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)

 

 

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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)

 

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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).

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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 :

STOP NEGATIVE THINKING – SELF HYPNOSIS DOWNLOAD

 

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

 

 

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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).

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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).
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Health Anxiety : Its Link To Childhood Trauma

health anxiety

We have already seen that, all else being equal, an individual who suffers significant childhood trauma is at greater risk than average of developing an anxiety disorder in adulthood. In this article, I will look specifically at health anxiety and what types of childhood experiences may put individuals at increased likelihood of developing it. With regard to this, the first question to answer, of course, is :

What Is Health Anxiety?

Health anxiety used to be referred to as hypochondria; however, this term is becoming increasingly obsolete due to its somewhat pejorative connotations. For a person to be diagnosed with health anxiety (and such a diagnosis, of course, can only be carried out by an appropriately qualified professional) s/he generally has to be preoccupied with thoughts centering around illness (i.e. a belief s/he is ill or an overwhelming conviction that s/he will imminently become ill) despite reliable, medical reassurances that this is not the case.

Furthermore, this preoccupation causes the individual significant distress and impairs normal, day-to-day functioning.

What Childhood Experiences Make It More Likely That An Individual Will Develop Health Anxiety?

First, individuals who suffered a serious illness as a child and were traumatized by the experience are at increased risk of developing health anxiety in adulthood.

Second, those who, in childhood, had a primary-carer who was excessively anxious about their health, or more generally overprotective, are at increased risk of developing health anxiety in adulthood.

Third, those who, in childhood, experienced a close family member (such as sibling, mother or father) being seriously ill are at increased risk of going on to develop health anxiety.

Fourth, people who, as children, had parents who excessively shielded them from the reality of health problems (e.g. parents who never talked about their own illnesses or the illnesses / deaths of other family members, including never allowing the child to attend funerals) are more likely to go on to develop health anxiety

Finally, growing up with parents who, to an excessive degree, feel the need to continually (and with excessive frequency) emphasize the vital and crucial importance in life of having one’s health.

Other Factors That Can Contribute To The Development Of Health Anxiety:

Childhood experience is not the only factor connected to the development of health anxiety in later life ; other factors that may contribute or be involved include :

1) Personality traits (characteristics) : e.g. a proneness to worry or intolerance of uncertainty

2) Chemicals in the brain (especially low serotonin activity)

3) Abnormal brain processes associated with low serotonin activity leading to excessive rumination (over-thinking)

health anxiety

 

Above : examples of the excessive ruminations that a person with health anxiety may have.

4) Genetic predisposition : it is possible some people may genetically inherit a tendency towards obsessive-like thinking.

Therapies :

Therapies available for the treatment of health anxiety include cognitive behavioral therapy (CBT) and trauma-focused therapy (CFT). However, sometimes (depending upon the individual’s particular constellation of psychological problems) other forms of psychotherapy may be more appropriate.

Also, because it is thought that serotonin-level abnormalities may sometimes be involved with health anxiety, antidepressants are sometimes prescribed for its treatment (under the guidance, of course, of an appropriately qualified professional).

RESOURCE :

Overcome Fear Of Illness (downloadable self-hypnosis MP3 or CD).

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

 

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Fear Of Success Stemming From Having Envious Parents

fear of success

 

 

When I was sixteen and received my O-level (the formal exams most school children took at this age in the UK in the 1980s) results (which were good though by no means outstanding) I remember informing my mother of my these results, possibly with some trepidatious excitement and an uncertain, tentative sense of pride, only to meet with a stony-faced, tight-lipped response and the single, indifferent, bored, monosyllabic utterance : ‘Oh?’

There was no ‘congratulations’ card. No suggestion of celebrating with a meal. A small spongecake, perhaps? Out of the question. Perhaps partially as a result of this and not altogether dissimilar experiences, when I gained my bachelor’s and master’s degrees, I attended neither graduation ceremony. But why do I suggest the two things may be linked?

THE POSSIBLE EFFECTS OF THE ENVIOUS PARENT – FEAR OF SUCCESS :

An envious parent resents his/her child’s successes, achievements and accomplishments and may even feel disdain for this child’s expressions of pride; this envy may be unconscious and the parent may rationalize it by telling him/herself that s/he does not encourage the child’s feelings of mastery in order to prevent him/her from becoming arrogant or conceited. S/he may express this envy through overt and withering comments such as : ‘Oh, you think you’re such a big shot!’, or in more subtle ways such as making a point of not sharing in the child’s joy when s/he is successful.

The underlying cause of such envy is usually the parent’s own sense of inadequacy and failure together with a narcissistic resentment of having the limelight shifted away from him/her in favour of the child.

Also, if the parent is possessive, s/he may view the child’s successes as steps towards independence and and freedom from dependency which instils in the parent feelings of anxiety in relation to being no longer needed and, potentially, abandoned.

Indeed, the relationship between parent and child may be enmeshed whereby the parent is unable to distinguish the child’s individual and separate needs from his/her (the parent’s) own and therefore feels bitter about the child having successes of which s/he (the parent) has been deprived.

Such negative reactions by the parent in response to the child’s successes can have an insidious and cumulative effect culminating in the child coming to fear success. Similarly, the child may come to feel embarrassed by even small successes and desperately try to play them down (not to be confused with false modesty which is something different, of course) or, when s/he achieves success, feel strongly that s/he does not deserve it or that absolutely anyone could easily have accomplished the same.

In the individual’s mind, success has become strongly associated with rejection and, thus, must be avoided at all costs, lest it lead to shame and confusion.

fear of success

COGNITIONS ASSOCIATED WITH FEAR OF SUCCESS :

We may rationalize our deep-rooted fear of success in various ways. A study conducted by Deeter-Schmelz and Ramsey (2001) found that those who feared success tended to have thoughts such as :

  • once at the top there follows a desperate struggle to maintain your position
  • others see successful people as aloof and arrogant
  • people who become successful change for the worse
  • the cost of success outweighs its rewards

Whereas those NOT afraid of success tend to have thoughts such as :

  • others look up to you when you’re at the top
  • achievement commands respect
  • success opens up many new doors

IMPOSTOR SYNDROME :

Linked to fear of successes, there is also a phenomenon known as IMPOSTOR SYNDROME, first described by Clance and Imes (1978) .  This occurs when we achieve some success but feel we don’t deserve it; therefore, we feel like a fraud or impostor – as if we shouldn’t inhabit the position we do.

Those who experience impostor syndrome tend to have thoughts such as:

  • my success is mainly due to luck
  • talking about my success makes me feel silly and embarrasses me
  • when I compare myself to others with similar achievements, I feel they deserve theirs but I don’t
  • I worry people will soon see through me and I’ll be exposed as the idiot I truly am
  • when people praise me, I feel like I’m being given something I have not earned and it makes me feel extremely uncomfortable
  • in the scheme of things, my so-called achievements mean nothing
  • my success will come to an abrupt end anytime now

When the fear of success reaches phobic proportions, positive visualization exercises, hypnotherapy, or a combination of the two can prove effective.

Resources :

Self-hypnosis MP3/CD : Overcome Fear Of Success – click here for details.

 

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

 

 

 

 

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Childhood Trauma, Obsessions, Compulsions And Rituals

childhood trauma and obsessive compulsive disorder

 

 

Research conducted by Mathews, Kaur and Stein at the University of California examined the association between childhood trauma and the development of symptoms of obsessive-compulsive disorder (OCD) symptoms.

It was found that those individuals who had experienced emotional abuse or physical abuse in childhood were significantly more likely than those who had not to suffer from symptoms of obsessive-compulsive disorder (OCD).

In this article, I will briefly describe the most common obsessions / compulsions / rituals from which individuals with OCD or OCD-like symptoms suffer.

Most Common Obsessions / Compulsions / Rituals :

These are as follows :

Let’s briefly look at each of these in turn :

1) FEAR OF ‘CONTAMINATION’ –  the individual who suffers from this is excessively concerned about germs, bacteria and anything that might harbour these such as other people, door handles, household surfaces, bathrooms, light switches etc.

For example, someone who is severely affected may feel compelled to wash their hands dozens, or even hundreds, of times a day to (very temporarily) ease their anxiety, or only use a door handle if their hand is protected by a glove / handkerchief / tissue etc.

2) EXCESSIVE CHECKING – a person who suffers from this feels driven to excessively check such things as that the door has been locked, the gas cooker has been switched off, the windows have been shut and locked etc.

For example, someone suffering from this type of OCD may check s/he has locked the front door behind him/her, get into his/her car and start to drive to work only to become anxious s/he didn’t ‘properly’  check the door was locked to the extent that after five minutes of driving s/he turns the car around and goes home to recheck that the door actually is locked. Having done this, s/he may restart the drive only to turn the car around again after a few minutes to make absolutely sure the front door is locked. S/he may repeat this scenario numerous times before s/he has reduced his/her anxiety enough to finally make it into work.

3) INTRUSIVE, DISTURBING, UNCONTROLLABLE THOUGHTS  – someone who suffers from this finds s/he is ‘mentally bombarded’ by unwanted, distressing, disturbing and upsetting thoughts that s/he feels s/he cannot control.

For example, s/he may fear s/he will seriously hurt someone, even his/her own children, commit some unspeakable crime, or act on inappropriate sexual impulses (even though s/he has never acted on such thoughts and abhors any prospect of doing so).

Indeed, there was a famous example of a man who chained himself to the bed every night as he feared that, otherwise, he might rise in his sleep ( this is sometimes referred to as somnambulism), commit some appalling crime in his unconscious state and, as a consequence, spend the rest of his life in jail.

4) EXCESSIVE HOARDING – an individual with this disorder can’t bring him/herself to throw away / obsessively collects useless or broken material and objects often to the point that his/her living environment becomes cluttered to a degree that is both unsafe and unhygienic (see image below).

childhood trauma, obsessions, compulsions, rituals

Above : an example of the results of obsessive hoarding.

5) EXCESSIVE CONCERN WITH ‘ORDERING’ AND SYMMETRY – someone suffering this disorder feels strongly compelled to arrange things (such as household objects and contents of fridges/cupboards) with painstaking, meticulous, absolute precision.

Another well known way in which this disorder manifests itself is aa a compulsion to precisely line up items (such as knives, plates, bowls and forks etc) at one’s table in restaurants ; Oscar Wilde developed this compulsion in Paris following his release from Reading Gaol and subsequent flight from England (see photo and caption below).

childhood trauma, obsessions, compulsions and rituals

Above : Oscar Wilde (left) and Lord Alfred (Bosie) Douglas. At the time this picture was taken Wilde suffered a compulsion to ‘precisely order’ the items on his table following his harrowing two years in Reading Gaol and being forced there to set his table for meals with ‘military’ precision. Circa 1899.

 

To read my article entitled :Childhood Trauma, Obsessive-Compulsive Disorder And Treatment’ click here.

 

Or to read my article providing more information about childhood trauma and its link to obsessive compulsive disorder in general click here.

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

 

 

 

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Does Trying To Relax Paradoxically Increase Your Anxiety?

Paradoxically, trying to relax can actually make some people feel more anxious and stressed, not less.

Indeed, when I was extremely ill and in hospital (I was hospitalized on several occasions due to the seriousness of my condition), I was encouraged to attend certain therapeutic classes (which, because I was almost catatonic with severe clinical depression and anxiety, I most resolutely did not want to do –  amongst other myriad other symptoms, I had no motivation whatsoever, together with an unshakable belief that there was no possibility at all of me getting even very slightly better (such thinking is almost universal amongst the seriously, clinically depressed).

However, I eventually agreed to attend a class in which the therapist tried to guide me (and the other patients who had attended) through a relaxation exercise. Just a minute or so into the exercises, I felt so overwhelmed by anxiety that I had to excuse myself and leave the room, seeking, instead, refuge in the smoking room where I chain-smoked innumerable cigarettes.

In fact, this such a paradoxical reaction to an attempt to relax is not especially rare – a small percentage of those with anxiety will react in a similar manner.

So, what is the cause of this paradoxical response? Several ideas have been proposed, and I briefly look at some of these below:

POSSIBLE CAUSES OF A PARADOXICAL RESPONSE TO ATTEMPTS TO RELAX :

  • Trying to relax and ‘let go’ of stressful mental activity can induce in some individuals a feeling of loss of control. Related to this is the phenomenon whereby some people feel that, if they stop worrying about things, something terrible will happen and that their constant worrying is therefore somehow ‘protective’. Psychologists sometimes refer to such mistaken belief systems ‘magical thinking’.
  • Fear of loss of identity – for some, being stressed (eg always busy, ‘driven’, ”keyed-up’ etc) forms part of their identity and they feel uncomfortable relinquishing this identity, fearing that if they do so others may see them as complacent, indolent etc rather than as the ‘dynamic’ individual they hope others perceive.
  • Brain wave activity – becoming relaxed correlates with a shift in brainwave activity from beta-waves to alpha-waves which may cause thinking to become cloudy, hazy and foggy; some individuals find this disconcerting.
  • Frustration – if we try to relax, and find we cannot immediately do so. this can lead to frustration which makes relaxation even more difficult; this can quickly develop into a vicious circle.
  • Fear – similarly to the above, we may fear we will not be able to relax (by thinking things like : ‘If I don’t relax soon, I’ll go completely and irreversibly insane’ – which was the kind of thing I used to think) thus putting too much pressure on ourselves. In this way, the fear that we will not be able to relax can rapidly become a self-fulfilling prophecy.
  • Depersonalization – relaxation techniques can lead to feelings of ‘depersonalization’ in some people. Depersonalization can manifest itself as feeling of being ‘detached from one’s body‘ or as being an ‘observer of oneself.’ Many find such a sensation unpleasant.
  • Derealization –derealization’ can manifest itself as a feeling that ‘the world is not real’ and more like a nebulous, hazy, dreamworld. Again, many find this unpleasant. (‘Dearealiztion’ is a type of ‘dissociation.‘)
  • Distraction – for some individuals, certain types of stress (such as always ‘keeping busy’) can operate as a distraction from problems and worries the person finds hard to face (in extreme cases, this may result in workaholism‘). In this way, the stress/’keeping busy’ works as a psychological defense mechanism – the sudden dropping of this defense may lead to the person becoming vulnerable to being overwhelmed by floods of previously suppressed anxiety.

In response to the problem of the possible paradoxical effect a small minority of individuals may suffer as a result of trying to relax, some hypnotherapists have been trained in technique of inducing what is referred to as an ALERT TRANCE which some may find to be helpful.

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Fighting Anxiety Can Worsen It’. Why Acceptance Works Better.’

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

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