Tag Archives: Hallucinations

Childhood Trauma And Psychosis

Although there is now a vast amount of research that has been conducted on the link between childhood trauma and the later development of non-psychotic disorders, the amount of research that has been conducted on the link between childhood trauma and the later development of psychotic conditions has been rather less plentiful ; however, increasingly, researchers are focusing on this, so far, less studied link and in this article I will review some of what is currently known or theorized about the association.

 

Childhood Trauma And Psychosis :

‘The psychiatric profession is about to experience an earthquake that will shake its intellectual foundations…there is tectonic, plate-shifting evidence'[for the environmental basis of psychosis]’

-Oliver James (leading UK psychologist). Comment in relation to the now overwhelming evidence that psychosis is strongly related to childhood trauma and the need to stop over-focusing on biological causes.

There is now extremely strong research evidence showing the link between childhood trauma and the affected individual’s likelihood of developing PSYCHOTIC ILLNESS in later life.

It is, of course, already well-established that there is a powerful link between childhood trauma and psychiatric conditions which include depression, anxiety, substance abuse, eating disorders, post traumatic stress disorder, sexual dysfunction, personality disorder, dissociation and suicidal ideation. Now, however, it is becoming increasingly apparent that there is also a strong link with psychotic conditions such as BIPOLAR DEPRESSION and SCHIZOPHRENIA.

An ever-increasing body of  evidence is now demonstrating the very high prevalence of experiences of severe childhood trauma in psychiatric patients who are suffering from psychotic illnesses

Indeed, many leading psychologists are arguing that researchers have neglected the importance of childhood experiences in relation to psychotic illness in the past. Here, then, I present some recent research which helps to redress the balance:

Studies About Childhood Trauma And Psychosis :

– Read et al reviewed 51 previous studies on causes of psychotic illness and found that 69% of female psychotic patients and 59% of male psychotic patients had suffered severe childhood trauma. It was also pointed out by the researchers that these figures, although already extremely high, may be UNDERESTIMATES due to the fact that experiences of child abuse are well known to be under-reported.

– Bebbington et al : these researchers, examining data generated from 8500 individuals, found that those suffering from psychosis were approx. 15 times more likely than the mentally well to have suffered severe childhood trauma.

– A Dutch study of 4000 patients found that those who had suffered severe childhood trauma were approx. 11 times more likely to have developed psychotic conditions in later life.

– A Californian study found that those who had suffered severe childhood trauma were 5 times more likely to have gone on to experience HALLUCINATIONS in later life.

HOW IS CHILDHOOD TRAUMA THOUGHT TO LEAD TO PSYCHOSIS?

– COGNITIVE THEORY: Due to adverse childhood experiences, the individual develops what is called a NEGATIVE COGNITIVE TRIAD of beliefs; these are:

a negative view of self
– a negative view of others
– a negative view of the world in general

More specifically, beliefs such as the following are likely to develop:
– I am vulnerable
others cannot be trusted
– the world is dangerous

Such beliefs can become so ingrained and severe that they eventually manifest themselves in the guise of psychotic symptoms e.g PARANOIA.

– AFFECT OF CHILDHOOD TRAUMA ON THE BRAIN: Research is showing that extreme stress in childhood can adversely affect the physical development of vital brain regions responsible for emotional control (e.g the AMYGDALA) which can lead to extreme emotional dysregulation (INABILITY TO CONTROL STRONG EMOTIONS) and concomitant over-sensitivity and emotional over-reactivity. If the problem becomes sufficiently intense psychotic conditions may result.

IMPLICATIONS:

It is thought a new, over-arching theory of the causes of psychosis (known in scientific circles as a PARADIGM SHIFT) is likely take root in the field of psychiatric research – namely one that emphasizes the enormous importance of adverse childhood experiences.

It is argued that patients who present with psychotic symptoms should ROUTINELY undergo DETAILED ASSESSMENTS relating to their childhood experiences and that there should be a much greater emphasis upon the importance of psychological therapy (as opposed to drug therapy- so popular up until now- based upon theories of the biological origins of psychotic conditions).

 

Early Signs Of Psychosis :

 

Usually a person does not suddenly become psychotic. Instead, the onset of psychosis is often a gradual process and sometimes individuals may start to show possible signs of incipient psychosis in their teens.

So what are the early warning signs? I provide a list based on the most current research in this area below. However, it is important to realize these symptoms are NOT specific to psychosis, they may also be due to numerous other conditions or set of personal psychosis. Anyone worried they or someone else may be psychotic or may be developing psychosis should seek an expert opinion and NOT attempt an amateur diagnosis based on the symptoms that follow.

 

Possible Early Signs That A Person May Be Becoming Psychotic:

These signs may be split into six categories as follows:

1) Cognitive symptoms

2) Neurotic symptoms

3) Changes in mood

4) Changes in volition

5) Behavioral symptoms

6) Physical symptoms

Let’s look at each of these six categories below:

Cognitive Symptoms:

– problems with concentration/attention/mental focus

– frequent daydreaming/ retreating into fantasy worlds

– thought blocking (a sudden lapse into silence during conversation due to the mind ‘going blank’. This most frequently occurs when the individual is asked about something that is, consciously or unconsciously, psychologically disturbing to him/her. It is a psychological defense mechanism and form of repression.)

– reduced ability to think in abstract terms

Neurotic Symptoms:

– restlessness/agitation

anger

– irritability

Changes in Mood:

guilt

– suicidal ideation

– depression

– mood swings

anhedonia (an inability to derive pleasure from people, events or circumstances – a feeling of emptiness, flatness and numbness)

Change in Volition:

– loss of drive

loss of interest in events, activities and people that used to interest one

– feelings of apathy and fatigue and a general lack of energy

Behavioural Symptoms:

– social withdrawal

– drop in standard of school/college work

– increase in impulsivity

– increasingly odd/strange behaviour

– aggression

– destructiveness

Physical Symptoms:

– weight loss

– poor appetite

sleep problems

 

The Main Types Of Psychotic Delusions :

 

Psychotic delusions can occur in two conditions linked to childhood trauma : 

A) DEPRESSION WITH PSYCHOTIC FEATURES (click here to read my article about the link between childhood trauma and depression) 

B) SCHIZOPHRENIA (click here to read my article about the link between childhood trauma and SCHIZOPHRENIA) may involve the sufferer developing psychotic delusions.

 

What Is Meant By The Term ‘PSYCHOTIC DELUSION?’

A PSYCHOTIC DELUSION results from a THOUGHT DISORDER that gives rise to BLATANTLY FALSE BELIEFS. Whilst the belief is clearly and obviously false, the person who holds it has an UNSHAKEABLE BELIEF that the belief is true, even in the face of utterly overwhelming evidence to the contrary.

Classification of delusions:

Delusions can be classified as follows:

They can be:

A) Bizarre or non-bizarre

and:

B) Mood-congruent or mood- incongruent

I define these classifications below:

BIZARRE – extremely strange and odd beliefs that are CLEARLY IMPOSSIBLE. For example, a belief that the birds’ singing is really Morse code and they are communicating with each other in such code in order to form a plot to take over the world.

NON- BIZARRE – the belief held is still clearly wrong but, theoretically, not totally impossible. For example, a belief that the government has placed listening devices in every room of one’s house.

MOOD – CONGRUENT – the delusion is in line with the mood the person manifests as a result of his/her condition. For example, a depressed individual who believes that aliens have removed the part of his/her brain the used to give rise to the experience of pleasure. Or, a person who is manic may believe s/he has supernatural powers

MOOD – INCONGRUENT – the delusion is not obviously in line with the individual’s prevailing mood  (eg. a newsreader on the TV is talking about him/her. These are sometimes referred to as ‘mood-neutral’ delusions

Within these classification groups, delusions can also be of a specific type. I list these types below:

   – Delusions of jealousy : an all-consuming obsession that one’s partner is being unfaithful when there is no evidence this is the case and there is no objective reason for suspicion.

   – Delusions of nihilism : the belief that oneself, other people or the world do not really exist

   – Delusions of grandeur ,: a belief one is a person of massive importance such as Jesus, Emperor of the World etc. Or the belief one has made a great achievement (that the world refuses to recognise) such as a belief one has written plays vastly superior to those of Shakespeare when, in reality, they are barely literate.

– Delusions of control : a belief that one is having one’s thoughts and behaviour controlled by an external force e.g. by aliens

– Delusions of reference : a clearly false belief that people are talking about one or making reference to one when they are not e.g. a belief that the newsreader on the radio is always referring to one in a or a coded or indirect manner

– Delusions of guilt : a false belief one is responsible for some terrible event (such as a belief one is personally responsible for all the starving people in the world

Erotomania : the belief a famous person or person of high status (normally a person the sufferer of the delusion has never met) is deeply and passionately in love with one ( click here to read my article on this)

– Delusions of mind-reading : the belief that others are reading one’s mind

– Delusions of persecution : the belief that others are conspiring against one ( e.g trying to poison or drug one)

– Religious delusions: Delusions with a religious theme e.g .that one is a human incarnation of God

– Somatic delusions : these are delusions about one’s body ( e.g. that ants are crawling under one’s skin)

ALL OTHER ARTICLES ABOUT PSYCHOSIS :

 

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

 

 

 

Overcoming Nightmares And Hallucinations With ‘Paradoxical Intention.’

bpd and neuroimaging

paradoxical intention

Childhood Trauma And Its Link To Adult, Psychiatric Disorders :

We have seen in many other articles that I have published on this site that there is a link between childhood trauma and the later development of a whole array of psychiatric disorders in adulthood (for example, see my article on the Adverse Childhood Experiences Study – sometimes referred to as the ACE Study).

Such psychiatric disorders include major depression, anxiety, alcoholism, borderline personality disorder (BPD), complex posttraumatic stress disorder (cPTSD) and psychosis (including schizophrenia).

All of these conditions may include the symptoms of nightmares and/or hallucinations (borderline personality disorder can sometimes involve brief psychotic episodes, as can depression).

Nightmares, Hallucinations And Trauma-Based Memories :

When nightmares and hallucinations are linked to psychiatric disorders which, in turn, are linked to childhood trauma, it is quite possible that the content of those nightmares and / or hallucinations are founded, at least in part, upon TRAUMA – BASED MEMORIES.

Paradoxical Intention :

paradoxical intention

Of course, the content of nightmares and hallucinations is frequently highly disturbing and distressing – I have had nightmares of such violence that they have, on more than one occasion, caused me to fall out of bed. Frequently, too, I have thrashed about so vigorously in my sleep that I have knocked lamps, clocks, overflowing ashtrays, radios and half-finished cups of tea off my bedside table (although never all at once, albeit small consolation) – however, one possible way to reduce their intensity, or, even, overcome them may, counter-intuitively, according to psychodynamic theory, be facilitated by a process known as PARADOXICAL INTENTION.

Paradoxical intention is a concept first described by Dr Viktor Frankl, the famous psychiatrist and concentration camp survivor who founded Logotherapy, based on the idea that psychological symptoms can be made worse by tying too hard to fight them, summed up by the pithy maxim, ‘What you resist persists.’

So, applying the idea of paradoxical intention to the treatment of nightmares and hallucinations involves a trained psychotherapist encouraging the client to view his/her nightmares and /or hallucinations from a completely different perspective,  i.e. rather than seeing the hallucinations / nightmares as something purely destructive and to be feared, the client is encouraged, instead, to try to see these phenomena as helpful clues (no matter how bizarre and nonsensical they may appear to be on the surface) which can be analyzed and interpreted for salient meanings (whether literal or symbolic), thus helping to expose, and shed light upon, possible trauma-based memories that underpin the individual’s psychiatric condition.

In this way, the client can be both empowered, and, under the care of an appropriately trained psychotherapist, can also be sensitively and compassionately helped to understand, where appropriate, the deep roots of his/her particular psychological difficulties, which may prove to be an effective first step towards ameliorating them.

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

Psychotic ‘Hallucinations’ : Could They Be Trauma-Based Memories?

hallucinations and trauma-based memories

are hallucinations trauma-based memories?

The renowned UK psychologist, Oliver James, argues both eloquently and convincingly in his most enlightening book :  ‘Not In Your Genes’, that the extremely serious and distressing psychiatric disorder, schizophrenia , is almost entirely the result of environmental factors, and far less related to genetic influences than has previously believed. In making this argument, he also alerts us to the incipient theory that so-called psychotic ‘hallucinations‘ may, in fact, frequently actually be intrusive, TRAUMA-BASED MEMORIES.

 

In fact, this theory is far from new ; over eighty years ago, in 1936, Sigmund Freud proposed that hallucinations were caused by repressed memories of trauma erupting out of the unconscious mind and into consciousness.

 

RESEARCH SUGGESTING LINK BETWEEN HALLUCINATIONS AND MEMORIES :

But there exists, too, much more recent research into the putative connection between hallucinations (both of the auditory kind – sometimes referred to as ‘hearing voices’ and of the visual kind – sometimes referred to as ‘visions’). For example, Read and Argyle (1999) conducted a study involving one hundred psychotic patients and found that, amongst the content of hallucinations that these patients reported, fully half of this material consisted of fragments of memories relating to trauma that they had suffered during their childhoods.

hallucinations and trauma-based memories

Furthermore, Morrison et al., (2002) conducted a study involving 35 psychotic individuals and found that very nearly half (17 out of the 35) reported having visual hallucinations, the content of which was associated with actual events which had taken place earlier during their lives.

 

Additionally, McCarthy-Jones et al.,(2014) conducted research into 199 patients who ‘heard voices’ (i,.e. experienced auditory hallucinations) and found that 12% of these individuals reported that these ‘voices’ exactly replicated actual conversations they had had in their earlier lives ; a further 31% reported ‘hearing voices’ that approximated actual conversations they had had in their earlier lives.

 

MORE RESEARCH NEEDED :

However, no firm conclusions may yet be drawn regarding the possible link between the content of hallucinations and trauma-based memories. One of the reasons for this is that most of the research that has been conducted in relation to intrusive, trauma-related memories (as occurs in PTSD and complex-PTSD) has focused upon VISUAL MEMORIES, whilst, on the other hand, most of the research that has so far be conducted into the hallucinations of psychotic patients has focused upon the AUDITORY SENSE. In order for more light to be shed on this topic, this dichotomy of research focus needs to be addressed.

 

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

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