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What Is Reactive Attachment Disorder?

what is reactive attachment disorder?

REACTIVE ATTACHMENT DISORDER :

 

REACTIVE ATTACHMENT DISORDER may occur when a child is severely neglected where the neglect involves being deprived of close, consistent, stable care and nurturing from those who would normally provide it (i.e. a parent or primary caregiver). For example, a child who is raised in an orphanage in which the child has no sole, main carer, but, instead, a variety of overworked carers who work in shifts would be at increased risk of developing the disorder.

There are two types of REACTIVE ATTACHMENT DISORDER ; these are :

  1. INHIBITED REACTIVE ATTACHMENT DISORDER
  2. DISINHIBITED REACTIVE ATTACHMENT DISORDER

Let’s look at each of these in turn :

 

THE TWO TYPES OF REACTIVE ATTACHMENT DISORDER : INHIBITED AND DISINHIBITED :

INHIBITED REACTIVE ATTACHMENT DISORDER :

A child suffering from inhibited reactive attachment disorder may commonly suffer a range of symptoms which include :

  • a preference for solitary play / no interest in games that involve interaction with others
  • avoidance of / detachment from others (including an avoidance of any physical contact with others)
  • avoidance of eye contact
  • appears sad and lethargic
  • lack of any positive response to attempts by others to give comfort / does not seek comfort from others
  • does not smile
  • failure to reach out when picked up

DISINHIBITED REACTIVE ATTACHMENT DISORDER :

A child suffering from disinhibited reactive attachment disorder may commonly suffer a range of symptoms which include

  • high anxiety level
  • unusually eager to interact with strangers /rarely socially distinguishes between caregiver and unfamiliar adults
  • exaggerating a need for help with basic daily tasks
  • behaving much younger than chronological age / taking part in activities appropriate to much younger children

 

MORE ABOUT THE CAUSES OF REACTIVE ATTACHMENT DISORDER :

I have already touched on the causes of reactive attachment disorder in the opening paragraph of this article. However, to elaborate further, a baby / young child does not only require his/her physical needs to be met (such as being fed or having his/her nappy changed) but also requires SIMULTANEOUS WARM EMOTIONAL INTERACTION WITH THE CAREGIVER WHO IS PERFORMING THESE PHYSICAL TASKS. 

Such warm, emotional interaction is less likely to occur in underfunded and under-resourced orphanages (as already mentioned above). Also, however, young children who are forced to undergo frequent changes in foster homes, or who live with severely mentally ill parents, or with parents with serious substance misuse problems, are also at higher risk of extreme emotional neglect and, consequently, at increased risk of developing reactive attachment disorder.

 

reactive attachment disorder

 

WHO SUFFERS FROM REACTIVE ATTACHMENT DISORDER ?

Research into reactive attachment disorder has focused on babies / young children between the ages of 0 and 5 years of age. It is not certain if the disorder exists in children over the age of 5 years ; more research needs to be conducted in order to establish whether or not it does.

However, some preliminary research suggests that older children and adolescents may express symptoms of reactive attachment disorder through :

  • callousness
  • lack of emotional responsiveness
  • cruelty towards animals
  • cruelty towards people
  • general problems relating to their behavior

CAN REACTIVE ATTACHMENT DISORDER BE SUCCESSFULLY TREATED?

Although there is currently no one, specific, specialized treatment or therapy for reactive attachment disorder, the evidence is that, with the right kind of intervention, children suffering from the disorder can learn to form healthy relationships with others.

As with all psychological problems, the earlier the therapeutic intervention is made, the higher its probability of success.

Therapies likely to be helpful include :

  • individual counselling
  • classes in parenting skills
  • family counselling
  • education of caregivers about the disorder
  • education of parents about the disorder

 

NOTE : The DSM IV refers to the inhibited and disinhibited forms of the disorder as :  emotionally withdrawn and indiscriminately social/disinhibited subtypes  , whilst the DSM 5 refers to them as two separate disorders, namely, reactive attachment disorder and disinhibited social engagement disorder. SEE TABLE BELOW :

 

reactive attachment disorder

 

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

 

 

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Histories Of Childhood Trauma Highly Prevalent Amongst Prison Inmates

childhood trauma and prison

Those who have experienced significant and protracted childhood trauma are far more likely to be incarcerated as adults than those individuals who were fortunate enough to experience relatively stable and secure childhoods (all else being equal).

PHYSICAL TRAUMA, EMOTIONAL TRAUMA AND ABANDONMENT :

For example, a study carried out by Wolff and Shi found that  56% of a sample of 4000 male prisoners had suffered physical trauma during their childhoods. Furthermore, in the same study, there was found a high proportion of inmates who had suffered emotional abuse as children including abandonment, rejection, humiliation, hostility, frequent and unreasonable criticism, intimidation and indifference ; of these forms of emotional abuse, abandonment was found to be particularly predictive of incarceration as an adult (indeed, more than a quarter of the prison inmates in the study had suffered abandonment as children).

ADVERSE EFFECTS OF CHILDHOOD ABANDONMENT COMPOUNDED BY ABANDONMENT IN ADULTHOOD :

In relation to the issue of childhood abandonment, the authors of the study also highlighted the fact that those abandoned as children not infrequently found themselves abandoned again (by both family and friends) when imprisoned, thus triggering in them memories and emotions connected with their original childhood abandonment – the inevitable result of this is that the psychological problems they are likely to have developed as a result of this original childhood abandonment are yet further compounded by this further experience of abandonment as an incarcerated adult.

childhood trauma and prison

 

How Does Childhood Trauma Make Individuals More Likely To End Up In Jail?

There are many reasons why the experience of childhood trauma increases a person’s risk of going to jail as an adult; these include :

Implications :

Because many of the behavior that bring individuals into conflict with the law are linked to these individuals’ experience of trauma during their childhoods, Wolff and Shi suggest that it would be of benefit to screen inmates for psychiatric disorders linked to childhood trauma (such as complex posttraumatic stress disorder) and then to offer inmates who could benefit from it trauma-informed therapy.

 

eBook :

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

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PTSD And ‘A Sense Of A Foreshortened Future.’

sense of foreshortened future

The DSM 4 (Diagnostic And Statistical Manual Of Mental Illness, 4th Edition) lists one of the symptoms of posttraumatic stress disorder (PTSD) as a ‘sense of a foreshortened future.‘ It is this specific symptom that I wish to concentrate upon in this article.

The psychologists Ratcliffe et al. (2014) suggested, based on their research, that this involved several elements of altered feelings, perceptions and beliefs, some of which I consider (although not exclusively) below.

NEGATIVE VIEW OF THE FUTURE :

An individual suffering from a ‘sense of a foreshortened future’ may have an extremely negative and pessimistic set of beliefs about the future ; these may include :

  • I will die young / soon / prematurely / imminently
  • I will never have a rewarding and successful career
  • I will never find a partner / have a family.

In other words, the individual who is experiencing a ‘sense of a foreshortened future‘ regards the future as bleak, empty a without meaning. 

  • It follows.of course, that the person’s feelings and emotions in relation to the future will also be negative – rather than being hopeful about it, s/he may fear and dread it.

 

ALTERATIONS IN PERCEPTION OF TIME :

Also, such a person may experience severe alterations in his/her perception of how time operates, including :

  • changes in perception of the passage of time and feeling unable to ‘move forward into the future’
  • changes in how PAST, PRESENT and FUTURE are experienced
  • changes in how the relationship between the PAST, PRESENT and FUTURE are experienced
  • the experience of flashbacks (in which the past is experienced as ‘happening now.’
  • a change in perception of the overall structure of experience

FEELING THAT LIFE IS OVER :

Freeman (2000) coined the term ‘narrative foreclosure’ which refers to a strong sense that one’s ‘life story has effectively ended.’ and that there is no further purpose to it, no further meaning that can be derived from it and no possibility that it will contain deep relationships with others or achievement of any kind. The individual affected in this way may also cease to feel s/he cares about anything or can be committed to any cause or project in the future.

In short, a sense of nihilism may prevail.

LOSS OF TRUST :

Also relevant to an individual developing a sense of a foreshortened future is that it is likely to be intertwined with a general loss of trust which may manifest itself through beliefs such as :

  • others cannot be trusted and pose a threat to me
  • the world is a dangerous place that I should interact with as little as possible

THE ‘SHATTERING’ OF ONE’S EXPERIENCE OF WORLD AND OF OTHER PEOPLE :

Greening (1990) puts forward the view that the individual’s ‘relationship with existence itself becomes shattered’. For example, the experience of trauma may leave the individual with a fundamentally altered views about the safety of the world (Herman, 1992) and his/her place within it ; the world seems meaningless, other people undependable and dangerous, and the self of no value.

LOSS OF PREDICTABILITY :

The individual, too, may come to see life as essentially random and unpredictable, feel that s/he can exercise no control over it, and that, therefore, there is no prospect of life unfolding in a dependable, coherent, cohesively structured way – s/he may feel s/he is no longer travelling through life on a reasonably straight set of tracks, but, rather, on tracks that twist and turn at random and from which one may be completely derailed at any time without warning. Indeed, Stolorow (2007) refers to how the individual may lose his/her sense of ‘safety’ and and of any meaningful ‘continuity’ in life.

Such a person may feel that ‘anything can happen at any time’ and that these things will, inevitably, be very bad. Because of this, s/he may feel perpetually trepidatious and vulnerable – alone in a an alien, sinister, hostile and frightening world ; a world in which there is no structure to hold one in place, no coherence and nowhere one can feel safe or a sense of belonging ; it can seem as if the foundations of one’s life are now built on sand rather than on solid ground and, as such, one’s life is liable to collapse at any time and without warning.

foreshortened sense of future

AN UNSHAKABLE SENSE OF IMMINENT DEATH :

Any future goals the individual had may now seem meaningless and pointless – even absurd ; linked to this can be a feeling that one is no longer moving forward in life and that there is no worthwhile direction in which life can go – any direction feels equally futile and devoid of meaning.

And, because the individual now sees only emptiness lying ahead of him/her in life this can translate into a perception that future time itself has somehow dissolved and has been replaced by a kind of ‘temporal vacuum’. This, in turn, leads to a feeling that nothing of meaningful substance lies between the present and death. Future time is anticipated as a void and in this sense ceases to be real – therefore, DEATH FEELS ABIDINGLY AND PERPETUALLY IMMINENT ; no buffer of a meaningful, substantive, solid, structured, ‘block of time’ is perceived to lie between NOW and DEATH’S OCCURRENCE ; instead, just a nebulous, indistinct haze of ‘virtual nothingness.’ (This is a difficult concept to relate to, or, even, comprehend  if one has not experienced such an unhappy state of being – or, perhaps more accurately put, non-being – oneself).

To all intents and purposes, therefore, to an individual suffering from a ‘sense of a foreshortened future, it feels as if one’s life is already over. Indeed, Herman (1992) noted that it was not unusual for those who had been affected by the experience of severe trauma reported feeling as if they were dead or as if part of them had died.

RECOVERY :

The psychologist and expert on trauma and its effects, Herman (referred to above), suggests that there are three main stages involved in recovering from PTSD – to read my article on these three stages, click HERE.

 

David Hosier BSc Hons; MSc; PGDE(FAHE)

 

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Four Types Of ‘Dysregulation’ Displayed By BPD Sufferers

types of dysregulation

BPD And Dysregulation :

We have already seen from many other articles that I have published on this site that those who have suffered severe and protracted childhood trauma are at greatly increased risk of going on to develop borderline personality disorder (BPD) than those who were fortunate enough to have experienced a relatively stable upbringing.

One of the main symptoms of this very serious and life-threatening condition (about ninety per cent of sufferers attempt suicide and about ten per cent die by suicide) is termed ‘DYSREGULATION.’

What Is Meant By The Term ‘Dysregulation?’

When the term DYSREGULATION is used in the psychological literature it most commonly refers to the great difficulty the BPD sufferer has controlling behavior and emotional states. However, more specifically, the dysregulation that those with BPD experience can be sub-divided into four particular types; these are :

1) EMOTIONAL DYSREGULATION

2) BEHAVIORAL DYSREGULATION

3) COGNITIVE DYSREGULATION

4) SELF DYSREGULATION

Below, I briefly define each of these four types of dysregulation :

  • Emotional Dysregulation :

This type of dysregulation refers to extreme sensitivity and difficulty controlling intense emotions. Individuals suffering from this type of dissociation not only feel emotions far more deeply than the average person, but also take longer to return to their ‘baseline’ / ‘normal’ mood.

For example, a person with BPD who is emotionally dysregulated may be easily moved to intense expressions of anger and then take far longer to calm down again compared to the average person. Others may disparagingly (due to their lack of knowledge and understanding of this life-threatening – see above – and acutely, indeed uniquely, mentally painful condition) describe such an individual as extremely ‘thin’skinned’, as ‘having a chip on his/her shoulder’, ‘a drama queen’ or as or as someone who is prone to extreme ‘over-reactions.’

A leading theory as to why individuals with BPD are emotionally dysregulated is that the development of their AMYGDALA (a brain region intimately involved with how we express emotions and how we react to stress) has been damaged as a result of severe childhood trauma.

emotional dysregulation

  • BEHAVIORAL DYSREGULATION :

This type of dysregulation refers to the severe problems those with BPD can have controlling their behavior ; such individuals may be highly impulsive and liable to indulge in high-risk behaviors that are self-destructive. Such behaviors may include :

    • excessive drinking
    • excessive drug taking
    • gambling
    • compulsive self-harm
    • risky sex
    • drink-driving / dangerous driving
    • excessive / compulsive spending leading to debt problems

 

  • COGNITIVE DYSREGULATION :

This type of dysregulation refers to disorganized thinking which may manifest itself as paranoid-type thinking and/or as states of DISSOCIATION.

BPD sufferers are also prone to ‘black and white’ / ‘all or nothing’ type thinking, indecision, self-doubt, distrust of others and intense self-hatred.

 

  • SELF DYSREGULATION :

This type of dysregulation refers to the weak sense of their own identity many BPD sufferers feel ( a typical BPD sufferer might express this by saying something along the lines of ‘I’ve no idea who I am‘), feelings of emptiness, and the difficulty many BPD sufferers experienced expressing their likes, dislikes, needs and feelings,

Dysregulation And Stress :

Individuals with BPD are far less able to cope with stress than the average person and dysregulation (relating to all four of the above categories) is especially likely to occur when such individuals are experiencing stress ; indeed, the greater the stress the individual is experiencing, the more dysregulated he/she is likely to become.

 

RESOURCES :

SELF-HYPNOSIS DOWNLOADABLE AUDIO :

‘CONTROL YOUR EMOTIONS.’ Click here for further details.

eBook :

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David Hosier BSc Hons; MSc; PGDE(FAHE)

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Impulse Control : Study Showing Its Vital Importance

impulse control study

We have already seen that those who suffer such severe, protracted childhood trauma that they go on to develop borderline personality disorder (BPD) have very significant problems regarding self-regulation (i.e, controlling intense emotions) and with IMPULSE CONTROL (along with a wide range of other symptoms).

This impaired ability to control impulses, in turn, can have a seriously adverse effect on myriad aspects of the individual’s life, potentially leading to, for example, relationships problems, substance abuse, gambling, compulsive sex, poor financial control due to compulsive shopping, lowered work /academic accomplishments, violent outbursts and many other difficulties.

In this article, I will briefly outline a study that helps to show the relationship between poor impulse control in childhood and later life success :

THE STUDY ON IMPULSE CONTROL AS A CHILD AND FUTURE LIFE OUTCOMES :

The study was conducted by Walter Mischel and E.B Ebbeson. A group of children were given two options :

OPTION ONE : They could have one marshmallow immediately.

OR :

OPTION TWO : They could have two marshmallows if they were prepared to wait fifteen minutes for them.

The children were then left alone with the marshmallows.

the marshmallow test

RESULTS :

Some children gave in to temptation immediately and some managed to defer gratification for a short amount of time (but not the full fifteen minutes).

HOWEVER : About one third of the children were able to defer gratification for the FULL FIFTEEN MINUTES (in the main they distracted themselves from the temptation to eat the marshmallow by playing or singing to themselves, according to the researchers).

TWELVE  YEARS LATER, a follow-up study was carried out on these same individuals. The results of this follow-up study were :

The individuals’ PERFORMANCE ON THE IMPULSE CONTROL TEST (as described above) was more highly correlated with future life success than any other measure, including socioeconomic status and I.Q.

In other words, on average, the children who managed to wait the full fifteen minutes before eating went on to have significantly more successful lives (as defined and measured by the twelve year follow-up study) than those children who were unable to do so. The fact that the level of an individual’s impulse control appears, according to this particular study, to be a better predictor of that same individual’s future life success than either their socioeconomic status or I.Q. implies that how well we are able to control our impulses is of vital importance.

 

RESOURCES :

eBook :

 

Above eBook now available on Amazon for instant download. Click here or on above image for further details. (Other titles available.)

 

Self-hypnosis download :

Improve Impulse Control. CLICK HERE FOR FURTHER INFORMATION.

 

David Hosier BSc Hons; MSc; PGDE(FAHE)

 

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Three Types Of Narcissist : Extraverted, Introverted / Covert And Communal

introvert extrovert communal narcissist

We have already seen what the effects can be upon the child who is brought up by a parent with narcissistic personality disorder as well as how some forms of dysfunctional upbringing can put the child him/herself at risk of developing narcissistic personality disorder.

However, some narcissistic individuals are more easy to identify than others and in this article I will briefly describe three different types ; these are :

  • THE EXTRAVERTED NARCISSIST :

  • THE INTROVERTED / COVERT NARCISSIST :

  • THE COMMUNAL NARCISSIST :

Let’s look at each of these in turn :

The Extraverted Narcissist :

Narcissists who have an extravert type personality are, as one would guess, the easiest to identify ; accordingly,they are also the ones who fit most people’s stereotype of a narcissist : They crave attention, always desiring to be center stage and in the limelight. If wealthy, they are likely to ostentatiously flaunt their economic status by the means of material objects (e.g. flashy cars with personalized number plates, extravagant jewelry etc. ). They are also likely to be highly competitive in the workplace with a strong urge to rise to the highest possible positions thus enabling themselves to exert maximum power over others and to be able to insist upon respect and deference.

introverted narcissist, extraverted narcissist, covert narcissist, communal narcissist

The Introverted / Covert Narcissist :

Introverted narcissists have just as strong a need to feel special and superior to others in the way that the extraverted narcissists do, but manifest this desire in more subtle and less obvious ways (which is why they are also sometimes referred to as ‘covert narcissists’ in the psychological literature).

In fact, on the surface, they may even appear to others to be self-effacing and, in direct contrast to extraverted narcissists, are likely to actively avoid being the center of attention (due to an intense fear of being negatively judged by others).

Such behavior, though, is paradoxical because underneath this seemingly humble exterior lies a firm conviction of great superiority to others. The introverted / covert narcissists rationalizes this belief of great superiority – in the absence, of course, of its confirmation by others – by telling him/herself that others are simply not intelligent or perceptive enough to have recognized his/her ‘supreme and unique’ talents.

Due to this perceived ‘failure of insight’ by others, the introverted narcissist may go through life feeling deeply bitter and resentful ; a typical, secret belief an introverted/covert narcissist might hold is : ‘The only reason other people don’t realize how brilliant, superior and wonderful I am is that they are just too stupid to see it!’

The Communal Narcissist :

The communal narcissist wishes to be seen by his/her community as an outstandingly compassionate, caring, giving, nurturing and charitable individual and derives his/her self-esteem and self-worth by cultivating such an image. Just like the extraverted narcissist and the introverted narcissist, the communal narcissist’s primary motivation is a desperate and overwhelming need to feel special.

 

RESOURCE :

DEALING WITH NARCISSISTIC BEHAVIOR – SELF-HYPNOSIS MP3 : click here for further details or to view other available titles.

 

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

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Hypervigilance And Complex Posttraumatic Stress Disorder (Complex PTSD).

hypervigilance and complex posttraumatic stress disorder

If we have grown up in a chronically stressful and traumatic environment in which we often experienced anxiety, trepidation, stress and fear we are at high risk of developing a fundamental, core belief (on a conscious and/or unconscious level) that the world is a dangerous place and that we need to be constantly on ‘red-alert’ and ‘on-guard’ in order to protect ourselves from sustaining further psychological injury.

In other words, we GENERALIZE our perception that our childhood environment was a dangerous place (because of the emotional and/or physical harm done to us there) into a perception that everywhere else/the world in general poses an on-going threat to us.

As a result, we may develop a symptom known as HYPERVIGILANCE.

HYPERVIGILANCE is a main symptom of complex PTSD (complex PTSD is a serious psychological disorder strongly associated with childhood trauma which you can read more about by reading my post entitled : Childhood Trauma : Complex Posttraumatic Stress Disorder (With Questionnaire).

hypervigilance

HOW DOES HYPERVIGILANCE MANIFEST ITSELF?

Individuals suffering from hypervigilance may :

  • constantly analyze the behavior (including body language, facial expressions, intonation etc) of those around them in an attempt to determine if they pose a threat (and, frequently, they may perceive a threat to exist when, in reality, it does not)
  • be in a constant state of anxiety, irritation and agitation
  • have an exaggerated startle response to loud, unexpected noises
  • experience excessive concern regarding how they are viewed by others
  • be excessively suspicious of others / expect others to betray them ; this can give rise to paranoid-like states
  • perceive danger everywhere even though this is not objectively justified
  • easily be provoked into aggression (as a means of defending themselves against perceived threats from others ; in other words, such aggressive outbursts are a (primarily unconsciously motivated) DEFENSE MECHANISM.
  • PHYSICAL SYMPTOMS (including elevated heart rate, hyperventilation, trembling and sweating)
  • have false perceptions that others dislike them, are plotting against them or mean them harm
  • see minor set-backs as major disasters (this is a cognitive distortion sometimes referred to as CATASTROPHIZING.
  • frequently experience fear and panic when, objectively speaking, it is not justified
  • experience obsessive worry and rumination that is intrusive and hard to control
  • suffer from sleep problems (including very frequent waking and nightmares)
  • feel constantly exhausted (due to both sleep problems and the sheer debilitating effects of being in a constant state of anxiety)
  • social anxiety / impaired relationships / social isolation

Therapies For The Treatment Of Hypervigilance :

Therapies that may ameliorate symptoms of hypervigilance include :

Some medications, such as beta blockers, may sometimes also be appropriate, but, it is, of course, always necessary to consult a suitably qualified professional before embarking upon such treatment.

 

Above eBook now available on Amazon for instant download. Click here or on above image for further details.

David Hosier BSc Hons; MSc; PGDE(FAHE)

 

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Characteristics Of Narcissistic Parents

effects of narcissistic parents on child

Typically, the narcissistic parent views his/her child as a kind of possession whose sole purpose is to continuously fulfill his/her (i.e. the narcissistic parent’s) emotional needs.

In order to keep the child in this role (i.e. the role of existing solely to meet the parent’s emotional needs), the narcissistic parent may exert power over the child in highly manipulative and controlling ways.

Because such parents are so possessive of the child, as the child grows older and starts to become more independent (especially during early adolescence), the narcissistic parent may feel threatened that his/her hitherto exclusive relationship with the child is becoming increasingly precarious. Indeed, if the child begins to show signs of no longer fulfilling the role that the narcissistic parent has assigned to him/her, such parents may become deeply resentful of the child and start to punish him/her through emotional abuse (including directing intense rage toward the child).

The narcissistic parent essentially EXPLOITS their child, capitalizing on the fact that the child is biologically programmed to be dependent upon him/her (but especially the mother); as already alluded to, this enables such parents to exert enormous power and control over the child, a power which they ruthlessly abuse. Such parents feel little or no empathy for their child and are have scant regard for the child’s personal boundaries.

narcissistic parents

Narcissistic abuse tends to be covert in the sense that it takes place in the privacy of the family home ; in public, the narcissistic parent tends to be extremely careful to present as good an image as possible (in an attempt to maintain the illusion of being superior to others), perhaps trying to act ‘the perfect parent’ to keep up appearances (as already implied, narcissists are exceptionally concerned about how others perceive them)’

The child of the narcissistic parent is doomed to failure in as far that whatever s/he does in order attempt to meet the parent’s emotional needs, it will never be enough as, in this regard, the narcissist is impossible to satisfy.

Unfortunately, when growing up with a narcissistic parent, the child is highly unlikely to realize that the parent is suffering from a serious disorder that results in highly dysfunctional parenting. This is because most children just accept their family circumstances as ‘normal’ given that they have no point of comparison (in most cases).

Even more sadly, if and when they do realize how dysfunctional their family environment was whilst they were growing up, perhaps in early to mid-adulthood, they may have already suffered a great deal of psychological damage which may well require extensive therapy to alleviate.

in order to minimize the psychological harm caused to children by narcissistic parents, EARLY, EFFECTIVE, THERAPEUTIC INTERVENTION IS OF FUNDAMENTAL IMPORTANCE.

 

YOU MAY WISH TO READ ONE OR MORE OF MY RELATED ARTICLES (LISTED BELOW):

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

 

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Types Of Dissociative Amnesia In Complex PTSD

types of dissociative amnesia

We have seen how the cumulative effect of repetitive and chronic, traumatic stress during childhood is associated with the later development of complex posttraumatic stress disorder (complex PTSD) and that many of those afflicted by complex PTSD experience symptoms of dissociation (e,g. Freyd, 1996 ; Peclovitz et al., 1997). [Click here to read my previously published post : SYMPTOMS OF DISSOCIATION : MILD AND SEVERE.]

We have also seen how dissociative symptoms may manifest themselves in different ways and that one such way is DISSOCIATIVE AMNESIA.

In this article, I intend to briefly recap on what is meant by the term DISSOCIATIVE AMNESIA, including a short outline of the DIFFERENT TYPES OF DISSOCIATIVE AMNESIA.

WHAT IS DISSOCIATIVE AMNESIA? :

If an individual is suffering from dissociative amnesia, it means that they are unable, for a period of time (usually relatively short periods of time such as minutes, hours or days, but, in mush less frequent cases, months or even years), to remember information about themselves / events in their past (sometimes referred to as autobiographical memory). And, perhaps more surprisingly, they may have periods of time during which they fail to remember a skill or talent that they have learnt (sometimes referred to as semantic memory).

For such memory loss to be diagnosed as dissociative amnesia the memory loss must be far more severe than in ‘normal forgetting’ and not accounted for by another medical condition.

dissociative amnesia

THE DIFFERENT TYPES OF DISSOCIATIVE AMNESIA :

According to the American Psychiatric Association (APA), dissociative amnesia can be subdivided into the following types :

  • localized
  • selective 
  • generalized
  • systematized

Let’s look at each of these in turn :

1. LOCALIZED :

This involves not being able to remember a specific period of time. Often, this period of time will be the first few hours after the traumatic event has occurred (including the traumatic event itself) and can occur as the result of an isolated traumatic episode.

2. SELECTIVE :

This involves not being able to remember some (but NOT all) of the events that occurred during a specific (traumatizing) period of time (often, this may be the most traumatic aspects of the events which occurred during this time period),

3. GENERALIZED :

This particularly alarming and devastating form of dissociative amnesia occurs when the individual afflicted by it is unable to remember their ENTIRE LIFE including, remarkably, who they are and where they are from. Fortunately, this extreme form of dissociative amnesia is very rare.

4. SYSTEMATIZED :

This type of dissociative amnesia involves being unable to recall information associated with a particular category such as being unable to recall any memories associated with one’s abusive parent or associated with a particular location where one was traumatized. For example, I have virtually no memory of living in my first or second house which incorporated the years between my birth and my being about eight years old when my parents divorced.

 

To learn more about DISSOCIATION, you may wish to read one or more of my other posts on the topic (shown below):

 

David Hosier BSc Hons; MSc; PGDE(FAHE)

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Yoga For Complex PTSD

yoga for complex PTSD

Overcoming Trauma Through Yoga: Reclaiming Your Body

 

Studies into the effectiveness of yoga already suggest that it can help to ameliorate both physical and psychological problems including diabetes, arthritis, fibromyalgia, depression and anxiety.

There also now exists evidence (e.g. van der Kolk, 2014, see below)) that it can help to reduce symptoms of Complex posttraumatic stress disorder (Complex PTSD).

Complex PTSD Gives Rise To Both Psychological And Physical Symptoms :

We have already seen how the cumulative effects of exposure to ongoing and repetitive trauma can result in the development of Complex PTSD and that the condition adversely affects the body’s physiology leading to impaired functioning of the autonomic nervous system and associated physical problems that can manifest in various ways including :

Furthermore, such symptoms are, in individuals with Complex PTSD, if not ongoing (though they can be : my own hyperventilation and physical agitation went on for years and the former continues to be set off by what most others would consider to be trivial anxieties, whilst my resting heart rate is still, worryingly, running at over one hundred beats per minute), very easily triggered by even relatively minor stressors ; this is because the individual’s capacity to tolerate stress is dramatically compromised, especially in relation to stressors that are linked (on either a conscious or unconscious level) to memories of the original traumatic experiences.

yoga for complex PTSD

Severe Physical Symptoms Of Complex PTSD May Prevent Or Impair Talk-Based Psychotherapy :

If such physical symptoms of Complex PTSD are severe and remain unaddressed there is potential for them to prevent or impair talk-based psychotherapy. For example, in my own case my physical symptoms were so bad that I frequently either could not attend therapy sessions (as I was unable to leave my flat), or, if I did manage to attend, was unable to focus or concentrate properly.

How Can Yoga Help Those Suffering From Complex PTSD?

Yoga that incorporates physical exercises, breathing exercises and mindfulness can be a more effective treatment of the physiological symptoms of Complex PTSD that talk-based psychotherapy because of the fact that it DIRECTLY ADDRESSES SUCH SYMPTOMS THROUGH BREATHING TECHNIQUES AND BODY WORK. Indeed, recent research supports the effectiveness of yoga in this regard – for example, van der Kolk’s study (2014), which I briefly outline below :

The Study :

  • The participants in the study were adult females with Complex PTSD who had not responded to the intervention of traditional psychotherapy
  • These same females were then randomly allocated to one of two groups as shown below :

GROUP ONE : The females who were randomly allocated to GROUP ONE underwent a TEN WEEK COURSE IN TRAUMA SENSITIVE YOGA (a special form of yoga that was developed at the Boston Trauma Center in the U.S.)

GROUP TWO : The females who were randomly allocated to GROUP TWO did NOT undergo this course.

The Results Of The Study :

The main findings of the study were as follows :

At the end of the ten week period :

  • Those in the treatment group (GROUP ONE) were significantly less likely still to meet the diagnostic criteria for Complex PTSD than those in the non-treatment group (GROUP TWO).
  • Furthermore, those in the treatment group (GROUP ONE) showed a significant reduction in depression and self-harm

Longer term studies have found similar results (e.g. Rhodes, 2014).

CONCLUSION :

Yoga may be an effective complementary treatment option to be used in conjunction with talk-based psychotherapies particularly when physical symptoms of Complex PTSD are so severe that they interfere with talk-based psychotherapies, as in my own case (see above).

A major benefit of yoga for the treatment of the physical symptoms of Complex PTSD is that it addresses such problems directly.

 

If you would like to read my related article : ‘TRAUMA RELEASE EXERCISES’, please click here.

 

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David Hosier Bsc Hons; MSc; PGDE(FAHE) Read More →

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