3 Core Unmet Needs Underlying Emotional Pain

3 core unmet needs underlying emotional pain

Core Unmet Needs

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

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

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

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

 

Core Feelings Associated With Core Unmet Needs :

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

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

emotional pain

Secondary Distress And Obscured Core Unmet Needs And Feelings :

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

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

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

Conclusion :

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

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

 

Childhood Trauma Linked To Psychologically Damaging Time Perspective

childhood trauma and temporal theory

Based upon Zimbardo’s and Boyd’s (2008) Time Perspective Theory, a therapeutic technique known as Time Perspective Therapy (Zimbardo, Sword and Sword) was developed.

Time Perspective Therapy is predicated upon Zimbardo’s idea that the way in which we view and relate to the past, the present and the future strongly influences how we think, feel, behave and perceive events that are going on around us.  According to this theory, each individual may be represented, to a greater or lesser degree) by any of the following types.

  1. THE ‘PAST-NEGATIVE’ TYPE
  2. THE ‘PAST-POSITIVE’ TYPE
  3. THE ‘PRESENT-HEDONISTIC’ TYPE
  4. THE ‘PRESENT-FATALIST’ TYPE
  5. THE ‘FUTURE-FOCUSED’ TYPE
  6. THE ‘FUTURE-TRANSCENDENT’ TYPE

time perspective therapy

Let’s look at each of these in turn :

  1. THE ‘PAST-NEGATIVE’ TYPE : this type of individual is preoccupied by the negative aspects of his/her personal past experiences
  2. THE ‘PAST-POSITIVE’ TYPE : this type of individual feels nostalgic about the past and might describe it with phrases like ‘the good old days
  3. THE ‘PRESENT-HEDONISTIC’ TYPE : this type of individual seeks immediate pleasure and has an impaired ability to delay gratification
  4. THE ‘PRESENT-FATALISTIC’ TYPE : this type of individual has a tendency to feel that making plans and decisions ‘now’ (i.e. in the present) is futile as the future is predetermined and beyond their control – in this way they may develop a kind of ‘whatever will be will be…‘ attitude.
  5. THE ‘FUTURE-ORIENTED’ TYPE : this type of person adopts an optimistic view of the future, is able to delay gratification for the sake of the longer-term good, makes confident plans for it, is ambitious and sets him/herself challenging goals.
  6. THE ‘FUTURE-TRANSCENDENT’ TYPE : this type of individual focuses on his/her belief that an ‘after-life’ exists.

The degree to which individuals can be represented by the above types can be measured by the Zimbardo Time Perspective Inventory (ZTPI).

Childhood Trauma And Time Perspective Type :

Individuals who have suffered severe and protracted childhood trauma and who have, perhaps, as a result, go on to develop conditions such as borderline personality disorder (BPD) or complex posttraumatic stress disorder (complex-PTSD) are prone to :

In terms of Zimbardo’s time perspective theory, therefore, such individuals tend to score highly on the following scales :

  • PAST NEGATIVE TYPE (e.g. obsessively dwelling on one’s past mistakes)
  • PRESENT HEDONISTIC TYPE  (e.g. frequent heavy drinking to ameliorate, in the short-term, mental pain)
  • PRESENT FATALISTIC  TYPE (e.g. feeling powerless to affect future)

It can be seen, then, that scoring highly on the three scales representing the above three types can suggest a poor state of psychological health.

Instead, it is more conducive to good mental health to :

  • make positive use of the past (e.g. remembering good things, learning from past mistakes etc)
  • learn to live more in the present but not in such a hedonistic way that it jeopardizes the future
  • learn to take a more optimistic view of the future and to plan for the future.

Time Perspective Therapy :

TIME PERSPECTIVE THERAPY (developed by Zimbardo, Sword and Sword), based upon cognitive behavioral therapy (CBT),  can help us develop healthier / more balanced time perspectives and this, in turn, can improve many areas of our lives including our relationships, our social lives and our careers

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

 

 

 

 

 

Dialectical Behavior Therapy (DBT) May Beneficially Change Brain Functioning

BPD, borderline personality disorder and reality testing

One of the most effective therapies for those suffering from borderline personality disorder (BPD) (as we have seen, BPD is closely linked to childhood trauma) is called dialectical behavior therapy (DBT).

What Is DBT?

DBT is based on the person’s need to change their behavior and their need to be accepted. The therapy was devised by Marsha Lineham, PhD.

What Does DBT Involve?

Typically, DBT involves :

  • individual psychotherapy (usually once per week), starting with changing the individual’s most concerning behaviors, then changing behaviors hindering therapy (e.g. missing appointments), and finally with ‘quality of life issues.’
  • skills training (within a group-therapy context). The four main skills that are taught are :
  1. MINDFULNESS
  2. INTERPERSONAL EFFECTIVENESS
  3. DISTRESS TOLEARANCE
  4. EMOTIONAL REGULATION

DBT changes brain

Research Suggests That DBT Can Beneficially Alter Brain Functioning :

THE STUDY :

Research conducted by Schnell and Herpertz (2006) involved looking at the effects of DBT (specifically, training in emotional regualation, see number 4, above) on female patients’ brain functioning (this was done by taking magnetic resonance images, or MRIs, a type of brain scan) after they had spent 12 weeks undergoing an inpatient treatment program.

RESULTS OF THE STUDY :

The female, BPD patients who improved following the DBT / emotional regulation skills 12 week inpatient program were found (by analysis of their MRIs) to show:

REDUCED ACTIVITY IN CERTAIN BRAIN REGIONS ASSOCIATED WITH THE GENERATION OF INTENSE EMOTIONS, INCLUDING THE AMYGDALA AND THE HIPPOCAMPUS.

Such a reduction of activity in these brain regions is associated with an increase in the individual’s abilty to prevent themselves from overreacting to stressful situations (overreacting to stressful situations, also known as impaired emotional regulation, is one of the hallmark features of BPD).

Conclusion :

The above can be interpreted as further evidence for the effectiveness of DBT for treating patients suffering from borderline personality disorder (BPD).

 

RESOURCES :

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

Reality Testing And Borderline Personality Disorder (BPD)

BPD, borderline personality disorder and reality testing

What Is Meant By ‘Reality Testing’?

Reality testing, a concept originally introduced by Sigmund Freud (1856-1939), can be described as the capacity of an individual perceive the external events going on around him/her objectively, accurately and based on conventional interpretation rather than in a way distorted by internal mental factors. The Medical Dictionary defines it as : ‘The objective evaluation of the external world and differentiation between it and the ego or self.’

Impaired Reality Testing :

Reality testing is most obviously impaired in individuals, such as some schizophrenics, who are in the grip of florid psychotic symptoms such as hallucinations (e.g. ‘hearing voices’ or ‘seeing things that aren’t there’) and delusions (e.g. believing one’s thoughts are being broadcast / audible to others).

bpd reality testing, borderline personality disorder, childhood trauma

Borderline Personality Disorder, Brief Psychotic Episodes And Reality Testing :

Individuals with borderline personality disorder (BPD) generally do not have such dramatically impaired reality testing (although they can suffer from brief psychotic episodes when experiencing extreme stress). However, their reality testing can fluctuate to a significantly greater degree than is found in relatively ‘psychologically healthy’ individuals.

For example, particularly when experiencing significant levels of stress, individuals suffering from BPD may lapse into a paranoid style of thinking or experience an impaired ability to self-reflect in a realistic fashion.

Problems That May Arise As A Result Of Impaired Reality Testing :

An impaired ability to reality test can lead to various problems, including :

Improving Impaired Reality Testing :

Studies suggest that cognitive behavioral therapy (CBT) can be an effective means of improving a person’s ability to reality test.

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David Hosier BSc Hons; MSc; PGDE(FAHE)

 

 

Splitting, Denial And Flooding : The Inter-relationship

childhood trauma, splitting, denial, flooding

‘SPLITTING’ :

This is an unconscious defense mechanism that involves us seeing things in extreme and exaggerated ways, either as ALL GOOD or ALL BAD ; this unconscious strategy is often seen in people suffering from borderline personality disorder (BPD). 

For example, those suffering from this disorder frequently vacillate between, at times, perceiving a friend or partner in an idealized way and then, at other times, often as a result of perceived rejection (which may frequently be a false perception), ‘demonizing’ this same individual.

‘DENIAL’ : A PREREQUISITE OF ‘SPLITTING’ :

However, in order for ‘splitting’ to take place, ‘denial’ must take place first. This is because, in reality, in order to see things (and, especially people) as ‘all good’ or ‘all bad’, or, to put it another way, in ‘black or white’, the grey areas must be kept out of conscious awareness – this process, which also occurs on an unconscious level, is known as ‘denial’ and causes our view of things to be skewed and distorted. In essence, denial prevents salient information about whatever (or whoever) it is that we are making a judgment about from permeating our consciousness ; this, in turn, prevents us from considering or taking into account factors that contradict our (unknown to us) biased view, often leading to dysfunctional decisions and reactions.

childhood trauma, splitting, denial and flooding

How ‘Splitting’ And ‘Denial’ Can Lead To ‘Flooding’ :

Paradoxically, although ‘splitting’ and ‘denial’ are, technically speaking, defense mechanisms, their combined effect can be to cause FLOODING, I explain what is meant by ‘flooding’, and how this happens, below :

When ‘splitting’ and ‘denial’ operate together our emotional experience is intensified and and this reaction, in turn, can trigger related, intense memories. This can lead to a sense of our consciousness being ‘flooded’ with copious intense emotions and recollections.

Research conducted by the psychologist Siegel suggests that this overwhelming process of splitting/denial/flooding can be triggered in less than half a minute ; in effect then, it can be like a lightning fast ‘hijack’ of our mental faculties.

If our views are skewed negatively, this can lead to irrational verbal outbursts and behaviors which we are likely to later regret. On the other hand, if they are skewed positively (e.g. idealizing an abusive partner) we are prone to making poor decisions (e.g. remaining in a relationship with an abusive partner).

Link :

Splitting : Effects Of The BPD Parent Seeing The Child In Terms Of ‘All Good’ Or ‘All Bad.’

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

Childhood Trauma Impairs Ability To Make Decisions And Assess Risks Study Suggests

childhood trauma impairs decision making

 The Study – Part One :

Part One of a study conducted by Professor Seth Pollak (University of Wisconsin-Madison) involving over 50 young people (from a range of backgrounds and all approximately 20 years of age), required the participants to engage in various tasks (for example, simulated gambling) in order to ascertain their behavioral responses reward / punishment and risk-taking.

Results Part One Of The Study :

It was found that those who had experienced trauma / severe stress as children had impaired ability to make good decisions and to accurately assess risk compared to those young people who had not experienced trauma / severe stress while growing up ; especially noteworthy was the finding that, whilst participating in such tasks, those individuals who had experienced trauma / severe stress as children showed a marked inability to learn from their mistakes as well as poor levels of concentration.

Brain Scans :

Whilst the participants were in the ‘decision making’ phase of the task, scans of their brains were taken ; these scans revealed that the individuals who had experienced trauma / severe stress during childhood displayed BELOW NORMAL ACTIVITY in the area of the brain associated with decision making.

childhood trauma and decision making

Part Two Of The Study :

The second part of the study was intended to discover how the same group of over 50 young people behaved in real life in relation to decision making.

This was carried out by giving the participants a questionnaire to fill out which comprised various questions about how much risk they took (e.g. do you wear a seat-belt?).

Results Of Part Two Of The Study :

The results of this part of the study were very similar to those found from the first part of the study, i.e. the participants who had suffered trauma / severe stress during childhood made worse decisions / indulged in riskier behaviors in real life compared to the participants who had not experienced trauma / severe stress during childhood.

Conclusion :

It was inferred from these results that severe stress during childhood adversely affects the way in which the brain functions when making decisions leading to poor judgment and a higher than normal propensity to indulge in  risk-taking behavior in those affected.

It was also found that these deficits in decision-making ability were unrelated to I.Q. or intelligence. Because of this, Pollak alikened such deficits to a specific ‘learning disability’ which impairs individuals’ ability to effectively process information relating to potential loss or risk.

Implications For Youth Justice System :

Pollak also points out that up to 90 per cent of young people who become embroiled with the criminal justice system have experienced childhood trauma, and, if they do indeed have a kind of specific ‘learning disability’ (as described above and as the findings of this study suggest) then, in many cases, punishment is neither appropriate nor a solution.

Instead, Pollak suggests that, when dealing with young offenders, it will often be far better for these individuals to participate in training programs that improve the brain’s decision making capabilities.

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

 

What Neuroimaging Tells Us About Borderline Personality Disorder (BPD)

neuroimaging and bpd

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 radioactively 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 :

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.

 

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

How Childhood Trauma Can Disrupt Developmental Progress

disruption of childhood development

Traumatic experience can seriously, adversely affect the child’s development.

What Is Meant By Childhood Development?

We can define childhood development as a complex process of developing competences and attaining achievements from early childhood through to adolescence / early adulthood. These fall into the following main categories :

– physical

– emotional

– social

– intellectual / cognitive

– moral

Young Child :

During early childhood developmental tasks include :

  • building a sense of trust
  • learning to separate from parents (e.g. when starting school)
  • learning to adapt to peer group
  • learning to adapt to authority figures
  • development of feeling of safety away from the home
  • development of friendships
  • development of thinking / cognitive / intellectual abilities
  • development of self-esteem

disrupted childhood development

 

Adolescence :

During adolescence boys and girls experience 6 main developmental tasks. These are :

  • maintaining progress towards independence
  • solidifying a capacity for meaningful relationships
  • clarification of a sense of sexual identity
  • development of interests and competencies
  • internalization of moral values
  • development of autonomy

 

Timing :

How the child is affected will depend upon the timing of the trauma (and its adverse consequences) and at which stage of the developmental process the child is at at this time. Depending upon this timing the child may develop problems relating to attachment (such as reactive attachment disorder, disorganized attachment disorder or insecure attachment), separation anxiety, psychosexual issues and social issues such as problems with peer relationships. However, any of the developmental tasks referred to above may be adversely affected.

If traumatic experiences coincide with critical developmental transitions, such transitions may be jeopardized ; how these ill-effects manifest themselves is subject to great variability – see below :

  • development may be interrupted
  • development may be delayed
  • development may be arrested (e.g. a traumatized teenager’s emotional development might get stuck at, say, thirteen)
  • the child may regress to an earlier stage of development (e.g. a toilet trained toddler might start having accidents)
  • a developmental stage may be accelerated / the child may undergo precocious development

Mastery :

Mastering these stages / developmental tasks are necessary for an emotionally and psychologically healthy adult life, and, because they require much psychic energy are largely dependent upon a safe, stable, supportive and nurturing environment.

 

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

 

Why BPD Sufferers Can Often Read Others’ Emotions So Perceptively

BPD and interpersonal sensitivity

When I was a young child, my mother always remarked upon how easily I picked up on the slightest emotional signals she, and others, displayed (such as a tiny change in expression, a very slight change in tone of voice, subtle variations of body language etc). What both she (I presume)  and I were unaware of at the time was that she herself was responsible (but, alas, not in a good way) for this ‘sixth sense’  (as she also sometimes referred to it).

I make this assertion because it has become clear to me now that I developed this ‘talent’ (I put that word in inverted commas because it is rather a mixed blessing) as a survival mechanism. As I have written elsewhere on this site, my mother was extremely emotionally volatile, prone to intense rages and expressions of unadulterated, poisonous hatred which threatened to (or, indeed, succeeded in) the psychological destruction of the child. Furthermore, such hysterical outbursts were highly unpredictable.

You can see, then, where this is going : it was necessary for me to be on constant ‘red alert’ for any sign that my mother was about to succumb to one of these tyrranical fits in order to give myself a chance of taking some sort of evasive action (which, sadly, was all too often not possible). This state of ‘red alert’ was not entered into as a result of a conscious decision, of course, but was unconsciously activated as a psychological defense mechanism; such a state is sometimes referred to as  hypervigilance (which is also a symptom of post traumatic stress disorder (PTSD) and of Complex PTSD) or as ‘interpersonal sensitivity‘.

bpd and oversensitivity

To talk in more general terms, many people with borderline personality disorder (BPD) who have been subject to such psychological abuse as children may have learned to, and, consequently, become neurologically hard-wired to, pick up on the cues of others so as to emotionally protect themselves.

However, there is experimental evidence to suggest that this ability to ‘read’ others can err too much on the side of caution and generate ‘false positives’ as has been demonstrated in an experiment that showed that those suffering from borderline personality disorder were more likely to interpret neutral facial expressions as hostile and angry facial expressions (click here to read my previously published article about this particular study).

 

RESOURCE :

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Three Types Of Child ‘School Shooter.’

school shooters

Is Dismissing ‘School Shooters’ As ‘Evil’, Whilst Entirely Understandable, Too Simplistic?

In the wake of another tragic school shooting in Florida, USA, it is utterly understandable, of course, that many choose to explain such appalling tragedies using phrases such as ‘it was simply an act of pure evil.’ However, do such explanations (based on entirely natural emotional responses with which we all sympathize) prevent us from looking for more complex, deep-rooted causes? And, if there are more complex and deep-rooted explanations, shouldn’t they be studied so as to help prevention of future, similar occurrences?

Langam PhD, in his excellent book, ‘Why Kids Kill’, attempts to do exactly this. Based on his research, he has theorized that those individuals whom he terms ‘school shooters’ fall into three main categories (though he accepts there may well be other categories that his own research has, as yet, not identified).

what causes school shooters?

Three Categories Of ‘School Shooters’ :

The three categories of ‘school shooters’ identified by Langam are as follows :

  1. Individuals who are psychopathic
  2. Individuals who are psychotic
  3. Individuals who are traumatized

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

  1. Psychopathic ‘school shooters’ :

Langam describes certain personality features of psychopathic ‘school shooters’ which may contribute to their lethal behavior. First, he says, they are egotistical, meaning that they consider themselves to be in some way fundamentally and intrinsically superior to ‘the mere mortals’ with whom they are infuriatingly forced live alongside. Second, they are egocentric, meaning they are highly focused on placing their own needs far above the needs of others. 

Furthermore, Langam describes this category of ‘school shooters’ as being amoral, lacking a conscience (including the capacity to feel guilt or remorse), lacking empathy for the feelings of others and as having problems controlling anger.

Also, Langam points out, psychopaths may be superficially charming, thus making their true intentions much more difficult to detect and making it easier for them to manipulate others.

Finally, Langam states that, whilst not all psychopaths are sadistic, those he examined during the course of his own research were sadistic. A person with a sadistic personality shows an enduring propensity to indulge in aggressive and / or cruel behavior, enjoys witnessing the suffering of others, and is prone instil fear in others in order to be better able to manipulate them. They may also enjoy deprecating, demeaning, devaluing, disparaging and humiliating others.

Notwithstanding the above, however, sometimes so-called psychopathic traits in adolesents may be symptomatic of profound feelings of inner, emotional distress.

          2. Psychotic ‘school shooters’ :

Those suffering from psychotic illnesses lose touch with reality’ (although this may only happen occasionally and need not be a permanent state) and the main symptoms of psychosis are delusions and hallucinations.

Hallucinations are most commonly auditory (frequently referred to as ‘hearing voices’) but may also be visual (self-explanatory), tactile (e.g. feeling as if insects are crawling over one’s skin), olfactory (‘smelling’ odors e.g ‘of dead people’ when such smells are, in fact, utterly absent), gastatory (sensing ‘tastes’ in the absence of a physical stimulus e.g. believing one can ‘taste poison’ in one’s food) or proprioceptive (hallucinations of posture e.g. feeling one is floating, flying, having an ‘out of body’ experience, believing part of one’s body to be in a different location or feeling the ‘presence’ a limb that has been amputated (phantom limb syndrome).

Delusions are blatantly false beliefs that are held with absolute conviction, unalterable (even in the face of powerful counterargument and contradictory evidence), and, frequently, bizarre and / or patently untrue (Karl Jasper).

Langam states that, amongst ‘school shooters’, common delusions are :

  • DELUSIONS OF GRANDEUR
  • PARANOID DELUSIONS

In the group of ‘school shooters’ which Langam based his research on, he reports that delusions of grandeur held by these individuals included beliefs about being ‘godlike’ and that paranoid delusions that they held included believing that ‘people, gods, demons, or monsters were intending to harm or kill them.’

3. Traumatized ‘school shooters’ :

Langam reminds us that traumatized / abused children trquently suffer consequences that include ‘anxiety, depression, hostility, shame, despair and hopelessness‘ and that they may, too, suffer a ‘reduced capacity for feeling emotions‘ and ‘feel cut off and detached from othersthreatened…and paranoid‘. And, further, they may suffer from constant ‘hypervigilance‘ (constantly anticipating danger / a feeling of being permanently in a sate of ‘red-alert’), self-destructiveness, self-harm, suicdal ideation and a propensity to behave violently.

It almost goes without saying, therefore, that the above provides yet further compelling evidence for the necessity to therapeutically intervene at the earliest possible opportunity when young people are displaying symptoms of emotional turmoil, traumatization and incipient mental illness (although, of course, it should, equally, hardly need saying that most such individuals are of no danger to others and are far more likely to be a danger to themselves due to self-harm (including heavy drinking, binge-eating, drug-taking, heavy smoking, anorexia and suicidal ideation / behavior) and general self-destructive behavior.

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