Many research studies (eg Arnold, 1995) have demonstrated a link between having been abused as a child
and self-harm. In one study,84 % of individuals who self-harmed reported that childhood trauma had
contributed to their condition.
WHAT IS SELF-HARM?
The following are examples:
-skin cutting
-skin burning
-compulsive skin picking
-self-hitting
-self-biting
-hair pulling
-interfering with wound healing
-swallowing foreign objects
-pulling off nails
Whilst it sounds counterintuitive, self-harm is fundamentally a COPING MECHANISM born out of trauma and
a profound sense of powerlessness.
’PAIN-EXCHANGE’.
Self-harm has been described as a kind of ’pain-exchange’. This means invisible, extreme emotional pain is
converted into visible, physical wounds. After a period of self-injury individuals report feeling calmer and more
able to cope. Self-injuring causes the brain to release ’natural pain killers’ which may have the twin effect of
diminishing psychological pain. A further theory is that, due to an individual’s self-loathing (see later in the
post), self-injury acts as a form of self-punishment which the individual consciously or unconsciously believes
s/he deserves.
Typically, people who self-harm are emotionally fragile and highly sensitive to rejection.
INDIRECT SELF-HARM. Not all self-harm is direct. Indirect methods include:
-substance misuse
-gambling
-extreme risk taking
-anorexia/bulimia
-staying in an abusive relationship
With these, the damage is not immediate, but, rather, they are physically and/or psychologically damaging
over the long-term.
TYPES OF CHILDHOOD TRAUMA ASSOCIATED WITH SELF-HARM.
The following have been found to be associated with self-harm:
-physical/sexual/emotional abuse
-loss of primary care giver (eg through divorce)
-having ’emotionally absent’ parent/s
-growing up in a chaotic family (eg due to parental mental health problems)
-being raised in the care system
-role reversal in child-parent relationship (eg child acting as a disturbed parent’s counsellor)
Furthermore, many who self-harm have NEGATIVE CORE BELIEFS such as the following:
-I am bad/evil
-I am worth nothing
-I shouldn’t have been born
-I’m never good enough
-I don’t deserve to be happy
-I’m unlovable
-I’m inferior
-I don’t fit in anywhere
-there’s something wrong with me
Such beliefs lead to: SELF-LOATHING and EXTREME LOW SELF-ESTEEM. This in turn leads to emotional
distress which can trigger acts of self-harm such as those illustrated in this article. My next post will look at
ways we can minimize our risk of self-harming.
A good site to visit for information about how Cognitive Behaviour Therapy (CBT) can help recovery from
trauma is:
http://www.psychologytools.org/ptsd.html
The Association Between Childhood Trauma and Borderline Personality Disorder (BPD).
Many research studies have shown that individuals who have suffered childhood trauma and neglect
frequently develop BPD as adults.
it is thought marilyn munroe suffered from BPD
WHAT IS BPD?
BPD sufferers experience a range of symptoms which are split into 9 categories. These are:
1) Extreme swings in emotions
2) Explosive anger
3) Intense fear of rejection/abandoment sometimes leading to frantic efforts to maintain a relationship
4) Impulsivity
5) Self-harm
6) Unstable self-concept (not really knowing ’who one is’)
7) Chronic feelings of ’emptiness’ (often leading to excessive drinking/eating etc ’to fill the vacuum’)
8) Dissociation ( a feeling of being ’disconnected from reality’)
9) Intense and highly volatile relationships
For a diagnosis of BPD to be given, the individual needs to suffer from at least 5 of the above. of abandoment
A person’s childhood experiences frequently rejected in childhood, BPD sufferers live in terror
has an enormous effect on his/her mental health in adult life. How parents treat their children is, therefore, of
paramount importance.
BPD is an even more likely outcome, if, as well as suffering trauma through invidious parenting, the individual
also has a BIOLOGICAL VULNERABILITY.
In relation to an individual’s childhood, research suggests that the 3 major risk factors are:
- trauma/abuse
- damaging parenting styles
- early separation or loss (eg due to parental divorce or the death of the parent/s)
Of course, more than one of these can befall the child. Indeed, in my own case, I was unlucky enough to be
affected by all three. And, given my mother was highly unstable, it is very likely I also inherited a
biological/genetic vulnerability.
EXAMPLES OF DAMAGING PARENTING STYLES:
1) Dysfunctional and disorganized - this can occur when there is a high level of marital discord or conflict. It is
important, here, to point out that even if parents attempt to hide their disharmony, children are still likely to be
adversely affected as they tend to pick up on subtle signs of tension.
Chaotic environments can also impact very badly on children. Examples are:
- constant house moves
- parental alcoholism/illicit drug use
- parental mental illness and instability/verbal aggression
2) Emotional invalidation. Examples include:
- a parent telling their child they wish he/she could be more like his/her brother/sister/cousin etc.
- a parent telling the child he is ’just like his father’ (meant disparagingly). This invalidates the child’s unique
identity.
- telling a child s/he shouldn’t be upset/crying over something, therefore invalidating the child’s reaction and
implying the child’s having such feelings is inappropriate.
- telling the child he/she is exaggerating about how bad something is. Again, this invalidates the child’s
perception of how something is adversely affecting him/her.
- a parent telling a child to stop feeling sorry for him/herself and think about good things instead. Again, this
invalidates the child’s sadness and encourages him/her to suppress emotions.
Invalidation of a child’s emotions, and undermining the authenticity of their feelings, can lead the child to start
demonstrating his/her emotions in a very extreme way in order to gain the recognition he/she previously
failed to elicit.
3) Trauma and abuse - people with BPD have very frequently been abused. However, not all children who
are abused develop BPD due to having a biological/genetic RESILIENCE and/or having good emotional
support and validation in other areas of their lives (eg at school or through a counsellor).
Trauma inflicted by a family member has been shown by research to have a greater adverse impact on the
child than abuse by a stranger. Also, as would be expected, the longer the traumatic situation lasts, the more
likely it is that the child will develop BPD in adult life.
4) Separation and loss - here, the trauma is caused, in large part, due to the child’s bonding process
development being disrupted. Children who suffer this are much more likely to become anxious and develop
ATTACHMENT DISORDERS as adults which can disrupt adult relationships and cause the sufferer to have
an intense fear of abandoment in adult life. They may, too, become very ’clingy’, fearful of relationships, or a
complex and distressing combination of the two.
Later articles will look at possible therapeutic interventions for BPD as well as ways the BPD sufferer can
help himself or herself to reduce BPD symptoms.
How Adult Children can Manage Their Relationship with Parents who have Borderline Personality
Disorder (BPD). Part 1.
Some of us experienced childhood trauma due to a parent being unstable. As has been described in previous
posts, BPD causes great instability in individuals, which can have a very serious impact on that individual’s
child/ren, so some of us who experienced childhood trauma may have grown up with a parent with BPD. This
could have contributed to ourselves developing similar problems, or, even, to us developing BPD ourselves.
However, whatever the state of our mental health, as adults now ourselves, we need to know the best way to
manage our relationship with BPD parent/s in the present, and, also, understand what effect our parent/s
condition may have had on our own lives. This is of particular interest to me as I was brought up by a highly
volatile and extremely unstable mother.
POSSIBLE EFFECTS ON THE CHILD OF A PARENT WITH BPD:
Parents with BPD can lack the necessary resources to bring their children up - in the worst case scenario,
this may lead to neglect and/or abuse.
Children of BPD parents have frequently grown up in a highly unstable emotional atmosphere, have
witnessed highly distressing behaviour in their parent/s, and, often, have been on the receiving end of
extreme hostility, expressed verbally and/or physically. Further, they may have been exploited by their
parent/s burdening them with their own emotional problems. My own mother, for example, used me,
essentially, as her own private counsellor from when I was about 10 or 11- years- old, and would, on top of
this, very often be terrifyingly verbally aggressive and hostile.
With experiences such as these, as adults, we can feel that our childhoods were stolen from us and we may
go on to enter a kind of mourning for the childhood we never had.
Being brought up with a parent with BPD leads to a much higher probability of us developing the following
problems:
- alcoholism - illicit drug use
- depression
- anxiety - suicidal feelings/ suicide attempts/ suicide
- behavioural problems eg impulse control
- personality/emotional disorders
Indeed, this is not altogether surprising when it is reflected upon that, as children, we may have been
exposed to many long, painful, distressing years of intense conflict and arguments, threats (eg of violence, or,
as in my own case, of abandoment),and unpredictable, unstable and highly volatile emotions.
Whilst we may feel deep resentment for the way in which we were treated, not infrequently necessitating
professional support to deal with it, it is necessary, also, to keep in mind that our parent/s with BPD have
developed it due to their own personal histories,including psychological, biological and social factors.
However, this is cold comfort when we are children struggling to understand ourselves and living in a
permanent state of acute distress.
POSSIBLE IMPACT OF A PARENT’S BPD ON THE CHILD:
1) The parent’s impulsivity: this could include alcohol, drugs, gambling etc causing enormous anxiety in the
child and possibly in him/her developing similar problems in later life (due to the psychological concept known
as ’modelling’).
2) The parent’s dependency on child: for example, the parent may become emotionally dependent upon the
child, using him/her as their personal counsellor, which can lead to the child feeling overwhelmed with
concern, responsibility and anxiety, leading later to anger and resentment.
3) The parent’s volatility, instability and unpredictability: this, again, often leads to the child developing
extreme anxiety and deep concerns about being abandoned - causing long-term, deeply ingrained insecurity
(the parent may threaten to send the child away to live with relatives or to live in the care system).
4) The parent’s threats of suicide: again, this can lead to the child experiencing acute anxiety, possibly
leading, later down the line, to the individual developing his/her own self-harming or suicidal behaviour.
5) The parent’s ambiguity towards the child: technically, this is known as ’SPLITTING’- being consumed with
passionate hatred towards the child one day, but then giving him/her extravagant praise the next - these
polarized attitudes towards the child vascillating in a deeply confusing fashion. This will often lead the child to
have an extremely unstable identity and self-concept - sometimes feeling they are better than others, but, at
other times, feeling worthless, inferior and consumed with self-hatred. Thus, the child can grow up not quite
’knowing who he/she is’.
This is not an exhaustive list, but, as I am trying to keep these posts to a manageable length and avoid
swamping the reader with information, the picture the examples give, I think, is sufficient as an introduction.
In later articles I will outline ways in which we can manage our problematic relationships with our BPD
parents.
Borderline Personality Disorder and Reasons for Low Self-Esteem.
We come to form our beliefs, including those about ourselves, through our life experiences. Of course, the
beliefs we hold because of what has happened to us in life can be very inaccurate.
Experiences that we have early in life have a particularly strong impact on how we feel about ourselves, and,
below, I list some that are likely to lead us to develop a feeling of low self-esteem, leading us to dislike
ourselves, overly criticize ourselves, lack confidence, feel unlovable and believe we’re not interesting or
important:
- our parents treating us as a constant disappointment in childhood
- being bullied/ left out/ maliciously teased when we were at school
-feeling, or being treated, like we don’t fit in at home - ’black sheep syndrome’
- suffering prejudice and discrimination when we were children
- experiencing systematic and cruel punishment as children
- being neglected when we were children (eg deprived of love, security, interest, praise etc)
- having constantly to cope with a parent’s distress/emotional needs when we were children, at a cost to
ourselves.
I elaborate on each of these below:
OUR PARENTS TREATING US AS A CONSTANT DISAPPOINTMENT IN CHILDHOOD:
This can include parents always putting our mistakes and weaknesses in the spotlight whilst simultaneously
ignoring our strengths and the positive aspects of ourselves. It can also involve being constantly ridiculed and
teased in a hurtful way ( my own mother referred to me as ’scabby’, because, as a child, I had the nervous
habit of picking at scabs on my arms and legs; and also ’poof’, because I was highly sensitive ). Over time, it
is all too easy to become conditioned into believing that there is something FUNDAMENTALLY wrong with us
and that we are of no value.
BEING BULLIED/LEFT OUT/MALICIOUSLY TEASED AT SCHOOL:
We all want to be accepted by our peer group when we are young and developing our fragile and vulnerable
self-concept. It is a human instinct, particularly pronounced during adolesence, to want to be accepted by the
group. We evolved, as a species, after all, as social animals because acceptance by the group added to our
chances of survival. It is, therefore, a fundamental psychological drive, created by millions of years of
evolution, difficult (putting it mildly), therefore, to overcome.
Indeed, it is so powerful that it can lead to problems such as feeling a need to conform to group expectations
even if it makes us uncomfortable (eg feeling a pressure to be confident and jovial when we actually feel
depressed and anxious).
If we don’t conform to the expectations of the group (unless one is an exceptionally strong personality, which
normally does not materialize until later in life) we may be rejected, bullied and cruelly teased and this can
have a very damaging and lasting effect on our self-esteem.
FEELING, OR BEING TREATED, LIKE WE DON’T FIT IN AT HOME:
This is sometimes referred to as ’being the black sheep of the family’. Perhaps there is something about us
that does not fit in. An example might be the central character of the film, ’BILLY ELLIOT’, who, at a very
young age, decides he wants to be a ballet dancer much to the violent chagrin of his tough, alpha-male,
former miner father (who would much rather see him incurring possible brain damage in the boxing ring). Or
simply being the quiet one, or the introverted one. Obviously, there is absolutely nothing wrong with being
any of these things, but, if it makes us stand out in the family, we might be treated as odd, a misfit, strange,
’not quite one of us’ and in some way deficient and of less value. Again, over time, this can significantly wear
down our self-esteem and can lead to growing up feeling rather like a pariah.
SUFFERING PREJUDICE AND DISCRIMINATION WHEN WE WERE CHILDREN:
There are many ways in which this can occur - I remember, when I was at school, a boy in my class who
came from a very poor and not especially caring family; he was not properly cared for by his parents and
used to turn up to school in very tatty and dirty clothes everyday. Cruelly, he was nicknamed ’Tramp’ by the
other boys. Another boy, perhaps slightly effeminate, was always being called ’Poof’. A third came from the
travelling community and was called ’Dirty Gypo’ and more or less completely ostracized. Children, then,
through no fault of their own whatsoever, can become the focus of hostility and contempt. They also, of
course, tend to be the most vulnerable, already struggling with self-image.
Such treatment, particularly if the child has a lack of solid emotional support at home, can have long-lasting
effects on self-esteem.
EXPERIENCING SYSTEMATIC AND CRUEL PUNISHMENT:
If we are often severely and unfairly punished as children, we may come to equate the fact with meaning we
must be a bad person, that we have somehow brought it upon ourselves, and that we deserve it. This,
especially, becomes true if the punishment is inconsistent and unpredictable (eg more to do with the parent’s
mood and lack of self-control than what the child has actually done), extreme and the child does not
understand what he/she is supposed to have done wrong.
Also, more ’subtle’ punishments, such as being ’given the silent treatment’ ( my mother had this down to a
fine art) can be equally damaging.
Such treatment is another very high risk factor in relation to causing long-term and severe problems with the
development of self-esteem.
BEING NEGLECTED WHEN WE WERE CHILDREN (eg being deprived of love, security, interest, praise
etc):
It is not just the presence of bad things in our childhoods which can affect self-esteem adversely, but, also,
THE ABSENCE OF GOOD THINGS. These include praise, interest, affection, reassurance of being loved,
reassurance of being wanted and reassurance of being valued. In other words, then, it is not just blatantly
bad treatment which impacts adversely upon the child’s self-esteem, but, also, the missing fundamental good
things.
HAVING CONSTANTLY TO COPE WITH A PARENT’S DISTRESS/EMOTIONAL NEEDS WHEN WE WERE
CHILDREN:
Some parents are emotionally immature and, in a kind of role reversal, actually turn to their children for
emotional support, as happened in my own case following my parents’divorce when I was eight. Indeed, by
the time I was eleven, my mother sometimes referred to me as her ’Little Psychiatrist’ (encouraging me to
continue in my rather bizarre role). This wa,s obviously, a great psychological burden and caused me great
worry and concern.
Also, if there is friction in the parents’ marriage, or other pressures, parents can transfer their own distress
onto their children and are more likely to become volatile, lose control, become prone to anger or withdrawal
due to their own problems. Such deficient parenting, too, can affect the child’s self-esteem.
I hope this post has been of interest to you. My next post, to be published very soon, will look at how, if we
have had some of these experiences, we can repair our damaged self-esteem.
Remember, if we have low self-esteem ,we will imagine there are things wrong with us that are not, in reality,
the case, however powerful the illusion is that they are.
Childhood Trauma: The Link with Future Violence. Part One.
A research study (Fonagy et al., 1997) showed that 90 % of young offenders had suffered significant
childhood trauma, including both abuse and loss (eg. of a parent through divorce). Neglect in childhood was
also a very significant factor in greatly increasing the risk of later violent offending. Violent offending following
such trauma is sometimes referred to as ’acting out’.
THE EFFECTS OF LOSS DURING CHILDHOOD.
The psychologist Bowlby (1969) studied the effects of loss in childhood (eg. through parental divorce). He
demonstrated that it very often led to the child responding by passing through three stages:
1) PROTEST (due to SEPARATION ANXIETY).
2) DESPAIR (due to grief over the loss. NB. The loss need not be due to death).
3) EMOTIONAL DETACHMENT (a defense mechanism).
Following loss, if the child is not treated sympathetically and emotionally supported, his or her response to the
loss can become pathological.
TYPES OF LOSS.
Two types of loss that the child might experience are death of a parent or parental divorce. But a feeling of
loss can, in fact, be just as damaging (or, indeed, even more damaging) following less overt forms of loss.
For example:
-parental rejection
-parental threats to abandon the child
-parental neglect/lack of emotional involvement
-parental abuse
-parents not giving the child love
Later work by Bowlby (1979) has shown that children often ’re-experience’ their childhood loss in later life
when faced with further separation and loss, or the threat of it, in their adult relationships. This may be
expressed by the individual ’re-experiencing’ his or her feelings of childhood loss by reacting with violence,
anger and hatred.
Furthermore, these dysfunctional response patterns are resistant to change as the individual’s perception of
adult relationships becomes distorted by their experience of childhood loss (in essence, leading to
error-correcting information being defensively and selectively excluded from consciousness).
CHILDHOOD TRAUMA AND LATER DIFFICULTIES REGULATING INTERNAL STATES/EMOTIONS.
Further research (Van der Kolk et al., 1995) has shown that childhood trauma can lead to the individual
experiencing a deep feeling of terror which he or she is unable to articulate; this in turn leads to the individual
experiencing extreme problems in relation to regulating internal states/emotions. Indeed, this dysfunction is
biological in origin, as the biological state of the individual has been adversely affected by the childhood
trauma.
HABITUAL AND REPETITIVE RELATIONSHIP DIFFICULTIES (ATTACHMENT DISORDER) IN ADULT
LIFE FOLLOWING CHILDHOOD TRAUMA.
It has also been demonstrated by research that, following loss-related childhood trauma, the individual’s adult
relationships very frequently induce great feelings of insecurity (’attachment insecurity’/attachment
disorder/attachment anxiety) in later life and that these reponses to interpersonal relationships become
repetitive and habitual.This can, and, often does, lead the individual to adopt dysfunctional coping strategies
including alcohol and drug misuse, violence and crime.
Further research into the connection between childhood trauma and its links to subsequent violent behaviour
in adulthood will be examined in the next article.
Childhood Trauma: The Link with Future Violence. Part Two.
It is possible that even just one, short-lived, traumatic event experienced in childhood, particularly in very
early childhood, can prove so overwhelming that it leads to intense emotional suffering. Much research has
been conducted upon this, and, to use just one example, a study by Pincus has demonstrated that just about
all violent adult criminals have, as children, undergone extreme psychological trauma leading to such intense
emotional suffering which has a dramatic impact on their subsequent psychological and physiological
development and thus on their behaviour as adults.
It is because the trauma is UNRESOLVED (ie. the individual who experienced it has not processed and
worked through it with the help of professional psychotherapeutic intervention) that its effect continues to be
played out, all too frequently, through violent behaviour.
ALTERED PHYSIOLOGY.
In such individuals, the instinctive, internal ’fight’ response is far more easily triggered, and, indeed, far more
intensely triggered, when the individual who has experienced childhood trauma perceives himself to be faced
with a threat. Due to the unresolved trauma, the PHYSIOLOGICAL RESPONSE TO THREAT ALSO
REMAINS UNRESOLVED. In fact, the individual’s nervous system is perpetually in a state of
HYPER-AROUSAL: expecting threat, perceiving threat everywhere, and, on a hair-trigger, ready to fight.
In essence, the individual is trapped in the moment when they did not release the aggressive energy in
response to the original trauma/s. This pent-up aggressive energy, then, is condemned, repeatedly, to
express itself in adulthood in the form of various types of emotions; these include anger, hatred and rage.
Until the trauma is properly resolved, the individual, unconsciously, becomes trapped in a cycle of attempting
to resolve the trauma through compulsive reenactment; we reenact the original trauma in a manner which is
closely linked to that original trauma. For example, a child who was exposed to a lot of aggression, hostility or
violence is quite likely, as an adult, to be repeatedly drawn into violent situations.
Far from this reenactment resolving the trauma, it actually perpetuates its effects. However, because the
behaviour is being driven by largely unconscious motivations, the individual reenacting the trauma is very
often powerless to alter his automatic responses to triggers such as perceived threat ( the threat, due to the
individual’s hyper-aroused nervous system, often being over-estimated or, even, imagined).
THE GOOD NEWS.
This is all very depressing. However, despite the fact it has been believed, in the past, that extreme trauma
leading to cyclical violence could not be cured, because, it was thought, the brain had been irreversably
damaged by the original emotional trauma (producing constant feelings of depression, anxiety and rage),
more up-to-date research is suggesting that pathological symptoms resulting from trauma do NOT have to be
caused by actual physical brain damage (ie. they can be caused by trauma which has not physically
damaged the brain) and that when the trauma is effectively resolved through therapy the individual’s nervous
system can return to normal and, thus, greatly improve the individual’s behaviour.
There is most certainly hope, then, for even the most severely traumatized amongst us.
Childhood Trauma: The Link with Alcoholism.
When childhood trauma remains unresolved (ie. it has not yet been worked through and processed with the
help of psychotherapy), alcoholism may result (together, frequently, with aggressive behaviour).
Indeed, it has been suggested that unresolved traumatic events are actually the MAIN CAUSE of alcoholism
in later life. The trauma may have its roots in:
- the child having been rejected by the parent/s
- too much responsibility having been placed upon the child
As would be expected, it has also been found that adult risk of both alcoholism and depression increases the
greater the number of traumatic events experienced and the greater their intensity.
Children who grow up in alcoholic households have also been found to be at greater risk of becoming
alcoholics themselves in adulthood, but this appears to be due to the fact that, as children with alcoholic
parent/s, they are more likely to have experienced traumatic events than children of non-alcoholic parents,
rather than due to them modelling their own behaviour regarding drinking alcohol upon that of their parent/s.
Furthermore, the more traumatic events experienced during childhood (of a physical, emotional or sexual
nature), the more intensely symptoms of ANGER are likely to present themselves later on.
In research studies on childhood trauma, the degree of trauma experienced (and it is obviously not possible
to quantify this with absolute precision) is often measured using the CHILDHOOD TRAUMA
QUESTIONNAIRE (Fink et al., 1995) which identifies EMOTIONAL INJURIES and PARENTAL NEGLECT
experienced during childhood and adolesence.
PSYCHODYNAMIC THEORIES view alcholism as A MEANS OF COPING WITH ANXIETY. Studies suggest
that an alcoholic adult is about ten times more likely to have experienced physical violence as a child and
about twenty times more likely to have experienced sexual abuse. Lack of peace in the family during
childhood is also much more frequently reported by adults suffering from alcoholism, as are: EMOTIONAL
ABUSE, NEGLECT, SEPARATION AND LOSS, INADEQUATE (eg distant) RELATIONSHIPS and LACK OF
PARENTAL AFFECTION.
IMPLICATIONS FOR THE TREATMENT OF ADULT ALCOHOLICS:
Psychotherapy to help the individual suffering from alcoholism resolve his/her childhood trauma may improve
treatment outcomes and reduce the likelihood of relapse. Further research is being conducted to help to
confirm this.
Childhood Trauma: The Link with Future Gambling.
Research suggests that childhood trauma increases the likelihood of future addictions, including gambling.
This gambling may become pathological. The types of childhood trauma that were experienced in
pathological gamblers include violence, sexual abuse and loss. For instance, Jacobs (2008) conducted
research demonstrating that childhood trauma greatly increased the risk of addictions in later life.
It has been hypothesized that gambling helps the individual cope with their childhood trauma through the
psychological process known as DISSOCIATION (whilst intensely involved with gambling the individual ’goes
into another world’, blissfully disconnecting, for a time, from painful reality).
Pathological gambling is closely connected to impulse and control disorders; indeed, such disorders
frequently express themselves in conditions linked to childhood trauma (such as borderline personality
disorder).Pathological gambling may involve:
- an overwhelming preoccupation with gambling
- lying to others to cover up the extent of the gambling
- a failure to stop gambling even when the individual strongly wants to do so
The profile of the pathological gambler is often a complicated one as the individual often suffers from an array
of other psychological disorders such as depression and anxiety (Abbot et al., 1999).
Studies estimate that about 2 % (although the figure varies somewhat from study to study) of the U.S.
population suffers from pathological gambling.
Factors other than childhood trauma which make an individual more at risk of developing pathological
gambling inclue:
- being male
- being young
- having other mental health problems
Polusny et al (1995) suggested that addictive behaviours help the individual avoid both the memories of their
childhood trauma together with the deeply painful feelings and emotions associated with it. Therefore,
because activities such as gambling reduce the emotional distress connected with childhood trauma, the
individual is driven to repeat the gambling experience again and again, due to the reward it provides of
reducing psychological pain (this is technically known as negative reinforcement). It is my contention that, on
some level, the benefits of reducing psychological pain must outweigh the financial losses; as losses can be
enormous this gives some indication of the level of psychological pain the individual is in and the strength of
the internal drive to reduce it. Of course, this can only be helpful in short-term bursts and, overall, it goes
without saying that the individual’s pain and suffering are compounded.
THE GENERAL THEORY OF ADDICTION:
This model proposes that there is an underlying biological state (ie an abnormal resting arousal state)
together with a psychological state which is painful for the individual (for example, by creating a feeling of
unbearable anxiety) often caused by childhood trauma to which activities such as gambling provide an
’escape route’ (temporarily). The individual becomes addicted to this short-term relief (although often he will
not realize this is the fundamental reason he continues to gamble, the drive frequently being unconscious).
Addictions which alleviate extreme stress in this manner are known as MALADAPTIVE COPING
STRATEGIES; they are, essentially, learned defences against UNRESOLVED TRAUMA-RELATED
ANXIETY (Henry, 1996).
Studies have revealed that up to 80 % of pathological gamblers have suffered extreme childhood trauma.
Further studies suggest that the more severe and protracted the trauma, the higher the risk is that the
individual will develop pathological gambling behaviour and the YOUNGER the individual will be when he
starts to use gambling as a coping strategy. Indeed, I myself started playing fruit machines at the age of
twelve (many places weren’t strict about the age of the person playing them in the late 1970s) and I can
remember quite distinctly the pleasant relief it gave to my already depressed and anxious emotional state.
TREATMENT IMPLICATIONS:
It seems likely, then, that childhood trauma which remains unresolved is likely to elevate the risk of
pathological gambling in individuals. When treating pathological gamblers, therefore, it is important to assess
the degree of trauma the individual might have suffered and to consider appropriate psychological
interventions which could be implemented to help the individual resolve the trauma. It is the psychological
pain which underlies the compulsion to gamble which it is necessary to address.
How Adult Children can Manage their Relationship with Parents who have Borderline Personality
Disorder (BPD). Part 2.
If we have been brought up as children with a parent who has BPD, it is often necessary to seek therapy to
help resolve the trauma that we have suffered and to help us come to terms with our loss - in effect, our
’stolen childhood’.
the unpredictable mood swings of the BPD sufferer
In therapy, it may often be necessary to work through the resentment we might well feel (particularly as this
feeling of resentment can be deeply painful for us to carry around) and consider how our lives have been
adversely affected. Also, we may want to work with our therapist to consider what positive or useful things we
may have learned from our difficult childhood, perhaps through strategies we adopted to deal with this
problematic period of our lives, or from other, more positive, role models (eg teachers, friends, counsellors
etc).
Reviewing things in such a way can bring to the surface very painful feelings, and, if we do not have a
therapist to speak to, talking things over with a sensitive and compassionate friend can be valuable.
Releasing emotions connected with our past through ’talking them out’ can help us to move forward in our
lives. Until we do this, our emotional development can remain arrested (’stuck’), as I am quite convinced
happened in my own case for more years than I care to recollect.
One way in which we can express our, perhaps, long pent-up feelings towards the parent with BPD is to write
them a letter describing how their behaviour made our lives so stressful and painful. (It is usually better not to
actually send the letter as this runs the risk of making matters worse still; however, some therapists may have
different views.)
HOW, AS AN ADULT CHILD, WE CAN NOW PROTECT OURSELVES FROM OUR PARENT WITH BPD.
Individuals with BPD find it very hard to understand that others have personal boundaries, thus it is
necessary to put more effort into establishing such boundaries with a parent with BPD than might otherwise
be the case. In some cases, it may be necessary to cut off completely from the parent with BPD, as the
relationship is mutually destructive and it appears that this is beyond remedy. That, very sadly, was the
decision I had to take with my own mother. However, such drastic action may not be required; it might,
instead, be necessary to make it clear we are unable to cope with constantly supporting the parent with BPD
with their endless emotional problems as we have our own to deal with; that we need time alone/personal
space/privacy; or that we are not prepared to discuss certain topics which always give rise to
unpleasantness, hurt and pain. These are just examples; there may be several other areas in which we need
to make clear our boundaries.
A parent with BPD will often put their own emotional needs ahead of ours; we need to be clear in our own
minds that we have a right to have our own needs respected. Indeed, we have a duty to ourselves to meet
our own needs, especially as so much emotional damage was done to us as children. We need to
ASSERTIVELY make this clear.
Of course, our parent with BPD is very likely to respond by trying to make us feel guilty and bad about
ourselves for expressing our own needs, so we need to be prepared in advance for this reaction and not to
give in to emotional blackmail. We need to maintain our strength and confidence - a good view to take is that
we have a duty to protect the hurt child who still resides within us.
As I have said, it is extremely advisable to have support when thinking about making such changes as I have
written about, ideally professional. If, however, this is not possible, there are many support groups for people
affected by BPD, both online and online.
How Childhood Trauma can Reduce Life Expectancy by 19 Years.
Childhood trauma clearly puts the child who experiences it under great stress; the more protracted and
intense the traumas, and the more traumas the child suffers, all else being equal, the more stress is inflicted
upon the child.
A recent study has shown that an especially traumatic childhood (in which the child experiences several
types of trauma) may reduce life expectancy by about 19 years (from approximately 79 years for those who
experienced no significant trauma, to about 60 years for those who experienced many significant traumas).
In the study, the traumas experienced included the following:
- witnessing domestic violence
- emotional/verbal abuse
- physical abuse
- parental alcohol/drug misuse
- parental imprisonment
- parental separation/divorce
SPECIFIC DETAILS OF THE STUDY:
- those who had suffered 6 or more traumas, on average, lost about 19 years of life (dying, on average, at
about 60 years, rather than at about 79 years, as was the average age of death of those who had suffered no
significant trauma).
- those who had suffered 3 to 5 traumatic events lost, on average, 5.5 years of life, dying, on average, at 73.5
years.
-those who had suffered 2 traumatic events lost, on average, about 3 years of life, dying, on average, at
about 76 years.
POSSIBLE REASONS FOR THE ASSOCIATION BETWEEN CHILDHOOD TRAUMA AND LOWER LIFE
EXPECTANCY:
One theory is that childhood trauma can lead to CELL DAMAGE (specifically, inflammation and premature
aging of the cells). It is also thought that exposure to high and sustained stress in childhood can also
DAMAGE DNA strands; this, in turn, can lead to increased risk of disease and premature death.
Furthermore, extreme stress in childhood (which makes it far more likely the child will go on to have a
stressful adult life) leads to greater production in the body of ADRENALINE (a neurotransmitter which
prepares the body for ’fight or flight’) and also of CORTISOL (a stress hormone); these biochemical effects
increase the individual’s likelihood of developing disease.
CHILDHOOD TRAUMA LEADING TO HARMFUL ADULT BEHAVIOUR:
Because individuals who suffer childhood trauma tend to have much more stressful adult lives, as adults they
are more likely to utilize coping strategies which are, in the long-term, damaging (these are known as
MALADAPTIVE COPING STRATEGIES). They include:
- smoking
- drinking alcohol to excess
- illicit drug use
- ’comfort eating’ of junk food
All of these behaviours, linked to childhood trauma, can dramatically reduce life expectancy. WHY NOT TO
PANIC:
Although the study shows that there is an association (or correlation) between childhood trauma and lower
life expectancy, this does NOT mean that childhood trauma directly and inevitably leads to losing years of life.
Rather, the link is indirect: childhood trauma tends to lead to more stress and harmful behaviours (as already
outlined) and it is these which can lower life expectancy, NOT the childhood trauma in and of itself taken in
isolation. The good news that follows from this is that we are able to address our stress and harmful
behaviours (such as excessive drinking, overeating etc) either through self-help or with the aid of professional
therapy; therefore, the childhood trauma we experienced need NOT lead to a shorter life.
Types of Relationship Problems the Individual may Experience as a Result of Childhood Trauma.
Early relationships between the parent and child have an enormous impact upon how the child manages
relationships throughout later life.
If the child experiences significant difficulties with relating to his/her parents, it often leads to problems with
relating to others later on in life.
The developmental psychologist, Bowlby (1998) proposed that there were, in very broad terms, two types of
attachment that the child could form with the parent/s: SECURE ATTACHMENT and INSECURE
ATTACHMENT.
If INSECURE ATTACHMENT develops, due to problems with how the parent relates to the child, the child
often goes on to develop relationship problems with others in later life, because, according to Bowlby, s/he is
prone to develop maladaptive (counter-productive) ways of relating to others which Bowlby terms
MALADAPTIVE ATTACHMENT STYLES.
Bowlby proposed that there were three main types of maladaptive attachment style which the child could
develop due to his/her problematic parenting; these are:
1) INSECURE-AVOIDANT ATTACHMENT STYLE
2) INSECURE-AMBIVALENT ATTACHMENT STYLE
3) INSECURE-DISORGANIZED ATTACHMENT STYLE
1) Insecure-avoidant attachment style: Children who relate to others in this way may appear withdrawn, and,
sometimes, hostile. By keeping their distance from others, they reduce their feelings of anxiety. However,
underlying this there tends to be a great vulnerability and need. In adulthood, they are likely to continue to be
distrustful of others and to maintain an emotional distance. Again, though, great vulnerability and need tend
to underlie this.
Because the individual who develops this attachment style tends to be constantly expecting to be let down
and betrayed by the person s/he is relating to, s/he may overcompensate for this feeling of vulnerability by
becoming over-controlling, in an attempt to stop the person from ’getting away’.
Individuals who develop this attachment style often have parents who were unresponsive to the needs of the
child, lacked warmth and showed little love. The parents may have rejected the child’s attempts to form a
close relationship with them.
2) Insecure-ambivalent attachment style:
With this style, the child oscillates between ’clinging’ to others and angrily rejecting them - this tends to occur
in ways which are largely unpredictable. Their relationships with others tend to be HIGHLY EMOTIONALLY
VOLATILE. Also, they tend to be EXTREMELY SENSITIVE TO ANY SIGNS THEY ARE BEING REJECTED
(sometimes misinterpreting signals and reading negativity into them when none was intended) and can
become extremely angry if they believe that they are being rejected. Underneath this display of anger,
however, the individual experiences deep hurt and emotional pain in response to the perceived rejection.
This pattern of relating to others often continues into adulthood. As with insecure-avoidant attachment styles,
they may overcompensate for their profound fear of being abandoned by becoming over-controlling.
Individuals who develop this attachment style have often had parents who were unreliable and unpredictable
in their manner of relating to the child - sometimes being available and sometimes not.
3) Insecure-disorganized attachment style:
This attachment style develops more rarely and is usually connected to particularly severe trauma during
childhood.
Children with this attachment style tend to be HIGHLY SUSPICIOUS of others and EXTREMELY CAUTIOUS
about forming relationships.
In adulthood, this tends to lead to profound difficulties with developing any kind of relationship and
maintaining it - in any relationship the individual does manage to form, s/he will tend to behave in a highly
unpredictable way and be highly vulnerable to sustaining further emotional wounds when they are, all too
frequently, rejected for being too ’difficult.’
A deep seated fear of others often underlies this attachment style which can lead to exploitation.
Individuals who develop this attachment style have often suffered severe abuse and have, also, often been
brought up in environments which were extremely CHAOTIC and NEGLECTFUL.
This post is based upon Bowlby’s Attachment Theory.
Effects of Childhood Trauma: The Interaction between Nature and Nurture.
TONY SOPRANO: And to think I’m the cause of it.
DR. MALFI: How are you the cause of it?
TONY SOPRANO: It’s in his blood, this miserable fucking existence. My rotten fucking putrid genes have
infected my kid’s soul. That’s my gift to my son.
Studies have shown that male children who are severely maltreated are more prone to anti-social and violent
behaviour in later life. Is this due to their parents passing on ’bad’ genes, the child growing up in a ’bad’
environment, or a combination of the two?
A study by Moffit et al looked at how children’s genes interacted with their environment to produce (or not to
produce) later anti-social behaviour.
The study focused upon one particular group of genes known as MAOA genes (MAOA is an abbreviation for
the brain chemical MONOAMINE OXIDASE A).
It was found that those with high activity MAOA genes were, in the main, protected from the potential adverse
effects of the problematic environment in which they were brought up:
THEIR HIGH ACTIVITY MAOA GENES MADE THEM RESILIENT AGAINST ENVIRONMENTAL
INFLUENCES WHICH CAN OTHERWISE LEAD TO AN ANTI-SOCIAL PERSONALITY.
The opposite was the case for those who had low activity MAOA genes:
THOSE WITH LOW ACTIVITY MAOA GENES WERE MUCH MORE LIKELY TO DEVELOP ANTI-SOCIAL
BEHAVIOUR PATTERNS IF THEY WERE MALTREATED AS CHILDREN COMPARED TO THOSE WITH
HIGH ACTIVITY MAOA GENES.
In the study, those in the second group (low activity MAOA genes) commited four times as many assaults,
robberies and rapes.
WHAT CAN BE CONCLUDED FROM THIS?
It seems, therefore, that PARTICULARLY BAD OUTCOMES, IN TERMS OF PROPENSITY TO DEVELOP
ANTI-SOCIAL BEHAVIOUR, are much more likely if the individual in question has had BOTH a ’bad’
childhood environment AND has inherited ’bad’ genes (low activity MAOA genes). Indeed, it would appear
that the JOINT EFFECT of BOTH is GREATER THAN THE SUM OF THE PARTS of the two factors.
This finding has been confirmed by other studies showing that low activity MOAO genes are connected with
the development of anti-social behaviour.
TREATMENT IMPLICATIONS:
These findings have implications for treatment of psychological conditions associated with aggression as
there are drugs which alter brain neurochemistry by acting upon monoamine oxidase. However, it should be
noted that these drugs are not without risk and cannot always be guaranteed to be helpful. All treatment
options require consultations with the relevant medical experts.
Childhood Trauma: What Experiments on Causes of Aggression in Rats Tell Us.
A recent Swiss study has looked at the effects of trauma on ’adolescent’ rats. It was found that those rats
who were exposed to trauma (fear and stress inducing stimuli) suffered adverse PHYSICAL EFFECTS ON
THE BRAIN (specifically, the PRE-FRONTAL CORTEX). This, in turn, leads to them displaying significantly
more aggressive behaviour than non-traumatized rats.
A very similar effect has been found to occur in young rats SEPARATED FROM THEIR MOTHERS.
Furthermore, ’adolescent’ rats exposed to trauma also develop ANXIETY and DEPRESSION type
behaviours. They were found to also have increased activity in the brain region known as the AMYGDALA
(which is linked to FEAR and VIOLENCE in humans). Additionally, they developed abnormally high levels of
TESTOSTERONE ( a hormone which, in humans, is linked to AGGRESSION and VIOLENCE). Even the rats’
DNA was found to be affected by the trauma (specifically, MAOA genes). These genes act to break down
SEROTONIN (a brain chemical, or neurotransmitter) and damage to it leads to too much serotonin being
broken down which, in turn, leads to aggressive behaviour.
However, ADULT RATS exposed to trauma did not undergo the same behavioural changes, so:
THE RESEARCH SUGGESTS IT IS TRAUMA IN EARLY LIFE, RATHER THAN IN ADULTHOOD, WHICH
HAS ESPECIALLY DEEP EFFECTS ON THE CHEMISTRY AND PHYSICAL STRUCTURE OF THE BRAIN,
THAT LEADS TO A PROPENSITY FOR AGGRESSIVE BEHAVIOUR.
CONCLUSION:
To what degree can we apply these findings to the effects of childhood trauma in HUMANS?
In fact, the findings I’ve outlined above mirror very accurately findings from studies on humans; this suggests
that similar physiological processes are going on in both rats and humans as a result of early trauma.
Studies on non-human primates have also given rise to very similar findings.
It is hoped that such research showing that physiological effects of early trauma seem to underlie a
development of a greater propensity towards violence and aggression will help lead to drugs being developed
that can reverse these physiological effects and therefore reduce levels of aggression in individuals affected
by early trauma. With this aim in mind, further human and non-human studies are being conducted.
The above post is based on a study by Marquez et al (2013).
Childhood Trauma, Borderline Personality Disorder (BPD) and Dissociation.
I have already written articles explaining the connection between childhood trauma and BPD. An important
symptom of BPD is DISSOCIATION, which this post will examine in greater detail.
Dissociation is generally considered to be a COPING MECHANISM in response to severe trauma or stress.
The phenomenon of dissociation can involve feeling disconnected from one’s emotions, one’s memories,
one’s thoughts or even from reality itself. It is common in those suffering from BPD; BPD frequently occurs in
individuals who have experienced childhood trauma.
Dissociation is, essentially, a way of ’escaping’ from the stressful situation, or memory of the stressful
situation, by changing one’s state of consciousness (this often occurs automatically and without intention);
sometimes people report feeling ’numb’. In situations of terror, one may dissociate, and, paradoxically, feel a
detached state of calm. It may feel, too, that the traumatic event is not happening to oneself, but that one is
’observing the traumatic event from outside of the body’, leading to passivity and emotional detachment.
Dissociative feelings of ’being outside of oneself’ are described as DEPERSONALIZATION and dissociative
feelings of being disconnected from reality are described as DEREALIZATION. Some experts have described
dissociation as working a bit like morphine - dampening down emotional and physical pain. However, it is yet
to be properly explained what the exact biological mechanisms are that underpin the dissociative experience.
The four main types of dissociation are:
1) DISSOCIATIVE AMNESIA
2) DISSOCIATIVE IDENTITY DISORDER
3) DISSOCIATIVE FUGUE
4) DEPERSONALIZATION DISORDER
Let’s look at each of these in a little more detail:
1) Dissociative Amnesia: here, large parts of, or all, the traumatic event/s cannot be remembered.
2) Dissociative Identity Disorder: this is also known as MULTIPLE PERSONALITY DISORDER. Here, the
person adopts two or more distinct, utterly different personas. The different personas talk in different voices,
use different vocabularies etc (they can also actually differ in handedness). The different personas do not
have access to ’each others” memories, studies have shown, so they have distinct ’personal histories’. It is
likely that each persona represents a different strategy for coping with stress.
3) Dissociative Fugue: in this state, individuals can disconnect from their previous personalities, and, then,
often, travel far from home to take on, and live under, a completely new persona. They may appear normal to
others who have never met them before, even though they are living under a completely new identity, having
left a whole life and set of memories behind.
4) Depersonalization Disorder: in this state, individuals can feel detached from their bodies or experiences. A
phrase I read in a novel recently may aptly illustrate the sensation: ’it’s like living in a dream underwater.’
A large number of people who have suffered extreme childhood trauma report experiencing such automatic
dissociative states. Furthermore, they may often seek to induce dissociative states, deliberately and
artificially, as a way of escaping the constant psychological pain resulting from the initial trauma by, for
example, USING ALCOHOL TO EXCESS, USING NARCOTICS, SELF-HARMING or GAMBLING. The kinds
of psychological state from which the individual is seeking to escape through dissociation include INSOMNIA,
NIGHTMARES, FEELINGS OF RAGE and INTENSE ANXIETY.
LONG-TERM PROBLEMS OF DISSOCIATION:
Dissociation may be helpful (adaptive) in the short-term but problems develop when the state persists long
after it has served any beneficial purpose. The psychologist ,Lifton, described prolonged states of ’psychic
numbing’ and ’mental paralysis’ often resulting from a dissociative response to severe trauma. This can make
even basic day-to-day functioning extremely problematic and requires professional intervention.
Childhood Trauma: Famous People who Experienced It. Kurt Cobain.
I was a big fan of Kurt Cobain and his band, Nirvana. I therefore remember where I was when I first heard
news of his death - it came on the TV in the gym I was in at the time (in an uninspiring town called Watford
just north of London, UK, as you ask). I had three things in common with him. I was born in the same year as
he was (1967) and, also like him, had developed a considerable degree of both emotional and behavioural
instability (despite doing, somehow, an MSc at the time). Thirdly, we had both experienced significant
childhood trauma. (Actually, his parents divorced when he was seven years old, whilst mine had divorced
when I was eight years old, so that’s very nearly four things in common. I was not, however, to the best of my
recollection, an international grunge rock superstar.)
Like many sensitive children, it was obvious from an early age that Kurt Cobain was very creative. Also, like
an increasingly large number of young people these days ( and it is certainly argued in some quarters that
this ’condition’ is over-diagnosed) he was labelled ’HYPERACTIVE’ - now usually described as having ADHD
(’ATTENTION DEFICIT HYPERACTIVITY DISORDER’) and prescribed the drug called RETALIN
(paradoxically, retalin is a derivative of amphetamine which, itself, more usually has a stimulant effect).
Due to his extreme sensitivity, Kurt Cobain experienced great distress and emotional trauma as a result of his
parents’ divorce. When this shattering event occurred, he was just seven years old. It is recorded that he
reported feeling unloved and deeply insecure after the divorce took place.
On top of all this, his life was made chaotic and disorganized by frequent moves to different geographical
locations during which period he stayed with various different sets of relatives; this pattern of constant
transience meant relationships he tried to form became disrupted and truncated.
Like many young people suffering from emotional distress, Kurt Cobain learned to mentally ’escape’
- in his case by losing himself in his music and developing his enormous musical talent.
The psychological symptoms of his tortured emotional state started to manifest themselves in the form of
INSOMNIA and a chronic stomach complaint which may well have been PSYCHOSOMATIC in origin ( the
word ’psychosomatic’ refers to the mechanism whereby mental stress causes physical problems in other
words, the mind’s effect upon the body).
In order to try to cope with his feelings of intense pain (both mental and physical) he started to ’self-medicate’
with narcotics. (Psychologists would describe this as ADOPTING A MALADAPTIVE COPING MECHANISM
IN ORDER TO DISSOCIATE FROM INTOLERABLE PAIN; see my post entitled: CHILDHOOD TRAUMA,
BORDERLINE PERSONALITY DISORDER (BPD) AND DISSOCIATION in order to learn more about the
phenomenon of dissociation acting as a psychological defense mechanism.)
When his band, Nirvana, became an international sensation, the effects of fame (as many famous people
discover too late) caused him further severe stress. He was not comfortable around the media and found the
attention, in general, overwhelming and intrusive. He became deeply, clinically depressed, complained that
he derived no pleasure whatsoever from performing in front of thousands of adoring fans, and, eventually,
attempted suicide in March 1994. He entered a coma and was hospitalized.
Very soon after this, he entered a drug rehabilitation facility in Los Angeles in an attempt to address his drug
addiction. Within two days, however, he fled the hospital, and, overwhelmed by feelings of despair and utter
hopelessness, committed suicide in his home by first injecting himself with a massive overdose of heroin and
then shooting himself in the head using a shotgun.
It is a very sad fact that many talented and creative people seem to be more prone than average to extreme
mental turmoil. Kurt Cobain was one such person, and, this, tragically, led to a vastly talented, perceptive and
sensitive human being’s life coming to a far too premature end.
Childhood Trauma: How the Child’s View of Their Own ’Badness’ is Perpetuated.
When a child is continually mistreated, s/he will inevitably conclude that s/he must be innately bad. This is
because s/he has a need (at an unconscious level) to preserve the illusion that her/his parents are good; this
can only be achieved by taking the view that the mistreatment is deserved.
The child develops a fixed pattern of self-blame, and a belief that their mistreatment is due to their ’own
faults’. As the parent/s continue to mistreat the child, perhaps taking out their own stresses and frustrations
on her/him, the child’s negative self-view becomes continually reinforced. Indeed, the child may become the
FAMILY SCAPEGOAT, blamed for all the family’s problems.
The child will often become full of anger, rage and aggression towards the parent/s and may not have
developed sufficient articulacy to resolve the conflict verbally. A vicious circle then develops: each time the
child rages against the parent/s, the child blames her/himself for the rage and the self-view of being ’innately
bad’ is further deepened. This negative self-view may be made worse if one of the child’s unconscious coping
mechanisms is to take out (technically known as DISPLACEMENT) her/his anger with the parent/s on others
who may be less feared but do not deserve it (particularly disturbed children will sometimes take out their
rage against their parent/s by tormenting animals; if the parent finds out that the child is doing this, it will be
taken as further ’evidence’ of the child’s ’badness’ ,rather than as a major symptom of extreme psychological
distress, as, in fact,it should be.
The more the child is badly treated, the more s/he will believe s/he is bringing the treatment on her/himself (at
least at an unconscious level), confirming the child’s FALSE self-view of being innately ’bad’, even ’evil’
(especially if the parent/s are religious). What is happening is that the child is identifying with the abusive
parent/s, believing, wrongly, that the ’badness’ in the parent/s actually resides within themselves. This has
the effect of actually preserving the relationship and attachment with the parent (the internal thought process
might be something like: ’it is not my parent who is bad, it is me. I am being treated in this way because I
deserve it.’ This thought process may well be, as I have said, unconscious).
Eventually the child will come to completely INTERNALIZE the belief that s/he is ’bad’ and the false belief will
come to fundamentally underpin the child’s self-view, creating a sense of worthlessness and selfloathing.
Often, even when mental health experts intervene and explain to the child it is not her/his fault that they have
been ill-treated and that they are, in fact, in no way to blame, the child’s negative self-view can be so
profoundly entrenched that it is extremely difficult to erase. In such cases, a lot of therapeutic work is required
in order to reprogram the child’s self-view so that it more accurately reflects reality. Without proper treatment,
a deep sense of guilt and shame (which is, in reality, completely unwarranted) may persist over a lifetime with
catostrophic results.
Any individual affected in such a way would be extremely well advised to seek psychotherapy and other
professional advice as even very deep rooted negative self-views as a result of childhood trauma can be very
effectively treated.
Childhood Trauma: Complex Post-Traumatic Stress Disorder (with Questionnaire).
Survivors of extreme trauma often suffer persistent anxiety, phobias, panic, depression, identity and
relationship problems. Many times, the set of symptoms the individual presents with are not connected to the
original trauma by those providing treatment (as certainly was the case for me in the early years of my
treatment, necessitating me to undertake my own extensive research, of which this blog is partly a result)
and, of course, treatment will not be forthcoming if the survivor suffers in silence. Any treatment not linked to
the original trauma will tend to be ineffective as THE UNDERLYING TRAUMA IS NOT BEING ADDRESSED.
Also, there is a danger that a wrong diagnosis may be given; possibly the diagnosis will be one that may be
interpreted, by the individual given it, as perjorative (such as a personality disorder).
Individuals who have survived protracted and severe childhood trauma often present with a very complex set
of symptoms and have developed, as a result of their unpleasant experiences, deep rooted problems
affecting their personality and how they relate to others. The psychologist, Kolb, has noted that the
post-traumatic stress disorder symptoms survivors of severe maltreatment in childhood might develop ’may
appear to mimic every personality disorder’ and that ’severe personality disorganization’ can emerge.
Another psychologist, Lenore Terr, has differentiated between two specific types of trauma: TYPE 1 and
TYPE2.
TYPE 1 refers to symptoms resulting from a single trauma; TYPE 2 refers to symptoms resulting from
protracted and recurring trauma, the hallmarks of which are:
- emotional numbing
- dissociation
- cycling between passivity and explosions of rage
This second type of trauma response has been referred to as COMPLEX POST-TRAUMATIC STRESS
DISORDER, and more research needs to be conducted on it; however, an initial questionnaire to help in its
diagnosis has been developed and I reproduce it below:
1) A history of, for example, severe childhood trauma
2) Alterations in affect regulation, including
- persistent dysphoria
- chronic suicidal preoccupation
- self-injury
- explosive or extremely inhibited anger (may alternate)
- compulsive or extremely inhibited sexuality (may alternate)
3) Alterations in consciousness, including
- amnesia or hypernesia for traumatic events
- transient dissociative episodes
- depersonalization/derealization
- reliving experiences, either in the form of intrusive post-traumatic stress disorder symptoms or in the form of
ruminative preoccupation
4) Alterations in self-perception, including
- a sense of helplessness or paralysis of initiative
- shame, guilt and self-blame
- sense of defilement or stigma
- sense of complete difference from others (may include sense of specialness, utter aloneness, belief no
other person can understand, or nonhuman identity)
5) Alterations in perceptions of perpetrator, including:
- preoccupation with relationship with perpetrator (includes preoccupation with revenge)
- unrealistic attribution of total power to perpetrator (although the perpetrator may have more power than the
clinician treating the individual is aware of)
- idealization or paradoxical gratitude
- sense of special or supernatural relationship
- acceptance of belief system or rationalizations of perpetrator
6) Alterations in relations with others, including
- isolation and withdrawal
- disruption in intimate relationships
- repeated search for rescuer (may alternate with isolation and withdrawal)
- persistent distrust
- repeated failures of self-protection
7) Alterations in systems of meaning
- loss of sustaining faith
- sense of hopelessness and despair
Anyone who feels their condition may be reflected by the above is urged to seek professional intervention at
the earliest opportunity.
Childhood Trauma: Damage Done by Breakdown of Maternal Bond.
’I have given suck, and know
How tender ’tis to love the babe that milks me: I would, while it was smiling in my face, Have plucked my
nipple from his boneless gums, And dashed the brains out, had I sworn as you Have done to this.’
-Lady Macbeth (on hearing that her husband plans to proceed no further with the murder of King Duncan).
Whilst the child has many relationships (eg with siblings, teachers, friends etc) the relationship between the
child and the mother is of paramount importance. How our mother relates to us in our early years has a
profound impact on our subsequent development and future lives, not least in terms of how we perceive
ourselves and how we relate to others.
For most children, the relationship with the mother is stable, supportive and loving (although, of course, there
will inevitably be the normal ups and downs, especially, frequently, during adolesence) but for a minority of
children the relationship becomes deeply problematic - the mother may persistently criticize, display frequent,
intense anger and hostility, put her own needs perpetually before the child’s, be emotionally abusive or
emotionally unavailable, or even reject and abandon the child.
In many instances in which the maternal bond with the child has not properly developed, the mother may
manipulate the child by exploiting his/her need for love and care; in other words, if the child fails to develop
strategies, at great cost to him/herself, to maintain a tolerable relationship, the mother will reject the child.
Indeed, the child may have this threat constantly hanging over him/her (my own mother employed this
strategy, until, finally, I was forced to move out and live with my father and step-mother when I was thirteen).
The child is put into a position whereby s/he must always meet the mother’s highly exacting needs or face
fear of abandoment.
This problematic relationship with the mother shapes the child’s view of him/herself - s/he may have to be
constantly ’on guard’ with the mother, monitoring (either consciously or unconsciously) her minutest reactions
in order to try to predict whether she is about to ’turn’ on him/her. As the child gets older, this can lead to
him/her becoming generally mistrustful of others (constantly on the look out for signs of imminent rejection
and betrayal, sometimes, due to the hyper-vigilence learned in childhood as a survival mechanism,
perceiving threats which do not, in reality, exist) which frequently leads to extreme difficulties in maintaining
relationships (especially intimate relationships) with others.
BIOLOGICAL EFFECTS ON THE CHILD.
If the child is exposed to prolonged stress by a problematic relationship with the mother, this can have a
PHYSIOLOGICAL EFFECT on him/her which LOWERS HIS/HER ABILITY TO COPE WITH STRESS IN
LATER LIFE. The constant anxiety felt by the child INTERFERES WITH THE DEVELOPMENT OF
NEUROLOGICAL (BRAIN) CIRCUITS REQUIRED FOR EMOTIONAL REGULATION. Without the normal
ability to regulate emotions and ’self-soothe’ (as it is often put in the relevant literature), the child may go on
to develop PROBLEMS WITH CONTROLLING ANGER, and, without the appropriate therapy, such problems
can severely blight his/her life and interaction with others.
THE ROLE OF GENES
Studies suggest that not all children are affected equally adversely by problematic interaction with the mother.
A main reason for this would seem to be that some children have GENES WHICH MAKE THEM RESILIENT
to difficult emotional environments, whilst others lack these PROTECTIVE GENES.
EFFECTS OF PROBLEMATIC MOTHER-CHILD INTERACTION ON THE CHILD’S DEVELOPING BRAIN.
A good bond between mother and baby starts to have effects on the baby’s brain development immediately.
When shown love and care, the baby’s brain becomes flooded with ENDOGENOUS OPIATES (pleasure
inducing brain chemicals).Indeed, the brain’s development is highly dependent on how the mother responds
to the baby’s feelings and needs; the relationship between mother and baby will have a day-to-day
BIOLOGICAL IMPACT ON THE DEVELOPMENT OF THE YOUNG BRAIN. When problems arise, NEURAL
NETWORK DEVELOPMENT IS DISRUPTED; If this disruption is protracted and severe, the affected
individual, as an adult, may become HIGHLY EMOTIONALLY DYSREGULATED, frequently feeling
overwhelmed by ANXIETY, FEAR and ANGER. Problems, too, as a result of EARLY NEUROLOGICAL
DAMAGE, will very frequently extend to significant difficulties in relation to IMPULSE CONTROL.
It has already been shown that emotional abuse in early life can lead to just as much harm as physical abuse;
prolonged stress, in early life, for whatever reason, does NOT ’toughen the individual up’; on the contrary, the
biochemical effect of the severe, protracted stress makes the individual affected MUCH MORE
VULNERABLE in terms of his/her ability to deal with stress in later life.
Childhood Trauma: Its Relationship to Psychopathy.
’Just because I don’t care doesn’t mean I don’t understand.’
- Homer Simpson.
The term ’psychopath’ is often used by the tabloid press. In fact, the diagnosis of ’psychopath’ is no longer
given - instead, the term ’anti-social personality disorder’ is generally used.
When the word ’psychopath’ is employed by the press, it tends to be used for its ’sensational’ value to refer to
a cold-blooded killer who may (or may not) have a diagnosis of mental illness. It is very important to point out,
however, that it is extremely rare for a person who is suffering from mental illness to commit a murder;
someone suffering from very acute paranoid schizophrenia may have a delusional belief that others are a
great danger to him/her (this might involve, say, terryfying hallucinations) and kill in response to that I repeat,
though, such events are very rare indeed: mentally ill people are far more likely to be a threat to themselves
than to others (eg through self-harming, substance abuse or suicidal behaviours).
The word psychopath actually derives from Greek:
psych = mind
pathos = suffering
Someone who is a ’psychopath’ (ie has been diagnosed with anti-social personality disorder) needs to fulfil
the following criteria:
- inability to feel guilt or remorse
- lack of empathy
- shallow emotions
- inability to learn from experience in relation to dysfunctional behaviour
Often, psychopaths will possess considerable charisma, intelligence and charm; however, they will also be
dishonest, manipulative and bullying, prepared to employ violence in order to achieve their aims.
As ’psychopaths’ reach middle-age, fewer and fewer of them remain at large in society due to the fact that by
this time they are normally incarcerated or dead from causes such as suicide, drug overdose or violent
incidents (possibly by provoking a ’fellow psychopath’ to murder them). However, it has also been suggested
that some possess the skills necessary to integrate themselves into society (mainly by having decision
making skills which enable this and operating in an context suited to their abilities, for example where cold
judgment and ruthlessness are an advantage) and become very, even exceptionally, successful; perhaps it
comes as little surprise, then, that they are thought to tend to be statistically over-represented in, for example,
politics and in CEO roles (think Monty Burns from The Simpsons, though I’m aware he’s not real. Obviously.).
WHAT KINDS OF CHILDHOODS HAVE ADULT ’PSYCHOPATHS’ HAD?
Research shows that ’psychopaths’ tend to be a product of ENVIRONMENT rather than nature ie they are
MADE rather than born. They also tend to have suffered horrendous childhoods either at the hands of their
own parent/s or those who were supposed to have been caring for them - perhaps suffering extreme violence
or neglect.
Post-mortem studies have revealed that they frequently have underdeveloped regions of the brain
responsible for the governing of emotions; IT APPEARS THAT THE SEVERE MALTREATMENT THAT
THEY RECEIVED AS CHILDREN IS THE UNDERLYING CAUSE OF THE PHYSICAL
UNDERDEVELOPMENT OF THESE VITAL BRAIN REGIONS. It is thought that these brain abnormalities
lead to a propensity in the individual to SEEK OUT RISK, DANGER and similar STIMULATION (including
violence).
IS THE CONDITION TREATABLE?
Whilst there are those who consider the condition to be untreatable, many others, who are professionally
involved in its study, are more optimistic. Indeed, some treatment communities have been set up to help
those affected by the condition take responsibility for their actions and face up to the harm they have caused.
Research is ongoing in order to assess to what degree intervention by mental health services can be
effective.
Childhood Trauma: The Five Main Personality Disorders.
Childhood trauma has frequently been linked to the later development of borderline personality disorder
(BPD),as we have seen. However, as childhood trauma can also contribute to other personality disorders, I
have decided it might be of help to outline the symptoms of those I have not yet covered.
The five main personality disorders are:
- PARANOID
- SCHIZOTYPAL
- ANTISOCIAL
- NARCISSITIC
- BORDERLINE
I elaborate on these below; first, however, it is worth pointing out that it is estimated 14 % of the population
suffer from one of the personality disorders. Let’s look at them now:
1) PARANOID PERSONALITY DISORDER: it is thought that as many as one in twenty people could suffer
from this disorder. Individuals who suffer from it find it very hard to trust others and view the world in general
with suspicion. Some important features of the condition suffered by individuals include:
- a feeling others relentlessly victimize them
- a feeling of being unacceptable to society
- an expectation others will betray them / being on the look out (perhaps obsessively) for signs of such
betrayal
- feelings of intense jealousy (particularly in relation to partner)
- a marked tendency to hold onto resentments against others
- a marked tendency to be excessively critical of others
Often, such individuals will not seek professional help as they will frequently have a deep distrust of
therapists and may, too, lack insight into their condition. Whilst environmental factors are at play in the
development of this disorder, genes are also believed to have a significant role.
2) SCHIZOTYPAL PERSONALITY DISORDER: about 2 % of the population are thought to suffer from this.
Those affected suffer social anxiety, lack social skills and avoid close relationships. Also, they frequently
have strange ideas and bizarre ways of behaving. Key features of this condition suffered by individuals
include:
- bizarre fantasies and superstitions (eg belief in telepathy)
- ’ideas of reference’: this is the belief that events relate to the sufferer when, in reality, they do not. For
example, a sufferer might believe that a newspaper headline refers to him/her or that a TV news item is about
him/her.
’poverty of speech’: this refers to speech which is vague, confused and difficult to follow or make sense of
(over-use of inappropriate and odd metaphors is not unusual).
- paranoia (see above)
- beliefs that parts of their body (eg an arm) are being controlled by outside or supernatural forces
With this disorder, too, genetics are thought to play a significant role. It is linked to schizophrenia, a more
serious condition, but does not necessarily lead to full-blown symptoms of this.
3) ANTISOCIAL PERSONALITY DIASORDER: about 2 % of the population is thought to suffer from this
condition; it is much more common amongst males. It is also believed that up to 80 % of the prison
population, at any one time, comprises individuals with this condition. Individuals with the disorder lack
empathy, feel little or no remorse (ie lack what is commonly referred to as a conscience), care little about the
generally accepted rules of society and can frequently be violent. However, not all are violent and many can
function, even excel, in society by capitalizing on personality traits such as ruthlessness, manipulativeness,
and, not infrequently, a superficial charm, to become, for example, successful politicians or CEOs. Key
features of the disorder include:
- frequent lying
- lack of feelings of guilt
- aggression
- irresponsible behaviours
- indifference to the suffering of others/lack of compassion
- irritabilty and hostility
- frequent impulsivity
Individuals with the disorder very frequently crave power and this ’power lust’ will usually take precedence
over forming long-term, meaningful relationships.
4) NARCISSISTIC PERSONALITY DISORDER: some have speculated that this disorder is becoming more
common in what is sometimes referred to as the current ’ME-GENERATION’ or ’X-FACTOR GENERATION’
(I never watch it. Honestly). At present, however, it is estimated about 1 % of the population suffer from it.
Individuals who are affected by it tend to be what many might term ’attention-seekers’. They will also tend to
have a grandiose self-image, believing that they are somehow entitled to special treatment. Their enormous
self-regard and sense of self-importance can lead to them behaving in a very arrogant and off-hand manner.
Key features of the condition include:
- self-absorption/self-obsessiveness
- a sense of great specialness
- a grandiose self-view
- a lack of empathy for others
- frequent feelings of great envy or jealousy
- a predisposition towards the exploitation of others
- intense competitiveness
These individuals may, too, greatly over-estimate their own talents, perhaps expecting to become an
enormous success, rich and famous (X -FACTOR comes to mind again here, for some reason). Rather than
engaging with others on a ’normal’ emotional level, they may uniformly see others, essentially, as merely
providing them with an audience.
5) BORDERLINE PERSONALITY DISORDER (this is covered extensively elsewhere in this eBook)
Childhood Trauma: Mental Illness and Responses to Stigma.
’You must be the change you wish to see in the world.’
- Mahatma Ghandi
As mental illness is dictated by a combination of environmental and genetic factors, it can happen to
absolutely anyone. Even individuals a long way into adulthood, who have previously always enjoyed good
mental health, can suddenly be plunged into a severe clinical depression by a single traumatic life event.
Nobody is immune. Mental illness HAS NOTHING TO DO WITH PERSONAL FAILINGS.
However, stigma connected to mental illness is still far from uncommon. Others can stigmitize those of us
who have suffered mental illness, and turn their backs in disdain and contempt with a feeling of smug,
self-satisfied superiority, due to their lack of education on the matter; also, however, some people who suffer
mental illness (having internalized society’s often less than compassionate take on the condition) can, in
effect, self-stigmitize: because mental illness often causes negative thinking patterns and feelings of
wortlessness, it is all too easy for us to fall into the trap of compounding our suffering by feeling bad about
being mentally ill (we may see ourselves as weak, for example). In other words, we may add a kind of
additional, unnecessary layer to our distress: feeling bad about ourselves for feeling bad about ourselves, as
it were. This has been referred to by some psychologists as METAWORRYING.
It is, of course, generally easier to alter the way that we feel about ourselves than it is to change the way
others feel about us; ignorance, after all, can have a dispiritingly tenacious quality. Therefore, a good place to
start in the fight against stigma is to change how we see ourselves for having experienced mental illness: we
need, in short, to stop stigmitizing ourselves.
TACKLING STIGMITIZATION BY SOCIETY:
Whilst stigmitization by society, as I have said, still, obviously, exists, attitudes are improving all the time with
greater public education and more and more individuals, with a prominent public profile, willing to talk openly
about their own experience of mental illness (most notably, perhaps, in the UK, the writer, actor and
comedian - and probably a lot of other things I can’t currently call to mind - Stephen Fry, who suffers bipolar
disorder).
Progress has been made in society in relation to racism and homophobia, and, it would seem, there is no
obvious reason why similar progress should not be made in relation to society’s attitude towards those
unfortunate enough to experience mental illness.
THE FIRST STEP:
The first step we can all make, as I have suggested, is to stop blaming ourselves, and feeling bad about
ourselves, for having suffered psychological difficulties (hence the reference to the quote by Ghandi at the top
of this post!).
If you would like to learn more about fighting the stigma surrounding mental illness you may wish to pay a
visit to www.shift.org.uk to see what they are doing in their campaign in relation to this. The campaign, for
those who are interested, is run by The National Institute for Mental Health, UK.
Self-Test Questionnaires for 10 Psychological Conditions Linked to Childhood Trauma.
Because this blog is about psychological conditions which are often linked with childhood trauma, I thought it
would be useful to provide links to self-test questionnaires for various disorders - these help the person who
takes the test decide if s/he may suffer from the disorder specific to it. The self-test questionnaires (or
inventories, as they are normally referred to by psychologists), cover the following 10 conditions (just click on
the relevant link to be taken to the specific test that you are interested in:
1) DEPRESSION INVENTORIES: www.psychology-tools.com
(there are several to choose from on this site).
2) ANXIETY INVENTORY: www.psychology-tools.com
(again, there are several to choose from).
3) ALCHOLISM ASSESSMENT: www.treatmentsolutions.com/alcohol-assessment.php
4) GAMBLING ADDICTION ASSESSMENT: www.problemgambling.sa.gov.au
5) POST-TRAUMATIC STRESS DISORDER www.ptsd.ne.gov/pdfs/ptsd.pdf
6) BIPOLAR DISORDER INVENTORY: www.psychology-tools.com
7) SOCIAL PHOBIA: www.psychology-tools.com
8) DISSOCIATIVE DISORDER INVENTORY:
www.healthyplace.com/abuse/wermany/dissociation-self-test/ 9) BORDERLINE PERSONALIY DISORDER
(BPD): www.bpddemystified.com/resources/online-test/
10) EATING DISORDER ASSESSMENT:
www.eatingdisorder.org/eating-disorder-information/online-selfasses sment/
Whilst all these self-tests provide an initial indication as to whether or not the test taker might be suffering
from the particular condition specific to the test” they are not a substitute for a professional diagnosis; if you
believe you may suffer from any of the above conditions, it is definitely advisable to seek professional advice.
Childhood Trauma: Its Link to Adult Anxiety.
Anxious personality types often result from childhood trauma. Research has shown that there are 7 major
factors which influence the way our personalities develop. These are:
- the way in which we are disciplined in childhood
- our place within the family eg birth order/sex
- the kinds of role model we had as children eg parents
- the belief system of the family we grew up in
- our genes/biochemical makeup
- the social and cultural influences we experienced as children
- the particular PERSONAL MEANING that we attach to each of the above
There are many ways that the above factors can interact to produce a personality dominated by anxiety in
adulthood. Below are some experiences, directly related to the above factors, which can contribute towards
us developing an anxiety disorder in adulthood:
1) AN ANXIOUS PARENT OR ROLE MODEL: one way in which children are programmed to learn by
evolution and develop their personalities is by a process referred to by psychologists as MODELLING
(copying the behaviour of role models, either consciously or unconsciously). It follows that a role model who
frequently displays intense anxiety is likely to lead to the child adopting a similar manner of behaving and
responding.
2) RIGID BELIEF/RULE SYSTEMS: if the child’s role models (especially parents) have a rigid belief system,
perhaps deriving from their culture or religion, the child may develop inflexible and ’black and white’ thinking
styles which can frequently become a source of anxiety in later life.
Additionally, if a child lives in a highly chaotic environment, due, for example, to parental mental illness or
substance abuse, s/he may learn to develop a rigid set of rules to give him/herself some sense of security
and stability. Again, carrying such rigid rules into adult life can often lead to high levels of anxiety.
3) CHILD ABUSE: abuse, during childhood, too, frequently leads to the abused child developing problems
related to anxiety in adult life. The types of abuse which may occur include: physical abuse, sexual abuse,
psychological abuse, neglect (physical and/or emotional), and cruel and unusual punishment.
4) ANXIETY RELATED TO SEPARATION AND LOSS: a child may be separated from a parent or carer for
extended periods of time, due, for example, to the following events:
- a parent/carer going into hospital for a long time
- divorce
- death
If the child DOES NOT UNDERSTAND WHY the parent/carer has become absent, this can be especially
anxiety inducing.
A more subtle, but, equally damaging, form of separation a child may experience is if the parent/carer is
PHYSICALLY PRESENT BUT IGNORES/FAILS TO INTERACT MEANINGFULLY with the child. 5)
REVERSAL OF PARENT-CHILD ROLES: for a significant part of my childhood, starting at around the age of
11 years, this was the situation that I found myself in. Essentially, I became my mother’s personal counsellor,
permanently, it seemed, on call (I’m surprised she didn’t provide me with a pager).Indeed, at this stage in my
childhood she began to refer to me as her ’Little Psychiatrist.’ A child may also find him/herself having to
adopt a parental role for many other reasons; for example, parental substance abuse, parental absence etc.
When the child, by necessity, in order to survive, takes on responsibilities which s/he is not old enough to
cope with, this can lead to a number of anxiety-linked personality traits; these may include: ’black and white’
thinking, suppression of feelings, unrealistically high levels of self-expectation, and a deep need to have
control.
Other childhood experiences which may lead to an anxious personality type in adulthood I list below:
- highly critical parents/carer
- overprotective parents/carer
- parental/carer pressures placed on child to suppress/deny his/her own feelings.
CONCLUSION:
We learn, then, certain ways of coping and behaving when faced with difficult childhood experiences; the
problem is, however, that carrying these ways of coping and behaving into adulthood is often unhelpful; this is
because, as adults, we are frequently presented with an environment to deal with which is very different from
the environment we needed to deal with as children - we therefore need to adapt our behavioural responses
to the new environment, in order to function in it effectively.
THE POSITIVE NEWS is that, as adults, it is possible to MODIFY OUR PERSONALITY
CHARACTERISTICS (which previously led to anxiety) and to learn new, more appropriate, ways of thinking
and behaving, adaptive to the new, adult environment into which we are inevitably plunged. One therapy
which research has shown can be particularly effective in treating anxiety which has its roots in childhood is
called COGNITIVE BEHAVIOUR (UK spelling!)
Possible Traumatic Consequences Faced by Gifted Children.
It is certainly not true for all gifted children, but some are at increased risk of ADJUSTMENT PROBLEMS and
consequently, of unhappineess. Problems, research shows, may develop in connection with the following:
- extreme sensitivity
- alienation
- uneven development
- perfectionism
- role conflict
- inappropiate environments
- adult expectations
- self-definition
Let’s look at each of these in turn:
INTENSE SENSITIVITY: because highly gifted children have a high level of internal responses they are often
INTENSELY SENSITIVE. Whilst this can certainly have its advantages, it can also EXACERBATE THE
NORMAL PROBLEMS OF GROWING UP. For instance, the child’s intelligence may lead him/her to be
unusually sensitive to social cues and may, for example, pick up on subtle signals leading him/her to sense
rejection where it may not have been intended. His/her sensitivity may lead him/her to respond strongly to
what other children of the same age may well regard as trivial and unimportant; the other children may then
ridicule and deride the child for what they perceive as his/her over-reations.The child may then go on to form
the view that there is something wrong with him/her and start to increasingly beieve he/she are odd, leading
to self-consciousness, low self-esteem and low social confidence. Importantly, also, the child may well pick
up on society’s hypocrisy and social injustice very early on in his/her life, leading to feelings of cynicism and
despair far earlier than others are likely to develop such feelings.
ALIENATION: the child’s high intelligence and giftedness may result in him/her relating to other children the
same age as him/her in a manner more like that of an adult than that of a child. This can lead to problems
with social integration. If he/she is not accepted by the other children this may lead him/her to socially
withdraw. In turn, this can hinder development of social skills which can then lead to the child being labelled
as ’odd’ or ’weird’. If the gifted child then INTERNALIZES such labels (ie. the labels lead to the child believing
he/she is as the labels describe him/her), this can lead to the child developing into an social isolation and
eccentriciy.
UNEVEN DEVELOPMENT: whilst the gifted child’s intelligence is very high, his/her emotional development is
likely to be at a normal level. However, adults may (unreasonably) expect the child to have high emotional
maturity because of his/her high level of intellectual development. When the child then has the normal
emotional tantrums that most children of his/her age have, he/she may be WRONGLY LABELLED AS
HAVING A BEHAVIOURAL PROBLEM.
PERFECTIONISM: the high praise the gifted chid will inevitably receive from school teachers etc. can lead to
the child setting him/herself excessively high standards. He/she may become a perfectionist and perceive
he/she has failed even when, objectively speaking, he/she has actually performed exceedingly well, and,
therefore, when he/she gets the objectively accurate feedback, he/she may come to start distrusting it.
ROLE CONFLICT: if the highly gifted child is male, he may well be in a school in which the prevailing culture
means it is the boys who are ’macho’ and good at sport etc. who obtain the approval and admiration of their
peers. If the gifted child happens, for example, to be more interested in intellectual pursuits, such as poetry or
chess, this can lead to ridicule and bullying.
INAPPROPRIATE ENVIRONMENTS: the gifted and highly intelligent child will often find that the school year
group he/she is in is not challenging enough and the pace of the learning is unsuitable. This can lead to
frustration, withdrawal and behaviour problems.
ADULT EXPECTATIONS: the gifted child may find him/herself pushed very hard by his/her parents and by
the teachers of every subject he/she is taking. In the reverse situation to the one described above, here the
child finds he/she is unable to satisfy all these demands and is unable to put in the extra effort expected in
relation to such a large array of subjects. This can result in the child’s OWN SPECIAL AREA OF INTEREST
being overlooked; indeed, it may well be better if the child focuses the extra effort mostly in just his/her
favoured area.
SELF-DEFINITION: the very gifted and intelligent child will tend to have an INTENSELY ANALYTICAL
approach to life; this can result in early, highly critical self-analysis. When coupled with his/her perfectionism
and the unreasonable expectations of adults, this can lead to identity problems.
Support for gifted children in the U.S. can be found at : http://www.us.mensa.org/learn/giftedyouth/
And for the U.K. it can be found at:http://www.mensa.org.uk/mensa/gifted and talented support.html
Why We Worry.
Other posts in this category have already dealt with how early life experience of trauma can contribute to us
becoming anxious adults, and, also, that the type of negative thinking (cognitive) style we may have
developed as a result of the early trauma can perpetuate symptoms of depression and anxiety. But what are
the other causes of excessive worrying and what are the other ways of dealing with the problem? It is to this
question I now turn:
CAUSES OF ANXIETY/EXCESSIVE WORRY:
1) OUR GENETIC INHERITANCE: It seems we can inherit a predisposition towards anxiety genetically. This
means, for example, if we have a parent who is very anxious, all else being equal, we are more likely to
become anxious ourselves due to our genetic inheritance. (Also, of course, if we have a very anxious parent,
we are more likely to develop anxious responses due to ’learned behaviour’ - ie modelling our behavioural
reponses on those of the anxious parent). However, the key word here is ’predisposition’; in other words,
having an anxious parent will not guarantee that we, ourselves, will become anxious adults, but, rather, we
will be more vulnerable to this happening if other factors also affect us in life (such as those detailed below):
2) LATER LIFE EXPERIENCES: If we have suffered the experience of early life trauma, the damage done by
this can be compounded (made worse) by going on to experience yet further trauma in later life. It is
particularly unfortunate, then, that early life trauma can in itself create problems for us in later life, thus
increasing the probability that further trauma will strike (which is one reason, amongst many others, why early
therapeutic intervention is crucial for those affected by childhood trauma).
3) DRUGS: It is not just a side-effect of many illicit drugs which can create anxiety conditions; some
prescribed drugs, too, can cause anxiety as a side effect. It is, of course, always important to ask doctors
about possible unwanted effects of the medications they may prescribe.
4) INTERNAL CONFLICTS: Sometimes we behave in ways which CONFLICT with our own ideals and
values, or the ideals and values we have INTERNALISED from our upbringing and culture (even if we have
only internalized them on an unconscious level). Freud believed we all have such internal conflicts, a price he
thought was paid for living in a ’civilized’ society, in which we are compelled to repress many natural human
instincts (for those who are interested, you may wish to investigate further Freud’s view of how the ’Id’ (the
name he gave to our instinctual self/basic impulses) and the ’Superego’ (the name he gave to our
conscience/moral selves, which develops due to learning from parents, teachers, society, culture etc) may be
constantly ’at war’ with each other.
Therapists who place emphasis on the link between INTERNAL CONFLICTS and ANXIETY tend to
recommend what is known as PSYCHODYNAMIC PSYCHOTHERAPY.
5) NEUROLOGICAL FACTORS: This refers to how the brain we possess is physically set up or ’wired’ Some
of us are, it seems, ’wired’ in such a way that our ’internal alarm systems’ are highly sensitive. I have
discussed in other posts how the brain’s physical ’wiring’ can be affected by the experience of early trauma.
The technique of hypnotherapy can be very effective at helping us to conquer our worries and reduce our
anxiety :
TO FIND OUT MORE ABOUT HYPNOSIS, HERE IS A LINK TO A RECOMMENDED HYPNOTHERAPY
BLOG TO WHICH THIS SITE IS AFFILIATED : http://www.hypnosisdownloads.com/blog/feed/?a=5719!blog
A Closer Examination of The Effects of Childhood Trauma. Part One.
It has been stated in several of the articles in this eBook that our childhood experiences have an incalcuably
large effect on how we develop later on in life, and, in particular, the quality (or lack, thereof) of the
relationship we had with our parents. Research has informed us that the effects of early, adverse experience
may permeate and poison major areas of the affected individual’s life later on in life.
I’d like to start by recapping the major areas of a person’s life that the experience of childhood trauma may
affect; these effects can last for many, many years, and, if effective treatment is not assiduously sought and
implemented, even a whole life-time :
1 - the individual’s ability to regulate (control) emotions
2 - the individual’s capacity to form lasting relationships and integrate/interact in an appropriate manner
socially.
3- the individual’s behaviour
4- the individuals cognitive ability (thinking skills) and achievements related to this
5- the individual’s physical health
In PART ONE of this post, I will look only at numbers 1 and 2 above. Numbers 3,4 and 5 will be examined in
PART TWO.
Let’s examine each of these in turn:
1) THE INDIVIDUAL’S EMOTIONAL HEALTH - Effects of childhood trauma can, and frequently do, lead to
the individual developing a perpetual and pervasive sense of unease, fearfulness and anxiety in later life.
Often, in an attempt to reduce these distressing feelings, the individual may WITHDRAW FROM
INTERACTING WITH OTHERS. In earlier childhood, such anxiety may have expressed itself through
self-harm such as hair pulling or creating lesions (sometimes with a knife) to the flesh.
If early stress in life has been protracted in nature, sleep disruption (eg constant waking, vivid, intense
nightmaers etc) may frequently develop.
If some of the trauma in childhood was of a particularly intense nature, it may also lead to ’flashbacks’ in later
life, together with the types of nightmares mentioned above.
In later life, too, the individual who has experienced childhood trauma may develop a constantly ’flat’ mood,
devoid of excitement or joy; indeed, the ability of the brain (this need NOT be permanent) to feel positive or
pleasant emotions may be completely lost (psychologists term this type of joyless, ’flat’ emotional state, in
which the brain loses its ability to create positive feelings, ANHEDONIA). A mental state such as this will also,
often, be accompanied by intense feelings of (usually irrational) GUILT.
However, some may be emotionally affected in a different way : as a result of having suffered childhood
trauma the affected individual’s emotions may become HIGHLY VOLATILE and UNPREDICTABLE. The
individual may become very quick to anger. and, also, as a result, s/he may develop a reputation as someone
who is EMOTIONALLY UNSTABLE and prone to EXTREME EMOTIONAL OVER-REACTIONS. The term
’over-sensitive’ may also be freely banded, in relation to the suffering and hurt individual, by incomprehending
and bemused others, and they are likely, sadly, to ’wash their hands’ of the individual, preferring not to invest
time attempting to get to the root of things and offer help and support.
As the individual who has experienced childhood trauma gets older, CHRONIC FEELINGS OF INTENSE
EMOTIONAL DISTRESS MAY DEVELOP. Relentless anxiety, which will, invariably, be a significant
component of such distress, may, too, lead to a state of constant exhaustion and dibilitating fatigue. This, in
turn, may well lead to DEPRESSION; the depression may, itself, then lead to alcoholism or misuse of other
mood altering substances.
Finally, as a result of severe childhood trauma, DISSOCIATIVE (see my post on DISSOCIATION) symptoms
may appear; when dissociative symptoms do develop, research suggests that such symptoms are linked to
EXCESSIVE ANGER and LOW SELF-ESTEEM.
2) THE INDIVIDUAL’S CAPACITY TO FORM GRATE/INTERACT APPROPRIATELY SOCIALLY in life, with
respect to their social functioning, in different ways. These include: LASTING RELATIONSHIPS AND INTE
- Different individuals will be affected later
- becoming very withdrawn (tragically, this may lead to them being perceived as sullen, morose and
unlikeable, which is then likely to lead on to SOCIAL REJECTION , and, even, perhaps, total
OSTRACISISM).
- becoming ’difficult’ (frequently, this also has damaging knock-on effects, such as conflict with others, and,
thus, as above, social rejection)
- becoming easily angry at other people to ’push them away’ (often this will operate on an unconscious level)
: the individual may have been so denigrated by others in childhood that s/he has been made to feel
worthless and ashamed (having INTERNALIZED THE VIEW OF HIM/HER THOSE CLOSE TO HIM/HER
HAVE TAKEN - as a result, very often, of PROJECTING THEIR OWN GUILT onto him/her (who may well
have been turned into A CONVENIENT FAMILY SCAPEGOAT, deflecting the need for other family members
to examine their own consciences).
- in adulthood, too, sexual promiscuity may also develop, possibly (and, again, unconsciously) in a (futile)
attempt to gain attention and love.
Childhood Trauma: Does ’Multiple-Personality Disorder’ Exist?
I have written other posts on DISSOCIATIVE DISORDERS of which one is DISSOCIATIVE IDENTITY
DISORDER, commonly referred to as ’MULTIPLE PERSONALITY DISORDER. I will not repeat what I’ve
already said in other posts, but, essentially, DISSOCIATIVE DISORDERS refer to the idea that, under
enormous stress, some people will ’cut off’ (dissociate) from unbearably painful reality (as they perceive it) as
a psychological defense mechanism.
In the interests of fairness, I have decided, in this particular post, to look at arguments AGAINST one specific
dissociative disorder, namely DISSOCIATIVE IDENTITY DISORDER (D.I.D), or, MULTIPLE PERSONALITY
DISORDER. My own position, for what it’s worth, is one of neutrality.
Although there is a sound and quite compelling theory behind why D.I.D should occur, together with research
evidence which purports to support its existence and the idea it is often caused by severe childhood trauma,
critics point out weaknesses in this ’supportive’ research evidence. For example, whilst a correlation has
been shown to exist between its reported existence and experiences of childhood trauma also reported by
the sufferer, it has been pointed out that a correlation does not necessarily imply causality (as all beginner
statisticians know). In other words, just because a person who has reported suffering from D.I.D and also
reports having suffered severe childhood trauma, this does not prove that the latter has CAUSED the former.
Some critics go a step furter in their skepticism, and challenge the idea that D.I.D. exists at all. They draw our
attention to the fact that much of the ’evidence’ (I use inverted commas in representation of the critics’
stance) for its existence derives from patient self-reports, as does the ’evidence’ that they’ve suffered severe
childhood trauma. Often, such ’evidence’ goes entirely uncorroborated.
It has been suggested, even, that in order to support their own theoretical frame-works (which they may have
a vested interest in preserving) some psychotherapists may put the idea of the condition into the patient’s
head, especially if they use hypnosis as one of their therapeutic tools (the suspicion being the idea of the
condition’s existence is given to the patient through suggestion - individuals tend to be, after all, particularly
suggestible whilst under hypnosis.
Furthermore, it has been stated that the media must bear some responsibility; many novels and films, after
all, have plot lines revolving around a character with ’multiple personality disorder’. It is said that this does not
only fuel the idea of its existence in the public’s imagination, but it may even give certain disturbed individuals
’the idea’ and they may, in some sense at least, mimic the symptoms they have learned about from such
media. Such critics have even suggested the individual purporting to have the condition is doing so in a
desperate bid for attention.
I must stress again that my own position is neutral, and, in the interests of such neutrality, I shall conclude by
pointing out that very recent research has supported the genuineness of the condition. These researchers
have also clearly stated that D.I.D. is likely to serve an adaptive and protective function as a
defense-mechanism against intolerable mental anguish, as suggested in my opening paragraph.
A Closer Examination of The Effects of Childhood Trauma. Part 2
In Part One I looked at how childhood trauma can adversely affect an individual’s ability to control his/her
emotions and his/her ability to maintain relationships and interact socially.
In this post, Part 2, I wish to look at how 3 other areas of the individual’s functioning may be adversely
affected by the experience of childhood trauma. These are:
- Behaviour
- Physical Health
- Cognitive Functioning (thinking skills).
Let’s look at how each of these 3 areas of functioning may be negatively affected now:
BEHAVIOUR - Because the effects of childhood trauma are so complex, it is not possible to fully articulate
them; a demonstration of their effects, then, may frequently be ’acted out’ through DISTURBED
BEHAVIOUR. Some individuals may become withdrawn and emotionally ’flat’, others may become disruptive,
aggressive, hostile and attention seeking.
PHYSICAL HEALTH - Sometimes, a secondary effect of emotional distress may express itself physically - in
other words, the individual may develop psychosomatic symptoms (the term ’psychosomatic’ refers to the
mind’s effects upon the body - chronic and severe stress, in other words, can create physical symptoms; it is
important to point out here that, just because a physical symptom is psychosomatic, it does not make that
symptom any less real or harmful than physical symptoms caused by non-psychological factors).
What sort of physical symptoms can occur as a result of protracted and intense stress? Examples can
include changes in appetite, insomnia, headaches and stomach aches, although this list is not an exhaustive
one.
COGNITIVE (THINKING) SKILLS - Severe and chronic stress can impair an individual’s ability to think
clearly, concentrate and learn; these impairments mean that the individual will be unable to live up to his/her
potential. This can result in difficulties maintaining employment; if this happens, self-esteem and
self-confidence are often adversely affected.
CONCLUSION - It is important to point out that just because an individual does display symptoms like those
described above, it does not mean for certain that the affected individual has suffered extreme childhood
trauma. However, because the symptoms signal great distress, it is likely that if childhood trauma is not
responsible, other serious stressors are at play.
Childhood Trauma Leading to Excessive Need for Approval.
If we did not receive approval from those close to us in childhood we may grow up to have an excessive need
for it from others later in life as a kind of compensation and in order to raise our shattered self-esteem. This
can make us vulnerable and excessively anxious to make everybody like us and admire us. Of course, this is
impossible to achieve. It is just not possible to interact fully in society without sometimes experiencing
disapproval and rejection. Very often, such rejection and disapproval does not mean that there is anything
particularly wrong with us. Indeed, it could be much more to do with failings in the other person, obvious
examples are prejudice, discrimination, biased and irrational thinking or misdirection of emotions which were
not originally generated by us (eg ’displacenment’ - the psychological term for when somebody takes
something out on us which was not our fault; or ’projection’ -the psychological term for constantly ’seeing’ in
other people the things we don’t like about ourselves and may have repressed). Frequently, too, a person’s
behaviour towards us might be due to distorted beliefs stemming from psychological wounds that have been
inflicted upon them in the past (eg a woman who distrusts men because her husband used to beat her).
When we are (inevitably) sometimes rejected, a useful exercise is to calmly think about why we have been
responded to in a negative manner and analyze if it really was something to do with us or to do with
something else not really connected to us. For example, perhaps the person who behaved in a negative way
towards us was over-tired or under a great amount of stress. In such a case, the disapproval is likely to be
ephemeral, in any event, and something we do not need to dwell upon or take personally.
Obviously, when someone rejects us it does not mean that we are of no value. Even if we have done
something wrong, one action or set of actions does not define us as a person (either in the present or in the
future). To become defined in such a way would be absurdly limiting and simplistic. Human beings are, after
all, complex creatures (hence expressions like : ’he’s the sum of his contradictions’).
Individuals who have an excessive need for approval often feel that it is imperative that EVERYBODY
approves of them. I repeat, this is impossible, and, in my view, undesirable (often, history has shown us, the
most enlightened and edifying views can meet with vicious opposition). We do not need the approval of
everyone we meet in order to live a happy and meaningful life. Also, other people’s views of us should not be
given equal weight (eg most of us would value the view someone we respected had of us more than the view
a stranger had).
It is also important to point out that we can sometimes feel hurt and upset if someone criticizes us in a
mannner which we do not feel is warranted - to avoid falling into such a trap we need to remind ourselves that
we need not let our mood be affected adversely by something negative someone says about us if we know it
not to be true.
Finally, it is worth saying how it might be helpful to react when someone disapproves of us when we HAVE
done something we regret. A constructive response might be as follows:
a) we can learn from the criticism
b) just because we know we have done something wrong, it is illogical to overgeneralize from this and view
ourselves as a wholly bad person
c) accept that we feel temporarily uncomfortable but to keep in mind, too, that this feeling will pass and that
we are not necessarily being totally written off as a person by the individual we have upset, let alone by
everybody else for evermore!
Hypnotherapy can be very useful in helping us to overcome the need for approval, by, for instance, helping
us to raise our self-esteem :
Latest Research Leads to New List Of Main Borderline Personality Disorder (BPD) Symptoms: The List
Recent research has led to an expansion of the description of the main symptoms of BPD. Following the
development of the Sheldern Western Assessment Procedure 200 (an assessment tool which includes 200
questions that aid in the diagnosis of BPD) experts, based on up-to-date research, have now developed a
much more detailed and comprehensive list of symptoms of BPD than used to be the case. The list is
published in a book by Patrick Kelly and Francis Mondimore -called Borderline Personality Disorder - New
Reasons For Hope - who are experts in the field of BPD. I reproduce the list of symptoms in full below:
SYMPTOMS OF BPD SUFFERERS:
- FULL OF PAINFUL AND UNCOMFORTABLE EMOTIONS : unhappiness, depression, despondency,
anxiety, anger, hostility.
- INABILITY TO REGULATE EMOTIONS : emotions change rapidly and unpredictably; emotions tend to
spiral out of control leading to extremes in feelings of anxiety, sadness, rage, excitement; inability to
self-soothe when distressed so requires involvement of others ; tends to catastrophize and see problems as
unsolvable disasters ; tends to become irrational when emotions stirred up which can lead to a drop in the
normal level of functioning ; tends to act impulsively without regard for the consequences
- BECOMES EMOTIONALLY ATTACHED TO OTHERS QUICKLY AND INTENSELY : develops feelings and
expectations of others not warranted by history or context of the relationship ; expects to be abandoned by
those s/he is emotionally close to ; feels misunderstood, mistreated and victimized ; simultaneously needy
and rejecting of others (craves intimacy and caring but tends to reject it when it is offered) ; interpersonal
relationships unstable, chaotic and rapidly changing.
- DAMAGED SENSE OF SELF : lacks stable self-image ; attitudes, values, goals and feelings about self may
be unstable and changing ; feels inadequate, inferior and like a failure ; feels empty ; feels helpless,
powerless and at mercy of outside forces ; feels like an outsider who does not belong ; overly needy and
dependent ; needs excessive reassurance and approval.
Quite a list! These symptoms, in my case, ring all too familiar sounding bells ; so much so, in fact, that a set
of ear-plugs would not go amiss. Actually, I feel exhausted just by having typed the list out! I think I’ll go and
have a lie down.
Childhood Trauma : Defense Mechanisms Resulting from Stress.
In response to stress resulting from our childhood trauma and other factors we often develop psychological
DEFENCE MECHANISMS in an attempt to protect ourselves (though, very often, we are not consciously
aware that many behaviours/defence mechanisms we have developed have developed in order to try to
reduce the adverse effects of stress (though not all, eg CONVERSION - see below). Often, however, the
behaviours we develop which serve as these defence mechanisms to protect ourselves against stress are, at
best, unhelpful, and, at worst, extremely damaging. I list and give a brief description of the main defence
mechanisms that may develop below:
1) COMPENSATION: this behaviour occurs to offset a weakness or failing in ourselves eg someone who has
very low self-esteem becoming a workaholic in an attempt to gain social status.
2) CONVERSION : anxieties can be CONVERTED into physical symptoms eg racing heart, sweating, high
blood pressure, psychosomatic illnesses.
3) DENIAL : this defence mechanism is well known and the term has entered into the realms of popular
vocabulary. It refers to a situation in which someone will not acknowledge something is wrong (eg after being
told by a doctor one has only 3 months to live).
4) DISPLACEMENT : this is when we transfer the emotions we feel caused by one person onto somebody
else who has nothing to do with how we’re feeling eg a man badly treated by his boss at work coming home
and taking his anger and frustration out on his children.
5) DISSOCIATION : this is when we avoid examining how our behaviours relate to our beliefs by avoiding
looking, too closely, at this relationship eg seeing ourselves as caring and compassionate but doing little or
nothing to help others
6) FIXATION : this is when we have behaviours which stay fixed at an earlier stage of development and are
therefore not appropriate to the life stage the individual is at eg a middle-aged remaining highly emotionally
dependent upon his parents
7) IDENTIFICATION : this is when we behave, dress etc in a way which duplicates the way the person we
are modelling ourselves on would behave and dress etc (this can occur on both conscious and unconscious
levels and is not considered abnormal in young people).
8) INTROJECTION : this is when we turn our feelings towards others onto ourselves. Freud, for example,
believed someone who is clinically depressed has, unconsciously, turned his/her anger with another/others
onto himself and is, therefore, in effect, punishing him/herself with his/her depressive feelings in a way he/she
unconsciously wishes to inflict upon others.
9) INVERSION : this is where we REPRESS a desire which we are uncomfortable having and act in a way
which expresses the opposite eg a repressed homosexual who acts in an obsessively homophobic manner.
This often occurs on an unconscious level.
10) PROJECTION : this is really the opposite of introjection (see above). It is where we constantly see faults
in others which we, ourselves, are ashamed of and feel guilty about having eg constantly pointing out
selfishness in others when we ourselves are ashamed of our own selfishness. Again, this can occur on an
unconscious level.
11) RATIONALIZATION : this is when we, in effect, deceive ourselves and tell ourselves that something we
have, in fact, done due to bad motives we have really done for socially acceptable reasons eg a man who
divorces his wife and leaves his young family may tell himself it’s in the best interests of everyone, when,
really, deep down, he is doing it purely in his own innterest
12) REGRESSION : this is when we go back to behaving in a way that is no longer appropriate and would
usually only occur at a much younger age eg a middle-aged man having a child-like tantrum.
13) REPRESSION : this is when we, unconsciously, bury feelings and attitudes which are unacceptable to
us, and contrary to our moral beliefs, deep in the mind away from conscious access eg an illicit sexual
attraction. When we consciously bury feelings that we are not comfortable with (often referred to in popular
language as ’putting something to the back of our mind’) it is called SUPPRESSION.
14) RESISTANCE : this is where there is a barrier between what we have repressed/banished into the
unconscious mind. In other words, what we have repressed is not allowed conscious access. Freud believed
this process meant the psychological tension produced by keeping the feeling, memory etc repressed can’t
be resolved and so perpetuates the emotional pain that the individual is feeling.
15) SUBLIMATION : this is where the energy associated with feelings that are unacceptable to us (usually
sexual, according to Freud) and buried in the unconscious mind is channeled into something else that is
socially acceptable. Unlike many of the other defence mechanisms that I have described, this can be very
positive, and, even, Freud thought, produce great art.
16) TRANSFERENCE : this is where feelings and emotions we have about a particular individual are
transferred onto somebody else who was not the original cause of them. For example, an individual in
therapy who transfers the feelings of hatred he feels towards his mother onto the therapist.
17) WITHDRAWAL : this is when we just cut off from a stressful situation, give up, lose interest and become
apathetic eg a man who stops trying to make conversation with his wife or take any interest in her after the
relationship has been very difficult for a long period of time and he can no longer cope with it
A Closer Look at the Link Between Childhood Experience.
One of the things that frequently marks the childhood of individuals who later develop BPD is LOSS,
especially when the loss has occurred as a result of death, divorce or serious illness (necessitating long
periods in hospital). In one particular research study looking at this, it was found that three-quarters of those
suffering from BPD had experienced such losses in childhood.
Abuse also plays a large part in the development of BPD. One study found that 75 % of those suffering from
BPD had experienced sexual abuse during their childhood compared to 33 % of those who suffered from
other psychiatric conditions.
However, it is not just obvious trauma in childhood that is linked to the later development of BPD. More subtle
forms of problematic parenting also put the child at risk. Examples of this include:
- the parent/s emotionally withdrawing from the child
- inconsistent parenting (eg praise and punishment being distributed in an UNPREDICTABLE manner)
- parent/s discounting, belittling or ignoring the child’s feelings
Another form of problematic parenting which has been linked to the child later developing BPD include:
- the parent behaving too much like a friend rather than a responsible, caring figure
- turning the child into a CONFIDANT
- role reversal : treating the child like a parent
OBJECT RELATIONS THEORY:
Parenting problems are so closely tied to putting the child at risk of later developing BPD because as
illustrated, for example, by object relations theory, the way a parent brings up a child has a critical influence
on the way the child develops, especially in relation to the following:
- how the child goes on to see him/herself (self-identity, self-concept)
- how the child goes on to view others
- how the child goes on to deal with relationships (functioning in this area often becomes deeply impaired).
The theory suggests, then, that problematic parenting can lead to the child developing identity problems later
on together with problems of self-image (affected children will often later develop a view of themselves as
’bad’, or, even, ’evil’) with concordant effects upon behavior. Often, also, a feeling of profound
HELPLESSNESS will develop.
In relation to how the affected child sees others, certain patterns have been found to emerge. For example,
the child may develop into an adult who deeply mistrusts those in authority, viewing them as overwhelmingly
vindictive, malicious and punitive. Interestingly, also, however, there can develop a tendency to IDEALIZE
people of importance to him/her in the initial stages of knowing them; because, however, this is likely to lead
to UNREALISTIC EXPECTATIONS of the one who has been idealized (especially in relation to them - the
idealized one, that is - being able to protect and nurture them) when these high expectations are not lived up
to the failure gives rise to feelings of having been BETRAYED in the one who had those expectations.
In conclusion, it should be pointed out that a very difficult childhood does not guarantee the later development
of BPD, but risk is elevated if the individual also has a genetic disposition to developing emotional problems.
The Vicious Cycle of Adult Problems Stemming from Childhood Trauma
’WE NEED TO SEE THE SYMPTOMS WE HAVE AS A RESULT OF OUR CHILDHOOD TRAUMA LESS AS
THE RESULT OF SOME CHARACTER FLAW, AND MORE AS THE RESULT OF HAVING SUFFERED
EXTREME AND PAINFUL EXPERIENCES WHEN WE WERE LEAST ABLE TO COPE WITH THEM. BY
CONSIDERING THE IDEA THAT OUR SYMPTOMS COULD BE SEEN AS NORMAL REACTIONS TO
ABNORMAL AND TRAUMATIC EVENTS IN CHILDHOOD, IT IS POSSIBLE TO USHER IN THE IDEA OF
CHANGE.’
- CHARTED CLINICAL PSYCHOLOGIST AND EXPERT ON EFFECTS OF CHILDHOOD TRAUMA.
People who have suffered childhood trauma frequently go on to develop multiple problems in adult life which
tend to build up over the long-term. A range of difficulties like the ones given in the fictional scenario below
would not be untypical:
Losing interest in school and unable to concentrate resulting in leaving at age 15 ; becoming disruptive and
difficult leading to home-life problems, so leaving home at 16 ; this could then lead to homelessness or
insecure housing (eg sleeping on friends’ sofas) ; depression and unsettled life style and lack of direction
could then lead to abuse of drugs and alcohol ; unable to hold down job for long (eg due to having problems
getting on with authority figures (stemming from problems with relationship in childhood with parent/s) and
inability to accept criticism (eg becoming angry and aggressive when criticized, this, again, stemming from
earlier relationship with parent/s, perhaps because they were physically abusive leading to a an intense need
to ’stand up for self’ and protect self).
The above example of how life can unravel as a result of childhood trauma, a whole string of problems
feeding in to one another and compounding one another, are likely, too, to be underpinned by feelings of
LOW SELF-ESTEEM, EMOTIONAL INSTABILITY and EMOTIONAL SCARS, A POOR SENSE OF OWN
IDENTITY, AN INABILITY TO TRUST AND ’PUT DOWN ROOTS’ - all these factors, also, stemming from the
problematic childhood.
STOPPING THE VICIOUS CYCLE : The key to BREAKING OUT OF THE VICIOUS CYCLE IS TO BECOME
AWARE AND RECOGNIZE THAT OUR PROBLEMS IN ADULT LIFE HAVE THEIR ROOTS IN OUR
DISTURBED CHILDHOOD. By doing this, we can begin to understand that our unhelpful behaviours are
rooted in our disturbed childhood and start to discard them. By understanding the enormous, destructive
impact the past has - up until now - had upon our life, we can begin to loosen the past’s invidious grip on us.
We need to understand that our traumatic childhood experiences have affected how we THINK, FEEL and
BEHAVE as adults. Apart from all the potential effects I have already described, our disturbed childhood is
likely, too, to have had a VERY ADVERSE IMPACT UPON THE RELATIONSHIPS WE HAVE HAD, SO
FAR, IN ADULTHOOD, perhaps due to feelings of FEAR, SHAME, FRUSTRATION, MOOD DISORDERS,
ANXIETY and DEPRESSION. Again, these symptoms will almost certainly have their roots in our adverse
childhood experiences.
LEARNING NEW WAYS OF COPING : Because our childhood experiences, the effects of which then
become compounded by the adult experiences we have which stem from these childhood experiences, we
are likely to have suffered EXTREME EMOTIONAL DISTRESS in our adult life, at worst leading to such
horrors as compulsive self-harm and suicide attempts. Due to such intolerable distress, we are likely to have
turned, in desperation, to any WAYS OF COPING possible. Often, these will have been unhelpful in the
long-term and will have made matters yet worse. The coping mechanisms may have included alcohol abuse,
drug abuse, withdrawal from society etc. These coping mechanisms may have become habits which we find
difficult to change. We may, too, have become so enmeshed in the damaging life-style we now find ourselves
in, it is difficult to step back and reassess why we are suffering our futile, negative, repeating pattern of
thoughts, feelings and behaviour.
Often, the only viable option will be to seek therapy and start the process of stepping back, understanding
how our lives have become as they have, stop blaming ourselves and feeling bad about ourselves, and,
gradually, seek new and more positive ways of approaching life.
We may have come to see the personal characteristics we have displayed up until now (our anxiety, our
depression, our bleak outlook, our problematic relationships etc, etc) as just ’who we are.’ This, though, is a
mistake which will only perpetuate matters. We need to detach these SYMPTOMS of our traumatic childhood
from our TRUE IDENTITY. We may need to realize we are not ’bad’ even though are childhood experiences
and the symptoms they have caused may have made us (FALSELY) believe that we were ’bad’.
CONCLUSION : AN IMPORTANT NOTE OF CAUTION:
Those who played a part in causing the childhood trauma (parents, step-parents, siblings etc) will often
ENTER A STATE OF DENIAL to PROTECT THEMSELVES FROM THEIR OWN GUILT. It will often suit
them to regard you as ’innately bad’, and to regard this ’badness’ as having nothing whatsoever to do with
their treatment of you. Freud, of course, would regard this as a flagrant example of the psychological defense
mechanism known as PROJECTION. I am inclined to concur.
Childhood Trauma : Its Link to Later Psychosis.
’The psychiatric profession is about to experience an earthquake that will shake its intellectual
foundations...there is tectonic, plate-shifting evidence’ (for the environmental basis of psychosis)
Oliver James (leading UK psychologist).
Comment in relation to the now overwhelming evidence that psychosis is strongly related to childhood trauma
and the need to stop over-focusing on biological causes.
There is now extremely strong research evidence showing the link between childhood trauma and the
affected individual’s likelihood of developing PSYCHOTIC ILLNESS in later life.
It is, of course, already well-established that there is a powerful link between childhood trauma and
psychiatric conditions which include depression, anxiety, substance abuse, eating disorders, post traumatic
stress disorder, sexual dysfunction, personality disorder, dissociation and suicidal ideation. Now, however, it
is becoming increasingly apparent that there is also a strong link with psychotic conditions such as BIPOLAR
DEPRESSION and SCHIZOPHRENIA.
A plethora of evidence is now demonstrating the very high prevalence of experiences of severe childhood
trauma in psychiatric patients who are suffering from psychotic illnesses
Indeed, many leading psychologists are arguing that researchers have neglected the importance of childhood
experiences in relation to psychotic illness in the past. Here, then, I present some recent research which
helps to redress the balance:
- Read et al reviewed 51 previous studies on causes of psychotic illness and found that 69 % of female
psychotic patients and 59 % of male psychotic patients had suffered severe childhood trauma. It was also
pointed out by the researchers that these figures, although already extremely high, may be
UNDERESTIMATES due to the fact that experiences of child abuse are well known to be under-reported.
- Bebbington et al : these researchers, examining data generated from 8500 individuals, found that those
suffering from psychosis were approx. 15 times more likely than the mentally well to have suffered severe
childhood trauma.
- A Dutch study of 4000 patients found that those who had suffered severe childhood trauma were approx. 11
times more likely to have developed psychotic conditions in later life.
- A Californian study found that those who had suffered severe childhood trauma were 5 times more likely to
have gone on to experience HALLUCINATIONS in later life.
HOW IS CHILDHOOD TRAUMA THOUGHT TO LEAD TO PSYCHOTIC CONDITIONS?
- COGNITIVE THEORY: Due to adverse childhood experiences, the individual develops what is called a
NEGATIVE COGNITIVE TRIAD of beliefs; these are:
- a negative view of self
- a negative view of others
- a negative view of the world in general
More specifically, beliefs such as the following are likely to develop:
- I am vulnerable
- others cannot be trusted
- the world is dangerous
Such beliefs can become so ingrained and severe that they eventually manifest themselves in the guise of
psychotic symptoms eg PARANOIA.
- AFFECT OF CHILDHOOD TRAUMA ON THE BRAIN: Research is showing that extreme stress in
childhood can adversely affect the physical development of vital brain regions responsible for emotional
control (eg the AMYGDALA) which can lead to extreme emotional dysregulation (INABILITY TO CONTROL
STRONG EMOTIONS) and comcomitant oversensitivity and emotional over-reactivity. If the problem
becomes sufficiently intense psychotic conditions may result.
IMPLICATIONS:
It is thought a new, over-arching theory of the causes of psychosis (known in scientific circles as a
PARADIGM SHIFT) is likely take root in the field of psychiatric research - namely one that emphasizes the
enormous importance of adverse childhood experiences.
It is argued that patients who present with psychotic symptoms should ROUTINELY undergo DETAILED
ASSESSMENTS relating to their childhood experiences and that there should be a much greater emphasis
upon the importance of psychological therapy (as opposed to drug therapy- so popular up until now- based
upon theories of the biological origins of psychotic conditions).
How Is a Personality Disorder Defined?
In order to address this question, it seems sensible to first outline what psychotherapists mean by a
HEALTHY personality. In general, one would expect someone with a healthy personality to exhibit the
following characteristics:
- an ability to engage in satisfying personal relationships
- generally has age-expected thoughts and feelings
- can function relatively flexibly when stressed
- has a clear sense of own personal identity
- are generally well-adapted to their own particular set of life circumstances
- don’t generally experience significant distress or impose it on others
An UNHEALTHY, or DISORDERED PERSONALITY, in stark contrast to the above, will display a personality
characteristic, or, far more frequently, a group of personality characteristics (or TRAITS, as they are referred
to by psychologists), so extreme as to be way outside the normal range of experience and to subsequently
cause the person suffering from the personality disorder SERIOUS PROBLEMS FUNCTIONING IN NEARLY
ALL AREAS OF THEIR LIVES.
Problems encountered by the personality disordered individual will often include:
- an inability to maintain relationships
- an inability to interact successfully in the work-place (eg problems with authority)
- inability to integrate successfully into the community
- inability to provide (consistently, or at all) for self
We need not be surprised to learn, given these life-ruining problems, that a person with a disordered
personality will, almost invariably, be unhappy, frustrated, angry, and, quite possibly, at times, suicidally
distressed.
As if this abject state of affairs were not enough for our heroic sufferer to contend with, the personality
problems s/he exhibits will tend to make others impatient, uncomfortable and angry. In short, the person with
a personality disorder will frequently alienate, and even make enemies, of others. The irony, of course, is that
the sufferer will often have a profound need for the acceptance and support of the very people s/he seems so
intent on driving away. It is a tragedy, however, that terror of rejection (stemming, frequently, from
psychologically devastating rejection in childhood from those supposed to be in the role of primary-carers) will
prevent this from being articulated.
In order to avoid the tremendous difficulties which result from having a personality disorder - a tormented,
emotionally impoverished and deeply lonely life, it is essential to seek therapy. The problems a personality
disorder gives rise to tend to interact with, and aggravate, each other (I’ll look at this in detail in my later
articles) in such a way that the sufferer will often find him/herself caught in a vicious downward spiral from
which it is almost impossible to escape from without intervention by professionals highly trained and
experienced in the relevant area of psychiatric care.
What Studies on ’Unloved’ Rats Tell us about Effects of Childhood Trauma (2013-07-09 09:47)
It is being increasingly recognized by research psychologists that the environment we are brought up in has a
critical effect upon our later development and functioning. As in all areas of medical research, animal studies
play a vital role in helping us to understand the possible causes of human psychological pathology.
Key studies on how early experiences can have adverse effects on psychological functioning have been
conducted on rats. In one important study, it was found that baby rats who were raised by mothers who
showed them little affection (affection in the rat world being demonstrated by licking) and were rarely licked
by their mothers incurred damage to the way in which their brains developed (this was discovered by
dissecting and examining their brains after death).
Baby rats who had been raised by their mothers in an affectionate way, however (ie they received their fair
quota of loving maternal licks), developed completely healthy brains; specifically, they had far more receptors
in a brain region called the HIPPOCAMPUS these receptors, greatly lacking in the ’unloved’ rats, are
considered to be crucial in the role of regulating (controlling and damping-down) stress responses (meaning
they would be much better at tolerating stress in later life).
Further study has demonstrated that a deprivation of affection damages vital DNA strands in rats and it is a
knock on effect of this damage which depletes the quantity of stress reducing receptors in the brain.
It can clearly be inferred from the above findings that the problems the ’unloved’ rats developed with their
ability to tolerate stress as adults was NOT caused by inherited genes, but by damage down to their DNA by
THE ENVIRONMENT IN WHICH THEY WERE RAISED (an environment in which they were deprived of
maternal affection).
The perennial question may be raised in response to the above findings that that’s all very well, but can we
extrapolate those findings to human beings? (my own view, for what it’s worth, is, not least because of our
evolutionary history and the similarities between human brains and those of our furry, nose-twitching,
be-whiskered little ratty friends, is that we can do so quite legitimately). However, for those who remain
unconvinced, related studies have been conducted on human beings . I summarize one such study below:
THE STUDY:
- the study involved the dissection and examination of 36 human brains, post-mortem (obviously)
- of the 36, 12 had died of natural causes (GROUP A) and 24 had died by suicide
- of the 24 who had died by suicide, 12 had suffered serious childhood trauma (GROUP B). The other 12 had
no (GROUP C).
THE FINDINGS OF THE STUDY:
GROUP B (those who had died by suicide AND suffered severe childhood trauma), like the ’unloved’ rats,
were found to have A GREATLY DEPlETED NUMBER OF BRAIN RECEPTORS RELATED TO STRESS
REGULATION/CONTROL. This was not true of groups A and C.
CONCLUSION:
These studies suggest that both rats and humans can incur serious damage to the way in which their brains
physiologically develop, due to early life trauma, affecting their abilities to tolerate stress in later life.
How Borderline Personality Symptoms Reinforce Each Other.
One of the greatest difficulties of managing borderline personality disorder (BPD) is that the symptoms it
creates tend to feed off, and intensify, each other; often this will end in a crisis point at which the affected
individual will become suicidal and/or require hospitalization. Until the disorder is properly treated with the
relevant therapy, the individual is likely to keep experiencing such crisis points throughout his/her life.
In this post, I want to look at how the symptoms of BPD can keep reinforcing and worsening each other,
leading to a downward spiral from which the majority will find it impossible to break free without professional
intervention. In order to do this, it is worth revisiting the main symptoms of BPD:
- almost always full of painful and distressing emotions
- becomes intensely attached to others very quickly, leading to feelings for, and expectations of, others that
are not warranted given the context and/or history of the relationship
- expects to be rejected by those s/he forms an emotional attachment to
- is simultaneously deeply needy of, and rejecting towards, others ; feels deep need of emotional intimacy
with, and caring from, others but then will tend to reject it when it is offered
- interpersonal relationships become unstable and chaotic
- experiences great difficulty in controlling (regulating) emotions which quickly become powerful and
overwhelming ; these frequent powerful, intense, uncontrollable emotions frequently spiral out of control and
then have a very adverse effect upon normal functioning
- inability to self-soothe (it is theorized that this is due to damage to the area of the brain known as the
AMYGDALLA,thought to be caused by severe trauma and high levels of stress during childhood)
- suffers from impulsivity and recklessness
- frequently, or continuously, prone to severe depression and anxiety
- feels, and almost always is (by non-experts), misunderstood
- tends to constantly expect utter and devastating calamity (a mind-set referred to by psychologists as
CATASTROPHIZING, a state of mind cognitive behavioural therapy, and other types of therapy for BPD,
seek to correct).
HOW SUCH SYMPTOMS INTERACT AND INTENSIFY ONE ANOTHER:
Because the symptoms of BPD trap the sufferer in a downward spiral, as I shall illustrate below, it is just
about impossible for individuals to cope with, let alone manage, the condition on their own. Professional
intervention is therefore imperative. Because BPD is frequently misdiagnosed, it is worth noting down
relevant symptoms and presenting them to the relevant professional in advance of an appointment. Also,
there is nothing to prevent one seeking a second (or even third!) opinion. It is important to seek out a
therapist who is expert in the condition and one is, of course, free to ask any potential therapist what
experience s/he has of the disorder, together with their views about treatments (eg medication, talk therapy, a
combination?) What is your own instinct on this? Let the therapist know.
Let’s now look at how the symptoms of BPD may become so mutually, destructively intertwined:
Because the person who suffers from BPD can be in such continuous, painful emotional distress it is very
common for him/her to turn to alcohol or drugs in an attempt to numb these intolerable feelings. The
individual may well then castigate him/herself about this alcohol/drug use, seeing him/herself as an alcoholic
or drug addict which lowers even further his/her already greatly damaged self-esteem. S/he may then seek
psychological support from a friend, but, as a consequence of his/her distress, become clingy and
demanding. In response to this, the friend may set down boundaries which the BPD sufferer interprets as
rejection, thus further lowering his/her self-esteem and causing further painful emotions leading to yet more
excessive drinking or drug taking...
Of course, this is just one example of how symptoms of BPD may unhelpfully feed off each other, though an
almost infinite variety of harmful interactions between other symptoms can be easily imagined. Essentially,
the BPD sufferer LACKS INTERNAL RESOURCES TO COPE WITH MENTAL PAIN AND STRESS, so will
turn, with depressing regularity, to DESTRUCTIVE EXTERNAL RESOURCES such as one-sided
relationships or activities which allow temporary, psychological DISSOCIATION from the emotional distress
being experienced, such as ALCOHOL, DRUGS, PROMISCUOUS SEX or GAMBLING in other words,
maladaptive (unhelpful) coping mechanisms.
As these maladaptive coping strategies continue to aggravate and worsen one another, the BPD sufferer is
likely to become increasingly desperate
and to undertake increasingly self-destructive behaviours. How can s/he break free from this vicious cycle?
Sometimes, as I said in the opening paragraph of this post, hospitalization may be required to interrupt the
cycle; however, this has its negative side: being placed in a psychiatric hospital can significantly worsen, yet
further, damaged self-esteem, making the sufferer feel like a pariah - stigmatized, demeaned, humiliated, and
on the bottom rung of society’s ladder. S/he will also be burdened with the often acute worry of how s/he will
now be perceived by others for having being placed in a psychiatric ward, making him/her less capable still of
finding the confidence to interact successfully with acquaintances, friends and society in general. In extreme
cases (eg when the sufferer is actively suicidal), however, there may, sadly, be little alternative.
Childhood Trauma : Its Link to Narcissistic Disorder
Several of my posts have already looked in some detail at the link between childhood trauma and the
subsequent risk of developing a personality disorder (or disorders) if appropriate psychotherapeutic
intervention is not sought.
Whilst precise mechanisms underlying the link between childhood trauma and subsequent development of a
personality disorder are still being researched, it is a statistical fact that the experience of childhood trauma
and personality disorder are very frequently indeed seen to be ’comorbid’ (this is a psychological term used to
mean existing in the same patient - ie if the patient has a personality disorder, he/she very probably also
experienced severe childhood trauma).
Suffering from a personality disorder has a profoundly damaging impact on a person’s life if it is left
untreated. People who suffer from personality disorders tend to have very rigid, inflexible and damaging (both
to themselves and others) ways of managing vital areas of their lives such as work, relationships and even
leisure time which, naturally, causes a whole host problems.
In this post, I want to look specifically at narcissistic personality disorder.
NARCISSISTIC PERSONALITY DISORDER :
A good place to start is to look at how the DSM-IV (a diagnostic manual used by psychologists and
psychiatrists) defines narcissistic personality disorder. Here’s the definition :
’a pervasive pattern of grandiosity, need for admiration, and lack of empathy’
Other features of narcissistic personality disorder are :
- a grandiose sense of self-importance
- expectations of being treated as special
- extremely fragile sense of underlying self-esteem
The psychologist Masterson (1981) expanded upon the definition to include two particular types of narcissist:
1) the manifest narcissist
2) the ’closet’ narcissist
Let’s look at both of these :
1) the manifest narcissist : similar to the description provided in DSM-IV (above)
2) the ’closet’ narcissist : the person suffering from this disorder tends to present him/herself as timid, shy,
inhibited and ineffective but reveals in therapy elaborate fantasies of a grandiose self
Narcissistic personality disorder is thought to be due to ARRESTED DEVELOPMENT. In therapy s/he will
tend to seek the admiration s/he craves from the therapist, and, if the therapist is skilled and experienced,
s/he will often uncover an array of psychological defense mechanisms which the patient uses to protect
him/herself from unbearable emotional pain. These can include :
1) IDEALIZATION : this is often the primary defense whereby the individual IDEALIZES HIS/HER
RELATIONSHIPS at first, elevating both self and other in terms of status and specialness to (illusionary) high
levels
2) DEVALUATION : this refers to the individual discounting and regarding as worthless anyone who
undermines his/her grandiose vision of him/herself
3) DETACHMENT : this is linked to DEVALUATION (above) and refers to the individual’s propensity to sever
links with anyone who threatens to undermine his/her exalted view of him/herself
4) ACTING OUT : this refers to performing extreme behaviours to express thoughts, feelings and emotions
the person feels incapable of otherwise expressing
5) SPLITTING : this refers to the cutting off from consciousness the part of themselves that holds the
emotional pain to prevent it from becoming integrated into consciousness, as, for this to occur, would be
psychologically overwhelming
6) PROJECTIVE IDENTIFICATION : this is when the person (unconsciously) projects onto another (imagines
the other to possess) parts of their own ego and then expects the other to become identified with whatever
has been projected
7) DENIAL : in its simple form this just means not accepting certain unpleasant parts of reality to protect the
ego
8) AVOIDANCE : also sometimes referred to as ’escape coping’ - making efforts to evade dealing with
particular stressors
9) PROJECTION : this defense mechanism involves attributing to others one’s own unwanted or
socially/culturally unacceptable emotions, attributes or thoughts.
In essence, the individual with narcissistic personality disorder lives in a world where everything is viewed in
extremes of ’good’ or ’bad’. Underneath the defense mechanisms, there invariably lies an extremely
FRAGILE SENSE OF SELF-ESTEEM. Therefore, the individual really feels EXTREMELY VULNERABLE and
tends to have an overwhelming need to PROTECT HIM/HERSELF FROM ANY THREAT TO HIS/HER
EXTREMELY PRECARIOUS SELF-IMAGE. The person with the disorder has a disturbance of the basic
structure of the self.
THE THERAPEUTIC APPROACH TO TREATING NARCISSISTIC PERSONALITY DISORDER :
Research suggests that one of the main keys to psychotherapeutic intervention is an acknowledgment of the
person’s pain, their overwhelming sense of their own vulnerability and their consequent desperate need to
protect themselves from further psychological suffering. The therapist needs to reassure them that their
defenses have been identified as self-protective, and, as such, are understandable.
Emotional Abuse and The Law
Emotional abuse is essentially where the perpetrator uses FEAR, HUMILIATION, or VERBAL ASSAULT to,
for example, undermine the victim’s self-esteem, confidence and trust in their own judgment.
Many believe if they are not being physically harmed, then what is happening does not count as abuse : THIS
COULD NOT BE FURTHER FROM THE TRUTH - in fact, protracted psychological abuse can damage the
way , for example, the AMYGDALA (a brain region that’s function relates to emotional control) develops,
which can then HAVE DEVASTATING EFFECTS ON THE REST OF THE VICTIM’S LIFE.
SOME RESEARCH INTO THIS AREA SUGGESTS PEOPLE WITH DAMAGE TO THIS AREA LIVE, ON
AVERAGE. NINETEEN YEARS LESS THAN THE AVERAGE PERSON - reasons include ruining health with
drink / drug addiction and suicide.
Emotional abuse can be compared to BRAIN WASHING ; I have already said that it undermines the
individual’s belief in his own judgments - it can, too, make them question THEIR OWN SENSE OF REALITY
AND THEIR OWN SANITY.
THIS LEADS TO THEM RELYING, AND BECOMING DEPENDENT UPON, THE VERY PEOPLE WHO ARE
ABUSING THEM.
PROOF.
Emotional abuse can be very difficult to prove. One reason for this is because it can be subtly inflicted over
years (a kind of drip, drip effect) and leaves no physical marks.
Effects of Parental Favouritism
The effects of long-term parental favouritism will clearly effect the way in which the favoured and unfavoured
child perceive themselves. The more extreme the difference in treatment, all else being equal, the more
extreme will be the effects on the respective children.
I will use the example of a step-family as I grew up in one. Very sadly, although there are step-families, of
course, in which all children are treated equally and the environment is happy and healthy, it can be the case
that, again, for example (as it relates to my own experience) the step-mother will favour her own son over her
step-son AND MAKE THIS ABUNTANTLY CLEAR.
To elaborate, if you’ll permit the small indulgence, a little more on my own case, my step-mother was, as far
as I could make out, essentially a religious fundamentalist (you know -’ gay people offend god’, speaking in
’tongues’, that sort of thing) although, to be honest, her belief structure seemed deeply confused - a veritable
pick and mix mishmash, perfectly tailored, in several respects, to her own purposes, which, it has to be said,
is not entirely untypical. Her own son she viewed as a kind of mini-messiah - a view, unhelpfully for him, he
can’t have failed to have introjected), whilst I was, naturally, and, no doubt, befittingly, the spawn of the devil.
Indeed, I spent much of my childhood worrying I was destined to be eternally tortured in hell.
In my own case, then, I would have needed to have been in a coma for seven years (although, to my
step-mother’s enduring chagrin, this happy event never came to pass) not to have picked up on things, but
even if the favouritism is much more subtle, it can be equally bad, especially if the step-parent is superficially
pleasant and in denial about it, which can create a sort of tortured confusion in the child.
Of course, too, the unfavoured child may well (and this was certainly true in my own case)not want to tell
anyone about it as often s/he will (ENTIRELY MISTAKENLY) believe that s/he deserves to be treated as the
’inferior’ and, again, as certainly happened to me, grow up WITH A PROGRAMMED- IN INFERIORITY
COMPLEX . something I myself am still trying to shake off (unsuccessfully, I might add, which the perceptive
reader of this blog is overwhelmingly likely to have realized!)
EFFECTS ON FAVOURED CHILD : s/he will tend to grow up with very high self-esteem and high levels of
self- belief (irrespective, to a large degree. of actual talents and abilities). Indeed, another very interesting
study discovered that every President since Roosevelt had been the favoured child.
EFFECTS ON UNFAVOURED CHILD : s/he has a greater probability of developing depression in later life
and can develop ill-will towards the favoured sibling/step-sibling.
BUT IT’S NOT NECESSARILY ALL BAD FOR THE UNFAVOURED CHILD!! The reason for this is that whilst
the favoured child may well go through life unconsciously trying to please the parent who favoured him/her,
and, if I may be permitted to coin a phrase - PERPETUALLY DANCE TO THE PARENT’S TUNE, the
unfavoured child is liberated from such expectations and is free to live an altogether MORE AUTHENTIC
LIFE , and plough, as it were, his/her own furrow.
EMOTIONAL ABUSE AND THE LAW. PART 2.
EMOTIONAL ABUSE IS JUST AS DAMAGING TO THE INDIVIDUAL PSYCHOLOGICALLY AS ANY OTHER TYPE
OF ABUSE.
Emotional abuse, which can happen selectively (ie a particular offspring is targeted, as opposed to all the
offspring) can lead to extreme anxiety, self-harming behaviours, profound loneliness, acute depression and.
without therapeutic intervention, personality disorders in later life, such as borderline personality disorder
(BPD). In extreme cases, it can lead to suicide. It can include :
VERBAL ASSAULT : eg the issuing of threats
EMOTIONAL NEGLECT : eg showing no love or affection. In some cases, the parent might provide well for
the offspring financially, but entirely neglect his/her emotional needs. It can, of course, include, too, being
almost entirely ignored and treated with off-hand contempt.
THE DEVASTATING EFFECTS OF INVALIDATION : one of the most damaging forms of abuse is for the
abusers to INVALIDATE the victim’s views and emotions in relation to his/her abuse. This is because IT
MAKES THE VICTIM LOOK LIKE S/HE IS IN THE WRONG.
FORMS INVALIDATION MAY TAKE :
1) DENIAL - it may be that those who caused the childhood trauma simply deny it
2) TELLING THE VICTIM S/HE IS ’OVER-ANALYZING’
3) TELLING THE VICTIM S/HE IS EXAGGERATING
4) TELLING THE VICTIM HIS/HER VIEW THAT S//HE WAS CAUSED/CONTINUES TO BE CAUSED
SUFFERING IS WRONG, or, as it was once put to me by a family member, that we must stop ’BLEATING
ON ABOUT IT’.
THOSE RESPONSIBLE FOR THE TRAUMA OFTEN TRY EXTREMELY HARD TO INVALIDATE THE
VICTIM’S VIEWS SO THEY DO NOT NEED TO FACE THEIR OWN GUILT OR ALTER THEIR BEHAVIOUR
TOWARDS THE VICTIM.
WHAT ARE THE CONSEQUENCES OF HAVING ONE’S VIEWS THAT ONE HAS BEEN
PSYCHOLOGICALLY SCARRED INVALIDATED?
Put simply, the invalidation can lead the victim TO BELIEVE S/HE HE MUST BE A BAD PERSON LEADING
TO :
- guilt
- shame
- self-hatred
- self-harming
- suicide
- drug/alcohol misuse
- rock bottom self-esteem
- rock bottom confidence
(the above list is not an exclusive one.)
HOW DOES THE LAW APPLY TO ALL THIS?
In the UK, it is likely emotional abusers may be prosecuted under domestic violence laws, if, for example, the
abuse involves THREATENING BEHAVIOUR ; however, like many areas of law, this is a confused and hazy
area. For this reason, I would like to add the disclaimer that legal advice should be sought before taking any
action, and, also, it is recommended in the strongest terms that someone who could be dangerous is NOT
directly confronted on the issues.
How Does PTSD Develop?
DEVELOPMENTAL PROCESS OF POST TRAUMATIC STRESS DISORDER
The psychologists Foa et al developed the following model to illustrate the psychological process through
which PTSD develops.
When a person experiences something which is very traumatic the memory becomes enmeshed into the
brain’s circuitry - in essence, a FEAR STRUCTURE becomes incorporated into the brain. THE FEAR
STRUCTURE can be divided into 3 individual units. These are as follows :
a) STIMULI of the trauma. This refers to things which my trigger memories of the trauma. Stimuli my gain
access to the brain via any of the 5 senses (ie sight, hearing, smell, taste and touch). To use a simple
example, someone traumatized by being injured in an explosion in a war may have the trauma response
triggered by loud bangs such as fireworks going off (the loud bang being the stimuli).
b) RESPONSES to the traumatic event. This includes both physiological responses (eg racing pulse,
hyperventilation) and psychological responses (such as a feeling of terror).
c) MEANINGS ATTRIBUTED TO THE STIMULI AND RESPONSES (eg this means I must be in great
danger).
When somebody suffering from PTSD experiences an event which triggers the original memory of trauma,
laid down in the brains circuitry, they feel intense distress. Typically, in response to this distress, they will take
evasive action (ie try to evade, or get away from, the event which is triggering the traumatic response). It is
the meaning aspect of the fear structure ( c, above) which creates the most anguish. The problem lies in the
fact that they find it exceptionally difficult to reconcile their old (pre-trauma) beliefs about events and their new
(post trauma) beliefs about events (doing this successfully, which therapy can help them, eventually, to do, is
known as the PROCESS OF ACCOMMODATION).
An example of pre- and post- traumatic beliefs, which, if the process of accommodation has not taken place,
would be in opposition with one another are :
PRE-TRAUMA - the world is a pretty safe place in which I can generally feel relaxed in
POST-TRAUMA - the world is very dangerous and unpredictable and I must always be on my guard against
threats which seem to be coming at me from every direction (at worst, leading to clinical paranoia)
COMPULSION TO MAKE SENSE OF THE TRAUMATIC BELIEF
The individual who suffers from PTSD will often try , obsessively, to make sense of the traumatic event which
occurred to him/her. This arises because s/he finds it impossible to square what has occurred with
pre-trauma beliefs.
THE DEEP PSYCHOLOGICAL PAIN OF TRYING TO MAKE SENSE OF THE TRAUMATIC EVENT
Whilst the individual suffering from PTSD feels driven to make sense of the trauma, constantly thinking about
it creates feelings which are both terrifying and overwhelming. THIS CREATES A TERRIBLE
PSYCHOLOGICAL TENSION IN THE MIND - there is the PULL TOWARDS ATTEMPTING TO MAKE
SENSE OF WHAT HAPPENED ON THE ONE HAND, BUT ALSO THE PULL OF TRYING TO STOP
THINKING ABOUT IT ON THE OTHER.
Foa and her colleagues have put forward the theory that it is the tension, created by having one’s thoughts
pulled powerfully in two directly opposing directions, which leads to the extreme HYPERAROUSAL (intense
anxiety).
The two opposing views of the world the individual tries desperately to fit together (’safe world’ versus’ unsafe
world’) is rather like trying to FIT TWO PIECES OF JIGSAW TOGETHER, ONE OF WHICH HAS BEEN
DAMAGED, SO IT NO LONGER FITS.
Therapy can lead to a resolution of this dilemma, leading to a compromise belief, linked to the two opposing
beliefs, such as :
THE WORLD IS GENERALLY SAFE FOR ME BUT NOBODY HAS A COMPLETE GUARANTEE,
OCCASIONALLY BAD THINGS HAPPEN.
TREATMENTS :
COGNITIVE BEHAVIOURAL THERAPY IS AN EFFECTIVE TREATMENT FOR THE EFFECTS OF
TRAUMA - there is a lot of research evidence to support this.
Childhood Trauma Leading to ’The Jumping to Conclusions’ Bias
Those who suffer childhood trauma, studies reveal, are far more likely than others, all else being equal, to
develop a specific COGNITIVE BIAS which has been termed, rather informally, ’The Jumping to Conclusions
Bias’.
Those who develop this cognitive bias demonstrate a marked tendency to quickly make decisions based
upon incomplete information in social situations, drawing negative inferences about others which may very
well not be objectively warranted ; this seems to be due to an impulsive mental processing.
The ’Jumping to Conclusions Bias’ at Its Extreme :
In extreme cases, this cognitive bias can be a symptom of psychosis. In relation to childhood trauma,
psychosis is more likely to develop if there has been an intent to harm (eg as in the case of emotional abuse).
In particular, maltreatment by adults and bullying by peers are strongly correlated with the later development
of psychosis (which, in one study investigating this link, was observed in children as young as twelve).
However, this finding apply to both individuals who were traumatized in early and later childhood.
On a neurological level, research demonstrates that prolonged stress in childhood has an adverse effect
upon brain development causing chronic overactivity in certain brain structures, including, for instance, the
hypothalamus.
The’ Jumping to Conclusions Bias’ and Its Adverse Effect upon Social Interactions :
Studies have shown, as mentioned, that one important way that the’ Jumping to Conclusions Bias’ can affect
the individual suffering from it is to interfere with social functioning. For example, as briefly alluded to above,
those afflicted by this cognitive bias are more likely to rapidly form negative opinions and views of those they
interact with. As has also been referred to above, if this cognitive bias becomes extreme it can meet the
criteria to be categorized as a psychotic symptom (of schizophrenia, for example) and manifest itself as
DELUSIONS OF PERSECUTION (in which others are automatically viewed as predominantly dangerous and
threatening).
How Cognitive - Behavioural Therapy (CBT) can Help :
Such cognitive biases as the ’Jumping to Conclusions’ bias may be helped by the intervention of CBT, even
in cases of schizophrenia, leading to more accurate social judgments, and, accordingly, improved social
functioning.
The Link Between Childhood Trauma and Future Suicide Attempts.
Research has shown that the experience of childhood trauma and the risk of the individual who suffered it
attempting suicide in later life (as a teenager or as an adult) are extremely strongly correlated.
A particular study, carried out by Dube et al (2001), which involved gathering data related to this issue, found
that those most seriously affected by childhood trauma were a staggering 51 Xs (ie 5100 %) at greater risk of
suicide attempts as a teenager compared to those who had experienced a settled childhood. As an adult they
were found to be at 30Xs (ie 3000 %) greater risk of attempting suicide compared to their more fortunate
contempories.
Other findings in the study by Dube et al were that about 67 % of adult suicide attempts were linked to the
experience of childhood trauma, and, also, that about 80 % of teenage suicide attempts were connected to
the experience of childhood trauma.
THE SPECIAL ADVERSE EFFECT OF EMOTIONAL ABUSE :
The same study also found that the type of abuse that was most strongly predictive of the individual who
experienced it making suicide attempts in later life was emotional abuse.
OTHER TYPES OF ABUSE FOCUSED UPON BY THE STUDY :
Dube et al’s study also found many other types of abuse to be powerfully correlated with increased risk of
suicide. These were :
- domestic violence
- loss of a parent (eg through divorce or abandonment)
- family member in prison
- parent with mental illness (eg depression
- parent with addiction
- physical neglect
- emotional neglect
- physical abuse
- verbal abuse
POSSIBLE ACTIONS TO TAKE IN LIGHT OF ABOVE FINDINGS :
Given the above facts, it is necessary to ask what may be done to address this tragic problem. I provide
some suggestions below :
- more training for those who work with children about the effects of childhood trauma and how best to treat
these effnects
- more education to be given to the public in general about the effects of childhood trauma
- rather than expel or suspend ’difficult’ children, schools should keep them in education and provide the
appropriate counseling and/or other professional support
- respond more sensitively and compassionately to ’problem behaviour’ (or, ’acting out’) by young people,
both in schools and other applicable environments.
Childhood Trauma : The Effects of Bullying
Being bullied when we were young can have long-lasting adverse effects, particularly if we were sensitive
and socially anxious as children.
The form that bullying takes can be both overt (blatant and obvious) or much more subtle, The subtle forms of
bullying are more difficult to detect, but they include :
- betraying a trust
- excuding people
- isolating people
- making unreasonable demands
- innuendo and gossip
- manipulation
When the above techniques are used to bully others, they will also be accompanied by a deliberate attempt
to control and/or exclude the person on the receiving end of the bullying. Bullying also involves victimization,
humiliation and intimidation.
EFFECTS OF BULLYING :
Bullying can create social anxiety or reinforce and exacerbate existing social anxiety. Five main areas it can
affect in this regard are :
1) Effects on our beliefs
2) Effects on our attention
3) Effects on our behaviours
4) Effects on our self-consciousness
5) Effects on our assumptions. Let’s look at each of these 5 types of effects in turn :
1) Effects on our beliefs - eg people cannot be trusted, I am unacceptable to others, people will always
exclude and reject me, I do not belong etc
2) Effects on our attention - constantly and/or obsessively checking on how people are responding to us eg
are they frownig? do they look bored? do they look irritated? etc. Often, this goes hand-in-hand with
imagining a person disapproves of us when there is, in fact, no objective reason to suppose this
3) Effects on our behaviours - eg excessive need for the approval of other, becoming withdrawn and ’keeping
ourselves to ourselves’, behaving according to expectations of others at the cost of our own individuality
4) Effects upon self-consciousness - excessive worry about how we behave/look/speak, excessive concern
about offending others, easily embarrassed by even the smallest social error/indiscretion etc
5) Effects on our assumptions - eg living by the policy that, in social situations, ’attack is the best form of
defense’ leading to over-aggression towards others, the assumption that everyone will take advantage of us,
the assumption that we must not get involved with anyone in a position of authority and influence etc
.
Intermittent Explosive Disorder (I.E.M.) and Childhood Trauma.
This disorder, which is listed in the DSM (Diagnostic and Statistical Manual of Mental Disorders), a manual
which is used by psychologists and psychiatrists to diagnose mental illness and provides the diagnostic
criteria (ie relevant symptoms) by which diagnosis of the specific psychiatric condition is made, is, as the
name implies, related to problems a person has with controlling his/her anger.
According to the DSM, the symptoms of IED are as follows :
1) Several episodes of being unable to suppress impulses of intense anger which leads to serious aggressive
acts such as assault and destruction of property
2) The high intensity of the aggression displayed during these episodes is clearly out of proportion to the
precipitating event (ie the event that triggered the aggression)
3) The episodes of aggression are not better explained by other mental conditions such as borderline
personality disorder (BPD) or anti-social personality disorder.
HOW COMMON IS IED IN THE GENERAL POPULATION?
Research into this area so far suggests that around 5 % of the population may suffer from IED during some
period of their life-span. Not infrequently, the disorder first appears during adolescence.
Often, too, the disorder will exist co-morbidly (ie together with/alongside) other mental health conditions.
WHAT ARE THE CAUSES OF IED?
IED can very adversely affect many crucial areas of the sufferer’s life, which include : relationships with
family, relationships with friends, reputation, career prospects and even freedom (if the uncontrolled
aggression results in an incident which leads to being sent to jail). Clearly, then, a person who suffers from
IED urgently requires treatment in order to prevent him/her from potentially ruining his/her own life. But in
order to treat it, of course, it is first necessary to understand what causes it. In relation to this quest, research
has focused on childhood trauma.
WHAT HAS THIS RESEARCH SHOWN?
Research indicates that the experience of childhood trauma, particularly childhood trauma connected to
problematic (ie dysfunctional) relationships with parents/carers is the strongest predictor of the development
of IED in adulthood. It is thought that the reason for this is that, as a result of such trauma, the affected
individual does not learn how to manage his/her emotions nor how to manage the intricacies of interpersonal
relationships.
Neurological issues may also be related to IED ; however, I should point out that such issues may
themselves have been caused by the childhood trauma - further research into this is necessary.
POSSIBLE THERAPIES FOR IED :
These include :
- Dialectical Behavioural Therapy (DBT).
- Trauma Focused CBT.
Borderline Personality Disorder Tests.
Borderline Personality Disorder Symptoms
Many people who believe that they may have borderline personality disorder (BPD) search out selfdiagnosing
tests on the internet. Whilst it is very important to exercise extreme caution when it comes to self-diagnosing,
a doctor may diagnose you as having BPD if you suffer from 5 or more of the following symptoms and these
symptoms are suffciently severe to adversely affect your everyday life and functioning. The symptoms below
are in line with UK government guidelines (NICE - National Institute for Medical and Clinical Excellence,
2009).
- difficulty in forming and maintaining relationships
- emotions which fluctuate between extremes (eg elation and despair) and often feeling empty and angry
- prone to reckless behaviour, taking risks without considering the consequences
- unstable and confused sense of own idenity
- fear of abandonment, rejection and of being alone
- prone to carrying out, or thinking about, self-harm (cutting self or attempting suicide)
- sometimes believing things which are not true (doctors call these delusions) or seeing or hearing things
which are not there (doctors call these hallucinations).
People with BPD often also have other mental health conditions which include, in particular :
- depression
- anxiety
- eating disorders
- substance misuse
BPD is a sensitive and controversial diagnosis, so it is important to remember that, if you do not agree with
the first diagnosis you are given, it is sensible to seek a second opinion.
Personality Disorder Clusters
It has been often stated in my posts that personality disorders are often linked to traumatic childhoods. I have
already described several personality disorders, but I would like to introduce you to some we have not met
before. I also wish to introduce the psychiatric concept of clusters.
There are very many personality disorders, but many of them have overlaps and symptoms in common. Due
to this fact, for the purposes of diagnosis, they have been split into 3 groups, or families, which psychiatric
professionals refer to as CLUSTERS.
THE 3 CLUSTERS OF PERSONALITY DISORDERS :
1) CLUSTER 1 - ODD and ECCENTRIC.
2) CLUSTER 2 - DRAMATIC, EMOTIONAL and ERRATIC
3) CLUSTER 3 - ANXIOUS and FEARFUL (also termed ANAKASTIC)
Let’s look at each of these in turn :
CLUSTER1. ODD and ECCENTRIC :
a ) PARANOID - suspicious, tends to hold grudges, feels easily rejected, believes others are being
unpleasant to him/her even when there is no evidence
b) SCHIZOID - emotionally cold, prefers own company, has a rich fantasy world
c) SCHIZOTYPAL - eccentric, has strange/bizarre ideas, has difficulties with thinking, lacking in emotional
responses or displaying inappropriate emotional responses, hears and/or sees things which are not there
(hallucinates)
CLUSTER 2. DRAMATIC, EMOTIONAL and ERRATIC :
a) ANTISOCIAL - not concerned with the feelings of others, easily frustrated, aggressive, prone to committing
crimes, finds intimate relationships problematic, impulsive, feels little guilt, unable to learn from bad
experiences
b) BORDERLINE/EMOTIONALLY UNSTABLE
c) HISTRIONIC - over dramatic, self-centered, has intense, but fleeting, emotions, can be suggestible,
worries about appearance, can be seductive
d) NARCISSISTIC
CLUSTER 3. ANXIOUS AND FEARFUL (also termed ANAKASTIC)
a) OBSESSIVE COMPULSIVE - worries a lot, perfectionist (eg need to keep checking things), rigid ways of
behaving, worries about doing the wrong thing, finds it hard to adapt to new situations, high moral standards,
judgmental, sensitive to criticism
b) AVOIDANT - anxious and tense, worries a lot, feels insecure and inferior, strong need to be liked and
accepted, extremely sensitive to criticism
c) DEPENDENT - passive, relies on others to make decisions for him/her, does what others want him/her to
do, finds it hard to cope with daily chores, feels hopeless and incompetent, easily feels abandoned.
Well, I don’t know about you, but after reading that lot I feel a little concerned - so now, if you’ll excuse me,
I’m off to make an urgent appointment with my psychiatrist...
High Conflict Personality (HCP) Link to Child Trauma
Individuals who suffer from the condition of HCP will often have an underlying personality disorder which falls
into the CLUSTER B range (dramatic, emotional and erratic). It is quite possible, therefore, that the individual
may also suffer from anti-social personality disorder, borderline personality disorder (BPD) or histrionic
personality disorder.
Sometimes, however, the person with HCP may not obviously fall into any of these specific categories, in
which case he or she may, instead, be diagnosed with what has been technically termed : ’personality
disorder not otherwise specified’.
WHAT ARE THE SYMPTOMS OF HCP?
These include :
- feeling easily threatened
- tendency to see things in ’black and white’ (eg ’good’ or ’bad’)
- generally untrusting
- tends to view self as victim
- tends to be controlling
- highly emotional
- highly aggressive
- has marked difficulty accepting blame
- finds it hard to see things from others’ points of view/perspective
- reluctance to take responsibility
- frequently initiates/escalates conflict
- conflict tends to be a very prominent feature of their relationships
- marked tendency to blame others
Often, HCP is used as a descriptive term rather than as a formal diagnosis.
HOW CAN HCP BE TREATED?
At present, the main treatments are :
- cognitive behavior therapy (CBT) ; click here to read my article on this
- dialectical behavior therapy (DBT) ; click here to read my article on this
- neurofeedback
Mental Health and Criminal Law - Introduction
’The link between mental illness and crime is well known’
- (General Synod, 13th February 2008).
It is fair to say, I think, that there are many people being punished in jail who are suffering from serious
mental illnesses and should not be there. Their, illness is made worse by their incarceration and they need,
instead, to be in a therapeutic environment.
But what are the facts surrounding the relationship between mental disorder and criminal justice and what
issues need to be considered?
The kinds of questions I intend to address in my posts in this category of my blog include :
- to what extent does mental disorder contribute to crime?
- to what extent are mentally disordered offenders responsible and culpable for their crimes compared to their
non-mentally disordered counterparts?
- to what degree are mentally disordered offenders’ conditions treatable?
- how can the human rights of mentally disordered offenders be best protected?
- where is the dividing line between deviance and disorder? In relation to this question, who should go to
prison and who should go to a therapeutic setting?
- what problems does the concept of ’severe and dangerous personality disorder’ pose for the criminal justice
system?
- to what extent is the disordered offender morally responsible for his or her offending?
- to what extent does the criminal justice system make the mental condition of the offender better or worse?
- does the criminal justice system lower the offending rate of disordered offenders?
- does the criminal justice system lead to successful treatment of the mentally disordered offender’s
condition?
- is the overlap between mental disorder and offending explicable by other factors such as discrimination,
poverty and social exclusion?
- does the criminal justice system deal fairly and equitably with the mentally disordered?
IMPORTANT NOTE : The link between mental disorder and crime is a very complex one, not least because
there is such a range of both mental disorders and types of crime. We are not, then, dealing with two simple,
clear cut variables. Quite the opposite, in fact.
Child Trauma and Obsessive-Compulsive Disorder (OCD) PART 1.
In this article, I want to consider one specific anxiety based disorder known as obsessive-compulsive disorder
(OCD). When a person has this disorder, as its name suggests, s/he suffers recurring obsessions and/or
compulsions. I define these below :
OBSESSIONS - intrusive and anxiety creating thoughts, images or impulses
COMPULSIONS - behaviours or mental acts intended to reduce the anxiety the obsession causes (but which,
in fact, actually makes the anxiety worse over the long-term). Any effect the compulsion has on reducing the
anxiety created by the obsession is temporary.
I show below how thoughts, feelings and behaviours flow into each other to keep the symptoms of OCD
going :
OBSESSIONS (intrusive thoughts or images related to contamination, sexuality, danger, morality etc)
>DISTRESS (eg shame, fear) >COMPULSION (repetitive behaviours or mental acts aimed at reducing the
anxiety created by the obsession) >TEMPORARY RELIEF >OBSESSIONS (intrusive thoughts or images
related to contamination, sexuality, danger, morality etc) > (eg shame, fear) >COMPULSIONS (repetitive
behaviours or mental acts aimed at reducing the anxiety created by the obsession) >TEMPORARY RELIEF >
and so on...and so on...leading to chronic distress.
In order for a person to be diagnosed with OCD, the following criteria normally have to be met :
a) the obsessions and compulsions cause significant distress
b) the obsessions and compulsions significantly interfere with day to day functioning.
c) the behaviours engendered by the OCD take up about an hour a day or more
d) the person with OCD is aware, at least at some level, that his/her behaviours are excessive and illogical
It is, of course, necessary to get a diagnosis from a professional as opposed to trying to self-diagnose.
HOW PREVALENT IS OCD THROUGHOUT THE GENERAL POPULATION?
It is estimated that approximately 2-3 % of the population will suffer from OCD at some point during their
lives. However, this may well be an underestimate as many people choose to keep their condition a secret.
Research indicates, however, that OCD is becoming increasingly common.
Whilst the condition can begin in childhood, its onset is more common in late adolescence. It seems to be
equally common in both men and women. However, women are more likely to seek out treatment for the
disorder.
OCD can be made worse by stress. Also, those who suffer from OCD often suffer from other conditions as
well. These include :
- depression
- excessive worry
- insomnia
- panic attacks
- social phobia
- specific phobias
- eating disorders
WHAT ARE THE MOST COMMON OBSESSIONS/COMPULSIONS?
In descending order. the most common are :
- checking and cleaning
- counting
- needing to ask or confess
- symmetry/ordering rituals
- hoarding
It should also be noted that people often nave multiple obsessions/compulsions and these can change over
time.
Due to the amount of distress OCD causes, and its link to other serious psychological conditions, if a person
suspects s/he suffers from it, it is very important to seek out professional advice.
Those Bullied as Children More Likely to Commit Crime as Adults.
Recent research has demonstrated that individuals who are bullied as children are more likely to get
convictions for committing crimes in later life and are more likely to end up in jail.
In the study, the individuals were split into 4 groups :
1) Those who had been bullied as children (under the age of 12 years)
2) Those who had been bullied as teens (over the age of 12 years)
3) Those who had suffered bullying throughout both their childhood and their teens
4) Those who had not been bullied.
FINDINGDS :
- 9 % from group 1 experienced prison as adults
- 7 % from group 2 experienced prison as adults
- 14 % from group 3 experience prison as adults
- 6 % from group 4 experienced prison as adults
FURTHER FINDINGS :
- 16 % from group 1 had at least one conviction
- 11 % from group 2 had at least one conviction
- 20 % from group 3 had at least one conviction
- 11 % from group 4 had at least one conviction
A COMPARISON BETWEEN THE EFFECTS OF BULLYING ON FEMALES VERSUS MALES :
The study also found that females who had experienced bullying both as children and as teens (ie from group
3) were significantly more likely to have alcohol addictions, drug addictions, a history of arrest and convictions
than their male counterparts who had also suffered bulling as both children and teens (ie also from group 3).
CONCLUSIONS DRAWN FROM THE STUDY :
It was concluded that health care professionals need to intervene to prevent bullying in the same way as
parents, teachers and guardians should. It is suggested that children and teens need to be asked appropriate
questions which try to uncover bullying as a routine part of medical check ups. There should also be
programs in place to address both the causes and effects of bullying to reduce the likelihood of those who
have been bullied coming into contact with the law in later life.
Child Trauma and Obsessive-Compulsive Disorder (OCD) Part 2.
OCD and the brain :
Brain scans have shown that the brains of people who suffer from OCD are different from people who don’t.
These scans show that there is overactivity in certain brain regions which include ;
- the basal ganglia
- the orbital frontal regions
- the caudate nucleus
Furthermore, it has also been shown that those who suffer from OCD have less serotonin (a
neurotransmitter) available in the brain. Indeed, medication called SSRIs ( selective serotonin reuptake
inhibitors) increase the amount of serotonin in the brain and can be an effective treatment for OCD.
There is also thought to be a genetic component to OCD.
However, childhood trauma also plays a part. An individual with a biological/physiological predisposition to
developing OCD will be more likely to suffer it if s/he suffers a traumatic childhood.
Various terms have been given by psychologists to what happens in the brain when a person has OCD.
Schwartz termed it ’brain lock’ whereas Rappaport referred to it as ’a brain traffic jam.’
TREATMENT :
As mentioned above, medications can be given to increase serotonin levels, and, also, decrease brain
activity in the relevant brain regions. Cognitive behavioural therapy (CBT) can also prove to be effective.
WHAT IS THE DIFFERENCE BETWEEN OBSESSIONS AND COMPULSIONS?
- OBSESSIONS are THOUGHTS, MENTAL IMAGES and IMPULSES
- COMPULSIONS are unwelcome and repetitive BEHAVIOURS. EXAMPLES OF OBSESSIONS - these
revolve around eight main themes :
a - CONTAMINATION eg ’I can’t shake hands, I’ll catch a terrible disease’.
b - ORDER eg ’the towels must be exactly in line
c - HARM eg ’that candle might start a fire’
d - HOARDING eg ’I must always keep all my rubbish, otherwise I could throw away something of value’
e - CERTAINTY eg ’Did I definitely turn off the gas.’
f- NUMBERS eg ’Whenever I turn off a light I must flick the switch 27 times.’
g - RELIGION/MORALITY eg ’Thinking that thought means I’m evil - I must never think it.’
h - SEXUAL eg ’If I think sexual thoughts I am sinful.’
Examples of compulsions are ;
- repeated hand washing
- repeatedly checking gas is switched off
- counting all the cracks in the pavement
- praying
- hoarding
- keeping things in order
- counting
Effects of Severe and Long-Lasting (Chronic) Trauma.
Long-lasting and repeated trauma can so adversely affect an individual that they lose their very sense of self.
This is also sometimes referred to as ’personality disintegration’.
People who have experienced this sort of trauma feel constantly and intensely hypervigilant and agitated the person also feel a continual sense of some terrible impending doom. Anything - however remotely
- reminding the person of the original trauma will inspire terror. This might manifest itself as pacing, crying or
even screaming. Nightmares involving horrible violence and other danger will also occur, as will insomnia.
The person will also develop somatic symptoms. These might include stomach problems, headaches,
tremors and a rapid heart beat.
Such symptoms deriving from chronic trauma can last many years or even decades if appropriate treatment
is not sought.
The experience of the trauma is likely to have been so unbearable that the person had to mentally escape it
through such psychological mechanisms as dissociation (click here to read my article on this), thought
suppression, minimization and denial.
When the trauma is over, survivors attempt to avoid memories of it - mentally sealing it off from
consciousness, as it were. However, this prevents the experience being worked through and integrated into
the individual’s life story. By keeping the experience locked away in a ’separate mental compartment’, this
actually makes its adverse psychological effect on the person all the worse.
Indeed, the past memories of trauma, without treatment, remain vivid and intense. Day-to-day present living,
in contrast, becomes hazy - like living in a thick fog.
Severe and prolonged trauma also gives rise to feelings of hopelessness ; the person therefore loses the
ability to make plans and use initiative.
The pathological bond the individual has had with the abuser also takes away the ability to trust.
Relationships become disrupted and the survivor may fluctuate between feeling intensely attached to another
and angrily rejecting him/her.
Not surprisingly, too, nearly all survivors of chronic trauma develop protracted clinical depression. Self-image
becomes debased and with this feelings of guilt emerge. The person withdraws socially and outbursts of
rage, also related to the trauma, may make him/her more isolated still.
Also, the survivor may turn their rage and anger against themselves, leading to suicidal behaviours.
Effects of Lack of Emotional Security in Childhood.
Children who grow up in emotionally secure environments are likely to develop good emotional regulation
(control) in later life and are unlikely to develop significant anti-social personality traits (characteristics).
However, when there is a lack of emotional security and the environment is hostile, the child will tend develop
’avoidant attachment’ with the parent/s or carer/s (ie avoid interaction with them where possible) and is likely
to become aggressive (especially if male - Renken et al, 1989). This is especially likely if the parents are
often angry (either with each other or with the child).
In this situation, the child will generalize from his experiences and come to see others as hostile and likely to
reject him/her. Also, because s/he is dependent upon the parents s/he will often be unable to fully express
the true level of his/her anger towards them so will tend to lessen it by avoiding contact with them. This
avoidant behavior, then, is not genetic, but a learned defensive response.
Once the child has learned this response, and both defensiveness and expectation of harsh treatment by the
parent/s or carer/s has become ingrained, s/he does not stand to lose much by rebelling and going against
their wishes. This leads to the parent controlling, or attempting to control, the child by instilling yet further fear
in him/her.
This pattern of maladaptive interaction between the parent and child can adversely affect how the child’s
brain develops. On a biochemical level, the hostile environment in which the child finds him/herself trapped
can lead to the brain receiving insufficient opiates. This means that the medial prefrontal cortex fails to
develop properly. The behavioural effect is that the child grows up believing others will either pay him/her no
attention or will act in a hostile or aggressive manner towards him/her. In essence, then, he generalizes
his/her experience of how his/her parent/s or carer/s treat him/her into his/her belief system relating to how
s/he expects others will treat him/her.
Studies have found (eg Dodge et al, 1987) that boys who have been brought up in this type of environment
are often likely to interpret the behaviour of others towards them as hostile even when, in objective terms, this
is not the case. In other words, their perception of reality may become distorted by the way in which the
environment they have grown up in has affected their brain development.
Effects on Sexuality of Childhood Trauma
I have already written extensively on the effects of childhood trauma on individuals such as PTSD, self-harm,
issues surrounding emotional regulation (control), alcoholism, self-esteem, relationship difficulties, drug
addiction, dissociative disorders and more. However, so far I have written little about the effect of childhood
trauma on sexuality. Why? Well, for one thing, it is a sensitive issue, and, possibly related to this fact,
relatively little research has been carried out in relation to this vitally important area. Some studies, however,
have shown links between childhood trauma and sexual addiction, sexual compulsion, homosexuality,
sadomasochistic behaviours, and prostitution. As these are, or have been in the past, viewed as deviant
behaviours, problems arise in their study due to associated stigma, inhibiting researchers from delving too
closely into such areas and discouraging people from putting themselves forward as potential subjects of
such research. It has been hypothesized that such behaviours may potentially develop in those who have
experienced childhood trauma as they :
1) serve as dissociative reenactments of early relational disturbances and/or
2 arise from difficulty integrating sexual activity with the normal concomitant emotional state (eg love or
affection).
In this introductory article I will very briefly outline some of the limited research into this area that has, so far,
been conducted :
Research by psychologist Toni Johnson refutes the commonly held notion that those who have been
molested as children will inevitably go on to molest others. It is a simple, empirical fact that this is not the
case.
Research by Cheryl Koopman has collected data that shows there is a strong correlation between those who
have suffered moderate to severe childhood trauma and those who are more likely to have unsafe sex (ie
unprotected sex with multiple partners).
Controversially, as far as some are concerned (I’m just the messenger), Colin Ross, in his study entitled
’Sexual Orientation Conflict in Dissociative Disorders’ has noted that a significantly greater than would be
statistically predicted proportion of patients seeking treatment for dissociative disorders are gay or lesbian.
More research needs to be conducted into this.
Why are such issues important? Psychologist Margo Rivera has answered this question (although I
paraphrase her answer) by stressing that sexuality is such a profound and fundamental part of the human
psyche that it is crucial that those whose sexuality does not reflect the mainstream have their sexuality both
acknowledged and accepted if therapy is to make meaningful headway. A humane note on which to end.
Adverse Effects on Physical Health of Childhood Trauma
A vast amount of research has been carried out on the potentially devastating psychological impact of
childhood trauma upon the individual. Far less, however, has been conducted on such trauma’s effect on
physical health (or, as it’s also termed, psychobiological effects). Indeed, it is only in the last decade that
studies into physical health effects of early trauma have become more frequent. In this article, which serves
as an introduction to the topic, I will review some of the main findings of research thus far.
The data collected so far shows that childhood trauma is related to poorer physical health in later life (ie
compared to those who did not suffer significant early trauma). It is certainly worth noting, too, that this
adverse effect on physical health of childhood trauma is DOUBLED if there continues to be significant stress
in later life.
An important point to make is that childhood trauma can adversely impact upon the later physical health of
the person in two different ways :
a) DIRECTLY
b) INDIRECTLY
It is theorized that DIRECT effects include the harmful effect childhood trauma can have on brain
development which then lowers the individual’s ability to cope with stress and also lowers his/her immune
functioning.
INDIRECT EFFECTS which might manifest themselves in response to childhood trauma:
- excessive drinking
- heavy/early onset smoking
- illicit drug use
- high risk sexual behavior (unprotected/multiple partners)
- decreased physical activity
- compulsive eating/severe obesity (Felitti et al, 1998).
WHICH PHYSICAL HEALTH PROBLEMS HAS CHILDHOOD TRAUMA BEEN LINKED TO ?
The list is, sadly, extensive. So far, studies indicate the following physical problems occur significantly more
frequently in those who have suffered childhood trauma :
- diabetes
- gastrointestinal problems
- irritable bowel syndrome
- obesity
- headaches
- breast cancer (Golding, 1994, 1999)
- thyroid disease (Stein and Barrett-Connor, 2000)
- bladder problems
- asthma
- heart problems (Dong et al, 2004)
THE ROLE OF FAMILY CHARACTERISTICS :
Family characteristics, linked to childhood trauma, may also contribute to poor health outcomes for those who
grew up in such families. These family characteristics include :
- parental abandonment
- parental psychopathology
- family conflict
- low socioeconomic status
- parental loss or absence
- parental divorce
Research into the relationship between family characteristics like those described above is ongoing in order
to distinguish the influence of such factors from co-occurring childhood adversities.
THE ROLE OF PSYCHIATRIC FACTORS :
Because those who suffer childhood trauma are at significantly greater risk of developing psychiatric
disorders. these too (eg by increasing risk taking behavior) will often have a marked knock on effect in
relation to the person’s physical health. In particular, insomnia leading to sleep deprivation is an area of
interest for more research into this. Also, of course, the side-effects of potent psychiatric drugs need to be
further examined.
Finally, it should be pointed out that different types of childhood trauma are likely to lead to different adverse
physical effects, which in turn means different treatment approaches need to be considered.
Childhood Trauma and Major Depressive Disorder.
Studies overwhelmingly show a strong link between childhood trauma and the development of major
depressive disorder in later life (in fact, nearly every study into this link has shown that the two are correlated
to a statistically significant degree). However, it continues to be treated most often as primarily a disorder
caused by faulty brain chemistry and there is, because of this, likely to be an over-emphasis on treating the
condition with drugs (mainly anti-depressants).
It has been argued that drug companies have promoted the idea that depression is caused by neurochemical
abnormalities in order to keep their vast profits flowing in. However, anti-depressant medication is not without
its risks and undesirable side-effects. Furthermore, studies are increasingly revealing that these drugs work
little better than placebos.
Studies on the effects of ACEs (adverse childhood experiences) on the individual are now suggesting that
childhood trauma may well be the greatest cause of later depression. Indeed, research has shown that
people who have suffered four or more ACEs are about 5 times more likely to experience depressive disorder
in later life. Additonally, they are about 12 times more likely to commit suicide, 7 times more likely to become
alcoholics and 10 times more likely to inject drugs.
It is therefore extremely important to recognize the effects of childhood trauma and to treat those effects
appropriately even if the psychological disorder develops decades after the actual experiences of the trauma.
WHAT ARE THE MAIN SYMPTOMS OF MAJOR DEPRESSIVE DISORDER?
Some of the most important features of the disorder are as follows:
- anxiety
- low mood
- a marked increase or decrease in appetite
- loss of interest or pleasure
- insomnia or increased need to sleep
- low energy levels/fatigue
- marked reduction in psychomotor activity
- difficulties with concentration/memory
- low self-esteem
- suicidal ideation/attempts
Depressive disorder can also be split into different sub-groups. Two major subgroups are :
1) ENDOGENOUS DEPRESSION - depression thought to be caused by internal factors such as brain
chemistry and genetic inheritance
2) EXOGENOUS DEPRESSION - depression thought to be caused by external factors such as trauma,
relationship breakdown etc
(it should be noted that there is some dispute about how valid the above distinction is and I myself feel a split
into these 2 categories is something of an over-simplification - this will be discussed in later posts.)
ENDOGENOUS depression is thought to account for about 30-40 % of all depressive disorders diagnosed
and if a person suffers from this treatment with anti-depressant drugs may be appropriate.
In the case of EXOGENOUS depression, however, it is clearly important to focus on the outside events which
have caused it and to tailor therapeutic interventions appropriately.
THE OVERLAP BETWEEN SYMPTOMS OF DEPRESSION AND SYMPTOMS OF POST - TRAUMAIC
STRESS DISORDER (PTSD).
Not only does depression commonly occur as part of PTSD, but PTSD symptoms can mimic many of the
symptoms of depression. From these observations it is now being suggested amongst many researchers that
those diagnosed with depression may well be PRIMARILY SUFFERING FROM PTSD, which clearly makes
sense in terms of the link between childhood trauma and the condition which is, at present, being diagnosed
as primarily depression.
Therefore, if what is currently being diagnosed as depression would more accurately be diagnosed as PTSD,
there is clearly a strong argument in favour of reviewing how current ’depressive disorders’ are being treated
by the medical profession.
DISCLAIMER : Do not make decisions about treatment of depression without seeking the appropriate
professional advice.
Posttraumatic Growth - How Trauma can Positively Transform Us
’Whatever does not kill me makes me stronger.’
- Nietzsche
Much of the research into the effects of severe trauma has concentrated upon its NEGATIVE effects; indeed,
a large proportion of the articles on this site have analysed such effects. However, as new research is
showing that the experience of trauma can also have a positive transforming effect upon a person’s life, I
thought I would redress the balance by including some articles, of which this is the first, on this new and
exciting area of research which has been named POSTTRAUMATIC GROWTH.
Research is showing that, rather than destroying a person’s life, severe trauma can lead, in the end, to
people gaining new strength and wisdom, redefining them in a positive way.
There are many documented cases of such transformations taking place. One such example, often quoted in
the literature about recovery from trauma, is that of a man named Leon Greenman, a Holocaust survivor who
spent years in a concentration camp. Years after he was liberated, during the 1960s (in response to a fascist
political organization called the National Front) he devoted his life to giving talks on his experiences and why
what he endured must never happen again - in this way, he found great meaning and was able to use his
appalling experiences to positive effect.
Trauma, then, can mark a great turning point in our lives. It can help us to become more true to ourselves, to
look at the world from a fresh perspective and to take on new challenges.
We are not able to undo that which has happened, but we can choose what new directions it will take us in.
Many people grow and develop following severe trauma, and it is only recently that studies have started to be
conducted on this positive aspect of the change in us that trauma can lead to; up until now, research has
concentrated very much upon the negative aspects, such as post-traumatic stress disorder (PTSD).
In fact, it is now being shown that trauma can act as a springboard to a higher level of functioning and growth
- it seems, indeed, that the initial effects of trauma can be reversed and turned to our advantage. In this way,
the negative and positive effects of trauma often go hand-in-hand. Posttraumatic growth is thought to be able
to take place by the person making sense of what happened and then going on to find new meanings and
understandings.
The new study of posttraumatic growth, then, focuses on how the suffering we endure as a result of trauma
can positively transform our lives, rather than on just the suffering itself.
Top 10 Most Common Thoughts of Those with PTSD.
One of the worst things about post traumatic stress disorder (PTSD) can be that we feel completely alone
and cut off from the rest of society. We can feel that nobody else could possibly comprehend the intensity of
our suffering. This is certainly what I felt when my depression and anxiety were at their worst - indeed, I felt
like this for several years as all therapeutic interventions in the first few years of my condition failed.
When we are at our lowest, it can be helpful to remember that others are suffering as much as we are. In the
case of PTSD, research has shown that sufferers tend to have the same kind of thoughts - I list the top ten
below:
- I can’t trust people anymore
- Other people want to harm me and the world is a dangerous and threatening place
- I am utterly helpless
- The reason I can’t cope is that I’m weak
- Something terrible is just about to happen
- I am completely unable to cope and this will never change
- It’s my fault that the trauma happened, I should have done something which would have prevented it
- From now on I can’t make a single mistake, if I do, it will be extremely dangerous to me
- I can never rely on anyone to protect me
- I will never recover from feeling this way
It should be noted that these thoughts could be operating beneath the level of conscious awareness.
However, therapy can help expose these underlying core beliefs and help the individual to replace them with
more positive ones; cognitive-behavioural therapy (CBT) is often very effective in this regard. However, some
people are uncertain whether or not to seek such therapy (many are available in addition to CBT). As a
general guide, it is probably best to seek professional help if you are suffering from symptoms such as those
described below:
One of the main questions to ask is:
- Are my symptoms interfering with my social, occupational or academic functioning?
If this is the case, it is definitely advisable to seek expert advice on what kind of therapy may ameliorate your
symptoms. Even just talking to someone about the traumatic experience/s can be of value. Specific
symptoms that can be addressed through various types of therapy include :
- poor sleep/insomnia
- the development of a harmful dependence on alcohol and/or drugs
- intrusive and distressing nightmares, memories or flashbacks
- constantly feeling agitated and irritable
- difficulty responding on an emotional level to family/partner
Professional support is particularly advisable for those who are socially isolated and/or have nobody else to
talk to about their traumatic experiences.
Was I a Disturbed Child?
Adult mental illness, as we know, can frequently be traced back to childhood. It is quite possible, then, that
many of us who have suffered emotional problems as adults were already showing signs of emotional
disturbance as children. This is certainly true in my own case : crying, screaming, getting into fights, outbursts
of uncontrolled rage, smashing up household items (they were mainly cheap and nasty, so this was no great
loss), threatening my step-parent/parents, getting drunk on a regular basis from about 14 onwards - once, I
recall, aged about 15, I shut myself in a small cupboard at home and refused to re-emerge (actually, I don’t
think anyone asked me to come out) for about two hours ( it was quite nice in there, as it happens). I could
add more to this list (quite a lot more, in fact), but I’ve probably embarrassed myself sufficiently for the time
being.
In general terms, if we were disturbed as children, the kind of symptoms that we are likely to have displayed
are as follows:
- aggression - this may be displayed towards people or animals; very disturbed children may torture animals
- great anxiety in social situations, leading to social withdrawal
- marked immaturity eg temper tantrums, inability to cope, tendency to cry in situations in which it would not
be normally expected of someone of the particular age of the person
- development of physical (somatic) symptoms in response to anxiety, also known as psychosomatic
symptoms (an example might be extreme anxiety leading to an upset stomach)
- hyperactivity (short attention span, impulsivity - although there is concern in some quarters that this is being
over-diagnosed)
- a sudden drop in academic performance/poor academic performance with no obvious explanation
- pervasive unhappiness and depression
- early use of/dependency on alcohol and/or drugs
In the most severe cases, the person may suffer from distorted thinking, extreme and excessive fear and
anxiety, odd physical movements (psychomotor behaviour,) or extreme and unusual mood swings.
IMPORTANT NOTE : if some of these symptoms are displayed, it does not guarantee that there is an
underlying emotional disturbance; however, the longer the symptoms persist and the more severe they are,
the more likely they are to indicate that professional intervention is required.
WHAT PROPORTION OF CHILDREN ARE THOUGHT TO BE EMOTIONALLY DISTURBED?
In the USA, about 15 % of those under the age of 18 may be significantly emotionally disturbed. Also, about 5
% of the same age group (about 3 million individuals) are currently on psychiatric medication in the USA.
TWO COMMON DISORDERS SUFFERED BY CHILDREN WITH AN UNDERLYING EMOTIONAL
DISTURBANCE :
- CONDUCT DISORDER
- ANXIETY DISORDER
Let’s look at each of these in turn:
- CONDUCT DISORDER : the person diagnosed with this may :
- have difficulty following rules
- have difficulty behaving in a way which is socially acceptable
- display aggression and hostility to people
- display aggression towards animals
- self-harm (eg cut self with knife or razor etc)
- frequently lie/ be deceitful and devious
- steal
- set fires
- vandalize property
- be frequently truant
The kind of therapies which can help with this are family therapy and training programs for children helping
them to develop problem solving skills.
- ANXIETY DISORDER : this disorder is the one which is most commonly diagnosed in children (and adults,
for that matter). Its symptoms are :
- severe and long lasting agitation/fear which the person finds very difficult or impossible to control (in this
situation, professional intervention should be sought - treatments are very often highly effective)
- irrational and overwhelming fear/anxiety may occur in what would normally be considered everyday/routine
situations
TREATMENT : Cognitive-behavioural therapy (CBT) can be extremely effective for treating anxiety. I myself
underwent a course in this about two years ago and it was definitely of considerable help.
Childhood Trauma : Avoidant Personality Disorder (APD).
If our experiences of relationships in childhood are largely negative and painful, in extreme cases, we may
develop social phobia as adults, or, in even more severe cases, avoidant personality disorder (APD).
What is APD? APD is similar to generalized social phobia, but of greater intensity. The person who suffers
from it tries to avoid social contact due to an underlying fear of being humiliated and rejected.
The Diagnostic Statistical Manual (DSM), which is a reference manual used by psychiatrists and
psychologists to help in the diagnosis of mental disorders, lists the following symptoms of APD :
- a pervasive pattern of social inhibition
- feelings of inadequacy
- hypersensitivity to negative evaluation by others
- preoccupied with being criticized and rejected in social situations
- views self as socially inept, personally unappealing and inferior to others
- reluctant to take personal risks or engage in new activities which run the risk of embarrassing self
- avoidance of occupational activities that would involve a significant degree of social contact due to fear of
criticism, disapproval or rejection
- reluctance to enter into intimate relationships fear of being shamed or ridiculed
Typically, APD starts to develop in early adulthood and it affects both males and females equally. Research
by the psychologists Millon and Everly listed the main areas of functioning affected by APD in a person as :
- BEHAVIOUR
- SPEECH
- INTERPERSONAL CONDUCT
- COGNITIVE (THINKING) STYLE
- AFFECTIVE (EMOTIONAL) STYLE
- SELF-PERCEPTION
Let’s briefly examine each of these areas in turn :
BEHAVIOUR : this will usually be withdrawn and wary, sometimes hostility may be displayed towards those
who attempt to be friendly. Tendency to reject others before they can reject him/her.
SPEECH : tendency to remain silent in company
INTERPERSONAL CONDUCT : tends to mistrust others which leads to difficulty forming relationships. In the
case whereby a relationship is started, the person with APD will tend to keep the other person at a distance,
be reluctant to share feelings or to become in any other way vulnerable. General avoidance of intimacy.
COGNITIVE STYLE : the term cognitive style here refers to the kinds of thought processes and thought
patterns the person with APD tends to undergo in social situations. There is a tendency towards excessive
monitoring of how others are reacting to him/her, with possible signs of rejection being constantly looked for,
to which s/he is highly sensitive - in other words, the person with APD is HYPERVIGILANT for signs of
rejection, and, because s/he is also HYPERSENSITIVE to such signs, will often detect them when,
objectively, they do not actually exist.
AFFECTIVE STYLE : the term affective style here refers to how the individual with APD tends to respond
emotionally during social interaction. S/he will tend to show little emotion in such situations due to fear that
this will make him/her vulnerable to rejection and humiliation (Kantor et al). To others, the individual with APD
may appear tense and anxious (Millon et al).
SELF-PERCEPTION : Individuals who suffer from APD tend to have low self-esteem, feel inferior to others,
feel unworthy of being in a relationship, be extremely self-conscious and lonely. Furthermore, they tend to
view any accomplishments they may have to their name as of little or no value (Millon et al).
In Part 2, I will look at possible causes of APD, then, in Part 3, at possible treatments.
Avoidant Personality Disorder (APD). Part 2 - Causes
Evolutionary psychology (the study of why behaviours evolve) explains in part the behaviour of those who
suffer from APD. Our ancestors developed the ’fight or flight’ response to things that they feared, and, as
individuals with APD, at root, fear other people, they can become hostile to others (reflecting the ’fight’
response), or do their best to avoid others (reflecting the ’flight’ response). However, research suggests that
ENVIRONMENTAL factors play a larger part in the development of APD than genetic factors (Millon and
Everly).
Two main influences on the development of APD are :
1) PARENTAL REJECTION
2) PEER REJECTION
Let’s look at each of these in turn :
- PARENTAL REJECTION : according to research conducted by the psychologist Kantor, parental rejection is
the environmental factor which is most strongly associated with an individual’s later development of APD.
This is borne out by the fact that those who suffer from APD are far more likely than others to have
experienced rejection; furthermore, their experiences of rejection have commonly been found to be
particularly intense and frequent.
Parental rejection will often set up the mindset (either consciously or unconsciously) in the rejected individual
which runs along the lines of : ’If my parents can’t accept me, how can I possibly expect anybody else to?’
This can have a catastrophic effect upon the person’s self-esteem, self-worth and confidence. It will often,
too, lead the individual to become profoundly self-critical, even to the point of self-hatred.
- PEER REJECTION : if, when we are young, our home environment is rejecting, critical, hostile and
undermines our sense of self-worth, but, on the other hand, outside of the home we have many experiences
which are positively reinforcing to us (eg supportive teachers, friends or other social networks), the latter
experiences may enable us to develop sufficient PSYCHOLOGICAL RESILIENCE to protect us from the
worst emotional effects of our home-life.
However, if a young person is rejected not only by parent/s, but, also, by siblings and peer group, APD is far
more likely to develop in later life, especially if the various rejections continue over a sustained period of time.
The experience of continual rejection and humiliation can lead to the individual internalizing others’ negative
view of him/her (ie coming to see him/herself in the same negative light in which others appear to see
him/her).
This leads him/her to become yet more self-critical and to feel even more inferior. These feelings of
worthlessness lead to even greater withdrawal from others, and, thus, increases to an even greater extent the
person’s loneliness and sense of isolation. In the mind of the person becoming increasingly cut off from
society, the rejection by his/her peers seems to justify and validate the parental rejection. In the end, the
individual may retreat so far from others that APD develops.
OTHER POSSIBLE PARENTAL CONTRIBUTIONS TO THE DEVELOPMENT OF APD :
1) INFANTALIZATION
2) TRANSFERENCE
I briefly outline these two possible contributors to the development of APD below :
- INFANTALIZATION : parents who infantalize their children (ie are overprotective and don’t let the child
develop a sense of self-responsibility) may make it hard for that child, as s/he grows up, to relate to others
outside of the family on equal terms. This may lead to the individual becoming regressive and/or dependent
in extra-familial relationships.
- TRANSFERENCE : (’transference’ refers to the psychological mechanism whereby we transfer a feeling we
have for somebody close to us onto a different person. An example would be a person who fears his/her
father later transferring that fear onto authority figures in general, such as their boss at work). Transference
can lead to avoidance behaviour when the person with APD distances him/herself from others who remind
him/her of someone s/he was afraid of as a child (usually a parent).
Part 3, the concluding part of this article on APD, will look at ways in which it can be treated. It will be
published very soon.
Avoidant Personality Disorder (APD). Part 3 - Treatments.
As has already been discussed in part 1 and part 2, those suffering from avoidant personality disorder will
generally endeavour to avoid social contact with others as a strategy to prevent themselves being rejected
and rebuffed. Over time, others become aware of this aloofness, and, frequently, will likewise avoid him/her
(this has been termed ’reciprocal avoidance’).
Worse still, especially if young (at school, for example), s/he may attract the attention of bullies who may
apply derogatory names to him/her (eg ’loner’ etc) as they see him/her as an easy target and perhaps as too
timid to stand up for him/herself. Adults, too, who suffer from APD, may be similarly discriminated against,
albeit often in a more subtle manner.
Those with APD often find themselves trapped within a vicious cycle : his/her withdrawn and aloof behaviour
leads to others not being well disposed towards him/her, this in turn leads to lowering the self-esteem of the
APD sufferer further, which, in turn, leads to further withdrawn behaviour...and so on...and so on... As the
cycle continues, the problem becomes increasingly intensified.
Because the person with APD is hypervigilant for any possible signs of rejection, as well as being
hypersensitive to such, this can often lead to him/her perceiving rejection where none, objectively speaking,
exists; or else s/he may greatly exaggerate and magnify minor signs of rejection. In the mind of the person
with APD, any signs of rejection are deeply personal - they see the perceived rejection as confirming the ’fact’
that they are a bad and worthless person. They assume that the perceived rejection is based on an in-depth
and accurate analysis of their personality (whereas, in reality, it is much more likely to be due to superficial
reasons, because the perceived rejecter is in a bad mood, or for any number of reasons that are not personal
in relation to the person with APD.
It has been pointed out by the psychologists Millon and Everly that conditioning is at play in the development
of APD; specifically, a type of conditioning known by psychologists as NEGATIVE REINFORCEMENT. A
behaviour which is NEGATIVELY REINFORCED is one which becomes associated with avoiding an
undesirable outcome. In the case of the individual with APD, the behaviour which is negatively reinforced is
aloofness as it can help the individual avoid the undesirable outcome of rejection. The more a behaviour is
reinforced in this way, the more ingrained the behaviour becomes.
POSSIBLE TREATMENTS AND THERAPIES :
3 types of treatment available for APD are :
1) Behaviour Therapy
2) Family Therapy
3) Medication Let’s briefly look at these in turn :
1) Behaviour Therapy - this form of therapy involves the therapist encouraging the person with APD to
interact with others in social situations for longer and longer periods of time whilst giving him/her support,
encouragement and positive reinforcement.
2) Family Therapy - in part 2 of this article I described how the development of APD might be contributed to
by the sufferer having been ’infantalized’ by his/her parents. If this is suspected to be the case, family therapy
may be appropriate.
3) Medication - doctors sometimes prescribe anti-depressants to those suffering from APD which can help
reduce the anxiety contributing to the condition.
Patterns of Behaviour Stemming from Childhood Trauma
Childhood trauma may affect all aspects of an individuals life - mental, physical, emotional and spiritual. It
may result in dissociation (cutting off from reality, either intentionally or unintentionally), constant
hypervigilance (ie being perpetually on ’red alert’ and expecting danger or calamity to strike at any moment),
impaired cognitive (ie thinking) abilities (for example, decision making skills may adversely affected), a total
inability to experience joy or pleasure of any kind (a symptom I myself had for many years and has not yet
been fully remedied - the phenomenon is also termed ’ANHEDONIA’), constant suspicion of others, an
inability to trust (which can spill over into paranoia), and a chronic, unremitting feeling of profound emptiness.
Many problem behaviours can also develop in later life as a result of childhood trauma. These include:
- excessive need for control
- neediness
- insomnia
- having weak boundaries
- making unhealthy partner choices
- neurosis
- eating disorders
- addictions to sex/relationships
- bipolar depression
- people pleasing
- obsessions/compulsions
- low self-esteem
- suicidal behaviours
- addictions to drugs/alcohol
- chronic physical illness
- severe depression
Let’s look at each of these:
1) EXCESSIVE NEED FOR CONTROL : this is a constant feeling that we need to dominate and control those
we come into contact with and tell them how to live their lives. This might include frequently criticizing other
people’s behaviour and life-styles, often imposing our own views on others and getting angry when other
people’s behaviour does not conform to our wishes.
Sometimes, constantly highlighting the faults of others can be a defence mechanism which we unconsciously
employ to protect us from having to focus too intently upon our own particular shortcomings.
2) NEEDINESS : needy people tend to find it difficult to be alone with their own company. It may involve a
constant need to phone friends to talk to and/or have people around in order to distract ourselves from our
own unhappiness and lack of personal fulfilment. Under stress we may frequently feel we cannot cope with
our particular difficulties by ourselves, but need to rely and depend upon others to give us advice and
support.
3) INSOMNIA : insomnia, related closely to stress, anxiety and depression, can manifest itself in various
forms which include frequent waking throughout the night (something I still suffer badly from), difficulty in
getting to sleep initially, early morning waking (eg at 4am) and not being able to get back to sleep again, not
feeling refreshed by the sleep we do get, and having nightmares (which may wake us up - I still get that, too).
4) HAVING WEAK BOUNDARIES : this might involve always feeling compelled to say ’yes’ to people when
we really want to say ’no’, or spending a lot of time with people we do not really want to be with or in
situations we don’t really want to be in. We may also find that we often lack the courage of our convictions.
We find it very hard to set boundaries and limits, or to see the choice to do this as our right; at the root of the
problem it is frequently the case that we lack the necessary confidence, self-esteem and assertiveness to do
these things. This can sometimes stem from having had our own boundaries ignored when we were children.
5) MAKING UNHEALTHY PARTNER CHOICES : we may find we choose partners with myriad problems of
their own such as alcoholism, drug addiction, violent tendencies, general instability, low integrity etc. This can
mean often finding ourselves feeling trapped in relationships which are neither fair nor equal and in which we
are not treated with respect, consideration or understanding.
Indeed, it is a sad fact that people with low self-esteem (which itself frequently results from having had a
traumatic childhood) often unconsciously select partners who will not treat them well. This can be due to the
unconscious belief that we do not deserve any better.
I will complete looking at our list (above) in Part 2.
Patterns of Behaviour Stemming from Childhood Trauma. Part 2.
In Part 1 of this article I examined how the following behaviour patterns can result in later life due to the
experience of childhood trauma : people pleasing; excessive need for control; neediness; insomnia; having
weak boundaries; and making unhealthy partner choices.
In this part, I will consider the remaining behaviour patterns, presented on the list in Part 1, which can result
from childhood trauma; these are :
- neurosis
- eating disorders
- addictions to sex/relationships
- bipolar disorder
- obsessions/compulsions
- low self-esteem
- suicidal behaviour
- addictions to drugs/alcohol
- chronic physical ill-health
- severe depression
Let’s look at each of these in turn :
- NEUROSIS : this can manifest itself in a number of ways, such as: a) constantly being anxious that others
dislike us or are trying to avoid us
b) sometimes having a distorted perception of reality (although not bad enough to be labelled as psychotic ).
c) being excessively anxiety prone in general
d) having phobias
e) having a nervous tremor and/or tics
f) often feeling fearful in situations most people would find relatively easy to deal with
g) a tendency to be excessively sensitive and to over-react
h) excessive smoking
- EATING DISORDERS : two well known eating disorders which may emerge (more commonly in females)
are anorexia and bulimia. Also, many people in psychological pain over- eat, or eat compulsively, for its
calming and comforting effects which, in turn, can lead to obesity or even morbid obesity.
- ADDICTIONS TO SEX/RELATIONSHIPS : for many people, addictions are a temporary escape from acute
psychological pain but leave us feeling even worse in the long run, these can include feeling constantly
compelled to have promiscuous, but essentially empty, sex or to obsessively pursue relationships which do
us no good. By masking the pain caused by psychological symptoms, they can also prevent us from taking
action to address the root cause of them. But addictions can only mask our pain for so long - reality needs to
be dealt with sooner or later (and, of course, the later we leave it, the more difficult it generally becomes).
Many have not one, but multiple, addictions (eg nicotine, coffee, alcohol, drugs, sex , damaging relationships
etc). We use our addictions to constantly try to keep the pain of the past at bay, thereby preventing us from
living fully in the present.
- BIPOLAR DISORDER : this very serious disorder has been linked to experiences of childhood trauma and
can involve very extreme fluctuations in mood; for example, a sufferer of this condition may feel elated and
euphoric on one day and then feel in a state of suicidal despair the next. These moods can overtake sufferers
’out of the blue’ and individuals who are affected by this illness tend to be far more governed by their feelings
in life as opposed to rational thought and logical planning. Sufferers show marked instability, and, without
treatment, can find it almost impossible to keep their lives in a state of equilibrium. If a person suspects s/he
may suffer from this condition, it is essential to seek appropriate professional advice.
The final six behaviours given on the list above are covered elsewhere in this book.
Effects of Mothers with Borderline Personality Disorder on Children
For those of us who grew up with mothers who suffered from borderline personality disorder (BPD), our
childhoods were often painful and anguished. We found ourselves living in a world that was contradictory and
confusing ; it is likely that we suffered chronic anxiety as we did not know how our mother would react or
behave from one moment to the next.
Due to our mother’s instability, it is likely that we started off life with an insecure emotional attachment to her,
and, throughout our childhood, it is likely that the mother with borderline personality disorder was
inconsistent, unpredictable (expressing affection one minute but rage the next), inappropriately intense and
emotionally controlling. She may, too, have been deeply verbally hostile, expressing hatred and issuing
threats. We may have often been told we were not wanted and that she might well abandon us. It may well
have felt like living in an emotional prison.
The effects of such a childhood can be devastating ; we can grow up feeling fragmented, confused and, later,
develop symptoms of psychological ill-health ourselves, such as impulsiveness, being full of rage and
hostility, being sometimes prone to violence, depression and deep anxiety. We may become in danger of
tipping over into psychosis under stress ( particularly in response to rejection and abandonment). We may,
too, develop addictions as short term coping mechanisms to deal with our psychological pain. In short, we
become at risk of developing borderline personality disorder ourselves.
Borderline personality disorder is diagnosed in women twice as frequently as in men. It has been
hypothesized that this could be due to the fact that men with BPD are much more likely to be mis-diagnosed
as having anti-social personality disorder and end up in the prison system. (which is often clearly likely to
make their condition even worse). It is estimated that, in the USA, there are about 6 million people suffering
from BPD, which, in turn, must mean that there are also millions of children living with mothers who have
BPD.
Below are some of the most frequent things people who have been brought up with mothers with BPD say
about them :
- she is completely unpredictable
- she denies what has happened
- she sees everything in extreme terms (also called ’black and white’ or ’all or nothing’ thinking)
- I sometimes find myself hating her
- I am not able to trust her
- she’s always exploding into rage
- she imposes her negative view of the world onto me
- she drives me insane
- she makes me feel terrible about myself
I will continue to look at the effects a mother with borderline personality disorder can have upon her children
in later articles.
Defining Emotional Abuse
Different researchers tend to define emotional abuse, or, as it is referred to in the USA, ’psychological
maltreatment’ in different ways. The difficulties with precise definition arise from the fact that several variables
need to be considered - including philosophical, scientific, cultural, political and legal factors (Hart et al.,
2002).
For example, some researchers differentiate between emotional ABUSE and emotional NEGLECT. Also,
whilst some researchers focus upon the ACTIONS OF THE PERPETRATOR (it should be pointed out that
’actions’ in this context refer to both acts of COMMISSION and acts of OMMISSION - or, to put it another
way, both upon what the perpetrator does and FAILS TO DO), others focus more upon THE EFFECTS
UPON THE CHILD. A third complicating factor is that there is often a significant delay between the abuse
itself and the disturbed behaviour which results from that abuse.
In the USA, emotional abuse (or ’psychological maltreatment’) is most frequently, formally defined in the
following way :
’ A repeated pattern of caregiver behaviour or extreme incidents that convey to the children that they are
worthless, flawed, unloved, unwanted, endangered or only of value in meeting the needs of another. It
includes :
- spurning
- terrorizing
- isolating
- exploiting/corrupting
- denying emotional responsiveness
- neglecting mental health, medical needs and education The above is the definition is from The American
Professional Society on Abuse of Children (APSAC), 1995
Let’s look at what is meant by each of the six items on the above list.
1) SPURNING - this may be verbal or non-verbal and includes belittling, shaming or ridiculing the child,
generally degrading him/her or rejecting/abandoning him/her
2) TERRORIZING - this includes placing the child in danger, threatening him/her or generally creating a
climate of fear
3) ISOLATING - this can involve placing severe restrictions on the child, preventing developmentally
appropriate social interaction and/or separating the child from the rest of the family.
4) EXPLOITING/CORRUPTING - this includes encouraging the child to develop in inappropriate and/or
antisocial behaviours and values, such as stealing, abusing others physically or verbally, breaking into
houses etc.
5) DENYING EMOTIONAL RESPONSIVENESS - this involves being emotionally unavailable, ignoring the
child, failing to express affection, and becoming distant physically and emotionally
6) NEGLECTING MENTAL HEALTH, MEDICAL NEEDS AND EDUCATION - this involves failing to provide
and attend to the psychological, medical, cognitive and mental needs of the child.
(1-6 above from Dorosa Iwaniec, 2006)
Four Types of Borderline Mother
All individuals who suffer from BPD experience its core symptoms; these are
- fear
- helplessness
- emptiness
- anger
However, one of these symptoms may PREDOMINATE and thus shape a particular BPD sufferer’s character.
In relation to this idea, James Masterson (1988) classified mothers with BPD into four sub-groups; these are :
1) THE WAIF MOTHER
2) THE HERMIT MOTHER
3) THE QUEEN MOTHER
4) THE WITCH MOTHER
Let’s look at each of these in turn :
1) THE WAIF MOTHER - personality traits include helplessness, hopelessness, proneness to deep despair,
extremely low self-esteem, very high sensitivity, having a ’victim mentality’, passivity and vulnerability. Sees
self as failure. May treat her children alternately indulgently and negligently. There often exists an intense
underlying feeling of rage which may be particularly likely erupt in response to abandonment (either real or
imagined).
POSSIBLE EFFECTS OF WAIF MOTHER ON CHILDREN :
- they may come to see themselves as failures for not being able to make her happy
- they may internalize her despairing view of the world and become despairing themselves
- they may become ENMESHED in their relationship with her and therefore find it difficult to separate from it.
2) THE HERMIT MOTHER - sees the world as dangerous and people in general as self-serving and callous.
Constantly expecting disaster to strike and sees signs of imminent calamity everywhere. Has a deep sense of
inner shame which she projects onto others. May have a tough exterior and a superficial image of being
confident, determined and independent. However, beneath this façade she tends to be distrustful, insecure
and prone to rage and paranoia. Gains self-esteem from work or hobbies.
POSSIBLE EFFECTS OF HERMIT MOTHER ON CHILDREN :
- they may internalize mother’s fear of world in general and therefore become anxious if they need to adapt to
new situations
- they may find it very difficult to learn appropriate coping skills in relation to a large variety of life’s problems
- they may find it difficult to trust others
3) THE QUEEN MOTHER - constantly craves attention; uses her children to fulfil her own needs; cannot
tolerate disagreement or criticism from her children - sees this as evidence that they do not love and respect
her; chronic feelings of emptiness; inability to ’self-soothe’ when distressed; powerful sense of own
entitlement - may be prepared to use blackmail in order to get what she wants; capable of planned and
premeditated manipulation; discards friends without guilt when they are no longer of use to her
POSSIBLE EFFECTS OF QUEEN MOTHER ON CHILDREN :
- essentially this type of mother sees her children as her audience who must constantly respond to her in
ways which bolster her (very fragile) self-esteem - she expects from them their unquestioning and
unwavering love, support, attention and admiration. As it is impossible for her children to satisfy her insatiable
emotional needs, conflict increases dramatically as the children get older. Rebellion, deep confusion and
anger are likely responses from children who live with this kind of mother, but beneath this the children long
for approval, recognition, consistency and unconditional love. In essence, however, the ’queen’ mother’s own
needs trump those of her children’s, as far as she is concerned.
4) THE WITCH MOTHER - this type of mother is consumed by self-hatred (often on an unconscious level)
and tends to be extremely hostile and cruel towards their children. Because of their feelings of rage mixed
with impotence, they have a propensity to be particularly cruel to those less powerful than they are (eg
younger). They also tend to be self-obsessed and have little or no concern for others. They are likely to
respond particularly venomously to criticism or rejection. At the base of their need for power and control is
their intense desire to prevent abandonment. This particular sub-group of BPD is very resistant to treatment
as those who suffer it tend not to allow others to help them.
POSSIBLE EFFECTS OF WITCH MOTHER ON CHILDREN :
- the children of this type of mother are likely to find themselves as the target of random, intense and cruel
attacks
- as with other forms of abuse, children who suffer the verbal/emotional/psychological abuse assume
(completely incorrectly) that it is they themselves who are at fault. As a result of this profound misconception,
they are likely to become depressed, subject to feelings of shame, insecure, hypervigilant (ie always on ’red
alert’ on the look out for danger) and dissociative (click here to read my article on dissociation). As adults,
they may develop difficulties with forming and maintaining relationships. It is possible, too, that they will go on
to develop post-traumatic stress disorder (PTSD) or suffer from BPD themselves, thus potentially
perpetuating the cycle.
The Five Main Routes Through Which Childhood Trauma Harms Us-Part 1.
It has already been established in previous articles on this site that childhood trauma can affect us ;
- psychologically
- neurologically
- biologically
It has further been described that the damage done by the experience of childhood trauma may manifest
itself in a variety of ways; these include :
- our ability to emotionally regulate (ie our ability to control our emotions)
- extreme anxiety
- high degree of impulsiveness (acting without thinking through the consequences, implications and
ramifications)
- sleep disturbance including insomnia, nightmares/night-terrors and, sometimes, an excessive need to sleep
- severe depression
- personality disorders
(NB the above list is by no means exclusive)
In this article, I want to look at the various routes through which the experience of childhood trauma adversely
impacts on us; these have been identified as the following :
- emotional
- behavioural
- cognitive
- social
- biological
1) THE EMOTIONAL ROUTE : If, as a child, we were unable to rely upon our primary caregiver to console
and soothe us when we were under psychological duress, research strongly indicates that we become
incapable of effectively dealing with stress as adults (assuming there has been no therapeutic intervention).
We lack the ability to self-soothe and therefore find we are highly reactive and sensitive to stress as adults, to
the degree that it may engulf and overwhelm us. The extreme emotional problems that we may find ourselves
having to deal with as adults (often, most unsuccessfully) have been documented by various researchers (eg
Van Der Horst et al., 2008).
It has also been demonstrated (eg Bowlby, 1988) that a failure to establish a healthy emotional bond with the
primary caregiver as children often leads to us experiencing significant difficulties with forming and
maintaining relationships in our adult life. Indeed, we may find that our adult relationships are full of conflict
and disruption (Henderson, 2006).
Bowlby’s extensive research on the vital importance of our experience of early relationships with caregivers
to how we form (or fail to form) relationships as adults has clearly indicated that we INTERNALIZE OUR
EARLY RELATIONSHIPS; it is this psychological process that affects how we relate to others later on in life.
In other words, the DYSFUNCTIONAL ATTACHMENT STYLE we had with our primary caregiver in
childhood repeats itself in the relationships we form in adulthood. In essence, OUR ADULT RELATIONSHIPS
WILL TEND TO MIRROR OUR EARLY, PROBLEMATIC RELATIONSHIP WITH OUR PRIMARY
CAREGIVER.
Bowlby described three types of dysfunctional attachment style (ie ways of relating to others) we may
develop as adults due to our adverse early experiences; these are :
a) AMBIVALENT ATTACHMENT
b) AVOIDANT ATTACHMENT
c) DISORGANIZED ATTACHMENT
Let’s look at each of these in turn:
a) AMBIVALENT ATTACHMENT - If we develop this dysfunctional attachment style as adults it is likely that
the parenting we received was inconsistent and emotionally negligent - often, the parent’s emotional
responsiveness to the child has been intermittent at best; the result of this tends to be that the child will
intensely cling to the parent on the rare occasion s/he is available in order to attempt to compensate for when
s/he is not and to, as it were, ’make the most of it.’
In adulthood, as a consequence of the above, the individual may become extremely ’clingy’, obsessive and
dependent in connection to relationships. S/he may, too, become excessively angry and/or upset in response
to perceived rejection.
b) AVOIDANT ATTACHMENT - If, as children, the parenting we received was hostile, rejecting and cold, we
may learn not to approach others for emotional support for fear of meeting with more painful rejection. As
adults, we may become obsessively self-reliant, dislike intimacy and view others as hostile and essentially
unreliable. Underlying this, there may well be feelings of anxiety, depression and general emotional distress
which we dare not confide in others about and attempt to keep hidden (eg Alexander and Anderson, 1994).
c) DISORGANIZED ATTACHMENT - Generally, this dysfunctional attachment style has been found to have
its origin in the early experience in which the child is frightened of interactions with the primary caregiver.
However, no matter how afraid of the primary caregiver the child might be, s/he must, by necessity, interact
with him/her and, for psychological protection, develops coping strategies to do so; a prime example of such
a coping mechanism is dissociation (click here to read my article on dissociation).
Following such childhood experiences, s/he may grow up to be an adult who views him/herself (erroneously)
as irredemiably bad and (also erroneously) as responsible for the trauma s/he experienced as a child. As an
adult, too, as a result of the traumatic childhood, social adjustment is frequently impaired and feelings of
depression and distress are likely to predominate.
Part 2 of this article will look at items 2-5 on the above list, namely the behavioural, cognitive, social and
biological routes through which the experience of childhood trauma can adversely affect us in our adult life.
Best wishes, David Hosier BSc Hons; MSc; PGDE(FAHE).
1.8.14 The Five Main Routes Through Which Childhood Trauma Harms Us-Part 2 (2013-09-26 09:15)
effects of childhood trauma
This post follows on from The Five Main Routes Through Which Childhood Trauma Harms Us Part 1. Click
here to read it.
We have already looked at the emotional route (item 1 on the list of the five routes - see Part 1) through
which childhood trauma may harm us in Part 1. In this post, I want to turn to the other four routes through
which childhood trauma can harm us; these are :
2) THE BEHAVIOURAL ROUTE
3) THE COGNITIVE ROUTE
4) THE SOCIAL ROUTE
5) THE BIOLOGICAL ROUTE
Let’s look at each of these in turn :
- THE BEHAVIOURAL ROUTE : Our adverse childhood experiences (eg rejection, betrayal, abuse) often
lead us to develop counter-productive coping mechanisms to attempt to deal with our distress in adult life; in
turn, these dysfunctional coping mechanisms are likely to adversely impact on our physical health; examples
include :
- smoking
- excessive drinking
- illicit drug use
- over-eating
- high risk sexual activity (ie unprotected, promiscuous sex)
- self-harm
Essentially, we adopt these behaviours in order to psychologically dissociate from our all too painful reality
(click here to read my post on dissociation).
Unfortunately, in addition to the fact that these behaviours can lead to physical illness, our reliance upon
them also PREVENTS US FROM LEARNING MORE EFFECTIVE COPING STRATEGIES.
- THE COGNITIVE ROUTE : The term ’cognitive’ relates to how we think about things; for example, the
attitudes and beliefs which, in large part, determine our day-to-day behaviour. As I have written about fairly
extensively in other posts, the experience of childhood trauma often results in us developing a cognitive
negative bias towards ;
- ourselves
- other people
- the world in general
This three-way despairing outlook has been termed ’THE NEGATIVE COGNITIVE TRIAD’ and is one of the
main hallmarks of clinical depression. We tend, for example, to (completely erroneously) blame ourselves for
the trauma that we suffered and this prevents us from developing good self-esteem or a cohesive and
positive self-identity (eg Kralik, 2005).
If, as children, we were in a more or less perpetual state of stress, it is likely that we frequently experienced
the ’fight/flight response’ as a reaction to frightening stimuli. If this occurred frequently enough, and over a
long enough period, such a response may well have become DEEPLY INGRAINED INTO OUR
PERSONALITY - we become conditioned to respond in this way (beyond our conscious control) whenever
we feel threatened.
Therefore, as an adult, we may, for example, frequently react with extreme anger which seems, to an
objective observer, as both excessive and inappropriate. However, such rage occurs because the (even very
small) threats we experience in adulthood remind us (usually on an unconscious level) of the threats we
experienced as children - thus the response which was conditioned into us over long years of suffering in
childhood is triggered.
- THE SOCIAL ROUTE : We have seen in previous posts how childhood trauma can lead us to experience
extreme difficulties in relation to our personal relationships in adult life (eg - click here). As a result, we may,
as adults, find we have little social support - in turn, a lack of social support and close personal relationships
has been shown (eg Draper et al., 2007) to be associated with poor physical and mental health. Indeed,
Tucker (1999) carried out research showing that our social environment is more important in relation to our
mental health than our physical environment.
- THE BIOLOGICAL ROUTE : Chronic stress in childhood can adversely affect our neurological development,
and, therefore, we are more likely to develop neuropsychiatric conditions as adults.
Post Traumatic Stress Disorder (PTSD) Test.
As we have seen in several of the previously published articles on this website (eg click here), severe
childhood trauma can lead to the development of post traumatic stress disorder (PTSD). If you are concerned
you might suffer from the condition, it is important to seek advice from a relevantly qualified mental health
professional.
However, if you want to find out if you have symptoms which PTSD can cause, you may find it interesting and
useful to look at the list of items below and count up how many apply to you. REMEMBER, THE TEST DOES
NOT REPLACE A PROFESSIONAL MEDICAL ASSESSMENT AND DIAGNOSIS.
SELF-REPORT POST TRAUMATIC STRESS DISORDER (PTSD) TEST :
(score 1 point for each item you answer YES to)
1) Have you been exposed to a traumatic event or events?
2) Did the trauma cause you to experience feelings of intense fear/ horror and
powerlessness/impotence/helplessness
3) Does it sometimes feel as if you are reliving or re-experiencing the trauma (ie flashbacks)
4) Do you experience nightmares which are associated with the trauma that you experienced
5) Did the traumatic experience involve you witnessing serious injury/death or did it involve you being
seriously injured/threatened with death?
6) Do you have thoughts or mental images related to the trauma which are intrusive, difficult to control and
hard to dispel from the mind?
7) When something reminds you of the trauma, or you find thoughts about it intruding on your mind, does it
cause serious distress?
8) Do you avoid things that remind you of the trauma? Examples include activities, people and places
9) Do you find you have less interest in activities that you used to enjoy?
10) Are you unable to remember something significant that occurred during the trauma (this is sometimes
referred to as repression)
11) Do you try to avoid speaking about what happened during the trauma? 12) Do you find yourself more
irritable than you were before the trauma occurred and that you get angry much more often?
13) Do you suffer from insomnia (such as finding it hard to get off to sleep and/or waking too early)?
14) Has your concentration become impaired since the trauma?
15) Do you find you no longer wish to interact with others as much as you did prior to the trauma and that you
now have difficulty trusting other people?
16) Do you fear that, because of the trauma you suffered, it will significantly, negatively impinge upon your
future life in areas such as career, relationships and life span?
17) Has your ’startle response’ become more sensitive since the trauma?
18) Have the symptoms that you’ve experienced since the trauma lasted for a minimum of one month so far?
19) Since the trauma, do you find it harder to feel emotions (eg feeling ’numb’ for much of the time) and/or
harder to display emotions to others?
20) Do you feel hypervigilant (ie feel as if you are constantly on ’red alert’) for much of the time and constantly
have a sense of impending disaster?
21) Have what used to be your everyday routines been disrupted by how you now feel (eg social life, work)?
A guide to interpreting your score :
0-3 It is not likely that you have PTSD
4-9 It is likely you have PTSD
10 + It is very likely you have PTSD
DISCLAIMER - This does NOT provide you with a diagnosis, it is just a guide. If you suspect you have PTSD,
or a related condition, you are strongly advised to seek the relevant professional advice. Best wishes, David
Hosier BSc Hons; MSc; PGDE(FAHE).
1.9 October
1.9.1 Why Is Emotional Abuse So Harmful? (2013-10-02 12:23)
effects of emotional abuse
Research shows that emotional abuse is just as damaging as physical or sexual abuse (although it is only
relatively recently that this has been acknowledged). In this article, I want to look at some of the reasons that
its effects can be so devastating.
Emotional abuse not only negatively affects the child at the time it is going on (by lowering his/her
self-esteem and causing him/her to live in a constant state of uncertainty and fear, for example), but, if there
is no therapeutic intervention, leads to a deeply unhappy adulthood as well.
When a person has grown up in an environment which is emotionally abusive, his/her adult experiences will
be viewed through the negative filter which was laid down during his/her childhood. This, in turn, is likely to
lead to maladaptive (unhelpful) behaviours in adult life which may well jeopordise his/her career prospects,
relationships and physical health, for example.
EFFECTS OF AN UNSTABLE EMOTIONAL ENVIRONMENT
If as a child, you lived in an emotionally unstable environment, as I did with my mother until I was thirteen
(when I was made to leave to go and live with my father and step-mother) you may, as I did, have felt that
you were robbed of security and value.
As children, we desperately needed consistency and the knowledge that we were unconditionally accepted
and valued by those who were supposed to deeply care for us. But, because an emotionally unstable
environment is one which is devoid of consistency, children brought up in such a home never learn what to
expect (their parent’/carers’ behaviour can wildly fluctuate in unpredictable ways) they are never able to feel
the environment is under control - they never know what might happen next or what lies ahead; there is
constant uncertainty and fear about how they will be treated. Anything seems possible. There exists in such
children a permanent state of nervous anticipation, if not outright terror.
If there seem to be no boundaries on the parents’/carers’ behaviour, fear is the result. There is never a sense
of safety. There is never a sense of securiy. The child can never relax. At any moment, unprovoked, can
come verbal or physical violence. There develops a never ending sense of dread, there is always the
question of how far the abuse might go. There is never a truly safe moment.
I will end this article with a short list and summary of some of the possible main damaging effects of
emotional abuse. They are:
- a necessity to be in a state of constant hypervigilence; this will often lead to acute sensitivity and easily
triggered hostility (attack, in this case, being a form of defense)
- if, as children, we are constantly told we are in the wrong, this can lead to procrastination, indecision and
inaction (we become constantly concerned anything we try will turn to disaster)
- if we are constantly provoked, we may start reacting with outbursts of rage
- being constantly treated in an unfair way can lead us to become obsessed with getting justice
- the constant psychological strain can lead to a state of emotional exhaustion - this can easily result in
apathy and depression (including losing motivation and an inability to derive any pleasure from activities or
social interactions)
- being perpetually criticized can lead to feelings of insecurity, shame and guilt I hope you have found this
post of interest.
Best wishes, David Hosier BSc Hons; MSc; PGDE(FAHE).
1.9.2 The Damaging Effects of Physical Abuse (2013-10-03 16:09)
effects of physical abuse
Physical abuse of children can be defined as an action which physically hurts or injures them. Usually, this is
not a one-off incident, but is a pattern of behaviour towards the child from the parent/s or someone else who
is supposed to be caring for him/her. Very frequently, too, the child who is physically abused will also be
emotionally abused.
It is estimated that approximately 1 in 6 reports of child abuse involve physical abuse. However, as has been
pointed out in other articles on this site, child abuse is notoriously under-reported (not least due to the
perpetrators’ desire to cover it up) so it is very likely that it is far more prevalent than suggested by official
statistics.
THE PSYCHOLOGICAL EFFECTS OF PHYSICAL TRAUMA :
As well as the physical harm done to the child, s/he will inevitably suffer associated adverse psychological
consequences. These can include :
- anxiety and fear
- depression
- traumatic stress
- a tendency to become aggressive
- difficulties with interpersonal relationships
- fear and distrust of those in authority
- low self-esteem
- self-blame
- a sense of shame (due to the fact it is common for the child to erroneously believe s/he deserved the harsh
treatment)
- it is also thought that the trauma of being physically abused, over time, can negatively impinge upon the
development of the brain
OTHER EFFECTS :
It is common, too, for the child who has suffered physical abuse to frequently ’act out’ his/her feelings.
Essentially, this involves ’problem’ behaviours, such as going into rages, as an expression (usually
unconsciously) of his/her inner emotional turmoil and distress. ’Acting out’ takes place because the child does
not have the verbal skills or understanding to effectively verbally express his/her deepest feelings and inner
pain.
Sometimes, however, in stark contrast to this, the child, in response to the physical abuse, will become
emotionally ’numb’, apathetic and resigned; s/he may become emotionally ’flat’ and stop expressing his/her
feelings.
UNPREDICTABLE PHYSICAL ABUSE :
The more unpredictable the physical abuse is (it is especially likely to be unpredictable if the parent/’carer’ is
unstable) the deeper will be the sense of fear the child finds him/herself having to live with.
THREATS OF PHYSICAL ABUSE :
If the child is often threatened with physical abuse (ie it is always ’just’ a threat, and never actually
materializes), the effects can be just as serious. Indeed, the psychologists Knutson et al., (2005) found that
living with such threats often led to depression, anxiety and aggression in the child.
THE LONG TERM CONSEQUENCES :
A research study carried out by Silverman et al., found that 80 % of young people who had experienced
significant physical abuse in childhood, had at least one psychiatric disorder by the age of 21 years. These
included :
- depression
- anxiety
- suicidal behaviours
- eating disorders
- substance misuse
On top of the above, those who have suffered physical abuse as children are much more likely to commit
crime in later life. They are also more likely to become violent themselves, having learned, as children, that
violence was an ’acceptable’ form of expression and control.
Possible Effects of Divorce on Children
My own parents divorced in the scorching summer of 1976, when I was 8 years old. At prep school, I was the
only boy in the class with divorced parents. I was deeply ashamed of this fact, and I did my best to keep it a
secret. I was so disturbed by my home life that, during this period of my life, the teachers at my school
thought I was developing deafness as I would never respond when my name was called - instead, I would be
sitting in a kind of oblivious trance (this is what psychologists term a’ dissociative state’, or’ psychologically
detaching’ from the pain of reality as a defense mechanism).
Indeed, when I was taken to see a doctor it was confirmed that there was nothing wrong with my ears.
Unfortunately, however, my parents did not regard it as necessary to arrange counselling for me, even
though I was displaying other worrying signs of emotional problems during this time.
Today, divorce is far more common than it was in the 1970s, and much less stigmatized. However, the
potential adverse effects of divorce upon children can still be just as devastating as they have always been.
Indeed, such effects can be carried into adult life, and, therefore, be passed on to the next generation.
POSSIBLE EFFECTS OF DIVORCE ON CHILDREN :
- REDUCED EDUCATIONAL ATTAINMENT : studies have shown that children of divorced parents can have
a reduced capacity for learning and perform, on average, worse in maths, spelling and reading than there
peers
- POVERTY : divorce results in a large drop in household income and, in the USA, 50 % of children from
divorced families are placed into poverty as a consequence.
- SUBSTANCE ABUSE : children of divorced parents are more likely to abuse alcohol and drugs, particularly
in order to try to cope with the emotional pain of conflict and rejection.
- CRIME : children of divorced parents are more likely to become involved with crime. For example, a study
by Robert Sampson, from the University of Chicago, showed that the divorce rate of specific areas was
predictive of the number of robberies carried out
- RELATIONSHIPS - divorce can weaken the relationship between the parents and the child. It can also lead
to the child developing destructive ways of handling conflict which can persist into adult life. Indeed, children
of divorced parents are more likely to divorce their own partners in adult life. Furthermore, children of
divorced parents show less desire to have children themselves when they become adults.
Children of divorced parents also often find in later life that their own capacity to have deep and trusting
relationships has been reduced. Also, if, as adults, they do decide to have children, they will often struggle to
create a positive and healthy environment for their families to live in.
- NEGLECT : children of divorced parents are twice as likely to suffer neglect. Studies have shown that
divorced mothers tend to be less able to provide their children with emotional support and divorced fathers
are less likely to have a close relationship with their children.
A LIST OF OTHER POTENTIAL EFFECTS : the child of divorced parents may :
- become prone to rage and anger
- become anxious/fearful
- become depressed
- feel rejected
- experience a sense of conflicting loyalties
- feel extremely lonely
- find that their confidence and self-esteem has been damaged
Arrested Psychological Development and Age Regression
Traumatic life events can cause the child to become ’stuck’ at a particular level of psychological development
for an extended period of time - s/he may, therefore, often seem immature as development was frozen at an
earlier stage. For example, an eleven year old child who was abandoned by his/her primary carer at age four
may throw tantrums similar to those one might expect of a four year old when left with an unfamiliar
baby-sitter. In other words, s/he may regress behaviourally to the developmental stage at which s/he became
frozen. Such regressive behaviour is a temporary reaction to real or perceived trauma.
Severe trauma can result in commensurately severe developmental delays. For example, a ten year old child
who has experienced severe trauma may not yet have developed a conscience (even though a conscience
usually develops around the of ages six to eight). This does NOT mean that the child is ’bad’, it is just that
s/he has not yet reached the relevant developmental stage. This can be rectified by the child identifying with
a parent or carer and internalizing that identification.
It is vital to point out that if a child has never had the opportunity to identify with a safe and rational adult and
has not, therefore, been able to internalize adult values, we cannot expect that child to have developed a
conscience. Indeed, if there has been little or no justice or predictability in the child’s life, and s/he is
ill-treated for no discernible reason by adults in a position of trust, developing a conscience may not even
have been in the child’s best interests. In extreme circumstances, for example, it may have been necessary
for the child to lie, steal and cheat purely in order to survive; once s/he has learned such behaviours are
necessary to his/her very survival, these same behaviours become extremely difficult to unlearn.
Below I list some of the main factors that may lead to arrested development. EXAMPLES OF TRAUMAS
WHICH CAN INTERRUPT PSYCHOLOGICAL DEVELOPMENT :
- separation from the primary care-giver
- all forms of abuse
- foster care
- adoption
- neglect
- parental alcohol/drug misuse
ATTACHMENT DISORDER :
One of the main traumas a child can suffer is a problematic early relationship with the primary care- giver;
these problems can include the primary care-giver having a mental illness, abusing alcohol/drugs, or
otherwise abusing or abandoning the child. In such cases, attachment disorder is likely to occur in the child this disorder can impair or even cripple a child’s ability to trust and bond with others. In such cases, it is the
child’s ability to attach to other human beings which is impaired by developmental delays.
Since such a child’s development has essentially become frozen in relation to his/her ability to bond with
others, s/he will not ’grow out’ of the problem behaviours associated with attachment disorder without a great
deal of emotional ’repair work.’
WHAT KIND OF BEHAVIOURS MIGHT A CHILD WITH AN ATTACHMENT DISORDER DISPLAY?
the main examples of these are listed below :
- little eye contact with parents
- lack of affection with parents
- telling extremely obvious lies
- stealing
- delays in learning
- poor relationships with peers
- cruelty to animals
- lack of conscience
- preoccupation with fire
- very little impulse control/hyperactivity
- abnormal speech patterns
- abnormal eating patterns
- inappropriate demanding behaviour
- inappropriate clingy behaviour
Neglect as a Form of Emotional Abuse
A child who is neglected may be treated with indifference, as if s/he is of no importance, ignored, or almost as
if s/he does not exist. It is the absence and withholding of the attention and approval the child expects and
needs that does the damage. It may involve the child often being given ’the silent treatment’ (one of my own
mother’s inexhaustible supply of specialities in psychological torture when I was a kid), not being listened to,
not having his/her views and feelings acknowledged or validated and frequently experiencing his/her parent/s
turning their back on him/her (either literally or metaphorically).
One of the main effects such treatment will often have upon the child is that s/he will start to seek attention
through ’bad’ behaviour (eg confrontational behaviour, outbursts of rage and temper etc). The reason for this
is often that even negative attention is better than nothing (although frequently this ’reasoning’ will be
operating on an unconscious level). This is because total withdrawal by the parent/s and the complete
withholding of any type of relationship, and the consequent feeling of total and utter rejection, would be
psychologically catastrophic for the child.
Such neglect is particularly confusing for the child when his/her parent/s, despite their emotional neglect of
him/her, meet his/her material needs more than adequately or even extravagantly. This is because the child
may feel intense guilt criticizing his/her parents when they do so much for him/her in financial terms. Indeed,
some parents who are aware that they are emotionally neglecting their child may overcompensate by
materially spoiling the child as a way of diminishing their own feelings of guilt, or, in a sense, in order to ’buy
the child off.’ Such a situation produces intense psychological conflict in the child’s mind. Obviously, the child
requires both physical AND emotional nurturing.
POSSIBLE EFFECTS OF EMOTIONAL NEGLECT :
Children who are emotionally neglected may be so adversely psychologically affected that they experience
developmental delay. They may, too, become so hungry for an emotional attachment that they start to cling to
other adults outside of the family. Eating disorders may also occur; food, or the control of the intake of food,
becomes a substitute for a proper emotional relationship. Also, the child may start to self-harm - this may take
the form of self-biting, cutting, scratching etc.
Sometimes, in adult life, the person who was neglected as a child may become an ’over-achiever’ and
accomplish a great deal in life; it has been theorized that, at the root of this, is an unconscious desire to finally
attain the interest, approval and admiration of the parent/s which could not be obtained during their childhood.
RECOVERY THROUGH ACCEPTANCE :
Eventually, it may be necessary for us to realize and acknowledge that the person/s who neglected us was a
flawed human being with their own psychological difficulties. It may have been the case that, as children, our
presence was not sufficient to over-ride these psychological difficulties our parent/s had, especially, for
example, if they themselves were mentally unwell or had a serious substance abuse problem. It may be that
the person we wanted our parent/s to be, or believed they could be, never existed except as an idealized
image in our own minds.
WHY WE SOMETIMES MISTAKENLY FEEL RESPONSIBLE FOR OUR OWN NEGLECT:
It is extremely common for those who were abused as children to feel responsible for their own illtreatment
and to believe that they must be a ’bad’ person. Why should this erroneous belief arise so frequently? The
main theory that seeks to explain this is that if we can deceive ourselves into believing that the abuse we
suffered was our own fault, and not the fault of our parent/s, we can delude ourselves into clinging on to the
hope that there is a chance that, if we change, our parent/s will become the person we want them to be, that
they are good parents after all. It seems that, on some level, we would prefer to believe we ourselves are bad
than to believe that our parents were.
In order to shake off this delusion and rid ourselves of the guilt of believing we are bad and somehow
’deserved’ our abuse, it may be necessary for us to finally come to the realization that our parent/s will never
become the person we want, no matter what we do. In this way we may perhaps finally be able to rid
ourselves of guilt and start to rebuild a sense of our own worth as human beings.
The Use of Religion as a Weapon of Abuse
When I was thirteen, shortly after my disturbed and deeply unstable mother had thrown me out of the house
and I was grudgingly received into the house (I won’t dignify it by calling it a home) of my father and his new
wife (my step-mother,) I became, as might be expected, and which I may conceivably expect to be forgiven
for, a rather argumentative and defiant child (although, interestingly, only at home - never at school). I
remember ( indeed, the memory is seered into my brain), that I was arguing with my step-mother in the
kitchen and she suddenly fixed me with a violent stare and started to shout (loudly and with a kind of
demented aggression) at me in ’tongues’. I do not know if she deliberately faked it or whether it was merely a
symptom of religious psychosis. I do know, however, that, as a naive thirteen year old, it profoundly disturbed
my sense of self. Was I not just bad, but evil? And not just evil, but so evil that god had just taken the trouble
to let me know , in no uncertain terms,personally (rather than, say, the serial killer that had been on the front
page of the paper that day?).
Emotional abuse by parents, or, indeed, if I may be so bold as to suggest, by step-parents, has such a
destructive effect not least because of the disparity in power between them and the child. The more authority
and power that the emotional abuser has, the more damaging the effects of that emotional abuse are likely to
be.
Those who use religion to abuse others employ the tactic of augmenting their power, authority and control BY
PRESENTING THEMSELVES AS HAVING DIVINE AUTHORITY. They have the breathtaking arrogance to
position themselves as god’s spokesperson. They will, too, of course, carefully select passages from religious
texts like the bible to bully, control and coerce others, robbing them of their individuality and authenticity even
their independence of thought. The victim of this abuse can find that they are left feeling bad, worthless, guilty
and ashamed.
They may even spend their childhoods, and, later, much of their adulthood, preoccupied that they are
destined for eternal torture in hell.
Childhood Trauma Leading to Anhedonia (Inability to Experience Pleasure).
There is an established relationship between having experienced trauma as a child and suffering from
anhedonia (the inability to experience feelings of pleasure) as an adult. This has been one of the symptoms
of my own illness, and I am sorry to report it is one that I am yet to overcome (although there has been some
improvement, I suppose).
Anhedonia drains the colour from life, rather like seeing a film in high resolution colour suddenly fade into a
grainy, blurred, black and white. One feels just intense emptiness and a complete blunting of positive
emotional response. It can affect all areas of life including :
- social interaction
- career satisfaction
- food
- sex
- music
- sports
- previous hobbies and interests
- previously close and/or intimate relationships
Many who suffer anhedonia will have every aspect of their lives affected, whereas others may be affected in
some areas but not in others.
In connection with research into the link between childhood trauma and anhedonia, Frewen et al have
introduced the concept of ’negative affective interference’. Essentially, this refers to the idea that in, in
response to positive events, those suffering anhedonia are not only unable to feel any pleasure but the
positive event may actually lead to them feeling worse. For example, when witnessing a beautiful sunset from
the balcony of a luxury hotel in an idyllic setting, not only will those with anhedonia experience no joy, but
experience an increase in negative affect (mood) such as intensified feelings of anxiety, guilt or shame. It is
this increase in negative feelings in response to positive events which is referred to as ’negative affect
interference’.
Frewen et al’s study also showed that different types of childhood trauma led to different kinds of negative
affective interference in response to positive events. For example, those who suffered emotional abuse as a
child were more likely to experience increases in anxiety, whereas those who had suffered childhood sexual
abuse were more likely to experience feelings of shame.
IMPLICATIONS FOR THERAPEUTIC INTERVENTIONS RELATING TO ANHEDONIA :
The above findings suggest that therapeutic interventions for those suffering from anhedonia should not only
focus on increasing positive affect but also on strategies for regulating negative affect in response to positive
events.
The Link Between Childhood Trauma and Chronic Fatigue Syndrome
A study conducted at the University of Toronto has added to the weight of already existing evidence that
individuals who have experienced childhood trauma are at greater risk of developing chronic fatigue
syndrome (also sometimes referred to as CFS, or, in medical circles, myalgicencephalomyelitis - try saying
that after a few drinks!)
Participating in the study were 7000 females, and it was found that those with CFS were TWICE as likely to
have experienced childhood trauma than those who were free of the condition. As implied in the first
paragraph, other studies have provided similar results.
It is believed that the reason behind the findings is that childhood trauma produces physiological effects upon
the developing brain that have an adverse effect upon the individual’s stress response system (click here for
one of my articles on the effects of childhood trauma on the developing brain).
Also, because the psychological effects of childhood trauma are also thought to contribute to the elevated risk
of developing CFS, doctors may well increasingly turn to treating the condition with psychotherpeutic
techniques (also sometimes referred to as ’talking therapies’).
It is not to be inferred from the above that childhood trauma is the main cause of CFS (or even a necessary
contributing factor, for that matter), but, rather, that it is likely to increase a person’s vulnerability to falling
victim to the condition.
Following these findings, it has been suggested that a useful way of building upon this research would be to
focus future studies specifically upon the precise physiological changes that occur in the brain as a result of
childhood trauma and analyse the mechanisms through which such changes put a person at higher risk of
developing CFS. Further, it is important to try to discover how physiological changes in the brain that are the
result of childhood trauma differ from changes that occur as a result of other types of long-term stress during
adulthood.
FACTS ABOUT CFS.
The symptoms of CFS are as follows :
- persistent fatigue/exhaustion which affects everyday life and is not rectified by sleep or rest
- in the UK, the condition is thought to affect approximately a quarter of a million people
- the condition is more prevalent in females than in males
- it normally affects people between about the ages of 20 - 45 years; however, it can begin during childhood if so, it normally begins between the ages of 13 and 15 years
SEVERITY LEVELS.
CFS can be split into 3 different levels of severity :
- MILD : the person can probably care for him/herself, but may require days off in order to rest
- MODERATE : at this level the individual may well experience reduced mobility, disturbed sleep, as well as a
need to sleep in the afternoon
- SEVERE : at this level the person will have significantly decreased mobility, possible impairments to his/her
ability to concentrate as well as greatly reduced ability to perform many everyday tasks
OTHER POSSIBLE CAUSES OF CFS :
As well as childhood trauma, other possible causes include :
- a viral infection
- problems with the immune system
- an imbalance of hormones
- the inheritance of a genetic predisposition
POSSIBLE TREATMENTS FOR CFS INCLUDE :
1) Cognitive Behavioural Therapy (CBT)
2) Graded Exercise Therapy
3) Medication (especially if the CFS includes symptoms such as pain, nausea or sleep disorders)
Possible Damaging Behaviours of the Borderline Personality Disordered Parent
In order to write the articles on this site, which now number nearly 200, I have spent a considerable amount
of time researching how borderline personality disordered parents can adversely affect the psychological
development of their children. For this post, therefore, I thought it might be interesting to simply list some of
the descriptions of how the borderline parent thinks, feels and acts that I have come across during my
research.
It should be borne in mind, of course, that people with borderline personality disorder will not necessarily
have all the symptoms listed, and, likewise, people without borderline personality disorder may have some of
the characteristics I list.
However, the more of the following characteristics a parent has, the more likely it is that he or she suffers
from borderline personality disorder.
THE LIST :
- deep need to exercise control over others
- prone to always blame others rather than take responsibility
- prone to explosions of intense rage, hostility and anger
- ignores the boundaries of others
- deep need for attention
- very accusing towards others
- emotions easily get out of control
- prone to extreme over-reactions
- projects own faults onto others
- billitles and derides others
- hugely self-destructive
- exclusively focuses on self and own problems
- deep sense of inferiority
- frightens and intimidates others
- holds inconsistent opinions
- uses threatening behaviour
- very quick to judge others, often on the basis of flimsy evidence
- issues ultimatums
- has rapid mood swings
- life tends to be a never ending series of crises
- very demanding
- prone to irrational thinking and behaviour
- sees things in ’black or white’ (ie sees things as either ’all good’ or ’all bad’)
- fluctuates between idealizing and devaluing/demonizing others (this is related to ’black or white’ thinking,
above)
- in constant denial in relation to own faults, but sees faults in others everywhere
- extremely intense
- prone to highly inconsistent behaviour
- impulsive/indulges in high risk behaviours
- distrustful
- oscillates between intensely clinging to others and then angrily pushing them away
- displays extreme emotions / often has dramatic outbursts
- emotionally exhausts others, especially those close to
- insatiable need for love, respect and admiration
- inconsistent and changeable behaviour confuses others / others do not know ’where they stand’
- unbalanced
- has highly volatile and unstable relationships
- verbally abusive/hostile
- very weak sense of own identity
Of course, people with borderline personality disorder, or BPD (click here to read one of my posts on this very
serious condition), have their good points too! However, the above list has been compiled to focus on the
damaging effects their behaviour may have on others.
Unfortunately, if we have been brought up by a parent with BPD, we are prone to develop some of the above
characteristics ourselves, or even develop BPD ourselves. The first step to overcoming BPD is to accept one
may be suffering from it. One of the most promising treatments for BPD is dialectical behaviour therapy (click
here to read my post on this).
PEOPLE SHOULD NOT BLAME THEMSELVES FOR HAVING BPD - IT IS AN EXCRUCIATINGLY,
PSYCHOLOGICALLY PAINFUL CONDITION WHICH, NOT INFREQUENTLY, ENDS IN SUICIDE.
THEREFORE, HOWEVER DIFFICULT RIT MAY SEEM AT TIMES, THOSE SUFFERING FROM IT
SHOULD BE TREATED WITH COMPASSION. ALSO, THERAPY FOR THE DISORDER, BY THE PERSON
WHO HAS IT, SHOULD, IN MY VIEW, BE URGENTLY SOUGHT. AS UNDERSTANDING OF THE
CONDITION INCREASES, MORE AND MORE PEOPLE ARE FULLY RECOVERING FROM IT. THERE
MOST DEFINITELY IS HOPE!
Effects of the Narcissistic Mother. Part 1.
As young children, we need our mother’s attention and approval, and, indeed, feel distressed if we fail to
receive it when it is necessary. As we grow older, for most of us, our mother’s view of us continues to be of
great importance, defining, in not insignificant part, how we view ourselves (in particular, our self-worth).
However, this view of ourselves becomes distorted when our mother is far more concerned with us fulfilling
her emotional needs than she is with fulfilling ours.
The narcissistic mother is likely to use us, as we grow up, to bolster her own aggrandized self-image, and to
continually require us to feed her insatiable hunger for flattery, compliments, reassurance, and having her
ego boosted.
Narcissists are entirely self-obsessed. Their conversation tends to focus exclusively upon themselves. They
also tend to greatly overestimate their own talents, achievements, skills and importance and may,
superficially, exude a smug sense of superiority. However, because of the fact that, beneath the surface, their
own sense of self-worth is actually extremely fragile, they will constantly rely upon others to bolster this
deluded self-image and to keep the illusion of their own fundamental superiority to all the other mere mortals
alive.
Narcissists will also tend to devalue, belittle and demean the achievements of others, fearing their lime-light
will be stolen. All admiration, and an inexhaustible supply of it, must, they believe, be directed from others
onto themselves.
Often, especially when the mother cannot obtain admiration from elsewhere, she will come to rely upon her
children to provide it. This means that they are deprived of being the focus of their mother’s attention indeed, in this regard, roles are reversed. It’s almost a case of the mother, I suppose, metaphorically riding
the bicycle and shouting out to her child, ’LOOK SON!! NO HANDS!’
My own mother, for example, would never come and see me play, say, rugby for the school, but would
INSIST I came to watch her performance in her latest amateur dramatics society’s production (amateur
dramatics being a tediously predictable hobby for the narcissisist, of course). After the performance ,
naturally, she would settle for no less than to be compared to Elizabeth Taylor and nominated for an Oscar.
Not that I’m bitter.
Because the narcissistic mother has a very poor sense of self-identity beneath the shallow veneer of
grandiosity, she will tend to vascillate between a highly inflated view of herself and deep insecurity. As she is
essentially highly vulnerable, she may be hugely sensitive to criticism, have her exquisitely delicate feelings
injured easily, and feel easily humiliated. In the face of attacks upon her self-worth, she may well become
intensely defensive, hostile and aggressive.
Furthermore, the narcissistic mother will tend to live her life carefully monitoring, in a hyper-sensitive manner,
other people’s reactions to her. She will be quick to perceive criticism, usually blowing it out of all proportion,
and may well hold long-lasting grudges against those who dare to suggest she has failings. Very often, too,
she will ’read in’ criticism where none was intended.
Those who do dare to criticize her will incur her wrath, and she will seek to punish them emotionally and
psychologically : she is likely to hold the person who criticized her in contempt and to openly and bitterly
express this contempt both to the ’offender’ and to others. She may declare that both he, and his views, are
worthless.
Effects of the Narcissistic Mother. Part 2.
It is extremely difficult for the child to reason with the narcissistic mother. She may explode into rages at the
slightest provocation (for example,if, when I was a young child, I needed to get up to use the toilet in the night
and accidently woke my mother when I did so, no matter how careful not to disturb her, she would become
apoplectic with rage; likewise, if I spilt a few millilitres of milk when making her a coffee, she would become
similarly demented with anger). Because such anger, however ridiculous and absurd, is justified in the mind
of the narcissistic mother, the child is, essentially, left with a choice of two strategies in order to attempt to
cope :
1) appeasing/placating the mother
2) rebelling against the mother
Often, the first strategy may be used to begin with, but, when it inevitably fails, due to the mother’s incapacity
to ever be satisfied with her child’s behaviour, the child is very likely to resort to strategy 2, that of rebellion.
Indeed, rebellion against the mother can be A NECESSARY SURVIVAL STRATEGY TO PREVENT HER
FROM EMOTIONALLY AND PSYCHOLOGICALLY UTTERLY CRUSHING AND DESTROYING THE CHILD.
(Once this strategy has been learned as a necessary means of PSYCHOLOGICAL SURVIVAL, it is very hard
indeed to unlearn; the child is then likely to carry a rebellious predisposition into adulthood, even if it is, by
this stage of his/her life, a largely obsolete, maladaptive and self-destructive way of behaving).
The child will invariably feel deeply insecure in connection with his/her relationship with his/her mother. The
relationship is felt to be extremely fragile - the child has a constant sense that it could totally fall apart and
collapse at any second. The child also knows s/he could very well be totally rejected (when I began to try rather feebly - to stand up to my mother when I was thirteen, and the hormones which accompany puberty
were kicking in, my mother threw me out of the house. Permanently. I had to go and live with my father and
step-mother, neither of whom wanted me either - and made this abundantly clear).
Indeed, the narcissistic mother is likely to have rejected many others during her life (friends, siblings etc, for
criticizing her or failing to show her ’sufficient deference’) and, as the child will have witnessed such
behaviour, will instinctively know that the threat of rejection is a very real one. Before my own mother finally
threw me out, she had issued innumerable threats that she would do this (as well as repeatedly telling me
that she wished I’d never been born, and, sometimes, that she felt she could easily ’knife’ me, or, even,
’murder’ me). Another of her favourite expressions -said in a suitably melodramatic and sinister tone of voice,
utterly terrifying to the a child, was : ’I FEEL EVIL TOWARDS YOU! EVIL!!’
Eventually, the narcissistic mother can essentially brain-wash the child into believing s/he is a bad (or even
evil) person - beyond any kind of redemption. This can then become the child’s fundamental view of
him/herself. Without therapy, s/he can go through the rest of his/her life with a deeply entrenched feeling of
self-hatred, self-loathing, and worthlessness. S/he may become utterly convinced that not only is s/he
’unloveable’, but even ’unlikeable’. This can lead to an inability to be able to accept affection from others and
a life in which satisfying relationships are impossible. A life, too, which is profoundly lonely and emotionally
agonizing.
Emotional Torture? When Parents Put Kids in a Psychological Double-Bind.
I first came across the phrase ’double-bind’ at university whilst studying for my first degree in psychology - it
struck a chord immediately.
In its simplist terms, the child who is placed in a psychological double-bind, by parent/s or carers, finds
him/herself in a ’no win’ and ’damned if I do, damned if I don’t’ situation.
As a child, I experienced this myself and found it emotionally excruciating. The double-bind involves
profound, deeply contradictory and confusing communication problems within the family. It is common in
highly dysfunctional and disturbed families, such as the one I grew up in (or, perhaps to put it rather more
accurately, failed to grow up in).
The concept of the double-bind was illuminated by the psychologist Bateson. He explains it in terms of having
six key elements which I have tried to summarize below :
THE SIX KEY INGREDIENTS OF THE PSYCHOLOGICAL DOUBLE-BIND :
1) It involves two or more people. One of these people is usually the mother, but could be the father or
another person responsible for the care of the child. The second person is the child him/herself. If a third
person is involved, it is usually another parent.
2) The experience of being placed in the double-bind is ongoing throughout a significant period of the
individual’s childhood. In other words, the double-bind does not refer to a single event, but is a recurrent,
repeated and pervasive element of the person’s childhood. To employ a simple analogy, if s/he were a fish,
the experience of the double-bind would be the water in which s/he swam.
3) It involves a primary injunction. The primary injunction can take two forms :
Either:
a) An injunction not to do something, eg ’don’t do this or I will punish you.’
or:
b) An injunction to do something, eg ’if you don’t do this, I will punish you.’
4) It also involves a secondary injunction. This is a much more subtle injunction and is NOT explicitly stated
but is tacit (non-linguistic) as so much of human communication is (eg an expression, intonation etc), This
makes it pretty much impossible for the child to precisely identify, let alone explain, the nature of the
interaction and why it causes him/her so much distress. Also, because it is so subtle, it is very easy for the
parents or carers to deny.
The secondary injunction, also enforced by threat of punishment (including of couurse psychological
punishment - the most damaging kind), and, this is the KEY POINT, DIRECTLY CONTRADICTS THE
PRIMARY INJUNCTION, thus putting the child in an impossible and unresolvable situation.
If more than 2 people are involved, the double-bind may be that if a child obeys one of his parents, this
necessarily involves disobeying the other.
But the plot thickens :
5) There is also an injunction preventing escape. As if the above were not confusing enough already (my
head has started to hurt writing this; I might be forced to have a lie down in a darkened room), there is also a
tertiary injunction which closes off any escape route from the double-bind explained above. Essentially, this
third injunction is that if the child evades the double-bind choice, s/he will be punished for that too.
6) Learned Perception. Bateson also made the CRUCIAL point that once the child has learned to perceive
(often, on an unconscious level as the whole disturded interaction process is so complex and subtle) their
dealings with their family in terms of being perpetually placed in a double-bind, ANY SMALL SUB-PART OF
THE BEWILDERING DOUBLE-BIND INTERACTION PATTERN EXPLAINED ABOVE WILL BE SUFFICIENT
TO PRODUCE EMOTIONAL DISTURBANCE WITHIN THE CHILD. This will most frequently take the form of
EXTREME, FRUSTRATED RAGE or PANIC.
A SIMPLIFIED EXAMPLE OF BEING PLACED IN THE DOUBLE-BIND TRAP FROM MY OWN
CHILDHOOD EXPERIENCES IS AS FOLLOWS:
In its simplest terms, the double-bind can be illustrated as shown below :
i) the child is presented with a choice (derived from the primary and secondary injunctions). The choice is
between A and B.
ii) if the child complies with the first injunction (choice A), s/he is punished. However, if s/he complies with the
secondary injunction (choice B) s/he is also punished.
iii) and, just to put the tin lid on it (an English expression, admittedly a rather silly one, if you are from outside
the UK!), if the child evades the choice between A and B, s/he is punished as well.
APPLYING THIS SIMPLIFIED EXAMPLE TO MY OWN CHILDHOOD EXPERIENCES :
Having been thrown out by my mother at age 13, I had to go and live with my father and stepmother, both of
whom did not want me there, but they were just about prepared to grudgingly tolerate me. I was treated like a
stranger but with an icy politeness in an attempt to conceal, I suppose, their fundamental distaste for me (this
failed, as the young are wont to say these days, EPICALLY).
In retrospect, although I could not articulate, or even properly understand, this at the time, I now perceive the
double-bind in which I was placed to be as follows:
CHOICE A : be warm and friendly towards my step-mother and father. However, if I did this the punishment
was to be rejected, pushed away and rebuffed,
CHOICE B: withdraw and become non-communicative. When I did this the punishment was that I was
scathingly told I was ’morose’, ’sullen’, ’hostile’, ’difficult’, was ’moping around with a self-pitying expression’
and that I was ungrateful to them for ’taking me on’ - after all. I was being done a great favour, wasn’t I?
And, as described in Bateson’s model above, the escape routes were all closed off. For example, had I
suggested, say, family therapy, the idea would have been dismissed. After all, the problems were all in my
paranoid imagination, weren’t they? I would be told I was being melodramatic, making mountains out of mole
hills, being generally difficult, silly and looking to create problems which simply did not exist.
Obviously, that example is grossly over-simplified, but I hope it conveys the gist of what I was attempting to
explain.
David Hosier BSc Hons; MSc; PGDE(FAHE).
1.9.13 Highly Dysfunctional Families and Borderline Personality Disorder (BPD) (2013-10-29 13:43)
dysfunctional families and bpd Those who go on to develop borderline personality disorder (BPD) almost
invariably grew up as children in highly dysfunctional families in which the parent/s was/were emotionally
unstable.
I have written about BPD extensively in other articles on this site (to access them, simply type ’BPD’ into the
site’s search box) so I will only briefly recap upon some of the main symptoms from which the individual with
BPD suffers :
- inability to control powerful emotions
- extremely chaotic interpersonal relationships
- extremely poor impulse control
- very poor sense of own identity (also sometimes referred to as ’identity confusion’)
- sees others in terms of being either ’all good’ or ’all bad’ with no middle ground (this is also sometimes
referred to as ’black and white’ thinking or ’dichotomous thinking)
- hypersensitivity, especiallly a tendency to interpret neutral, innocuous comments of others as personal
slights
Overwhelmingly, the most important risk factors leading the child to go on to develop BPD are child abuse
and child neglect. Indeed, these two risk factors easily outweigh the influence of biological and social factors.
DOUBLE MESSAGES
The child who goes on to develop BPD as an adult is very likely to have grown up in a household in which he
received ’double messages’ from his/her parent/s - in other words, the child’s parent/s are very likely to have
both felt and expressed EXTREME AMBIVALENCE towards the child. I describe how this ambivalence
towards the child generally manifests itself below :
THE FORM PARENTAL AMBIVALENCE TOWARDS THE CHILD TAKES :
It is theorized that the parent holds, simultaneously, 2 attitudes towards being a parent which are
contradictory and in direct opposition to each other. It is thought the 2 conflicting attitudes are :
ATTITUDE 1 : the parent/s believe their role as a parent is of great importance and central to their lives
ATTITUDE 2 (in direct opposition to the above but simultaneously held) the parent/s deeply resent having to
fulfill a parental role and regard the child as an IRRITATING OBSTACLE PREVENTING THEM FROM
PURSUING THINGS THAT WOULD LEAD TO THEIR PERSONAL FULFILLMENT.Not infrequently, such
ambivalent feelings will focus upon just one child, leaving his/her siblings relatively emotionally undamaged.
HOW DOES THE CHILD RESPOND TO SUCH AMBIVALENCE?
Unconsciously, the child has a deep need to keep the ambivalent parent/s as emotionally stable as possible
(in Darwinian terms, this is clearly in the interests of his/her survival). The dilemma is, therefore, as follows :
On the one hand, s/he needs to remain of great importance to the ambivalent parent/s (in order to support
attitude 1 (above)). On the other hand, however, s/he needs to allow them to justify, in their own minds, their
hostility, anger and resentment towards him/her (in order to support attitude 2 (above)).
But how can this possibly be achieved?
Building upon an original idea of Melanie Kline, it has been theorized that, in order to maintain his/her
parent’s/parents’ psychological equilibrium, the child must adopt what has been termed spoiler behaviour
(this is NOT a conscious decision of the child’s - it is driven by unconscious forces).
’Spoilier behaviour’ involves :
- in effect, refusing to grow up
- remaining dependent on the parent/s (as not able to function competently as an adult)
- rebelling against and severely denigrating the parent/s
Without therapy, such ’spoiler behaviour’ may be maintained deep into the formerly abused child’s adulthood.
Such behaviour is a way of INVALIDATING THE PARENT/S IN EXACTLY THE SAME WAY AS THEY
INVALIDATED HIM/HER AS A CHILD. In essence, s/he is ’giving back as good as s/he got.’
The now adult child will continue to try to keep his parent/s emotionally stable by (and I repeat,
unconsciously) desperately trying to regulate their ambivalent emotions towards him/her :
- if they begin to feel too guilty (due to attitude 1, above), he will make them angry. However :
- if they become too angry (due to attitude 2, above) s/he will make them feel guilty
This is, I think, a very ingenious theory; however, it is very difficult to prove theories which are based in part
upon ideas relating to unconscious mental processes.
If I could briefly indulge myself by suggesting a theory of my own : IF A CHILD KNOWS S/HE IS
ESSENTIALLY DISLIKED BY HIS/HER PARENTS, IS IT NOT EASIER TO TOLERATE IF S/HE ACTS IN
SUCH A WAY THAT HELPS THE PARENTS, IN THEIR OWN MINDS, TO JUSIFY THEIR DISLIKE,
RATHER THAN TO TRY HARD TO GET ON WITH THE PARENTS, AND OBTAIN THEIR ADMIRATION,
AND YET STILL BE DISLIKED? In the former case, the child can almost convince him/herself s/he wants to
be disliked, and is only disliked due to his/her behaviour. Whereas, to be disliked whilst trying desperately to
be liked by one’s parents would surely be psychologically catastrophic?
Childhood Fame : The Downside.
’I think every child star suffers through this period because you’re not the cute and charming child that you
were. You start to grow, and they want to keep you little forever.’
-Michael Jackson on the perils of getting older.
In the era of X-Factor and Britain’s Got Talent, more and more young people are being lured into developing
an insatiable lust for fame. Whilst fame can bring enormous rewards, it is likely that just about every famous
person would acknowledge that there is also a downside. To some, of course, the negative side of fame is
more damaging than to others. However, young people are likely to be especially vulnerable to this negative
side, and, in this post, I want to explore the adverse effects the experience of early fame can have on child
stars.
Of course, some child stars cope with their fame very well and can enjoy it. An example of someone who
fitted this category is Leonardo DiCaprio (for those who have not seen films in which he starred as a child, I
recommend the film ’What’s Eating Gilbert Grape?’) who made an extraordinarily successful transition into
adult stardom.
Stars who did not cope so well with early fame include Michael Jackson (indeed, he attributed many of his
adult difficulties to the effect of his childhood). In interviews, Jackson described his childhood as being lonely
and unhappy. it has also been alleged that his father used, sometimes, to beat him if he made mistakes
during the arduous rehearsals he was forced to undertake. He also stated that he would often see happy
children playing together through the window of his rehearsal room and cry because he could not join them
and felt left out. As an adult, he felt his childhood had, in a very real sense, been stolen from him. In response
to this, he tried to relive his childhood as an adult which is, of course, extremely well documented.
problems of childhood fame
There is also the case of McCauly Culkin. He attributes the fact that he turned to drink and drugs, at least in
part, to the enormous pressure he was under as the world’s most famous child. Also, as soon as he was
able, he cut off all contact and communication with his father.
To bring things up to date, there are also YouTube clips of Justin Bieber losing his world famous cool with
paparazzi.
FACTORS RELEVANT TO HOW EARLY FAME MAY AFFECT YOUNG PEOPLE :
The main factors include :
- the degree to which the child is being manipulated for financial gain
- the degree of unwanted pressure exerted by so-called ’pushy parents’
- the age at which the child has to contend with the pressures of fame
- the level of emotional support the child receives from parents, friends, management etc
- the length of time spent in the limelight, and, if relevant, how this ends (eg by choice or due to no longer
being offered work)
- the environment in which the child works (eg the influence of older stars)
- degree to which the child feels able to exercise choice in relation to whether s/he works
- to what degree the parents want their child to be famous in order to derive a vicarious experience of fame
(ie to live out their own unfulfilled dreams through their child).
- degree to which they are exposed to ’showbiz style’ drink and drug taking
- degree to which they are isolated from ’normal’ society
On top of the above, child stars will also need to cope with jealousy (not only from their peers and siblings,
but by some adults too (eg relatively unsuccessful older actors, and, even, in some cases, from their own
parents), intense public scrutiny, loss of privacy, unwanted attention (eg by obsessed fans), pressure to
maintain an image which may well be at odds with their true personality, fear of work drying up (eg being a
’has been’ at 17 years of age with the best part of his/her career over), fear of re-adjustment to non-stardom
(if it happens), becoming overly self-important and arrogant. Finally, too, it is worth remembering the phrase
that : ’It’s lonely at the top.’
SYMPTOMS OF STRESS YOUNG PEOPLE MAY EXHIBIT IN RESPONSE TO THE PRESSURES OF
EARLY FAME :
For those 12 years of age and younger, stress symptoms might include :
- REGRESSION : ie reverting to behaviour more commonly displayed by younger children
- DEPRESSION/EXCESSIVE CRYING
- ANXIETY ATTACKS/’CLINGING BEHAVIOUR
For those in their teens :
- POOR ACADEMIC PERFORMANCE
- DRUG AND ALCOHOL ABUSE
- SELF-HARM
- EATING DISORDERS (a well known example of a child star from the UK who later developed an eating
disorder - in this case anorexia - is Lena Zavaroni, who tragically died from the condition).
THE PROBLEM OF ACHIEVING ICONIC STATUS :
It has been suggested that another problem which may arise from being a child star is that the public has a
tendency to psychologically project their ideas of what is good, beautiful and innocent onto the famous child,
so that the child becomes a symbol, or icon, representing these qualities. In other words, the child is idealized
and romanticized and placed on a pedestal - an image which is clearly impossible to live up to.
FINANCES :
The highly successful child star is likely to become his/her family’s chief bread-winner, earning in a year,
possibly, more than his/her parents, combined, will earn in a life-time. In terms of who is the family financial
provider, then, there is a reversal of ordinary roles. It is possible that unscrupulous parents will exploit this,
pushing the child to do work that s/he does not want to do (eg the case of Michael Jackson, referred to briefly
above).
Also, if the young star is a teenager with access to his/her money and becomes involved with drugs, s/he is
more likely to take them in very large quantities as s/he can afford to do so.
’I JUST WANT TO BE NORMAL!’
This is a common refrain of children, who, universally, want to fit in with their peers. The child star, however,
is set apart, by definition of being famous, which deprives him/her of a fundamental psychological need.
The Dysfunctional Family’s Scapegoat.
I went to live with my father and obsessively religious step-mother when I was thirteen, having been thrown
out of the house by my disturbed and highly unstable mother.
She and my father already had her own biological son living with them. She treated her own son, essentially,
as a demi-god, whist viewing me as the devil incarnate - even at that age, (given I had the capacity to carry
out elementary mental reasoning and was not intellectually retarded) I did not believe in god, and, consistent
with this, refused to attend church with the other members of the household who regarded twice weekly
attendence as their pious duty.
Indeed, and I write these words in all seriousness, it is even possible that my step-mother believed I was
possessed by some kind of diabolical spirit - after all, soon after I went to live with her and my father, during a
trivial argument in the kitchen, she began to shout at me in what she believed to be ’tongues’. And, when I
was a bit older, if one particular friend had been round to see me and she returned to the house later, she
would say she knew he’d been round as she could ’sense evil’ (actually, he was a very nice person). You
couldn’t make it up.
In dysfunctional families, viewing one child as being able to do no wrong, and the other as being able to do
nothing OTHER THAN wrong, is not an uncommon scenario. The latter, of course, becomes the family
’scapegoat.’
Whilst I have grown up with a profound inferiority complex, my step-brother has grown up, I think it is fair to
say, puffed up with an impregnable sense of self-love, self-belief and self-pride; expecting others to admire
him is his default position. Expecting others to despise me is mine. (And, in this regard, I’m seldom
disappointed). This outcome, of course, would not be entirely unpredictable to anybody with an IQ above
about 70.
Sadly, it invariably tends to be the most vulnerable and sensitive child who becomes the scapegoat. It is also
not uncommom that the child fulfilling the role of scapegoat has a characteristic, or characteristics, which a
parent shares but represses, projecting his/her self-disapproval onto the scapegoat.
The scapegoat will be blamed for the family’s deep rooted problems. Anger, disapproval and criticism will be
directed at him/her, leading him/her to develop feelings of great shame, to lose all confidence and self-belief,
and, in all probability, to experience self-loathing, depression and anxiety. And to expect everyone else to
hate him/her too.
The motivation of the rest of the dysfunctional family, both consciously and unconsciously, for denigrating and
demonizing the scapegoat is that it enables them to convince themselves that they are good and right. By
telling relatives and friends that all the family’s woes derive from him/her they are also able to maintain a
public image of blamelessness.
In this way, the scapegoat finds him/herself not only rejected by his/her own immediate family, but, possibly,
by those outside it too. S/he becomes utterly isolated and unsupported.
Also, by blaming the scapegoat for the family’s difficulties, they not only evade their own responsibility but are
also relieved, in their own minds, of any responsibility to support or help the scapegoat, who, because of the
position in the family s/he has been allocated, and its myriad ramifications, will inevitably be suffering severe
psychological distress.
Because the scapegoat is blamed for the family’s problems, the rest of its members are able to stay in
DENIAL in relation to their own contributions to this sorry state of affairs; they will tend to reinforce one
another’s false beliefs that whenever something goes wrong it is the fault of the scapegoat - in this way, a
symbiotic relationship develops between them : they all protect each other from feeling guilty and from
shouldering their rightful portion of responsibility, drawing the strength of their fallacious convictions from
being in a mutually reinforcing majority.
If the scapegoat is brazen enough to protest that not everything is his/her fault, these views are dismissed
with scorn and derision - in this way, s/he is denied the opportunity to express them, allowing the other family
members to conveniently side-step any searching questions being put to them which might otherwise
produce deep discomfort.
If the scapegoat becomes too insistent about expressing his/her point of view, the rest of the family may cut
him/her off from it entirely, thus totally isolating him/her.
Often, the rest of the family’s own guilt may be so profound that facing up to it would be psychologically
overwhelming; in such a case there will be a powerful unconscious drive to maintain the illusion that
everything is really the fault of the scapegoat - maintaining the illusion allows them to deflect blame which,
more accurately, should be directed towards themselves.
It is likely, then, that they will not be fully aware that their projection of their own feelings of guilt onto the
scapegoat is, in essence, a psychological defense mechanism necessary to allow them to maintain a positive
image of themselves. Their views that they are in the right and the scapegoat is in the wrong become a
necessary delusion.
Eventually, the scapegoat will come to INTERNALIZE (ie believe to be true) his/her family’s scathing view of
him/her, and, therefore, his/her view of him/herself as a bad and unworthy person is in distinct danger of
becoming a self-fulfilling prophecy.
S/he is likely to develop feelings of intense psychological distress, perform well below his/her best
academically and, later, vocationally, encounter serious problems with social interaction, and become hostile,
aggressive and resentful towards both his/her family and those outside of it. This plays into the hands of the
other family members, of course, as it facilitates their desire to continue projecting their own guilt onto the
scapegoat.
As the scapegoat goes through life, s/he is likely, due to the powerful conditioning s/he has been subjected to
as a child, to see him/herself as not merely unloveable, but, even, as unlikeable - unfit to be part of ’decent’
society. Believing him/herself to be a terrible person, s/he may not even make any attempt to develop close,
let alone intimate, relationships. After all, in his/her own mind, rejection would be ’inevitable’, serving only to
confirm and reinforce his/her wretched self-view.
Human Stress : Why We Should Envy Gazelles
The human stress/fear response evolved millions of years ago in our ancestors to allow them to survive - it is
commonly known as the ’fight or flight’ response. If we saw a tiger, it was necessary to feel fear as this fear
motivated us to freeze and then to run away when it was safe to do so. Modern day humans have inherited
this mechanism.
One of the areas of the brain that becomes highly active when we experience fear, and gives rise to the
fight/flight response, is called the AMYGDALLA. This area of the brain is also stimulated in other animals,
such as gazelles, when they perceive danger.
.
Let’s imagine that a group (I don’t know the collective term for them - herd?) of gazelles is calmly grazing
when they become aware that a tiger is preparing to launch a ferocious and potentially lethal attack. What is
their response? Well, what happens on a physiological level is that the sighting of the tiger instantaneously
triggers intense activity in their brains’ amygdallas and their ’fight/flight’ response is triggered. This causes
them to experience feelings of panic and terror which in turn leads them to flee the tiger as fast as they are
able (which, given they are gazelles. is very fast indeed - they don’t hang around!
Once the danger has passed, however, the activity in their amygdallas quickly returns to normal and,
therefore, they are able to return to calmly grazing.
The gazelle, then, is easily able to ’switch on’ their amygdalla, but, just as easily, ’switch it off’ again when its
activity is no longer required.
Sadly, we poor humans are not nearly as good at doing this. Because we have, language, which allows us to
carry out internal monologues, have imagination and are able to dwell on the past and contemplate the
future, we are able to constantly torment ourselves with worries, regrets, concerns, fears and so on. In this
way, especially if we suffer from anxiety, we can find ourselves constantly feeling we are trapped in the ’fight
or flight’ response - our amygdallas become permanently over-stimulated, even though we do not wish them
to be and it is not in our survival interests that they are; indeed, being is such a state of permanent anxiety
and fear imperils our survival (eg we might smoke and drink more, or, in extreme circumstances, attempt
suicide).
MINDFULNESS :
It is now well established by scientific research that mindfulness and meditation are extremely effective at
treating anxiety (and many other conditions) and can significantly and permanently reduce the general level
of activity in the amygdalla, which, in turn, allows us to live our daily lives, gazelle-like, in a far calmer state of
mind.
Fifteen Types of Depression.
On average, and all else being equal, the more traumatic a person’s childhood, the more likely it is that s/he
will experience depression at some point in his/her life.
I list below fifteen different categories of depression. A person can fit into more than one category at any one
time.
THE FIFTEEN CATEGORIES OF DEPRESSION :
1) AGITATED DEPRESSION - with this type of depression the person suffering from it is constantly restless,
intensely worried and deeply anxious/fearful (I suffered this type of depression and was often incapable of
even staying seated).
2) RETARDED DEPRESSION - this type of depression causes the person suffering from it to very
significantly slow down both mentally and physically (this is technically referred to as PSYCHOMOTOR
RETARDATION). There will also be great difficulty in concentrating. In its most extreme manifestation, the
afflicted individual cannot move, speak or eat which carries with it the risk that s/he will starve to death. This
state of complete inactivity is sometimes referred to as CATATONIA.
3) PSYCHOTIC DEPRESSION - with this type of depression the individual may lose touch with reality and
may suffer from delusions (outlandish false beliefs) or hallucinations (seeing or hearing things which are not
there). It can be treated with anti-psychotic medication.
4) NEUROTIC DEPRESSION - (this term is now falling into disuse and is being replaced with the term ’mild
depression). It is a less severe form of depression than psychotic depression (see above) and the person’s
mood may fluctuate from day to day and also during the day (often, for example, feeling bad in the morning
but improving in the evening). The person suffering from it may have symptoms of irritability and disrupted
sleep (finding it hard to go to sleep and frequently waking during the night; however, with this type of
depression there does not tend to be early morning waking which is a hallmark of other types).
5) ORGANIC DEPRESSION - this type of depression has a physical cause and can manifest itself as a result
of side effects of medication. For example, the British comedian Paul Merton suffered a serious depression,
for which he needed to be hospitalized, as a complication of taking anti-malaria tablets.
6) DYSTHYMIA - this is a relatively mild but persistent type of depression. Its main symptoms are low
self-esteem and difficulties in making decisions. It often responds better to psychotherapy than to treatment
with drugs.
7) BRIEF RECURRENT DEPRESSION - this term is relatively new and refers to serious depression which
comes and goes but tends only to last for a few days at a time.
8) MASKED DEPRESSION - this is also sometimes referred to as ’smiling depression’. Whilst the individual
who has this type of depression will report that they DO NOT feel depressed, they will, nevertheless, have
some of the symptoms of depression. Indeed, the symptoms will often respond well to anti-depressant
medication.
9) BIPOLAR DISORDER - this used to be referred to as ’manic-depression’. With this disorder, the person
vascillates between feelings of elation and periods of despair. During their highs (the ’manic’ phase) there will
be a reduced need for sleep, excessively high energy levels often leading to frenzied activity, racing thoughts
and a ’flight of ideas’, reduced need to eat and possible delusions (eg believing they are the reincarnation of
a Roman Emperor, are next in line to the throne or have special, superhuman powers) and hallucinations.
Often, too, judgment will be extremely impaired leading to, for example, massive gambling losses, vast
overspending or investing huge amounts of money in doomed business ventures. Also, the individual
suffering from such mania is likely to feel ’invincible’ and that s/he ’can achieve anything.’ However, these
periods burn themselves out and are replaced by depression which may be so severe the sufferer considers
or attempts suicide.
The depression may be made worse due to the lack of judgment s/he experienced during the manic phase
and the self-destructiveness this may have involved (eg s/he may have taken on enormous and unrepayable
debts).
10) SEASONAL AFFECTIVE DISORDER (S. A. D.) - this is a form of depression which only strikes in the
winter months due to the lowered amount of sunlight during this period. Symptoms can include an increased
need for sleep and carbohydrate cravings.
11) UNIPOLAR DEPRESSION - this is, by a very long way, far more common than bipolar depression - only
low mood is experienced ; there are no highs/manic episodes.
12) REACTIVE DEPRESSION - sometimes called ’endogenous depression’. This type of depression occurs
as a reaction to a stressful event, such as being made redundant ; it is normally relatively short-lived and
often responds well to counselling or family support.
13) RECURRENT DEPRESSION - any period of depression which is not the first one the person has
experienced is called ’recurrent depression.’
14) CHRONIC DEPRESSION - the word ’chronic’ means long lasting (some people misuse the word when
what they actually mean is ’severe’). Doctors refer to a depression as being ’chronic’ if it has gone on for at
least two years.
15) TREATMENT RESISTANT DEPRESSION - this refers to a depression which does not improve with
anti-depressant drugs. This was the type of depression I had/have. In such cases, if the depression is very
severe and life-threatening (due to self-neglect or high suicide risk) electro-convulsive shock therapy
(ECT)may be used as as a last resort. I myself had to undergo ECT on a number of occasions over the years
(although, unfortunately, this had no positive effect whatsoever in my own case ; however, for some it can be
life saving).
On Being Suicidal (or Why I Carried a Rope in a Bag around London for 3 Months).
I carried a rope in a bag around with me, every day, for 3 months.
Why?
You might well ask.
Was I a master of the Indian Rope Trick, ready to give my performance at the drop of a hat (or indeed,
turban), perhaps?
Not quite.
How I might look performing Indian Rope Trick.
I had booked into a squalid B and B in London’s Earl’s Court where I was to remain, subsisting mainly on
whisky, cigarettes and bags of crisps, for 3 months.
Prior to booking in, I had visited a B and Q store to purchase a rope. I had selected it with meticulous
attention to detail : not too long, not too short. Not too thick (it needed to be pliable enough to tie an effective
noose) and not too thin (it needed to hold my - at this time in my life - not inconsiderable weight).
My intention was, on the first day of booking into the B and B, or, at the latest, the second, to get extremely
drunk so that I would have enough courage (in contrast to what some believe, suicide attempts are not a
’coward’s way out’ - they actually take tremendous courage) to hang myself.
But then came the practicalities of actually finding somewhere suitable to attach the other end of the rope (ie
the end which would not be wound around my neck). I knew the drop would have to be sufficiently long to
break my spinal cord, thus severing its connection to the brain and fatally depriving it of oxygen. If the drop
was too short, I knew that I would face death by slow strangulation. Thanks very much for the offer - but, no
thanks.
Everyday I would go to a nearby pub (my rope secreted in my bag) and plan to carry out my final, decisive
task in a nearby park under cover of darkness from a suitable tree that very night. Despite carrying out my
reconnaissence work, I could never find a suitable tree. The ones with high enough and strong enough
branches were impossible to climb (in retrospect, should I also have purchased a ladder and masqueraded
as a window cleaner?)
I suppose, had I been absolutely determined to end it all, I would have found a way to accomplish it. But I
convinced myself that the only reason I was not getting round to it was purely that I could not locate a suitable
place to do it. I did not have the motivation to travel to parks or wooded areas further afield.
In this way, I dithered and procrastinated for 3 months, having taken the rope in my bag out with me every
single day, fully believing ’today will be the day.’
In the end, I gave up the idea of hanging myself and I bought a Stanley Knife with the intention of cutting my
wrists instead - but wasn’t there a special way of doing it? If I did it wrong, wasn’t it possible I would not die
but lose so much blood my brain would not be fed enough oxygen and I’d incur irrevocable brain damage,
thus suffering the fate of becoming an even bigger moron than I was already?
The whole episode, then, was a farcical failure. It was also an expensive one. The cost of staying in my
squalid room alone had been nearly £5000. An expensive holiday - I decided then and there not to book
again next year.
Many would say that ’deep down’ I did not, in fact, want to die.
This could, on an unconscious, have been true. But it certainly felt to me that I did.
List of Life Events Categorized According to Their Stressfulness.
If we have experienced significant childhood trauma, research shows that our ability to cope with stress can,
as a result, become severely reduced in adult life (click here to read one of my articles about this). We may
well find, then, that we are particularly affected by some of the life events listed below in this article.
Any major change in our lives can produce stress (even positive changes like getting married). The more an
event challenges our ability to cope with it, the more stress it is likely to produce.
A list of various life events which can give rise to stress is given below. Over any given period of time, the
more of these events we experience, and the higher their combined rating, the more stress they are likely to
produce.
It is also worth noting that it is not just the occurrence of a stressful event per se which produces feeling of
stress in us (both physical and emotional), but also how significant we perceive the event to be. Other facors
which contribute to how stressful we find particular events include their predictability, their familiarity, their
unavoidability and their intensity.
The list below is far from set in stone as the subjective experience people have of the events, and the events
themselves, vary widely from case to case. The following should, therefore, be seen as a rough guide :
STRESSFUL LIFE EVENTS.
CATEGORY ONE : VERY HIGHLY STRESSFUL :
- death of husband/wife/life-partner
- death of close family member
- divorce/separation from long-term partner
- jail sentence
- marriage
- significant personal injury or illness
- loss of job
CATEGORY TWO : HIGHLY STRESSFUL :
- retirement
- serious illness of family member
- death of close friend
- money problems
- new child
- pregnancy
- change of job
- sex diffculties
CATEGORY THREE : MODERATELY STRESSFUL :
- change in living conditions
- change in work responsibilities
- son or daughter leaving home
- difficulties with in-laws
- outstanding personal achievement
- difficulties with boss at work
- revision of personal habits
- large mortgage or loan
- legal action over debt
- starting or finishing school
- partner begins or stops working
- family arguments
CATEGORY FOUR : LOW LEVEL STRESSORS :
- change in social activities
- Christmas
- holidays
- minor violations of the law
- change in eating habits
- change in sleeping habits
- change in work hours
- change in recreational activities
Physical Symptoms of Stress and How to Reduce Them
If we have experienced a traumatic childhood, it is frequently the case that our capacity to deal with stress as
adults is seriously diminished (click here to read one of my articles about this).
When we experience stress, it almost invariably involves unpleasant physical symptoms; these include :
- dry mouth/throat
- upset stomach
- frequent urges to pass urine
- muscular twitches
- fatigue
- inability to settle/restlessness/fidgeting
- tingling sensations in hands/feet
- indigestion
- trembling
- muscle weakness
- muscle tension
- shallow, fast breathing (also known as hyperventilating (this worsens the anxiety so it is extremely useful to
learn techniques to help control this - see below)
- dilated pupils
- sweating
- loss or increase in appetite
- sweating
- rapid, uneven or pounding heart beat
- a feeling of nausea
- headaches
- sleep difficulties
- over-alertness/feeling extremely ’on edge’ (this is also sometimes referred to as ’hypervigilance’ or
’hyperarousal’)
- aches and pains (eg in the back)
This is not an exhaustive list, but covers most of the main physical symptoms people tend to experience
when suffering from the effects of excessive stress.
HOW TO DEAL WITH THE PHYSICAL SYMPTOMS OF STRESS :
It sounds too simple to be true, but one of the most effective methods for dealing with the physical symptoms
of stress, such as those listed above, is to use controlled breathing techniques.
Normally, of course, breathing is an unconscious process. However, by taking conscious control, for a short
period of time, over how we breathe, we can very significantly ameliorate the unpleasant physical sensations
which can accompany stress. By changing how we breathe, we can dramatically change how the act of
breathing makes our bodies feel.
The beneficial breathing technique which I refer to has been called by various different names ’diaphragmatic breathing’, ’paced respiration’ or, rather less grandly, ’deep breathing.’ Its physiological effect
is simple but effective ; it increases oyygen levels in our bodies and decreases levels of carbon dioxide.
WHAT ARE THE MAIN BENEFITS OF THIS TYPE OF BREATHING TECHNIQUE?
Research is now showing that this conscious breathing technique is much more powerful, and has far more
benefits, than people had, hitherto, been aware of. These are :
A) the parasympathetic nervous system is stimulated into action and this counters the ’fight or flight response’
triggered by our sympathetic nervous system
B) it reduces the physical damage stress can do to the body by lowering levels of cortisol (cortisol a hormone
- levels can dangerously increase in response to excessive stress)
C) it increases levels of the neurotransmitter acetylcholine which helps to keep us calm
D) it lowers our blood pressure and our heart rate thus lowering the risk of cardiovascular disease
E) new research now suggests it actually helps a part of the brain involved in attentional processes to grow
larger
F) recent research also provides evidence that it helps to improve our immune system
THE DEEP BREATHING TECHNIQUE :
Below I describe a simple breathing technique that helps to counter the effects of stress :
1) Get into as comfortable a position as possible 2) Close eyes
3) Drop jaw and shoulders
4) Allow muscles, especially if you can feel that some muscle groups are particularly tense, to relax as much
as possible. Don’t worry if they do not feel completely relaxed.
5) Breathe SLOWLY and DEEPLY, IN THROUGH NOSE, OUT THROUGH MOUTH
6) Try to FILL LUNGS as much as possible by EXPANDING ABDOMEN and RAISING RIBCAGE
7) HOLD BREATH FOR 3-6 SECONDS
8) BREATHE OUT SLOWLY AND TRY TO COMPLETELY EMPTY LUNGS (allow abdomen and ribcage to
relax to help with this)
Sessions should be at least 5 minutes (although even a shorter length of time is helpful) and the breathing
exercise should be carried out without straining.
Mindfulness meditation therapy is becoming increasingly recognized, due to recent and current research
being conducted at universities world wide, as being extremely effective for treating stress, anxiety and many
other conditions.
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Why a Mother’s Influence is so Powerful
’A boy’s best friend is his mother.’
- Norman Bates, from the film ’Psycho’, 1960.
Our mothers have an enormous influence upon how we view ourselves and the value that we place upon
ourselves. Indeed, during our early development, the quality of our interactions with our mothers actually
shapes the neural circuits in our brains. These same circuits in turn affect our ability to control our own
emotions as well as how we interpret the feelings and thoughts of others.
Whilst young children form many other relationships (eg with other relations, friends of the family etc) their
relationship with their mother is the most critical. The way in which the mother and child interact on an
emotional level creates the fundamental sense of being someone with feelings who can communicate those
feelings to others.
Ideally, of course, the relationship the mother has with the child should be consistently attentive, supportive
and comforting. But what happens if this way of interacting breaks down, or never materializes in the first
place? If, when we are young, our mother fails to be attentive and supportive, we may infer from this that it
must be that we are in some way ’bad’ and, therefore, we can easily come to believe that we cannot be
worthy of proper attention.
If our mother perhaps resents us and the ’burden’ (as she sees it) we place on her when young she may
become frequently angry and excessively punishing towards us. This, in turn, can lead us to become
hyperalert and hypervigilant ; intensely wary, for example, about slight changes in our mother’s expression
and whether or not it may signal we are in danger.
it is then possible that we carry this hypersensitivity into adult life, constantly trying to ’read’ others and detect
signs of hostility towards us in their body language, intonation, facial expressions etc - a kind of social
paranoia. This can cause enormous difficulties with our adult relationships.
Humans remain immature (ie as babies and children) far longer than any other primate. One of the main
reasons for this is our need to learn how to interact effectively with others, and, critically, to learn how others
respond to us.
If our mother is constantly responding to us in a dysfunctional way, and is not properly attuned to our needs,
the potential effects are very damaging. Indeed, studies now show that the child’s brain development can be
harmed, leading to an impaired ability to control, manage and identify his/her emotions.
As a result, we can find that we are constantly overwhelmed by feelings like anger, anxiety and fear whilst
lacking the ability to calm ourselves down or to ’self-soothe.’ Our inability to control our emotions, stemming
from an unhealthy early relationship with our mothers, also lead to major difficulties controlling our impulses,
achieving goals and in decision making.
It is now clear that the young child who is not properly emotionally nurtured can suffer as much psychological
damage as the child who is physically abused. The child’s brain’s biochemical makeup becomes harmful to
his/her modes of behaviour and emotional experience. Growth of the neural circuits which protect against
day-to-day stress is disrupted.
Contrary to the popular opinion of some, early stress in a person’s life does not ’toughen them up’
- it makes them far more vulnerable to stress later on in life. As adults, because they have been deprived of
the ability to naturally regulate their own intense and overwhelming responses to stress, they are likely to turn
to unhealthy coping mechanisms such as smoking, drinking excessive amounts of alcohol, or taking illicit
drugs.
THE MOTHER WHO FOCUSES ON OWN NEEDS AT CHILD’S EXPENSE :
When a mother is habitually focusing on her own needs at the expense of the child’s, the child may start to
have highly emotionally charged arguments with her in an unconscious attempt to gain the attention and
understanding that he or she so desperately needs.
Furthermore, the child needs to attempt to master an impossible balancing act : s/he must try to maintain a
sense of value of his/her own needs, whilst maintaining a strong relationship with the mother.
If she feels powerless, she may try to control her child by frightening him/her, to give her the feeling she does
have some power after all and is therefore not entirely impotent.
If she cannot cope with her own emotions and feelings, she may turn the child into her caregiver, thus
reversing normal roles.
The particular type of interpersonal dysfunction which existed between the mother and the child will directly
influence how the child’s social brain develops which, in turn, will largely dictate his/her social expectations
and interpretations once s/he is an adult, as well as how s/he thinks, feels and reacts in connection to social
interaction and interpersonal relationships.
Repressed Memories : The Need for Further Research.
More research needs to be conducted into whether traumatic memories can become repressed (ie hidden
from consciousness / buried in the unconscious with no access to conscious recall).
The concept of repressed memories was made popular by Sigmund Freud (1856 - 1939) who hypothesized
that traumatic memories could be buried deep in the unconscious without conscious access for long periods
of time and that this caused his patients mental distress and neurotic symptoms.
Sigmund Freud (1856-1939)
He also put forward the view that it was only by uncovering these memories and bringing them back into
conscious awareness that these patients could be cured.
Now, around a century later, the debate surrounding the concept of repressed memories is still not resolved
and research into the phenomenon is ongoing.
At present, leading researchers believe some people may have repressed memories, but, if they do, the
phenomenon happens extremely rarely.
One problem which contributes to the lack of certainty regarding the issue is that the subject area cannot be
experimentally investigated as it would clearly be unethical to subject people to severe trauma and then
investigate whether or not they repressed their memory of it.
If the phenomenon does indeed occur, a main theory to explain why it happens is that it serves to protects
the person from the overwhelming psychological pain that recalling the traumatic event would entail
- in other words, it is a form of dissociation (please click here to read my article on dissociation). If it is thought
previously dissociated memories have been recovered they are also sometimes referred to as ’delayed
memories’. However, more conclusive empirical evidence for this process still needs to be collected.
Leading researchers into the relationship between the experience of trauma and the memory process are
also largely in agreement that, sometimes, people construct ’memories’ of events that did not, in reality,
occur. The term which has been given to such false memories is ’pseudomemories.’ However, it is often
extremely difficult to prove that these memories are indeed false and, therefore, this area of research is
somewhat controversial.
Because processes underlying both repressed memories and pseudomemories are still not properly
understood there still remain many important questions upon which it is necessary for future research to
focus; such questions include :
A) How, exactly, are traumatic memories processed differently by the brain compared to non-traumatic
memories and how might this interfere with both their storage and their subsequent recall?
B) Are some people more likely to develop pseudomemories than others? If so, why is this?
C) If pseudomemories have been formed, under what kinds of conditions is this most likely to happen (eg
suggestions made by/the influence of poorly trained therapists?)
D) If memories have actually been repressed, what are the most effective techniques that can be used in
order to recover them as accurately as possible?
Childhood Trauma Linked to Homosexuality. So What?
To what degree do nature and nurture contribute to homosexuality?
It is a politically sensitive debate, but in the light of solid scientific findings, it is necessary to have the courage
to address such matters. Childhood trauma has been linked in several research studies with sexual
addiction/compulsion (see my article on this by clicking here) due to the dissociative state it produces (see
my article on dissociation by clicking here), sadomasochism, prostitution and homosexuality. Many gay
people resent this finding (understandably so) and fear it will encourage right-wing religious fundamentalists
absurdly to declare homosexuality an ’illness’ that needs to be ’cured.’
However, assuming the scientific studies are valid, need we fall into a deep pit of despair, never to
re-emerge? I think not.
Here’s an analogy which is meant to be neither flippant nor frivolous : suppose I am walking down the street
and someone hits me, very hard, on the head with a hammer. I lapse into a coma and am taken to hospital.
On coming out of my coma, I find I am fully recovered, and, although, prior to my accident, being unable
competently to draw a stick man, now find I am an artistic genius, able to create paintings which sell for
millions of pounds (similar things do and HAVE happened as the result of brain injury - extremely rarely).
Should I be ashamed of my artistic talents?
Clearly not. Why? It was not my fault I suffered a head trauma. Nor is the result (my painting abilitiy) to my
disliking. I would not regard it as a symptom of my trauma in need of curing. Quite the contrary, as it
happens.
Similarly, if I suffer childhood trauma which contributes to me becoming gay, the same argument applies.
EXAMPLES OF STUDIES SHOWING THE LINK BETWEEN CHILDHOOD TRAUMA :
A study at Otago University in New Zealand with 13,000 participants (98.3 % heterosexual. 0.8 %
homosexual, 0.6 % bisexual, 0.3 % ’other’) conducted in 1992 found that those who had suffered severe
childhood trauma such as violence and sexual assault were statistically very significantly more likely to be in
the non-heterosexual group.
It is also detailed in an academic paper by Schwartz entitled ’Hypersexuality Secondary to Childhood Trauma
and Dissociation’ and another by Colin Ross entitled, ’Sexual Orientation Conflict and Dissociative Disorders’,
that childhood trauma is far more common in gay people than their straight peers.
NOTE OF CAUTION : PLEASE DO NOT ATTEMPT TO HIT YOURSELF OVER THE HEAD WITH A
HAMMER IN THE HOPE OF BECOMING A GREAT ARTIST.
Effect of Early Trauma on Brain’s Right Hemisphere Development.
As recently as 25 years ago, it was still frequently believed that the structure of the brain had already been
genetically determined at birth. Now, however, we of course know that this is absolutely NOT the case.
Indeed, the experience, in early life, of trauma, abuse or neglect can have a profoundly adverse effect upon
both the brain’s chemistry and its architecture (ie the way in which its physical structure develops).
Studies on animals can help us to understand the effects of trauma on the developing human brain. For
instance, if animals are subjected to inescapable stress they develop behaviours such as :
- abnormal alarm states
- acute sensitivity to stress
- problems relating to both learning and memory
- aggression
- withdrawal
The symptoms listed above are, in fact, very similar to those displayed in humans who are suffering from
post-traumatic stress disorder (PTSD).
In both the cases of humans and of animals, investigations suggest that prolonged exposure to stress
adversely ffects a vital brain system ( the NORADRENERGIC BRAIN SYSTEM).
Indeed, in humans it has been found that even in adults (let alone children) just one exposure to severe
trauma (eg a terrifying battle) can significantly alter an adult’s brain and lead to PTSD.
STUDIES ON EFFECTS OF CHILDHOOD TRAUMA ON BRAIN :
Drissen et al (2000) found that those who had suffered severe childhood trauma had smaller volumes of two
vital brain structures which play a role in stress management; the two structures physically ffected by trauma
were :
1) THE AMYGDALA
2) THE HIPPOCAMPUS
On average, those who had experienced severe childhood trauma were found to have :
- amydallas which were 16 % smaller than those who had not experienced significant trauma
- hippocampuses which were 8 % smaller than those who had not experienced significant childhood trauma.
Further research by Shore (2001) has shown that the brain’s right hemisphere (see diagram of the brain’s
right and left hemispheres above), which has deep connections into the limbic and autonomic nervous
systems, is impaired in terms of its ability to regulate these systems properly; leading to profound difficulties
managing stress in those who had suffered serious childhood trauma.
Fifteen Emotional Symptoms of Stress
If we have suffered long-lasting significant stress when we were children it is very likely to have affected the
physical development of our brains in an adverse manner which makes it very much harder to cope with the
effects of even minor stress as adults. On an emotional level, we react far more intensely to it than those
whose brain development was normal (click here to read my article on how childhood stress affects the
physical development of the brain).
In this post, I therefore thought it might be helpful to list some of the main emotional symptoms we might have
indicating that we are suffering the effects of stress.
Before I do this, however, I should also point out that when we are finding it difficult to cope with the effects of
stress it affects other aspects of ourselves, too - not just our emotions. It also affects us physically and how
we behave.
It is important to point out that different people are affected by stress in different ways. In some, the
symptoms of stress may be obviously apparent (overt), whilst in others they may be hidden or ’invisible’
(covert). Furthemore, in some individuals the symptoms may be short-term, whilst in others they may be
long-term (ie chronic). The warning signs that someone is suffering the effects of excessive stress may
include headaches, chest discomfort, indigestion, muscle tension (physical symptoms) or behavioural
symptoms (eg physical aggression, increased alcohol intake etc).
However, in this post I want to focus on EMOTIONAL SYMPTOMS OF STRESS, and, in keeping with the title
of this post, I list 15 of these below :
- inability to feel pleasue (psychologists sometimes refer to this as anhedonia)
- feelings of aggression towards others
- feelings of frustration
- a tendency to become easily tearful
- feeling constantly under intense pressure
- increased feelings of suspiciousness
- increased feelings of irritability and increased likeliness to complain
- more easily triggered ’fight/flight’ impulse and feelings of wanting to ’hide away.’
- feeling in a constant state of fear
- finding it hard to make decisions
- a feeling of being mentally drained and exhausted
- feeling tense, agitated and unable to relax
- impaired ability to concentrate
- social self-consciousness
- fears of imminent death, ’madness’ or collapse
Trauma, Depression and Learned Helplessness
If we suffered a traumatic childhood in which we felt powerless to change our situation for the better, we may
have become conditioned to believe that there is no point in trying to improve our situation in life as any such
attempt will inevitably be doomed to failure. Such a state of mind, one of the hallmarks of clinical depression,
has been termed ’learned helplessness’ by psychologists. If we are suffering from learned helplessness, we
will lack motivation to create positive change even when it is clearly possible to do so from an objective
perspective.
The following experiment, involving dogs, helps to illustrate precisely what psychologists mean by the
condition of learned helplessness. It is a controversial experiment which is ethically questionable and I do not
think I would feel comfortable carrying out such a research activity myself. However, here are the findings :
PHASE 1 OF EXPERIMENT :
The experiment, part of a research study by Martin Seligman, was carried out in the 1960s and involved two
sets of dogs. Both sets of dogs were given electric shocks ; however :
- one group of dogs could stop the pain by learning to press a lever
- the other group of dogs could not escape the pain whatever they did
PHASE 2 OF EXPERIMENT :
After this unpleasant experience, BOTH groups of dogs were placed in shuttle box with two sides separated
by a short barrier. Again, electric shocks were applied through the floor in the cage. This time, however, IT
WAS POSSIBLE FOR BOTH SETS OF DOGS TO ESCAPE THE PAIN by jumping over the short barrier to
the other (safe) side of the box.
RESULTS :
- the first group of dogs (who had control in the first phase of the experiment by being able to press the lever
to stop the shocks) learned to avoid the pain by jumping the barrier in phase 2.
HOWEVER :
- the second set of dogs (who had no control over the electric shocks in the first phase of the experiment)
failed to avoid the punishment (they did not learn they could do so by jumping the barrier) in phase 2.
It is thought, in the same way, that if as children we have been in traumatic situations over extended time
periods that we were unable to escape, as adults we might become, like the second group of dogs in the
experiment, despondent, depressed and unable to try to help ourselves.
However, also like the second set of dogs in the experiment, we may falsely believe we can’t help ourselves
(due to our past experiences) when, in fact, we can - it can be our depressed and helpless frame of mind,
formed in our childhoods, that creates the illusion that there is no way out for us when, in fact, there is.
Childhood Trauma and Obsessive Love Disorder
Obsessions are a symptom of an underlying anxiety disorder and materialize as a result of great stress such
as severe emotional injury during childhood. In order to escape a world of intolerable psychological pain, the
person suffering from obsessive love disorder escapes into a world of fantasy and obsession.
obsessive love disorder
The disorder can come about as a result of having experienced a childhood in which the sufferer had
chronically emotionally unresponsive parents, and, thus, did not have his/her emotional needs fulfilled when
young. In essence, then, the sufferer has, in childhood, frequently been starved of emotional nurturance, love
and acceptance.
However, the object of the ’obsessive love’ is idealized and misperceived as someone who can supply the
emotional nurturance that the sufferer was denied as a child.
obsessive love disorder
A typical dysfunctional childhood the sufferer of the condition may have experienced is to have been rejected
early on in life by his/her mother, causing intense psychological pain, and, very often too,to have had a father
who was critical and disapproving. As a result of this, the neglected child grows up feeling worthless and
inadequate. Indeed, so great is the experience of childhood trauma that psychological and emotional
development has frequently become arrested at an early stage (so that, as an adult, the individual still has
the emotional needs s/he did at the time his/her development became arrested).
Therefore, as an adult, the emotionally damaged individual is very likely to experience constant failure when
trying to form close relationships. Due to the instability of his/her realtionship with his/her parents when a
child, s/he will tend to be anxious and fearful in relation to attempts to form intimate bonds with others.
A preoccupation with ’ideal love’ may then develop and the sufferer of the condition can then become fixated
on unavailable and emotionally inaccessible objects of this idealized love.
FACTORS RELATED TO OBSESSIVE LOVE DISORDER :
- sufferer experienced lack of nurturing and attention when young
- sufferer feels profound inner emotional pain
- sufferer is frequently isolated and detached from the rest of his/her family
- sufferer mistakes ’intensity’ for ’intimacy’ in connection to relationships
- sufferer compartmentalizes relationship, thus keeping it separated from, and unitergrated with, other
aspects of his/her life
- sufferer has driven, desperate and intense personality and is prone to being ’dramatic’
- the sufferer has a need of others to relieve his/her psychological pain
- the sufferer is prone to severe depression
- the sufferer has an insatiable need for close emotional attachment as s/he was denied this when young and
is likely to be developmentally emotionally arrested at a stage in childhood when close, dependable
emotional attachment was desperately needed (so the need remains unfulfilled)
- sufferer feels an inner rage over the lack of emotional nurturing s/he received as a child
- sufferer very likely to have other addictions/obsessions
- sufferer has a deep inner sense of worthlessness
Signs of Borderline Personality Disorder in Adolescence
Giving a diagnosis of borderline personality disorder (BPD) to an adolescent is problematic. However, given
the emotional problems I had at that stage in my life, I wish, in retrospect, there had been professional
intervention - for one thing, I was deeply depressed, and, in my teens, would cry with a regularity more
commonly associated with toddlers (including even bursting into tears in lessons at secondary school). How I
would have responded to the idea of such professional intervention at the time, however, is another matter.
How I might have reacted to being told I needed psychiatric help as a teenager.
Most professionals are reluctant to give an adolescent a diagnosis of borderline personality disorder (BPD)
due largely to the fact that during teenage years personality traits such as rebelliousness, uncertainty
regarding identity, fluctuating emotions, changeable relationships, poor decision making, anger and
impulsivity, are, to a degree, a normal part of the developmental stage the young person is at. ; this
complicates and confuses the diagnostic process in relation to BPD.
Also, if the diagnosis is wrong, the adolecsent may become unnecessarily stigmatized. Furthermore, young
people often resent professional intervention in connection with such a sensitive issue as mental health and
may regard such intervention as another stressor/problem. Indeed, if professional intervention is mis-handled,
it can do yet further substantial damage to the young person’s already rock-bottom self-esteem
How do we know if these the traits referred to above are just symptoms of being an adolescent or whether,
instead, they are a sign of something more serious? In order to attempt to resolve this question, clinicians will
usually focus on the following three factors :
1) PERSISTANCE OF SYMPTOMS eg are there long-standing emotional instability and chronic relationship
problems which show no sign of abating or of being resolved?
2) SEVERITY OF SYMPTOMS eg is suicidal behaviour/ideation present? Is self-harming/selfmutilating
behaviour present? Is anger so extreme that it puts the adolescent, or others, in danger? Is impulsivity so
extreme that it puts the adolescent, or others, in danger?
3) AMOUNT OF DISTRESS CAUSED BY THE SYMPTOMS eg is the adolescent in obvious significant
emotional pain (perhaps due to loneliness, depression or anxiety)? This is likely to be the most important
consideration of all.
Because of the problems entailed in diagnosing a young person with BPD, clinicians tend much to prefer
making a diagnosis of the adolesent having ’borderline personality traits.’ This means that the young person
shows some behaviours similar to those found in adults with BPD (which go beyond the normal range of
behaviours one typically finds in teenagers/young people), but it is too early to make a definite diagnosis of
BPD.
WHAT ARE THE POSITIVE ASPECTS OF RECEIVING A DIAGNOSIS ?
It is important to point out that, despite the problems noted above, receiving professional intervention and a
diagnosis can bring potentially tremendous, even life-saving ( ten per cent of BPD sufferers end up killing
themselves), benefits.
There is strong evidence that making an early diagnosis reduces the risk of the development of fullblown
BPD as an adult, as well as reducing the risk of the development of co-morbidities such as addictions and
self-harm.
In short, then, early intervention can save the adolesent from an adulthood of profound emotional pain,
despair and loss.
WHAT SYMPTOMS NEED TO BE LOOKED OUT FOR IN THE ADOLESCENT ?
The symptoms to look out for are similar to the symptoms that an adult sufferer of BPD would display (click
here to view a video on BPD). However, in adolescents the fluctuations in mood may be even more extreme
and dramatic than those of an adult with BPD. Because of this, adolescents who are later diagnosed as
having BPD have not infrequently initially been misdiagnosed as having bipolar disorder.
At present dialectical behaviour therapy, or DBT (click here to read my article on DBT) is the main treatment
provided to adolescents, though it is a form of DBT that has been specially adapted for young people.
The treatment given to adolescents with BPD traits differs from that given to adults with BPD. FAMILY
INVOLVEMENT WITH THE TREATMENT IS CRUCIAL as adolescents are, in general, more psychologically
enmeshed with their families than are adults. Also, the family may be the main source of the young person’s
stress, or, indeed, paradoxically, his/her main source of support as well.
Furthermore, the social context in which an adolescent finds him/herself (friends, acquaintances, peers etc) is
a vital part of his/her life and goes a long way towards moulding the young person’s sense of his/her own
identity. It is again crucial, therefore, that clinicians gain a good understanding of how this may be affecting
the adolescent.
Another way in which DBT for young people differs from DBT given to adults is that, whilst adults are
encouraged to take ’full ownership’ of their illness, most adolescents will not realize that one of the main
causes of their own problems is likely to stem from their more extreme behaviour ; this can be because they
have not yet had enough adverse as evidence for the connection (whereas an adult, for example, may have
lost his/her home, family, job, friends etc as a consequence of his/her BPD).
Instead of seeing the link between their behaviours and their predicament, adolescents are far more likely to
EXTERNALIZE their problems (eg blame them on others - although, of course, this may be partly or pretty
much wholly correct in some circumstances).
BLAME?
It follows from the above that the adolescent should not be blamed for his/her behaviour as, for one thing, this
is likely to have the effect of yet further diminishing his/her self-esteem which will, in turn, almost inevitably
increase the level of problem behaviours. Instead, the focus should be on trying to understand the root
causes of the problem behaviours and rectifying, as far as possible, these. Parents need to attend the DBT
sessions along with their child where they, too, will be informed and educated about BPD as well as trained in
the skills that the young person is trained in to manage BPD symptoms.
It is important for the adolescent to understand that, if he/she is diagnosed with having BPD traits that its
symptoms have, hitherto, been out of his/her control. It also needs to be acknowledged that it is the young
person’s deeply painful and distressing emotions which lie behind his/her behaviour, not malice.
Borderline Personality : Difference in Symptoms Between Men and Women.
The most up-to-date research shows that there are a number of differences between the symptoms that
borderline personality disorder (BPD) tends to lead to in men compared to those it tends to lead to in women.
THE DIFFERENCES IN SYMPTOMS MEN AND WOMEN WITH BPD TEND TO DISPLAY :
- men with BPD are more likely than women with BPD to suffer from :
1) explosive temperaments (when this condition is pathological it is termed : INTERMITTENT EXPLOSIVE
DISORDER, or I.E.D. - click here to read an article that I previously published on this site about I.E.D.)
2) abuse of alcohol/illicit drugs
3) anti-social personality
4) sadistic tendencies
5) paranoia
6) passive-aggressive behaviours
7) narcissism
- women with BPD are more likely than men with BPD to suffer from :
1) eating disorders
2) mood disorders
3) anxiety
4) post traumatic stress disorder (PTSD)
As can be seen by reviewing the above two lists, men tend to become more anti-social if they have BPD than
women ; as a consequence of this, men with BPD are more likely to go to prison than women with BPD
(although this is also true of the general population who do not have BPD, of course, which, in my view,
confuses the picture somewhat).
SYMPTOMS OF BPD THAT ARE ABOUT EQUAL IN MEN AND WOMEN :
1) research shows that there does not appear to be a significant difference between men and women in
terms of the mental pain, anguish and distress they suffer as a result of their condition
2) levels of self-harm, too, seem to be about equal amongst men and women who suffer from BPD
DO MEN AND WOMEN WITH BPD SEEK THE SAME TREATMENT?
Whilst both men and women utilize mental health services about equally, it has been found that men are
more likely to seek treatment for substance misuse whereas women are more likely seek psychotherapy and
take medication.
IS THE PREVALENCE OF BPD EQUAL BETWEEN MEN AND WOMEN ?
Until recently it was thought that women were about 3 times more likely to suffer from BPD than men.
However, the most up-to-date research suggests men and women are EQUALLY likely to suffer from the
condition.
Finding Optimism and Positive Moods : The Neuroscience
The beliefs that we hold about ourselves, others and the world in general, powerfully affect how we feel.
Indeed, we have seen in previous articles published on this site how cognitive behavioural therapy (CBT)
takes advantage of this fact (click here to read one of my articles on CBT). Brain imaging techniques have
shown that CBT has a direct effect upon the brain by activating the region known as the hippocampus (see
picture below).
location of hippocampus and other brain regions
Learning positive thinking skills through therapies like CBT, when repeatedly practised. creates permanent,
beneficial changes in the brain.
Neuroscience, Belief, The Placebo Effect and the Brain :
Just how powerful ’mere’ beliefs can be is demonstrated very well by research that has been carried out on
the placebo effect. One shocking finding is that about 80 -100 % of the beneficial effect that people obtain by
taking anti-depressants is due to the placebo effect (click here to read my article on this).
Believing we will get better, per se, then, makes it more likely that we will. Indeed, the power of belief/the
placebo effect even makes it more likely that we will recover from physical illnesses (demonstrating again the
powerful link between mind and body). Below, I provide statistics relating to the placebo effect upon physical
illnesses (based on the findings of the psychological researcher Nieme, 2009) :
- CANCER - approximately 5 % of tumours were reduced in size by the placebo effect
- IRRITABLE BOWEL SYNDROME (IBS) - approximately 40 % improved as a result of the placebo effect
- DUODENAL ULCER - approximately 40 % improved as a result of the placebo effect
WAYS OF TRAINING THE BRAIN IN ORDER TO BENEFICIALLY ’REWIRE’ IT :
1) People who are depressed often see things in ’black or white’, or, to put it another way, think in terms of
extremes. Instead of this, it is very helpful to replace such a thinking style with one that sees things in less
extreme ways (more in ’shades of grey’ rather than ’black or white’)
2) Depression causes extreme pessimism and those who are severely depressed tend to vastly overestimate
probabilities of catastrophic outcomes. It is helpful to cultivate more optimistic thinking ; for example, rather
than dwelling on a negative change in life circumstances, seeing the new situation as a challenge and one
which can open new doors and avenues of personal development
3) Another very useful skill is learning to see one’s situation in a more DETACHED manner, becoming,
perhaps, like a kind of dispassionate observer of one’s own life - rather like watching a film ; distancing
ourselves from events in this way can be very helpful.
4) It is also very helpful to EXTERNALIZE events more - this means not letting things lower one’s self-esteem
when they go wrong, but rather to channel the energy that would have been wasted on castigating oneself
into trying to constructively resolve the situation.
’BRAIN CELLS THAT FIRE TOGETHER, WIRE TOGETHER.' :
The more we practise positive thinking, the more neural connections will be created to elevate our mood likewise, the greater will be the rate at which neural connections that create low mood will wither away and
die. This idea is summed up by the phrase, coined by neuroscientists, that ’brain cells that fire together, wire
together’.
Borderline Personality Disorder (BPD) : Latest Facts and Figures
Borderline Personality Disorder : Facts and Figures :
- about three quarters of those who suffer from BPD have a history of self-harm
- about 10 % of those who suffer from BPD eventually commit suicide
- the majority of those who suffer from BPD improve over time (over 70 % go into long-term remission).
- about 50 -60 % of those with BPD have a history of having been sexually abused
- one of the main hallmarks of BPD is severe dissociation
- a diagnosis of BPD does not define the person nor detract from their positive qualities
- psychotherapy, especially Dialectical Behaviour Therapy (DBT), has been shown by studies to be the most
effective treatment
- if a person suffers from BPD, s/he is likely to have other mental health issues that run along side it (known
as comorbidities). Often, these other conditions include depression, psychotic symptoms and bipolar disorder
- about half of those who suffer from BPD have experienced a history of having been the victim of violence
- about 1 % of the population suffers from BPD ; whilst it is just as likely to affect men as women, the
condition is under-diagnosed in men who are more likely to become caught up in the justice system or to use
substance abuse services instead having their BPD directly addressed.
Childhood Trauma and Anorexia
Those who have suffered significant childhood trauma, once adults, frequently need to find ways in which to
manage the emotional pain that they have been caused as a result of it.
One method frequently used to achieve this psychologists call ’dissociation’, or ’mental escape’ to put it more
plainly (click here to read my article about this dissociation). Very frequently, those in emotional distress
develop addictions as a means of achieving this mental escape ; for example, heavy drinking, chain-smoking,
taking illicit drugs or pathological gambling.
It is not only their emotional pain that may lead those who have had a traumatic childhood to develop
addictions, but, also, because the experience of difficult relationships with parents/carers in early life
frequently leads to problems forming close relationships in adult life (click here to read my article about this).
Deprived, then, of satisfying relationships in adulthood to turn to for emotional support, the temptation to take
refuge in addictions becomes all the more compelling.
ANOREXIA AS AN ADDICTION
Like illicit drugs, alcohol or cigarettes, the effect of not eating/eating very little is itself addictive.
Anorexia usually starts in adolescence or early adulthood. It is a very serious condition and can even be fatal
(in fact, about 5-20 % of those suffering from eating disorders eventually die (either as a direct physical
consequence of their condition or as a consequence of the psychological pain underlying the condition
leading to suicide). The reason that the condition of anorexia becomes addictive is that when the body is
starved of the carbohydrates it requires, the brain starts to produce opioids which creates a natural high. It is
the production of these opioids and the resultant natural high that drives the addiction of denying the body of
sufficient fuel.
Therefore, by starving themselves, those suffering from anorexia will become addicted to the relief from
painful emotions that their very limited food intake creates in a similar way to how the heavy drinker becomes
addicted to finding relief in alcohol. Those who suffer from anorexia also often report that the effect of eating
so little makes them feel numb and helps them to suppress uncomfortable feelings such as anger and
anxiety.
Therefore, the anorexia serves to help the sufferer regulate emotions (difficulty in regulating emotions is
common amongst those who have suffered childhood trauma, particularly if the experience of childhood
trauma has led to the development of borderline personality disorder (BPD) - click here to read one of my
articles on BPD). Indeed, recent research suggests that one of the main characteristics of the sufferer of
anorexia is difficulty managing emotional states, especially in relation to the expression of anger and their
own wishes.
It is hypothesized that this inability that the anorexic has to successfully regulate emotions derives from not
having had their feelings adequately identified and responded to in early life. This can lead to great
dependence on others during adulthood, and an intensive and desperate search to find the ’perfect partner’
who will provide the emotional needs that were not fulfilled during childhood.