Over 600 high quality articles all written by psychologist, writer, researcher and educator David Hosier MSc, Founder of childhoodtraumarecovery.com.

Hartman’s 12 Stages Of Post-Traumatic Stress Disorder (PTSD)

12_steps_of_ptsd

I have written extensively on this site about how severe and chronic childhood trauma can lead to the development of post-traumatic stress disorder (PTSD) in adulthood (see the PTSD section on the main menu). This is also sometimes referred to as complex post-traumatic stress syndrome (CPTSD). In order to understand the theoretical difference between PTSD and CPTSD, click here.

In connection with PTSD, the writer and researcher, Hartman, has proposed a model of how the terrible mental illness can progress over time, involving the afflicted individual going through 12 painful steps.

This theoretical model is shown in diagrammatic form below:

 

The 12 Steps Of Post-Traumatic Stress Disorder (PTSD):

12_steps_of_PTSD_diagram

 

PTSD Treatment:

The NHS provides excellent information about treatment options for PTSD and this can be found by clicking here.

Information For Therapists:

A downloadable course that trains practitioners to treat PTSD  (using the Rewind Technique) can be found by clicking here.

EBook:

brain damage caused by childhood trauma

 

Above eBook now available for instant download from Amazon – click here for further details.

 

David Hosier BSc Hons; MSc; PGDE(FAHE).


Brain Areas That May Be Adversely Affected By Childhood Trauma

BPD_and_brain_areas

We have already seen in other posts that I have published on this site that, if we have been unfortunate enough to have been subjected to severe and chronic childhood trauma, it is possible that this adversely affected how our brain physically developed during our early life.

And, if we have been particularly unlucky, this disrupted brain development could have made us highly susceptible to developing borderline personality disorder (BPD) in our adult lives.

 

Indeed, research involving brain scans suggest that sufferers of BPD can have abnormalities in the following brain areas :

– prefrontal cortex

– anterior cingulate

– medial frontal cortex

– subgenual cingulate

– ventral striatum

– ventromedial prefrontal cortex

– amygdala

 

Below : Brain Areas Which May Have Had Their Physical Development Adversely Affected By Our Traumatic Childhood Experiences, Particularly If We Have Developed Borderline Personality Disorder ( BPD) :

BPD brain

 

What Are These Brain Areas Associated With?

The function of these brain areas are described below:

PREFRONTAL CORTEX:

– decision making

– conscious control of social behaviour

– speech / writing

– logic

– purposeful (as opposed to instinctual) behaviour

– planning for the future

– expression of the personality

ANTERIOR CINGULATE :

– decision making

– heart rate

– blood pressure

– impulse control

– emotions

MEDIAL PREFRONTAL CORTEX:

– decision making

– memory

SUBGENUAL CINGULATE :

– sleep

– appetite

– anxiety

– mood

– memory

– self esteem

– transporting serotonin

– our experience of depression

VENTRAL STRIATUM :

– decision making

– emotional regulation (the control of emotios)

– the extinction of conditioned responses

AMYGDALA :

– appetite

– emotion

– emotional content of memories

– fear

The Effects Of Disruption Of The Above Brain Areas :

Poor decision making ; poor control of social behaviour ; impaired ability to think rationally ; poor planning for the future ; dysfunctional personality ; increased physiological response to stress ; poor impulse control ; poor emotional control ; insomnia ; changes in appetite ; severe anxiety ; mood instability ; low self-esteem ; impairment of the brain’s ablity to make effective use of serotonin leading to clinical depression ; changes in appetite ; emotionally charged memories leading to flashbacks, nightmares, intrusive thoughts, panic attacks ; feelings of being under constant threat, fear, terror and extreme vulnerability.

Two types of therapy that may be useful are cognitive behavioural therapy (CBT) and dialectical behavioural therapy (DBT).

Resources :

General Information :

NHS information about borderline personality disorder (BPD). Click here.

EBook :

brain damage caused by childhood trauma

Above eBook now available for instant download from Amazon. Click here for more details.

Self-help :

For immediate help with many of above problems click here.

David Hosier BSc Hons; MSc; PGDE(FAHE).


BPD And The Triune (3 Part) Brain

reptilian_brain

Our brains can be divided into three parts, as follows:

1) Reptilian Brain (also called the brain stem):

This part of our brain is the oldest in evolutionary terms, and, therefore, the most primitive. It reacts to events instinctively without conscious deliberation ; in particular, it gives rise to :

– our fight / flight / freeze / fawn responses

– our immediate biological sexual responses

Essentially, then, this part of our brain is responsible for our survival. If we feel seriously threatened, it over-rides the two other parts of our brain (see below).

Also, if we drink too much, the influence of the reptilian brain becomes more dominant, as alcohol can significantly reduce the activity of the two (mammalian and neomamallian) higher parts of the brain; when drunk, therefore, we are more likely to get into fights or indulge in promiscuous and/or unsafe sex.

2) The Mammalian Brain (also called the limbic system or midbrain)

This was the second part of our brain to evolve. It is involved in :

– the generation and experience of our emotions

– memory and other aspects of learning

3) The Neomammaliam Brain (also called the neocortex) :

This is the most recently evolved part of our brain and is involved with :

– decision making

– conscious control of social behaviour

– speech / writing

– logic

– purposeful (as opposed to instinctual) behaviour

– planning for the future

– expression of the personality

triune_brain

Which Animals Do We Share These Three Parts Of Our Brain With?

1) Reptilian Brain :

reptilian_brain

We have this part of our brain in common with crocodiles and snakes

2) Mammalian Brain :

mammalian_brain

We have this part of our brain in common with cats and dogs

3) Neomammalian Brain :

neomammalian_brain

We have this part of our brain in common with chimpanzees and gorrilas.

What Has All This Got To Do With Borderline Personality Disorder (BPD)?

If we have suffered significant childhood trauma, it is possible that the physical / biological development of our brains has been adversely affected. And, if we are unlucky, and, especially, if we have a genetic susceptibility, we may, as a result, go on to develop borderline personality disorder (BPD) as adults.

Indeed, a leading theory relating to BPD, is that the brain has developed in an atypical and detrimental manner in connection with our ability to regulate our emotions and control our behaviour.

As such, the neomammalian part of the brain (responsible for conscious control of behaviour, decision -making, planning and logic) may be underactive.

AND :

The more primitive parts of the brain (the reptilian brain and the mammalian brain) may be overactive and too easily to being triggered (e.g. even a very small threat may trigger great activity in the reptilian part of the brain which is responsible for the fight or flight response.

This combination of faulty brain areas can mean that individuals with BPD experience emotions, such as anger and fear, far more frequently, and far more intensely, than the average person; and, also, have a significantly impaired ability to exercise control of their behaviour, make sensible decisions, plan for the future and think rationally.

How Can BPD Sufferers Gain More Control Over Their Feelings And Behaviour?

In order to gain greater control of their lives, it follows from the above theory that it is necessary for BPD sufferers to make the neomammalian part of the brain more dominant and to quieten the more primitive brain areas.

Research shows that an effective way to do this is to practice mindfulness meditation – if possible, on a daily basis.

Resources:

brain damage caused by childhood trauma.

Above ebook now available for instant download on Amazon. Click here for further details.

David Hosier BSc Hons; MSc; PGDE(FAHE).


Feelings Of Alienation And Disconnectedness Linked To Childhood Trauma

alienation and trauma

If we have suffered severe and protracted childhood trauma, especially if it has resulted in post traumatic stress disorder (PTSD), we may find, as adults, that we feel alienated and emotionally disconnected from other people – we may find we have lost our fellow-feeling, our empathy, concern and compassion for others, as well as our ability to relate to them in any meaningful way.

This can make us feel that we have become cold and callous, leading to feelings of self-hatred, self-disgust and profound loneliness and isolation.

As a result, we may become reclusive and pathologically avoidant of social interaction.

Why might this happen?

A main theory is that it is due to unconscious memories of trauma. In effect, we may have become psychologically trapped at the time of our trauma, feeling and reacting as if the traumatic situation we were once in is going on in the present.

Therefore, we continue to feel extremely unsafe and perpetually under threat, distortedly perceive situations and people, and behave accordingly (e.g. constant hypervigilance, fear and suspicion of others and pre-emptive hostility).

The problem is an inabity to distinguish between our past world (in which we felt in constant danger) and our present (relatively safe) world. So we are, essentially, trapped in a kind of psychological time-warp.

Because of this, when events occur that remind us of our original trauma (even if such reminders are very subtle and operating on an unconscious level, we are in danger of suffering from flashbacks).

We are likely, too, due to our fear and suspicion of others, frequently to get into conflicts with people when we are forced to temporarily, socially integrate (psychologists sometimes refer to this phenomenon as having a disorganized attachment style).

Our sense of isolation and alienation may be further accentuated by our knowledge that others are incapable of understanding the depth of our former, and current, suffering; mere language cannot convey its intensity. As a result, these others may treat us with intolerance, disdain and in an inappropriately morally judgmental manner. This can lead to deep feelings of frustration, resentment, anger and rage.

Useful Link :

Advice on dealing with PTSD from the Royal College of Psychiatrists – click here.

David Hosier BSc Hons; MSc; PGDE(FAHE).


Four Types Of Stress Exacerbated By Childhood Trauma

types of stress

We have already seen that those of us who have suffered severe and chronic childhood trauma are at increased risk, compared to those who experienced a relatively happy and stable childhood (all else being equal), of experiencing extreme difficulty dealing with stress in our adult lives ; it is theorized that this is often, in no small part, due to damage to our brain’s development in early life, in particular to brain regions called the amygdala, hippocampus and prefrontal cortex.

Indeed, research shows a clear link between early life trauma and the later development of borderline personality disorder (BPD) ; one of this condition’s hallmark symptoms is the inability to adequately control one’s emotions, in particular those emotions induced by stress such as anxiety and anger.

So which areas of our lives are likely to be adversely affected if we have developed a particular sensitivity to stress?

Albrecht, an expert and pioneer in the development of stress management techniques identified four key types of stress. These are:

1) Time Related stress

2) Anticipatory Stress

3) Situational stress

4) Encounter stress

Let’s look at each of these in turn:

Time Related Stress

If we feel this type of stress, we are likely to worry about all the things we need to do and how little time we have to do them in, especially if we have deadlines to meet. We will tend to rush things and feel a constant, oppressive sense of pressure, leading to a perpetual state of anxiety, tension and unease.

We may, too, frequently find ourselves obsessively ruminating, at night in bed, about what we need to do the next day, leading, perhaps, to insomnia.

Anticipatory Stress

This type of stress may :

a) be linked to a specific event or activity we have to undertake in the future, such as a job interview, public speaking engagement or examination.

b) be ill-defined, vague and generalized and, when severe, may take the form of a pervasive sense of dread about the future and a constant and abiding feeling of impending doom or disaster.

This negative view of the future is one of the negative cognitive triad of clinical depression, the other two being a negative view of the self and a negative view of other people.

Situational Stress

This type of stress may occur when:

– we find ourselves in a threatening situation over which we are unable to exert control

– we feel unaccepted (e.g. by work colleagues)

– we suffer a sudden drop in social status, such as being fired from a good job and becoming unemployed

– we find ourselves involved in interpersonal conflict (e.g. with boss or family member).

Encounter Stress:

This kind of stress can occur if we have to mix socially with others who intimidate us or who make us feel awkward and self-conscious or whom we simply dislike.

Also, interacting with those who are unpredictable can give rise to this category of stress.

Those who work in jobs which involve interacting with others who are emotionally distressed (e.g. doctors or police officers) are also susceptible to this kind of stress.

Important: If we have suffered childhood trauma that has led us to develop conditions such as BPD, it is imperative that we reduce the stress we experience to manageable levels in as many areas of our lives as possible if we are to give our brains a chance of recovery.

 

Resources:

Time management hypnosis  Time Management – advanced self-hypnosis download. Click here for more details.

 

Social anxiety hypnosis  Ten Steps To Overcome Social Anxiety – advanced self-hypnosis download. Click here for more details.

 

Overcome anticipatory anxiety. Overcome Anticipatory Stress – advanced self-hypnosis. Click here for more details.

 

pack-beat-fear-anxiety. Overcome Anxiety – advanced hypnosis pack. Click here for more details.

EBook:

 

brain damage caused by childhood trauma

Above eBook  (instant download) now available on Amazon. Click image for more details.

 

David Hosier BSc Hons; MSc; PGDE(FAHE).


Unrequited Love : Its Link To Childhood Trauma

unrequited_love

Do you find you have a tendency to fall in love with those who are very unlikely to reciprocate your love? Or those who are highly likely, sooner or later, to reject you? Or those with whom a relationship would be frankly all but impossible? Or entirely impossible?

Have I ever had such an experience? Well, as our American cousins might say: don’t even go there, dude!  (I learned that expression by watching Breaking Bad and now consider myself bilingual).

But seriously.

If the first paragraph is applicable to you, it could be that you are unconsciously driven to fall in love with such people due to your childhood experiences. I explain below:

Rejection And Repetition Compulsion:

unrequited_love

It has been hypothesized (originally by Freud, but also by much more recent researchers) that if we suffer a terrible trauma in childhood, such as parental rejection, we will (on an unconscious level) be compelled to put ourselves through similar experiences in adulthood (in this case, by engineering situations in which we are bound to be rejected again, either in ways described above, or by behaving in such a manner that forces the other person to reject us).

Why should we be unconsciously driven to behave in such a self-destructive and despair – inducing manner?

A leading theory (again, originating from Freud but endorsed by later researchers) is that we are unconsciously attempting to gain mastery over such trauma.

Because such re-enactment of the original rejection is unconsciously compelled, this may explain why we fall in love with the ‘wrong’ person time and time again and seem utterly incapable of learning from bitter experience.

Of course, the trauma we re-enact need not be restricted to parental rejection. Indeed, another example comes from human sexuality; it has been theorized that those traumatized by being spanked in childhood may incorporate ‘spanking behaviour’ (to coin a phrase) into their adult sexual relationships – blissfully unaware of why they’re induced to behave in this somewhat abstruse, esoteric and recondite manner.

Understanding our unconscious drives and becoming aware of how they influence our behaviour is the first step to freeing ourselves from their tyranny.

Resources:

Move On From Unrequited Love:

move_on_from_unrequited_loveMove On From Unrequited Love : Click here for more information.

David Hosier BSc Hons; MSc; PGDE(FAHE).


Suicide : Who’s Particularly At Risk?

effects_of_childhood_trauma

We have already seen that those who have suffered severe and chronic childhood trauma are at an increased risk of ending their lives by suicide than the average. Indeed, an astonishing ten per cent of those suffering from borderline personality disorder, or BPD (a severe mental illness linked to childhood trauma) die by their own hand.

I myself made a suicide attempt, at the peak (or should that be trough?) of my illness which left me in a coma in intensive care for five days.

So, apart from those suffering from BPD, which other groups of individuals are at a heightened risk of commiting suicide?

At greatest risk, as one would imagine, are individuals who are mentally ill – nine out to ten people who die by suicide are suffering from a diagnosable mental illness.

Of the mentally ill, those suffering from schizophrenia or bipolar disorder are especially at risk (like those suffering from BPD, one in ten with either of these mental health conditions eventually commits suicide).

suicide_risk_factors

Hopelessness:

Of course, whilst about ten per cent of those suffering severe mental illnesses such as BPD, bipolar disorder and schizophrenia end their lives by suicide, we need not be mathematical geniuses to deduce from this that 90℅ do not. So what tips people in these groups over the edge?

Research suggests that the main predictor of an individual with severe mental illness commiting suicide is if they also experience a profound sense of hopelessness. Like me, when I made the suicide attempt I referred to above, they feel that their intolerable mental pain will never end, that everyday will be a day of intense psychological suffering and turmoil, and that there is absolutely no way out whatsoever.

An aspect of the tragedy is, of course, that a person’s state of mind can make the individual believe 100℅ that things can never get better when, objectively, this is not the case. There are many who can vouch for this, happily, from their own former bitter experiences.

Rejection:

Feeling rejected by family, friends and society in general is another important predictor of suicide.

Impulsivity:

Whilst some suicide attempts are methodically planned (as my own was), others are made on impulse. It follows, of course, that those who have an impulsive type personality (impulsivity is often a feature of BPD) are also at higher risk.

Being Male:

About twice as many men die by suicide than women.

However, unsuccessful suicide attempts are approximately twice as likely to be made by females than by males.

The Paradox Of Getting ‘Better’:

Those suffering from severe depression, at their illest, may be so lacking in motivation, and so close to being in a catatonic state, that they wish to die but cannot muster the mental energy required to end their lives (they may, too, in such a state of illness, lack the requisite planning and decision making abilities necessary). Paradoxically, it is sometimes only when such depressive symptoms start to lift slightly that they find themselves able to make a suicide attempt.

 

David Hosier BSc Hons; MSc; PGDE(FAHE).

 


Why A Part Of You May Have Remained Very Child-Like.

effects_of_childhood_trauma

As a teenager, when upset, under stress or in conflict with my parents/step – parent (and at any given time, it seems, retrospectively, I was in at least one of these states) my behaviour could become regressive (i.e. I would act in a manner far more typical of a much younger child).

This regressive behaviour, in my case, included raging tantrums, uncontrollable sobbing and, once, even, as I’ve mentioned in a previous post, shutting myself in a wardrobe, when I was about fifteen years old, after an argument with my father and stepmother.

I could go on, but you get the general picture, I imagine.

If we suffer significant trauma at an early age, it can result in part of us remaining child-like. This childhood part is cut off and separate from the main part of our personality (psychologists call it a dissociated part) and represents a phase of our childhood that was severely disrupted due to psychological and emotional turmoil.

Depending on the phase of our childhood was disrupted, this part of us may be infant-like, toddler-like, child-like or adolescent-like.

As the part of us in question as a dissociated part (as explained above) it can often remain hidden, both from ourselves and others.

However, at times of stress, this part of us may rise to the surface and express itself in an overt manner. When this happens, we both feel and act like an infant / toddler / child / adolescent.

inner_child

In accordance with this temporary transition we may, for example :

– suck our thumb

– cling to a soft toy

– hide under a table (or, in my case, shut ourselves in a wardrobe – see above)

– feel an intense sense of vulnerability

– feel exceptionally dependent on others and emotionally ‘needy’ with an overwhelming desire to be protected, loved and cared for

– display tantrum-like behaviour

Whilst we should aim not to indulge such aspects of ourselves in ways that are ultimately self – destructive, it is important that we acknowledge they exist and accept them in a spirit of self-compassion.

We need, too, to grant ourselves permission to grieve for our unmet childhood needs, and look for ways to satisfy these needs in the here and now that are not self – destructive and which do not compromise our adult lives (e.g. holding a soft toy at home OK, but probably not a good idea to take it to the board of directors’ meeting at work, sit it next to you at the table and provide it with a name tag embossed with the moniker Ted E. Bear).

For advice about managing our ‘inner child’, a useful link can be found by clicking here.

Resource:

EBook – click image below:

 

David Hosier BSc Hons; MSc; PGDE(FAHE).

 


Over 600 high quality articles all written by psychologist, writer, researcher and educator David Hosier MSc, Founder of childhoodtraumarecovery.com.