Category Archives: Posttraumatic Growth Articles

Study Shows 73% Recover from Borderline Personality Disorder (BPD)

recovery from BPD

Until recently, it was frequently suggested that borderline personality disorder (BPD) was very difficult, if not impossible, to treat. During my research for this article, I have been disturbed to discover, also, that in the recent past some clinicians did not regard BPD as an illness at all – instead, they put forward the view that those diagnosed with BPD were not mentally disordered, but, rather, simply ‘bad’ and ‘manipulative’ people!

This reminds me of a time I made a very serious and determined suicide attempt and the psychiatrist I saw afterwards (who knew very little about me) tried to make the case that I had not really intended to kill myself but was seeking attention and sympathy. When I protested and tried to explain the attempt had been made very much in earnest (one might even say, ‘deadly earnest), he responded (and I quote him verbatim) : ‘It sounds like you’re talking bullshit to me!’

Highly professional, I must say!

In connection with the cynical and deeply insulting attitude that my psychiatrist displayed, I would also point out that, in my own personal view, some individuals (in my case, certain family members and former friends) like to take the view the BPD sufferer is not really ill as this, in their minds, absolves them of any responsibility to provide help and support.

Despite such pessimism, a study funded by Columbia University found that 73.5% of the participants who took mpart in their study recovered from BPD within 6 years. Even more encouragingly, it was found in the same study that more than half actually recovered within just 2 years.

Another encouraging finding of the study was that only 6% of those who had recovered relapsed (and, even if they did, this was mainly due to the effects of an extremely stressful event/s).

FURTHER RESULTS FROM THE STUDY :

– 1.4% of the participants commited suicide in the first 2 years of the study

– 1.7% of the participants commited suicide in the next 2 years of the study

– 0.7% of the participants commited suicide in the final 2 years of the study

(This gives a total of 3.8%, or about 1 in 25, who commited suicide during the study).

– 65.9% achieved good psychological functioning by the end of the study (32.4% after 2 years, 48.3% after 4 years, 65.9% by end of study).

SPECIFIC SYMPTOMS THAT IMPROVED IN THE INDIVIDUALS IN THE STUDY :

– Impulsiveness (this symptom improved best of all)

– Mood/affect (although this improved leat well)

– Interpersonal functioning

Self-mutilation

– Suicidal behaviours

Psychotic symptoms

The study also showed that the two factors which most helped the individuals to recover were :

1) Ending a destructive relationship

2) Determination to get well.

-76_AA278_PIkin4,BottomRight,-69,22_AA300_SH20_OU02_childhood traumachildhood trauma therapies and treatments

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Best wishes, David Hosier BSc Hons; MSc; PGDE(FAHE).

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Copyright 2013 Child Abuse, Trauma and Recovery

Posttraumatic Growth – How Trauma can Positively Transform Us

posttraumatic growth

childhood trauma posttraumatic growth

‘Whatever does not kill me makes me stronger.’

– Nietzsche

Much of the research into the effects of severe trauma has concentrated upon its NEGATIVE effects; indeed, a large proportion of the articles on this site have analysed such effects. However, as new research is showing that the experience of trauma can also have a positive transforming effect upon a person’s life, I thought I would redress the balance by including some articles, of which this is the first, on this new and exciting area of research which has been named POSTTRAUMATIC GROWTH.

Research is showing that, rather than destroying a person’s life, severe trauma can lead, in the end, to people gaining new strength and wisdom, redefining them in a positive way.

There are many documented cases of such transformations taking place. One such example, often quoted in the literature about recovery from trauma, is that of a man named Leon Greenman, a Holocaust survivor who spent years in a concentration camp. Years after he was liberated, during the 1960s (in response to a fascist political organization called the National Front) he devoted his life to giving talks on his experiences and why what he endured must never happen again – in this way, he found great meaning and was able to use his appalling experiences to positive effect.

Trauma, then, can mark a great turning point in our lives. It can help us to become more true to ourselves, to look at the world from a fresh perspective and to take on new challenges.

We are not able to undo that which has happened, but we can choose what new directions it will take us in. Many people grow and develop following severe trauma, and it is only recently that studies have started to be conducted on this positive aspect of the change in us that trauma can lead to; up until now, research has concentrated very much upon the negative aspects, such as post-traumatic stress disorder (PTSD).

In fact, it is now being shown that trauma can act as a springboard to a higher level of functioning and growth – it seems, indeed, that the initial effects of trauma can be reversed and turned to our advantage. In this way, the negative and positive effects of trauma often go hand-in-hand. Posttraumatic growth is thought to be able to take place by the person making sense of what happened and then going on to find new meanings and understandings.

The new study of posttraumatic growth, then, focuses on how the suffering we endure as a result of trauma can positively transform our lives, rather than on just the suffering itself.

More posts will follow this introduction to posttraumatic growth, which will focus on how we can achieve it.

I hope you have found this post encouraging.

childhood trauma borderline personality disorderchildhood traumachildhood trauma therapies and treatments

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Best wishes, David Hosier BSc Hons; MSc; PGDE(FAHE).

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Recovery from Childhood Trauma – Improving Our Mindset.

changing mindset

developing a positive mindset

If our mental well-being is poor as a result of childhood trauma, one thing we can do, which comes from the scientific discipline known as POSITIVE PSYCHOLOGY, is to practise improving our mindset.

The psychologist Dweck, from Stanford University in the USA, proposed that there are essentially two types of mindset. These are :

1) THE FIXED MINDSET

2) THE GROWTH MINDSET

Let’s look at each of these in turn :

– People with a FIXED MINDSET tend towards the belief that their personal qualities and abilities (eg intelligence) are ‘carved in stone’ and unchangeable

– People with a GROWTH MINDSET, on the other hand, believe these same personal qualities and abilities can be changed and improved over time.

Dweck’s research found that the type of mindset we have has a strong effect on our behaviour and our general approach to life. For example, according to Dweck, someone who is depressed and anxious and also has a FIXED MINDSET will assume that they will permanently remain so, whereas the GROWTH MINDSET may, for example, believe they will emerge from their ordeal a stronger and better person was more empathy with the suffering of others.

According to the research, there are 4 main areas of behaviour that our particular mindset affects. These are:

1) OUR GOALS IN LIFE

2) OUR RESPONSE TO FAILURE

3) THE EFFORT WE PUT INTO ACHIEVING OUR GOALS

4) OUR WILLINGNESS TO TRY OUT NEW SOLUTIONS IN THE FACE OF DIFFICULTIES

Let’s look at how these areas are affected by our mindset :

– GOALS : Fixed mindset people tend to set PERFORMANCE GOALS which are easily measured; for example ‘I must get at least 70% in my test.’ If they get 70% or more, they consider themselves ‘a success’. If they don’t meet their target, they consider themselves ‘a failure.’ This is sometimes called ‘all or nothing’ thinking or ‘black and white’ thinking.

Growth mindset individuals, on the other hand, are less concerned with the specific performance outcome, but, instead, with what are termed ‘learning goals’ – they would therefore be more focused on what they learned from the experience of working toward and sitting the exam, rather than dwelling on whether they should label themselves a ‘success’ or ‘failure.’

In summary, to use a travelling metaphor, the FIXED MINDSET individual is concerned only with the destination, whereas the the GROWTH MINDSET individual is much more focused on what they learned from the experience of having taken the journey to the destination.

– RESPONSE TO FAILURE : Again, according to Dweck, people with a FIXED MINDSET feel ‘hopeless and helpless’ and also ‘feel depressed and lose confidence and motivation’ when they fail. They tend to believe if they fail at a task once, they are doomed to always fail at it. They therefore give up and right themselves off. For example, the FIXED MINDSET individual who fails an exam may decide never to re-sit it as s/he believes s/he would be bound to fail again. The GROWTH MINDSET individual, on the other hand, may well form the attitude that with some  extra work s/he will be able to pass the exam the second time around.

– EFFORT PUT INTO ACHIEVING GOALS : People with FIXED MINDSETS tend to believe they can either do something or they can’t ; that they are good at it or bad at it and that this state of affairs will remain permanently in place, The GROWTH MINDSET individual, on the other hand, may take the view that you can become pretty good at just about anything if you put your mind to it and are not afraid to put in the practise. Therefore, the latter group are less likely to quit trying, and are less prone to becoming discouraged if they find something difficult at first.

– WILLINGNESS TO TRY OUT NEW SOLUTIONS : When faced with a problem, difficulty or challenge, individuals with a FIXED MINDSET will tend to keep applying the same behaviour in order to attempt to overcome it. When they finally realize that performing the particular behaviour is to no avail, they will tend to give up. Their GROWTH MINDSET counterparts, on the other hand, will be much more willing to try to apply various new and novel solutions, which, in turn, leads to a greater probability of overcoming whatever the particular problem happens to be.

DEVELOPING A GROWTH MINDSET :

One of the main techniques employed by Dweck to help people develop a GROWTH MINDSET is to teach them about the brain’s neuroplasticity . When we learn something new, the brain physically changes – for example, it grows new neural connections (neurons are just another name for brain cells) and increases its density in the area of the brain related to the particular skill. A well known example comes from London taxi drivers. Studies revealed that the part of taxi drivers’ brains which deal with spatial awareness are denser than the same brain area of non-taxi drivers. The brain, in this respect, is rather like a muscle – by practising a particular skill, the area of the brain related to that skill actually physically develops.

I hope you have found this post of interest. Please leave a comment if you wish – I will respond asap.

Best wishes, David Hosier BSc Hons; MSc; PGDE(FAHE).

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Recovery: How the Brain can ‘Rewire’ Itself (Neuroplasticity).

childhood_trauma_effects

Severe childhood trauma can adversely affect the way in which the brain develops, leading to, for example, extremes in anxiety or great difficulty in controlling emotions. However, there has been exciting research conducted showing that the brain is able, under certain conditions, to ‘rewire’ itself, correcting its own faulty circuitry, and, thus, alleviating the behavioural and emotional problems caused by the original damage.

The adult brain is much more changeable and modifiable than had previously been believed. There is now a large amount of evidence to show that damaged neural (brain) circuitry resulting from severe childhood trauma can be corrected, reshaping our brain anatomy and consequent behaviour, with the right kind of therapeutic interventions. In other words, it is now clear that brain architecture continues to change throughout adulthood and this can be manipulated in highly beneficial directions.

Many people who suffer extreme childhood trauma go on to develop personality disorders as adults; one hallmark of these disorders is rigid, destructive behavioural patterns. Research is now showing, however, that certain therapeutic interventions, due to neuroplasticity (the brain’s ability to change itself), can change those behaviours to become more flexible and adaptive (helpful in creating a more successful life).

Another problem those who have suffered extreme childhood trauma  develop later on is extreme and obsessive worry which can be so severe it is pathologically categorized as obsessive-compulsive disorder (OCD). For the purposes of explaining how neuroplasticity works, let’s take that (ie OCD) as our example of a problem which needs to be alleviated.

With OCD, obsessive worries can become so extreme that the person experiencing them becomes actively suicidal. Such a tortured state of mind can persist for months or even (as in my own case) years. Indeed, one suicide attempt nearly killed me and I even underwent electroconvulsive therapy (ECT) — to no avail, most regretably (see the ‘My Story’ category if you want to read a bit more about this profoundly distressing period of my life). When anxiety is this pathological, medications may dampen the symptoms somewhat, but, this, of course, fails to address the root psychological cause of the problem.

With this kind of anxiety, terrible and terrifying events are unremittingly anticipated – whether these are largely imagined or not is not the point : the problem is that the threats FEEL real. When something truly appalling is even remotely possible, in the mind of the individual experiencing obsessional anxiety, it FEELS INEVITABLE.

In order to address such life-threatening (due to risk of suicide) conditions, the psychologist Jeffrey Schwartz has developed a NEUROPLASTICITY-BASED TREATMENT; it has already yielded excitingly successful results.

To understand his form of treatment, let’s first examine the theory of why those suffering from OCD become mentally fixated on their intense anxieties.

Schwartz, first of all, compared the brains of those who suffered from OCD with the brains of those who did not (by taking scans). After he delivered his form of psychotherapy, he took the scans again which revealed the brains of the patients had normalized.

In ‘normal’ people, when something goes wrong, there is a period of anxiety which gradually wears off. However, with OCD sufferers, the period of anxiety is not only much more intense but also maintains an iron mental grip on the sufferer – the individual becomes ‘stuck’ in this intense anxiety phase. So what is going on in neurological terms?

Schwartz generously enlightened us in the following manner :

1) When something anxiety inducing occurs, a region of the brain, known as the ORBITAL FRONTAL CORTEX, is alerted. Activity in this region of the brain is far greater in those who suffer OCD – it becomes HYPERACTIVE.

2) A chemical message is then sent from that brain region to another brain region – the CINGULATE GYRUS, triggering the anxiety response. IN PEOPLE WITH OCD, the activity here is, again, far more than normally intense. Crucially, too, in people with OCD, the intense activity in this brain region STAYS ‘LOCKED ON’ (as if the ‘ON SWITCH’ which has activated it CANNOT BE ‘SWITCHED OFF’). Indeed, Schwartz referred to this phenomenon as ‘BRAIN LOCK’. (In ‘normal’ individuals the activity in the stimulated brain regions gently fades away, as the brain designed it to do).

The treatment Schwartz developed is designed to ‘UNLOCK’, and normalize, the manner in which the brain’s circuitry works.

THE FIRST STEP in the therapy is for the OCD sufferer to RELABEL what s/he is experiencing AS A SYMPTOM OF HIS/HER OCD. S/he should remind him/herself that it is ‘just’ the neurological malfunctioning (the ‘brainlock’) which is the true cause of his/her discomfort, NOT the content of the anxiety itself. This relabeling provides some mental distance from the content of the obsessive concern. The more the person can concentrate on the physiological reasons for the feeling of distress, and the more s/he can distance her/himself from its actual content, the more effective the therapy tends to be.

Once this has been acknowledged, THE SECOND STEP is to REFOCUS THE ATTENTION ON SOMETHING POSITIVE and, ideally, pleasure-inducing.

As the person gets better at implementing these steps, new brain circuits start to develop : the obsessive circuits begin to be bypassed. Of course, changes do not materialize instantaneously – the brain takes time to ‘rewire’ itself.

If the person finds implementing the above two steps difficult to do, s/he should remind him/herself that even distancing him/herself from the content of the anxiety and doing something pleasurable instead for just one minute will help develop the beneficial new brain circuitry.

Two rather pithy sayings, often quoted by psychologists, help us to remember the theory behind the therapy :

– ‘neurons that fire together, wire together’

– ‘neurons that fire apart, wire apart’

To end this post with an encouraging statistic, it is worth recording that 80% of Schwartz’s patients got better when this therapy was combined with medication.

RESOURCES:

EBOOKS :

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

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Copyright 2013 Child Abuse, Trauma and Recovery

How Cognitive-Behavioural Therapy (CBT) Can Aid Recovery From Childhood Trauma.

WHAT IS COGNITIVE BEHAVIORAL THERAPY (CBT) AND HOW CAN IT AID RECOVERY FROM CHILDHOOD TRAUMA ?

Put simply, CBT works on the basic observation that:

1) how we think about things and interpret events affects how we feel

2) how we behave affects how we feel

therefore:

3) by changing how we think about things, interpret events and behave will CHANGE HOW WE FEEL.

I have over-simplified here but those are the essential three points and my aim in this blog is not to present information in an over-complex way.

RESEARCH

CBT is widely used by therapists to treat survivors of childhood trauma and there is now a solid base of research which supports its effectiveness. I myself underwent a course of CBT some time ago and found it very helpful.

WHAT WE THINK ABOUT THINGS DECIDES HOW WE FEEL

In this post I wish to concentrate on how our thinking styles affect our state of mind and emotions. Survivors of childhood trauma often develop depressive illness and, as a result, thinking styles often become extremely negative:
NEGATIVE THINKING

Depression often gives rise to what is sometimes called a COGNITIVE TRIAD of negative thoughts. These are:

– negative view of self
-negative view of the world
-negative view of the future

I have referred to this NEGATIVE COGNITIVE TRIAD in previous posts, but it is worth revisiting. The aim of CBT is to change these negative thinking patterns into more positive ones. It aims to correct FAULTY THINKING STYLES.

FAULTY THINKING STYLES:

Individuals who suffer from this cognitive negative triad of depressive thoughts, as I did for more years than I care to remember, are generally found to have deeply ingrained faulty thinking styles; I provide the most common ones below and give a very brief explanation of each type (if the examples seem a little extreme, it is merely to illustrate the point):

1) GENERALIZATION:

eg. someone is rude to us and we conclude: ‘nobody likes me or ever will’.

So, here, the mistake is vastly over-generalizing from one specific incident.

2) POLARIZED THINKING:

eg. ‘unless I am liked by everyone then I am unpopular’.

This is sometimes referred to as ‘black or white’ thinking ie. seeing things as all good or all bad and ignoring the grey areas.

3) CATASTROPHIZING:

eg. ‘I know for sure this will be an unmitigated disaster and I’ll be utterly unable to cope.’

Here, the mistake is to overestimate how badly something will turn out or to greatly overestimate the odds of something bad happening. It often also involves underestimating our ability to cope in the unlikely event that the worst does actually happen. Also known as ‘WHAT IF…’ style thinking.

4) PERSONALIZATION:

eg. taking an innocent, casual, passing remark to be a deliberate and calculated personal attack. Here, the mistake is thinking everything people do or say is a kind of reaction to us and that people are pre- disposed to wanting to gratuitously hurt us.

5) SELF BLAME

eg. someone says our team has not met its monthly target and we then look for ways to convince ourselves it is specifically and exclusively due to something we have done wrong. With this type of faulty thinking style, we blame ourselves for something for which there is no evidence it is our fault.

6) MINIMIZATION.

eg. ‘I failed one exam out of ten, therefore I’m stupid and a complete failure’.

Here, the positive (passing nine out of ten exams) is pretty much ignored (minimized) and the negative (failing one exam) completely disproportionately affects our view of ourselves. Individuals who minimize the positive tend to also MAXIMIZE (ie. make far too much of) the negative.

CONCLUSION.

What tends to underlie all these faulty thinking styles is that we UNNECESSARILY BELIEVE NEGATIVE THINGS IN SPITE OF THE FACT WE HAVE NO, OR EXTREMELY LIMITED, EVIDENCE FOR SUCH BELIEFS. Therefore, we unnecessarily and irrationally further lower our own sense of self-esteem and self-worth. Because of these faulty thinking styles, we increase our feelings of inadequacy and depression.

In my next post I will look at how we can challenge and correct these faulty thinking styles.

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

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Childhood Trauma: Recovery.

effects-of-childhood-trauma

Research shows those who suffer childhood trauma CAN and DO recover.

Making significant changes in life can be a very daunting prospect, but those who do it in order to aid their own recovery very often find the hard work most rewarding.

Some people find making the necessary changes difficult, whereas others find it enjoyable.

THE DECISION TO CHANGE

Change does not occur instantly. Psychologists have identified the following stages building up to change:

1) not even thinking about it
2) thinking about it
3) planning it
4) starting to do it
5) maintaining the effort to continue doing it

childhood_trauma_recovery

THE RECOVERY PROCESS

Each individual’s progress in recovery is unique, but, generally, the more support the trauma survivor has, the quicker the recovery is likely to occur.

Often recovery is not a steady progression upwards – there are usually ups and downs (eg two steps forward…one step back…two steps forward etc) but the OVERALL TREND is upwards (if you imagine recovery being represented on the vertical axis of a graph and time by the horizontal). Therefore, it is important not to become disheartened by set-backs along the recovery path. These are normal.

Sometimes, one can even feel one at first is getting worse (usually if traumas, long dormant, are being processed by the mind in a detailed manner for the first time). However, once the trauma has been properly consciously reprocessed, although this is often painful, it enables the trauma survivor to work through what happened and to form a new, far more positive, understanding of him/herself.

Once the trauma has been reworked (ie understanding what happened and how it has affected the survivor’s development) he or she can start to develop a more positive and compassionate view of him/herself (for example, realizing that the abuse was not their fault can relieve strong feelings of guilt and self-criticism).

Once the reworking phase has been passed through, improvement tends to become more consistent and more rapid.

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

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