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BPD Sufferers Need To Be ‘Held’ According To Theory

holding

Buie And Adler :

Buie and Adler propose that the pathology displayed by sufferers of borderline personality disorder (BPD) such as instability, uncontrolled rage and anger, can be attributed, primarily, to early dysfunction in the relationship between the individual as a young child and his/her mother.

More specifically, Buie and Adler hypothesize that, as a young child, the BPD sufferer was insufficiently ‘held’ by the mother, particularly during the rapproachment phase of interactions.

What Is Meant, In Psychotherapy, By ‘Holding’?

In psychotherapeutic terms, the word ‘holding’ does not necessarily entail literal, physical holding (although, ideally, of course, a mother would physically hold her young child when s/he was distressed and in need of comfort), but can also involve its emotional equivalent (verbally comforting and soothing the child, for example).

However, because of the mother’s failure to sufficiently ‘hold’ (physically, emotionally or both) the BPD sufferer when s/he was a young child in distress, s/he never had the opportunity to internalize adequate maternal ‘holding’ behavior so that now, as an adult, s/he lacks the ability to self-soothe in response to the further distress that s/he will inevitably experience as an adult.

self-soothe

Profound Feelings Of Aloneness :

Buie and Adler further propose that the BPD sufferer’s inability to ‘self-sooth’ at times of high stress leads to a pervasive and profound sense of aloneness ; indeed, Buie and Adler consider this deep sense of loneliness to be a core feature of the BPD sufferer’s psychological experience and describe it in the following manner :

‘an experience of isolation and emptiness occasionally turning into panic and desperation.’

Projection :

Also, according to Buie and Adler, BPD sufferers use the psychological defense mechanism of projection in relation to their profound feelings of inner isolation which means, in short, that they project these feelings onto the external environment, and, as a result of this, perceive the outside world, and life in general, to be empty, meaningless and devoid of purpose.

Longing To Be Held By Idealized Others :

Furthermore, Buie and Adler propose that this inability to self-soothe and self-nurture (due to the original failure to internalize maternal holding behavior, itself a result of the mother’s dysfunctional interaction with the BPD sufferer when s/he was a young child) leads to intense, desperate longing and desire to be ‘held’ by idealized others.

Separation Anxiety :

Additionally, according to Buie and Adler, such longings perpetually leave the BPD sufferer vulnerable to feelings of extreme separation anxiety.

Rage :

Because of the BPD sufferer’s proneness to idealize others (see above), Buie and Adler point out that this can lead to him/her (i.e. the BPD sufferer) to develop extremely exacting expectations of such idealized others that it is not possible for them (i.e. the idealized others) to live up to.

This inevitable failure of the idealized others to live up to the BPD sufferer’s stratospheric expectations can then induce feelings of extreme rage and anger in him/her (i.e. the BPD sufferer) directed at the ‘failed’, idealized other.

Implications For Therapy :

In line with their theory, Buie and Adler put forward the view that it is the role of the therapist to provide the holding and soothing functions that the BPD sufferer is not capable of providing for him/herself. The ultimate goal of this is that the BPD sufferer is eventually able to internalize these functions (holding and self-soothing) so that s/he learns to provide them for him/herself in a way that s/he was unable to as a child due to the defective nature of the mothering s/he received.

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

 

Childhood Trauma And Revictimization

childhood trauma and revictimization

What Is Meant By Revictimization? :

Revictimization can be defined as harm done to an individual as a result of his/her inability to self-protect. It has also been viewed as an unconscious form of self-harm.

Why Are Survivors Of Traumatic Childhood Abuse At High Risk Of Revictimization?

Survivors of traumatic childhood abuse are at high risk of being revictimized. Indeed, sometimes such individuals seem to actually actively seek out situations within which revictimization is likely to take place (although this is likely to occur on an unconscious level). Why should this be?

Several theories have been advanced in an attempt to elucidate this, on the face of it, rather perplexing phenomenon.

Sigmund Freud (1856-1939) proposed that revictimization could be explained by his theory of REPETITION COMPULSION whereby individuals are unconsciously driven to ‘re-enact’ past traumatic experiences in an attempt to ‘gain mastery’ over them – to read more about this you may wish to read my previously published article : SELF-DEFEATING PERSONALITY? ITS LINK TO CHILDHOOD TRAUMA.

Briere (1992) suggests two possible explanations. First, survivors of traumatic abuse have grown up ‘getting used to’ living in the context of problematic relationships so that, when they experience further dysfunctional relationships with others in later life, even if these again result in them being on the receiving end of further abuse, they are liable to accept it as ‘just the way things are’ ; indeed, they may assume that such relationships are an inevitable part of life and can’t be escaped (see my previously published article on LEARNED HELPLESSNESS, which is relevant here).

Second, those who have suffered childhood abuse frequently experience low levels of self-esteem as a result (see my previously published article : CHILDHOOD TRAUMA : A DESTROYER OF SELF-ESTEEM for more about this) which may lead them to develop a false belief that they are somehow unworthy of being part of a healthy, non-exploitative, mutually loving relationship (see my previously published article : THE PROCESS BY WHICH OUR ADULT RELATIONSHIPS MAY BE RUINED).

It has also been pointed out (e.g. Finkelhor, 1979), and this would seem a matter of common sense, that those who are abused as children are also at greater risk of being revictimized as they are liable to place themselves in dangerous situations when trying to escape their home environment.

Self-Revictimization :

In a desperate attempt to escape emotional pain , those who have experienced significant childhood trauma may attempt to dissociate from their suffering by becoming dependent upon dysfunctional coping techniques such as excessive alcohol intake, gambling or risky, promiscuous sex ; such self-harm may also take on a more direct guide in the form of self-cutting, self-burning etc.

 

RESOURCE :

ESCAPE A VICTIM MENTALITY – click here for further details.

 

David Hosier BSc Hons; MSc; PGDE(FAHE)

Is Mental Illness Caused By Trauma?

Is Mental Illness Caused By Trauma?

There exists a clear link between the experience of childhood trauma and the development of mental illness in later life ; in other words, the greater the experience of trauma during childhood, the more likely one will suffer from psychological difficulties in the future.

However, if we ask : ‘Is mental illness caused by trauma during childhood?‘ this is too complex a question to receive a simple answer. Whether or not it does so will depend upon numerous factors, the main ones of which are as follows :

  • the type of trauma (e.g. physical, sexual and emotional abuse)
  • the severity of the traumatic experience
  • whether the traumatic experience was a single event or was frequent / chronically ongoing (in general, chronically ongoing trauma is likely to damage psychologically the child more than ‘single event’ trauma)
  • the age / developmental stage of the child at the time of the traumatic event/s (in general, the younger the child at the time the trauma takes place, the more severe the adverse effects of the trauma on the child’s mental health are likely to be)
  • whether or not the harm inflicted upon the child was deliberatethe relationship to the child of the perpetrator of the harmful event/s (if the perpetrator is related to the child – e.g. one of the child’s parents – the more severe the psychological harm inflicted upon the child is likely to be),
  • the level of the child’s resilience
  • the level of psychological support the child receives to help him/her cope with / process the traumatic event/s
  • biological / genetic factors
  • societal / cultural factors
  • the child’s perception and interpretation of the potentially traumatic events

In conclusion, then, we can say that the degree to which an individual is adversely affected by traumatic childhood experiences will depend upon numerous, complex and interacting factors.

BRIEF SELECTION OF RELATED ARTICLES (however, there are over 800 other free articles on this site related to childhood trauma in total):

 

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

Ego Regression And Progression In Response To Trauma

kalscheds regressed and progressed selves

According to Kalsched (1996) severe childhood trauma can result in the person’s ego / psyche / self fragmenting into both a REGRESSED SELF and a PROGRESSED SELF.

What Are The ‘Regressed’ And ‘Progressed’ Selves?

  • REGRESSED SELF : this part of the self / ego / psyche regresses (reverts) to an infantile state
  • PROGRESSED SELF : this part of the self / ego / psyche (henceforth I will simply refer to the ‘self’) becomes precociously advanced in relation to the individual’s actual, chronological age.

Interaction Between The ‘Regressed’ And ‘Progressed’ Selves :

Kalsched explains that the ‘progressed’ part of the self then functions as the protector / defender/ caretaker of the ‘regressed’ part of the self.

But what is the ‘progressed’ part of the self serving to protect the ‘regressed’ part of the self from? According to Kalsched, it serves to protect the ‘regressed’ self from further traumatic experience. In order to accomplish this, it closely monitors all interactions with the outside world and is hypervigilant.

Problems Created By The ‘Progressed’ Self :

Unfortunately, however, Kalsched explains, the ‘progressed’ self fails to learn from experience, and, as such, is likely to continually sound ‘false alarms’, causing us to be overly cautious and to perceive potential danger where it does not, in fact, objectively speaking, exists.

The effect of this over-zealous, chronic, unremitting scanning of our environment for signs of danger is that our view of the world becomes very negative and we lose the spontaneity we had before we were affected by our traumatic experiences.

Dysfunction And Pathology :

Furthermore, the way in which the ‘progressed’ self attempts to defend and protect ‘regressed’ self may become dysfunctional and pathological in numerous different ways which may include :

RELATED POST :

Arrested Psychological Development And Age Regression. Click here.

eBook :

Above eBook now available for instant download from Amazon. Click here for further information or to view other titles.

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

Eleven Types Of ‘Self’ That May Develop After Trauma

effect of trauma on the self

In his book, The Posttraumatic Self, the psychotherapist John Wilson describes eleven types of ‘selves’ (or, what Wilson refers to, more technically, as ‘typologies of personality that form unique configurations of self-processes’) that may develop in the individual following severely traumatic experiences.

These eleven ‘selves’ can be seen as existing on a continuum such that the first (THE INERT SELF) represents those individuals most severely psychologically damaged by their traumatic experiences whereas, at the other end of the spectrum, the eleventh (THE INTEGRATED-TRANSCENDENT SELF), represents those individuals who have proved the most resilient in the face of their traumatic experiences and can be said to have ‘transcended’ them.

I list all eleven of the types of ‘selves’ below :

  1. Inert Self
  2. Empty Self
  3. Fragmented Self
  4. Imbalanced Self
  5. Overcontrolled Self
  6. Anomic Self
  7. Conventional Self
  8. Grandiose Self
  9. Cohesive Self
  10. Accelerated Self
  11. Integrated-Transcendent Self

There follows a brief outline of each of these eleven types :

effects of trauma on the self

1) THE INERT SELF :

Wilson describes those individuals who develop an ‘inert self’ in response to trauma as ‘broken in spirit‘, ‘autistically withdrawn‘ and devoid of all motivation (‘even the motivation to be safe’); they are emotionally numb and facially expressionless. They may, too, experience catanoid states, brief episodes of psychosis or paranoid states.

2) THE EMPTY SELF :

Individuals displaying the ’empty self’ are passive and devoid of energy. They have also lost interest in activities which they previously (before their traumatic experiences) found to be engaging and have become withdrawn, socially isolated (having lost social confidence and social skills) and insecure. They also suffer from anhedonia (the inability to experience pleasure), are anxious, fearful and have lost trust in the world. Suicidal ideation is also a prominent feature of this group of individuals.

3) THE FRAGMENTED SELF :

Individuals in this category suffer from identity defusion (confusion about their identity and about ‘who they are’ – in other words, they have lost of a coherent and solid sense of self). They also feel as if their personalities have become fragmented (click here to read my previously published article about the ‘fragmented personality’).

Furthermore, they experience problems with relationships (including intense emotional responses towards others which fluctuate dramatically), are likely to function erratically in the work place, may experience dissociative states and develop traits similar to those suffering from dependent personality disorder.

4) THE IMBALANCED SELF :

Those who respond to trauma by displaying an imbalanced self suffer from extreme emotional lability similar to that suffered by individuals who have developed emotional instability disorder.

They are also afraid of being left alone and have a constant need for reassurance, to be looked after and cared for.

Furthermore, they suffer from chronic anxiety and their relationships with others are highly dysfunctional ; if they perceive themselves to be abandoned by others, even briefly, they are prone to becoming severely agitated and/or angry.

5) THE OVERCONTROLLED SELF :

Such individuals have difficulty expressing their emotions and have a fear of losing control. They display trairs similar to those displayed by individuals suffering from obsessive-compulsive disorder (OCD).

They are highly driven, disciplined, routine-orientated and ‘overactive’ – this ‘overactivity’ unconsciously serves to exert a sense of control over inner, deep-seated feelings of anxiety; in other words, their frantic attempts to impose control over their external world represents an  an unconscious overcompensation for an anxiety-provoking sense of loss of control over their internal world.

It has also been suggested (e.g. Horowitz, 1999, cited in Wilson) that their intense overactiviry is an unconscious defense mechanism which serves to ‘block out’ / prevent conscious attention being directed towards traumatic memories.

6) THE ANOMIC SELF :

These individuals experience life as empty and meaningless, are mistrustful of society in general and feel alienated and disconnected from it; indeed, often they may be seen as ‘loners’. They rebel against authority and lead an unconventional lifestyle. Also, because of the trauma they have suffered, they are wary of forming close emotional bonds with others. Furthermore, they may suffer from antisocial personality traits.

7) THE CONVENTIONAL SELF :

In contrast to individuals displaying an ‘anomic self’ (see above), these individuals have adjusted to, and reintegrated with, society following their traumatic experiences. By connecting with others, they help themselves redevelop a feeling of being safe; in relation to this, they have a strong need to gain the approval of others and to be liked and respected by them ; this powerful desire drives them to be highly conventional and conformist (Wilson, 1980).

8) THE GRANDIOSE SELF :

These individuals strive to achieve and succeed in the desperate attempt of gain recognition from others in orded to restore their shattered self-esteem (caused by their traumatic experiences).

Their grandiosity can be seen as a defense mechanism serving to ward off and protect from inner feelings of vulnerability, similar to the function it serves in those suffering from narcissistic personality disorder.

9) THE COHESIVE SELF :

Such individuals have proved resilient in the face of their traumatic experiences and may be described by others as having bounced back.’ In contrast with the ‘anomic type’ (see above), these individuals are prosocial and concerned with questions relating to ethics and justice.

10) THE ACCELERATED SELF :

Those displaying the ‘accelerated self’ type have become highly individualistic as a result of having overcome their traumatic experiences. Wilson also describes them as being ‘tough, resolute, resilient, morally principled, altruistic and self-directed [who have] ‘transformed traumatic impact into prosocial humanitarian modes of functioning’.

Wilson refers to such people as displaying an ‘ACCELERATED’ self as they have, as a result of their profound, traumatic experiences, had their psychosocial development ‘speeded up’ which, in turn, has led them to consider ‘critical life-stage issues‘ earlier than would normally have been the case.

11) THE INTEGRATED-TRANSCENDENT SELF :

Such individuals have optimally overcome their traumatic experiences and, therefore, can be described as having ‘transcended’ them to achieve a ‘structurally [integrated] self, the components [of which] reflect optimal functioning.’ Indeed, they can be seen as having achieved what Maslow describes as ‘SELF-ACTUALIZATION.’

These individuals embrace growth and challenges, have achieved ‘spiritual transcendence‘, gained profound wisdom and have the ‘capacity to have peak experiences of the numinous.‘ Wilson also describes such individuals as altruistic and able to ‘live in the present with consciousness attuned to a higher awareness of reality and cosmic order.’

 

To read my previously published article : Posttraumatic Growth : Achieving Maslow’s ‘Self-Actualiztion.’ CLICK HERE.

 

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

 

Possible Shaming Effects Of Parents Who Objectify Their Children

objectification and shame

Objectification Leading To Self-Objectifying Feelings Of Shame :

Parents may objectify their children in various ways. For example, a parent may harbor a burning desire that his/her son or daughter become a famous musician or sportsperson to such a degree that this wish dominates the way in which s/he interacts with his/her child.  As a result, the child may come to feel that s/he is being constantly judged and evaluated by his/her parent in relation to how well s/he is developing the requisite musical or sporting skills and how close s/he is to fulfilling his/her parents’ dream.

A child brought up in this manner is likely to feel objectified by his/her parents and, according to Broucek, this leads the child (unconsciously) to learn, increasingly over time, to have objective thoughts about him/herself.

In this way, states Broucek, the child gradually learns to self-objectify, and, whenever s/he fails to live up to his/her parents’ idealized expectations, s/he is liable to feel overwhelmed by a sense of shame.

Broucek is also of the view that such feelings of shame are exacerbated by a sense of ‘being perceived from the outside’ by the parents at the expense of receiving parental empathy in relation to his/her internal, emotional experiences.

parental objectification of child

Early Life Experiences :

Broucek further hypothesizes that this parental objectification of their offspring can also occur very early in life and that such objectification can be communicated to the very young child in extremely subtle, non-verbal ways such as by a mother’s facial expression/gaze.

For example, if a very young child frequently experiences gazes from his/her mother (or other primary carer) which do not reflect his/her inner mental experiences, i.e. the mother’s facial expression fails to match / mirror the child’s inner sense of self and his/her internal experiences (to read my previously published article about research relating to this, THE ‘STILL FACE’ EXPERIMENT, click here) then s/he will develop an increasing sense of not being responded to as his/her ‘true self’ but, instead, of being objectified by the mother (or other primary carer).

Notwithstanding this, Broucek accepts that some of the time the mother’s (or other primary caregiver’s) gaze will inevitably not reflect / mirror the young child’s inner mental state but that such ‘objectifying’ facial expressions / gazes need to be balanced with gazes / facial expressions that DO reflect the child’s subjective experiences.

If, though, the mother (or other primary caregiver) fails to strike such a balance but, instead, establishes a chronic and predominant pattern of refecting the child as an object (as opposed to as a subject), the child is at risk of developing deep feelings of shame in relation to the mother’s (or other primary caregiver’s) objectification of him/her.

Cognitive behavioral therapy can help us to challenge our shame inducing thoughts though other forms of psychotherapy (such as psychodynamic psychotherapy) may be more appropriate for some individuals.

 

RESOURCE :

LET GO OF SHAME (downloadable audio) – click here for further details.

David Hosier BSc Hons; MSc; PGDE(FAHE)

Peer Rejection Leading To Withdrawal, Increased Aggression And Feelings Of Shame

effects of peer rejection

The Implicit Social Hierarchy :

In schools, it is unavoidable that children will be judged by their peers in relation to their perceived likability / popularity / desirability / acceptability etc so that, in effect, they are informally and implicitly ‘assigned’ a position in the social hierarchy.

Social Exclusion And Effects On Self-Esteem :

The way in which we were affected by such judgment by our peers when we were at school (our sensitivity to the acceptance / exclusion process tends to peak in middle school which coincides with the period in our lives when we are trying to discover our own personalities, independent of our family) has a significant effect upon how our self-esteem develops and this effect can extend well into adulthood, or even endure for a lifetime.

Responses To Social Exclusion : Aggression Or Withdrawal :

Those individuals who are chronically bullied, victimized and / or ostracized by their peers at school frequently respond in one of two ways : by becoming aggressive or by withdrawing.

Aggression :

An aggressive response might manifest itself by being directed specifically at those who have rejected the individual, or, alternatively, by being directed at other children more generally (a form of displacement , making others the victims).

Withdrawal :

If, however, the child passively accepts his/her rejection, s/he is likely to become socially withdrawn, sad and depressed.

peer rejection

A Study On The Link Between Peer Rejection And Increased Aggressive Behavior :

A study by  conducted Dodge et al. (2003) showed that rejection by peers in early elementary school was correlated with increased antisocial behavior later on (however, it should be noted that, in this study, the correlation was only significant among children who, prior to experiencing rejection by peers, were already displaying a greater than normal propensity to behave in an antisocial manner). The study also found that this effect applied equally to both male and female students.

The researchers involved in this study also suggested that the increase in students’ propensity to behave in antisocial ways following rejection by their peers could, in large part, be attributed to the fact that their experience of having been rejected had caused them to develop ‘biased patterns of processing social information’ (for example, in this study it was found that these rejected students were more likely misinterpret a neutral or non-hostile social signal as being hostile). Indeed, the child rejected by his/her peers may become hypervigilant to any potential signs of hostility directed towards him/her by others. (Cognitive therapy can be very helpful in helping people to overcome biased informational processing).

On a more positive note, the researchers of this study also suggested that even a relatively low, but stable, level of positive regard by peers during childhood can have a very significant ‘buffering’ effect on the later development antisocial behavior (i.e. make such a development less likely to occur).

Rejection, Shame And School Massacres :

Although it is extremely rare, according to research conducted by Leary et al., 2006, students who carry out (or attempt to carry out) school massacres have very frequently  been socially rejected and shamed by their peers prior to commiting (or attempting to commit) the atrocity.

The Lingering Effects Of Shame :

Being made to feel shame as a child can frequently lead to a profound sense of being intrinsically and irreparably ‘flawed’ as a person, unworthy of love or respect ; such self-loathing can (in the absence of effective therapy) last well into aduthood or even for an entire lifetime.

Shame And Alcoholism :

Research by Brown (2006)  has found that females who have experienced significant and chronic feelings of shame as children are at much increased risk of turning to alcohol as adults in an attempt to reduce the intensity of the emotional pain they feel in connection with this abiding sense of shame. Indeed, Brown suggests that such individuals can be helped to reduce their dependency on alcohol by embarking upon therapy that helps them to overcome their shame.

Shame And Grandiosity :

Another possible response to shame is a kind of over-compensation, resulting in grandiosity and a desperate need acheive and succeeed so as to gain and maintain a constant sense of external validation to help ward off deep-seated feelings of shame which continually threaten to overwhelm one. Such individuals may become highly competitive and driven to be more ‘successful’ than others, especially individuals who make up their social group, including their friends – indeed, they may adopt the mantra : It is not enough to succeed. Others must fail.‘ (Gore Vidal).

 

RESOURCE :

Let Go Of Shame – click here for further details.

 

eBooks :

childhood anger ebook     childhood trauma and depression

Above eBooks now available on Amazon for instant download. Click here for further information (or to view other titles).

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

 

How World War One Helped Us To Understand Posttraumatic Stress Disorder (PTSD).

world war one and PTSD

A vast number of troops were psychologically traumatized by their horrific experiences of trench warfare in World War One.

So-Called ‘War Neurosis’ :

In the British Army alone, 80,000 individuals were treated for such trauma (at the time it was – somewhat disparagingly – referred to as ‘war neurosis’) during the conflict and, additionally, 200,000 received pensions after the war was over for war-related ‘nerves’ (Young, 1995).

So-Called ‘Shell Shock’ :

Due to lack of knowledge about the psychological effects of trauma at the time, and the prevailing ‘stiff upper lip’ type culture, those in authority became worried that these traumatized individuals would make a large proportion of the Army appear ‘weak’ and ‘cowardly.’ This worry, coupled with the predominant medical model interpretation of illness at the time, led to these soldiers’ traumatized condition being referred to as ‘shell shock’.

According to the (incorrect) theory of ‘shell shock’, the soldiers’ traumatized state could be explained by concussion to the head, caused by exploding shells, adversely affecting the brain’s blood vessels. (In this way, the authorities could explain away the troops’ condition as having a physical cause, thus dispelling any notion that it had anything to do with ‘moral weakness’ or ‘cowardice’.)

world war one PTSD

However, it soon became apparent that a significant number of soldiers who were suffering from ‘war neurosis’ / ‘shell shock’ had NOT been exposed to exploding shells, nor had they been physically wounded ; therefore, another cause needed to be found.  In 1918, the psychiatrist, Rivers, who served in the Royal Army Medical Corps, proposed such a cause :

Rivers’ (1918) Explanation Of ‘War Neurosis’ – Overwhelming Fear Of Death.

Rivers’ explanation for the cause of ‘war neurosis’ was that it was due to the witnessing of the terrible horrors on the Western Front and an overwhelming fear of death – such intense fear, said Rivers, induced in the soldiers a sense of terror which they could not suppress (due to the instinct of self-preservation) and led to symptoms that were an involuntary response to such terror.

Rivers also stated that his hypothesis was supported by the fact that prisoners of war and the seriously wounded (who were, therefore, no longer able to fight) had a low incidence of ‘war neurosis’; he attributed this to the fact that their lives were no longer in danger.

Rivers’ interpretation of the causes of ‘war neurosis’ significantly helped people to understand that it was NOT a form of cowardice or moral weakness, but, instead, a disturbance to the instinct of self-preservation.

Conclusion :

Rivers’ theory, based on his study of soldiers who fought in World War One, can be seen as a very significant step towards our modern-day, more enlightened and compassionate view of individuals suffering from posttraumatic stress disorder from which those diagnosed with ‘war neurosis’ or ‘shell shock’ in World War One were, in fact, suffering.

Tragically, this more enlightened view came too late for many.

306 British and Commonwealth Soldiers Were Shot For ‘Cowardice’ In World War One.

 

 

Resource :

childhood trauma and cptsd

Above eBook now available for instant download from Amazon. Click here for further information or to view other titles.

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

Body Dysmorphic Disorder : Its Link To Childhood Trauma

childhood trauma and body dysmorphic disorder

Studies (see below) suggest that those of us who suffered traumatic childhoods are significantly more likely to develop body dysmorphic disorder (BDD) than those who were fortunate enough to have experienced relatively stable and nurturing childhoods. I briefly summarize two of these studies below :

Study One :

A study conducted by Didie et al., 2006 involving 75 participants who had been given a diagnosis of body dysmorphic disorder (with an average age of 35 years) found that 78.7 % reported having experienced maltreatment during childhood ; and, more specifically, of these 78.7 % :

  • 68 % reported emotional neglect
  • 56 % reported emotional abuse
  • 34.7 % reported physical abuse
  • 33.3 % reported physical neglect
  • 28 % reported sexual abuse

(NOTE : the above figures add up to more than 100 % because some participants in the study had suffered from more than one type of childhood trauma.)

Study Two :

A study conducted by Semiz et al., 2007 compared 70 in-patients suffering from borderline personality disorder (BPD) with 70 matched, healthy controls.

Results showed that 54.3 % of those suffering from borderline personality disorder (BPD) (a disorder which itself is closely linked to childhood trauma) were also suffering from body dysmorphic disorder (BDD).

Further statistical analysis revealed that these individuals (i.e. who were suffering from both BPD and BDD) had experienced significantly more trauma in childhood than those without BDD and that traumatic experiences during childhood were a significant predictor of the comorbid diagnosis of BDD in BPD sufferers.

body dysmorphia disorder

What Is Body Dysmorphic Disorder (BDD) ?

BDD is the preoccupation with a specific ‘blemish’ of physical appearance in an individual who is, in fact, of normal appearance. It mostly occurs during adolescence and affects males and females equally.

As we saw above, it is linked to childhood trauma but can also be influenced by parental attitudes to appearance, the prevailing culture (e.g. general high value placed upon youth and beauty, especially in the media) and low self-esteem.

How Does Body Dysmorphic Disorder Make The Individual Suffering From It Feel?

Typically, the individual suffering from BDD perceives him/herself as ‘ugly’ and is obsessively concerned about some imagined physical ‘flaw.’ In order to be diagnosed with BDD, the individual’s concern with his/her appearance must be severe enough to negatively impact upon his/her daily functioning (including avoidance of social interaction due to self-consciousness in connection with the imagined physical ‘flaw.’

Can A Person Diagnosed As Having Body Dysmorphic Disorder Actually Have A Physical Defect?

Yes, but the individual exaggerates its significance in relation to his/her appearance.

Considerations Relating To Diagnosis :

For BDD to be diagnosed it must exist ‘in its own right’ and not be explained as a symptom of another disorder such as anorexia nervosa, social phobia, avoidant personality disorder, delusional disorder (somatic type), other somatization disorders or normal concerns about appearance.

Cognitive-Behavioral Therapy :

One of the main treatments for BDD is cognitive-behavioral therapy aimed at psychosocial functioning and body image.

 

RESOURCE :

OVERCOME BODY DYSMORPHIC DISORDER

 

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

 

Family Therapy And Adolescent BPD Sufferers

family therapy and adolescent BPD

Borderline Personality Disorder In Adolescents :

I have written elsewhere about why some mental health clinicians are reluctant to diagnose borderline personality disorder (BPD) in adolescents. However, when an adolescent is believed to be suffering from this extremely serious psychiatric condition, family therapy can be of potentially crucial importance.

What Is Family Therapy?

Quite simply, family therapy is a form of counseling that treats more than one member of the family in the same therapy sessions; this is predicated on the notion that the behavior of a specific individual within the family is intimately connected to how other family members interact with him/her. (Two related posts that I have previously published about this phenomenon are : ‘Did Your Dysfunctional Family Make You Identified Patient?’ and ‘The Dysfunctional Family’s Scapegoat’

How Does Family Therapy Help?

The aim of family therapy is to educate all its relevant members about :

  • how family dynamics influence and maintain the behaviors of individuals within it
  • communication within the family
  • how adaptive (desirable) behaviors can be reinforced
  • ways in which the family can collaborate (work together) to solve problems within the family

It is often the case that, prior to such therapeutic intervention, the adolescent, due to his/her acting out‘, was seen (by the other members of the family) as the source of the family problems but, as the therapy sessions unfold, it becomes apparent that, in fact, the collective dysfunction of the whole family is at the root of the issue.

It is also not infrequently the case that through the process of family therapy it is revealed that other members of the family, too, have serious psychological conditions which need addressing (e.g. many adolescent sufferers of BPD will have a parent with the same condition or a similar personality disorder such as narcissistic personality disorder). When this found to be the case, such parents can also be helped (assuming they are willing) by the therapist which can, in turn, help them to relate to their family in a healthier way, hopefully culminating in a less dysfunctional relationship between them and their adolescent child.

Another very important aspect of family therapy is the therapist’s close observation of non-verbal communication between the parents and the adolescent (e.g. body language, facial expressions, intonation etc). By carrying out such observations, the therapist can point out to the family when such non-verbal signals may be less than helpful.

Family therapy can also include group training in parenting skills which can provide parents with :

  • emotional support
  • advice on how to create less dysfunctional family environments
  • how to set their children good examples / be good role models
  • how to reinforce their child’s positive behaviors

RESOURCES :

Enhance Parenting Skills – click here for further information.

Couples Therapy – click here for further information

eBook :

adolescent borderline personality disorder

Above eBook now available on Amazon for intant download. Click here for further details or to view other titles.

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