Borderline Personality Disorder And Childhood Trauma

We can say, with a very considerable degree of confidence indeed, that there exists a strong link between borderline personality disorder and childhood trauma; a large body of research has shown that individuals who have suffered childhood trauma and/or neglect are far more likely to develop borderline personality disorder (BPD) as adults than those who were fortunate enough to have experienced a relatively stable childhood.

Before we look at how borderline personality disorder and childhood trauma are linked, it is first useful to briefly describe the main symptoms of this most serious psychological disorder.


Borderline personality disorder experience a range of symptoms which are split into 9 categories. These are:

1) Extreme swings in emotions
2) Explosive anger
3) Intense fear of rejection/ abandonment sometimes leading to frantic efforts to maintain a relationship
4) Impulsiveness
5) Self-harm
6) Unstable self-concept (not really knowing ‘who one is’)
7) Chronic feelings of ’emptiness’ (often leading to excessive drinking/eating etc ‘to fill the vacuum’)
8) Dissociation ( a feeling of being ‘disconnected from reality’)
9) Intense and highly volatile relationships

For a diagnosis of BPD to be given, the individual needs to meet at least 5 of the above borderline personality disorder criteria.

A person’s childhood experiences have an enormous effect on his/her mental health in adult life. How parents treat their children is, therefore, of paramount importance.

A borderline personality disorder is an even more likely outcome, if, as well as suffering trauma through dysfunctional parenting, the individual also has a BIOLOGICAL VULNERABILITY.

In relation to an individual’s childhood, research suggests that the 3 major risk factors are:

– trauma / abuse
– damaging parenting styles
– early separation or loss (e.g due to parental divorce or the death of the parent)

Of course, more than one of these can befall the child. Indeed, in my own case, I was unlucky enough to be affected by all three. And, given my mother was highly unstable, it is very likely I also inherited a biological/genetic vulnerability.


1) Dysfunctional and disorganized – this can occur when there is a high level of marital discord or conflict. It is important, here, to point out that even if parents attempt to hide their disharmony, children are still likely to be adversely affected as they tend to pick up on subtle signs of tension.

Chaotic environments can also impact very badly on children. Examples are:

– constant house moves
– parental alcoholism/illicit drug use
– parental mental illness and instability/verbal aggression

2) Emotional invalidation. Examples include:

– a parent telling their child they wish he/she could be more like his or her brother/sister/ cousin etc.
– a parent telling the child he is ‘just like his father’ (meant disparagingly). This invalidates the child’s unique identity.
– telling a child she or he shouldn’t be upset over something, therefore invalidating the child’s reaction and implying the child’s having such feelings is inappropriate.
– telling the child he or she is exaggerating about how bad something is. Again, this invalidates the child’s perception of how something is adversely affecting him or her.
– a parent telling a child to stop feeling sorry for him or herself and think about good things instead. Again, this invalidates the child’s sadness and encourages him/her to suppress emotions.

Invalidation of a child’s emotions, and undermining the authenticity of their feelings, can lead the child to start demonstrating his/her emotions in a very extreme way in order to gain the recognition he/she previously failed to elicit.

3) Child trauma and child abuse:

People with BPD have very frequently been abused. However, not all children who are abused develop borderline personality disorder due to having a biological/genetic RESILIENCE and/or having good emotional support and validation in other areas of their lives (e.g. at school or through a counsellor).

The trauma inflicted by a family member has been shown by research to have a greater adverse impact on the child than abuse by a stranger. Also, as would be expected, the longer the traumatic situation lasts, the more likely it is that the child will develop borderline personality disorder in adult life.

4) Separation and loss:

Here, the trauma is caused, in large part, due to the child’s bonding process development being disrupted. Children who suffer this are much more likely to become anxious and develop ATTACHMENT DISORDERS as adults which can disrupt adult relationships and cause the sufferer to have an intense fear of abandonment in adult life. They may, too, become very ‘clingy’, fearful of relationships, or a distressing mixture of the two.


Borderline Personality Disorder (BPD) Statistics, Facts and Figures :

– about three-quarters of those who suffer from BPD have a history of self-harm 

– about 10% of those who suffer from BPD eventually commit suicide 

– the majority of those who suffer from BPD improve over time (over 70% go into long-term remission). 

– about 50 -60% of those with BPD have a history of having been sexually abused

– one of the main hallmarks of BPD is severe dissociation 

– a diagnosis of BPD does not define the person nor detract from their positive qualities

– psychotherapy, especially Dialectical Behaviour Therapy (DBT), has been shown by studies to be the most effective treatment 

– if a person suffers from BPD, s/he is likely to have other mental health issues that run alongside it (known as co-morbidities). Often, these other conditions include depression, psychotic symptoms and bipolar disorder

– about half of those who suffer from BPD have experienced a history of having been the victim of violence

– about 1% of the population suffers from BPD; whilst it is just as likely to affect men as women, the condition is under-diagnosed in men who are more likely to become caught up in the justice system or to use substance abuse services instead of having their BPD directly addressed.

Neuroimaging And Borderline Personality Disorder (BPD) :

Are the brains of people with borderline personality disorder (BPD) physically different from the brains of those without BPD? Neuroimaging techniques can help to answer this question.

What Is Neuroimaging?

Neuroimaging incorporates various techniques which take images of the brain’s structure and functioning. However, there is controversy surrounding just how accurately such images may be interpreted.

Neuroimaging techniques include :

  • Magnetic resonance imaging, or MRI (this technique uses magnetic fields and radio waves to produce two or three-dimensional images of the brain).
  • Positron emission tomography, or PET (this technique also produces two or three-dimensional images by measuring emissions from radioactive chemicals that have been injected into the bloodstream)
  • Magnetoencephalography (this technique measures the magnetic fields produced by electrical activity in the brain).

Meta-analysis Of Neuroimaging Studies Relating To Borderline Personality Disorder (BPD) :

Researchers at the University of Freiburg (2006) conducted a meta-analysis (an overarching analysis of relevant, previously published studies) of all the research to date (i.e. 2006, see above) relating to BPD and neuroimaging.

They found that all of these studies found abnormalities in :

  • the limbic system (a region of the brain involved in generating emotions including fear, anger and those connected with sexual behaviour, the formation of memories, especially memories connected with intense emotions)
  • the frontal lobes (a region of the brain involved in functions including understanding the consequences of actions, decision making, the regulation (control) of emotions and the suppression of unacceptable social impulses (including impulsive aggression).

Conclusion :

These abnormalities in these two regions of the brain, given the functions of those regions, are consistent with symptoms found in individuals suffering from BPD. It can, therefore, be inferred that the limbic system and frontal lobes are involved with the disorder.

However, research (at the time of writing) is not advanced enough to enable actual diagnosis of BPD using neuroimaging techniques.

Common Misunderstandings About Borderline Personality Disorder : 

Due to the fact that borderline personality disorder (BPD) is a highly complex condition, there are, notoriously, many misunderstandings and misconceptions surrounding the true nature of this extremely serious psychiatric illness; they include the following :

1) The condition is untreatable – unfortunately until relatively recently, many of those working in the field of mental health regarded BPD as essentially untreatable. It is very sad that this meant a lot of individuals were left to suffer extreme distress which could, with proper treatment, have been alleviated.

Fortunately, there is now much research showing that, in fact, treatment can be very effective for those suffering from BPD. Other therapies for BPD, include :

  • Mentalization-Based Therapy (MBT)
  • Intensive Short-Term Dynamic Therapy
  • Dynamic Deconstructive Therapy (DDT).

Indeed, approximately three-quarters of those who receive proper treatment will improve so significantly that they no longer meet the criteria to be diagnosed with BPD.

2) Stigmatization – It is true that there is still a significant stigma surrounding the diagnosis of BPD, but things are improving.

It used to be the case that many mental health professionals even refused to work with BPD sufferers because they were regarded as too difficult and challenging. This situation has greatly improved due to the much better understanding that now exists surrounding what compels BPD sufferers to behave the way they do and how this behaviour is very often linked to intense feelings of distress and having suffered a deeply painful childhood.

3) Diagnosis –  In the past, psychiatrists frequently did not even like to diagnose their patients with BPD because they did not wish to stigmatize them. Again, now, with the accruing of much greater understanding and knowledge about both the causes and true nature of the condition, psychiatrists are not so likely to be deterred from diagnosing the illness.

There is, in fact, a great value in receiving a correct diagnosis of BPD, as it allows the sufferer to understand the source of his/her difficulties and what may have caused them (click here to read my post about the link between childhood trauma and the subsequent development of BPD,) therefore making it far more likely that these difficulties can be effectively addressed. Learning about one’s illness and its likely causes means that an individual no longer needs to fight it with ‘one hand tied behind their back’

4) The misconception that those who suffer from BPD are deliberately manipulative – it used to be claimed by some that individuals with BPD had a tendency to be deliberately manipulative. In fact, however, when BPD sufferers become intensely angry, for example, or otherwise ‘act out’. it is generally the case that such behaviour is impulsive, spontaneous and completely unplanned.

Indeed, because one of the symptoms of BPD is an impaired understanding of how social interaction operates, they are unlikely to have the necessary skills to plan out the intricacies of how to approach others in a manipulative and self-serving way.

5) The misconception of ‘attention-seeking’ suicide attempts – the fact of the matter is, an absolutely astounding ten per cent of individuals with BPD ultimately end their lives by suicide. THIS SUICIDE RATE IS ONE THOUSAND TIMES GREATER THAN IN THE GENERAL POPULATION IN THE UK! That statistic speaks most eloquently for itself, I think. Given this horrendous figure, one is left wondering, and deeply bewildered, as to why those with BPD do not demand MUCH MORE ATTENTION, LEFT AS THEY ARE, SO OFTEN, TO FEND FOR THEMSELVES WITH NO PROPER MEDICAL INTERVENTION.

Study Shows 73% Recover from Borderline Personality Disorder (BPD):

Until recently, it was frequently suggested that borderline personality disorder (BPD) was very difficult, if not impossible, to treat. During my research for this article, I have been disturbed to discover, also, that in the recent past some clinicians did not regard BPD as an illness at all – instead, they put forward the view that those diagnosed with BPD were not mentally disordered, but, rather, simply ‘bad’ and ‘manipulative’ people!

This reminds me of a time I made a very serious and determined suicide attempt and the psychiatrist I saw afterwards (who knew very little about me) tried to make the case that I had not really intended to kill myself but was seeking attention and sympathy. When I protested and tried to explain the attempt had been made very much in earnest (one might even say, ‘deadly earnest), he responded (and I quote him verbatim: ‘It sounds like you’re talking bullshit to me!’

Highly professional.

In connection with the cynical and deeply insulting attitude that my psychiatrist displayed, I would also point out that, in my own personal view, some individuals (in my case, certain family members and former friends) like to take the view the BPD sufferer is not really ill as this, in their minds, absolves them of any responsibility to provide help and support.

Despite such pessimism, a study funded by Columbia University found that 73.5% of the participants who took part in their study recovered from BPD within 6 years. Even more encouragingly, it was found in the same study that more than half actually recovered within just 2 years.

Another encouraging finding of the study was that only 6% of those who had recovered relapsed (and, even if they did, this was mainly due to the effects of an extremely stressful event/s).


– 1.4% of the participants committed suicide in the first 2 years of the study

– 1.7% of the participants committed suicide in the next 2 years of the study

– 0.7% of the participants committed suicide in the final 2 years of the study

(This gives a total of 3.8%, or about 1 in 25, who committed suicide during the study).

– 65.9% achieved good psychological functioning by the end of the study (32.4% after 2 years, 48.3% after 4 years, 65.9% by end of study).


– Impulsiveness (this symptom improved best of all)

– Mood/affect (although this improved least well)

– Interpersonal functioning

– Self-mutilation

– Suicidal behaviours

– Psychotic symptoms

The study also showed that the two factors which most helped the individuals to recover were :

1) Ending a destructive relationship

2) Determination to get well.




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

Borderline Personality Disorder (BPD) and Sexuality

Borderline Personality Disorder (BPD) and Sexuality


Why Does Traumatic Experience Harm Some People More Than Others?

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People are affected by the experience of trauma in different ways. What factors are behind these individual differences in response to adversity?

I provide a list of examples below:

– if we receive support from family, friends, professionals etc during a traumatizing period of our lives the adverse effects of the trauma may be reduced. For example, a child whose parents are involved in acrimonious divorce but who receives emotional support from loving grandparents may be less psychologically damaged than a child who is going through a similar experience but receives no such support.

– similarly, if we receive support after experiencing trauma from, for example, a close set of friends and/ or relations, we are likely to cope with the negative effects of our traumatic experience more effectively

– some people’s genetic inheritance may make them more resilient to the effects of trauma than others

– those who bonded well with/formed a secure attachment to their primary caregiver during babyhood/infancy are, all else being equal, likely to be able to cope with the adverse effects of trauma in later life than those individuals who did not develop this psychologically protective bond but, instead, developed an insecure attachment with their mother during their early development

– a person who is helpless in the face of his/her traumatic experience and has no control over it is likely to be more badly affected by it than a person who can exert some control over his/her fate.

– traumatic experiences that continue over a protracted period of time are, in general, more psychologically damaging to an individual than traumas that are one-off event

– the effects of trauma are likely to be more serious if the harm is perpetrated by another person (as opposed to the harm being caused by an impersonal event such as a natural disaster).

– effects of trauma are at their most severe when perpetrated by a person whose role is to love and protect us, especially a parent.

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

Childhood Trauma Leading To Adult Paranoia


If we suffered from childhood trauma, particularly if, as a child, we felt frequently persecuted, then, all else being equal, we are more likely to develop symptoms of paranoia in our adult lives than those who were fortunate enough to have experienced a relatively benign childhood.

In this post, I will focus on how FAULTY REASONING, also known as COGNITIVE DISTORTIONS, are a major contributory factor in fueling symptoms of paranoid. Such faulty reasoning has its roots in adverse childhood experience.

I will look at four main types of faulty reasoning. These are:

1) A need for certainty

2) Blaming others

3) Jumping to conclusions

4) A failure to look for alternative explanations

Let’s look at each of these in turn.

1) Need for certainty:

When we are under stress and occurrences take place that upset us and disturb our peace of mind there is a human tendency to develop a strong desire to obtain a definite reason why the event happened (as, theoretically, if we know the true cause, we put ourselves in a less vulnerable position).  However, this need for knowledge may become so potent that it can, potentially, lead us to prefer an upsetting explanation to no explanation at all/being forced to live in an uncomfortable state of uncertainty and ignorance.

Indeed, cognitive therapists, who help to treat people who suffer from serious psychological problems compounded by their tendency to employ faulty reasoning, have found that individuals who can accept living with uncertainty are less likely to develop suspicious/paranoid thoughts.

2) Blaming others:

When unpleasant events happen to us we assign the cause to one of two categories. These are:

a) internal factors

b) external factors

(or, of course, to a combination of both).

If we attribute the cause to internal factors, this tends to mean we blame ourselves; if, on the other hand, we attribute the cause of the unwanted event to external factors, this will tend to mean that we see the negative happening as having been outside of, and beyond, our personal control.

For example, let’s say I’ve just failed an exam. I may attribute my failure to:

a) internal factors (eg I failed to revise adequately or am simply too stupid to have passed)

or, alternatively, I may attribute it to:

b) external factors, thus exonerating myself from responsibility (eg whilst I sat the exam it was 98 degrees Fahrenheit in the shade outside and the air conditioning had broken down, or, the person next to me impaired my concentration with his constant hiccuping).

If I am the type of person who tends to attribute my problems to the kind of explanation represented by the second example of ‘b’, above ( the habitual hiccuper) and, therefore, tends to blame external factors/ other people when undesirable things happen to me, then, research suggests, I am also more likely to be the kind of person who suffers from suspicious/ paranoid thoughts.

In the case of my example, if I was very paranoid indeed I might even think that the relentless hiccuper was only pretending to have hiccups simply to distract and infuriate me (perhaps, I might think, I have an enemy who was paying him ten pence per hiccup).

3) Jumping to conclusions:

Anxiety may compel us to jump to hasty conclusions without gathering, scrutinising and assessing all of the relevant evidence.

This is related to:

4) Ignoring alternative, less upsetting explanations for what has happened.

Why Paranoid Thoughts May Persist.

Once we start to think in paranoid ways, we may set off a chain of behaviours and beliefs which perpetuate our paranoid thoughts. Examples include:

– CONFIRMATION BIAS: this is a common error (and is certainly not limited to paranoid thinking). It involves focusing on evidence that supports one’s theory, whilst ignoring or minimising the, quite possibly more compelling evidence, against it.

– BEHAVING IN ACCORDANCE WITH OUR ERRONEOUS PARANOID BELIEFS: eg by avoiding situations we (falsely) believe to be threatening and dangerous. This perpetuates our fear as we do not allow ourselves to confront and master the fear. It also prevents us from learning that the previously feared situation is not a danger to us after all.

– NOT SEEKING HELP WITH AN ANXIETY CONDITION (anxiety and paranoid thinking are closely linked)

– NOT SEEKING HELP FOR A DEPRESSIVE CONDITION (depression leads to the kind of negativity that paranoid thinking thrives upon





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



Unconscious Processes : How Our Past Affects Our Present.


Our past experiences, in particular our childhood experiences, create in our brains unconscious processes that affect our present.

This idea is based upon various sub-types of psychoanalytic theory. These include:

1) Freudian theory

2) Ego psychology

3) Object relations theory

Let’s look at each of these in turn:

1) Freudian Theory

According to Sigmund Freud, often referred to as the ‘father of psychoanalysis’, the essential and fundamental drives that galvanise human behaviour are :

a) The sex drive

b) The aggressive drive

(this makes sense in terms of evolutionary theory, as these drives would have helped our ancestors survive and reproduce/pass on their genes to the next generation).

Importantly, however, Freud stated that people are largely unaware that these drives partially determine their day-to-day behaviour; the process by which the drives exert their insidious influence is unconscious. According to his theory, such powerful, primitive and animal drives reside in the ID (by which he meant the part of the brain which is not directly available to the conscious mind).

Freud went on to explain that because we are bound by society’s rules and values, we cannot allow ourselves to give these drives free rein. Instead, we (at least partly) suppress them. According to his theory, it is the part of the mind that he called the SUPEREGO which keeps these powerful drives at bay (it is then the EGO’S job, influenced by both the superego and the id, to direct our behaviour in such a way that it is in accord, as much as possible, with society’s expectations. Clearly, of course, we cannot simply indulge drives emanating from the id with the spontaneity of wild animals; civilisation, and the moral codes we have imbibed over the course of our lives, precludes such behaviour.

How our ego and superego function is largely determined by our culture, society and the values we learned from our parents as we grew up.

The third part of the mind, then, already referred to above, Freud theorised, is the ego. Its impossible job is to somehow satisfy the needs of the id whilst not impinging upon the rules our superego imposes upon us. Because this can’t be done, compromises need to be made continually.

To employ the use an analogy, the ego is a bit like a referee in charge of a fight between a crazed chimpanzee (the id) and a pious, sanctimonious and domineering aunt (the superego).


2) Ego Psychology

Inspired by Freud’s theories, ego psychology aims to help us adapt our behaviour to the demands of the society and culture in which we live.

As stated above, the ego is in a more or less constant state of conflict; it needs to continually try to balance the opposing demands of the id and the superego (see above) in a manner which society deems to be acceptable.

Essentially, then, ego psychology aims to help the individual adapt to the particular society in which s/he finds him/herself immersed. This involves, for example:

  • help with impulse control.
  • help with relating to others appropriately.
  • help with controlling emotions.
  • accurately perceiving the demands of reality and acting accordingly.
  • improving coping mechanisms.
  • help to reduce unhelpful defence mechanisms.


3) Object Relations

This theory is based upon the idea that the view we developed of ourselves and others during our childhood deeply affects how we relate to others in our adult lives.

According to this theory, we have a marked tendency to repeat our old ways of relating to others. For example, if we were abused during our childhood, we may, as adults, be unconsciously drawn to form relationships with others who will abuse us.

Why should this be? It is theorised that we have a strong, unconscious drive to repeat our early life traumatic experiences so that we can ultimately gain mastery over them. This is also known as the repetition compulsion.


In summary:

a) We can say that Freud believed that the superego develops in individuals as a result of the moral codes they absorbed as they were growing up from, for example, their parents, society and culture. Also, he believed that the part of the mind he called the ‘id’ houses our most basic, animal instincts and drives, although these are generally unconscious.


b) We can also say that, according to object relations theory, that the way we interacted with our primary caregivers when we were children has a powerful effect upon how we relate to others in our adult lives. Again, however, the effect is likely to act largely via unconscious processes.


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



Brains Of Children Exposed To Domestic Violence Affected In Similar Way To Exposure To Combat


A study carried out at University College London (UCL) has found that when a child is continually exposed to domestic violence, such as the father regularly beating the mother, their brains are negatively affected in a similar way to how the brains of soldiers are affected by exposure to combat in war.

As a result, the children’s brains may become HYPERSENSITIVE TO PERCEIVED THREAT, or, to put it informally, ‘stuck on red alert.’  This, in turn, may lead to the child becoming trapped in a distressing state of hypervigilance and extreme wariness/distrust of others.

The research study which discovered this entailed children being shown pictures of angry/threatening faces whilst undergoing a brain scan and from this it was found that their emotional response to these faces was far more intense than was the emotional response of another group of children who were from stable backgrounds (known as the ‘control group’) who underwent the same procedure.

Specifically, the brain scans revealed that the children who had been exposed to domestic violence showed unusually high activity levels in two parts of the brain when shown the pictures of the angry/threatening faces, namely: 1) The anterior insula and 2) The amygdala, when compared to the children shown exactly the same pictures but whom had had a stable, loving and protected childhood.

The similarity to the effect of exposure to combat on the brain:

Such increased activity in these two brain regions has also been found to occur, from previous research, in the brains of soldiers who have experienced protracted exposure to armed conflict.

Short-term benefits but long-term losses:

One of the psychological researchers involved in the UCL study pointed out that this changed brain activity may be helpful to children who live in homes where there is domestic violence in the short-term by helping them to avoid danger.

However, in the long-term, the changes may cause the individual severe problems – for example, as an adult, the individual may constantly overestimate the degree of danger that other people present to him/ her. In turn, this may lead that same individual to be prone to becoming disproportionately aggressive towards those s/he perceives to be a threat to him/her.

The individual, too, may perceive threats where they, in reality, do not exist due to his/ her constant wariness of others together with a pervasive sense of paranoia.


The researchers involved in this study also drew our attention to the fact that not all children who are exposed to domestic violence develop the kind of mental disturbance described above and that more research needs to be conducted in order to ascertain which factors contribute to this resilience.

Anxiety and depression:

Research also shows that children exposed to domestic violence are at significantly increased risk of developing anxiety and depression; indeed, both the anterior insula and the amygdala play a prominent role in the generation of anxiety disorders.













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


Erotomania: Its Origins In Childhood Trauma


de_clerambaults_syndromeErotomania is also sometimes known as de Clerambault’s Syndrome and refers to a psychotic delusion held by the person suffering from it that someone else is deeply in love with them. This ‘someone else’ usually has an elevated social status such as a pop star, film star or other successful prominent public figure and will usually be completely unobtainable. Usually, too, the sufferer does not know the person they believe to be in love with them but admires him/her from afar (perhaps keeping a scrapbook dedicated to the object of desire).

The delusion includes the false belief that the admired person is sending the sufferer covert, subtle messages. The so-called messages (which the admired person is not actually sending – they exist only in the sufferer’s imagination) the sufferer believes, are intended to convey the admired person’s love for him/her and desire to have a relationship with him/her (both males and females can suffer from erotomania).

The erotomaniac wrongly perceives these ‘messages’ are being sent in various ways which can include the admired one’s facial expressions, posture, body language, looks and glances (even if these are from behind a TV screen). The sufferer of the condition may also believe that the admired one is sending these supposed ‘messages’ telepathically.

Psychologists call such misperceptions delusions of reference (the erotomania believes the admired one’s glances, body language etc are being directed at him/her whereas, in reality, this is not the case).

The delusion is usually elaborate and the sufferer may convince him/herself that the reason the admired one is sending the ‘ messages’ subtly/covertly is that s/he (the admired one, too, can be male or female) is desperately trying to keep the ‘incipient love-affair’ (as the sufferer of the condition perceives it) a secret from the media and public.

Because the erotomaniac believes the admired one is encouraging him/her to communicate, the sufferer of the condition will frequently bombard the high-status individual with letters, phone calls (if the erotomaniac has managed to obtain the relevant phone number – and s/he is likely to go to extraordinary lengths to do just this) and unsolicited gifts.

The sufferer of the condition may, too, start to stalk the admired one, perhaps standing outside his/her house, gazing through windows or going so far as to repeatedly knock at the victim’s door and try to gain entrance. In some cases, the police may become involved as the erotomaniac frequently becomes intensely obsessive about forming a relationship (or, as the sufferer perceives the case to be, taking the ‘relationship’  with the admired person to ‘the next level’) and may pursue him/her with a disturbingly tenacious zeal.

It cannot be stressed too much the sufferer’s belief that the admired person is deeply in love with him/her is patently false and delusional. However, if a third party tries to gently explain to the erotomaniac that s/he is, as it were, barking up the wrong tree, s/he will often become upset, hostile, angry and highly defensive.

So the erotomaniac’s belief is resolutely and unquestioningly held – indeed, the belief becomes central to his/her raison d’etre. All evidence against the belief being true is discounted by him/her. Indeed, one of the hallmarks of the individual who suffers from erotomania is that s/he completely lacks insight into his/her delusional state.

It has been estimated that about 15 people out of every 100,000 suffer from erotomania; however, this figure is likely to be an underestimate as those who suffer from the condition tend to avoid becoming involved with psychiatric services.

Erotomania can exist as a primary condition (ie exist on its own in the absence of any other psychiatric condition) or it may be secondary to conditions such as schizophrenia and bipolar disorder.

A major factor that may contribute to its development is thought to be a childhood which involved being rejected, abandoned or feeling unloved. However, because the condition is, comparatively speaking, so rarely seen within the world of psychiatry and psychology more research is needed.

Interestingly, it has also been found by researchers that some people who have suffered damage to their brain’s right hemisphere spontaneously develop the condition.

Some sufferers of the condition respond to psychiatric medication and it is also thought that cognitive behavioural therapy can play a useful role in some cases.


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

Early Stardom : The Drawbacks

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How many young people yearn to achieve stardom? A lot, if the numbers of them who audition for shows like The X Factor, Britain’s Got Talent and America’s Got Talent are anything to go by.

But is early mega-stardom as good a thing for those rare individuals who achieve it as many imagine it to be?  Almost certainly not. When we imagine what stardom would be like, we tend to overestimate the positive elements whilst underestimating, or ignoring altogether, the negative aspects.

One example of a casualty of early fame is Zayn from One Direction whose departure from the group appears to have been due, at least in part, to the intolerable pressure of being constantly in an intense spotlight (both literally and metaphorically) with his every move under relentless scrutiny and endlessly reported upon. And, of course, to sell papers, such reporting amongst certain sectors of the press was based upon wild rumours and speculation.

Zayn was nearly an adult when he achieved his stratospheric level of fame, but what about those who achieve it at an even more tender age?

Most experts agree that if psychological harm is to be kept to a minimum, the young star’s childhood needs to be kept as close to ‘normal’ as possible (although, of course, it would be impossible to keep it completely so). Parents play a vital role in ensuring this happens, as do mentors and others with whom the young person comes into professional contact.

Crucially, this involves making sure that the young person has similar rules, boundaries and limits set for him as anyone else of his age. In the case of Justin Bieber, in the early days of his fame when he was already earning a passive income, it was reported that his mother, who used to travel with him on tour, allowed him only a small allowance to spend each week in order to help him ‘keep his feet on the ground’. (How much good this has done in the long run, however, many might consider being a moot point.)

This brings us on to the next important consideration, namely that it is also of great importance that those connected to the child star professionally do not behave towards him/her in a totally submissive, obsequious and sycophantic way – in other words, it is not helpful for the psychological development of the young star to be constantly and solely surrounded by ‘yes- men’. There have been some reports in the media that this was at the bottom of some of Justin Bieber’s legal difficulties.

If the young star has his every need pandered to, it will impair his/her ability to learn how to cooperate with others in life, reach compromises, negotiate and build up a tolerance for not invariably getting his/her own way. If we do not learn these things as we grow up, but, instead, develop an attitude of complete and utter entitlement, life becomes far more difficult and stressful than it otherwise would be when we are adults.

‘Can’t Complain’.

Just because a person is rich and famous, perhaps, too, adored from a distance by millions, this does not mean he is immune from emotional suffering. He can develop psychological problems that are just as painful as anyone else’s. Indeed, the pressure of fame itself can often be a significant contributory factor to the development of poor mental health. Consider, for example, how many rich and famous individuals have committed suicide over the last fifty years or so.

However, such celebrities can come across the problem, if they are, say, very depressed, of others taking the ignorant attitude towards them best expressed by the phrase ‘what have you got to be depressed about?’ Equally badly, the famous person may unnecessarily berate himself with similar sentiments, thus compounding the guilt which is invariably an intrinsic component of clinical depression.

Parent-Child Role Reversal:

If the parents of the young star fail to set their celebrity offspring appropriate limits, rules and regulations, but, instead, concentrate entirely upon catering for his every whim, a kind of role reversal may occur within the relationship, whereby it almost becomes as if the child is the parent and the parents the children.

This will be even more likely if the child star becomes the family’s primary money-earner.

If this happens, the child can feel as if he has lost his innocence which he is likely to later mourn. 

Overnight Success:

Many child stars find that they are thrust into the public eye ‘overnight’ which itself is problematic as they are deprived of a transitional period during which they can gradually adjust to their new, elevated social status.

Psychological Splitting:

Young child stars find that they are compelled to develop a kind of split personality – a false, professional image to be presented in public (which may require the adoption of a confident and happy persona the star does not feel) and a private, authentic self.

Sometimes, problems may develop if the two presentations of self start to merge so that the child star feels that he is not at all certain as to who he ‘really is’ (i.e. identity confusion may develop).

It’s Lonely At The Top

Young people very often ‘just want to be normal’, so becoming a major star can feel very lonely and isolating. Inevitably, the dynamics of friendships the star has with non-famous friends are likely to become confusingly complex. Perhaps some friends will become so intensely admiring of the star it makes him feel awkward and uncomfortable, whilst others may become madly jealous. The young British star, Jamie Bell, who played Billy Elliot in the original screenplay, spoke of how some at his school bullied him as a result of his success. The young British diver, Tom Daley, also experienced bullying as a fifteen- year -old Olympian.

Furthermore, it is easy for the young celebrity to become mistrustful of new people he meets as there is always the possibility, if they show interest in the star, that they are primarily drawn by the brute fact of his fame and the prestige it may bring by proxy, rather than by his inner personality. This is particularly difficult for adolescent stars as adolescence is well known for being a time of deep personal insecurity even under ‘normal’ circumstances.

Amplification of mistakes:

Making social errors when a teenager is mortifying as we are so self-conscious during this period in our lives. Imagine, then, how teenagers feel who find their indiscretions and faux pas plastered over the front page of a national tabloid newspaper due to their stardom. Many find this price of success too high.

‘Property of others’

Many young stars feel they can no longer be ‘their own person’ but seem to become almost a commodity. Some have described it as being treated like a performing seal or monkey at the zoo.

Loss of fame and anticlimax:

Some young stars do not make the transition from child stardom to continued success in the same field as an adult. Sometimes, of course, as in the case of Macaulay Culkin, this is by choice.

If, however, it is not by choice, the young adult may become depressed by believing the best part of his life is already over and that the rest of his life will, by comparison, be one massive disappointment and anticlimax. This may result in the adoption of unhelpful coping mechanisms such as over-reliance on alcohol and drugs (indeed, obtaining these may be facilitated if s/he accumulated a large amount of wealth as a child star, thus increasing temptation).

Perfectionism Linked To Having Inflexible, Authoritarian Parents

Childhood Fame : The Downside And Cost Of Fame

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



Idealization Of Others : A Defense Mechanism Stemming From Childhood Trauma

Image licensed by Shutterstock.

Within the discipline of psychology, there exists a concept known as ‘splitting’. Splitting refers to a false perception of seeing others as either ‘all good’ or ‘all bad’. During childhood, this is normal. However, it can persist into adulthood, operating as a psychological defence mechanism, which prevents us from taking a more realistic, considered and complex view of others (ie seeing them as possessing a blend of positive and negative characteristics).

One of the main reasons why we may continue to ‘split’ others when we become adults is that we suffered early childhood trauma which caused as to become psychologically arrested or ‘stuck’ at the splitting stage.

What is meant by idealizing another person?

When we idealise another person (often a person we would like to have a romantic relationship with) we see them through a distorting lens so that they seem to us perfect in every way, or, as the name of the defence suggests, the ideal person.

However, because it is obviously impossible for someone to be perfect, she or he will, as surely as night follows day, inevitably fall sadly short of our stratospherically, over-exacting and unforgiving standards. In short, we have created an image of the person in our minds which may, in fact, have little in common with the person this image misguidedly represents.

Inexorably, then, initial intense infatuation, even worship, will be eroded away to leave us feeling bitterly disappointed, disillusioned, and betrayed.

How does this work as a defence mechanism?

When we idealize someone, it acts as a defence mechanism against acute feelings of inner pain and despair.

Our initial profound infatuation with the person creates a feeling similar to a drug-induced ‘high’ which temporarily elevates us out of our depression.

Unfortunately, however, our depression will return with redoubled severity when the idealised person fails to live up to our impossible standards.

Indeed, the very intensity of our feelings may themselves make the recipient of them feel uncomfortable and suffocated, thus being, in the final analysis, deeply counterproductive. That we are unable to see this at the time is part of the general irrationality of our feelings and concomitant behaviour (although it is worth pointing out that it could, conceivably, be argued that, for want of a better phrase, ‘normal love’ could not exist without its irrational aspects; my parents’ marriage to each other is a case in point here, I think).


Our idealised image of the person is, essentially, a fantasy we have created, existing only in our minds. In a sense, then, it is our imaginative process and its results that we are ‘in love’ with.

Similarity to hypomania

Hypomania is a state of excitement and heightened energy which is not as extreme as mania which occurs in people who are suffering from bipolar disorder. It is a way of escaping painful inner feelings and some experts believe that when we idealise another person it produces a similar feeling to hypomania.


Sadly for all concerned, when the idealised person fails to live up to expectations, the person who had idealised him/her and seen him or her as all-good may now suddenly switch to seeing him/her as all-bad (as splitting is still operating). Psychologists describe this as moving from idealising the person to devaluing him or her.

Needless to say, this leaves the originally idealized individual in a state of confusion and bewilderment.



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

Why Betrayal In Childhood May Increase Risk Of Being Revictimised As An Adult


Whilst much research has been conducted suggesting that those of us who were betrayed by parents/primary caregivers in our early life are more likely to mistrust others once we become adults, other research also shows that those of us who were betrayed in childhood are also more likely to be re-victimised as adults.

It has been pointed out that these two findings would appear to contradict one another. After all, wouldn’t distrusting others actually make it less easy for others to exploit and hurt us?

One school of thought suggests this apparent contradiction can be explained by the fact that the research suggesting early betrayal lowers our ability to trust is methodologically flawed and that, actually, the opposite is the case: the experience of early life betrayal increases the likelihood that we will trust others once we become adults.

This seems utterly paradoxical and counterintuitive. Why should being betrayed as a child increase our trust in others?

The psychologist, Zurbriggen, suggested that the experience of being betrayed in early childhood results in damage of a cognitive mechanism which, in turn, reduces our ability to judge how trustworthy other people are, leading to an over-willingness to trust others thus leaving us vulnerable to re-victimisation.


In essence, then, Zurbriggen (2006) and other researchers (e.g. Marx et al, 2002) are of the view that early trauma makes us less able to detect untrustworthiness of others and the risk and threat they might pose.

Another researcher, Chu (1992), explains our increased likelihood of being revictimized as adults if we were betrayed in childhood by theorizing that we fail to learn from our original, childhood betrayal because our memory of it becomes fragmented and, as a defence mechanism, as adults, we dissociate from emotions that would otherwise suggest a person is a threat to us.

In summary, then, theorists such as those mentioned above believe that if we experienced a high level of betrayal in childhood, in our adulthood we will :

– have clouded judgment when it comes to trying to decide if others are likely to exploit, cheat or harm us due to damage done to our ability to cognitively process the relevant information

– be less able to detect an intimate partner’s infidelity

– be naively trusting of those who pose a threat to us

– be more likely to stay in a relationship in which we have been re-victimised/betrayed by our partner.


The ideas expressed above clearly contrast with the more mainstream view that, if we are betrayed during childhood, we will become deeply untrusting of others as adults.

Therefore, much further research is called for in this area.


Chu JA. The revictimization of adult women with histories of childhood abuse. J Psychother Pract Res. 1992 Summer;1(3):259-69. PMID: 22700102; PMCID: PMC3330300.

Zurbiggen. Evaluating the impact of betrayal for children exposed in photographs. Children And Society. First published: 10 March 2006.





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

The Gifted Child : Characteristics And Potential Problems.


What Is Meant By ‘A Gifted Child’?

According to the National Association For Gifted Children, a gifted child is one who is in the top 3 to 5% of children of his age in one of the following areas:

1) General intellectual ability

2) Specific academic aptitude

3) Creative thinking

4) Visual and performance arts

5) Leadership ability

Of course, greatly more has been written about child giftedness and the above represents an oversimplification, but it is beyond the scope of this article to go into extensive detail on this.

What Kind Of Characteristics A Gifted Child Posses?

It is useful to provide a list of the main characteristics that researchers (for example, Webb 1993, 2007) have typically found a gifted child to possess. These are as follows:

  1. high level of interest in, and curiosity about, a large range of topics; a seemingly insatiable thirst for knowledge and understanding; always asking questions
  2. an idiosyncratic and creative sense of humour
  3. experiences and displays intense feelings and emotions
  4. studies things that interest him with tenacity and persistence 
  5. has a long attention span
  6. can absorb and retain large amounts of information
  7. has a good memory
  8. early and superior understanding regarding nuances, subtleties and complexities of language (for example,  facility to make clever puns, understanding of subtext, implication, insinuation and the drawing of inferences)
  9. can form unusually complex sentences
  10. highly sensitive
  11. good at divergent thinking 
  12. good at putting things together in a creative and original manner
  13. good autodidacts; for example,  often largely teach themselves to read and write prior to going to primary school
  14. good at devising complex games
  15. invents imaginary playmates
  16. many, diverse and wide-ranging interests
  17. likes experimenting and takes an original approach to things

Unfortunately, in both the areas of education and psychology, research into gifted children is, relative to other areas of study within these disciplines, quite limited so firm conclusions about problems faced by gifted children are yet to be drawn; however, there are definite indications that many gifted children are misunderstood and that the causes of many of their behavioural characteristics are being misinterpreted.

What Kinds Of Problems Might A Gifted Child Experience?

It is certainly not true for every gifted child, but some are at increased risk of ADJUSTMENT PROBLEMS and consequently, of unhappiness. Problems, research shows, may develop in connection with the following:

extreme sensitivity
– alienation
– uneven development
– perfectionism
– role conflict
– inappropriate environments
– adult expectations
– self-definition

Let’s look at each of these in turn:


Because highly the gifted child has a high level of internal responses they are often INTENSELY SENSITIVE. Whilst this can certainly have its advantages, it can also EXACERBATE THE NORMAL PROBLEMS OF GROWING UP. For instance, the child’s intelligence may lead him/her to be unusually sensitive to social cues and may, for example, pick up on subtle signals leading him/her to sense rejection where it may not have been intended.

His/her sensitivity may lead him/her to respond strongly to what other children of the same age may well regard as trivial and unimportant; the other children may then ridicule and deride the child for what they perceive as his/her over-reactions. The child may then go on to form the view that there is something wrong with him/her and start to increasingly believe he/she are odd, leading to self-consciousness, low self-esteem and low social confidence. Importantly, also, the child may well pick up on society’s hypocrisy and social injustice very early on in his/her life, leading to feelings of cynicism and despair far earlier than others are likely to develop such feelings.


The child’s high intelligence and gifts may result in him/her relating to other children the same age as him/her in a manner more like that of an adult than that of a child. This can lead to problems with social integration. If he/she is not accepted by the other children this may lead him/her to socially withdraw. In turn, this can hinder the development of social skills which can then lead to the child being labelled as ‘odd’ or ‘weird’. If the gifted child then INTERNALIZES such labels (ie. the labels lead to the child believing he/she is as the labels describe him/her), social isolation and eccentricity may result.


Whilst the gifted child’s intelligence is very high, his/her emotional development is likely to be at a normal level. However, adults may (unreasonably) expect the child to have high emotional maturity because of his/her high level of intellectual development. When the child then has the normal emotional tantrums that most children of his/her age have, he/she may be WRONGLY LABELLED AS HAVING A BEHAVIORAL PROBLEM.



The high praise the gifted child will inevitably receive from school teachers etc. can lead to the child setting him/herself excessively high standards. He/she may become a perfectionist and perceive he/she has failed even when, objectively speaking, he/she has actually performed exceedingly well, and, therefore, when he/she gets the objectively accurate feedback, he/she may come to start distrusting it.


If the highly gifted child is male, he may well be in a school in which the prevailing culture means it is the boys who are ‘macho’ and good at sport etc. who obtain the approval and admiration of their peers. If the gifted child happens, for example, to be more interested in intellectual pursuits, such as poetry or chess, this can lead to ridicule and bullying.


The highly intelligent and gifted child will often find that the school year group he/she is in is not challenging enough and the pace of the learning is unsuitable. This can lead to frustration, withdrawal and behaviour problems.


The gifted child may find him/herself pushed very hard by his/her parents and by the teachers of every subject he/she is taking. In the reverse situation to the one described above, here the child finds he/she is unable to satisfy all these demands and is unable to put in the extra effort expected in relation to such a large array of subjects. This can result in the child’s OWN SPECIAL AREA OF INTEREST being overlooked; indeed, it may well be better if the child focuses the extra effort mostly in just his/her favoured area.


The very gifted and intelligent child will tend to have an INTENSELY ANALYTICAL approach to life; this can result in early, highly critical self-analysis. When coupled with his/her perfectionism and the unreasonable expectations of adults, this can lead to identity problems.

However, gifted children can fare well if their giftedness is recognised and they are therefore given a suitable environment which nurtures and supports their unusual talents. If, on the other hand, such an enriched and appropriate environment is not provided, the child is more likely to face problems.

Of especial concern is that some clinicians have put forward the view that gifted children, due to the unusual characteristics they display that relate to their giftedness, are having such characteristics misinterpreted as signs of a psychiatric condition. Such mistakenly diagnosed conditions, they state, include:

  1. Asperger’s syndrome
  2. Obsessive-compulsive disorder
  3. ADHD
  4. ADD
  5. Oppositional defiance disorder
  6. Bipolar disorder

Finally, it should be noted that some research also suggests that some a gifted child may be more likely to suffer (and to be correctly diagnosed with) anorexia and depression (especially existential depression).

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



Indirect Abuse: Effects On Children Of Witnessing Domestic Violence.


Domestic violence often involves a man physically abusing a woman on repeated occasions (although it can, of course, involve a woman assaulting a man or a partner assaulting a same-sex partner in the case of gay relationships). In this article, however, to save complications, I’ll use the conventional example of a man who attacks a woman.

If the man and the woman are parents/step – parents to children who live in the same house, the psychological harm done to these children can be very severe.

Indeed, although the children may themselves not be physically abused, the fact that they witness the abuse (a study by Hughes (1992) showed that in 90% of cases the child is in the same room, or next room to the room, in which the violence is taking place, meaning, of course, they see and/or hear it happening) the experience can have an equally damaging mental effect on them as would occur were they to suffer direct abuse.


In fact, experts now regard children forced to witness direct violence between parents as having emotional abuse inflicted upon them.

Because however, research into the effects on children of witnessing domestic violence is relatively recent, the damage being done to young people in this manner has gone largely undetected in the past, leading some researchers to refer to these children as ‘hidden’ or ‘unacknowledged’ victims of abuse.

Specific psychological effects upon the child of witnessing domestic abuse:

Children who regularly witness this kind of domestic violence in the home are made to feel powerless, afraid and, often, terrified. They are forced into the alarming realisation that:

a) those who are supposed to be strong and protect them are highly vulnerable and unable to protect themselves (implying they may not be able to protect their children either).

b) those who are supposed to protect them are capable of violently turning against those that they are supposed to care for and love.

Both of the above combine to make the child feel highly unsafe, vulnerable and insecure.

When indirect abuse turns into direct abuse:

Worse still, when domestic violence occurs in the house, it is possible for children to become directly involved in it.

For instance, their pity for their mother may compel them to intervene in order to try to protect her from the father.

Alternatively, a parent may encourage an impressionable and frightened child to join in the violence against the victim.

Furthermore, studies have revealed that approximately 70% of children who live in households in which the father physically abuses the mother are themselves physically abused by him – thus making this large group of children both indirect and direct victims of abuse.




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Characteristics Of Perpetrators Of Domestic Violence.

Domestic Violence And Its Direct And Indirect Effect On Children

Brains Of Children Exposed To Domestic Violence Affected In Similar Way To Exposure To Combat

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

Childhood Trauma And ADHD : Is PTSD Being Misdiagnosed As ADHD?


IMPORTANT NOTE: This article considers the possible link between childhood trauma and ADHD. However, to clear up any possible misinterpretation of this article, it is important to state at the outset that ADHD is undoubtedly a genuine disorder and it is not by any means implied below that all cases involve underlying trauma.

In the USA, about one in every nine children are diagnosed with ADHD; this equates to a total of 6.4 million American youths.

But should a significant proportion of these young people’s primary diagnosis be one of PTSD, not ADHD?

Many experts think so. Post Traumatic Stress Disorder (PTSD) may be being misdiagnosed as Attention Deficit and Hyperactivity Disorder (ADHD) in up to a million children per year in the USA.

The psychologist, Brown, an expert in the field, has drawn attention to the fact that many children who have been diagnosed with ADHD have symptoms which one would expect to find in people suffering from PTSD such as difficulty controlling behaviour/impulsivity, severe mood fluctuations, hypervigilance and dissociation ( or ‘zoning out’).

The confusion may arise when such symptoms are mistaken for those of ADHD. For example:


  • – difficulty controlling behaviour/mood fluctuations may be seen as wilful disruptiveness.
  • – hypervigilance may be seen as distractability.
  • – dissociation may be seen as deliberate inattention/lack of focus (indeed, I suffered from this when I was eight. I didn’t respond to my name in class, so lost and caught up was I in my internal distressing thoughts, leading to my teachers suspecting that I was going deaf. I was taken for an ear test, but there was nothing whatsoever wrong with my hearing – let this serve as a salutary lesson to teachers as to how a child’s distress may manifest itself in unexpected ways and be misinterpreted entirely; indeed, another good example is the possibility that a child’s anger is serving to soothe his / her emotional pain.


Brown’s suspicions that, often, children diagnosed with ADHD should have been diagnosed with PTSD were heightened further by the observation that standard ADHD treatment did not work for many children.

Perhaps, then, Brown hypothesised, these children were, in fact, ‘acting out’ (what psychologists refer to as ‘externalizing’) their distress caused by living in a dysfunctional family (the children in the study came from low-income families and were known to live in environments in which high levels of stress and violence were prevalent).

To examine the issue further, Brown set up a study looking at the overlap between the symptoms of ADHD and the effects of traumatic stress on children caused by maltreatment and abuse.

The study was based on a survey of 65,000 children in the USA, and the results showed that those who had been diagnosed with ADHD also had a significantly higher than average chance of coming from a background of divorce, poverty, violence and/or families who misused drugs and alcohol.

Indeed, those who had experienced the great stress of 4 or more ADVERSE CHILDHOOD EXPERIENCES (ACEs)   were three times more likely to have been diagnosed with ADHD and prescribed medication for it than those who had not experienced any.

The psychologist, Szymanski, derived similar results from a study of 63 children who had been treated by a psychiatric hospital. On average, the children had suffered 3 ACEs, yet only 8 per cent had been diagnosed with PTSD, while 33 per cent had been diagnosed with ADHD.

Another study (Burke et al., 2011) of relevance involved the analysis of 701 children’s medical records. The children involved came from violent and economically deprived neighbourhoods in the Sans Francisco area.

It was found that two-thirds of the young people had experienced at least one ACE, and 12 per cent had experienced four or more ACEs. Further analysis of the data revealed that the more ACEs the children had experienced, the more likely they were to display behavioural problems.

Significantly, the researchers involved in the study expressed the concern that many such children may be receiving diagnoses of ADHD when a diagnosis of PTSD, or other stress-induced condition, would be more appropriate. It was suggested that this error might be occurring because symptoms of severe stress, such as hyperarousal and cognitive dysregulation were being mistaken for signs of ADHD.

Furthermore, Techer et al.conducted research that found that approximately 1 in 3 children who have experienced severe abuse meet the diagnostic criteria for ADHD and that children who are particularly at risk of going on to develop ADHD-like behaviour experienced such abuse very early in life.

Techer also draws our attention to the fact that ADHD is reliably found to be associated with abnormal neuroanatomy (brain structure) – specifically, a smaller than normal cerebellar vermis. Based on this and other evidence showing a link between physical brain abnormalities (e.g. in the mid portions of the corpus callosum) and the emergence of symptoms similar to those found in ADHD such as impulsivity Techer suggests that abuse in early life may result in physical alterations of the brain’s structure which, in turn, create ADHD-like symptoms.

The above studies suggest that, in some cases, PTSD me be mistakenly diagnosed as ADHD and that many children could be being wrongly diagnosed with ADHD whereas their primary diagnosis ought to be one of PTSD. Some estimates suggest that up to one million children per year could be being misdiagnosed in this way.

If some children are being treated for ADHD when they should be being treated for PTSD, their treatment may be inappropriate.

Indeed, one treatment for ADHD is the prescription of stimulants. However, this could worsen symptoms of agitation (agitation is a symptom of PTSD).

Furthermore, treatment for ADHD does not deal sufficiently with the emotional and psychological distress that the child with PTSD suffers.

Very obviously, the above does not in any way imply that all cases ADHD should, in fact, have been diagnosed as PTSD and, equally obviously, a child may simultaneously fulfil the diagnostic criteria to be considered to be suffering from both conditions (i.e. justifying a co-morbid diagnosis; indeed, research suggests the two conditions share familial risk factors) which is why I include the following warning: N.B. Any changes in medication should only be made on the advice of a suitably qualified professional who is familiar with the specific case under consideration.

One reason that has been suggested is that the companies producing the drugs for ADHD use advertising campaigns which, in effect, encourage the diagnosis of ADHD and its treatment, thus increasing their profits.

A second suggestion as to why ADHD may be being misdiagnosed as PTSD is that the assessment of children by clinicians is not extensive or thorough enough due to time and financial restrictions. A fifteen-minute or half-hour appointment is not enough to evaluate, sufficiently, a child’s mental state and factors related to his / her home life which may be damaging it.

It is also worth reiterating how there exists an overlap between the symptoms of ADHD and the symptoms of PTSD (e.g. Daud, 2009); these include, sleep difficulties, giving the impression of not listening in class, restlessness, disorganisation, restlessness and easy distractibility.

For useful advice about whether a child has ADHD or the effects of traumatic stress, you may wish to read this (CLICK HERE) helpful article from WebMD.




Perhaps the best way to demonstrate how ADHD and complex PTSD differ from one another is to list symptoms SPECIFIC to each condition followed by a list of the symptoms that both ADHD and complex PTSD have in common. I do so below:




  • agitation
  • hypervigilance
  • feelings of shame and guilt
  • risk-taking behaviours
  • proneness to aggressive behaviours
  • self – destructiveness
  • irritability
  • perpetual feelings of being on ‘red alert’ / under threat
  • hyperarousal
  • avoidance behaviours
  • outbursts of rage/anger
  • dissociation




  • problems following instructions
  • fidgeting and squirming
  • poor organisational skills
  • excessive talking
  • interrupting or intruding on others
  • losing items that are necessary for tasks and activities
  • difficulty concentrating
  • problems with waiting and turn-taking



  • restlessness
  • sleep problems
  • distractibility
  • giving the impression of not listening
  • hyperactivity
  • problems with concentration


The above lists are based upon research conducted by The National Child Traumatic Stress Network (NCTSN).

To reiterate what I said in the opening paragraph of this article, however, ADHD is a very real and genuine condition and, whilst it is acknowledged that it cannot be diagnosed by any biological tests at present (though this may change), advocates of the reality and potential seriousness of the condition point out that it has been linked to abnormalities in the growth and development of the brain and that it runs in families. It is also associated with increased morbidity and mortality.

Although many individuals with ADHD eventually appear to ‘outgrow’ it, about 1 in every 25 adults has a diagnosis of ADHD and it is likely that many others also have the condition but, as yet, remain undiagnosed.



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Intellectualization as a Defense Mechanism Following Childhood Trauma


Intellectualisation is a psychological defence mechanism which serves as an escape route from interacting on an emotional level with others, and the outside world in general, into the refuge of ‘the life of the mind’. People who employ this defence mechanism, then, prefer to ‘live in their heads’, finding participating overly in the harsh and unforgiving reality of the outside world somewhat distasteful and, therefore, best, as far as feasible, avoided.

Research shows that people who rely upon this defence mechanism tend to have had disrupted early relationships with their primary carer, especially the mother. Indeed, the psychologist, Winnicott, stated that a compulsive need to gain knowledge could be regarded as a kind of self-mothering – knowledge standing in as a substitute for the mother’s love/care/attention/interest (of which the individual was deprived).

Intellectualisation can also be viewed as a type of dissociation, leading the individual to suppress/repress his/her emotions. This can be problematic as it is usually necessary to feel, and process, emotions connected to one’s childhood trauma in order to fully resolve one’s psychological difficulties that have arisen as a result of it. 

The early traumatic experience of not forming a secure attachment to their primary caregiver disrupts affected individuals’ ability to self-soothe in response to stress, and this inability can persist into adulthood.

As a result, such persons’ sympathetic nervous systems can become ‘stuck’ in a permanent and highly debilitating state of overarousal (I, myself, suffered from this for many years – it can be quite agonising).

Alongside this tormenting state of hyperarousal can often exist an unrelenting and merciless sense of profound dread (even though one is often unable to pinpoint why this should be so

The overarousal will inevitably manifest itself somatically and physiologically (i.e. in the body) leading the individual with the need to dissociate, and disconnect, from his/her body and escape into a ‘life of the mind.’ Interacting with others also leads to extreme psychological discomfort.

Therefore, those who suffer in this way will often choose careers involving solitary academic work, computer programming etc. which minimises the need to mix with other people. Or they may become philosophers, possibly becoming great thinkers.

These individuals also tend to be exquisitely vulnerable to the effects of further stress in their lives and can feel like a frightened child forced to masquerade as a functional adult.

They tend, furthermore, to have a weak and hazy sense of their own identity and, as a result, their work can become vital to them as a way of bolstering this poorly formed sense of who they are.

Most distressingly, too, such people often suffer from a deep inner conflict involving, on the one hand, being very frightened of interacting with others, yet, on the other, feeling a profound need to do so. So, they find themselves in the no-win situation of needing intimacy but being unable to tolerate it due to the level of psychological discomfort which it affords them.

As a result, those affected in such a way tend to feel utterly ’empty’. They will usually be aware that their compulsion to follow intellectual activities does not solve this problem, yet be too scared to change their focus in life.


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

Escaping The Pain of The Past : A Five Stage Grieving Model

If we had a troubled childhood, it is not unusual to find we become preoccupied with certain elements of it, or even obsessed. In this way, we can let it define who we are now in a way which is not good for us, preventing us from enjoying the present, and stopping us from feeling any optimism regarding the future.

We become, essentially, prisoners of our past.

However, freeing ourselves from this darkest of prisons we have constructed around ourselves is not easy; in fact, it is a process which can be both long and arduous.

A very important part of this process is to allow ourselves to fully experience the feelings that the memory of our traumatic childhood gives rise to and not to repress them. In other words, we must allow ourselves to grieve for our past and for our lost or stolen childhoods.


Kubler-Ross’s model, which can be applied to the grieving process that relates to remembering a lost or stolen childhood (although the model was originally intended to describe the grieving process following the death of a loved one) involves five stages we may need to go through before our grief can heal. These five stages are shown below:

1) Denial – during this stage, we find it hard to believe our loss has actually happened; it can seem unreal. In the case of childhood trauma, for example, we may find it very hard to believe that our parent/s or primary caregiver had/have betrayed us.

Instinctively, we do not want to think ill of our parents, especially when we’re children.

This is why many children who are mistreated feel guilty; they (irrationally) turn the blame that should be directed at the parent/s onto themselves to protect themselves from the knowledge that their parents are bad/have behaved badly.

2) Anger – once such denial has been overcome, anger about one’s lost childhood can follow (to read my article about childhood trauma and anger, click

3) Bargaining – not everyone experiences this stage but it may include trying to make ‘deals’ with any particular deity one believes in through prayer (eg ‘ if you just get me through this, I promise…’ etc).

4) Depression – now that the reality of one’s loss really starts to sink in, together with its accompanying implications, one can finally allow oneself to feel the sadness evoked by the loss. It is important to allow oneself to fully feel this sadness, as it is cathartic in that it allows one to work through and process one’s pain.

5) Acceptance – finally, we reach a stage at which we have processed what has happened to us, have psychologically integrated the experience and accepted it as part of our life experience. We have come to terms with it and no longer let it control and hinder us – we are ready to move forward in our life.

It is important to note, however, that not everyone goes through these exact stages – therefore, when we go through the process of grief, we need not worry if our evolving feelings precisely mirror this model.

After coming to terms with our adverse childhood experiences, there are various things we can do to help us move forward in our lives:

1) We need to stop seeing ourselves as a victim.

Clinging on tenaciously to our sense of betrayal, our anger and our blame of others serves mainly only to hurt ourselves. Whilst we cannot change the past, we can change our attitude to it and, by doing this, we can prevent the memory of it from inflicting further serious damage on our progress in life.

For example, we can start to consider what we may have gained from our experiences – perhaps it’s made us stronger or given us the empathy any insight to help others experiencing various forms of psychological distress.

2) Take a step back from life and consider what we really want from it, and then start setting ourselves relevant, challenging, but achievable, sub-goals and goals to help us to achieve our desires, whether these be to run our own business, help others, study or whatever else we set our heart on.

3) Surround ourselves with positive, like-minded, empathetic and supportive people (as far as this might be possible). This may involve joining a particular club, group or society or changing our social milieu.

4) Seek out opportunities, however small, to help us to achieve our sub-goals and goals. We are much more likely to achieve our goals if we choose something we really like doing and for which we have an aptitude. Whilst most of us need to make money, the importance of doing a job/having a career that is intrinsically rewarding cannot be over-emphasized.

Indeed, studies show that once we’re reasonably comfortably off, having more money, even vastly more, makes very little difference to our happiness in the medium and long-term. Some people waste a lifetime learning this, becoming trapped upon what psychologists refer to as a ‘hedonistic treadmill’.



Traumatic Grief in Childhood

What Are The Differences Between The Traumatized And Normal Brain?

David Hosier BSc Hons; MSc; PGDE(FAHE)

Psychotic Symptoms In Adolescence Linked To Childhood Trauma

A recent study (Upthegrove et al.) has shown that individuals who have experienced significant childhood trauma are far more likely to experience early (ie during adolescence) symptoms of psychosis than those fortunate enough to have experienced a relatively stable childhood.

The study involved over 200 young people and focused upon the effects on these individuals’ mental health of the following categories of childhood trauma:

1) Physical abuse

2) Sexual abuse

3) The witnessing of domestic violence

4) Bullying

In order to find out if there was a relationship between these kinds of childhood trauma and the early development of psychotic symptoms, interviews were conducted with each of the participants in the study.

Let’s look at the effects on the mental health of each of these four types of abuse:

1) Effects of physical abuse: those who had been physically abused were found to be at much greater risk of developing early signs of psychosis than those who had not had traumatic childhoods

2) Effects of sexual abuse: those who had been sexually abused were not found to be of significantly higher risk of developing early signs of psychosis than those who had not had a traumatic childhood. However, this finding might have been due to methodological shortcomings of the study

3) The witnessing of domestic violence: those who had been exposed and subjected to the witnessing of domestic violence within their household were found to be of much greater risk of developing early signs of psychosis than those who had not had traumatic childhoods

4) Effects of being bullied: those who had been significantly bullied were not found to be at increased risk of developing early signs of psychosis.

However, these individuals were found to be significantly more likely than those who had had a more settled childhood to become bullies themselves.

This finding could be due to:

a) modelling their behaviour on the behaviour of the person who was physically abusing them.

b) modelling their behaviour on that of the perpetrator of the domestic violence they were exposed to witnessing in the home

c) genetic reasons – for example, if they had a violent father who physically abused them they may have inherited a set of genes that predisposed them to behave aggressively and violently

d) a need to express control/power – if these individuals felt powerless at home due to being physically abused, they may have developed the need to express power over others in order to ‘psychologically compensate’ themselves/feel less powerless/gain the control they lacked at home


In all, 6.6% of the original 200+ studied had psychotic symptoms, mainly visual and auditory hallucinations (seeing and hearing things in the absence of corresponding external stimuli – ie things that weren’t there).

Compared to those who had had relatively stable childhoods:

  • those who had been physically abused were 6x more likely to have experienced early psychotic symptoms.
  •  those who had witnessed domestic violence were 10x more likely to have experienced early psychotic symptoms.


Comorbid conditions:

Those who had developed early psychotic symptoms due to childhood trauma were also more likely to have other mental health problems alongside these (psychologists often refer to these as comorbid conditions). These included:

  • depression
  • conduct disorder
  • phobias
  • ADHD
  • PTSD
  • nervous tic
  • over anxiousness
  • oppositional defiance disorder
  • separation and anxiety order

Males were more at risk of developing early psychotic symptoms than females.

How Does Childhood Trauma Make A Young Person More At Risk Of Developing Early Signs And Symptoms Of Psychosis?

Experts now believe the experience of significant childhood trauma can adversely affect the biological development of the brain.

Specifically, prolonged exposure to significant stress in childhood can adversely affect:

  • structure of the brain
  • biology/chemistry of the brain
  • and, as a result, its functionality of the brain

For example, prolonged stress can affect the production in the brain of the hormones known as adrenalin and catecholamine (involved in the body’s stress/threat response; often referred to as the fight/flight response) and interfere with the physical development of a structure in the brain known as the amygdala (also involved in regulating how the individual responds to stress/perceived threat).


This study supports an already vast quantity of research that shows a link between childhood trauma and the development of mental illness (in this case, psychosis).




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