Neurofeedback And Reducing Activity In Brain’s Fear Circuitry.

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According to Mobbs, the brain consists of two areas involved in how we experience fear as shown below :

It is becoming increasingly recognized that overactivity in the brain’s fear circuitry may be of fundamental relevance to not only complex-PTSD and PTSD, but to many other psychiatric disorders as well and it clearly follows, therefore, that damping down the over-intensity of neuronal firing in this part of the brain may be key to effective therapy for the treatment of a whole array mental health issues. In relation to this, there is mounting excitement about how NEUROFEEDBACK / BIOFEEDBACK can benefit many individuals who suffer from acute psychological distress.

  • the reactive-fear circuit

  • the cognitive-fear circuit

Let’s look at each of these in turn :

THE REACTIVE-FEAR CIRCUIT :

This circuit deals with threats that are IMMEDIATE and require an instant reaction (namely, activation of the ‘fight or flight’ response); it involves the interconnection between two areas of the brain as shown below :

  • the periaqueductal grey
  • midcingulate cortex

THE COGNITIVE-FEAR CIRCUIT :

This circuit deals with threats that DO NOT require an immediate response, allowing us time to consciously consider the risk they pose to us and how we should respond to them; this circuit involves connections between the following brain areas :

  • the posterior cingulate cortex
  • the ventromedial prefrontal cortex
  • the hippocampus

THE SEE-SAW METAPHOR :

Mobbs asserts that the relationship between these two brain regions can be compared to the two ends of a see-saw; in other words, as one goes up, the other comes down, which means :

  • The more activated the reactive-fear circuit becomes, the less activated the cognitive-fear circuit becomes.

And the reverse is also true, so :

  • The more activated the cognitive-fear circuit becomes, the less activated the reactive-fear circuit becomes.

RELEVANCE TO THOSE WHO HAVE SUFFERED CHILDHOOD TRAUMA: 

As we have seen from many other articles that I have already published on this site, if we have suffered severe and protracted childhood trauma we are at increased risk of developing various disorders as adults (such as complex PTSD and borderline personality disorder) which are underpinned by having oversensitive and overactive fear-response circuitry and, correspondingly, underactive cognitive-response circuitry.

HOW DOES NEUROFEEDBACK HELP VICTIMS OF CHILDHOOD TRAUMA?

Armed with this information, and by continuing to learn from the neurofeedback their brains provide them with (via the software mentioned above), the patients can then, gradually, be trained to exercise control over their brain wave activity (for example, by soothing it with visualization techniques, breathing exercises or calming thoughts etc.). With enough training, the patients’ dysregulated brains can be helped to heal and to become less fear-driven.

This results in the reactive-fear circuit become less sensitive and active which, in turn, provides the cognitive-fear circuit, as it were, ‘more room to manoeuvre.’ In this way, irrational feelings of fear that were originally being driven by the (unthinking and automatic) reactive-fear circuit can now be more soberly and rationally considered by the (reflective and thinking) cognitive-fear circuit and, therefore, more easily be dismissed as unwarranted, made impotent and deprived of their power to cause us anguish.

ZEN MEDITATION, ALPHA WAVES AND NEUROFEEDBACK :

According to Buzsaki, Professor of Neuroscience at Rutgers University, Zen meditation needs to be undertaken for years until the person practising it is able to slow the frequency of the brain’s alpha waves and to spread the alpha oscillations more forward to the front of the brain; slowing these brain waves have many beneficial effects including :

  • reducing fear
  • reducing ‘mind chatter’
  • increasing feelings of calm
  • reduce anxiety
  • reduce feelings of panic

However, Buzaki states that (as alluded to above) whilst it takes years of Zen meditation to optimally alter alpha wave brain activity, the same results can be obtained after a mere week’s training with neurofeedback.    

 

David Hosier BSc Hons; MSc; PGDE(FAHE)

Posted in: ANXIETY, ARTICLES, BPD, BRAIN, COMPLEX PTSD / PTSD, SOMATIC THERAPY AND TRAUMA , Tagged:

Twelve Signs We Are Recovering From The Effects Of Childhood Trauma

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These 12 signs that we are recovering from our traumatic experiences are as follows:

1) More able to live in the present:

We finally come to the full realisation that the past is truly over and that the trauma we experienced need no longer be central to our identity nor define us as a person

2) Greater inclination to contemplate the future, whereas, before, we may have suffered from a sense of a foreshortened future.

This is due to the fact we are no longer trapped in our past nor obsessed with ceaselessly analysing it

3) Become less avoidant:

Before, we may have felt it necessary to avoid situations and people which reminded us of our traumatic experiences. However, we no longer feel compelled to do this as we find such reminders less difficult for us to cope with

4) Able to participate more fully in life:

Our energy is no longer exhausted by merely just about managing to cope and survive; we can begin to start actively pursuing positive activities

5) Our trauma-related thoughts, feelings and memories become easier to deal with :

We still experience such thoughts, feelings and memories but no longer with the intensity which we previously found so overwhelming

6) Become less reliant on dysfunctional coping mechanisms :

For example, we may find we have more control over drinking too much alcohol, drug use, over-eating etc

7) More able to control our emotions :

For example, anger and fear (emotional volatility and dysregulation are often one of the hallmark symptoms resulting from the experience of childhood trauma).

8) Reduction in negative thoughts about ourselves:

Another extremely common symptom of having experienced significant childhood trauma is the development of the false belief that we are an intrinsically bad person (click here to read my article about this phenomenon).

Part of our recovery involves rediscovering our positive qualities which may have been lying dormant or may have been masked by feelings of anger, self-absorption, resentment and cynicism.

9) Reduction in feelings of helplessness :

It is also extremely common for survivors of childhood trauma to develop a condition known as learned helplessness (click here to read my article about this).

However, when we start to recover, this feeling of helplessness begins to disperse and we subsequently become more aware that we are in a position to choose to do things to help ourselves and to exert some control over our future. In short, we start to feel more empowered.

10) Feeling that we are starting to get back some self-respect:

(Many who experience childhood trauma lose their self-respect – this may involve self-sabotaging behaviour, continuously putting oneself at risk, believing oneself to be unworthy of love or happiness, complete lack of interest in appearance etc).

11) A cessation in the forming of unhealthy relationships:

If we have suffered severe childhood trauma, many of us develop what is known as a repetition compulsion (click here to read my article on this) which involves us (unconsciously) seeking out relationships with others who are likely to treat us very badly. We may, too, put up with bad relationships as we have developed (again, quite possibly unconsciously), a kind of ‘ I don’t deserve any better’ mentality.

However, with the return of our self-respect, we can decide to no longer tolerate such destructive relationships.

12) No longer feel like a victim:

Instead, we can start to concentrate on posttraumatic growth. This may entail, for example, using our former deep suffering to initiate positive change e.g. becoming a stronger and more resilient person, gaining a better perspective on life, developing a better ability to empathise with the suffering of others, and to help them.

Click here to browse all articles in the recovery section of this site.

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

 

 

 

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Forensic Inpatients, Crime, Complex PTSD, Childhood Trauma

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We have already seen from numerous other articles that I have previously published on this site that there is an association between the early life experience of interpersonal childhood trauma and the development of violent and aggressive tendencies which may persist into adulthood and even lead to a label of ‘antisocial personality disorder’ or, even, in rare instances, ‘dangerous and severe personality disorder (DSPD).

What is a forensic inpatient? A forensic inpatient is a person (usually between the ages of 18 and 65) who has been detained by Court Order or under the Mental Health Act for various reasons including assessment and treatment for an individual who no longer requires care in a high-security unit but, nevertheless, needs ongoing treatment in a secure setting or for an individual can no longer be cared for by mainstream services due to the risk they pose to themselves, others or both. In relation to this, in a study entitled ‘complex posttraumatic stress disorder and child maltreatment in forensic inpatients’, Spitzer (2007) points out that there exists ever-mounting evidence that a very large proportion of forensic inpatients have suffered extreme traumatization during childhood including both abuse (physical, psychological and sexual) and neglect (emotional and physical).

The Study: The study involved 32 patients who were assessed using the Structured Interview For Disorders Of Extreme Stress (SIDES) and The Childhood Trauma Questionnaire (CTQ) and it was found that :

  • 75% had suffered emotional abuse as children
  • 59% had suffered neglect as children
  • 52% had suffered physical abuse
  • three-month prevalence of complex PTSD was 28%
  • the lifetime prevalence of complex PTSD was 44%

Conclusion:

The researchers stated that these findings – that nearly 50% met the criteria necessary to be diagnosed with complex PTSD and that a significant proportion had suffered severe childhood abuse/neglect – were consistent with previous research findings in relation to forensic inpatients.

 

The Link Between Childhood Trauma, Addiction And Crime

We have seen in previous articles published on this site that, if we have experienced significant childhood trauma, we are at increased risk of becoming addicted to illegal drugs as a result in order to help dull our emotional pain/dissociate from our problems (this is not only because our lives our more likely to be stressful if we have experienced childhood trauma, but also because the experience of childhood trauma can damage the development of a part of the brain called the amygdala which, in turn, makes us more susceptible to, and less able to tolerate, the effects of stress). Unfortunately, too, if we become addicted to illegal drugs, we then become at increased risk of becoming involved in crime (over and above the crime of buying and taking illegal drugs). Below, I explain some of the main reasons why this is so :

Why Drug Abuse Puts Us At Risk Of Becoming Further Involved In Crime: – some drugs can decrease inhibition, increase impulsivity and increase the propensity to become violent (though obviously not an illegal drug, this is especially true of alcohol – and the experience of childhood trauma also makes it more likely we will abuse alcohol for the same reasons that we may become addicted to illegal drugs) – the desperate need to acquire money quickly to buy the drugs that feed the addiction – buying illegal drugs brings the addict into contact with the criminal world which exposes him/her to the danger of becoming ‘sucked into’ a more general, criminal lifestyle.

The Development Of The Vicious Circle: Not only does drug abuse increase one’s risk of becoming involved in crime, but the reverse is also true: being involved in crime can increase one’s likelihood of becoming/remaining an addict. This is because the money that can be accumulated through criminal endeavours can be used to start a drug habit, maintain a drug habit, increase the frequency of use of a drug, increase the dosage of drug per session, and allow the addict to buy new types of drugs s/he couldn’t previously afford or to which s/he previously did not have access. And, if s/he goes to prison due to crime, s/he is likely to encounter a thriving drug culture – indeed, many prisoners state that it is even easier to acquire drugs inside jail than it is outside. The childhood trauma/addiction/crime association is more likely to affect males than females (eighty per cent of all crimes are committed by males). However, females are more likely to turn to prostitution in order to sustain their drug habit.

 

Those Bullied as Children More Likely to Commit Crime as Adults.

Recent research has demonstrated that individuals who are bullied as children are more likely to get convictions for committing crimes in later life and are more likely to end up in jail.

In the study, the individuals were split into 4 groups :

1) Those who had been bullied as children (under the age of 12 years)

2) Those who had been bullied as teens (over the age of 12 years)

3) Those who had suffered bullying throughout both their childhood and their teens

4) Those who had not been bullied.

FINDINGS :

– 9% from group 1 experienced prison as adults

– 7% from group 2 experienced prison as adults

– 14% from group 3 experience prison as adults

– 6% from group 4 experienced prison as adults

FURTHER FINDINGS :

– 16% from group 1 had at least one conviction

– 11% from group 2 had at least one conviction

– 20% from group 3 had at least one conviction

– 11% from group 4 had at least one conviction

A COMPARISON BETWEEN THE EFFECTS OF BULLYING ON FEMALES VERSUS MALES :

The study also found that females who had experienced bullying both as children and as teens (ie from group 3) were significantly more likely to have alcohol addictions, drug addictions, a history of arrest and convictions than their male counterparts who had also suffered bullying as both children and teens (i.e. also from group 3).

CONCLUSIONS DRAWN FROM THE STUDY :

It was concluded that health care professionals need to intervene to prevent bullying in the same way as parents, teachers and guardians should. It is suggested that children and teens need to be asked appropriate questions which try to uncover bullying as a routine part of medical check-ups. There should also be programs in place to address both the causes and effects of bullying to reduce the likelihood of those who have been bullied coming into contact with the law in later life.

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

 

RESOURCES:

 

Overcome Addiction: Self Hypnosis Downloads.

Help for Workplace Bullying | Self Hypnosis Downloads

How to Stop Being a Bully | Self Hypnosis Downloads

Bullied as a Child | Self Hypnosis Downloads

 

 

REFERENCES: Carsten Spitzer, Cathrin Chevalier, Michael Gillner, Harald J. Freyberger & Sven Barnow (2006) Complex posttraumatic stress disorder and child maltreatment in forensic inpatients, The Journal of Forensic Psychiatry & Psychology, 17:2, 204-216, DOI: 10.1080/14789940500497743

Posted in: ADDICTION, ARTICLES, COMPLEX PTSD / PTSD, VIOLENCE AND AGGRESSION

Dangerous And Severe Personality Disorder (DSPD)

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In 1999 the U.K. government introduced a new concept in relation to personality disorders (which, as we know, are much more likely to occur in individuals who have suffered extreme and repetitive interpersonal childhood trauma) called DANGEROUS AND SEVERE PERSONALITY DISORDER (DSPD) and a treatment and assessment program was developed with the aim of ameliorating this newly constructed condition. In order to be deemed to be suffering from DSPD an individual needs to fulfil the following three criteria:

  1. have a severe disorder of personality.
  2. present a significant risk of causing serious physical or psychological harm from which the individual would find it difficult or impossible to recover.
  3. the risk of offending should be functionally related to the personality disorder.

However, with compassion and insight, Kingdon (2007) argues that in order for any treatment to be effective, the issue of stigma needs to be addressed. Pointing out that the term ‘personality disorder’ itself is already an insulting and abusive term (ironically as those labelled as having a personality disorder have very frequently already suffered from abuse in childhood and hardly need to be abused further) and to add the adjectives ‘dangerous’ and ‘severe’ compound the problem further. Indeed, Kingdon entitles the article in which he expresses this view: ‘DSPD or ‘Don’t Stigmatize People in Distress.’

Indeed, we have seen in other articles that I have published on this site that the diagnosing of a personality disorder is fraught with problems in terms of both reliability and validity (e.g. What Are The Differences Between BPD And Complex PTSD?);  Should BPD Be Renamed Emotional Intensity Disorder?;  ‘Unhappy With BPD Diagnosis? Is Formulation The Answer?; ‘Traumatized As A Child And Wrongly Diagnosed With BPD?’ and ‘Labelling People With BPD May Adversely Affect Their Treatment.’).

According to Spitzer et al. (2006), many of those who have received DSPD treatment have a combination of complex PTSD and a documented criminal history.

Treatments:

Notwithstanding the above, a very eclectic approach has been taken to the treatment of DSPD and therapies that have been trialled in treatment units include dialectical behaviour therapy (this therapy was initially devised to treat those suffering from borderline personality disorder), schema-focused therapy, cognitive behavioural therapy, occupational therapy, cognitive interpersonal therapy (in relation to the treatment of past trauma), mindfulness. Treatment units have also provided psychoeducation (e.g. boundary setting, emotion modulation); the teaching of psychological skills (e.g. social skills, anger management, coping skills, stress reduction and emotional management) and programs to specifically address sexual offending, violent offending and drug/alcohol abuse.

Controversy:

Like other personality disorders, DSPD has no real medical basis and the argument for adhering the label to individuals is based upon circular argument i..e. the person behaves as s/he does because s/he has DSPD and has been labelled as having DSPD due to his/her behaviour (by the way, I write ‘s/he’ and ‘his/her’ although only about 2% of those labelled as having DSPD are female. It has also been pointed out that the UK government brought in the concept of DSPD as a way of legally detaining a tiny section of society whom they previously had no legal way removing from society and for political reasons following some particularly heinous crimes that had attracted a great deal of media coverage. Indeed, recently the initial enthusiasm for the DSPD approach to treatment/incarceration in psychiatric hospitals has been in decline.

Is the treatment effective? 

According to the IDEA (Inclusion for DSPD Evaluating Assessment and treatment) study of four pilot DSPD units, based at Oxford University, in the U.K., formal treatment of DSPD patients lasted, on average, for less than 2 hours per week whilst structured activities occupied approximately nine hours per week. Unfortunately, the study was unable to answer the question as to whether or not DSPD units and the treatment they provided ‘worked’ or not as there was no comparison group of individuals who fulfilled the criteria to be admitted to a DSPD unit for treatment but did not do so. However, some initial conclusions were drawn from the study including that treatment was more successful for single men than for married men; treatment was more successful for those from ethnic minorities; increased treatment time was associated with more positive outcomes.

Insights gained from interviews with recipients of treatment in DSPD units:

  • importance of relationships with staff, especially in relation to consistency of staff behaviour
  • importance of relationships between patients (a problematic dichotomy between vulnerable patients and violent patients was described)
  • however, patients interacting with each other seemed to reduce hostility, though not eliminate it
  • access to telephone, television and papers may reduce hostilities
  • the route through the program and ultimate re-emergence into society was opaque which reduced patient motivation
  • patients receiving the DSPD program in hospital settings was associated with a self-perception of being unwell and entitled to treatment
  • patients receiving the DSPD program imprison settings were much less demanding and had fewer entitlements and less control over their situation. 

Further research:

The study concluded that the only way of determining whether the DSPD program works is by implementing a random controlled trial or, failing that, a case-control trial. Long-term follow-up of patients treated at DSPD units into the discharge period and analyzing their recidivism rates is also necessary, concludes the study.

Reducing patients’ distress:

Kingdon emphasizes that whilst reducing the risk of patients/prisoners reoffending, it is also vital not to overlook the need to reduce their personal distress irrespective of whether the individual is in a hospital or prison setting.

The need for empathy:

Kingdon also recognizes that empathy with the patient is necessary in order for treatment to be helpful and whilst some might find this problematic its development is more likely to occur when one considers the often tragic childhoods patients have endured. Given the importance of staff genuineness and their ability to empathize with, and validate, patients feelings and emotions, such qualities, when selecting staff, may be of greater importance than their technical knowledge.

Ethics:

Given that the DSPD program makes it easier to detain individuals against their will and the difficulty in defining what DSPD actually is it is of ethical importance to assess properly its overall benefits.

 

REFERENCES:

  • Kingdon, D., DSPD or ‘Don’t Stigmatise People in Distress’. Advances in Psychiatric Treatment (2007), vol. 13, 333–335  doi: 10.1192/apt.bp.106.003426
  • Tony Maden, Peter Tyrer. Dangerous and Severe Personality Disorders: A New Personality Concept from the United Kingdom. Journal of Personality Disorders 2003 17:6, 489-496.
  • Spitzer, C., Chevalier, C., Gillner, M., et al (2006) Complex posttraumatic stress disorder and child maltreatment in forensic inpatients. Journal of Forensic Psychiatry and Psychology,
  • 17, 204–216.
  • IDEA (Inclusion for DSPD Evaluating Assessment and treatment) study

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

 

 

Posted in: ARTICLES, RECOVERY, VIOLENCE AND AGGRESSION

The Difference Between Psychology, Psychiatry, Psychotherapy And Psychoanalysis

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psychotherapy

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It is not uncommon for people to be unclear about the difference between psychology, psychiatry, psychotherapy and psychoanalysis. So how do these four terms differ? To answer this question, let’s look at each in turn:

 1. A clinical psychologist has expertise in both normal human behaviour and abnormal human behaviour. In connection with the latter, a clinical psychologist is especially highly trained in diagnosing and treating emotional, mental and behavioural conditions. Clinical psychologists focus on the use of talking therapies and behavioural interventions in order to treat mental health issues. They are also qualified to administer and interpret psychological tests which can serve as tools in the diagnostic process.

2. A psychiatrist is qualified as a medical doctor specializing in the diagnosis and treatment of mental disorders. S/he tends to focus most on the management of mental disorders using psychoactive medications such as anti-depressants and anti-psychotics.

Despite their differences, clinical psychologists and psychiatrists also have many skill and qualities which overlap with, and/or complement, each other. They frequently work together.

3. Psychotherapy is sometimes also referred to as ‘talk therapy’ or ‘the talking cure’ and is used to treat mental and emotional conditions. It involves talking to a trained therapist either on a one-to-one basis, in a group (group psychotherapy), with one’s partner or with one’s family. There are many different types of psychotherapy and these fall into five main categories:

  • psychoanalysis (see below)
  • behaviour therapy: this type of therapy has the aim of helping the client to identify behaviours that are dysfunctional and self-destructive and then changing them. It is based on the principle that behaviours are learned.
  • cognitive therapy: this type of therapy is based on the idea that how we think about situations, other people, events, ourselves etc. influences both how we feel and how we behave. It aims to help people identify cognitive errors (errors in thinking) and encourage them to replace such erroneous thinking with a thinking style that is less distorted and less skewed towards the negative, theoretically leading to improvements in how we feel and behave.
  • humanistic therapy: this type of therapy revolves around the basic assumption that people are innately good and that human behaviour is essentially driven by ethical principles, a moral sense and good intentions. It also emphasizes the importance of living an authentic life, true to one’s own values and free from self-delusion (‘This above all: to thine own self be true, And it must follow, as the night the day, Thou canst not then be false to any man’, as Polonius puts it in Hamlet) and that is as personally fulfilling as possible. Another core principle of this type of therapy is that everyone has their own unique perspective and way of looking at the world which underpins their choices and actions.
  • integrative/holistic therapy: this type of therapy recognizes the complexity of the human mind and that each individual may need to be treated by more than one, single therapeutic approach and understood from numerous perspectives including behavioural, cognitive, physiological and social.

4. Psychoanalysis: this is a particular type of psychotherapy (see above) originating from Freud’s theory that how we behave, relate to others, and feel are strongly influenced by the unconscious part of our minds and that unconscious conflicts can lead to a wide variety of psychological problems such as mood disorders, problems in our relationships with others, sexually aberrant behaviour, obsessions and anxiety disorders. The psychoanalyst helps the client to gain awareness of, and insight into, his/her unconscious conflicts and how they may be connected to early life relationships. This awareness and insight are, in turn, intended to free the client from destructive effects of (previously) unconscious forces. Psychoanalysts are professionals who were initially trained in general psychotherapy and then went on to study psychoanalysis as a speciality.

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

 

 

Posted in: ARTICLES, RECOVERY

Effects Of Childhood Trauma On The Stress Hormone Cortisol

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cortisol

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We have seen from many other articles that I have published on this site that severe and protracted childhood trauma can greatly impair our ability to control our stress levels as adults (meaning we are more adversely affected by stress than the average person, both in terms of our physical and mental health).

Cortisol is a primary stress hormone that helps us to control our mood, levels of fear and our levels of motivation. It is produced by the adrenal glands. The body increases its level of cortisol production when we are in a highly stressful situation. The functions of cortisol include the following:

  • helps control our blood pressure
  • increases blood glucose levels thus aiding the ‘fight/flight’ response
  • helps us to cope with stress by increasing our energy levels
  • plays an important role in our sleep/wake patterns
  • helps the body to return to a state of equilibrium after a stressful event
  • reduces bodily inflammation
  • manages respiration
  • increases muscle tension
  • regulation of digestive, reproductive and immune systems
  • growth whilst growing up
  • balances salt in the body
  • converts food to energy

The amount of cortisol in the blood at any one time is controlled by the brain’s hypothalamus and pituitary gland.

How Does Childhood Trauma Affect Cortisol Levels?

If a stressful event is short-lived and not too severe, the level of cortisol the body produces should settle down once the event is over (e.g. after a minor road accident) bringing the body back into a state of comfortable equilibrium (e.g. the heart rate and blood pressure both return to normal levels).

However, a severely traumatic childhood can involve feeling highly stressed and frightened for very extended periods of time, by which I mean years, with limited respite. This, unsurprisingly, overloads the body’s ability to control stressful reactions in a normal way and alters our physiological stress response. In terms of cortisol production and how the body makes use of it, the process, under such conditions, can become seriously disrupted and dysfunctional.

This can give rise to a large range of conditions, both physical and mental. These may include:

  • increased weight
  • problems concentrating
  • anxiety
  • heart disease
  • headaches
  • irritable bowel syndrome
  • insomnia
  • depression

An excess of cortisol in the blood can also lead to Cushing’s syndrome, symptoms of which include: increased weight, blood clots, bruises, weak muscles, depression, heart attacks, high blood pressure, broken bones, infections and type 2 diabetes. However, according to the National Centre For Health Research, there is so far no evidence that stress causes Cushing’s syndrome either directly or indirectly. Instead, its causes include the use of glucocorticoid medications, pituitary tumours, adrenal cortical tumours and lung, thyroid and thymus tumours.

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On the other hand, too little cortisol in the blood can lead to a condition known as Addison’s. This includes the following symptoms: weak muscles, low mood, increased level of thirst, loss of appetite and weight loss (NOT as a result of dieting), low levels of motivation, lack of energy and fatigue.

Image licenced by Shutterstock

 

 

 

 

  • To learn more about Addison’s, including treatments, click here for the relevant NHS page.
  • To learn more about Cushing’s disease, including treatments, click here to visit the relevant NHS page.

THE THEORY OF ”ADRENAL FATIGUE’:

The theory of ‘adrenal fatigue’ (Wilson, 1998). According to Wilson, ‘adrenal fatigue’ refers to various symptoms caused by the adrenal glands failing to function correctly and can develop as a result of prolonged, intense exposure to stress. Symptoms include sleep-related problems such as difficulty falling asleep and/or frequent waking during the night, sugar and salt cravings, and fatigue. However, such symptoms are non-specific and frequently occur in relation to many conditions and the theory of adrenal fatigue remains controversial. However, Wilson contests that the syndrome comes about by chronic, severe stress over-activating the adrenal glands (which release cortisol and adrenaline) as part of the fight/flight response) which, in the long-term, causes them to overproduce cortisol and eventually ‘burn out.’

RESOURCE:

Help for Adrenal Fatigue | Self Hypnosis Downloads

 

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

Posted in: ANXIETY, PHYSICAL ILLNESS

The ‘Orphanhood Effect’ And Related Phenomenon

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Many exceptionally successful people (in terms of personal achievement) can trace the source of their success to their childhood suffering.

One example of this is the so-called ‘orphanhood effect.’ Of course, losing a parent as a child is a terrible experience. but, for some, as alluded to above, the loss can act as a spur to great achievement.

This phrase ‘orphanhood effect’ was coined to reflect this link between devastating early loss and later great success. 

Gladwell, in his book, David And Goliath, Underdogs, Misfits And The Art Of Battling Giants (published by Little Brown and Co, 2013) refers to several studies of relevance to the ‘orphanhood effect.’ One study that provides supportive evidence for such an effect looked at 700 hundred eminent individuals and found that 45 per cent had experienced the death of a parent before they’d reached the age of twenty-one. Another study focused specifically upon authors and found that over half had similarly experienced the death of a parent, but, in their case, even earlier – before they had reached the age of 15 years. A third study (conducted by the historian Iremonger) found that 67 per cent of prime ministers who were in office between the start of the nineteenth century and the Second World War had suffered the loss of a parent before they reached the age of 16 years. Furthermore, nearly a third of American Presidents lost a parent while they were young. Numerous other studies have produced similar findings (e.g. Silverman, 1974; Eisenman, 1995).

Childhood Trauma, Personality Disorder And High Achievement

Many articles that I have already published on this site discuss the link between severe and protracted childhood trauma and the later development of personality disorders such as borderline personality disorder (BPD), anti-social personality disorder (APD) and obsessive-compulsive disorder (OCPD). 

Whilst, as we have seen, such disorders lead to much suffering, they can, in some instances, also give rise to high or exceptional achievement.

For example, Board and Fritzon looked at 3 types of personality disorder: narcissistic, histrionic and obsessive-compulsive personality disorder and found that the incidence of these disorders was greater in top-level executive business people than they were in psychiatric patients incarcerated in Broadmoor Hospital (a high-security psychiatric hospital in Berkshire, England).  Why should personality disorders sometimes contribute to a high level of occupational success? be? I consider this question below, with reference to narcissistic personality disorder, anti-social personality disorder and obsessive-compulsive) personality disorder.

A study conducted by Papageorgiou suggests narcissists tend to do better in exams than their natural ability would predict (and better than non-narcissists who were judged to have the greater natural ability). Papageorgiou inferred that this was because they were highly motivated, determined, possessed ‘mental toughness’ and tenacity, driven by the belief that they were superior to their competitors.

Psychopaths may thrive in certain occupations such as surgery, sales and holding powerful positions such as CEOs. According to  Babiak and O’Toole, success in the workplace is achieved by psychopaths by taking advantage of various personality traits including self-confidence, a grandiose sense of self-worth, the absence of a fear of failure, bravado, a propensity to lie with impunity, a willingness to take risks, the ability to multitask and aggressive ambition.

Furthermore, according to Dr Sara Swart (a neuroscientist and psychiatrist), psychopaths, too, are able to hold onto their nerve under pressure, ‘resilient to chaos’ (which others are likely to find very stressful), fearlessness, charisma, ruthlessness, lack of guilt and an absolute focus on only own perspective.

Those with obsessive-compulsive personality disorder, according to Widiger and Gore, 2016, may be particularly successful in their chosen careers due to personality traits such as conscientiousness, perfectionism and workaholism.

Conclusion

Those severely emotionally wounded in childhood may be more likely to strive to compensate themselves for their early life emotional losses by various means and for various reasons. For example, a child largely ignored by his/her parents may grow up to desperately seek fame in order to gain the attention of which s/he was deprived in early life; the child who felt completely powerless because of abusive parents may ardently seek positions of great power in adult life in order to feel the sense of control s/he was unable to experience in youth, and the child made to feel worthless may grow up to crave enormous wealth and high status. Sadly, such strategies tend to fail to bring the solace and contentment so dearly desired as the root psychological issues remain unaddressed.

REFERENCES:

Russell Eisenman (1995) Creativity and Eminence: On Albert’s Genius and Eminence, Creativity Research Journal, 8:2, 201-204, DOI: 10.1207/s15326934crj0802_8

Malcomb Gladwell David And Goliath, Underdogs, Misfits And The Art Of Battling Giants (published by Little Brown and Co, 2013)

Silverman, S. M. “Parental Loss and Scientists.” Science Studies, vol. 4, no. 3, 1974, pp. 259–264. JSTOR, www.jstor.org/stable/284524.

T.A. Widiger, W.L. Gore, in Encyclopedia of Mental Health (Second Edition), 2016

Posted in: ARTICLES, POSTTRAUMATIC GROWTH

Possible Effects Of Maternal Depression On Infants’ Cognitive, Social And Emotional Development

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Mothers suffering from serious depression are less likely than non-depressed mothers to interact with their infants in joyful, stimulating and positive ways. Instead, they are more likely to demonstrate negative moods around their infants, to exhibit more anxiety, sadness and agitation, to be less playful, to smile and laugh less, to frown more, to lack animation and to speak in a less encouraging and more monotone manner, to be withdrawn, unresponsive and disengaged.

MIMICRY AND TRANSMISSION:

According to Field, infants of depressed mothers start to mimic the maternal behaviour. For example, they demonstrate lower than average of motor activity, are less vocal, are less inclined to make eye-contact and protest more frequently. Field is also of the view that infant’s find the emotional absence of the mother more stressful than her physical absence.

According to Tronick, the mother’s emotional disturbance is essentially ‘transmitted’ to the infant via her dysfunctional interactions with her child.

ADVERSE EFFECT ON BRAIN PHYSIOLOGY: OVERACTIVATION OF RIGHT HEMISPHERE AND UNDER STIMULATION OF LEFT HEMISPHERE

It has been hypothesized using EEG brain measurements that the activation of the brain’s left and right frontal hemispheres (sides) are involved in the expression of different emotions. For example, according to Dawson, the right frontal area of the brain is relatively more activated when experiencing sadness, disgust and distress whereas the left frontal area of the brain is relatively more activated when experiencing joy and curiosity. As might be guessed from these findings, it has also been found that depression is associated with  increased levels of activity (as measured by EEG) in the brain’s right frontal region whereas happiness is associated with increased levels of activity in the brain’s left frontal region. It therefore follows that depressed mothers increase activation of the infant’s right frontal brain region at the expense of activation of their infant’s left frontal hemisphere.If this pattern of overstimulating the right frontal hemisphere and understimulating the infant’s left hemisphere is ongoing and chronic,

ADVERSE EFFECT ON THE CHILD SOCIALLY, EMOTIONALLY AND COGNITIVELY

Research suggests the process described above may have long-term adverse effects on:

  • how the child relates to others in general in the future
  • increase the level of stress children feel, leading them to experience more problems at school, both socially and academically
  • suffer from elevated levels of cortisol (sometimes referred to as the ‘stress hormone’) making them emotionally vulnerable, especially under stressful conditions
  • overactivation of the adrenocortical system
  • impaired ability to self-soothe
  • impaired ability to monitor and control his/her emotions which may result in aggressive and self-destructive behaviour
  • the child’s thinking (i.e. a preoccupation with negative thinking)
  • the child’s general emotional state (i.e. a preoccupation with negative emotions)
  • the child’s emotional and cognitive patterns (i.e. rigid and inflexible due to a fear of losing control)

According to Field, the young person may be at greatest risk of being adversely affected by having a depressed mother when s/he is between the ages of 8 and 18 months, whilst Dawson suggests that the presence of a competent, mentally healthy father/partner/caregiver may to some extent protect the infant from the adverse effects on his/her emotional/cognitive/social development that may result from solely being cared for by the depressed mother.

ADVERSE EFFECTS OF MATERNAL DEPRESSION MAY EXTEND INTO ADOLESCENCE AND BEYOND:

The effects of being primarily cared for by a depressed mother in early life can extend in adolescence (and beyond). However, the relationship between maternal depression and child outcome is complex and involves many factors including the type of depression, when it occurs, how long it lasts and how severe it is. Also, being depressed does not automatically equate to poor parenting.Below is a table (Source: Maternal depression and child development. Paediatr Child Health) showing possible effects on child development from birth to adolescents:

PRENATAL: inadequate prenatal care, poor nutrition, higher preterm birth, low birth weight, pre-elampsia and spontaneous abortion.

INFANT: Anger and protective coping style, passivity, withdrawal, self-regulatory behavior, and dysregulated attention and arousal. Lower cognitive performance.

TODDLER: Passive noncompliance, less mature expression of autonomy, internalizing and externalizing problems, lower interaction, lower creative play, lower cognitive performance..

SCHOOL AGE: Impaired adaptive functioning, internalizing and externalizing problems, affective disorders, anxiety disorders and conduct disorders. Attention deficit/hyperactivity disorder and lower I.Q. scores.

ADOLESCENT: Affective disorders (depression), anxiety disorders, phobias, panic disorders, conduct disorders, substance abuse and alcohol dependence, attention  deficit/hyperactivity disorder and learning disorders.

Source: Maternal depression and child development. Paediatr Child Health

TREATMENT FOR DEPRESSED MOTHERS AND THEIR BABIES:

In the light of continuing research into maternal depression and its effect upon the infant, new ways of treating the mother and her baby are being developed and modified.These include massage therapy, music, yoga, aerobics and visual imagery and other methods with the aim of lifting the mothers’ moods and encouraging more positive interaction with their infants.

RESOURCES:

Beginner’s Journey 14 Class Yoga Program

Experience Yoga Nidra by the Pro’s

Improve Visualization

 

REFERENCES:
Dawson, G., Hessl, D., & Frey, K. (1994). Social influences on early developing biological and behavioral systems related to risk for affective disorder. Development and Psychopathology, 6(4), 759-779. doi:10.1017/S0954579400004776REFERENCES:

Tiffany Field Ph.D.Maternal Depression Effects on Infants and Early Interventions..Preventive Medicine.Volume 27, Issue 2, March 1998, Pages 200-203

Tronick, E.Z. and Gianino, A.F., Jr. (1986), The transmission of maternal disturbance to the infant. New Directions for Child and Adolescent Development, 1986: 5-11. https://doi.org/10.1002/cd.23219863403
Maternal depression and child development. Paediatr Child Health. 2004;9(8):575-598. doi:10.1093/pch/9.8.575

 

Beginner’s Journey 14 Class Yoga Program

Posted in: BRAIN, DEPRESSION, RELATIONSHIPS

Reasons Why, Sometimes, No Therapy Works.

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No one therapy, of course, works for everyone and there is no one-size-fits-all’ solution to mental distress. Furthermore, some people with psychiatric conditions adamantly do not wish to engage with psychiatric services. Others may be unable to interact with psychiatric services in any meaningful or sustained way. This group includes those persistently high on drugs, incapacitated by alcohol or in a state of unrelenting paranoia and suspicion of the motives of others, including those who profess to wish to help. Some individuals, too, may be in a state of denial about their mental condition even when, objectively speaking, it seems clear that their lives are being ruined by it.

If one particular form of therapy does not suit an individual, it is important that s/he is able to explore other treatment options. Sadly, though, many people give up too soon because the initial therapies and treatments they’ve tried have proved unhelpful. Such people may have low motivation and pessimistic outlook anyway (e.g. if they are suffering from depression) and, with the addition of the disappointment caused by failed attempts to benefit themselves through therapy to contend with, are tipped into a state of utter despair, hopelessness and helplessness.

Those who have some kind of secret relating to their emotional distress may also avoid therapy because they are terrified of the deep sense of shame the revelation of their secret may entail. For example, they may be carrying out some form of abuse connected to their own abuse in childhood (this is not, of course, to say that all those who have suffered abuse will go on to abuse others).

Another group of people who may avoid interaction with therapists, counsellors, psychiatrist etc. are those who realize that their psychological problems are connected to their traumatic childhoods but are afraid that ‘raking over the past’ will entail unbearable emotional pain. However, talking about one’s own experiences in a safe place and with a therapist who one trusts with whom a bond of empathy exists, can prove highly beneficial. This is because, often, if we have had a traumatic childhood, defence strategies and coping mechanisms we (mainly unconsciously) developed to protect ourselves, while serving a vital purpose at the time, are no longer useful once we are free of the traumatizing environment of our childhood. Yet they may have become so deeply entrenched that they continue to dominate how we feel, think and behave. For example, we may find we are hypervigilant and constantly on ‘red-alert’, expecting catastrophe at any moment even though now, as adults, we are relatively very safe. Or we may, due to betrayal by our parents/primary carers, feel deeply distrustful of everyone, making healthy relationships with others extremely problematic.

“The unexamined life is not worth living.” Socrates, The Trial of Socrates from Plato’s Apology.

Talking all this through with a therapist, helping us to understand how our current dysfunctional behaviour and ways of thinking and feeling are closely tied to our traumatic childhood experiences can, by giving us a greater understanding of ourselves and our motivations, help to free us from the unconscious forces of the past that continue to conspire against us. Furthermore, understanding ourselves can also help us to forgive ourselves for things we might have done to hurt others and help us to develop greater self-compassion. Also, through talking things through with a therapist and gaining this deeper understanding we can come to realize that our behaviour has not been abnormal – instead, it has been a normal reaction to abnormal circumstances.

However, because talk therapy can be so emotionally painful, it is highly important that we work with an appropriately trained therapist who we can trust, and who understands, validates and empathizes with us. (For other articles about the benefits of self-understanding, see Start Your Own Mental Health Blog or Study Suggests Writing About Our Traumatic Experiences Can Be Beneficial To Health.

 

Some Suggestions If Nothing Has Worked So Far

  • Has success not yet come because of a mismatch between yourself and your therapist? Research shows that the biggest predictor of whether or not therapy is successful is the extent to which the client and therapist are a ‘good fit.’ Indeed, this good fit appears to be more important than the type of therapy applied.
  • Has the length of the treatment been sufficient to allow it to work? Are we unrealistically expecting a ‘quick fix’?
  • Have all treatments and therapies been considered?
  • Is the therapist fully qualified and sufficiently experienced?
  • Discuss with the therapist why the therapy might not be working and how this situation might be resolved. A good therapist should be happy to have such a conversation and may explore avenues such as changing the frequency of the therapy sessions, changing which day/time of day they take place, taking a break from therapy, changing therapist or changing the type of therapy.
  • Are we resistant to treatment because talking about issues such as childhood trauma is emotionally painful, even though experiencing such psychological discomfort (In a safe place with a compassionate therapist) may be necessary for the long-term success of the treatment? It may be helpful to discuss this with the therapist.
  • Has therapy been disrupted due to transference (the redirection of feelings about another person, such as a parent, onto the therapist) or counter-transference (the redirection of the therapist’s feelings towards the client)?
Some examples Of Action That Can Be Taken When No Appropriate Therapy Can Be Undertaken
  • lifestyle changes such as removing ourselves from our stressful environment, if possible., improving diet, taking sufficient exercise, mindfulness meditation, talking to supportive and compassionate others such as friends, self-hypnosis, yoga, trauma-release exercises and other ‘bottom-up’ strategies.

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

 

Posted in: ARTICLES, RECOVERY

The Importance Of Understanding The Meaning Of The Traumatized Child’s Behaviour.

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When trying to understand why a traumatized child is behaving in a particular way – such as being prone to outbursts of rage aggression or being perpetually withdrawn – it is important to remember that all behaviour carries with it meaning and is a form of (often unconscious) communication.

When a child is behaving in a negative way, which is exacerbating the level of stress any particular family is having to cope with, parents/primary carers may focus solely upon exerting control over the child by using cognitive (e.g. self-instruction, self-praise,, thinking about benefits of achieving a particular goal etc.)and behavioural strategies (e.g. using a rewards chart, creating a family rules board, selective ignoring, having a consistent rewards/consequences approach to the child’s behaviour etc.).

However, an alternative way of intervening is, rather than taking a cognitive or behavioural approach, to take a psychodynamic approach. The psychodynamic approach has the advantage of helping us answer questions such as ‘What are the underlying reasons for the child’s negative behaviour?’ ; ‘What is the child unconsciously trying to communicate through his/her behaviour?’ ; ‘What does the child’s behaviour mean?’ and ‘Why is the child behaving in this way at this particular time?’

Unfortunately, many families wish to avoid taking the psychodynamic approach due to a fear of the emotional pain and guilt digging into and exposing, the deeper reasons for the child’s behaviour is likely to entail (in connection with this, you may wish to read my previously published article entitled: Family Secrets And The Damage They Do).

Psychodynamic Counselling

Psychodynamic counselling is predicated upon the notion that how our mind works as an adult is strongly influenced by our early life experiences. The psychodynamic therapist helps the client to understand unconscious forces created by childhood experiences that may be adversely affecting his/her behaviour and interpretation of the world in the present. For example, suppressed anger towards a parent stemming from childhood may be connected to the client’s generalized feelings of aggression towards others in his/her present, adult life.

By resolving previously hidden, unconscious conflicts relating to childhood and bringing exposing them to the revealing light of consciousness, the psychodynamic therapist is able to, through making suggestions about, and offering interpretations of, the client’s present behaviours, increase his/her level of self-awareness and insight into the reasons for these current behaviours.. This increased level of insight and self-awareness is intended to facilitate the client’s ability to behave is different, more positive and beneficial ways both in relation to himself and to others.

You may also be interested in reading my related articles:

 

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

Posted in: ARTICLES, COMPLEX PTSD / PTSD

Childhood Trauma And Somatic Psychology

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Image licensed by Shutterstock.

We have seen how significant and protracted trauma in childhood can adversely affect the body’s physiology leading to constant feelings of hypervigilance in adulthood due to a dysregulated autonomic nervous system and how therapy involving the body can help reverse such effects.

Somatic psychology is a type of therapy which focuses on somatic (i.e. bodily) experiences and is therefore often extremely relevant to those who have suffered severe childhood trauma and, as a result, find themselves perpetually tense, anxious, fearful and hypervigilant as adults. (In relation to this you may wish to read my previously published article: How Childhood Trauma Can Lead To Hypervigilance).

According to Shapiro (2020), somatic psychology can be divided up into 3 main categories. These are as follows:

  • SOMATIC PRACTICES AND ARTS
  • SOMATIC THERAPY
  • SOMATIC PSYCHOTHERAPY AND DANCE MOVEMENT THERAPY

Let’s look at each of these in a little more detail:

SOMATIC PRACTICES AND ARTS:

These develop the individual’s awareness of their SOMA (defined as the body as distinct from the soul, mind or psyche) through movement, embodiment  (see embodiment theory below) and expressive arts, including:

  • Authentic movement
  • Five rhythms
  • Open floor qigong
  • Alexander technique
  • Body-mind centring
  • Feldenkrais method
  • Yoga

SOMATIC THERAPY:

Somatic therapy involves embodiment-based (see embodiment theory below) and movement-based activities to repair and expand developmental motor skills and movement range as well as movement techniques to repair the body. These include:

  • Yoga chakra theory
  • Rolfing structural integration
  • Bioenergetics
  • Network spinal analysis
  • Reiki
  • Kestenberg movement profile

SOMATIC PSYCHOTHERAPY AND DANCE MOVEMENT THERAPY:

These involve the body, embodied experiences (see embodiment theory below), movement impulses and expressions that help one understand and repair emotional, social, developmental and psychological scars and lacunae. These include:

    • Somatic experiencing
    • Moving cycle
    • EMDR
    • Dance movement therapy
    • Hakomi method
    • Body-Mind psychotherapy
    • Sensorimotor psychotherapy

EMBODIMENT THEORY:

Embodiment theory stresses the important influence the body has upon emotional experience (e.g. a warm bath inducing feelings of relaxation). The theory also encompasses the idea that we make use of our somatic (bodily) experiences to facilitate our comprehension of not only our own emotional experience (e.g. feeling our face burn red with embarrassment) but also our emotional experience of others (e.g. shaking if another person is frightening us). The theory offers us a mechanism (i.e. bodily sensations modifying and interacting with how we feel emotionally) that increases our understanding of how we process our emotions.

RESOURCE:

A LARGE SELECTION OF ANXIETY TREATMENT SELF HYPNOSIS AUDIOS | SELF HYPNOSIS DOWNLOADS

 

David Hosier BSc Hons; MSC; PGDE(FAHE)

Posted in: ARTICLES, COMPLEX PTSD / PTSD, SOMATIC THERAPY AND TRAUMA

Very Early Life Trauma can ‘Burn’ Memories into The Brain that are not Consciously Recollectable

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Image by mohamed Hassan from Pixabay

MEMORY AND EARLY LIFE

Most of us have no conscious memory of our experiences that occur before the age of two or older (I myself remember nothing that happened to me before the age of five and only very little indeed of what happened to me before the age of about eleven apart from highly emotionally charged, negative events. There is also a complete gap in my memory for anything at all that happened to me between the ages of six and eight – my parents divorced when I had just turned nine but whether or not this is relevant I don’t know; however, I suspect it is for reasons I may write more about at some stage in the future.

‘BURNT IN’ MEMORIES

Anyway, as I said, whilst nearly everyone remembers nothing before the age of two, this does NOT mean that these very early life experiences fail to be stored in the brain. We know this due to some extraordinary research, some of which I outline below. This research provides irrefutable evidence that traumatic events that we experience before the age of two, consciously irretrievable, are, figuratively speaking, ‘BURNT INTO (Terr) the brain’ in the form of unconscious memories.

JUST BECAUSE SOME EXPERIENCES STORED IN THE BRAIN AREN’T CONSCIOUSLY RETRIEVABLE DOES NOT MEAN THESE EXPERIENCES DON’T AFFECT OUR FUTURE LIVES:

Because of these burnt in, unconscious memories we now also know that what used to be believed, i.e. as because nothing before the age of two is remembered, these have no effect upon the person’s life, are categorically mistaken.

This is illustrated by research conducted by Terr (university of California Medical Center, San Francisco. Terr’s study involved children aged 5 years-old who had experienced significant trauma (for which there existed evidence including eye witness statements and police reports) before they were 34 months old (i.e. at an age before verbal memory had developed)

Despite this, it was apparent that these children HAD retained unconscious memories of their trauma as they were reflected in their play behaviour, sometimes in their entirety.

Other research, conducted by Clifton and Myers (University of Massachusetts) has found that children exposed to mildly frightening stimuli at the age of 6 months show behavioural signs as having unconsciously remembered the experience through behavioural responses to similar stimuli at the age of 30 months.

I was confidently informed, as a child that, I would not have been affected by the trauma I was exposed to in my household when I was a baby and infant because I had no memory of it. The above research adds further evidence that such an assertion is misplaced.

Traumatic Amnesia Resulting From Childhood Trauma

Why Trauma Survivors May Find It Hard To Learn From Past Behaviour.

Childhood Trauma And Memory – Why Some Remember, Others Forget

Effects Of Repressed Anger Towards Parents

Childhood Trauma : Reactions to Trauma According to Age

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

Posted in: ARTICLES, BPD, BRAIN, COMPLEX PTSD / PTSD

Unable To Live In The Present? Therapy And Dual Awareness Can Help

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Many people who have suffered severe and protracted childhood trauma and, as a result, go on to develop complex posttraumatic stress disorder or related conditions often feel permanently stuck in the past and unable to live in the present. Indeed, the past may seem more real and substantial than the present – in fact, what’s going on in the present may feel so nebulous and ethereal that it has little impact on how one feels; it is as if it isn’t really happening. Instead, one’s feelings and behaviours remain rigid and inflexible, fixed in place by one’s adverse childhood experiences, even experiences that happened years or decades ago. Indeed, something traumatic which happened ten years ago may feel more real and more recently occurring than something that happened five minutes ago.

In this distressing state, the individual may feel constantly hypervigilant, dissociated or fluctuate between these two extremes. Whilst these responses might have been adaptive responses at the time of the trauma if one’s situation is now relatively safe and secure and one has long escaped the traumatic environment, they may now be highly dysfunctional and prevent the person from living in the ‘now.’

For example, someone who, for years, was a child victim of his/her father’s physical violence may, long after s/he he has left his/her abusive childhood environment, continue to be frequently triggered when interacting with any male authority figures (even though they pose no threat) and react and feel as s/he did at the time s/he was experiencing the abuse. The effects of this might be dramatic, such as repeatedly getting into physical fights, walking out of jobs due to minor criticism from the boss or seeking oblivion from painful recollections of the past through drink, drugs, gambling, promiscuous sex or other behaviours that augment a dissociative state.

And, because these (now) unhelpful ways of behaving are so deeply rooted in past experience, they can prove hard to change whilst one’s traumatic experiences remain unresolved so one may find oneself constantly reenacting the past yet be unable to learn from experience even though such behaviour simply compounds the person’s emotional and practical problems. Such a person, also, may find they frequently suffer ‘flashbacks, intrusive thoughts and nightmares connected to their past trauma.

Such a state of being unable to feel properly engaged in the present is also frequently accompanied by a state of anhedonia.

How ‘Dual Awareness’ Can Help Us To Once Again Live In The Present

In order to free him/herself from the past, and from being constantly caught up in distressing emotions connected to it, such as fear and anger, and/or from being tormented by intrusive thoughts and memories, the individual must know, feel and believe, on a deep level, that s/he can do so in a safe environment such as with a therapist who empathizes with him/her and whom s/he trusts. In such an environment, sometimes figuratively referred to as a ‘holding environment‘, the individual can start to utilize a state called ‘dual awareness

A holding environment is a term originally coined by Winnicott who defined it as: “That aspect of the mother experienced by the infant as the environment that literally-and figuratively, by demonstrating highly focused attention and concern – holds him or her comfortingly…’

Bebette Rothschild defines ‘dual awareness as the ability “to recognize that I’m feeling upset right now…that I might even be having a flashback, but what’s going on with me right now has to do with something from the past, and I’m aware of where I am in the here and now, which is separate from that memory of the past.

This ability allows the person to start properly processing hitherto suppressed, traumatic memories that may be upsetting whilst ALSO understanding that, at the present time, s/he is not in danger. In other words, dual awareness involves, metaphorically, having one foot in the past and, simultaneously, having one foot in the safety and security of the present. Thus, s/he can revisit his/her traumatic experiences but his/her dual awareness (i.e.that s/he is presently in a safe and secure holding environment) helps to prevent him/her from being overwhelmed by distressing feelings which, without ‘dual awareness’ would make therapy and recovery more difficult.

MINDFULNESS MEDITATION TRAINING | SELF HYPNOSIS DOWNLOADS

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

 

PTSD Nightmares : Content, Symbols, Information Processing Theory And Paradoxical Intention

Childhood Trauma Leading to Anhedonia (Inability to Experience Pleasure).

Unconscious Processes : How Our Past Affects Our Present.

Unconscious Processes : How Our Past Affects Our Present.

Posted in: ARTICLES, BPD, COMPLEX PTSD / PTSD, RECOVERY

Labelling People As Having BPD May Adversely Affect Their Treatment

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Image by BRRT from Pixabay

 

 

A study conducted at Bath University in the United Kingdom has found that labelling an individual as suffering from BPD can lower the standard of treatment they receive.

THE STUDY:

The study involved 3 groups of mental health clinicians and required them to watch a video of a man manifesting symptoms of anxiety disorder.

However, each of these 3 groups was given different sets of information about the man featured in the video. These differences were as follows:

GROUP 1: Those in GROUP 1 were provided with only simple and basic information about the man in the video

GROUP 2: Those in GROUP 2 were given the same information as those in GROUP 1 AND ADDITIONALLY given information about the man’s behaviour that implied he might be suffering from BPD.

GROUP 3: Those in GROUP 3 were ADDITIONALLY informed that the man in the video had previously been FORMALLY DIAGNOSED as suffering from BPD by a psychiatrist.

RESULTS OF THE STUDY:

Despite the fact that mental health clinicians in each of the 3 groups watched exactly the same video and were given identical instructions to make an evaluation and assessment of the man in the video, the researchers involved in the study found that many of them had been negatively influenced in their interpretations of what they saw because they believed the label of borderline personality disorder had been attached to the patient.

WHAT CAN BE INFERRED FROM THE RESULTS OF THE STUDY?

The results of the study suggest that mental health clinicians may be negatively influenced in their analysis of a patient’s behaviours by their prior expectations, even if those prior expectations are predicated upon false information – in this case, that the man in the video was likely to have or was formally diagnosed as having borderline personality disorder as those in GROUP 2 and GROUP 3 respectively believed due to the bogus information with which they were supplied by those running the experiment.

Researchers at Bath University (where the study was conducted) suggested that such negatively biased attitudes towards patients based upon the psychiatric labels (in this case, borderline personality disorder) that have been foisted upon them may adversely affect the treatment they receive.

REFERENCE:

Lam, D.C.K., Salkovskis, P.M. and Hogg, L.I. (2016), ‘Judging a book by its cover’: An experimental study of the negative impact of a diagnosis of borderline personality disorder on clinicians’ judgements of uncomplicated panic disorder. Br J Clin Psychol, 55: 253-268. https://doi.org/10.1111/bjc.12093

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

READ MORE ABOUT RELATED ISSUES SHOWN IMMEDIATELY BELOW:

Attitudes Of Medical Professionals Towards BPD Sufferers

Unhappy With BPD Diagnosis? Is ‘Formulation’ The Answer?

The Link Between ‘Mental Illness’, Ideology, Meaning And Powerlessness

Traumatized As A Child And Wrongly Diagnosed With BPD?

Posted in: ARTICLES, BPD

Study Suggests Writing About Our Traumatic Experiences Can Be Beneficial To Health

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Image by mohamed Hassan from Pixabay

 

 

 

 

 

 

We know that childhood trauma is strongly associated with poor mental and physical health in later life (e.g. see the ACE study) due to the hazardous, longterm effects of prolonged and repetitive toxic stress and the effect that has on the mind, brain and body e.g. due to the prolonged overproduction of the stress hormone, cortisol. In connection with this, you may wish to read my article about how the experience of severe and prolonged exposure to childhood trauma may reduce our life-expectancy by 19 years.

It follows then that if we can reduce the psychological effects of trauma over the longterm, we can also improve our physical health.

Trauma therapy aims to achieve just this by helping us to process our trauma experiences (as long as we feel safe and secure enough) integrate them into our personal historical narratives (or, more simply, our ‘life-story) in a healthily processed manner.

The study described below suggests that writing about our traumatic experiences (if we feel safe and secure enough to do so – see above) may be one way to help us achieve this, i.e. help us to process and integrate our traumatic experiences and consequently benefit our health.

Relevant to the above is a study conducted by Pennebaker (1986) was carried out to see if writing about one’s traumatic experience was beneficial.

THE STUDY:

The study involved students who were asked to spend 15 minutes writing about the most traumatic/stressful thing that had ever happened to them. They were required to carry out this writing exercise every day over 4 consecutive days. They were also encouraged to describe their most profound and, if applicable, (previously) secret thoughts and feelings relating to the traumatic/stressful event/experience about which they had chosen to write. Although some of the students found the exercise emotionally distressing, when given the option of whether to continue taking part in the experiment or not, they all wanted to carry on rather than leave the study. (I refer to this group as GROUP 1).

In order to find out whether it was writing about the trauma that could be helpful or if just writing, in general, was beneficial, a control group was also set up. Those in the control group also carried out the 15-minute writing exercise over the 4 day period, the only difference being that they wrote about neutral topics (GROUP 2).

THE RESULTS OF THE STUDY:

All of those who had taken part in the study were followed up over a six month period and it was found that individuals who had written about a traumatic/stressful experience made significantly fewer visits to the doctor than those in the group that had written about a neutral topic thus suggesting those in the first group had gained health benefits by writing specifically about their traumatic/stressful experience. However, it was also found that those in GROUP 1 had relatively higher blood pressure and higher self-reports of negative feelings immediately after completing the writing exercise (though they felt more positive a few days later) compared to those in GROUP 2.

IMPORTANCE OF TYPE OF LANGUAGE USED WITHIN THE WRITING EXERCISES:

Pennebaker (1986) also examined the type of language students had used in their writing exercises.

He found, for example, that those who used the word ‘because’ the most, in comparison with the other students in GROUP 1, tended to benefit more than their counterparts and Pennebroke suggested that this may be because it showed they were often trying to ‘make sense of’ what had happened to them. He also found that those in GROUP 1 who transitioned, during the writing exercises from initially writing in the first person singular to, later on in the writing exercises, writing in the third person singular were also particularly likely to be benefited – this, Pennebaker surmised, may be because the alteration in the use of grammar indicated that they were trying to comprehend what had occurred to them using a multiple-perspective approach so that they were able to analyze what had happened to them from a variety of psychological angles.

THERAPIES THAT HELP US TO PROCESS THE PAST:

Therapies that may help us to process the past include the following:

 

  • DESENSITIZATION THERAPY – This involves reflecting on the trauma, including sensory details (i.e.details pertaining to the five senses), feelings and thoughts associated with it with the aim of this process leading the individual to become ‘desensitized’ to thinking g about this information – i.e. reaching a stage in which thinking about this material is significantly less emotionally distressing and less physiologically activating (i.e. reduces feelings of hypervigilance and hypersensitivity to stress).

 

  • COGNITIVE PROCESSING THERAPY – This form of therapy aims to help the individual identify and overcome thoughts that are preventing him/her from attaining resolution of the trauma s/he has experienced.

It also involves specific writing tasks involving writing about one’s traumatic experience including as much detail as possible about sensory elements of the experience (i.e. relating to touch, taste, vision, hearing and smell) and also about thoughts and feelings one experienced during the traumatic event.

The individual undergoing is also encouraged to read out what s/he has written to him/herself every day and also to his/her therapist during the session following the written task (so having a therapist one can trust and feel comfortable with is vital, as it is in all therapeutic relationships).

 

REFERENCE:

Pennebaker, J. W., & Beall, S. K. (1986). Confronting a traumatic event: Toward an understanding of inhibition and disease. Journal of Abnormal Psychology, 95(3), 274–281. https://doi.org/10.1037/0021-843X.95.3.274

RESOURCE:

Write Everyday | Self Hypnosis Downloads.  CLICK HERE

 

Posttraumatic Growth : Trauma, The Brain, Dissociation And Creativity

Trauma Release Exercises For Effects Of Childhood Trauma

Posted in: COMPLEX PTSD / PTSD, PHYSICAL ILLNESS, RECOVERY

How Borderline Personality Disorder Symptoms Reinforce Each Other

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How Borderline Personality Symptoms Reinforce
Each Other.


One of the greatest difficulties of managing borderline personality disorder
(BPD) is that the symptoms it creates tend to feed off, and intensify, each
other; often this will end in a crisis point at which the affected individual
will become suicidal and/or require hospitalization.

Until the disorder is properly treated with the relevant therapy, the individual is likely to keep
experiencing such crisis points throughout his/her life.
In this article, I want to look at how the symptoms of BPD can keep
reinforcing and worsening each other, leading to a downward spiral from
which the majority will find it impossible to break free without professional
intervention. In order to do this, it is worth revisiting the main symptoms of
BPD:


– almost always full of painful and distressing emotions


– becomes intensely attached to others very quickly, leading to feelings for,
and expectations of, others that are not warranted given the context and/or
history of the relationship


– expects to be rejected by those s/he forms an emotional attachment to


– is simultaneously deeply needy of, and rejecting towards, others; feels
deep need of emotional intimacy with, and caring from, others but then will
tend to reject it when it is offered


– interpersonal relationships become unstable and chaotic


– experiences great difficulty in controlling (regulating) emotions which
quickly become powerful and overwhelming; these frequent powerful,
intense, uncontrollable emotions frequently spiral out of control and then
have a very adverse effect upon normal functioning


– inability to self-soothe (it is theorized that this is due to damage to the area
of the brain known as the AMYGDALA, thought to be caused by severe
trauma and high levels of stress during childhood)


– suffers from impulsivity and recklessness


– frequently, or continuously, prone to severe depression and anxiety


– feels, and almost always is (by non-experts), misunderstood


– tends to constantly expect utter and devastating calamity (a mind-set
referred to by psychologists as CATASTROPHIZING, a state of mind
cognitive behavioural therapy, and other types of therapy for BPD, seek to
correct).


HOW SUCH SYMPTOMS INTERACT AND INTENSIFY ONE
ANOTHER:


Because the symptoms of BPD trap the sufferer in a downward spiral, as I
shall illustrate below, it is just about impossible for individuals to cope
with, let alone manage, the condition on their own. Professional
intervention is therefore imperative. Because BPD is frequently
misdiagnosed, it is worth noting down relevant symptoms and presenting
them to the relevant professional in advance of an appointment.

Also, there is nothing to prevent one seeking a second (or even third!) opinion. It is
important to seek out a therapist who is expert in the condition and one is,
of course, free to ask any potential therapist what experience s/he has of the
disorder, together with their views about treatments (eg medication, talk
therapy, a combination?) What is your own instinct on this? Let the
therapist know.


Let’s now look at how the symptoms of BPD may become so mutually,
destructively intertwined:


Because the person who suffers from BPD can be in such continuous,
painful emotional distress it is very common for him/her to turn to alcohol
or drugs in an attempt to numb these intolerable feelings.

The individual may well then castigate him/herself about this alcohol/drug use, seeing
him/herself as an alcoholic or drug addict which lowers even further his/her
already greatly damaged self-esteem.

S/he may then seek psychologically support from a friend, but, as a consequence of his/her distress, become
clingy and demanding. In response to this, the friend may set down
boundaries which the BPD sufferer interprets as rejection, thus further
lowering his/her self-esteem and causing further painful emotions leading to
yet more excessive drinking or drug taking…


Of course, this is just one example of how symptoms of BPD may
unhelpfully feed off each other, though an almost infinite variety of harmful
interactions between other symptoms can be easily imagined.

Essentially, the BPD sufferer LACKS INTERNAL RESOURCES TO COPE WITH
MENTAL PAIN AND STRESS so will turn, with depressing regularity, to
DESTRUCTIVE EXTERNAL RESOURCES such as one-sided
relationships or activities which allow temporary, psychological
DISSOCIATION from the emotional distress being experienced, such as
ALCOHOL, DRUGS, PROMISCUOUS SEX or GAMBLING in other
words, maladaptive (unhelpful) coping mechanisms.


As these maladaptive coping strategies continue to aggravate and worsen
one another, the BPD sufferer is likely to become increasingly desperate
and to undertake increasingly self-destructive behaviours.

How can s/he break free from this vicious cycle? Sometimes, as I said in the opening
paragraph of this post, hospitalization may be required to interrupt the
cycle; however, this has its negative side: being placed in a psychiatric
hospital can significantly worsen, yet further, damaged self-esteem, making
the sufferer feel like a pariah – stigmatized, demeaned, humiliated, and on
the bottom rung of society’s ladder.

S/he will also be burdened with the often acute worry of how s/he will now be perceived by others for having
being placed in a psychiatric ward, making him/her less capable still of
finding the confidence to interact successfully with acquaintances, friends
and society in general. In extreme cases (eg when the sufferer is actively
suicidal), however, there may, sadly, be little alternative

BPD Sufferers May Have Subtle Learning Difficulties

Childhood Trauma : Reactions to Trauma According to Age

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

Posted in: BPD

BPD Link To Mothers Who Fluctuate Between Nurturing And Abusive Behaviour

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As we have seen from other articles that I have published on this site, individuals who have been diagnosed with borderline personality disorder (a very serious psychiatric disorder strongly associated with severe and protracted childhood trauma) have a strong tendency to see others and ‘black and white’ terms or as ‘all good’ and ‘all bad’. Indeed, BPD sufferers may suddenly switch from idealizing a person, such as a partner, to ‘demonizing’ this same person.

Unfortunately, as I know from my own experience, mothers with BPD or with BPD traits may treat their own children in this way – sometimes smothering them with love and engulfing them, then, unpredictably and dramatically, altering their behaviour to treating them in a highly psychologically abusive way. In other words, their parenting is inconsistent in a particularly extreme way

Obviously, to be on the receiving end of such treatment is disorientating, deeply confusing, toxically stressful and traumatizing, particularly (as in my case) the mother is a single parent and there is no stable father or partner to protect and comfort the child. (Throw into the mix a complicit, bullying older sibling and things are apt to turn out especially badly).

TWO IRRECONCILABLE, DIAMETRICALLY OPPOSED MENTAL REPRESENTATIONS OF THE MOTHER:

Because of the diametrically opposed ways in which the mother has of treating her child (vacillating between nurturing and abusive), this may lead to the child to being unable to construct an integrated mental representation of his/her mother that encapsulates her whole range of potential behaviours (from very good to very bad) towards him/her.

STORAGE OF CONTRASTING MATERNAL REPRESENTATIONS STORED IN DIFFERENT BRAIN HEMISPHERES:

Instead, the child forms two mental representations of the mother (one reflecting her ‘all bad’ side and one representing her ‘all good’ side and stores these representations, it has been hypothesized, in two different parts of the brain, as follows:

  • the mental representation of the ‘all good’ mother is stored in the right hemisphere of the brain.
  • the mental representation of the ‘all bad’ mother is stored in the left hemisphere of the brain. 

IMPLICATIONS OF HAVING POORLY INTEGRATED LEFT AND RIGHT HEMISPHERES:

The process described above is often referred to by psychologists as ‘splitting‘, a psychological defence mechanism which can lead to not only two opposing, unintegrated mental representations of the mother (‘good’ and ‘bad’) but, similarly, two such contrasting, unintegrated views of the world in general. Because of the mother’s extremes of behaviour, the two hemispheres in the brain are theorized not to develop in the normal, integrated way, but to develop in such a way that makes each hemisphere relatively autonomous. 

MORE GENERAL EFFECTS OF LACK OF HEMISPHERE INTEGRATION AND RELATIVE HEMISPHERE AUTONOMY:

This lack of integration between the two hemispheres, and because of the different ways in which each hemisphere operates, may also mean that the individual whose brain development has been harmed in such a way may also develop a marked tendency to dramatically fluctuate between viewing people, events and circumstances in a logical or over-valuing way (when in what we might call ‘left-hemisphere mode’) and viewing these same people, events and circumstances in a severely hostile, negative and critical way when in the ‘right-brain mode’, seeing everything in terms of ‘black and white’ rather than in more subtle, nuanced and sophisticated shades of grey. 

As I said at the beginning of this article, seeing everything in terms of ‘black and white’ is one of the defining characteristics of sufferers of BPD so it can be seen from the above why mothers with BPD are far more likely to have children who develop BPD than the average mother although there are, of course, many other reasons why this is the case which I write about elsewhere but are beyond the scope of this current, brief article.

 

Childhood Trauma, Therapy And The Right Brain

Why A ‘Love-Hate’ Relationship Develops Between The Abusive Parent And The Child

Bowlby’s Theory Of The Damaging Psychological Effects Of Maternal Deprivation

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

 

Posted in: ARTICLES, BPD