Types Of Childhood Trauma

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types-of-childhood-trauma

There are many traumatic events that can befall us in childhood which, as we have seen in other articles I have published on this site, can, potentially, result in us incurring significant and long-lasting psychological damage, especially in the absence of appropriate therapy and meaningful, emotional support from others. 

In this article, I will list several types of childhood trauma that can occur and give a brief explanation to elucidate each of these traumatic events :

TYPES OF CHILDHOOD TRAUMA :

 

  • Natural Disasters 
  • Trauma Related To Being A Refugee
  • Living In A Violent Community
  • Medical Trauma
  • Being Affected By Terrorism
  • Abuse (Emotional, Physical, Sexual – the effects of such abuse are significantly worse if the perpetrator is a parent or primary carer)
  • Emotional Neglect
  • Living In A Household In Which There Is Domestic Violence
  • Complex Trauma
  • Early Life Trauma
  • Traumatic / Complex Grief

Let’s look at each of these in turn :

 

 

1) TRAUMA RELATED TO NATURAL DISASTERS :

Natural disasters include floods, hurricanes and droughts. According to Carolyn Kousky, the three main ways in which children can be harmed and traumatized by natural disasters fall into three broad categories (see immediately below) :

Physical Harm :

The examples Kousy provides are : injury ; malnutrition (e.g. due to disrupted food supplies) ; illness caused by contamination ; and disruption to the supply chain of medical equipment / medications.

Harm To Mental Health :

This may be caused by a number of factors. Examples provided by Kousky include : the stress caused by witnessing the natural disaster itself ; damage to their homes / possessions (or, indeed, loss of these) ;  the strain of having to migrate ;  grief due to losing friends / family / loved ones ; abuse and / or neglect which might arise from the situation the find themselves in due to the disaster (e.g. if having to live in a makeshift ‘camp-site in close proximity to strangers or death of primary carers) ; breakdown of their social network ;  and ruined local economies.

Harm To Education :

This may occur due to enforced closure of schools or schools being destroyed (e.g. in the case of a hurricane) ; or because the child is forced to leave school and work in order to earn money to help the family recover from the effects of the disaster.

 

2) TRAUMA RELATED TO BEING A REFUGEE :

Refugee children may experience long-term, toxic stress (which can have damaging effects on both mental and physical health) due to the extreme hardships they face in relation to :

  • the factors (such as war) which forced them to leave their country of origin in the first place
  • the journey to the country of refuge (e.g life-threateningly unsafe sea travel in makeshift, overcrowded craft)
  • resettlement in the country of refuge (including fear of being deported back to their country of origin)

An example of how extreme the stressful effects of being a refugee child is given below :

 

  • Resignation Syndrome :

In Sweden, a research paper published in Acta Paediatricia (a medical journal) has reported that many child refugees, on learning that they and their families are to be deported back to the country from which they had fled, are, as a result, developing ‘RESIGNATION SYNDROME‘ (‘Uppgivenhetssyndrom) which involves them going into a comatose-like state. Extremely disturbingly, those developing the syndrome become bed-ridden (or, at least, confined to a wheel-chair), mute, incontinent and unable to eat or drink (they are, therefore, fed through a tube) and essentially catatonic according to the article.

 

Furthermore, scans of these children’s brains revealed that they had NOT been physically damaged, from which we can infer that the children’s symptoms were psychological in origin – i.e. occurring as a result of their traumatic experiences and terror of being returned back to their country of origin where they may face terrible and terrifying danger, rather than as a result of physical brain damage ; this inference is further supported by the fact that, if the decision to deport them is reversed, they gradually recover from this appalling condition.

 

 

3) TRAUMA RELATED TO LIVING IN A VIOLENT COMMUNITY :

Young people who live in communities in which they are frequently exposed, directly or indirectly, to violence (e.g. in certain economically deprived parts of inner city London) may find themselves living in a constant state of fear about being a victim of violence (e.g. muggings, beatings, stabbings or even shootings). If the exposure to violence (and/or the constant threat of violence) is fairly constant, symptoms of trauma may arise such as frequently being in a state of fight or flight and hypervigilanceindeed, in some cases, individuals may develop posttraumatic stress disorder (PTSD) or complex posttraumatic stress disorder (complex PTSD).

 

4) MEDICAL TRAUMA :

 

The term ‘medical trauma’ refers to the trauma children may suffer as a result of serious illness or injury, as well as the treatments associated with these. Whilst, all else being equal, the more serious / threatening / endangering the child’s illness / injury / treatment is, the more traumatic it is likely to be, of crucial importance, too, is how serious / threatening / endangering the child PERCEIVES them to be.

Other factors that can affect the child’s emotional response to the his/her illness or injury include :

  • pain due to illness injury itself
  • pain due to treatments / medical interventions
  • the interactions the child has with the medical treatment providers (Marsac et al., 2014)

 

5) TRAUMA RELATED TO BEING AFFECTED BY TERRORISM :

Terrorism, defined as a violent act (e.g. bombing or shooting) against unsuspecting people and countries can have extremely, psychologically (as well, obviously, as physically) damaging effects upon the child which include :

Factors affecting the child’s emotional response to such events include how s/he and his/her family / friends have been affected, his/her personality / temperament and the amount of social support and counselling s/he receives.

 

6) ABUSE :

Please see my previously published article : Childhood Trauma. What Is It?

 

7)  TRAUMA RELATED TO LIVING IN A HOUSEHOLD IN WHICH THERE IS DOMESTIC VIOLENCE :

Please see my previously published articles :  

 

 

 

 

 

8) Complex Trauma :

Please see my previously published articles : 

 

 

 

9) Early Life Trauma :

Please see my previously published articles :

 

 

 

 

 

10) Traumatic Grief :

Please see my previously published article :

 

 

Childhood Trauma Symptoms :

 

 

Symptoms of childhood trauma can also be split up into two types : TYPE 1 and TYPE 2 :

 

TYPE 1:

These symptoms tend to come about as a result sudden, unexpected, catastrophic event such as, for example, the threat of death or serious injury (sometimes referred to as ‘critical incidents‘).

Symptoms which may develop in response to such an adverse event may range from, at the mild end of the spectrum, disrupted sleep, worry and feelings of insecurity, to, at the other end of the spectrum, the development of post-traumatic stress disorder (PTSD) which is an ongoing condition that may manifest itself through :

-extreme over-arousal of the sympathetic nervous system

-intrusive and distressing memories (flashbacks), nightmares etc

-constant and intense feelings of being under threat

– avoidant behavior (eg an avoidance of social interaction and of situations/activities which trigger disturbing memories of the traumatic event)

NB The above list is not exhaustive.

TYPE 2 :

This category of symptoms may emerge if trauma has continued, repeatedly, over an extended period of time. Often, in these circumstances, the development of symptoms may well be delayed (click here to read my article on this). Symptoms that do eventually develop may include :

– significant difficulties forming and maintaining social relationships (click here to read my article on this)

– problems relating to anger management (click here to read my article on this)

– dissociation (click here to read my article on this)

– a negative cognitive triad (this is a term used by psychologists to refer to a distorted, negative view of the self, others, and the world in general – it may be addressed through a therapy known as cognitive behavioural therapy (CBT) – click here to read my article about CBT.

The earlier in life that the extended experience of trauma begins, the more damaging its long-term effects are likely to be (trauma experienced in the first three years of life is known to be particularly harmful).

At the extreme end of the spectrum, extended trauma may lead to personality disorders, especially borderline personality disorder (BPD) – click here to read my article on BPD.

 

A COMBINATION OF TYPE 1 AND TYPE 2 SYMPTOMS OF TRAUMA :

As we have already seen, Type 1 trauma commonly gives rise to symptoms of acute distress and severe over-arousal of the sympathetic nervous system, whilst Type 2 trauma frequently results in more complex and deep-rooted adverse changes to the personality.

In some cases, the individual will experience both Type 1 and Type 2 symptoms; for example, a child who is severely abused over a long period of time may initially display Type 1 symptoms and, then, later in life, develop Type 2 symptoms.

POSSIBLE TREATMENTS

Due to the highly complex causes of Type 2 symptoms, they will usually need to be addressed through psychotherapy (eg CBT, which I have already referred to, or dialectical behavior therapy, abbreviated to DBT – click here to read my article on DBT).

On the other hand, Type 1 symptoms, at the more mild end of the spectrum, may sometimes be able to be addressed through social support, physical relaxation and sometimes, as a short-term measure, tranquilizers.

NB It is always very important to consult an appropriately qualified professional when considering treatment options for psychological conditions.

 

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

 

 

 

 

 

Why Labelling The Child As ‘Mentally Ill’ Can Be Unhelpful

ADHD-wrong-diagnosis

In his critically acclaimed book : ‘CRACKED : WHY PSYCHIATRY IS DOING MORE HARM THAN GOOD‘, the author, James Davies, argues that psychiatry is a pseudo-science which :

  • over-medicalizes human behavior, labelling individuals as mentally ‘ill’ when it is not appropriate to do so

 

In order to illustrate this argument, one of the examples that Davies presents us with is that of a child displaying behaviors that would traditionally be associated with attention deficit hyperactivity disorder (ADHD), leading to two, alternative treatment scenarios (Davies recommends the second scenario) :

FIRST CASE SCENARIO : TRADITIONAL APPROACH / IN LINE WITH THE MEDICAL MODEL :

In the first case scenario, the child would be treated according to the traditional, medical model : i.e. assessed by a psychiatrist, and, if he met the diagnostic criteria, as designated by DSM V (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), diagnosed with ADHD, ‘labelled’ as having ADHD, and put on psychoactive medication.

effect-labelling-people

SECOND CASE SCENARIO : A MORE HUMANE APPROACH :

However, Davies proposes that a better, initial approach would be as follows :

The psychiatrist does NOT diagnose the child with ADHD, but, instead, interviews his mother to ascertain the family’s history.

From this interview, the following transpires :

  • The mother and the son had been living with a household in which there was domestic violence for several years before the physically abusive man responsible for this violence finally left the home.
  • As a result, the child incurred psychological damage which led to his behavior becoming ‘chaotic’ / angry / hypervigilant 

However, in this scenario, rather than diagnosing the child with ADHD and putting him on medication, the psychiatrist focuses on helping him and his mother gain insight into the underlying reasons for the child’s behavioral difficulties.

Davies then expands upon this second case scenario :

  • Whilst the psychiatrist, in one session, is trying to help the mother and son gain insight into the reasons for the boy’s problems, the mother begins to feel guilty about having exposed her son to a violent environment, and starts to cry.

 

  • In response to his mother’s tears, the boy is quick to rebuke the psychiatrist, perceiving him (i.e. the psychiatrist) to be ‘yet another man hurting his mother.’

 

  • This event then opens up the opportunity for the psychiatrist to discuss with the boy and the mother that such hypervigilance reflected by the boy’s quickness to rebuke the psychiatrist was quite understandable given how he (i.e. the boy) would have had to have learned to become hypervigilant whilst living with the physically abusive man as a matter of self-preservation so that now such behavior had become automatic in situations in which he perceives himself or his mother to be under threat (whether the ‘threat’ is real or imagined).

 

  • In other words, his hypervigilance has become an unconsciously motivated survival response in situations which remind him, even on an unconscious level, of the danger once posed to him and his mother by the physically abusive man who used to live with them.

Armed with this information, the psychiatrist, during further sessions, is then able to develop a meaningful relationship with the boy and his mother and help them to understand the reasons behind his (i.e. the boy’s) behavior (chaotic, angry, hypervigilant etc) and talk through his issues. In this way, the boy is able to gain insight into his own psychological issues which, in turn, leads to an improvement both in his behavior and in how he feels about himself. And this is achieved without the need of a diagnosis or medication.

 

N.B. The above does not imply, nor is intended to imply, that medication for psychological conditions is always inappropriate. Davies himself accepts that medication in psychiatry still has its place in certain situations.

 

You may also wish to my related article :

THE HARMFUL EFFECTS OF LABELLING THE CHILD AS ‘BAD’

 

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

Emotional Neglect And Lack Of Love In Childhood May Switch Off Crucial Genes

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Emotional Neglect And Epigenetics.

 

Studies suggest that emotional neglect and a lack of warm, affectionate, loving nurture in childhood can, in effect, switch off crucial genes that help us to regulate stress.

This is thought to be due to a phenomenon known as epigenetic modification.

 

What Is Meant By The Term ‘EPIGENETICS?’

Epigenetic modification refers to the mechanism whereby the way in which genes express themselves can be altered by external, environmental factors (and such changes are then heritable).

 

Evidence From The Study Individuals Who Had Committed Suicide :

Poulter, et al., 2008 studied the brains of individuals who had been diagnosed with schizophrenia and had subsequently committed suicide. He then compared these brains to the brains of healthy individuals (who had died in accidents).

The result of this rather macabre comparison was as follows  :

In the brains of the individuals who had been diagnosed with schizophrenia and had subsequently committed suicide, the genes responsible for regulating stress had been, effectively, SWITCHED OFF.

HOWEVER :

This was NOT found to be the case when the brains of the previously healthy individuals were examined.

It was concluded that the genes responsible for regulating stress in the individuals who had been diagnosed with schizophrenia and had subsequently committed suicide may have shut down as A RESULT OF SEVERE STRESS DURING CHILDHOOD AND RESULTANT EPIGENETIC CHANGES

 

Another, similar study, was conducted by McGowan et al., 2009 

In this study, the researchers examined :

1) the brains suicide victims WHO HAD SUFFERED CHILDHOOD TRAUMA

and compared them with

2) the brains of deceased, mentally healthy individuals

and with

3) the brains of individuals who had committed suicide BUT HAD NOT SUFFERED FROM CHILDHOOD TRAUMA.

DNA

RESULTS :

It appeared from the results of these examinations that epigenetic changes had occurred in those who had committed suicide and had suffered childhood trauma, but NOT in those who had been mentally healthy prior to death nor in those who had committed suicide but had NOT suffered childhood trauma.

 

CONCLUSION :

These results add weight to the hypothesis that epigenetic modifications can be caused by emotional neglect / inadequate protection from stress during childhood which may, in turn, increase the risk of the affected individual developing a mental disorder and, ultimately, of committing suicide.

 

Evidence From Animal Studies

A study by Bagot et al., 2012 found that stress genes involved in the regulation of stress in newborn rats ARE SWITCHED ON BY THE ATTENTIVE LICKING AND GROOMING OF THEIR MOTHERS. So, this study, too, suggests that epigenetic changes may well be related the quality of parental care during postnatal development (although further research is required to ascertain to what degree the findings of this study can be extrapolated to humans).

 

Implications For Treatment Of Psychological Conditions Related To Childhood Trauma :

Although such research as described above is in its incipient stages, it is hoped that, as such studies accrue, new, effective and innovative ways of treating adult conditions connected to severe stress during crucial stages of early life, psychological development will be created.

 

 

eBook :

childhood-trauma-effect-on-brain

 

Above eBook ‘How Childhood Trauma Can Physically Damage The Developing Brain‘, now available for immediate download from Amazon

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

 

 

Why Complex PTSD Sufferers May Avoid Eye Contact

A study by Lanius  et al. was conducted to cast light upon why many with individuals suffering from posttraumatic stress disorder (PTSD), including those suffering from complex-PTSD, often find it excruciatingly uncomfortable every time the rules of social etiquette compel them to make eye to eye contact with another human being (I, myself once attempted to circumvent this problem by deliberately buying a pair of glasses with lenses that were by far the wrong strength for me so that, whilst, to whomever it was I was required, as the law of social norms decrees, to make eye contact, I appeared to be doing so in the conventionally stipulated manner,  in fact, all that my eyes were actually meeting with was a comfortingly, non-threatening blur).

Returning to Lanius’ et al.’s experiment :

The experiment consisted of two groups :

1) Survivors of chronic trauma

2) ‘Normal’ controls

What Did The Experiment Involve?

Participants from both of the above groups were subjected to brain scans whilst a making eye to eye contact with a video character in such a way as to mimic real life face to face  contact.

What Were The Results Of The Experiment?

In the case of the ‘normal’ controls (i.e. those who had NOT suffered significant trauma), the simulated eye to eye contact with the video character caused the are of the brain known as the PREFRONTAL CORTEX to become ACTIVATED.

HOWEVER:

In the case of the chronic trauma survivors, the same simulated eye contact with the video character did NOT cause activation of the PREFRONTAL CORTEX. Instead, the scans revealed that, in response to the simulated eye contact, the part of the chronic trauma survivors’ brains that WAS ACTIVATED was a very primitive part (located deep inside the emotional brain) known as the PERIAQUEDUCTAL GRAY.

 

 

INTERPRETATION OF THESE RESULTS :

The prefrontal cortex helps us judge and assess a person when we make eye contact, so we can determine whether their intentions seem good or ill.

However, the periaqueductal gray  region is associated with SELF-PROTECTIVE RESPONSES such as hypervigilance, submission and cowering.

Therefore, we can infer that those with PTSD / complex PTSD may find it hard to make eye contact because their brains have been adversely affected, as a result of their traumatic experiences, in such a way that, when they make eye contact with another person, the ‘appraisal’ stage of the interaction (normally carried out by the prefrontal cortex) is missed out and, instead, their brains, due to activation of the periqueductal region, cause an intensely fearful response.

This constitutes yet another example of how severe and protracted childhood trauma can damage the physical development of the brain.

 

Link : Lanius et al’s study.

 

eBook :

 

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

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

Can New Drug Treatment Induce Memories And Feelings Of Safety In PTSD Sufferers?

An experiment carried out at the University of Puerto Rico (Quirk et al.) on rats has shown that administering a drug directly into their brains can induce in them a sense of safety in a situation in which they were previously fearful.

 

Brief Summary If Experiment :

Rats can be conditioned to fear the sound of a particular tone (the fearful response takes the form of the rats ‘freezing’ )if, each time the tone is sounded, the experimenter administers to them an electric shock (this works through technique known as classical conditioning).

However, this conditioned, fearful response to the same tone can be extinguished / eliminated if it is then sounded a sufficient number of times during which, now, when the rats hear it, they are NOT administered with an electric shock (this is known as ‘extinguishing training’).

It was also found that the extinguishing of the rats’ fear response to the sound of the tone is NOT due to their fear memory / memory of the electric shocks being wiped out, but, instead, due to a NEW MEMORY OF THE SOUND’S (NOW) SIGNALLING OF SAFETY (i.e. NO ELECTRIC SHOCK ADMINISTERED WHEN TONE IS HEARD) BEING  CREATED.

DRUG MIMICS EXTINGUISHING EFFECT :

Crucially, the researchers involved in the study found that, instead of the rats needing to go through this extinguishing process / training to stop them feeling fearful (freezing) in response to the tone being sounded, but, instead, feeling safe in response to it, the same effect can be obtained by administering a drug (the drug used was a protein, brain-derived neurotrophic that helps the brain’s neurons to grow) directly into the rats’ brains.

In other words, it seems that the researchers involved in the experiment have found a way to pharmacologically (i.e. through the use of a drug), CREATE IN THE RATS’ BRAINS A MEMORY OF SAFETY.

 

IMPLICATIONS OF THE ABOVE FINDINGS :

The hope is that research like the above will help with the development of drugs which can be given to humans in order to help create feelings and memories of safety in individuals who are suffering from PTSD, a condition which, in the absence of effective treatment, can completely incapacitate and ‘paralyze’ sufferers with unremitting, intense feelings of fear and terror.

 

RESOURCE :

FEEL SAFE – SELF HYPNOSIS DOWNLOADS

 

eBook :

complex PTSD

Above eBook now available from Amazon for immediate download. Click here.

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

 

 

Self-Defeating Personality Disorder And Its Link To Childhood Trauma

Self-defeating personality disorder (also sometimes referred to as masochistic personality disorder), whilst not included in the current edition (fifth) of the DSM (Diagnostic and Statistical Manual of Mental Disorders), is still frequently referred to by mental health professionals to help explain various aspects of behavior.

 

What Is Self-Defeating Personality Disorder?

In order to be considered as suffering from self-defeating personality disorder, an individual will be suffering from a minimum of five of the following symptoms :

– avoidance of accepting help offered by other people

– drawn to people and situations which lead to negative outcomes (e.g. to relationships with abusive partners) despite availability of more positive options

– avoidance of pleasurable activities despite having the psychological capacity to experience pleasure (unlike those suffering from anhedonia) or a reluctance to admit to feelings of enjoyment (e.g. due to feeling guilty such feelings and that they are ‘undeserved)

– tendency to induce anger in, and rejection by, others, but then feeling emotionally shattered when this happens

– undermines own abilities by not undertaking vital tasks (of which s/he is capable) that would allow him/her to achieve his/her personal goals, leading to under-achievement and under-performance. Also, may set self clearly unobtainable goals which ensure failure and humiliation.

– indulges in excessive, unsolicited self-sacrificing behavior

– rejects, or undermines relationships with, those who treat him/her well (instead, forming relationships with those who are likely to have a negative impact upon him/her – see above) as feels unworthy of love, particularly the love of ‘decent’ people

 

Theories Relating To How Self-Defeating Personality Disorder / Masochism May Be Related To Adverse Childhood Experiences :

   – Francis Broncek theorized that self-defeating personality disorder / masochism is linked to the episodic or chronic experience of not being loved as  a child, as having been rejected / abandoned as a child, and / or having been used as a scapegoat in childhood,.

– Berliner (1947) stated : ‘in the history of every masochistic patient, we find an unhappy childhood, and frequently to…an extreme degree.’ He also proposed the idea the masochism serves as a defense mechanism which protects against the development of depression or, even, schizophrenia.

Grossman (1991) stated that self-defeating personality disorder and masochism are linked to severe traumatization inhibiting a person’s ability to sublimate the pain psychological pain generated by the traumatic experience into productive mental activity.

– It has also been hypothesized that a child who has been brought up by a very strict parent or other significant authority figure ,and  has been treated in such a way as to make him/her feel worthless ,  unlovable and frequently deserving of harsh punishment, may grow up to internalize such views so that they form part of his/her set of core-beliefs. Such individuals are also likely to have profound, pent up feelings of shame and guilt which they seek to exculpate and atone for through self-punishment (both consciously and unconsciously) or by subjecting themselves to abuse, mistreatment and punishment by others.

 

Treatment :

Treatment for this disorder can be complex, not least because those suffering from it may well shun offers of help (a symptom of the condition – see above). However, treatment options include group therapy, family therapy, cognitive behavioral therapy and counseling.

 

 

RESOURCE :

Stop Self Sabotage | Self Hypnosis Downloads

 

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

 

 

 

 

Emotional Detachment Disorder And Childhood Trauma

Extreme emotional detachment can operate as an unconscious defense mechanism to help us cope with traumatic experiences including, of course, childhood trauma (such as emotional, sexual and physical abuse). If it is necessary for us to employ this coping mechanism for extended periods of time, it can become a deeply ingrained and pervasive part of our psychological make-up and we may continue to use it to protect ourselves from potential, emotional harm for the rest of our lives.

Conditions that we may develop which are profoundly linked to feelings of emotional detachment include depersonalization and dissociation, both of which are characterized by feelings of ’emotionally numbness.’  /psychic numbing.’ (To read my previously published article on ‘OVERCOMING EMOTIONAL NUMBNESS,’ click here.)

Extreme emotional detachment can also lead to a lack of empathy for others, which, in turn, is associated with a higher likelihood of developing other psychiatric problems such as antisocai personality disorder or pronounced sadistic tendencies.

More frequently, however, those who have learned to detach emotionally as a way of mentally escaping the psychological pain of their adverse childhood experiences go on to develop serious difficulties with adult relationships due to a deep mistrust of others and a general fear of intimacy ; furthermore, such individuals may come across to others (including family members) as ‘cold,’ ‘aloof’, ‘distant’ and ’emotionally unavailable’.

Other symptoms of being cut off from emotions include a lack of emotional intelligence, a tendency to have a preference for logical and rational thinking styles and a propensity to intellectualize potentially emotionally charged subjects.

Suppression of emotions may also result in dysfunctional, ‘compensatory’ behaviors including promiscuous sex / sexual addiction, drug / alcohol abuse and gambling.

In very extreme cases, some theorists believe that when emotional detachment gives rise to severe dissociation as in cases of, for example, posttraumatic stress disorder, multiple personality disorder may result.

To read my previously published article, OVERCOMING EMOTIONAL NUMBNESS,’ click here.

 

RESOURCE :

Get In Touch With Your Emotions | Self Hypnosis Downloads

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

 

 

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