In the United States, about 50% of children experience at least one traumatic event during their childhood.

Many of these live with chronic, perpetual and relentless trauma (e.g. living in a family in which there is ongoing abuse) thus denying the child periods of time for recovery between events (which can lead to developmental trauma / complex posttraumatic stress disorder (complex PTSD).

After a traumatic life event, the vast majority nof children will experience severe distress ; however, in the case of complex postraumatic stress disorder, effects may be considerably delayed.

The more social and family support the child has, the more likely it is that he / she will be able to make a recovery. However, many children will also require clinical intervention. Sadly, at the current time, the majority of children who require clinical intervention do not receive it. This is, in part, due to the fact that childhood trauma frequently goes unacknowledged.

The child’s reaction to trauma is affected by the context in which it occurs.

How the child reacts to the trauma will be affected by his / her age and level of maturity.

The child’s response, and adjustment, to trauma can involve several stages.

Individuals who have been exposed to severe, ongoing, chronic trauma during childhood are at high risk of developing an SERIOUSLY IMPAIRED CAPACITY to cope and deal with subsequent stress in their lives.

Early life trauma can reprogram our DNA.

When a child is affected by trauma his / her parents / family are also affected and how they respond, and how they interact with the child, will also affect how the child reacts to the traumatic experience.

The child’s developmental level will affect how s / he responds to the trauma.

The culture in which the child exists will affect how s / he responds to the trauma.

FURTHER INFORMATION :

FOR MORE STATISICS ON CHILDHOOD TRAUMA : CLICK HERE.

FOR STATISTICS ON CHILD MENTAL HEALTH : CLICK HERE.

EFFECTS ON US OF TRAUMA / ENVIRONMENT VERSUS GENES – THE STATISTICS  : CLICK HERE.

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

We have already seen from many other articles published on this site that severe and protracted childhood trauma dramatically increases the probability that the individual will go on to develop borderline personality disorder (BPD) in later life. We have also seen that one of the major symptoms of BPD is chronic difficulty in forming and maintaining relationships with others. Recent research suggests that one of the important reasons that BPD sufferers experience such interpersonal difficulties is due to an impaired ability to send both receive and send social signals  (also referred to as SOCIAL COGNITION).

In terms of RECEIVING social signals from others, research has consistently shown that sufferers of BPD are liable to dysfunctionally and inaccurately infer the mental state of others (by, for example, interpreting the social signals these others are sending out are hostile when, in objective terms, they are not ; in other words, often, when BPD sufferers are trying to work out how others feel about them in social situations. they tend towards paranoid-style thinking styles – although usually not to such extreme levels that would qualify as being indicative of flagrant psychosis [it should be noted, though, that sufferers of BPD can occasionally suffer brief periods of psychosis, usually in response to particularly severe stress]).

In terms of the social signals that BPD sufferers SEND / GIVE OUT to others, recent research also suggests that they may also have an impaired ability to do this, too. It has been noted, for example, that BPD sufferers are more likely to send out ‘mixed’ social signals and also to express their emotions in more opaque and ‘hard to read’ ways than is the social norm.

In connection with the above, it is important to note that social signals can be sent and received on BOTH a conscious level AND on an unconscious level. And, although much of the research on the deficits BPD sufferers experience in relation to this is still at an early stage,  it is becoming increasingly apparent that such deficits in social cognition may be at the very heart of the myriad interpersonal difficulties those with BPD frequently face.

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

According to the traumagenic dynamics model (Finkelhor and Browne), severe and protracted childhood interpersonal childhood trauma (interpersonal trauma refers to types of trauma that occur between the child and significant others e,g, physical abuse, sexual abuse, emotional abuse, neglect and witnessing domestic violence) can give rise to pervasive feelings of betrayal, powerlessness, stigmatization and traumatic sexualization, which in turn, can have extremely adverse effects upon self-image, one’s view of the world and one’s emotional responses.

This can then lead to two contrasting negative effects upon the individual’s sexuality :

• some may respond by becoming sexually compulsive

• others may respond by becoming sexually avoidant

Sexual compulsion is sometimes referred to as hypersexuality and involves the individual being preoccupied (to the extent that it causes the individual distress and / or negatively impacts important parts of his / her life such as physical health, vocation and relationships) with urges, fantasies and / or activities that are hard to keep under control ; these may include excessive promiscuity, risky sex, masturbation, paying for prostitutes, pornography and cybersex.

The term ‘sexual avoidance,’ on the other hand, refers to chronic lack of sexual desire which has serious adverse effects upon the individual’s quality of life ; if the extent of sexual avoidance and related symptoms meet a certain threshold, it can be diagnosed as sexual aversion disorder. A person suffering from this disorder may avoid sex due to feelings of fear, revulsion and disgust in relation to sexual activity and suffer panic attacks at the thought of participating in it ; this, in turn, can, of course, seriously damage intimate relationships.

Both sexual avoidance and sexual compulsion are thought to be defense mechanisms (albeit dysfunctional ones) serving to protect the individual from intrusive, traumatic memories and flashbacks, or to reduce feelings of low self-esteem related to the devastating effects of the original childhood, interpersonal trauma. For example, a person with very low self-esteem may compulsively try to attract sexual partners to help him / her feel ‘desired’, ‘wanted’ or ‘loved’, however illusory, fleeting and superficial such faux-feelings may be.

Such promiscuity undertaken in a (futile) attempt to bolster self-esteem can, of course, ultimately serve only exacerbate feelings of loneliness, emptiness, guilt and shame ; indeed, it should be noted that some individuals alternate between periods of sexual compulsion and periods of avoidance. This ambivalence towards the concept of sexual activity reflects how individuals can be prone to switch between sexually compulsive behavior – in a desperate attempt to feel better – and sexually avoidant behavior – when they realize such behavior has left them feeling even worse).

Finally, it should be stated that research suggests sexual dysfunctional behavior not only can affect those who have experienced interpersonal trauma through sexual abuse, but also through physical and psychological abuse, as well.

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

Posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (complex PTSD) can both be considered forms of brain INJURY even though the cause of the injury is extreme psychological trauma rather than a physical trauma such as a blow to the head with a hammer or car accident.

However, when psychiatrists treat PTSD with drugs, they do so, in the vast majority of cases, without looking at the organ they are treating (i.e. the brain), unlike, say, a cardiologist, who would not consider treating the heart without, first, physically evaluating it.

In relation to this, the psychiatrist Dr. Daniel Amen stresses the importance that, before prescribing psychoactive drugs in patients suffering from PTSD (and other disorders), it is vital that the patient’s brain is physically evaluated in order to help ascertain in what ways it may be behaving sub-optimally ; he argues that such physical evaluations of the brain would reduce the amount of guess work psychiatrists (who do not examine the brain) must currently employ when prescribing medications intended to beneficially alter brain function and thus ameliorate the patient’s particular symptoms.

The method Amen recommends for physically evaluating what is going on in the brains of patients seeking therapeutic intervention for their particular condition is called SPECT (Single Photon Emission Computed Tomography) imaging.

What Information Does SPECT Imaging Provide About The Brain?

SPECT imaging measures blood flow in the brain and, because this blood flow reflects brain activity, it provides three important preces of information about the brain’s functionality ; these are :

1. Areas of the brain that are functioning well.
2. Areas of the brain that are overactive.
3. Areas of the brain that are underactive.

Armed with this information, Amen argues, the psychiatrist who makes use of SPECT imaging is in a much stronger position to tailor his / her treatment to the specific needs of the individual based upon the results of this imaging technique, whereas the psychiatrist who does not physically evaluate the brain in such a manner is forced to merely speculate what is happening in the patient’s brain, thus making his / her decisions about which psychoactive drugs need to be administered less informed and, potentially, therefore, less effective.

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

ABOVE : SHORT VIDEO SUMMARY (2 MINUTES) OF MAIN POINTS OF ARTICLE.

We have seen from numerous other articles that I have published on this site how severe and protracted childhood trauma can, in some cases, lead to the development of complex posttraumatic stress disorder (complex PTSD) in later life and that one possible symptom of this condition is the experiencing of FLASHBACKS.

Flashbacks involve the individual who suffers from them re-experiencing and reliving traumatic events involuntarily in such an intense and vivid way (sometimes involving hallucinations) that it feels like they are actually happening in the here-and-now.

Flashbacks are generally triggered by something that reminds the individual (on a conscious or unconscious level) of the original traumatic event, even very tandentially.

FLASHBACKS, MEMORY AND THE PREFRONTAL CORTEX :

A study conducted in 2008 involving sufferers of disorders related to stress has helped to cast some light upon what is happening in the brains of individuals who are prone to experiencing flashbacks.

First, it was found that these individuals’ ability to perform general memory tasks was inferior in comparison to the performance on the same tasks by healthy individuals.

Second, when those suffering from a stress-related condition were asked by the researchers to carry out a ‘suppression task’ (a task in which they were required to attempt NOT to think about something) they demonstrated LESS ACTIVITY IN THE PREFRONTAL CORTEX than did the healthy individuals when instructed to undertake the same task.

From this finding it was inferred that these individuals’ (i.e. those suffering from a stress-related disorder) underactive prefrontal cotices interfered with their ability to prevent traumatic memories breaking through into conscious awareness.

Learning ‘GROUNDING TECHNIQUES’ can help individuals cope with their flashbacks (grounding techniques involve using the five senses – sight, hearing, touch, taste, smell – to reconnect with the present) although many may also require the services of an appropriately trained, qualified and experienced therapist, paticularly if suffering from disorders such as PTSD or complex PTSD.

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

When a child is born into the world, s/he is utterly helpless and dependent upon his / her mother, and, in the early days of life, as long as his / her mother is present and sufficiently responsive to his / her needs, the baby is able to feel relatively safe, content and secure.

However, when the mother is absent, the baby quickly becomes panicked and distressed (as s/he has no way of knowing for certain that the mother will return.

As the baby develops, though, and continues to receive at least adequate nurturing from the mother, s/he becomes more able to tolerate periods of time when the mother is not present, especially if s/he is able to derive some compensatory comfort during such periods from objects such as soft toys and dummies. This is possible because s/he has managed to internalize the emotional nourishment s/he has previously received from the mother in such a way as to protect him/herself from developing overwhelming feelings of insecurity during temporary, maternal absences.

A metaphor that helps to elucidate this process is that of the ‘leaky cup,’ If an infant has received adequate ’emotional nourishment’ from the mother during the very early part of his/her life, s/he will have a good store of this nourishment in his/her (metaphorical) cup, and, during separations from the mother, the nourishment will only slowly ‘leak out of the cup.’ In other words, the infant is able to draw on this ‘nourishment’ during ephemeral periods of maternal absence as the store is reasonably voluminous and enduring.

However, in the case of an infant who has received inadequate nurturing from his mother during his/her early life, his/her ‘cup of emotional nourishment’ will be far less full than the relatively secure infant’s cup, and, what’s more, far ‘leakier’. Such a poorly cared for infant, then, will have an insufficient supply of previously stored emotional nourishment upon which to draw and is liable to become highly distressed as a result of even very brief periods of maternal absence (in terms of Bowlby’s theory, the infant is ‘insecurely attached’ to the mother).

Putting it simply, then, the nurtured infant can be viewed as adequately ‘full’ in terms of ’emotional nourishment’, whereas the neglected infant can be viewed as nearly ’empty’ in terms of such maternal nourishment.

As the neglected / empty child grows (assuming this lack of emotional nourishment is not somehow corrected, s/he will then, of course, eventually become an adult who also feels a pervasive sense of emptiness, especially if the extent of his/her childhood neglect has led him/her to develop borderline personality disorder (BPD) or complex posttraumatic stress disorder (complex PTSD).

In such cases, this feeling of ’emptiness’ can lead to severe and chronic psychological suffering and anguish.

It has been hypothesized, therefore, that these feelings of emptiness (one hallmarks of BPD, as alluded to above) are intimately connected to another frequent symptom of the disorder, namely that of impulsive thrill-seeking and risk-taking.

In short, in a desperate (and, ultimately, of course, futile) attempt to rid him/herself of intolerably painful feelings of emptiness,the BPD is exquisitely vulnerable to developing an array of risky, self-destructive addictions, including drug-taking, alcoholism, chain-smoking, gambling and self-harm.

Currently, one of the most effective treatments for BPD available is dialectical behavior therapy.

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