Category Archives: Depression And Anxiety Articles

3 Core Unmet Needs Underlying Emotional Pain

3 core unmet needs underlying emotional pain

Core Unmet Needs

Many of us who have suffered significant childhood trauma experience intense emotional pain as adults; such pain my present itself as severe anxiety, depression or anger, for example.

According to Timulak et al., 2012, three core unmet needs underlie such emotional suffering; these are :

  • unmet needs for safety and security
  • unmet needs for love and meaningful connection to others
  • unmet needs for acceptance, validation and recognition by others 

Sadly, such unmet needs frequently stem from growing up in a  dysfunctional family. (To read my previously published article : Dysfunctional Families : Types And Effects, click here).

 

Core Feelings Associated With Core Unmet Needs :

Timulak elaborates on the above by stating that these three core unmet needs are associated with corresponding core feelings as shown below :

  • unmet needs for safety and security are associated with feelings of fear and insecurity
  • unmet needs for love and meaningful connection to others are associated with feelings of sadness and loneliness
  • unmet needs for acceptance, validation and recognition by others are associated with feelings of shame and worthlessness

emotional pain

Secondary Distress And Obscured Core Unmet Needs And Feelings :

Timulak also alerts us to the fact that when individuals suffering from emotional pain present themselves to therapists, their core unmet needs and corresponding core feelings may be obscured and concealed because these are overlayed by surface, ‘secondary distress’ (i.e. distressing, surface feelings that have their roots in the underlying core unmet needs and associated core feelings).

Examples of such ‘secondary distress’ / ‘surface feelings’, Timulak states, include :

  • feelings of helplessness
  • feelings of hopelessness
  • feelings of depression
  • feelings of anger
  • feelings of anxiety
  • somatisation (e.g. insomnia, physical tension, exhaustion, teeth grinding, stomach pains, chest pains, loss of appetite, headaches, dizziness etc.)

Conclusion :

It is important for patients and therapists to consider the possible core issues that may lie beneath adverse surface feelings (secondary distress). Often, these core issues will have their roots in childhood trauma.

eBook :

childhood trauma and depression

Above eBook now available for immediate download from Amazon. Click here for further details or to view other titles.

 

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

 


Factors That Put The Child’s Mental Health At Risk

factors that put the child's mental health at risk

The Risk And Resilience Model :

According to the Risk And Resilience Model (Pearce , 1993) there exist three categories of factors that put the child’s mental health at risk. These are as follows :

  1. Factors relating to the child’s / young person’s environment
  2. Factors relating to the child’s / young person’s family
  3. Factors relating to the child / young person himself / herself

child mental health risk factors

The List Of Risk Factors (Split Into The Three Categories Given Above) :

Let’s look at each of these three categories of factors in turn :

  1. Factors relating to the child’s / young person’s environment :

These include the following :

  • living in a violent community
  • socioeconomic deprivation
  • living in an environment in which one is discriminated against
  • homelessness
  • living in the environment as a refugee or asylum seeker
  • disaster
  • other significant, adverse life event

 2. Factors relating to the child’s / young person’s family :

    3. Factors relating to the child / young person himself / herself :

  • low I.Q. / learning difficulties
  • genetic influences
  • temperamental difficulties
  • communication difficulties
  • specific developmental delay
  • chronic physical illness
  • gender identity conflict
  • low self-esteem
  • academic failure
  • poor school attendance
  • neurological disorder

Resilience : Factors That Help To Protect A Child / Young Person From Becoming Mentally Ill :

Pearce’s model also includes factors that help to protect a child / young person from becoming mentally ill which he refers to as RESILIENCE FACTORS ; I list these below :

  • social skills
  • self-esteem
  • familial compassion and warmth
  • a stable family environment
  • a skill or talent
  • a social support system that encourages personal development and coping skills

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

 


Antidepressants : Are Those Who Experienced Early Life Trauma Less Responsive To Them?

MDD, early life-trauma and antidepressants

Antidepressants And Childhood Trauma :

As part of the international Study to Predict Optimized Treatment for Depression (iSPOT-D) involving over one thousand individuals who had been diagnosed with major depressive disorder (MDD). research was undertaken to compare the prevalence of histories of early childhood trauma in this group with the same prevalence in  a group of ‘healthy’ controls (this latter group was comprised of 336 matched individuals).

antidepressants and childhood trauma

Results :

Depressed individuals more likely to have suffered early-life stress (see below)

When the two groups were compared, it was found that :

  • In the group of individuals who had been diagnosed with major depressive disorder (MDD), 62.5% had suffered more than two traumatic events before the age of 18.
  • In the group of ‘healthy’ individuals, 28.4% had suffered more than two traumatic events before the age of 18.

(The number of traumatic events each individual was determined to have suffered before the age of 18 was defined with reference to Early-Life Stress Questionnaire.)

Another part of the study examined how the individuals suffering from major depressive disorder (MDD) responded to antidepressant treatment (the treatment period was eight weeks and individuals were treated with one of three antidepressants : escitalopram, sertraline or venlafaxine).

Results :

It was found that individuals who had histories of abuse (physical, sexual or emotional), particularly if this abuse occurred before the age of 7 years, had an impaired response to all three (see above) antidepressants used in the study.

Those individuals who had suffered abuse (physical, sexual or emotional) between the ages of 4 years and 7 years and were treated with sertraline (see above) had the poorest of all response to the treatment.

Conclusion :

This study suggests that individuals who have suffered significant levels of early-life stress may be less likely to respond positively to treatment with antidepressants than those who have not. However, further research is necessary to cast more light upon this apparently inverted relationship between the two variables.

eBook :

childhood trauma and depression

Above eBook now available for instant download from Amazon. Click here for further details.

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

NB :  The above is for information only. Always consult an appropriately qualified professional when making decisions relating to medication.

 


Deep Feelings Of Shame Resulting From Emotionally Impoverished Relationships With Parents

shame due to dysregulating oyjers

According to DeYoung, author of the excellent book : ‘Understanding and Treating Chronic Shame : A Relational / Neurobiological Approach‘, the experience of shame comes about as a result of dysfunctional relationships with other people (in particular, of course, with our parents when we are growing up) who are of emotional importance to us as opposed to affecting us as isolated, independent individuals. Because of this, DeYoung describes the experience of shame as being RELATIONAL (i.e. linked to the quality of our relationships with others who are important to us).

More specifically, DeYoung proposes that we can develop a deep and pervasive sense of shame in early life when ‘we experience our felt sense of self disintegrating in relation to a dysregulating other.’

What Is Meant By A Dysregulating Other?

According to DeYoung, a ‘dysregulating other’ is :

‘A person who fails to provide an emotional connection, responsiveness and understanding of what another needs in order to be in order to be well and whole.’

And, of course, if this ‘dysregulating other’ is a parent when we are very young and that parent behaves in a chronic and consistently ‘dysregulating’ way towards us, then we are especially likely to grow up into adults with a deep, pervasive and abiding sense of shame.

DeYoung also states that a dysregulating other (who, as already stated, is important to us, especially a parent) is someone we ‘want to trust‘ and, indeed, ‘should be able to trust‘, but, when we turn to that person because we are in emotional distress and need to be comforted and soothed, the way the dysregulating other responds to us / fails to respond to us leaves us feeling WORSE STILL. This is because the dysregulating other is emotionally misattuned to / disconnected from us ; the relationship is emotionally impoverished.

cause of shame

In turn, this, according to  DeYoung, can lead to us developing ‘core feelings of shame‘ as we conclude, ‘consciously or unconsciously, that there is something wrong with our neediness and that we are somehow ‘bad’ because of the painful and troubling nature of our ongoing interactions (or lack thereof) with this dysregulating other.

However, we may not be consciously aware (see above) of the fact that such feelings of shame are directly attributable to our early relationships with our parents / important others and may, therefore, erroneously attribute these profound feelings of  shame to factors that, in truth, are NOT their primary source of origin (such as our physical appearance, sexuality, perceived lack of intelligence /abilities, social status or a vast array of other factors).

What Is Meant By A Sense Of Self Disintegration?

DeYoung states that such emotionally impoverished interactions with parents / important others, when sustained and chronic, make us feel that our sense of self is disintegrating. 

This sense of disintegration can include feeling of our ‘self’ being  ‘shattered,’ ‘incoherent’ ‘blank’, ‘fragmented‘, and, furthermore, can make us vulnerable to feelings of deep humiliation (even in response to small, objectively trivial events), under threat of ‘psychological annihilation’ or induce strong desires in us, metaphorically, to be ‘swallowed up by the ground’ or ‘disappear.’

In order to emphasize just how powerful the effects of shame can be, DeYoung offers the extreme example of the Japanese suicide ritual of hari-kiri which used to be carried out by warriors who had been ‘disgraced.’

RESOURCES :

  • DeYoung’s Book / eBook (Click on book’s title below) :

Understanding and Treating Chronic Shame: A Relational/Neurobiological Approach

 

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

 

 


What Is ‘The Trauma Model’ Of Mental Disorders?

trauma model of mental disorders

The Trauma Model Of Mental Disorders :

According to the trauma model of mental disorders (also sometimes referred to as the trauma model of psychopathology), many professionals involved with the treatment of psychiatric disorders (such as psychiatrists) have been excessively preoccupied by the medical model of mental disorders (the medical model stresses the importance of physical factors that may underlie mental disorders such as a person’s genes and/or neurochemistry ; in line with this hypothesis, those who adhere to the medical model of mental disorders focus primarily on psychoactive medication – such as anti-depressants and major tranquilizers – or physical therapies – such as electro-convulsive therapy – as primary treatment choices) at the expense of taking into account the individual’s history of traumatic experience, especially severe and protracted trauma in early childhood.

According to the trauma model, too, significant problems relating to bonding and to the building a healthy, loving, nurturing, dependable relationship between the child and primary caregiver (most frequently the mother) are particularly predictive of such a child developing serious mental health difficulties in later life. However, childhood trauma leading to psychiatric problems in later can also take the form of physical, sexual and emotional abuse (the potentially catastrophic effects of significant and protracted emotional abuse have only recently started to be fully understood).

Significant Psychologists / Psychiatrists Who Have Adopted A Trauma Model Perspective Of Mental Disorders (Past And Present) :

Past psychologists / psychiatrists who have adhered to the trauma model of mental disorders include Arieti, Freud, Lidz, Bowlby, R.D. Laing and Colin Ross (see below for further, brief details) :

 

  • Arieti (1914-1981) advocated the treatment of those suffering from schizophrenia using psychotherapy
  • Freud’s (1856-1939) enormously influential work can be seen as representing the start of the academic discipline of child psychology and compelled society to acknowledge the profound relationship between a person’s childhood experiences and his/her mental health in later life.
  • Lidz (1910-2001) emphasized the severe psychological damage parents who ‘constantly undermine the child’s conception of himself’ do to their off-spring; he considered such treatment of the child by the parents as so serious because such psychological abuse can constitute a sustained and catastrophic attack on his (the child’s) ‘inner self’, which, in turn, so Lintz proposed, could lead to the disintegration of the child’s personality and the subsequent development of schizophrenia.
  • Bowlby (1907-1990) theorized that when the primary carer fails to healthily, emotionally bond (or, in Bowlby’s terminology attach‘) with the baby / young child the latter is put at high risk of developing mental health problems in later life.
  • R.D. Laing (1927-1989) proposed that schizophrenia is the result of the individual who develops it having grown up in a severely dysfunctional family.
  • Colin Ross (contemporary  psychiatrist) the most recent, significant proponent of the trauma model, emphasizes the harm done by abusive parenting by drawing attention to the fact the perpetrators of the abuse are the very people to whom the ‘child had to attach for survival.’ And he also states : ‘the basic conflict, the deepest pain, and the deepest source of symptoms is the fact that mom and dad’s behavior hurts, did not fit together, and did not make sense.’

eBook :

 

effects of childhood trauma ebook

Above eBook, The Devastating Effects Of Childhood Trauma, now available on Amazon for instant download. Click here for further information.

David Hosier BSc ; MSc; PGDE(FAHE)

 

 


Psychotic Depression, Schizophrenia And Childhood Trauma Sub-Types

childhood trauma, schizophrenia and psychotic depression

Sub-Types Of Childhood Trauma :

As we have seen from other articles I have published on this site, childhood trauma can be split into 4 main sub-types : emotional abuse, sexual abuse, physical abuse and neglect.

In this article, I briefly describe some of the main research findings in regard to the association between childhood trauma and risk of suffering from psychosis as an adult.

More specifically, I will examine which specific sub-types of childhood trauma may particularly increase an individual’s risk of developing psychosis as an adult, and if specific sub-types of childhood trauma are linked to increased risk of developing specific types of psychotic disorder as an adult and, if so, which specific types of psychotic disorder.

Study That Suggests Link Between Childhood Trauma And The Later Development Of Psychotic Depression :

A study carried out by Read et al. found that those individuals who had suffered from childhood trauma were more likely to have suffered from psychotic depression as adults. (Psychotic depression is similar to ‘ordinary’ major depression only there are additional symptoms of a psychotic nature – delusions, hallucinations and psychomotor agitation or psychomotor retardation).

More specifically, those who had experienced physical abuse or sexual abuse were found to have been particularly likely to have developed a psychotic depression later in life. (Of those in the study who had suffered from psychotic depression as adults, 59% had suffered physical abuse as children and 63% had suffered sexual abuse.)

childhood trauma, schizophrenia, psychotic depression

Studies That Suggests Link Between Childhood Trauma And The Later Development Of Schizophrenia :

A study (Compton et al) found that of those who had been sexually abused as children and of those who had been physically abused as children, 50% and 61% respectively developed schizophrenia-spectrum disorders later in life.

Another study (Rubins et al) found evidence suggesting that whilst sexual abuse in childhood is associated with the later development of depression and schizophrenia, physical abuse during childhood is associated with the later development of schizophrenia’ alone.

Finally, a study by Spence et al found that both physical and sexual abuse were associated with the later development of schizophrenia and, of these two associations, the association between physical abuse and the later development of schizophrenia was the strongest.

Type Of Psychotic Symptoms :

Studies (e.g. Read, 2008) that have focused on the specific psychotic symptoms suffered by those who develop a psychotic illness AND have a history of childhood trauma have found that the most common are AUDITORY HALLUCINATIONS and PARANOIA.

David Hosier BSc Hons; MSC; PGDE(FAHE)

 


Possible Long-Term Effects Of Highly Stressed Mothers On Infants

possible effects of stressed mothers on infants

Mothers who are suffering severe and protracted stress (e.g. due to an anxiety disorder) for a significant period of time whilst bringing up their infants are likely to be less attentive to their off-spring than are mothers who are mentally healthy.

In such a deprived environment, the part of the infant’s neuroendocrine system known as the HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS is likely to be repeatedly activated during this critical part of his/her development due to a variety of stressors (e.g. by sensing the mother’s anxiety, not being sufficiently soothed when in distress etc).

WHAT IS THE HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS?

The HYPOTHALAMIC-PITUITARY-ADRENAL (HPA)  AXIS is a major part of the neuroendocrine system that controls the infant’s stress response. The repeated activation the HPA axis undergoes over time, due to the stressed mother’s inattentiveness (this is not to say, of course, all stressed mothers are inattentive ; it only applies to mothers who are so severely stressed that it significantly impairs their maternal functioning), has the effect of signalling to the infant that s/he is growing up in a dangerous environment.

Under such conditions, the HPA axis can become highly sensitized to both real and perceived threats. In other words, the infant’s fear response becomes very easily triggered due to the HPA axis becoming oversensitive / over-reactive.

Whilst this exaggerated fear response acquired during infancy would have been of evolutionary adaptive value to the future lives (i.e. childhood and adulthood) of our ancestors living in physically dangerous environments, it has no such adaptive value as far as the modern-day infant’s future life is concerned ; indeed, it can lead to serious problems as we shall see below.

HPA axis

ABOVE : The components of the HPA axis : the hypothalamus, the pituitary gland and the adrenal cortex ; their interaction controls the fear-response.

WHAT ARE THE POSSIBLE ADVERSE EFFECTS OF HAVING AN OVER-SENSITIVE HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS?

Having an HPA axis that is, in effect, constantly on red-alert, may have myriad adverse, long-term effects. These include :

  • A damaged immune system (leading to an increase in the likelihood of suffering from a variety of diseases, including cancer).
  • Impairment to cognitive functioning (e.g. loss of neurons in the hippocampus (a region of the brain involved with memory function)
  • Increased likelihood of psychiatric conditions (e.g. anxiety and depression)
  • Perceiving danger to exist where, objectively, it does not / over-estimating risks/dangers
  • Less ‘mental energy’ (being constantly fearful and anxious is debilitating, demoralizing and enervating) for positive activities (e.g. play, creativity and building healthy relationships)

Important note : Although the damage done to the infant happens very early in life, many of the problems that such damage results in may not become apparent until very much later in, and, without effective therapeutic intervention, may even persist throughout the lifetime.

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


Techniques (Evidence-Based) For Reducing Negative Thoughts.

evidence based techniques to reduce negative thoughts

We have seen that if we suffered significant, recurring trauma as children, we are put at increased risk of developing depression as adults (see the DEPRESSION AND ANXIETY section of this site which contains many articles about the link between childhood trauma and depression). One of the hallmarks of depression is, of course, NEGATIVE THINKING.

Fortunately, however, much scientific research has been conducted into techniques those suffering from depression can employ in order to reduce their tendency constantly to think in negative ways ; I briefly describe several of the most effective of these techniques below :

1) LEARNED OPTIMISM :

The psychologist, Seligman, has developed a method by which people who are pessimistic and prone to negative thinking can train themselves mentally to respond to adverse events in ways that are less negative and more optimistic by challenging their initial pessimistic responses.

Seligman developed his idea of how optimism may be learned whilst he was studying a phenomenon known as LEARNED HELPLESSNESS (you can read my article Trauma, Depression And Learned Helplessness’  by clicking here); he reasoned that if people, through conditioning, can ‘learn’ to be helpless they may, too, be able to learn a more positive attitude to life and its vicissitudes.

There exists research to support Seligman’s theory. For example, the findings of a scientific study (Buchanan) conducted at the University of Pennsylvania strongly suggested that individuals with a tendency towards pessimism can be made significantly less vulnerable to depression and anxiety by being taught Seligman’s learned optimism techniques.

HOWEVER, there is a balance to be struck here as constantly striving to be positive and ‘upbeat’ at all times is likely to backfire – it is, I think we can all safely agree, axiomatic that one cannot go through life without encountering distress (some of us more than others, of course). Even so, we can make distress less painful to endure by learning techniques in DISTRESS TOLERANCE you can read my article about this by clicking here.

(Interestingly, trying to relax can backfire, too – you can read about why this is in my article : Does Trying To Relax  Paradoxically Increase Your Anxiety?  by clicking here).

 

2) COGNITIVE BEHAVIORAL THERAPY (CBT) :

This can help us challenge our negative thoughts and correct irrational, faulty thinking styles associated with negative thinking (you can read two my articles relevant to this by clicking below):

 Cognitive Behavioral Therapy : Challenging Negative Thoughts

or

Cognitive Behavioral Therapy For Childhood Trauma

 

3) DEFENSIVE PESSIMISM : 

Despite the finding that learned optimism can be helpful in reducing depression it may, too, be paradoxically the case that a tendency towards pessimism, in certain situations, can sometimes be, as it were, strategically exploited.

This can be achieved by considering the worst possible outcome of an event in order to put things in perspective (the caveat being that it is necessary to put an action plan into operation to ensure the worst possible outcome does not come to fruition!).

 

MINDFULNESS :

This involves allowing negative thoughts to pass through the mind whilst NOT emotionally engaging with these thoughts or judging them – a simile that is sometimes used is that one should just observe, in a detached manner, these thoughts running through our heads with the same tranquility we would feel were we to be watching leaves on the surface of a river gently flow past us. You can read more about mindfulness in the HYPNOSIS AND MINDFULNESS section of this site.

 

THE ADVERSITY HYPOTHESIS :

It is important to remember that even very distressing experiences can improve us as a person (e.g. by providing us with a better perspective on life, making us realize what’s important in life, helping us to get our priorities straight, increasing the empathy we feel with others who have suffered in a similar way to ourselves, and toughening us up mentally.

An article of mine you may wish to read relating to this is :

 

RESOURCE :

Information about online therapy – click here.

 

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

 

 


Do Only Good People Get Depressed?

do only good people get depressed?

If, when we are growing up, our parent/s make us feel constantly inadequate and that we were never ‘good enough’ due to their constant criticisms and general, perpetual air of  disapproval, we are put at risk of developing a serious depressive illness later on in life which produces feelings in us which echo what we were made to feel in childhood – that we are somehow deficient, unacceptable and, in short, not good enough.

However, Dorothy Rowe, a world renowned clinical psychologist and author, has, in fact, stated that it is her belief that only good people get depressed. After all, if an individual were a very bad, wholly amoral person without a conscience, s/he would hardly be concerned about not being good, let alone about not being good enough; such an individual couldn’t care less. In other words, only essentially good people worry about the possibility that they are not good enough. And, as, according to Rowe, a sense of ‘not being good enough’ lies at the heart of depression, it follows, as Rowe sees it, that it is only good people get depressed.

As well as good people being more prone to guilt, self-blame and self-hatred for (in their minds) ‘not being good enough’, Rowe also suggests that those who believe the world is ‘fundamentally just’ are also at greater risk of suffering from depression.

This is because their ‘just world’ belief entails the (erroneous) idea that ‘the good will always be rewarded and the bad will always be punished.’

Therefore, when something (randomly) happens to such people that is bad (like contracting an illness), then, based on their erroneous ‘just world’ theory, they may make the irrational inference that they somehow ‘deserve’ to be ill and are ‘being punished.’ And it is this mistaken view that adds another (unnecessary) layer of suffering which, in turn, makes it more likely that they will succumb to depression.

eBook :  Childhood Trauma And Its Link To Depression And Anxiety :

Above eBook available from Amazon, click here for further information.

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


Effects Of Divorce On Children Under Five

effects of divorce on children

 

What Are The Effects Of Divorce On Children Under Five?

I have already written more generally about the effect of divorce on children elsewhere on this site (click here to read one of my related articles). However, this article considers the effect on children who are particularly young (under the age of five years) with specific reference on how it affects the security of their relationships with their parents once they themselves become adults.

A study conducted by Fraley and Heffernan (2013) examined the injurious psychological and emotional effects of parental divorce on very young children in comparison with those sustained by children who were older when their parents divorced.

In essence, it was found that if parents divorce when the child was very young (defined as being 0 to 3-5 years of age) then, once the child becomes an adult, s/he is likely to have a more difficult (specifically, more insecure and less trusting) with his/her parents than those adult individuals whose parents divorced when they were older.
Adverse Effect On Relationship With Father Compared To Adverse Effect On Relationship With Father :
The study also found that parental divorce tends to effect the individual’s relationship with his/her father more negatively than his/her relationship with his/her mother (again, in terms of feelings of trust and security).
It was hypothesized that this finding may be accounted for by the fact that the mother, in most cases, retains custody of the child which tends to mean that there is less damage done to the level of security a child feels with his/her mother compared to that which s/he feels with his/her mother.
Indeed, a further study by the same pair of researchers seemed to bear this hypothesis out as it was found that :
  • if the mother was awarded custody of the child, the child was more likely to have a damaged relationship (in terms of feelings of security) with his/her father
  • however, if the father was awarded custody, the child’s relationship with the father (in terms of security) was relatively less damaged.

Effect On Adult, Romantic Relationships :

The study also found (though the evidence here was rather more tenuous in statistical terms) that those individuals whose parents divorced during his/her childhood were at more likely (though certainly not guaranteed) to be adversely affected by anxiety in connection with adult, romantic relationships in later life.

Resource :

 

eBook :
depression and anxiety

Childhood Trauma And Its Link To Depression And Anxiety, by David Hosier MSc.

Click on image above for further details.
David Hosier BSc Hons; MSc; PGDE(FAHE).