David Hosier BSc Hons; MSc; PGDE(FAHE), Author at Childhood Trauma Recovery - Page 3 of 17
Childhood Trauma RecoveryOver 750 free articles by psychologist and childhood trauma survivor David Hosier MSc on effects of childhood trauma, therapies, self-help and related topics
A ‘top-down’ therapy is one that aims to create a positive change in the individual’s behavioral, emotional and somatic symptoms in a ‘top-down’ direction (i.e. by beneficially ALTERING THE INDIVIDUAL’S THOUGHT PROCESSES). Techniques for doing this include cognitive restructuring and increasing the traumatized individual’s insight into his or her condition, amongst many others.
Whilst ‘top-down’ therapies are necessary, and can be very effective, there is now a growing realization, when treating the traumatized individual, the addition of ‘bottom-up’ therapeutic techniques may be of paramount importance in relation to treating the bodily adverse effects of trauma such as sensorimotor symptoms and autonomic dysregulation.
WHAT ARE ‘BOTTOM-UP’ THERAPEUTIC TECHNIQUES FOR THE TREATMENT OF TRAUMA?
Unlike ‘top-down’ therapies, which concentrate on an individual’s thinking processess to treat the effects of trauma, ‘bottom-up’ therapies concentrate upon BODILY EXPERIENCES as an initial route through which to treat the effects of trauma by ameliorating dysfunctional trauma-related, chronic and automatic bodily responses. This approach is taken because it is theorized that our nervous systems and muscles store distressing images and memories on a unconscious, nonverbal level and that this is manifested in various physical and bodily ways, such as :
A study conducted by Infuma et al., (2015) suggests that those who have suffered significant and protracted childhood trauma suffer significantly more problems and disturbances in their daily life, as well as more dysfunctional reactions to such problems and disturbances, during middle-age and beyond (when compared to those who have been fortunate enough to avoid the experience of significant childhood trauma).
This adds to the already enormous amount of evidence suggesting that the adverse effects of childhood trauma, both physical and psychological, in the absence of appropriate, effective therapy, can last for years, decades, or, indeed, a whole lifetime (for example, see my article about the ADVERSE CHILDHOOD EXPERIENCES (ACE) STUDY).
The study required the participants to keep a daily diary for a total of 30 days and record within it of NEGATIVE EVENTS, POSITIVE EVENTS and CHANGES IN WELL-BEING AS A RESULT OF THESE EVENTS.
THE HYPOTHESIS OF THE STUDY WAS :
Those who had experienced significant childhood trauma would REPORT MORE NEGATIVE EVENTS each day, and LESS ENGAGEMENT WITH POSITIVE EVENTS each day, than participants who had NOT experienced significant childhood trauma.
AND THAT…
Those who had experienced significant childhood trauma would REPORT HIGHER LEVELS OF EMOTIONAL REACTIVITY TO BOTH POSITIVE AND NEGATIVE EVENTS that occurred each day than participants who had NOT experienced significant childhood trauma.
For both NEGATIVE AND POSITIVE EVENTS that the participants recorded in their diaries, participants were required to make a note of which of the following categories the event fell into :
Spouse / Partner
Family
Friends
Work Finances
Health
Other
RESULTS FOR NEGATIVE EVENTS :
Those who had experienced childhood trauma had a 43 per cent increased likelihood of reporting a daily negative event on any particular day.
Those with HIGHER LEVELS OF CHILDHOOD TRAUMA, on average, experienced daily negative events on 66 per cent of the 30 days, whereas for those with LOWER LEVELS OF CHILDHOOD TRAUMA this figure fell to an average of 50 per cent.
The more childhood trauma that a participant had experienced, the stronger his emotional reactivity, and consequential reduction in well-being, to NEGATIVE EVENTS FOCUSED UPON FRIENDS AND HEALTH.
RESULTS FOR POSITIVE EVENTS :
The more childhood trauma the participant had experienced, the greater his increase in positive emotions in response to positive events focused upon spouse / partner, family, friends and work.
CONCLUSION :
Extrapolating from the above figures, these results suggesr that
Over the period of a year, those who have experienced significant childhood trauma experience negative events on 60 more days (on average) each year than those who have experienced little or no childhood trauma.
Those who have experienced significant childhood trauma experienced greater emotional reactivity to both positive and negative events than those who have experienced little or no childhood trauma.
IMPLICATIONS FOR PHYSICAL HEALTH :
The researchers also suggested that the differences found between those who had experienced significant childhood trauma and those who had not, as described above, may help to explain why individuals who have experienced significant childhood trauma, on average, suffer worse physical health than those who have not (in relation to this, you may wish to read my previously published article entitled : How Childhood Trauma Can Reduce Life Expectany By 19 Years). This is because previous research has shown that daily stressors, over time, can, cumatively, have a seriously damaging effect upon our physical health (both directly – by increasing the level of damaging hormones such as cortisol in our blood stream – and indirectly – by increasing the likelihood that we will turn to unhealthy coping strategies such as drinking, smoking and drug-taking).
It may also be the case that the increased emotional reactivity that those who have experienced significant childhood trauma show in response to negative daily events and the associated increased activation of the sympathetic and parasympathetic nervous system may also adversely impact upon health (although increased reactivity to positive events may off-set this to some degree), according to the researchers.
Finally, the fact that those who have experienced significant childhood trauma show increased reactivity to positive daily events and that this may off-set, to some degree, physiological damage caused by increased reactivity to negative events, suggests, according to the researchers, that for those seeking therapy this finding could be exploited by encouraging such individuals to undertake more pleasurable activities by using therapeutic techniques such as behavioral activation.
A study conducted by McCormack (Newcastle University, UK) interviewed the (now adult) children of children of parents who had various mental illnesses (such as depression and schizoaffective disorder.
The researches found that the information they gathered could be distilled down into various main effects which were as follows :
1) Concerns about be loved, cared for and wanted, leading to feelings of loneliness, helplessness, abandonment and of being ignored.
2) Traumatization, stress and anxiety : some individuals in the study reported being neglected and abused and of living in an environment that was very frightening over extended periods of time and that this had significantly traumatized them, leading to severe anxiety and hypervigilance.
3) Feelings of having been betrayed, due to the failure of both parents to protect them and make them feel safe (in the case of the non-mentally ill parent, the sense of betrayal derived from this parent’s failure to protect them from the harmful effects of the mentally ill parent).
4) Guilt, sadness and self blame : sadly, children living in abusive homes almost invariably, irrationally blame themselves for this abuse and falsely believe that they ‘must be a bad person‘ which, in turn, leads to profound feelings of shame.
5) Parentification / adopting role of child carer to the mentally ill parent. The child of the mentally ill parent may become ‘parentified’ ; this involves a role-reversal whereby the child is placed into the position whereby he is required to act as the parent’s parent.
6) Avoidance, development of strategies to stay safe and associated hypervigilance.Children in abusive homes learn strategies to keep themselves as safe as possible ; these include : placating the patent, avoiding the parent (for example when the parent is drunk or experiencing a violent, psychotic episode). However, the price they pay for the development of such strategies is the need to be permanently on ‘red-alert’ and on the look out for signs of potential danger (hypervigilance).
7) Development of empathy, compassion and resilience. Some individuals in the study reported that, as well as negative effects, their childhood experiences also had some positive effects, including helping them to develop feelings of empathy and compassion and, also, increasing their resilience. (When the experience of trauma ultimately helps the individual grow and develop as a person in positive ways, it is known as posttraumatic growth.)
8) Regarding school as a refuge (although children who are abused at home can be more vulnerable to beingbulliedat school).
9) Feelings of being stigmatized : for example, the child can feel terrified that their peers at school will find out that their parent has a mental health issue and, as a result, subject him to bullying, ridicule and mockery. Indeed, this can lead to irrational, profound feelings of shame. Also, the feeling of desperately having to keep their unfortunate home situation a secret exacerbated their sense of extreme anxiety.
9) Self-hatred transitioning into self-acceptance and wisdom : many of the participants reported that whilst, as children, their traumatic experiences had led them to feel a sense of irrational shame and self-hatred, as they became adults and developed a better understanding of how these experiences had adversely impacted on their lives they were able to develop a liberating sense of self-acceptance.
STATISTICS :
Approximately 68 per cent of women and 57 per cent of men with a severe mental illness such as schizophrenia or bipolar depression are parents.
(Source : Royal Society Of Psychiatrists).
OTHER PROBLEMS THE CHILD MAY DEVELOP AS A RESULT OF LIVING WITH A MENTALLY ILL PARENT :
Other research suggests that children living with a parent with mental illness may :
– fear that they themselves will one day go on to develop the same mental illness (some children do develop a similar illness and emotional problems).
– find it difficult to concentrate on their school work
– develop somatic illnesses
(Source : Royal Society Of Psychiatrists).
FACTORS THAT MAKE IT MORE LIKELY THAT A CHILD WILL BE ADVERSELY AFFECTED BY THEIR PARENT’S MENTAL ILLNESS :
the child believes he is to blame for the parent’s illness.
the child develops a similar condition.
the child does not have a proper understanding of their parent’s illness.
the child is repeatedly separated from the parent because this parent is regularly being hospitalized.
the child feels insecure and unsure about his relationship with the mentally ill parent.
the child is being hit or otherwise abused by the mentally ill parent.
the child is having to act as the mentally ill parent’s caretaker or his having to care for younger siblings due to the parent’s mental illness.
the child is being bullied or teased at school because of their parent’s mental illnesslive in povertyhave an unstable life.
What Are The Signs Of Posttraumatic Stress Disorder (PTSD) In Very Young Children And Toddlers?
Because the linguistic development of very young children and toddlers is so restricted, they are unable to articulate their distress in anything other than a very rudimentary way ; therefore, in order to infer whether they are suffering from PTSD, it is necessary to observe their behavior and emotional expression.
These behavioral and emotional reactions to trauma will, of course, vary between individuals, both in terms of the number displayed and their intensity. Clearly, all else being equal, the greater the number of symptoms and the more severe such symptoms are, the greater the imperative for therapeutic intervention.
Possible signs of PTSD in very young children and toddlers include the following :
Above : Brain scan showing difference between the brain of a ‘normal’ three-year-old and a severely traumatized (in this case, due to extreme neglect) three-year-old.
disrupted sleep pattern
physical symptoms such as stomach aches and headaches
developmental regression ; the child may regress to an earlier stage of development and, as a result, lose some learned skills (e.g. toilet training).
post-traumatic play : this can manifest itself as repetetive play that mirrors the events of the original trauma. For example, a child involved in a car crash may repetetively play with toy cars in a way that reenacts the accident. Also, traumatized children may dramatically reduce their ‘exploratory’ play.
over-sensitive startle response ; the child may become extremely startled and fearful in response to unexpected events, including trivial ones that would not have bothered him before the trauma, especially, of course, if the unexpected event triggers memories (on either a conscious or unconscious level) of the original traumatizing experience.
obsessive preoccupations ; the child may become obsessed by a particular toy or cartoon character, for example.
acute separation anxiety ; represented as intense fear of being separated from the primary caregiver.
reactions as if the traumatic experience is recurring, which, in extreme cases, can manifest itself losing awareness of present surroundings (also referred to as ‘dissociation’)
habitual avoidance of activities, places and other reminders associated with the original traumatic experience
deterioration in relationships with significant others such as parents, caregivers and peers, increased wariness of strangers, ‘clingyness.’
impaired concentration
socially withdrawn behavior
fears of things that might seem unconnected to the trauma but are actually representative and symbolic of it ; for example, a fear of an imaginary monster (that represents, on an unconscious level, someone who has harmed the child).
One of the key features of those who have suffered significant and protracted childhood trauma, especially if it has resulted in associated conditions which can go under the various names of borderline personality disorder (BPD), complex-PTSD or developmental disorder, depending on the frame of reference upon which the diagnosing clinician is drawing, is an impairment of empathic feelings for others.
This impairment may manifest itself in 2 opposing ways :
The individual may be unable to feel very much empathy for others at all, or, alternatively :
The individual may be overwhelmed by intense feelings of empathy for others.
Let’s look at each of these in turn :
1, UNABLE TO FEEL EMPATHY FOR OTHERS.
Individuals with conditions such as borderline personality disorder (BPD) (see above) are in a state of such intense psychological pain, fear and anxiety that it is essentially impossible for them to focus upon anyone’s suffering but their own (just as someone suffering from excruciating tooth-ache, for example, would find it hard to think of anything else). When such extreme anguish continues relentlessly for months and years, the individual is liable to become ‘stuck’, through no fault of his own, in survival mode, or, in other words, in an habitual state of ‘fight, flight or freeze. This is an automatic, physiological response that has hard-wired into us all through millions of years of evolution, and forces the mind to be solely focused upon one’s own survival).
Often, too, those who cannot feel empathy for others have themselves missed out on empathic care during their childhoods (particularly early childhood). And, to make matters even worse, this early life emotional neglect can greatly impair their own ability to evoke feelings of empathy and caring directed towards themselves from others, perhaps ending up with a diagnosis of anti-social personality disorder and becoming a social pariah, left to drown in a sea of profound loneliness and despair. In essence, as a young child, the individual was been unable to internalize, or form an adequate mental representation of, a caring, loving, nurturing, attentive and attuned mother.
A third reason such individuals are unable to feel empathy for others may be due to their traumatic early life experiences disrupting their emotional development to such an extent that they were unable to develop a ‘theory of mind.’ The term ‘theory of mind’ refers to having the ability to understand that other people have minds that, whilst similar to one’s own, contain different desires, plans, intentions, beliefs, knowledge, emotions. and mental states in general. The failure to develop such a ‘theory of mind’ in those who have experienced dysfunctional mothering as babies, infants and young children may occur due to the lack of adequate bonding and attunement between the mother and child in early life.
However, it should also be noted that impaired development of a ‘theory of mind’ is also linked to various other conditions, including autism, schizophrenia, bipolar disorder, mental retardation, congenital blindness and attention deficit hyperactivity disorder (ADHD) and damaged frontal and / or right hemisphere brain regions.
2) OVERWHELMED BY INTENSE FEELINGS OF EMPATHY FOR OTHERS.
What appears to be hyper-empathy (i.e. excessive empathy) displayed by those who have experienced disrupted development in early life may, in fact, be explained by the individual’s inability to form an adequate boundary between himself and others, resulting in him experiencing their mental anguish as his own. For example, such an inability to form boundaries can also occur as a result of an ‘enmeshed’ relationship with a narcissistic mother.
Finally, it has also been hypothesized that, when parenting is unpredictable and abusive, children develop enhanced empathic abilities so that they are able to sense and ‘pick up on’ subtle and subconscious signals that parents may give out that alert the child to the need to be ‘on guard.’ In other words, in such cases, hyper-empathy has developed, in evolutionary terms, to help the child protect himself and, ultimately, to survive.
causing the child to feel excessive guiltand ashamed for failing to live up to the parent’s expectations/demands
with-holding love as a form of punishment to cause emotional distress
direct or implied threats of physical punishment
making the child feel s/he is ‘intrinsically bad’ for not always bending to the parent’s will
Financial manipulation. Some parents may manipulate their child using money for a who;e host of reasons, including spoiling the child and then accusing him of ingratitude ; as a tacit way of ‘keeping the child quiet’ about abuse ; to ‘compensate’ the child for emotional neglect and ameliorate feelings of guilt ; to make the child feel indebted ; to increase the child’s dependence ; to induce feelings of guilt in the child either explicitly or implicitly ; as a tool to regulate the child’s behavior ; as an expression of the parent’s ‘superiority’ and contempt for the child ; as a superficial way of acting ‘the good parent.’
making the child believe he is ‘uncaring’ for not fully meeting the parent’s needs
Such parents may also be very controlling ; if our parents were overly controlling the characteristics they may have displayed include the following :
Did not show respect for, or value, our reasonable ideas and opinions
Imposed over-exacting demands on us and refused to listen to even the most reasonable and considered objections
Were preoccupied with criticizing us, whilst minimizing or ignoring our good points
Were excessively concerned about our table manners (for example, failing to hold a knife and fork ‘ correctly’)
Were excessively rigid about what we eat
Discouraged us from developing independence of thought, especially if it led to a mismatch between our opinions, views and values and those of the parent
Imposed excessive demands on us regarding household rules, duties and regulations which we were not permitted negotiate even if any reasonable person would regard them as inappropriate
Never admit to being in the wrong, even in very clear-cut circumstances
Were excessively and unreasonably controlling regarding our appearance; not respecting our wishes to express our individuality (for example, choosing all our clothes without any interest in our opinion about them).
Did not respect our choice of career and made demands on us to reconsider and instead pursue a career the parent regarded as more ‘suitable’ even when this would make us very unhappy.
Expected us to reach standards which were impossible to attain and berated us when we inevitably, in their eyes, ‘failed’.
Did not allow us to voice reasonable objections (for example, about the family dynamics and how they caused us unhappiness).
Were unnecessarily rigid regarding who we ‘ought’ to associate with in a way that reflected prejudice and discrimination against individuals we wished to associate with
Tried to make us suppress perfectly normal emotions such as anger, fear and unhappiness.
Violated our privacy (for example, searched our bedroom for our personal diary without a good cause).
Tried to control us with emotional blackmail, psychological manipulation, intimidation and threats.
Whilst some parental attempts to manipulate and control are fairly blatant, as can be seen from the above examples, some are far mote subtle. This means that when we were young we may not have been aware that we were being manipulated; we may only come to realize it, in retrospect, with the extra knowledge we have gained as adults.
ATTACHMENT THEORY AND THE ‘MATERNAL SENSITIVITY HYPOTHESIS’:
According to attachment theory, the way we react in our relationships with others, specifically in relation to our reactions to being hurt by, threatened by or separated from significant others, depends largely upon our ATTACHMENT STYLE.
Ainsworth (one of the most significant researchers to have worked in this field) proposes that the particular type of attachment style we develop is mainly determined by how our mothers behaved towards us, particularly in terms to sensitivity and attunement to our needs, moods and feelings, when we are infants; Ainsworth first proposed this idea in 1978 and it is known as the ‘MATERNAL SENSITIVITY HYPOTHESIS.’
THE FIVE ATTACHMENT STYLES :
Five main types of attachment styles have been identified; these are :
SECURE ATTACHMENT
AVOIDANT ATTACHMENT
AMBIVALENT ATTACHMENT
DISORGANIZED ATTACHMENT
REACTIVE ATTACHMENT
WHAT KIND OF INTERACTION BETWEEN MOTHER AND INFANT GIVES RISE TO THESE FIVE ATTACHMENT STYLES?
SECURE ATTACHMENT : this results when the mother is well attuned, sensitive and responsive to the infant’s needs, moods and feelings
AVOIDANT ATTACHMENT : this results when the mother is too frequently unavailable to, and rejecting of, the infant.
AMBIVALENT ATTACHMENT : this results when the mother behaves inconsistently, and sometimes too intrusively, towards the infant.
DISORGANIZED ATTACHMENT : this results when the mother ignores or fails to understand the infant’s needs and behave in a frightening and traumatizing way towards the infant.
REACTIVE ATTACHMENT : this results when the mother is extremely unattached or has a disrupted nervous system.
HOW DO EACH OF THESE FIVE ATTACHMENT STYLES AFFECT THE INDIVIDUAL’S ADULT RELATIONSHIPS?
SECURE ATTACHMENT STYLE : able to form positive, meaningful relationships, form healthy boundaries and be empathetic.
AMBIVALENT ATTACHMENT STYLE : anxious, insecure, unpredictable, erratic, blames others but can be charming.
DISORGANIZED ATTACHMENT STYLE : insensitive to feelings of others, prone to explosive rage, abusive, craves security but unable to trust others.
REACTIVE ATTACHMENT STYLE : unable to form meaningful, positive relationships.
Our adult attachment style is so closely related to early life relationships because these (consciously and unconsciously) act as models for how we expect others will treat us and behave towards us ; in other words, we are essentially ‘programmed’ by these early relationships to perceive, and behave towards, others in ways that reflect them ; in this way, we unwittingly replicate our old patterns of behavior when interacting with others in the present, especially intimate partners and offspring.
Childhood Trauma, Depression And Learned Helplessness
Arrested Psychological Development and And Age Regression
Effects Of Repressed Anger Towards Parents
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