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Seeing Symptoms Of Complex PTSD As Adaptive Capacities. 

…those who are unaware of the child’s history of trauma or those who are ignorant of the potential effects of severe, protracted, interpersonal childhood trauma may confound matters further still by attaching pejorative labels to the young person (such as a diagnosis of antisocial personality disorder).

According to Ford, 2009, symptoms of complex PTSD should not be seen as psychopathological, but (initially), as self-defensive and protective adaptive capacities that develop as a (largely unconscious) drive to increase resilience in the face of overwhelming and intolerable stress. To provide a simple example, a child who is constantly made fearful by recurring parental rages may,/herself, become highly (reactively) aggressive as a means of self-defense. Unfortunately, however, if the child goes on to develop complex PTSD or a similar condition, such aggressive responses may dysfunctionally generalize to other areas of his/her life in inappropriate and ultimately self-defeating ways as a result of hypervigilance, especially if the development of the limbic system and prefrontal cortex has been damaged by severe, chronic or repetitive trauma in early life. However, this does not alter the case that, originally, the child’s aggressive response developed due to a drive to protect him/herself and survive.

 

The Neurological Basis Of Why Such Adaptive Capacities Are So Difficult To Control. 

 

So, to continue with the above example, the child’s reactive aggression essentially has developed as an adaptive capacity but one that has become so ingrained on a neurological level that it can spill over into other areas of life in all sorts of problematic ways. Sadly, those who are unaware of the child’s history of trauma or those who are ignorant of the effects of severe, protracted, interpersonal childhood trauma may confound matters further still by attaching pejorative labels to the young person (such as a diagnosis of antisocial personality disorder). 

 

This is because, in extreme cases, when a child lives in a toxically stressful environment in which s/he frequently feels threatened for long enough periods, the brain can become dominated by the brain stem and the limbic system (including the amygdala and hippocampus) whilst the prefrontal cortex, responsible for rational thinking and judgment, effectively ‘shuts down’. And, when the brain stem and limbic system are in control, unrestrained by higher brain regions, the result can be that we go into a kind of instinctive, animal-like survival mode in which intense emotions, such as fear and rage (often two sides of the same coin) fueled by an uninhibited limbic system run amok. 

In ‘healthy’ individuals, this neurological response only occurs appropriately in response to perceived danger, then, once the danger or perception of danger passes, the brain returns to its normal state (i.e. the prefrontal cortex reasserts itself and the activity of the limbic system and brain stem cools down to normal levels). 

However, in the case of those who develop complex PTSD or a similar condition, the prefrontal cortex can become chronically underactive allowing the survival brain to become overdominant.  The drive to survive is extremely powerful, of course, which is why adaptive capacities, as we are defining them in this article, are so difficult to control. In those with complex PTSD or closely related conditions such as BPD, the brain can, in effect, be tricked into believing stressful situations that arise that ‘healthy’ others may be able to deal with relative equanimity are ‘life or death’, emergency occurrences.

This can lead to various problems including dysfunctional relationships, learning, achieving goals and meaning in life, and a healthy sense of identity.

‘Acquired Callousness’ In Young People Is Not The Same As Psychopathy
A recent study conducted at the University of Vermont and published in the Journal Of Child Abnormal Psychology by psychological researchers Gill and Stickle (2016) suggests that those in the medical profession who are prone to see young people displaying certain characteristics and behaviors as nascent psychopaths may not properly appreciate the complexities involved in the diagnosis of psychopathy.
In the Diagnostic and Statistical Manual of Mental Illnessedition 5 (DSM V), psychopathy is listed under antisocial personality disorders and it is currently hypothesized that the disorder is rooted significantly in genetic determinants and involves chemical abnormalities in the brain. In other words, the condition is thought to be substantially determined by biological factors.
 What Is A Psychopath?
Typically, a psychopath:
ignores the rights of others
– is highly egoistical/narcissistic
– is bold
– is disinhibited / impulsive / problems delaying gratification
 
– lacks empathy
 
– is callous, cold, and unfeeling
 
– disregards the law (although many psychopaths never break the law)
 
– is prone to violence (though, again, many psychopaths are not)
 
– has little or no conscience / does not feel remorse or guilt
 
– does not fear punishment
 
The Study :
 
The study referred to in the first paragraph involved 150 participants (both male and female) residing in juvenile detention centers.
All of the participants were aged from 11 years old to 17-years-old.
All the participants had been classified as :
callous
– unemotional
– extremely, behaviourally antisocial
– incipiently psychopathic
 
What Did The Study Find?
Using more sensitive and sophisticated means of testing (especially with regard to examining personality traits) than is usually used to investigate psychopathy and psychopathic characteristics it was found that although, superficially, the young people appeared callous, unemotional, and pre-psychopathic their actual diagnosis (according to the more accurate and appropriate tests used), in the main, was that they were :

severely depressed

– severely anxious

– in a state of high emotionality

(In other words, they were not psychopathic but suffering from intense emotional distress).

Implications Of Study:

Due to these findings, the researchers pointed out that young people displaying behavioral problems such as those in this study should not be unthinkingly labeled as incipient psychopaths, punished, and stigmatized but, instead, be given appropriate support and treatment such as cognitive-behavioral therapy (CBT) and help to control their intense and volatile emotions.

Non-Treatment Stores Up Problems For The Future:

Unfortunately, however, research by Ford et al., (2012) found that young people who are given such labels as ‘delinquent’, ‘antisocial’, and ‘aggressive’ are frequently judged not to be suitable for therapy even when they are also showing signs of severe distress connected to their traumatic upbringings – this is clearly a travesty and not only a betrayal of the young person but extremely damaging to society as a whole as such an approach only creates more problems down the line with, potentially, devastating, cumulative effects. It cannot be stressed enough that when young people are showing signs of acute distress the earliest possible intervention is crucial.

Acquired Callousness As A Defense Rather Than As A Sign Of Untreatable Psychopathy:

Ford et al., (2010) conducted research suggesting that young people with a history of complex trauma do NOT develop PROACTIVE AGGRESSION (e.g. going out looking for aggressive confrontations for the sake of it) but, rather, REACTIVE AGGRESSION as a learned defense mechanism that emerges due to a desperate need for self-preservation and self-protection in the face of extreme, ongoing abuse. As a consequence of protracted, repetitive, severe trauma, such reactive aggression can be easily triggered even by (objectively speaking) minor triggers (or even imagined threats). This can occur because severe, ongoing trauma has altered the way in which the brain functions (I have written about how childhood trauma can impair brain development extensively elsewhere on this site, e.g. see my previously published article about a phenomenon known as ‘amygdala hijack’). Ford and colleagues also found that, in addition to developing tendencies toward reactive aggression, such traumatized young people may also display a reduced bodily response to physical pain and that this combination (i.e. learned, reactive aggression, and a high pain threshold) can result in the young person being miscategorized as a psychopath and as ‘callous’ and ‘unemotional.’ However, many researchers argue that such ‘callousness’ be better referred to as ‘acquired callousness’ and is the result of dissociation and alexithymia rather than true signs of authentic psychopathy.

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REFERENCES:

Gill, A.D., Stickle, T.R. Affective Differences Between Psychopathy Variants and Genders in Adjudicated Youth. J Abnorm Child Psychol 44, 295–307 (2016). https://doi.org/10.1007/s10802-015-9990-1

JULIAN D. FORD et al 2010  University of Connecticut School of Medicine TRAUMA AND AGGRESSION IN SECURE JUVENILE JUSTICE SETTINGS,

 

 

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