Psychotic Depression, Schizophrenia And Childhood Trauma Subtypes

 

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 subtypes: 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 the 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.)

For NHS advice on the treatment of psychotic depression, click here.

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)

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

 

If we were significantly maltreated by our parent/s when we were children, we may well, as a psychological defence against the intolerable dilemma this put us in, have unconsciously developed a ‘love-hate’ relationship with them.

In such cases, feelings of love and hate for the parent are compartmentalised/separated because the state of mind required to both love and hate the parent simultaneously is an impossible, contradictory and paradoxical concept that the child does not have the emotional resources to materialise.

Therefore, to allow an emotional attachment with the parent develop that will allow his/her (i.e. the child’s) psychological survival, the child has no choice but to hold the feelings of love and hate for the parent in ‘separate mental compartments’). This leads the child to perceive his parents in terms of ‘black and white’ rather than in ‘shades of grey’. Indeed, this was a psychological defence I unconsciously developed as a result of my own childhood experiences, vacillating between idealizing my parents and demonising them. It is only now that I understand more completely why this occurred that I am able, I hope, to hold a somewhat more balanced view (although, admittedly, I still don’t always succeed in this; however, the psychological warfare, borne of profound, emotional conflict, that rages on is, these days, restricted to the confines of my still grievously injured, but recovering mind).

Anger Turned Inwards :

Often, the anger and hatred that the child feels towards the parent may, as another psychological defence, be turned INWARDS, leading to the child experiencing self-hatred and self-loathing; this defence mechanism occurs when the child perceives (on a conscious or unconscious level) that feelings and expressions of anger and hatred towards the parent would lead to him/her (i.e. the child) being put in danger (e.g. liable to incur severe psychological and/or physical damage). And, as Freud pointed out, anger turned inwards may lead to severe depression (as well as numerous other undesirable psychological conditions).

Goal Of Therapy :

According to this theory, in order to help the individual overcome his/her love-hate conflict, it is necessary for the therapist to help him/her to integrate the two ‘separate compartments’ of his/her mind (i.e. the ‘compartment’ that holds feelings of love for the parent needs to be combined with the ‘compartment’ that holds feelings of hatred for, and resentment of, the parent) so that s/he may start to see his/her parent, more realistically, in ‘shades of grey’ rather than in terms of either ‘black’ or ‘white'(See above). Individuals, too, are likely to require help with understanding how and why their negative feelings towards the parent have arisen and why such feelings may have been hitherto largely repressed/dissociated.

This is usually a long process and often does not occur until near the end of the course of therapy.

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

 

 

 

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

 

Dr Jekyll And Mr Hyde: Do BPD Sufferers Have A ‘Split Personality’?

 

Do BPD Sufferers Have A ‘Dr Jekyll And Mr Hyde’ Personality?

In terms of symptoms, there exists a clear overlap between the psychiatric conditions of borderline personality disorder (BPD) and dissociative identity disorder (DID). DID use to be referred to multiple-personality disorder.

Borderline Personality Disorder, Dissociative Identity Disorder And ‘Splitting’

‘Splitting’ is a psychological defence mechanism in which one ‘part’ of the personality becomes separated / un-integrated with / isolated from another ‘part’ of the personality. In the case of individuals suffering from BPD, these two parts can, in simple terms, be described as PART ONE and PART TWO, where :

PART ONE represents the part of the person’s personality which is relatively accepting of him/herself and others

whereas :

PART TWO represents the part of the person’s personality which is full of self-hatred, as well as anger and hostility (and, underlying the latter two emotions, fear of being psychologically harmed) in relation to others.

When PART ONE is ‘operational’, it tends to enter a state of denial about the existence of PART TWO.

This may be because when PART ONE is ‘in charge’, the individual develops a state of mind similar to amnesia regarding the existence PART TWO; alternatively, the denial may be underpinned by feelings of profound shame. However, more research needs to be conducted in relation to these possibilities.

‘Splitting’ and amnesia (when one part of the personality is unaware of how another part of the personality has manifested itself) are also symptoms of dissociative identity disorder.

Borderline Personality Disorder And ‘Switching’ Between ‘Part One’ And ‘Part Two’

As stated above, ‘PART ONE’ and ‘PART TWO’ have become un-integrated in the personality of individuals suffering from BPD (the BPD sufferers personality, in this respect, may be described as having ‘disintegrated’). A more formal way to put this would be to describe the BPD sufferer as having an un-integrated ego-state (in contrast to the relatively integrated ego-state that psychologically ‘healthy’ individuals enjoy).

Those with BPD ‘switch’ between ‘PART ONE’ and ‘PART TWO’ and this can occur quite suddenly (but is not usually dramatically instantaneous).

Furthermore, these un-integrated ego-states interfere with each other (because they are not completely separate from one another) and this may cause symptoms such as the following :

  • unstable mood / affect / emotions (sometimes referred to as emotional lability)
  • unstable sense of identity (some sufferers describe this with phrases such as: ‘I have no idea who I am…’).

How ‘Splitting’ Affects The BPD Sufferer’s Relationships With Others :

When ‘PART ONE’ is ‘in charge’, the BPD sufferer desires emotional attachments with others. However, when ‘PART TWO’ is dominant, s/he becomes hostile towards others and withdraws from them – this leads to the classic ‘love-hate’ scenario.

Why Does This Unintegrated Ego-State Arise In Those Suffering From BPD?

The two separate parts can develop in a person who has suffered severe and prolonged abuse as a child.

When the abused child becomes an adult, PART TWO (hostility etc) can be kept in abeyance for much of the time to allow daily social functioning. However, PART ONE makes itself apparent when the BPD sufferer is reminded of the abuse s/he suffered as a child (such a reminder is called a ‘trigger’).

This reminder/trigger may be detected by the BPD sufferer consciously or unconsciously and occurs as a defence mechanism against real or perceived psychological threat (especially the threat of betrayal, rejection or abandonment as occurred in the individual’s childhood).

If the individual had not developed this defence mechanism as a child, s/he faced what may reasonably be termed as ‘psychological destruction.’ In other words, the development of the ‘splitting’ defence mechanism makes complete evolutionary sense as it allowed the individual to survive childhood – it is a normal, predictable, adaptive response to childhood loss, fear, distress and betrayal.

There is an overlap between symptoms of borderline personality disorder and dissociative identity disorder in as far as they both involve ‘splitting’ and ‘dissociating’. However, in the case of DID, the separation between the different PARTS of personality are MORE DISTINCT AND CLEAR CUT THAN THEY ARE IN THE CASE BPD. Those suffering from DID may have more than two un-integrated / separate PARTS of their personality / ego-state; however, arguably, this can also be the case in those suffering from BPD (although this is beyond the scope of this article).

The Different Ways In Which Memory Operates In The Individual With BPD Compared To The Individual With D.I.D.

D.I.D can be viewed as a more serious form of BPD, especially in the way it affects memory. Although an individual with BPD shows dramatic swings in personality, the opposing personalities usually share one, intact memory. In the case of individuals with D.I.D, however, there are several distinct personalities or fragments of personality, each with a different (and incomplete) set of memories (e.g. when the person suffering from D.I.D is controlled by one particular personality state s/he is unable to recall that would be available to him/her in a different personality state. For example, when in a subdued, submissive and depressed personality state s/he may not be able to remember details of his/her life story that s/he is able to recall when in a hostile and angry personality state).

In conclusion, though, we can say, with some confidence, that BPD sufferers do have a ‘split personality’, but the division between these two parts is more nebulous and indistinct than in the case of DID sufferers.

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Does Your Personality Feel ‘Fragmented’?

Identity Disturbance And Borderline Personality Disorder (BPD)

Identity Problems And Their Link To Childhood Trauma

 

Childhood Trauma: Identity Problems and How to Tackle Them.

‘Splitting’ – What BPD Sufferers And 18 – 36 Month Old Infants Have In Common

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

Posttraumatic Growth : An Existential Perspective

 

 

Not only possible to recover from the adverse effects of trauma but even to go on to develop as an individual in response to them in ways that would not have been possible had the traumatic events not occurred.

The concept of posttraumatic growth is closely related to existential philosophy/psychology. Yalom (1980) asserts that the four fundamental existential concerns that mankind faces are :

DEATH

FREEDOM

ISOLATION

MEANINGLESSNESS

Whilst most people go through life without dwelling on these four existential concerns too deeply (distracted as they are by life’s more superficial and mundane problems), there are certain life events that can bring them sharply into focus, including what Yalom refers to as a ‘COLLAPSE IN MEANING-MAKING SCHEMAas may occur as a result of severely traumatic experiences. (The term schema refers to the mental models we construct that help us make sense of / interpret the world around us. 

 

Yahom suggests that when a person becomes aware of one (or more) of these existential concerns as a result of trauma, s/he will enter a state of anxiety (i’e’ s/he will experience as EXISTENTIAL CRISIS).

Crucially, however, Yahom states, how long this state of anxiety lasts, together with its intensity, determines whether or not the individual who experiences the existential crisis a result of his / her traumatic experiences enters :

A) A positive state of posttraumatic growth 

or

B) A negative state of psychopathology

If s/he is fortunate enough to enter a positive state of posttraumatic growth, the individual can experience a profound sense of renewed meaning in life.

In relation to existential concerns, this may involve a far deeper appreciation of life given a more vivid awareness of one’s mortality and how precarious human existence is (specifically, this is connected to the existential concerns of meaning and death).

Or, to provide another example, a person may realize, given life’s brevity and uncertainty, s/he should make the free choice to live life more authentically, perhaps involving a radical change of career, lifestyle and social acquaintances (specifically, this is connected to the existential concerns of death and what to do with one’s freedom of choice).

A third example would be that of a person who finds a new, meaningful cause, related to the traumatic experience s/he suffered, to work for in life, such as a person who survived a highly disturbed childhood deciding to undertake to help disturbed children as his/her vocation (specifically, this is connected to the existential concern of finding meaning in life, and, thus, overcoming an existing, perceived state of meaninglessness).

 

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

 

 

Controlling Emotions : The Emotional Regulation System

 

If, as children, we experienced, significant and protracted trauma we are at increased risk of developing various psychological difficulties as adults, including an increased risk of developing borderline personality disorder (BPD) and complex posttraumatic stress disorder.

One of the hallmarks of BPD, as we have also seen from other articles, is that the sufferer of the condition finds it very difficult indeed to control intense and volatile emotions. In effect, the emotional regulation system of individuals diagnosed with BPD is out of kilter and dysfunctional.

What Is The Emotional Regulation System?

The emotional regulation system is fundamentally comprised of three interacting parts of the brain; these are as follows :

  1. THE THREAT SYSTEM (detects and reacts to threats)
  2. THE DRIVE SYSTEM (motivates us to identify and seek resources)
  3. THE SOOTHING SYSTEM  (helps balance the two systems above and engenders in us a sense of well-being, satisfaction and contentment)

Each of these three systems is neither good nor bad per se, as long as they are in balance and interacting healthily and functionally. However, each system is vulnerable to becoming dysfunctional (as occurs in the case of those suffering from BPD, for example).

THE ROLE OF NEUROPLASTICITY IN THE DEVELOPMENT OF THE EMOTIONAL REGULATION SYSTEM :

How the brain is shaped and develops depends, in no small degree, upon our early life experiences (e.g. Schore, 2003); this is because of the quality of the brain known as neuroplasticity.

Because of the brain’s neuroplasticity, if, when we are young, we are regularly exposed to fear and danger because, for example, of the abusive treatment we receive from a parent or primary caregiver, the THREAT SYSTEM is at very high risk of being constantly over-activated in a way that leads it to operate in a dysfunctional manner; this dysfunction takes the form of the ‘fight/flight/freeze; response becoming hypersensitive, resulting in the affected individual developing grave difficulties keeping related emotions (such as anger, fear and anxiety) in check. Without appropriate therapy, such dysfunction may last well into adulthood or even for an entire lifetime.

On the other hand, if, when we are young, we experience consistent and secure love, care and emotional warmth from our parents / primary caregivers, our SOOTHING SYSTEM is ‘nourished’ and becomes optimally (or close to optimally) developed resulting in us becoming more able to cope with life’s inevitable stressors, less vulnerable to feelings of anxiety and fear, and more able to calm ourselves down and ‘self-soothe’ than those who had who were brought up in an environment in which they were exposed continuously to fear and danger.

However, even if we have had a traumatic early life and have problems regulating our emotions, there are various, simple things we can do to us control our feelings (see below).

  • AVOID REACTING IMMEDIATELY / IMPULSIVELY: For example, if someone triggers our anger, rather than making a reflexive response (such as saying something we’ll deeply regret later) it is better to wait until the rage has subsided – this may involve calming physiological symptoms like fast heart rate and tense muscles by using relaxation exercises such as deep breathing and visualization; we may, therefore, need to remove ourselves for a while (if possible) from the presence of whoever it may be that has upset us.
  • MAKE POSITIVE ALTERATIONS TO THE SITUATION GIVING RISE TO OUR NEGATIVE EMOTIONS (although this will not always be feasible, of course)
  • ALTER FOCUS OF ATTENTION (e.g. undertaking a distracting activity)
  • ALTER WAY IN WHICH WE ARE THINKING ABOUT THE SITUATION: A therapy that can help with this is COGNITIVE BEHAVIORAL THERAPY (CBT).

USING NEUROPLASTICITY TO OUR ADVANTAGE :

Although the brain’s quality of neuroplasticity can work against us if we experience a traumatic early life, we can also take advantage of it later in life to help reverse any damage that was done to the development of our young and vulnerable brains. DIALECTICAL BEHAVIORAL THERAPY (DBT) :

Dialectical Behavior Therapy (DBT) is a therapy that was designed primarily for those who are suffering from borderline personality disorder (see above). A particularly useful skill taught within this therapy is called DISTRESS TOLERANCE which can be very helpful for those experiencing emotional distress due to intense, negative feelings.

However, a recent metanalysis (Harvey et al., 2019)  concludes that the effectiveness of DBT for helping with the control of emotions, over and above those of other standard treatments, should not at the time of writing be over-stated and that further research in relation to this is necessary.

COMPASSION FOCUSED THERAPY (CFT) :

Compassion Focused Therapy (CFT) can also be an effective therapy for those suffering from emotional dysregulation.

REFERENCE:

Harvey, L. et al. (2019). Dialectical Behaviour Therapy for Emotion Regulation Difficulties: A Systematic Review. Published online by Cambridge University Press: 26 April 2019

Schore, A. THE EFFECTS OF EARLY RELATIONAL TRAUMA
ON RIGHT BRAIN DEVELOPMENT, AFFECT REGULATION, AND INFANT MENTAL HEALTH INFANT MENTAL HEALTH JOURNAL, Vol. 22(1–2), 201–269 (2001)

 

RESOURCE :

CONTROL YOUR EMOTIONS – SELF HYPNOSIS DOWNLOADS

 

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

 

Childhood Psychological Trauma Can Lead To Brain Inflammation

 

It has recently been discovered that chronic, unpredictable, psychological stress in early life can lead to inflammation in the brain. This has come as something of a surprise to many researchers as it had previously been believed by most of those working in this recondite field of neurology that such inflammation of the brain had to have a physical (rather than psychological) cause such as a head injury or an infection.

According to McCarthy, an expert in this area of study, chronic and unpredictable stress in early life can cause particular brain cells (called microglia) to malfunction. This malfunctioning causes the microglia to produce neurochemicals that lead to neuroinflammation (i.e. inflammation of the brain).

What Is The Function Of Microglia?

Under normal circumstances (i.e. in a healthy brain) the function of microglia is to control the number of neurons needed by the cerebral cortex by ‘pruning away’ neurons that are superfluous to requirements.

What Happens When Microglia Malfunction?

However, when, due to chronic and unpredictable stress, the microglia malfunction, this may result in them going into a kind of destructive overdrive and the subsequent ‘pruning away’ of NECESSARY BRAIN CELLS THAT ARE VITAL TO EXECUTIVE BRAIN FUNCTIONING; this destructive process can lead to various neurological problems such as POOR IMPULSE CONTROL and IMPAIRED REASONING ABILITY.

Research also suggests that malfunctioning microglia may interfere with the generation of new neurons in the hippocampus and that this may be closely linked to the development of depressive disorders.

Depression, Microglia And Animal Studies :

Indeed, the hypothesis that malfunctioning microglia may interfere with the generation of new neurons in the hippocampus which may, in turn, give rise to depressive disorders has been supported by studies of mice; when HEALTHY microglia are reintroduced into the brains of mice which have been induced into a depressive state their depressive symptoms ameliorate.

Implications For Treatment Of Depression In Humans :

However, more research needs to be conducted in order to discover what (if any) extent we can extrapolate from these studies in mice to help us develop similar ways of treating depression in humans.

REFERENCES:

McCarthy RC, Sosa JC, Gardeck AM, Baez AS, Lee CH, Wessling-Resnick M. Inflammation-induced iron transport and metabolism by brain microglia. J Biol Chem. 2018 May 18;293(20):7853-7863. doi: 10.1074/jbc.RA118.001949. Epub 2018 Apr 2. PMID: 29610275; PMCID: PMC5961037.

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

Possible Long-Term Effects Of Highly Stressed Mothers On Infants

HPA axis

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.

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 exist / 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).

What Is The Difference Between Repression And Dissociation?

 

 

I have frequently referred to the concepts of DISSOCIATION and REPRESSION on this site as, of course, both are highly relevant to the subject of childhood trauma. But what is the difference between the two?

REPRESSION :

In terms of psychoanalytic theory (of which Sigmund Freud is considered to be the ‘father’) REPRESSION can be divided into two types :

  1. PRIMAL REPRESSION
  2. REPRESSION PROPER

I briefly explain these two types of repression below :

REPRESSION PROPER :

This refers to an unconscious process whereby the part of the mind that Freud referred to as the ego prevents distressing and threatening thoughts from ever permeating consciousness. Freud believed that often such thoughts were kept banished from conscious awareness as otherwise, they would produce intolerable guilt (generated by the part of the mind that he referred to as the superego). 

Examples of types of thoughts that Freud believed are kept repressed by this process are those concerning certain types of sexual and aggressive impulses and instincts (generated by the part of the mind Freud referred to as the id) that we have learned from our environment (influence of culture, parents etc) are unacceptable.

PRIMAL REPRESSION :

The term primal repression refers to an unconscious process whereby the ego buries distressing and threatening thoughts, feelings and memories down below the level of consciousness into the id.

So, to summarize: in the case of repression proper, distressing and threatening thoughts are prevented from ever gaining access to conscious awareness whereas, in the case of primal repression, distressing and threatening thoughts, feelings and memories which have gained ephemeral access to consciousness are banished from it (buried in the id).

However, Freud also pointed out that there is a high price to pay for the unconscious process of repression in so far as this hidden, buried information that has been forced down into the id will create symptoms of anxiety.

DISSOCIATION :

In the case of dissociation (one of the core features of complex PTSD), thoughts/feelings/memories do NOT get pushed down into / buried in the id; instead, they become separated/compartmentalized in a different part of the ego.

So, we can finally summarize in this way :

  • In the case of repression, mental information/content is split off into the id.
  • In the case of dissociation, mental information/content is split off into a separate part of the ego.

NB: This distinction relates to how the terms are used in psychoanalytic theory; in other areas of psychology, the term ‘dissociation’ can take on other meanings. 

 

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

 

 

 

 

 

 

Complex PTSD And ‘A Sense Of A Foreshortened Future.’

 

Image licenced by Shutterstock

Those suffering from Complex PTSD may live their lives as if there is, literally, no tomorrow. This might include spending all of their money as soon as they get it or entering into destructive relationships. Also, individuals may be completely uninterested in setting themselves long-term goals as they feel it would futile. They may, too, not engage with mental health services and be prone to risk-taking. They feel hopeless about the future because to have hope would entail the possibility of again being disappointed which they no longer have the strength to cope with. Feeling this way has been termed by psychologists as having ‘a sense of a foreshortened future’ which I look at in greater detail below.

The DSM  (Diagnostic And Statistical Manual Of Mental Disorders) lists one of the symptoms of posttraumatic stress disorder (PTSD) as a ‘sense of a foreshortened future.‘ It is this specific symptom that I wish to concentrate upon in this article.

The psychologists Ratcliffe et al. (2014) suggested, based on their research, that this involved several elements of altered feelings, perceptions and beliefs, some of which I consider (although not exclusively) below.

NEGATIVE VIEW OF THE FUTURE :

An individual suffering from a ‘sense of a foreshortened future’ may have an extremely negative and pessimistic set of beliefs about the future; these may include :

  • I will die young / soon / prematurely / imminently
  • I will never have a rewarding and successful career
  • I will never find a partner / have a family.

In other words, the individual who is experiencing a ‘sense of a foreshortened future‘ regards the future as bleak, empty a without meaning. 

  • It follows. of course, that the person’s feelings and emotions in relation to the future will also be negative – rather than being hopeful about it, s/he may fear and dread it.

 

ALTERATIONS IN PERCEPTION OF TIME :

Also, such a person may experience severe alterations in his/her perception of how time operates, including :

  • changes in perception of the passage of time and feeling unable to ‘move forward into the future’
  • changes in how PAST, PRESENT and FUTURE are experienced
  • changes in how the relationship between the PAST, PRESENT and FUTURE are experience
  • the experience of flashbacks (in which the past is experienced as ‘happening now.’
  • a change in perception of the overall structure of experience

FEELING THAT LIFE IS OVER :

Freeman (2000) coined the term ‘narrative foreclosure’ which refers to a strong sense that one’s ‘life story has effectively ended.’ and that there is no further purpose to it, no further meaning that can be derived from it and no possibility that it will contain deep relationships with others or achievement of any kind. The individual affected in this way may also cease to feel s/he cares about anything or can be committed to any cause or project in the future.

In short, a sense of nihilism may prevail.

LOSS OF TRUST :

Also relevant to an individual developing a sense of a foreshortened future is that it is likely to be intertwined with a general loss of trust which may manifest itself through beliefs such as :

  • others cannot be trusted and pose a threat to me
  • the world is a dangerous place that I should interact with as little as possible

THE ‘SHATTERING’ OF ONE’S EXPERIENCE OF WORLD AND OF OTHER PEOPLE :

Greening (1990) puts forward the view that the individual’s ‘relationship with existence itself becomes shattered’. For example, the experience of trauma may leave the individual with a fundamentally altered view about the safety of the world (Herman, 1992) and his/her place within it; the world seems meaningless, other people undependable and dangerous, and the self of no value.

LOSS OF PREDICTABILITY :

The individual, too, may come to see life as essentially random and unpredictable, feel that s/he can exercise no control over it, and that, therefore, there is no prospect of life unfolding in a dependable, coherent, cohesively structured way – s/he may feel s/he is no longer travelling through life on a reasonably straight set of tracks, but, rather, on tracks that twist and turn at random and from which one may be completely derailed at any time without warning. Indeed, Stolorow (2007) refers to how the individual may lose his/her sense of ‘safety’ and of any meaningful ‘continuity’ in life.

Such a person may feel that ‘anything can happen at any time’ and that these things will, inevitably, be very bad. Because of this, s/he may feel perpetually trepidatious and vulnerable – alone in an alien, sinister, hostile and frightening world; a world in which there is no structure to hold one in place, no coherence and nowhere one can feel safe or a sense of belonging; it can seem as if the foundations of one’s life are now built on sand rather than on solid ground and, as such, one’s life is liable to collapse at any time and without warning.

 

AN UNSHAKABLE SENSE OF IMMINENT DEATH :

Any future goals the individual had may now seem meaningless and pointless – even absurd; linked to this can be a feeling that one is no longer moving forward in life and that there is no worthwhile direction in which life can go – any direction feels equally futile and devoid of meaning.

And, because the individual now sees only emptiness lying ahead of him/her in life this can translate into a perception that future time itself has somehow dissolved and has been replaced by a kind of ‘temporal vacuum’. This, in turn, leads to a feeling that nothing of meaningful substance lies between the present and death. Future time is anticipated as a void and in this sense ceases to be real – therefore, DEATH FEELS ABIDINGLY AND PERPETUALLY IMMINENT; no buffer of a meaningful, substantive, solid, structured, ‘block of time’ is perceived to lie between NOW and DEATH’S OCCURRENCE; instead, just a nebulous, indistinct haze of ‘virtual nothingness.’ (This is a difficult concept to relate to, or, even, comprehend if one has not experienced such an unhappy state of being – or, perhaps more accurately put, non-being – oneself).

To all intents and purposes, therefore, to an individual suffering from a ‘sense of a foreshortened future, it feels as if one’s life is already over. Indeed, Herman (1992) noted that it was not unusual for those who had been affected by the experience of severe trauma reported feeling as if they were dead or as if part of them had died.

RECOVERY :

The psychologist and expert on trauma and its effects, Herman (referred to above), suggests that there are three main stages involved in recovering from PTSD – to read my article on these three stages, click HERE.

 

 

David Hosier BSc Hons; MSc; PGDE(FAHE)

 

Impulse Control In Early Life : Study Showing Its Vital Importance

 

We have already seen that those who suffer such severe, protracted childhood trauma that they go on to develop borderline personality disorder (BPD) have very significant problems regarding self-regulation (i.e, controlling intense emotions) and with IMPULSE CONTROL (along with a wide range of other symptoms).

This impaired ability to control impulses, in turn, can have a seriously adverse effect on myriad aspects of the individual’s life, potentially leading to, for example, relationships problems, substance abuse, gambling, compulsive sex, poor financial control due to compulsive shopping, lowered work /academic accomplishments, violent outbursts and many other difficulties.

In this article, I will briefly outline a study that helps to show the relationship between poor impulse control in childhood and later life success :

THE STUDY ON IMPULSE CONTROL AS A CHILD AND FUTURE LIFE OUTCOMES :

The study was conducted by Walter Mischel and E.B Ebbeson. A group of children were given two options :

OPTION ONE: They could have one marshmallow immediately.

OR :

OPTION TWO: They could have two marshmallows if they were prepared to wait fifteen minutes for them.

The children were then left alone with the marshmallows.

RESULTS :

Some children gave in to temptation immediately and some managed to defer gratification for a short amount of time (but not the full fifteen minutes).

HOWEVER: About one-third of the children were able to defer gratification for the FULL FIFTEEN MINUTES (in the main they distracted themselves from the temptation to eat the marshmallow by playing or singing to themselves, according to the researchers).

TWELVE  YEARS LATER, a follow-up study was carried out on these same individuals. The results of this follow-up study were :

The individuals’ PERFORMANCE ON THE IMPULSE CONTROL TEST (as described above) was more highly correlated with future life success than any other measure, including socioeconomic status and I.Q.

In other words, on average, the children who managed to wait the full fifteen minutes before eating went on to have significantly more successful lives (as defined and measured by the twelve-year follow-up study) than those children who were unable to do so. The fact that the level of an individual’s impulse control appears, according to this particular study, to be a better predictor of that same individual’s future life success than either their socioeconomic status or I.Q. implies that how well we are able to control our impulses is of vital importance.

N.B. UPDATE 

However, researchers from New York and California Universities have unsuccessfully attempted to replicate the results of the above study to help confirm its reliability. More specifically, their study suggested that differences in levels of impulsivity found in 4 – year – olds had largely disappeared by the time that these same children reached the age of fifteen.once the confounding variable of these children’s parents had been controlled for.

In contrast to Mischell’s and Ebbeson’s study, this second study found that by the time children were fifteen years old, the children of wealthier parents, in general, had better impulse control than fifteen-year-olds from less wealthy families, irrespective of the level of impulse control the children had (from either wealthy or less wealthy families) at the age of four.

Related Post: Childhood Trauma: Is PTSD Being Misdiagnosed As ADHD?

RESOURCE:

IMPROVE IMPULSE CONTROL | SELF HYPNOSIS DOWNLOADS

David Hosier BSc Hons; MSc; PGDE(FAHE)

Types Of Narcissist : Extraverted, Introverted/Covert And Communal

 

We have already seen what the effects can be upon the child who is brought up by a parent with a narcissistic personality disorder as well as how some forms of dysfunctional upbringing can put the child him/herself at risk of developing a narcissistic personality disorder.

However, some narcissistic individuals are easier to identify than others and in this article, I will briefly describe three different types; these are :

  • THE EXTRAVERTED NARCISSIST 

  • THE INTROVERTED/COVERT NARCISSIST 

  • THE COMMUNAL NARCISSIST 

Let’s look at each of these in turn :

The Extraverted Narcissist :

Narcissists who have an extravert type personality are, as one would guess, the easiest to identify; accordingly, they are also the ones who fit most people’s stereotype of a narcissist: They crave attention, always desiring to be centre stage and in the limelight. If wealthy, they are likely to ostentatiously flaunt their economic status by the means of material objects (e.g. flashy cars with personalized number plates, extravagant jewellery etc. ). They are also likely to be highly competitive in the workplace with a strong urge to rise to the highest possible positions thus enabling themselves to exert maximum power over others and to be able to insist upon respect and deference.

 

The Introverted/Covert Narcissist :

Introverted narcissists have just as strong a need to feel special and superior to others in the way that the extraverted narcissists do, but manifest this desire in more subtle and less obvious ways (which is why they are also sometimes referred to as ‘covert narcissists’ in the psychological literature).

In fact, on the surface, they may even appear to others to be self-effacing and, in direct contrast to extraverted narcissists, are likely to actively avoid being the centre of attention (due to an intense fear of being negatively judged by others).

Such behaviour, though, is paradoxical because underneath this seemingly humble exterior lies a firm conviction of great superiority to others. The introverted/covert narcissists rationalize this belief of great superiority – in the absence, of course, of its confirmation by others – by telling him/herself that others are simply not intelligent or perceptive enough to have recognized his/her ‘supreme and unique’ talents.

Due to this perceived ‘failure of insight’ by others, the introverted narcissist may go through life feeling deeply bitter and resentful; a typical, secret belief an introverted/covert narcissist might hold is: ‘The only reason other people don’t realize how brilliant, superior and wonderful I am is that they are just too stupid to see it!’

The Communal Narcissist :

The communal narcissist wishes to be seen by his/her community as an outstandingly compassionate, caring, giving, nurturing and charitable individual and derives his/her self-esteem and self-worth by cultivating such an image. Just like the extraverted narcissist and the introverted narcissist, the communal narcissist’s primary motivation is a desperate and overwhelming need to feel special.

 

RESOURCE :

DEALING WITH NARCISSISTIC BEHAVIOR – SELF HYPNOSIS DOWNLOADS

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

Hypervigilance And Complex Posttraumatic Stress Disorder (Complex PTSD).

Above image licensed by Shtterstock

If we have grown up in a chronically stressful and traumatic environment in which we often experienced anxiety, trepidation, stress and fear we are at high risk of developing a fundamental, core belief (on a conscious and/or unconscious level) that the world is a dangerous place and that we need to be constantly on ‘red-alert’ and ‘on-guard’ in order to protect ourselves from sustaining further psychological injury.

In other words, we GENERALIZE our perception that our childhood environment was a dangerous place (because of the emotional and/or physical harm done to us there) into a perception that everywhere else/the world in general poses an on-going threat to us.

As a result, we may develop a symptom known as HYPERVIGILANCE.

HYPERVIGILANCE is the main symptom of complex PTSD (complex PTSD is a serious psychological disorder strongly associated with childhood trauma which you can read more about by reading my post entitled: Childhood Trauma: Complex Posttraumatic Stress Disorder (With Questionnaire).

 

HOW DOES HYPERVIGILANCE MANIFEST ITSELF?

Individuals suffering from hypervigilance may :

  • constantly analyze the behaviour (including body language, facial expressions, intonation etc) of those around them in an attempt to determine if they pose a threat (and, frequently, they may perceive a threat to exist when, in reality, it does not)
  • be in a constant state of anxiety, irritation and agitation
  • have an exaggerated startle response to loud, unexpected noises
  • experience excessive concern regarding how they are viewed by others
  • be excessively suspicious of others / expect others to betray them; this can give rise to paranoid-like states
  • perceive danger everywhere even though this is not objectively justified
  • easily be provoked into aggression (as a means of defending themselves against perceived threats from others; in other words, such aggressive outbursts are a (primarily unconsciously motivated) DEFENSE MECHANISM.
  • PHYSICAL SYMPTOMS (including elevated heart rate, hyperventilation, trembling and sweating)
  • have false perceptions that others dislike them, are plotting against them or mean them harm
  • see minor set-backs as major disasters (this is a cognitive distortion sometimes referred to as CATASTROPHIZING.
  • frequently experience fear and panic when, objectively speaking, it is not justified
  • experience obsessive worry and rumination that is intrusive and hard to control
  • suffer from sleep problems (including very frequent waking and nightmares)
  • feel constantly exhausted (due to both sleep problems and the sheer debilitating effects of being in a constant state of anxiety)
  • social anxiety / impaired relationships / social isolation

Therapies For The Treatment Of Hypervigilance :

Therapies that may ameliorate symptoms of hypervigilance include :

 

RESOURCE:

OVERCOME HYPERVIGILANCE | SELF HYPNOSIS DOWNLOADS

David Hosier BSc Hons; MSc; PGDE(FAHE)

 

Trauma-Sensitive Yoga For Reducing Symptoms Of Complex PTSD

Image source: Adobe Stock: Licence 214324112

 

Studies into the effectiveness of yoga already suggest that it can help to ameliorate both physical and psychological problems including diabetes, arthritis, fibromyalgia, depression and anxiety.

There also now exists evidence (e.g. van der Kolk, 2014, see below)) that it can help to reduce symptoms of Complex posttraumatic stress disorder (Complex PTSD).

Complex PTSD Gives Rise To Both Psychological And Physical Symptoms :

We have already seen how the cumulative effects of exposure to ongoing and repetitive trauma can result in the development of Complex PTSD and that the condition adversely affects the body’s physiology leading to impaired functioning of the autonomic nervous system and associated physical problems that can manifest in various ways including :

  • hypervigilance
  • dissociation / psychic numbing
  • hyperventilation
  • accelerated heart/pulse rate
  • sweating
  • elevated blood pressure
  • restless, physical agitation


Furthermore, such symptoms are, in individuals with Complex PTSD, if not ongoing (though they can be: my own hyperventilation and physical agitation went on for years and the former continues to be set off by what most others would consider being trivial anxieties, whilst my resting heart rate is still, worryingly, running at over one hundred beats per minute), very easily triggered by even relatively minor stressors; this is because the individual’s capacity to tolerate stress is dramatically compromised, especially in relation to stressors that are linked (on either a conscious or unconscious level) to memories of the original traumatic experiences.

Severe Physical Symptoms Of Complex PTSD May Prevent Or Impair Talk-Based Psychotherapy :

If such physical symptoms of Complex PTSD are severe and remain unaddressed there is potential for them to prevent or impair talk-based psychotherapy. For example, in my own case my physical symptoms were so bad that I frequently either could not attend therapy sessions (as I was unable to leave my flat) or, if I did manage to attend, was unable to focus or concentrate properly.

How Can Yoga Help Those Suffering From Complex PTSD?

Yoga that incorporates physical exercises, breathing exercises and mindfulness can be a more effective treatment of the physiological symptoms of Complex PTSD that talk-based psychotherapy because of the fact that it DIRECTLY ADDRESSES SUCH SYMPTOMS THROUGH BREATHING TECHNIQUES AND BODYWORK. Indeed, recent research supports the effectiveness of yoga in this regard – for example, van der Kolk’s study (2014), which I briefly outline below :

The Study :

  • The participants in the study were adult females with Complex PTSD who had not responded to the intervention of traditional psychotherapy
  • These same females were then randomly allocated to one of two groups as shown below :

GROUP ONE: The females who were randomly allocated to GROUP ONE underwent a TEN WEEK COURSE IN TRAUMA SENSITIVE YOGA (a special form of yoga that was developed at the Boston Trauma Center in the U.S.)

GROUP TWO: The females who were randomly allocated to GROUP TWO did NOT undergo this course.

The Results Of The Study :

The main findings of the study were as follows :

At the end of the ten-week period :

  • Those in the treatment group (GROUP ONE) were significantly less likely still to meet the diagnostic criteria for Complex PTSD than those in the non-treatment group (GROUP TWO).
  • Furthermore, those in the treatment group (GROUP ONE) showed a significant reduction in depression and self-harm

Longer-term studies have found similar results (e.g. Rhodes, 2014).

TRAUMA-SENSITIVE YOGA (TSY) :

TSY was developed as an adjunct therapy by David Emerson (who founded the Trauma Center in Brookline, Massachusetts) in 2003 and its main goal is to help traumatized individuals control their emotions and associated, dysfunctional behaviours and concentrates on breathing techniques, meditation. specific physical postures and gentle movements.

CONCLUSION :

Yoga may be an effective complementary treatment option to be used in conjunction with talk-based psychotherapies particularly when physical symptoms of Complex PTSD are so severe that they interfere with talk-based psychotherapies, as in my own case (see above).

A major benefit of yoga for the treatment of the physical symptoms of Complex PTSD is that it addresses such problems directly.

REFERENCES:

Rhodes, A. et al.Yoga for Adult Women with Chronic PTSD: A Long-Term Follow-Up Study. J Altern Complement Med. 2016 Mar;22(3):189-96. doi: 10.1089/acm.2014.0407. Epub 2016 Feb 10.

van der Kolk, B.. et al. Yoga as an Adjunctive Treatment for Posttraumatic Stress Disorder: A Randomized Controlled Trial. The Journal of Clinical Psychiatry 75(6):e559-e565 · June 2014

 

David Hosier Bsc Hons; MSc; PGDE(FAHE)

What Are The Differences Between BPD And Complex PTSD? A Study

 

 

Because there is considerable overlap in symptoms between those suffering from borderline personality disorder (BPD) and those suffering from complex posttraumatic disorder (complex PTSD), those with the latter condition can be misdiagnosed as suffering from the former condition.

In order to help clarify the differences between the two conditions and help show how they are distinct from one another, this article is about a research study that sought to delineate these two very serious psychiatric conditions.

What Are The Differences In Symptoms Between Those Suffering From Borderline Personality Disorder (BPD) And Those Suffering From Complex Posttraumatic Stress Disorder (Complex PTSD)?

A study into the different symptoms displayed by sufferers of borderline personality disorder (BPD) and complex posttraumatic stress disorder (complex PTSD) involving the study of two hundred at eighty adult women who had experienced abuse during their childhoods and published in the European Journal of Psychotraumatology in 2014 compared the symptoms of those suffering from BPD with those suffering from complex PTSD. The following results from the study were obtained :

SYMPTOMS SHARED APPROXIMATELY EQUALLY BETWEEN THOSE SUFFERING FROM BPD AND THOSE SUFFERING FROM COMPLEX PTSD :

Some symptoms were found to be shared approximately equally between those suffering from borderline personality disorder (BPD) and those suffering from complex posttraumatic stress disorder (complex PTSD). The symptoms that fell into this category were as follows :

  • AFFECTIVE DYSREGULATION (ANGER) i.e. frequent feelings of intense rage that the individual cannot control (regulate)
  • VERY LOW FEELINGS OF SELF-WORTH
  • AFFECTIVE DYSREGULATION (SENSITIVE) i.e. feelings of hypersensitivity that cannot be controlled (regulated)
  • INTENSE FEELINGS OF GUILT
  • INTERPERSONAL DETACHMENT / ALONENESS i.e. feeling cut-off and alienated from others, isolated and apart
  • FEELINGS OF EMPTINESS

However, some symptoms were found to be significantly more prevalent amongst those suffering from borderline personality disorder (BPD) than amongst those suffering from complex posttraumatic stress disorder (complex PTSD) as shown below :

SYMPTOMS THAT WERE FOUND TO BE SIGNIFICANTLY MORE PREVALENT AMONGST THOSE SUFFERING FROM BORDERLINE PERSONALITY DISORDER (BPD) THAN AMONGST THOSE SUFFERING FROM COMPLEX POSTTRAUMATIC STRESS DISORDER (COMPLEX PTSD) :

  • INSTABILITY
  • FEELINGS OF PARANOIA / DISSOCIATION
  • UNSTABLE RELATIONSHIPS
  • SELF-HARM
  • SUICIDAL BEHAVIOR
  • DESTRUCTIVE IMPULSIVENESS
  • IDENTITY PROBLEMS / UNSTABLE SENSE OF SELF
  • EXTREME OUTBURSTS OF TEMPER
  • FRANTIC ATTEMPTS TO AVOID ABANDONMENT

BPD – A Masked Illness: Other Reasons Why It’s Hard To Identify

Not only can BPD and complex PTSD be easily confused, but there are other reasons why BPD is hard to accurately identify and diagnosed and, therefore, many BPD sufferers are at risk of going undiagnosed or misdiagnosed. The reason for this is that BPD can generate a number of symptoms associated with other conditions that mask the underlying illness (BPD). Sadly, because of this, BPD can go undiagnosed for years, decades or a whole lifetime. This means many go without the proper treatment they require. When one considers that approximately ten per cent of those diagnosed with BPD end their lives by suicide, the full, tragic implications of this failure of accurate diagnosis can be appreciated.

What Symptoms Of BPD Can Mask It, Thus Making It Less Likely To Be Accurately Diagnosed?

They include :

– excessive use of alcohol, leading to a diagnosis of alcoholism

– self-harm / suicidal thoughts, leading to a diagnosis of depression

– instability of mood, leading to a diagnosis of cyclothymic or bipolar disorder

– aggression/violence, leading to a diagnosis of sociopathy (sometimes still referred to as psychopathy)

– eating problems, leading to a diagnosis of anorexia nervosa or bulimia

Whilst this list is not exhaustive, it represents some of the ways in which BPD can seemingly, upon preliminary investigation, present itself as other psychological conditions, leading to misdiagnosis or incomplete/partial diagnosis.

Because, too, many with BPD are able to work successfully, and/or socially integrate successfully, much of the time without displaying blatant signs of psychological pathology, identifying BPD in individuals becomes trickier still.

However, such individuals are still likely to display tell-tale signs of the disorder due to sudden, dramatic and unpredictable shifts in mood (such as explosions of rage) which may, by the layman (or even the professional) be put down to ‘a difficult temperament’.

In order to correctly diagnose BPD it is necessary to look at the whole tapestry of the interplay of the individual’s behaviours and emotions in the context of their lives as a whole, with a particular focus on their relationship history (tends to be tumultuous), mood stability/instability, drug/alcohol use, sexual history (tends to be promiscuous and high risk), internal/mental life (often marked by feelings of chronic emptiness and lack of identity), emotional reactiveness/lability, and, vitally, of course, the experience of childhood trauma.

In short, accurate diagnosis calls for a holistic approach; only then will all BPD sufferers get the treatment they both desperately need and deserve.

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

REFERENCE:

Marylène Cloitre, Donn W. Garvert, Brandon Weiss, Eve B. Carlson & Richard A. Bryant (2014) Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis, European Journal of Psychotraumatology, 5:1, DOI: 10.3402/ejpt.v5.25097

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

Dysfunctional Ways Parents May Seek To Over-Control Children

 

 

 

I outline some of the most common ways in which parents may attempt to exert excessive control over their children below :

Emotional Enmeshment :

This occurs when a parent is intensely and overwhelmingly emotionally involved with his/her child so that, rather than seeing the child as an individual with his/her own thoughts, feelings, likes and dislikes, views him/her as an extension of him/herself.

The parent who emotionally enmeshes the child may be over-dependent on him/her :

  • in relation to seeking advice that the child is not mature enough to give (e.g. a parent asking a ten-year-old for advice on romantic relationships),

  • for companionship,

  • for psychological counselling.

Such parents may also inappropriately interfere with the child’s life and fail to respect his/her boundaries. Divorced / single parents may even expect their child to serve as a kind of ‘spouse substitute’ (most frequently in emotional terms).

Parentification :

Emotionally immature parents may expect their child to act as a kind of substitute parent – you can read my article about how parents may ‘parentify’ their child by clicking here.

Perfectionism :

Perfectionist parents may constantly insist upon laying down myriad petty, unnecessary and, perhaps, seemingly arbitrary rules and regulations (for example, my father used to be obsessed with making sure I held my cutlery in precisely the right way – apparently I would ‘mistakenly’ hold my knife ‘like a pen’ which would cause my father an absurdly disproportionate level of unnecessary angst more appropriate to me holding a live grenade in a way that would allow it imminently to detonate.

Living in such a household can put the child into a constant state of tension, or, even, hypervigilance, leading him/her constantly to anticipate the next shaming and disheartening criticism.

Perfectionist parents may also psychologically damage their children by expecting them to achieve in sports, academia, music etc in ways that are unreasonable and unrealistic. In relation to this, they may only offer their children love and approval when they excel, withholding such love and approval the rest of the time.

These types of parents may, too, strongly disapprove of their children expressing particular emotions such as anger or sadness, perhaps to the extent that they even ridicule their children for doing so.

Micromanagement :

The parent who micromanages their child may be unnecessarily and inappropriately involved in what a child eats or how a child dresses. Such parents may also interfere in superfluous and counter-productive ways with the child’s school life (e.g. visiting the school to complain to teachers about the child’s grades or about the child not making a particular school sport’s team). Or they may not respect their child’s privacy (e.g. constantly checking their child’s room for no good reason, looking through their diary or unnecessarily texting their child whilst s/he is at school to ‘check-up’ on him/her in a way the child finds oppressive).

Such parenting is also sometimes referred to as ‘helicopter parenting’, a term originally coined by Dr Haim Ginott in the late 1960s.

Coercive Control :

The term ‘coercive control’ was first coined by the Duluth Abuse Intervention Project (DAIP) but the concept can also be applicable to the parent-child relationship. The DAIP propose that coercive control can take many forms which include :

  • intimidation (including threatening body language and facial expressions)

  • humiliation

  • isolation

  • minimizing the level of abuse

  • denying any abuse has taken place

  • blaming the victim for the perpetrator’s abuse

  • homophobia

  • coercion and threats

Parents Who Use Their Child For ‘Narcissistic Supply’ :

The concept of narcissistic supply stems from psychoanalytic theory. A parent in need of narcissistic supply may emotionally exploit his/her children by overly depending upon them to express their admiration of him/her (the parent), to emotionally support him/her and to bolster his/her self-esteem. 

 

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