Tag Archives: Mental Illness

Childhood Trauma and Self-Harm : How it can be Addressed.

childhood-trauma-fact-sheet

Three key elements to reducing our risk of harming ourselves are:

1) distracting our thoughts away from self-harm
2) reducing the intensity of our emotional arousal to levels which we are able to manage
3) dealing with internal critical ‘voices’ (ie thought processes).

However, as self-harming is often deeply ingrained, we cannot expect instantaneous results. It needs working at.

Let’s look at each of the 3 elements in turn:

1) DISTRACTION: these can be very simple things such as listening to music, watching a movie, going for a walk or a run, reading, calling a friend, browsing the internet, doing something creative like art or craft (eg making a collage), taking a bath, and keeping a journal or diary (including writing down our feelings).

2) REDUCING THE INTENSITY OF OUR EMOTIONAL AROUSAL: one way to do this is to get the painful emotion out. Again, there are simple ways to accomplish this. They include: going for a run, punching a punch bag (or even a pillow), writing a letter to, for example, our parents (without actually sending it), writing out our feelings in a journal, calling a crisis line, going to an online chatline/support group and sharing our feelings, writing poetry about how we feel, playing moving music/crying.

RELEASING ANGER SAFELY:

Sometimes our anger can overwhelm us, so it is important to be able to discharge it in a safe way. Those of us who have experienced childhood trauma have very frequently been taught to blame ourselves. This can result in remaining angry at ‘the child within us’. It is therefore necessary to realize:

a) this child did nothing wrong and does not deserve our anger.
b) the anger needs to be appropriately and safely redirected at those who caused our childhood trauma (in a way which is not destructive to ourselves or them).
c) FEELING angry is not the same as EXPRESSING anger, so does no harm: so we don’t need to fear these angry feelings.
d)we need to stop repressing or misdirecting our anger (at those who do not deserve it – known as DISPLACEMENT in psychodynamic theory) as this can lead to it becoming obsessive.
e) we need to learn to express our anger safely, appropriately and positively. For example, writing a letter we have no intention of sending in order to release our pent up feelings, taking up Judo or a martial art, role playing with a friend or counsellor ( saying to him/her what we would like to say to those who caused our childhood trauma).

SOME DOs AND DON’Ts RELATED TO ANGER:

DO:

A acknowledge anger
N nip it in the bud
G get help for your anger if necessary (eg anger management classes)
E express anger constructively
R release anger appropriately and let it go

DON’T:

A avoid it
N numb it with food/ illicit drugs/alcohol etc
G grin and grit your teeth (ie suppress it as it will just ‘fester’)
E explode
R rationalize it (ie explain it away)

3) DEALING WITH OUR INTERNAL CRITICAL ‘VOICES’: growing up with negative parents leaves many of us with a lot of negative messages running around our heads – we may have had horrible things said about us so often that we have INTERNALIZED them (ie come to see them as true so they form the basis of our self-concept). As adults, we first need to acknowledge that we have these self-lacerating thoughts. This is because the attempt to ignore them can paradoxically make them all the more intense and tenacious.

We may come to notice triggers for these thoughts. For example, if someone is just slightly off-hand with us we may feel we must be a horrible person who everyone will always reject as a matter of course. The root of this may be that we were rejected by one or both of our parents. Being able to trace our self-critical thoughts back to their roots in such a way, and, therefore, understand their triggers, can reduce their intensity of them quite considerably.

In order to retrain the way we think about ourselves, it is helpful, every time we have a negative thought about ourselves, to replace it with a positive one. It can be helpful, too, to write those positive messages down and to keep them somewhere they can easily be retrieved so that we can, on occasion, read through them. It is even possible to make an audio file of them and listen to them occasionally.

As time goes on, it is necessary to let our self-critical messages go and to stop emotionally tormenting ourselves – instead, we need to treat ourselves with compassion.

When individuals come to the point that they are ready to stop hurting themselves with self-critical messages, some make a kind of ritual out of it such as writing down all the negative thoughts they used to have about themselves on a piece of paper and then burning it or tearing it up and throwing it away.

In summary, then, we need to realize that we have absolutely nothing whatsoever to gain, for either ourselves or others, by constantly emotionally torturing ourselves. It is necessary, instead, to start treating ourselves with the love and compassion which may well have been denied us in childhood. We can give ourselves the love and compassion the child within us deserves.

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

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Electro-Convulsive Therapy (ECT) And My Experience of It.

left vagus nerve

 

Childhood trauma can lead us to become severely clinically depressed as adults, and this happened to me. Electro-convulsive therapy (ECT) is only used as a last resort on people who are at high risk of suicide and/or are unable to function in even the most basic areas of life.

ECT is, in fact, misunderstood by the vast majority of people – many see it as barbaric and frightening. Such views, in large part, derive from the popular media (eg from films such as ‘One Flew Over the Cockoo’s Nest’).

However, most controlled research suggests that ECT is helpful as a treatment for severe depression (eg Pagnia et al., 2004). It is normally only used when other interventions, such as psychotherapy and drug treatment, have failed.

There are, though, some risks. Approximately 2-10 patients per 100,000 treatments (ie less than 0.01%) die during the procedure – however, this is no higher than the risk of dying from anesthesia alone (patients have a general anesthetic before undergoing ECT).

After the treatment patients might have headaches, aching muscles or nausea. Also, some patients experience some memory loss (but, generally, only mildly) which can last up to six months (Sackeim et al. 2007).

Patients who undergo ECT, however, tend to view it positively. In one study, 98% of patients who received it said they’d undergo it again if their depression recurred (Pettinati et al., 1994).

ect

MY OWN PERSONAL EXPERIENCE OF ELECTRO-CONVULSIVE THERAPY (ECT).

My own depression was so severe and protracted that I underwent ECT sessions (an ECT treatment session normally comprises blocks of 6 individual treatments) on more than one occasion. I was suicidal and almost completely unable to function (not even able to carry out the most basic self-care, such as shaving, brushing my teeth or taking a bath or shower). As I say, these periods went on for several months, or years, at a time.

Frankly, I did not care whether I lived or died (actually, that’s not quite true, I wanted to be dead), nor what happened to me. Thus, when I was hospitalized, my psychiatrist strongly advised me to undergo ECT. I put up no resistance, nor would I have had the energy or will to do so.

Over the years, each time I underwent ECT sessions, the results were pretty much the same, so I’ll just describe the effect of one set of treatments:

The best thing about it was being given the general anesthetic – such was the extreme nature of my mental anguish that I constantly longed to be unconscious (or dead). Unfortunately, however, the treatment is quick so one is only unconscious for a few minutes!

When I awoke, I’d have very bad, pounding headaches and many of my muscle groups would be painful. Sometimes, I’d need to walk with a stick for a few days after the treatment until the muscles in my legs recovered.

Also, and this was frightening, for about the first five or ten minutes after the treatment I would be so disoriented and confused that I did not know where I was, or even WHO I was. It is impossible for one to imagine how disturbing this is until one has experienced the sensation for oneself. Fortunately, as I said, this did not last long.

On the topic of memory, it felt to me that my memory was impaired for a couple of years after the final treatment session (though not severely). I would make the point, however, that severe clinical depression in itself can impair memory so I cannot attribute it to ECT without some equivocation.

Finally, and most importantly, my own ECT did not have any beneficial effect on me whatsoever; my depression was not even slightly ameliorated.

Obviously, overall, my experience of ECT was fairly negative. However, it is necessary to stress that I am, of course, just one patient out of thousands who have received ECT, so not very much can be concluded from my personal experience it. The research I have already quoted suggests that, for the majority, it is beneficial. Indeed, there are many who believe it has saved their life.

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My Own Story : A Brief Overview.

childhood trauma story

My own childhood was highly chaotic and traumatic.

I started to suffer severe emotional problems very early on (for example, when I was 8 the teachers at the prep school I was at thought I had gone deaf, so I was taken to see my GP. It transpired, however, that there was nothing at all wrong with my ears, rather, the problem was psychological in origin: I had been ‘retreating into my own inner world’). Psychiatrists term this ‘dissociation’, which is a topic I refer to in my posts in the EFFECTS OF CHILDHOOD TRAUMA category.

As an adolescent I became deeply depressed and my behaviour became erratic, compounded by heavy drinking.

In adulthood, I became very ill indeed. I was hospitalized many times with depression so acute in nature I underwent electro-convulsive shock therapy (ECT) during more than one admission.

I made several suicide attempts, one of which left me in a coma on life-support for five days in intensive care.

It is these experiences which motivate me in my study of childhood trauma, its effects and what one can do to help oneself recover. I am fortunate in having a relevant academic background which helps facilitate this.

  borderline personality disorder ebook

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A Closer Look at the Theory of Repression of Traumatic Memories.

Most of us are familiar with the idea that people who have experienced severe traumas sometimes REPRESS the memory of them (ie. bury them deep in the unconscious where they cannot be consciously recalled). This is thought to be an automatic process (ie. not under conscious control) which operates as a defense mechanism. Freud thought that such repressed memories festered in the unconscious, causing neurotic symptoms or hysteria, and that they needed to be brought back into consciousness and worked through in order for healing to take place.

Psychologists refer to the inability to recall traumatic events DISSOCIATIVE AMNESIA.

Many have claimed that repression of traumatic memories is very common. For example, one therapist, Renee Frederickson (1992), claimed: ‘millions of people have blocked out frightening episodes of abuse, years of their lives, or their entire childhood.’ Indeed, today, many psychotherapists regard uncovering repressed memories as vital to the treatment of their patients.

But what does the research indicate?

Loftus (1993) found that most people seemed to have no trouble recalling traumatic events, up to, and including, the Holocaust. Indeed, such memories disturbed many in the form of FLASHBACKS.

The scientific community has also become increasingly aware that the ‘memory recovery’ procedures some psychotherapists use, such as hypnosis, can generate false memories of traumatic events, due, often, to a combination of SUGGESTION and LEADING QUESTIONS. So, patients can be encouraged to ‘recall’ something that, in fact, never actually happened. Indeed, so powerful can the effect be that the patient may truly believe the ‘recalled’ event happened, despite documentary evidence disproving it.

HOWEVER, NOT ALL RECOVERED MEMORIES (EVEN AFTER DECADES) ARE FALSE (eg. Schooter et al. 1997) SO RECOVERED MEMORIES OF TRAUMA SHOULD BE TAKEN SERIOUSLY AND CERTAINLY NOT DISMISSED. Instead, corroborating evidence should ideally be sought.

I hope you found this post interesting. You are very welcome to leave a comment or question.

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

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Copyright 2013 Child Abuse, Trauma and Recovery

The Effect of Childhood Trauma on Genes and Susceptibility to Depression.

genes and depressin

ENVIRONMENTAL EFFECTS ON DNA :

Recent studies have shown that childhood trauma can actually change the structure of DNA in the person who has suffered it and consequently alter how these genes work (it has been known for some time that how genes express themselves is influenced by their interaction with the environment).

Animal studies support this finding: in rats it has been shown that QUALITY OF MATERNAL CARE HAS A LARGE EFFECT ON GENES RESPONSIBLE FOR THE STRESS RESPONSE IN OFFSPRING:

POOR MATERNAL CARE = ADVERSE EFFECT ON GENES OF OFFSPRING = HIGH SUSCEPTIBILITY TO STRESS IN OFFSPRING.

Indeed, there is a growing body of evidence that psychological abuse of children has BIOLOGICAL effects. Research suggests that the effects of abuse on the child’s DNA lowers their resistance to stress. This effect can persist throughout life and increases the suicide risk of the individual.

It is thought that trauma/abuse in early childhood (before the age of six) can have a particularly damaging effect on the DNA which controls the individual’s stress response.

(For those that are interested, environment affects DNA (and thus how it expresses itself) by punctuating it with what are technically known as EPIGENETIC MARKERS. It follows from this that the function of DNA is not permanently fixed from birth, but can be altered by its interaction with the environment).

The good news is, however, that the adverse effects on DNA caused by childhood trauma can be reversed in adult life by appropriate interventions. Key to these are the replacement of the traumatic environment with one which is supportive, loving, stable, safe and relatively stress-free. This is because just as traumatic environments can leave harmful epigenetic marks, good environments, over time, can reverse this effect.

CHILDHOOD TRAUMA, GENES AND DEPRESSION.

Just as trauma can affect genes, pre-existing genes can affect the impact trauma is likely to have on us; it is, to this extent, a two-way street then. It has already been stated in previous posts how exposure to trauma in childhood can lead to psychological problems such as clinical depression; studies now show that the risk becomes even greater if the sufferer of childhood trauma has a particular genetic make-up making him or her more vulnerable to the effects of stress:

So: children who are genetically predisposed to being particularly vulnerable to stress will typically be more adversely affected by the childhood trauma than those children who do not have the genetic vulnerability. THIS HELPS TO EXPLAIN WHY TWO CHILDREN WHO SUFFER SIMILAR TRAUMA MAY BE AFFECTED QUITE DIFFERENTLY FROM ONE ANOTHER.

Further study has shown that the children with the particular genetic variation are MORE SENSITIVE TO THE ENVIRONMENT AROUND THEM (they process emotional information differently) than children without the variation. The genes involved are responsible for the production of SEROTONIN (a chemical affecting mood, also known as a neurotransmitter) in the brain.

DISCORD BETWEEN PARENTS and NEGLECT (again, especially if the child is under six) have specifically been linked to the child developing HIGH EMOTIONAL SENSITIVITY and a greater susceptibility to stress. Again, if the child has the genetic variation making him or her particularly vulnerable, the adverse effects of the discord or neglect will be increase such vulnerability.

The research producing such findings as illustrated above is still in a relatively early stage and future research is likely to help clarify the complex interactions between our genes and how childhood trauma affects us.

genes and depression

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

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How Neurological Problems Relating to Childhood Trauma can be Addressed.

childhood-trauma-fact-sheet

As I said in my previous post, neurological problems resulting from childhood trauma can be reversed, and it is to the research into this exciting and fast developing area of study that I now turn.

Studies have shown that because SEROTONIN (a chemical, also known as a neurotransmitter, in the brain) can become depleted by childhood trauma, ANTI-DEPRESSANTS (eg. setraline) which increase the availability of serotonin in the brain can help to REVERSE the harmful effects of childhood trauma on it.

However, the beneficial effects of anti-depressant treatment is greatly increased if, in addition, the childhood trauma survivor’s ENVIRONMENT is also significantly improved, providing as many positive experiences as possible. Indeed, positive experiences can BENEFICIALLY AFFECT BRAIN CHEMISTRY (eg. by increasing the availability of serotonin and other important neurotransmitters in the brain), just as anti-depressants can.

So: brain chemistry can be affected by environmental factors, as well as by medication.

Because survivors of childhood trauma often FEEL OVERWHELMED BY THEIR EMOTIONS, studies have been conducted which also show that activities that discharge these emotions in a creative or constructive manner can also change brain chemistry for the better. Examples include drawing, painting, writing or even undertaking exercises such as hitting a punch bag at the gym.

In addition to human studies, there have also been some studies on animals. There is now a growing body of evidence that new experiences can regenerate animals’ brain cells. Studies in this area are likely to be conducted on humans in the near future.

Because many of these studies are new, their implications have not yet been fully taken advantage of in the construction of treatment programs. Indeed, it is estimated that fewer than 10% of childhood trauma survivors are receiving appropriate therapeutic interventions.

The exciting conclusion that we are able to draw from all of the above is that there is now good evidence that even if the brain has undergone neurological damage as a result of childhood trauma, this CAN BE REVERSED due to the fact that THE BRAIN CONTINUES TO CHANGE THROUGHOUT LIFE.

brain_damage_Caused_by_childhood_trauma

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Neurological Effects: How Childhood Trauma can Damage the Developing Physical Brain.

effects of trauma on physical development of brain

Recently, there have been various cutting-edge studies into the neurological effects of child abuse and child neglect- in other words, how childhood trauma has been shown to damage the developing physical brain.

It has been shown that BEHAVIOURAL PROBLEMS, following childhood trauma, can be scientifically traced back in origin to damage, caused by child abuse, neglect etc., to both the brain’s PHYSICAL STRUCTURE and its CHEMISTRY. As well as behavioural problems resulting from this damage, it has also been shown to impair the sufferer’s ability to LEARN.

Indeed, it has been estimated that about 75% of children in the care system could have suffered such adverse effects on the physical brain following their particular traumas.

THE POSITIVE NEWS

This is all very depressing; however, there is also good news: the damage that the brain has suffered is NOT ALWAYS PERMANENT. If therapeutic interventions are made, especially when the brain is still developing during childhood, the brain is able, to some extent (due to its plasticity), to rewire itself in such a way that development can return much closer to the norm than it would have done without such intervention. The intervention needs to include the child being given a loving, secure, stable and supportive environment.

In general, the more protracted and intense the childhood trauma, the more serious the damaging effects on the physical brain will have been.

effects of childhood trauma on the physical development of the brain

Above –  Neurological Effects : An illustration of how childhood trauma can seriously, adversely affect physical developmemt of the brain

 

WHICH BRAIN REGIONS ARE AFFECTED?

Severe and prolonged childhood trauma has been demonstrated to potentially damage:

a) THE CORTEX (the function of the cortex is to facilitate RATIONAL THINKING).

b) THE HIPPOCAMPUS (the function of the hippocampus is, in part, to facilitate the REGULATION of our EMOTIONS).

Given that these regions of the brain are sometimes damaged by childhood trauma, and given the function of these regions, we need hardly be surprised that if we have suffered childhood trauma we might find ourselves behaving IRRATIONALLY at times and finding it very difficult to CONTROL OUR EMOTIONS.

Indeed, in one study it was found those who had suffered childhood trauma were much more likely to have:

a) an underdeveloped cortex

b) a smaller hippocampus

Further studies have found that another brain area, the AMYGDALA (which also has a very prevalent role in regulating our emotions) becomes OVERSENSITIVE and OVERACTIVE in those who have suffered childhood trauma. As a result, it will often signal extreme danger – putting us constantly on ‘red-alert’, as it were – even when, in objective terms, there is no, or very little, danger threatening us. Our fear response, then, operates on a hair-trigger.

HOW BRAIN CHEMISTRY IS AFFECTED BY CHILDHOOD TRAUMA:

Studies have also found that prolonged and severe STRESS in early life can also affect the production of chemicals (also known as neurotransmitters) in the brain. For example:

a) CORTISOL (which regulates stress)

b) SEROTONIN (which is closely tied to MOOD and BEHAVIOUR)

Dysfunction of these chemicals leads, respectively, to:

a) us becoming far more susceptible and far more likely to be adversely affected by stress

b) us becoming far more prone to severe, CLINICAL DEPRESSION and much more prone than normal to IMPULSIVE VIOLENCE/AGGRESSION.

child_trauma_and_NEUROPLASTICITY, functional_and_structural_ neuroplasticity

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

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Cognitive Behavioral Therapy: Challenging Our Negative Thoughts.

 

challenge negative thoughts

This article examines how we can use cognitive behavioral therapy to challenge our negative thoughts.

When we have negative thoughts, it is important to ask ourselves:

‘What is the evidence to support this negative thought/belief?’ OFTEN, WILL WILL FIND THERE IS VERY LITTLE OR AT LEAST NOT THE COMPELLING EVIDENCE WE’D ORIGINALLY SUPPOSED.

It is important for us to get into the habit of challenging negative thoughts in this way because very often the negative thoughts come to us autmatically (due to entrenched negative thinking patterns caused in large part by our traumatic childhoods) without us analysing them and examining them to see if they are actually valid.

So, to repeat, we need to try to get into the habit of CHALLENGING OUR NEGATIVE THOUGHTS AND ASKING OURSELVES IF THERE REALLY IS PROPER EVIDENCE TO SUPPORT THEM.

A SUGGESTED EXERCISE:

1) Think of two or three negative thoughts that you have experienced lately.

2) Ask yourself what evidence you have to support them.

3) Ask yourself how strong this evidence actually is.

4) Now think of evidence AGAINST THE NEGATIVE THOUGHT.

Step 4 above is very important.This is because when we are depressed and have negative thoughts we tend to focus on the (often flimsy) evidence which supports them BUT IGNORE ALL THE EVIDENCE AGAINST THEM (in other words, we give ourselves an ‘unfair hearing’ and , in effect, are prejudiced against ourselves). This is sometimes referred to as CONFIRMATION BIAS.

Challenging our negative thoughts and FINDING EVIDENCE TO REFUTE THEM is a very important part of CBT. It is, therefore, worth us putting in effort to search hard for evidence which weakens or invalidates our automatic negative thoughts/beliefs.

ALTERNATIVE THOUGHTS:

When we have successfully challenged our negative thoughts, and found, by reviewing the evidence, reason not to hold them anymore, it is useful to replace them by MORE REALISTIC APPROPRIATE THOUGHTS.

One way to get into the habit of this is to spend a little time occasionally writing down our automatic negative thoughts. Then, for each thought, we can write beside it:

1) Evidence in support of the negative thought.

2) Evidence against the negative thought.

3) In the light of the analysis carried out above in steps 1 and 2, replace it with a more realistic, valid and positive thought. Here is an example:

Negative Thought: I failed my exam which means I’m stupid and will never get the job I wanted or any other.

1) Evidence in support of negative thought:

‘after a lot of revision, I still didn’t pass.

2) Evidence against negative thought:

‘I only failed by a couple of per cent and was affected by my nerves – failing one exam does not make me stupid’.

3) Alternative, more valid, realistic and positive thought:

I can retake the exam and still get the job. Even if I don’t get my first choice of job, that does not mean there won’t be other jobs I can get, and they may turn out to be better.

Getting into the habit of occasionally writing down negative thoughts, challenging them, and coming up with more positive alternative thoughts will help to ‘reprogram’ the brain not to just passively accept the automatic negative thoughts which come to us without subjecting them to scrutiny and challenging their validity.

 

Self-Help Link :

Ten Steps To Overcoming Negative Thinking. Click here for further information.

 

 

David Hosier BSc Hons; MSc; PGDE(FAHE)

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