~~~
How to overcome childhood developmental trauma
A quick introduction, by Dr Jim Byrne, Doctor of Counselling
Posted on 21st January 2024
Page summary
Dr Jim Byrne shares his personal journey as a childhood trauma survivor and expert in counseling, discussing how he overcame challenges related to parental abuse, bullying, and autism. His work emphasizes the severe impacts of childhood trauma, distinguishing between PTSD and Complex PTSD. He highlights the need for tailored therapeutic approaches to address emotional dysregulation, relationship dysfunction, and developmental deficits stemming from prolonged abuse. The text introduces concepts like Adverse Childhood Experiences (ACEs) and Developmental Trauma Disorder (DTD), advocating for holistic recovery strategies that integrate psychological and physical healing, fostering resilience and emotional intelligence in trauma survivors.
Personal introduction
Hello, My name is Jim Byrne, and I am a survivor of childhood development trauma.
It took me many years, and many different strategies, to fix the cognitive and emotive deficits that I suffered because of parental violence (both verbal and physical); sibling and peer bullying; being a country boy in a city school; being malnourished, and physically weak, and thus unable to defend myself physically. And so on. I was largely autistic, making no friends in the ten years I spent in public schools.
But I was able to recover from all of those traumatic adversities, and to become a Doctor of Counselling, helping others to address their own childhood trauma.
One of the best ways for me to introduce you to my approach to trauma recovery is to post Chapter 1 of my main book on trauma, below. I hope you enjoy it, and find it interesting and helpful.
If you want me to help you to address your own childhood developmental trauma, please contact me:
~~~
Chapter 1: Introduction to the key concepts in trauma therapy
By Dr Jim Byrne, Doctor of Counselling, September 2021
Revised edition: Updated in February 2024
~~~
1. What is trauma?
According to my Oxford English Dictionary, trauma means: “… (1) a deeply distressing experience. … (And) (3) Emotional shock following a stressful event”. (Soanes, 2002, page 893)[i].
And my Oxford Dictionary of Psychology says it’s: “…a powerful psychological shock that has damaging effects”. (Colman, 2002, page 755)[ii].
To further clarify the meaning of ‘trauma’, let us take a look at how Sue Gerhardt, a psychotherapist who deals with childhood trauma, defines this concept.
She describes the opening scene of the film, Fearless, in which Jeff Bridges plays the role of a man who survives a plane crash, with several others. He looks at the scene of devastation without a flicker of concern; walks away; gets into a taxi, and leaves the burning plane, ambulances, fellow survivors, and fire engines behind him. His friend and business partner has died in the crash; so, not surprisingly, the Jeff Bridges’ character is ‘traumatized’.
As Gerhardt writes (describing how this character is when he returns to his home life):
“His relationships are affected: he has difficulty relating to his wife and son, and starts instead to form a bond with another survivor who lost her baby. He has flash backs to the crash, reliving the moments as the plane went down. He impulsively takes extreme risks with his body, walking blithely across a busy highway. He is dissociated (or detached – JB) from reality”. (Gerhardt, 2010, page 133).
Trauma disrupts our thoughts, feelings and behaviours.
And, in the case of prolonged childhood trauma, the damage also affects, to a greater or lesser degree, depending on the extent of depth of the trauma:
– Personality development;
– The ability to reason, and to think critically/ logically (also known as ‘cognitive development’);
– The ability to engage effectively in social relationships;
– And the ability to regulate one’s emotions (which can therefore escalate into inappropriate shame, anxiety, anger, guilt and depression).
Indeed, as Dr Bessel van der Kolk (2015) writes, “All trauma is preverbal”. Traumatized individuals cannot find words to express their terrible feelings. They may freeze, like statues; or fight verbally or physically, with the wrong people; or find various ways of running away, as if you could run away from your own central nervous system’s panicky arousal! They may also ‘fawn’ over others to placate them, if they were bullied and abused by their parents.
As Van der Kolk expresses it: “Even years later traumatized people often have enormous difficulty telling other people what has happened to them. Their bodies re-experience terror, rage, and helplessness, as well as the impulse to fight or flee, but these feelings are almost impossible to articulate. Trauma by nature drives us to the edge of comprehension, cutting us off from language based on common experience or an imaginable past”. (Page 43).
Van der Kolk has worked with traumatized individuals for decades, including war-damaged soldiers and victims of childhood abuse and neglect. And his insights and approach to the subject – as I understand it -have also been strongly influenced by working closely with Dr Judith Herman (1997/2015), who has been in the field of stress management about as long as he has – and she has mainly worked with female victims of childhood sexual abuse, adult rape and domestic violence; (although she has also studied the literature on war-damaged soldiers and victims of political terror). (Van der Kolk’s first book on PTSD appeared in 1984, and Herman’s in 1992).
Eventually, trauma sufferers do come up with what Van der Kolk calls “a cover story”, which is their best attempt to tell a story which accounts for their trauma; but it rarely captures the essence of the experience. “It is enormously difficult to organize one’s traumatic experiences into a coherent account – a narrative with a beginning, a middle, and an end”.
I (Jim Byrne) know that this is true from my own experience. I only became aware of my own prolonged childhood abuse when I was thirty years old, and I met a woman who cared enough to listen to my story, and to tell me “…that was not normal. And that – what they did to you – was not okay!” Subsequently, I was fortunate enough to be able to write the story of the first forty years of my life, in such a way as to make sense of my trauma; and to ‘put it to bed’[iii].
~~~
Trauma does not just affect our consciousness; our memories; and our minds. Modern neuroscience, since the 1990’s, has revealed to us just how much the brains of traumatized individuals are changed (for the worst) by their horrible experiences. Trauma leaves its imprint on our brain, our mind and our body. And these imprints affect how we think, feel and behave in later life, even decades after the traumatic experience. Trauma changes our perceptions, and our capacity to think/feel. But even when we begin to think/feel about our traumatic experience – and to create a helpful story of what happened – we are still left with the imprints in our bodies: the automatic physical and hormonal responses to present-time reminders of the trauma which was inflicted on us back there; back then. The ‘there and then’ is always with us, in our bodies, here and now: unless and until we process those physical and hormonal responses. To quote Van der Kolk again: “For real change to take place, the body needs to learn that the danger has passed, and to live in the reality of the present”. (Page 21).
~~~
In this section I have presented two kinds of trauma: discrete experiences of trauma, like the plane crash; and protracted experiences of trauma, like prolonged childhood abuse. It is important to be clear about the distinction between the first – which is called post-traumatic stress disorder (PTSD) – and the second, which is called developmental trauma, or Complex-PTSD.
Let us first define PTSD.
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
2. What is post-traumatic stress disorder (PTSD)?
The form of trauma illustrated by Sue Gerhard’s description of the plane crash victim – played by Jeff Bridges – is commonly called post-traumatic stress disorder (PTSD), since at least 1980, when a group of US soldiers, who had been traumatized by violent warfare in Vietnam, successfully petitioned the American Psychiatric Association (APA) to create a diagnosis which would accurately describe their symptoms and some appropriate treatments. (Psychiatry being the psychological wing of the medical establishment, this has now become a ‘normalized’ condition).
PTSD is defined by Mike Cardwell (2004)[iv] like this:
“Post-traumatic stress disorder refers to a distinct pattern of symptoms that develop as a result of some traumatic event (such as an aeroplane crash, kidnapping or rape). The symptoms of post-traumatic stress disorder begin shortly after the event and may last for months or even years. The symptoms include:
- re-experiencing the event – recurring recollections, including dreams and nightmares about the traumatic event
- avoidance – the person tries to avoid anything that is associated with the traumatic event; for example, if they have been in an air crash, they may avoid even watching movies that have aeroplanes in them
- reduced responsiveness – where the person feels a detachment from others and a sort of emotional numbness
- And increased arousal, anxiety and guilt – people may experience hyper-alertness and sleep disturbances. In some kinds of event (such as an air crash), people may experience guilt that they survived where others did not.”
Some proportion of people who are prone to this kind of PTSD may have had earlier, childhood trauma experiences. For example, Van der Kolk (2015) has argued that it’s the intensity of battle that determines whether or not a soldier will develop PTSD; and, when there are no underlying childhood traumas, the person is likely to recover spontaneously from PTSD over the subsequent ten to fifteen years. However, a war stressed soldier who was carrying underlying trauma from childhood will not experience this kind of spontaneous recovery. And thus, for cases of underlying childhood trauma, we need a new diagnosis of Complex-PTSD, which required relevant forms of help and support and psychological treatment models of recovery.
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
3(a). What is Complex PTSD?
Let us look at a brief definition of Complex PTSD (or C-PTSD) by Pete Walker, an American trauma therapist with thirty-five years’ experience, who also healed his own trauma of growing up in a loveless home:
“C-PTSD is a more severe form of post-traumatic stress disorder. It is delineated from this better known trauma syndrome by five of its most common and troublesome features: emotional flashbacks (with no visual component – JWB!), toxic shame, self-abandonment, a vicious inner critic[1] and social anxiety.” (Page 3 of Walker, 2013)[v].
Complex-PTSD is a relatively new concept, which owes a lot to the influential work of Dr Judith Herman (1997/2015). In her famous book about Trauma and Recovery (which first appeared in 1992, and was reissued with an updated epilogue in 2015), she wrote about the need to go beyond the definition and conception of post-traumatic stress disorder (PTSD), to include the extra-traumatizing effects of prolonged child abuse and/or protracted domestic violence, or captivity. On page 119 she writes:
“The existing diagnostic criteria for (PTSD) are derived mainly from survivors of circumscribed traumatic events. They are based on the prototypes of combat, disaster, and rape. In survivors of prolonged, repeated trauma, the symptom picture is often far more complex. Survivors of prolonged abuse (as adults) develop characteristic personality changes, including deformations of relatedness and identity. Survivors of abuse in childhood develop similar problems with relationships and identity; in addition, they are particularly vulnerable to repeated harm, both self-inflicted and at the hands of others. The current formulation of post-traumatic stress disorder fails to capture either the protean[2] symptomatic manifestations of prolonged, repeated trauma or the profound deformations of personality that occur in captivity”.
She recommended that this more complex form of trauma be given the new name of “complex post-traumatic stress disorder”. Although this proposal was rejected by the American Psychiatric Association, for reasons which have been challenged by Herman and Van der Kolk, it was eventually adopted by the World Health Organisation, in its International Classification of Diseases-11[vi]:
“The World Health Organization’s proposals in ICD-11[3], released for comment by member states in 2018, introduce for the first time in a major diagnostic system a distinction between post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (C-PTSD).” (Brewin, 2020)[vii].
The story of the emergence of Complex-PTSD is taken up by Professor Steven Gold, who worked with trauma victims from the early 1980’s, and developed his own system of therapy to help them. Gold acknowledges that there are two factions within the world of psychology, psychiatry and psychotherapy, as follows:
– One, in line with the American Psychiatric Association (APA), holds that all forms of trauma, including those referred to by Herman, Van der Kolk and others, can be accommodated within the PTSD formulation within the Diagnostic and Statistical Manual (DSM-5) – even though DSM-5 broadly invalidates the idea that a person’s emotional disorder may have social roots!
– The other faction, in line with the World Health Organization’s ICD-11, “…maintains that C-PTSD differs in essential respects from PTSD and requires a distinct approach to treatment: a period of extensive ‘stabilization’ prior to confronting the traumatic history. The preliminary phase of treatment is aimed at reducing stress-related symptoms and bolstering coping capacities so that, when traumatic events are subsequently addressed directly, the outcome is beneficial rather than overpowering and debilitating”. (Gold, 2020b)[viii].
The position of this latter faction is also in line with the content of this present book, and the approach of this author when dealing with traumatized clients in counselling relationships. This approach has been supported by three strands of research:
- The first is the research that resulted in the inclusion of C-PTSD in the World Health Organization’s ICD-11.[ix]
- The second is the research by Dr Felitti on Adverse Childhood Experiences (ACEs) – which is discussed in the Section 6 of this chapter, below. And:
- The third is the research that firmly established that a broad range of symptom patterns beyond PTSD, including anxiety, depression, substance abuse, dissociation and even psychosis, may be elevated in individuals with a protracted history of trauma[x].
Steven Gold adds: “In addition to the symptoms of PTSD, including enduring reminders of trauma, the studies (listed above) revealed three distinct signs of C-PTSD:
– Difficulties managing interpersonal relationships;
– A compromised ability to control emotional reactions;
– A negative self-image.
“This triad of difficulties is referred to in the literature as disturbances in self-organisation (DSO). In fact, the research shows that C-PTSD was more common (in one study, three times more common) than PTSD alone.” (Gold, 2020b).
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
But what is going on inside the body-brain-mind of an individual suffering from Complex-PTSD?
Bessel van der Kolk explains that “Research from (neuroscience, develop-mental psychopathology, and interpersonal neurobiology) has revealed that trauma produces actual physiological changes, including a recalibration of the brain’s alarm system, an increase in stress hormone activity, and alterations in the system that filters relevant information from irrelevant. We now know that trauma compromises the brain area that communicates the physical, embodied feeling of being alive. These changes explain why traumatized individuals become hypervigilant to threat at the expense of spontaneously engaging in their day-to-day lives. They also help us to understand why traumatized people so often keep repeating the same problems and have such trouble learning from experience. We now know that their behaviours are not the result of moral failings or signs of lack of willpower or bad character – they are caused by actual changes in the brain”. (Pages 2 and 3 of Van der Kolk, 2015).
This view of the brain-mind-body-&-society perspective on trauma is supported by the research and writings of Dr Allan Schore, Dr Joseph LeDoux, and Dr Daniel Siegel[xi].
Dr Allan Schore’s summation of a vast field of literature from various disciplines has established that there is actual “de-evolution” of two significant areas of the right brain, which are responsible for damping down the fight-or-flight alarm signals of the amygdala. (He describes those two elements, combined with the amygdala, as “the rostral limbic system”). Those two areas are the anterior cingulate and the orbitofrontal cortex. (There also seems to be some involvement of the insular cortex, although this is not part of the limbic system).
The anterior cingulate (and perhaps the insula) is wired up – (as a source of external affect regulation [or external emotional soothing]) – by our mothers, in the first couple of years of our lives, mainly via physical touch.
The insula is the area of the brain into which every part of the body sends nerve signals describing their state. When the insula does not get this kind of early physical soothing, it does not ‘learn’ (or get ‘wired up’ to understand) how to self-sooth in the context of later occurring stressors, in school, in work, and in wider adult life.
The second area of the right brain which is “de-evolved” by abusive or neglectful mothering, is the orbitofrontal cortex. This is the seat of our social-emotional intelligence, and our capacity to damp down socially induced fight-or-flight responses from the amygdala.
Thus individuals who failed to get adequate mothering through soothing physical touch, and, later through calming face to face communication, have a marked inability to manage their later stress responses, because they lack the brain-based resources to do so. (Allan Schore, in Rass, 2018; pages 103-133).
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
Coming up to date, let us look at a definition of Complex-PTSD by Mind-UK, a prominent British charity that deals with mental health problems[4]:
“Complex post-traumatic stress disorder … is a condition where you experience some symptoms of PTSD with some additional symptoms, such as:
- difficulty controlling your emotions
- feeling very hostile or distrustful towards the world
- constant feelings of emptiness or hopelessness
- feeling as if you are permanently damaged or worthless
- feeling as if you are completely different to other people
- feeling like nobody can understand what happened to you
- avoiding friendships and relationships, or finding them very difficult
- often experiencing dissociative symptoms[5] such as
- and regular suicidal feelings.”[xii]
~~~
One of the features of all forms of trauma, whether regular PTSD or Complex-PTSD, is the experience of flashbacks. Most readers will be familiar with the visual-experiential flashback which relates to circumscribed traumatic experiences, such as a plane crash, or the scene of a heavy battle during war, or being raped. The victims are prone to find themselves reliving the experience, months after the event, in full Technicolor in their minds: during their waking lives, and/or in nightmares, and with all the feelings of terror and shock that they felt at the time.
By contrast, individuals who are subjected to prolonged child abuse, or protracted domestic violence, captivity (such as being a prisoner of war) and so on, will tend to have “flashbacks” without the images. (For this reason I prefer to call them ‘bash-backs’!) They will just have the feelings (without the images); and just as if those feelings related to what is going on here and now. So that, when a victim of abuse in childhood, which involved physical abuse, finds themselves in an argument with a spouse years later, they will tend to “flashback” (or feel bashed-back) to those childhood feelings of powerless-ness, fear and pain, as if these feelings were caused by the current verbal conflict. This has a horribly complicating effect on the intimate relationships of those victims of Complex-PTSD.
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
It is shocking to think that the most common abusive environment that many children face is their own home; and their abusers are the very people who are supposed to love and take care of them: their parents; and sometimes older siblings; or other relatives. As Judith Herman (1994/2015) points out:
“Chronic childhood abuse takes place in a familial climate of pervasive terror, in which ordinary caretaking relationships have been profoundly disrupted. Survivors describe a characteristic pattern of totalitarian control, imposed by means of violence and death threats[xiii], capricious enforcement of petty rules, intermittent rewards, and destruction of all competing relationships through isolation, secrecy and betrayal”. (Page 98).
Further down that page she adds:
“In addition to the fear of violence, survivors consistently report an over-whelming sense of helplessness. In the abusive family environment, the exercise of parental power is arbitrary, capricious, and absolute. … Survivors frequently recall that what frightened them most was the unpredictable nature of the violence. Unable to find any way to avert the abuse, they learn to adopt a position of complete surrender”. (Page 98).
~~~
What does Judith Herman recommend to those who need to diagnose childhood abuse in their clients? She suggests a set of seven diagnostic criteria for identifying Complex-PTSD in patients/clients, as follows:
- The person will have had a history of subjection to totalitarian control over a period of months to years.
- Their ability to regulate their affects (or feelings/emotions) – like anger, anxiety, depression, guilt, shame, and so on – will have been damaged, resulting in having feelings which are outside of their “window of tolerance” – plus some extreme behavioural malfunctions, like suicidal preoccupation, self-injury and sexual behaviour extremes (too high or two low).
- Abnormal states of consciousness: Including forgetting the history of trauma; or not being able get it out of their mind; flashbacks or ruminative preoccupation with the trauma; dissociation and depersonalization.
- Negative distortions of self-perception: Including a sense of being very different from other people; or total personal isolation from others; senses of helplessness and drifting through life; sense of defilement by abuse, or stigmatized by the trauma, resulting in a shamed, guilt-ridden, or self-blaming identity.
- Paradoxical distortions in their perceptions of their abuser(s): Including either preoccupation with revenge, or idealization of the perpetrator; sense of the total power of the abuser and powerlessness of the victim; internalizing the beliefs and values of the abuser.
- Unusual relations with others, including: repeated search for a rescuer, alternating with isolation and withdrawal; lack of trust in others; they often fail to protect themselves from repeated abuse; great difficulty with intimate relationships.
- Problems with the meaningfulness of life: Including loss of a sustaining faith, or hope in the future; and a sense of despair and/or the pointlessness of their own life.
(Adapted from page 121 of Herman, 1994/2015)
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
3(b). Proposed category of ‘Developmental Trauma Disorder’ (DTD)
Van der Kolk and his colleagues have suggested that childhood Complex-PTSD needs to be seen as a separate disorder from that caused by protracted abuse in later years. The logic of their position seems to me to be unassailable, because protracted child abuse gives rise to developmental disruption and deficiencies which cannot possibly occur in protracted abuse of an adult. That is why they have chosen to call it Developmental Trauma Disorder (DTD). (See Ford, Grasso, et.al. 2013)[xiv].
These authors further suggest that prolonged abuse during childhood leads to symptoms that are quite distinct from those described for adult traumatic experiences; and they include the following:
– Problems with attachment: especially unclear boundaries with other people; damaged trust; difficulty reading emotions in others; and a tendency towards personal isolation.
– Difficulty managing own emotions; plus a lack of assertive communication, especially failing to communicate what they want or need.
– Medical problems arising out of biological effects of abuse; including problems integrating sensory information; physical clumsiness; and the conversion of emotional problems into physical symptoms.
– Dissociation, resulting in amnesia; depersonalization; compartmental-ization of memories linked to separate states of consciousness; and “impaired memory for state-based events”.
– Problems with attention, judgement, self-monitoring, planning, and use of materials. Also, problems with the processing of new information; poor object constancy; difficulties with logical, cause and effect thinking. Problems concentrating on and completing tasks. Plus language development problems, especially in the area of self-expression.
– Disrupted, shattered or dissociated autobiographical narrative (which is the basis of the individual’s self-concept). Also problems with negative bodily self-perception; low self-esteem; exaggerated sense of shame; and negative internalized models for relating to others.
– And finally: Difficulty with impulse control; disrupted sleep patterns; behavioural problems, including aggression; or drug and alcohol use to self-medicate.
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
4. How widespread is Complex-PTSD?
We have seen above that, in at least one study, Complex-PTSD (from protracted abuse, etc.) seems to be at least three times as common as regular PTSD, (resulting from a single-incident trauma). (Gold, 2020b).
Dr Bessel van der Kolk begins the prologue to his 2015 book, about how the body stores memories of our traumatic experiences, by pointing out that you don’t have to be a combat soldier or a refugee in a holding camp to encounter trauma. Trauma is all around us, and in us; in our friends, neighbours and family members. He points out that:
“Research by the Centres for Disease Control and Prevention has shown that one in five Americans was sexually molested as a child; one in four was beaten by a parent to the point of a mark being left on their body; and one in three couples engages in physical violence. A quarter of us grew up with alcoholic relatives, and one out of eight witnessed their mother being beaten or hit[xv].” (Page 1, Van der Kolk, 2015).
A quick look at the statistics for England and Wales for 2019 suggests that the situation in the UK is no better, as “…one in five adults aged 18 to 74 years experienced at least one form of child abuse, whether emotional abuse, physical abuse, sexual abuse, or witnessing domestic violence or abuse, before the age of 16 years (8.5 million people).” (ONS, 2019)[xvi].
However, this may be an underestimation because of the problem of secrecy, as indicated by the fact that “…around one in seven adults who called the National Association for People Abused in Childhood’s (NAPAC’s) helpline in the latest year had not told anyone about their abuse before.” (ONS, 2019).
Furthermore, a prominent telephone helpline for children in the UK, known as ‘Childline’, “…delivered 19,847 counselling sessions to children in the UK (in 2019) where abuse was the primary concern”. (ONS, 2019).
And in the Irish Republic, where I was abused, at home and in school[xvii], the Irish Times reported that “…Over 10,000 children (were) referred to Tusla (The Child and Family Agency) for suspected emotional abuse”. Plus, “…Figures for last year show significant increase in referrals”. (Irish Times, 21st June 2019)[xviii].
The content of the article shows that the figure of 10,000 was misleading (because it singled out one category of abuse, the emotional, from all others):
“Some 24,815 children were referred to Tusla for various forms of suspected abuse last year, an increase from 20,357 in 2017.
“Neglect, physical, sexual and emotional abuse were the most common reasons children were referred.
“The figures show a significant increase in the number of children being referred for suspected emotional abuse last year – at 10,130 compared to 7,615 in 2017.” (Irish Times, 21st June 2019).
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
Back in the USA, Dr Judith Herman’s original study (in 1992) found that, “The mental health system is filled with survivors of prolonged, repeated childhood trauma”. She goes on to point out that “the data… are beyond question. On careful questioning, 50-60 percent of psychiatric inpatients and 40-60 percent of outpatients report childhood histories of physical or sexual abuse or both”[xix]. And she states that one study found 70 percent of psychiatric patients had histories of abuse. (Herman, 1997/2015, page 122).
She also points out these psychiatric patients are just the tip of the iceberg because “…most people who have been abused never come to psychiatric attention.” It seems that most victims of child abuse are left to resolve their trauma on their own, or not at all[xx].
Clearly, child abuse and neglect are widespread, and – instead of declining with assumed increases in ‘enlightenment’ or ‘social progress’ – they can often increase! And, in this author’s opinion, there is not enough emphasis placed on child protection by modern governments, and especially neoliberal governments which want to leave the poor and needy to their own devices!
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
5. What are Adverse Childhood Experiences (ACEs)?
There is overwhelming evidence in the field of psychology[xxi] that childhood experiences shape our adult selves – even though the bible of American psychiatry (called the DSM-5) now largely denies this obvious, empirically verified fact[xxii].
Bessel van der Kolk (2015) raises an interesting question in this connection:
“How do you turn a new-born baby with all its promise and infinite capacities into a thirty-year-old homeless drunk?” (Page 143).
And he responds to his own question by pointing out that, in 1985, this vast question was answered by Dr Vincent Felitti, head of preventive medicine at Kaiser Permanente, a health management company in San Diego, California. Felitti was trying to help obese individuals, mainly women, to reduce their weight, because of the adverse effects of obesity on general health outcomes, (including diabetes and cancer, in particular). He succeeded in developing a highly successful rapid weight-loss program; but then some of the women began to put weight back on again, very rapidly, when they found they were attracting unwanted sexual attention from men. When Felitti and his team looked into the data, from interviews with 286 obese patients, they found that “…most of their morbidly obese patients had been sexually abused as children”, alongside “…a host of other family problems”. (Page 144 of Van der Kolk, 2015).
Next, somebody from the Centres for Disease Control and Prevention (CDC) “…encouraged Felitti to start a much larger study, drawing on a general population”, (and not just obese individuals). “…The result was the monumental investigation of Adverse Childhood Experiences (now known as the ACE study”). (Page 144, van der Kolk, 2015).
According to Judith Herman (1997/2015), 17,000 patients took part in the ACE study, filling in questionnaires about their childhood experiences of:
- physical and sexual abuse;
- neglect; and:
- witnessing domestic violence.
They also responded to questions about:
- “…whether a parent had been drug addicted, alcoholic, mentally ill, or in prison; or whether a parent had died during their childhood. One point was scored for each category”, and there were ten categories.
The outcome of the ACE study showed that traumatic experiences were much more common than had been expected.
If you want me to help you to address your own childhood developmental trauma, please contact me:
Here are some illustrations:
- “More than twenty-five percent answered ‘Yes’ to the questions:
- “Did one of your parents often or very often push, grab, slap, or throw something at you?”
- “Did one of your parents often or very often hit you so hard that you had marks or were injured?”
(According to Van der Kolk, these answers suggest that “…more than a quarter of the US population is likely to have been repeatedly physically abused as a child” – and this research study’s respondents “were mostly white, middle class, middle aged, well educated…”, so imagine how much worse the abuse is likely to be among those sections of the population where economic circumstances are much more stressful, for parents and children alike).
- “Ten percent answered ‘yes’ to the question: “Did a parent or other adult in the household often or very often swear at you, insult you, or put you down?”
- Twenty-eight percent of women, and sixteen percent of men, confirmed that they had been sexually abused by an adult, or by an older child, at least five years older than themselves.
- One out of eight respondents answered ‘Yes’ to the questions:
- “As a child, did you witness your mother sometimes, often or very often being pushed, grabbed, slapped, or had something thrown at her?” and:
- “As a child, did you witness your mother sometimes, often or very often being kicked, bitten, hit with a fist, or hit with something hard?”
Furthermore:
- “…only one third of the respondents reported no adverse childhood experiences”. This suggests that about two people out of every three in the US have experienced some degree of adverse childhood experience.
(All data from Van der Kolk, 2015, page 145).
The ACE questionnaire had 10 questions, which had taken more than one year to develop and refine.
This is it:
Before your 18th birthday:
- Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?
- Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?
- Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?
- Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?
- Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
- Were your parents ever separated or divorced?
- Was your mother or stepmother: Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
- Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
- Was a household member depressed or mentally ill, or did a household member attempt suicide?
- Did a household member go to prison?
~~~
Each question scored one point if answered in the affirmative; and 87% of respondents scored two or more!
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
The first place where the negative impact of childhood trauma was found to play out, by Felitti and his co-researchers, was in school, where “…more than half of those with ACE scores of four or higher reported having learning or behavioural problems, compared with 3 percent of those with a score of zero”.
So, having a number of ACEs definitely correlated with later childhood difficulties; which the children did not grow out of as they aged; and those difficulties followed them into adulthood. “For example, high ACE scores turned out to correlate with higher workplace absenteeism, financial problems, and lower lifetime income”.
And chronic depression in adulthood also correlates strongly with ACE scores of 4 or more; the incidence of depression being “… 66 percent in women and 35 percent in men, compared with an overall rate of 12 percent in those with an ACE score of zero”.
Suicide attempts also increase proportionately to ACE scores; and people with an ACE score of four or more were seven times more likely to be alcohol addicted than adults with a score of zero.
And individuals who scored six or more on the ACE test were highly likely to be injecting hard drugs.
The likelihood of being raped in adulthood, and the incidence of physical health problems, also rose in proportion to ACE scores. (Van der Kolk, 2015, page 146. Herman, 1997/2015, pages 257-258; Gold, 2020b).
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
Clearly, childhood trauma is a major source of problems in adulthood, including problems of emotional dysregulation; relationship dysfunction; and work, career and income problems; plus personal safety in the sexual domain; and vulnerability to drug abuse.
And Alan Schore has argued that adult victims of PTSD have relatively short-lived symptoms, unless they were also traumatized in childhood!
And thus we should pay more attention to how we can help survivors to recover from traumatic experiences, and to thrive instead of merely surviving.
This research also supports Van der Kolk’s suggestion that we need a diagnosis of Developmental Trauma Disorder (DTD).
~~~
6. What are some solutions to Childhood Developmental Trauma or Complex PTSD?
Some of the earliest experiences I had, which, (I later realized), helped to ameliorate my childhood developmental trauma, were social/emotional:
– Being hugged (just once, for a minute) by a nun, when I was ten or eleven years old; a totally rare event of loving, human contact;
– Being given a homemade drawing book by two local ‘spinsters’, who seemed to think I was ‘handsome’ – when I was about six years old. (Very rare positive feedback from the world).
– Being taught to draw by one of the lovers of my mother. (He bought me a coloured pencil – double-ended, red and dark blue – and a pad to draw on). He also visited us every week, bringing sweets, pocket money, and cooked food!
Some of the major curative experiences which helped to alleviate my constant state of social anxiety were physical:
– Learning to do judo, from the age of fourteen to eighteen years. And running in the Phoenix Park, in Dublin.
– Learning to relax – (Passive Progressive Relaxation therapy) – and to paint pictures (Art therapy) – when I was twenty-two years old.
Nevertheless, when I began to work – as a psychotherapist – with my own clients, in 1998, I focused in on the stories of my traumatized clients. Along the way, I had come to think of the personal narrative as the key to healing childhood trauma. (That is to say, I’d forgotten the importance of the body!)
This belief in the primacy of the client’s narrative was a widespread belief at that time. As Janina Fisher writes:
“…we (trauma therapists) unconditionally accepted the idea that uncovering buried memories was the key to setting trauma suffers free”. (Fisher, 2014).
But I, like Janina Fisher, and Steven Gold (2020b), quickly discovered that, if you move too quickly to the client’s story about their traumatic experiences, you run the risk of re-traumatizing them. If their perceptions have not changed since their traumatic experience, they will perceive it just as they did way back when it happened.
(Of course, I still believe that helping the traumatized individual to tell their story is one of the keys to recovery; but not the primary key; and it normally has to be delayed for a time, until the client has been helped to feel safe, and to be stabilized; and also to have made up some of their developmental deficits, especially in the areas of communication, assertion, trust, etc.)
According to Dr Judith Herman (1994/2015), the first task is to help the trauma victim to feel safe; to ground them in the present moment. Or, as Janine Fisher describes Judith Herman’s approach: “… She believed that good trauma treatment required a much more patient approach – delaying the focus on traumatic memories until survivors felt safe in their daily lives and had sufficient affect regulation[8] to tolerate the stress of remembering dark episodes in their histories”.
That is why this book is structured as it is, with a lot of emphasis upon bodily processing, switching of the fight or flight response, and building physical and mental resilience in preparation for facing up to whatever traumatic memories might (later on) emerge!
I begin this revised and updated version of my book with chapters on the following topics, which are specifically focused upon the symptoms of childhood developmental trauma:
Chapter 2. Fear of facing up to painful emotions
Chapter 3. Managing non-visual, emotional flashbacks
Chapter 4. Breathing to calm your central nervous system
Chapter 5. Case studies of traumatized individuals I’ve known or helped
Chapter 6. Sleep, stress and trauma
Chapter 7. Physical exercise for the reduction of overly-aroused
Chapter 8. Physical Exercise to break up body memories of trauma
Chapter 9. Part 1 of emotional processing: Overcoming your compromised ability to control emotional reactions: Reframing using the windows model;
Chapter 10. Eye Movement Desensitization and Reprocessing (EMDR) – to break up trauma triggers
Chapter 11. Part 2 of building emotional intelligence, using Gestalt writing exercises…
Chapter 12. Overcoming a negative self-image (by defeating your Inner Critic)
Chapter 13. Part 3 of emotional processing: Completing your emotional experience of your most difficult feelings
Chapter 14. Difficulties managing interpersonal relationships, and how to make progress
Chapter 15. Boundaries in relationships; and assertive rights
Chapter 16. Assertive communication skills…
And others…
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
Despite the fact the Dr Bessel van der Kolk worked closely with Dr Judith Herman, at Cambridge Hospital in Massachusetts, there is a significant difference in their understanding and treatment of complex trauma, or, what Van der Kolk calls Developmental Trauma Disorder (when it is diagnosed in children). The biggest difference is in the way Van der Kolk takes the body into account, while Herman, like very many people in the field, tends to get stuck focusing on the mind alone, or the mind in relationship to others: the socialized brain-mind. Herman is aware of the effect of trauma on the body, but in her treatment approach – which became widely followed by professionals in many fields around the world in the 1990’s – she tends to emphasize three stages of recovery for all forms of trauma (ranging from single event PTSD to prolonged abuse and Complex-PTSD).
She writes:
“Because the traumatic syndromes have basic features in common the recovery process also follows a common pathway. The fundamental stages of recovery are
– establishing safety,
– reconstructing the trauma story, and
– restoring the connection between survivors and their community.” (Page 3, Herman 1994/2015).
Because of this emphasis, Herman continued to advocate and promote talk therapy – emotive, relational, sensitive, slow, talk therapy.
On the other hand, Bessel van der Kolk was influenced by neuroscience: especially Joseph LeDoux and Antonio Damasio[xxiii]; and he began to teach his associates to “focus on the body”, instead of “the story”. This was a move away from talk therapy; or rather a broadening out of talk therapy to include processes that focused on the body, including eye movement desensitization and reprocessing (EMDR), sensorimotor psychotherapy, Somatic Experiencing, Internal Family Systems[9], yoga therapy, and neurofeedback[10].
If you want me to help you to address your own childhood developmental trauma, please contact me:
On page 53 of his 2015 book, Van der Kolk writes this: “After trauma the world is experienced with a different nervous system. The survivor’s energy now becomes focused on suppressing inner chaos, at the expense of spontaneous involvement in their lives. These attempts to maintain control over unbearable physiological reactions can result in a whole range of physical symptoms, including fibromyalgia, chronic fatigue, and other autoimmune diseases. This explains why it is critical for trauma treatment to engage the entire organism, body, mind and brain.” (Page 53, Van der Kolk, 2015).
Later, on page 89, he writes about how “I discovered that my professional training, with its focus on understanding and insight, had largely ignored the relevance of the living, breathing body, the foundation of our selves”. And elsewhere he emphasized that prolonged child abuse disrupts the child’s development in three areas:
– the cognitive domain (or thinking/reasoning);
– emotional control (as in reduced ability to moderate emotional extremes);
– and social connection/ isolation (as in the inability to form satisfactory social relationships).
And these disruptions are not just in the mind – as thoughts, beliefs or attitudes – but stored in the body-brain, in the form of both neurology, and the biochemistry of hormone secretion.
Thus it is important to emphasize that, in this present book, you will find:
– A strong emphasis, at the appropriate points, on the importance of diet, exercise (especially yoga and tai chi, or chi kung), sleep, and breath-work, and other systems that engage the body in recovery from trauma (including eye-movement desensitization); plus:
– Training in the ability to reason about difficult problems;
– Some guidance on how to rectify social/relational deficits; and:
– How to manage your emotions.
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
Van der Kolk (2015) suggests that there are really only three broad approaches to trauma therapy, as follows:
- “…top down, by
- “…by taking medicines[xxvii] that shut down inappropriate alarm reactions, or by utilizing other technologies that change the way the brain organizes information” (such as neurofeedback – Ed.);
- “…bottom up: by allowing the body to have experiences that deeply and viscerally contradict the helplessness, rage, or collapse that result from trauma – (such as yoga, tai chi, EMDR, muscle relaxation, etc. – JWB.)” (Van der Kolk, 2015, page 3).
It may be that most traumatized individuals need some elements of all of the approaches above, in some kind of individualized combination.
In point 3, above, and elsewhere throughout his book, Van der Kolk emphasizes the importance of dealing with body sensations as a major source of information about the individual’s traumatic memory. I have integrated this task more fully into the early chapters of this revised and updated text.
~~~
Just as Dr Van der Kolk had reservations about Dr Judith Herman’s classic approach to trauma therapy, so also did Professor Steven Gold, a professor at Nova Southeastern University (NSU) Centre for Psychological Studies, in Fort Lauderdale, Florida.
Gold, who has been involved in developing and providing trauma therapy since the early 1980’s, comments as follows:
“Herman advocates that the first phase of treatment aims to stabilise the client. We agree, but add that, in large part, this is accomplished by promoting remedial psychological development and the shoring up of adaptive capacities not only weakened by trauma, but also stunted by developmental deprivation.”
The point here is that children who are subjected to prolonged abuse suffer developmental deficits in the following domains:
- Cognitive, (or reasoning and thinking);
- Emotive (or visceral and psychological moods, feelings and affects); and:
- Interpersonal relations. (Including insecure attachments bonds to other people, and problematical personality adaptations).
Therefore, there is a need to address those developmental delays and deficits, in order for their recovery to be successful.
Gold goes on to say: “By fostering effective interactions with others, establishing a mutually trusting, collaborative treatment relationship, and promoting sound reasoning ability guided by logic, the client and the therapist together can construct strategies for mastering coping abilities and other life skills.” (Gold, 2020b).
If you want me to help you to address your own childhood developmental trauma, please contact me:
In this present book, which you hold in your hand (or are viewing on this screen!), we provide extensive curative treatments for domains 1 and 2 above. However, our ‘interpersonal interactions’ with the reader are necessarily limited – (by being purely one way – from the author to the reader) – and thus it is important for the reader to recognize that they need to address this area of need by seeing a face-to-face counsellor or psychotherapist – (in person, or over the telephone, or via web camera).
Your counsellor/therapist should be one who understands trauma, and especially traumatic damage to attachment bonds; and to personal development. Or, if that is not possible, try to find a good friend (or friends) who has a secure attachment style, and healthy personality adaptations, from whom you can learn to be securely attached in your relationships, and to have healthier personality adaptations.
In Steven Gold’s system, “…initial treatment helps … clients (to) develop the abilities needed to feel better and function better in the present, rather than assuming that they would first need to be directed to revisit their traumatic past to address the root of their distress. We found that, once they had made substantial progress toward expanding their adaptive capacities and living more gratifying and effective lives in the present, trauma processing could be conducted productively without disruptive consequences.”
Potential readers of this book should assure themselves that they have addressed the interpersonal damage done to them in childhood as early as possible in their recovery process.
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
Dr Van der Kolk (2015) has researched the effectiveness and appropriacy of the following treatments for Complex-PTSD:
- Talk therapy;
- Eye movement desensitization and reprocessing (EMDR);
- Somatic experiencing[11];[xxviii]
- Yoga and mindfulness meditation (both of which depend upon conscious breathing techniques);
- Theatre and psychodrama;
- Neurofeedback;
- And others.
He has no preferred treatment modality, because “…no single approach fits everybody”. (Page 4). He does, however, work in a way which prioritizes the body over the mind, as well as working on social relationships before revisiting the traumatic experience. And that is now my preferred sequence of treatment.
My own approach to trauma therapy is strongly influenced by Judith Herman, Bessel van der Kolk, Steven Gold, and others, including the major neuroscientists who influenced Van der Kolk (including Joseph LeDoux and Antonio Damasio).
The main principle that I take from Herman and Gold is this: You have to proceed slowly and cautiously in order not to re-traumatize yourself!
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
7. The content of this book
In the remainder of this book, we will show you how to work on the thinking-feeling-perceiving aspects of re-authoring your life, if you have been affected by some form of developmental trauma, or prolonged childhood abuse or neglect.
Interspersed with that, we will also present guidance on how to manage your body, using physical exercise (which can help to process trauma); eye-movement desensitization and reprocessing (EMDR); sleep hygiene; breathing exercises and focusing on bodily sensations; plus diet/nutrition, which can help to keep your brain-mind in a healthy state, and which will also support the processing of trauma, by helping to regulate your emotions.
Additionally, we will introduce some ideas on self-assertion and self-management; plus meditation and relaxation. And how to develop your emotional intelligence.
~~~
However, there is one thing we cannot do in this book, and that is to help you to work on your interpersonal relationships in order to achieve secure attachment. Our inputs on self-assertion, and maintaining your personal boundaries, will help you to some degree to begin to recover your sense of having rights to fair treatment. But it will also be important to make sure you either become securely attached to an intimate partner; or some very good friends who have been through therapy themselves. And/or to begin to see a good, recommended, Attachment Therapist; and/or somebody who practices Developmental Trauma Therapy (DTT), which was created by Dr Bessel van der Kolk.
Nevertheless, if you work with the strategies outlined in this book, combined with some healthy social relating, you will be able to recover from your childhood trauma, no matter how severe it might have been.
Good luck with your journey of recovery!
Best wishes,
Jim Byrne, Doctor of Counselling, Hebden Bridge, August/September 2021
~~~
If you want me to help you to address your own childhood developmental trauma, please contact me:
~~~
Endnotes
[1] We provide detailed instruction on how to control, reduce and defeat your Bad Inner Critic, in Appendix D, below.
[2] Protean means “…tending or able to change frequently or easily”.
[3] The ICD-11 is the eleventh edition of the International Classification of Diseases, by the World Health Organization, and includes physical diseases and emotional disorders.
[4] Mind-UK provides advice and support to empower anyone experiencing a mental health problem. They campaign to improve services, raise awareness and promote understanding.
[5] “Dissociative symptoms” are those which involve the mind of the individual detaching from sense data from eyes, ears, skin, etc.
[6] “Depersonalization” means: a state in which your thoughts and feelings seem unreal, or to not belong to you.
[7] “De-realization” is where the world around you seems unreal, or unfamiliar; or foggy or lifeless.
[8] “Affect regulation” is a psychological term for “managing your emotions”. We all start out in life with a main carer (normally mother) who sooths us when we get upset. This is the first stage of ‘affect regulation’, and it is mainly physical and soothing-sounds. As we grow as children, we learn to internalize our mother’s ability to soothe us (or to regulate our affects, to within a tolerable range). Victims of childhood abuse or neglect do not get an adequate quality or amount of external affect regulation, so when they are older, they tend to become hyper-aroused (as in anger and anxiety) or hypo-aroused (as in feeling depressed, grief-stricken, or inappropriately guilty and ashamed).
[9] Internal Family Systems (IFS) uses Family Systems theory—the idea that individuals cannot be fully understood in isolation from the family unit—to develop techniques and strategies to effectively address issues within a person’s internal community or family. This evidence-based approach assumes each individual possesses a variety of sub-personalities, or “parts,” and attempts to get to know each of these parts better to achieve healing. This type of therapy was developed in the early 1990s by Richard Schwartz.
[10] “Neurofeedback is a way to train brain activity; it is biofeedback for the brain. To understand neurofeedback, first we need to understand a little about brainwaves.” See the online information at Brainworks – Train your mind. Located here: https://brainworksneurotherapy.com/what-is-neurofeedback
[11] “Somatic experiencing (SE) focuses on the physiological responses that occur when someone experiences or remembers an overwhelming or traumatic event, in his or her body, rather than only through the thoughts or emotions connected to it.” Banschick (2015). This is addressed in Chapter 12, below.
[i] Soanes, C. (2002) Paperback Oxford English Dictionary. New York: Oxford University Press.
[ii] Colman, A.M. (2002) A Dictionary of Psychology. Oxford: Oxford University Press.
[iii] Byrne, J.W. (2017) Metal Dog – Long Road Home: A mythical journey through the eye of a needle. The fictionalised memoir of an improbable being. E-CENT Institute Publications.
[iv] Cardwell, M. (2000) The Complete A-Z Psychology Handbook. Second edition. London: Hodder and Stoughton.
[v] Walker, P. (2013) Complex PTSD: From surviving to thriving. Lafayette, CA: Azure Coyote Publishing.
[vi] World Health Organization (2019). International statistical classification of diseases and related health problems (11thed.). https://icd.who.int/
[vii] Brewin, C. (2020). Complex post-traumatic stress disorder: A new diagnosis in ICD-11. BJPsych Advances, 26(3), 145-152. doi:10.1192/bja.2019.48
[viii] Gold, S. (2020a) Contextual Trauma Therapy: Overcoming Traumatization and Reaching Full Potential. Washington, DC: American Psychological Association.
Gold, S. (2020b). ‘Escaping a toxic childhood: A new therapy helps survivors improve their lives by facing the psychological impoverishment that often accompanies abuse’. An online article in Aeon Magazine, here: https://aeon.co/essays/ contextual-trauma-therapy-can-limit-the-impact-of-a-toxic-childhood.
[ix] Elklit, A., Hyland, P. and Shevlin, M. (2014) Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples. European Journal of Psychotraumatology 2014, 5: 24221. http://dx.doi.org/10.3402/ejpt.v5.24221
[x] Elklit, A., Hyland, P. and Shevlin, M. (2014). ‘Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples’. European Journal of Psychotraumatology 2014, 5: 24221. http://dx.doi.org/10.3402/ejpt.v5.24221
Murphy, S., Elklit, A., Dokkedahl, S., & Shevlin, M. (2016). ‘Testing the validity of the proposed ICD-11 PTSD and complex PTSD criteria using a sample from Northern Uganda’. European Journal of Psychotraumatology, 7, 32678. https://doi.org/ 10.3402/ejpt.v7.32678
Brewin, CR, Cloitre, M, Hyland P, et al. (2017) ‘A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD’. Clin Psychol Rev. 2017;58:1-15. doi:10.1016/j.cpr.2017.09.001
[xi] Schore, A.N. (2015) Affect Regulation and the Origin of the Self: The Neurobiology of Emotional Development. London: Routledge. And:
LeDoux, J. (1996). The Emotional Brain: The mysterious underpinnings of emotional life, New York. Simon and Schuster. And:
Siegel, D.J. (2015) The Developing Mind: How relationships and the brain interact to shape who we are. London: The Guilford Press. And:
[xii] Mind (2020) ‘Post-traumatic stress disorder (PTSD) – What is complex PTSD?’ Online information: https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress -disorder-ptsd/complex-ptsd/. © Mind. This information is published in full at mind.org.uk. Accessed on 20th June 2020.
[xiii] Some readers might find it incredible that very many parents would engage in death threats against their own children. My parents were not the most abusive parents in our neighbourhood, to the best of my knowledge and belief. They were seen by our neighbours as good, pious, religious people who cared for their religious, well behaved children.
But I frequently had my mother and my father say, as they slapped me, with their face right in mine: “I’ll be hung for you!” (Meaning I’ll kill you, and then be tried and hung). “I’ll murder you!” “I’ll give you away to the gypsies” (which is a kind of death). “I’ll swing for you” (same message: “I’ll kill you!”) “I’ll beat you within an inch of your life!” – “I’ll strangle you!” And those are only the ones I can easily remember. I can’t remember very much from before the age of ten years, and not much between ten and fourteen. This kind of amnesia is common in cases of prolonged childhood abuse.
[xiv] Ford JD, Grasso D, Greene C, Levine J, Spinazzola J, van der Kolk B (2013). ‘Clinical significance of a proposed developmental trauma disorder diagnosis: Results of an international survey of clinicians’. The Journal of Clinical Psychiatry. 74 (8): 841–9. doi:10.4088/JCP.12m08030. PMID 24021504.
[xv] Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., et.al. (1998). ‘Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: The Adverse Childhood Experiences (ACE) Study’. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/ 10.1016/S0749-3797(98)00017-8. Here is the Abstract to clarify that this is not just about physical diseases:
Abstract
8,506 adults (aged 19–92 yrs) completed a questionnaire about adverse childhood experiences (ACEs). Seven categories of ACEs were studied: psychological, physical, or sexual abuse; violence against mother; or living with household members who were substance abusers, mentally ill or suicidal, or ever imprisoned. The number of categories of ACEs was then compared to measures of adult risk behaviour, health status, and disease. Results show that more than half of the (subjects) reported at least 1, and 25% reported more than 2 categories of ACEs. There was a graded relationship between the number of categories of ACEs and each of the adult health risk behaviours and diseases that were studied. The 7 categories of ACEs were strongly interrelated and (subjects) with multiple categories of ACEs were likely to have multiple health risk factors later in life. (PsycINFO Database Record (c) 2019 APA, all rights reserved). Accessed on 21st June 2020.
Source: https://psycnet.apa.org/record/1998-04002-001
(The study also focussed on the link between ACEs and depression, suicidality, IV drug use, and other ‘mental health’ issues. See Van der Kolk, 2015, page 146.)
[xvi] ONS (2019) ‘Child abuse extent and nature, England and Wales: Year ending March 2019’. London: Office for National Statistic. Available online at: https://tinyurl.com/ycswggtr
[xvii] Byrne, J.W. (2017a) Metal Dog – Long Road Home: A mythical journey through the eye of a needle. The fictionalised memoir of an improbable being. E-CENT Institute Publications.
And:
Byrne, J.W. (in press) Recovery from Childhood Trauma: How I healed my heart and mind – and how you can heal yourself. Hebden Bridge: The Institute for E-CENT Publications.
[xviii] McMahon, A. (2019) ‘Over 10,000 children referred … for suspected emotional abuse’. The Irish Times, Friday June 21st 2019. Online: https://www.irishtimes.com/ news/social-affairs/over-10-000-children-referred-to-tusla-for-suspected-emotional-abuse-1.3933653. Accessed on 21st June 2020.
[xix] Jacobson, A. and Richardson, B. (1987) ‘Assault experiences of 100 psychiatric inpatients: Evidence of the need for routine inquiry’. American Journal of Psychiatry, 144: 908-913.
Bryer, B., Nelson, B.A., Miller, J.B., and Krol, P.A. (1987) ‘Childhood sexual and physical abuse as factors in adult psychiatric illness’. American Journal of Psychiatry, 144: 1426-1430.
Jacobson, A. (1989) ‘Physical and sexual assault histories among psychiatric outpatients’. American Journal of Psychiatry, 146: 755-758.
Briere, J. and Runtz, M. (1987) ‘Post sexual abuse trauma: Data and implications for clinical practice’. Journal of Interpersonal Violence, 2: 367-379
[xx] Herman, J.L., Russell, D.E.H., and Trocki, K. (1986) ‘Long-term effects of incestuous abuse in childhood’. American Journal of Psychiatry, 143: 1293-1296.
[xxi] Siegel, D.J. (2015) The Developing Mind: How relationships and the brain interact to shape who we are. London: The Guilford Press. And:
Wallin, D.A. (2007) Attachment in Psychotherapy. New York: Guildford Press. And:
Bowlby, J. (1951). Maternal care and mental health. World Health Organization Monograph (Serial No. 2). And:
Bowlby, J. (1958), The nature of the child’s tie to his mother. International Journal of Psycho-Analysis, XXXIX, 1-23. And:
Bowlby, J. (1959). Separation anxiety. International Journal of Psycho-Analysts, XLI, 1-25. And:
Bowlby, J. (1960). Grief and mourning in infancy and early childhood. The Psychoanalytic Study of the Child, VX, 3-39.
And:
Bretherton, I. (1992). ‘The origins of Attachment Theory: John Bowlby and Mary Ainsworth’. Developmental Psychology, 28, 759-775.
[xxii] ‘A group of 12 researchers have suggested that the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) does not give enough consideration to social factors that influence the diagnosis of mental health disorders. The DSM-5 will be published in May 2013.
“The identification and diagnosis of mental disorders are controversial and weighty topics. Mental disorders are complex, and knowledge about their causes and contributing factors is still evolving,” wrote Helena B. Hansen, MD, PhD, of New York University in New York City, and colleagues in a commentary in the online April Health Affairs.
The group of researchers say that the DSM-5 Task Force focused on identifying neuroscientific evidence for diagnosis even though such evidence is currently insufficient for those purposes”. ‘ (See: Hansen HB, Donaldson Z, Link BG. ‘Independent review of social and population variation in mental health could improve diagnosis in DSM revisions’. Health Affairs. 22 April 2013; [Epub ahead of print].
Source: LeBano, L. (2013) ‘DSM-5 Review Process Does Not Address Social Issues, Researchers Say’. Psychiatry & Behavioural Health Learning Network. Online: https://www.psychcongress.com/ article/ dsm-5-review-process-does-not-address -social-issues-researchers-say
[xxiii] LeDoux, J. (1996). The Emotional Brain: The mysterious underpinnings of emotional life, New York. Simon and Schuster. And:
Damasio, A. R. (1994). Descartes’ Error: emotion, reason and the human brain. London, Picador. and:
Siegel, D.J. (2015) The Developing Mind: How relationships and the brain interact to shape who we are. London: The Guilford Press. And:
Hofstadter, D. (2007) I am a Strange Loop. New York: Basic Books.
~~~
[xxiv] Talk therapy can be conducted in ways which are essentially cerebral – left-brain to left-brain – or more physico-psycho-emotional (or right-brain to right-brain) in ways which engage the emotional brain, the central nervous system, and visceral sensations in the body of the client. (See Hill, 2015; and Fisher, 2014).
Fisher, J. (2014) ‘Putting the Pieces Together: 25 Years of Learning Trauma Treatment’. Online blog, Psychotherapy Networker, June/July 2014: Available: https://www.psychotherapynetworker.org /magazine/ article/108/putting-the-pieces-together. Accessed on 24th June 2020.
Hill, D. (2015) Affect Regulation Theory: A clinical model. London: W.W. Norton and Company.
[xxv] For many traumatized individuals, connecting or re-connecting with others involves working on their ‘attachment styles’, which are often either ‘avoidant of intimacy’ or ‘clingy/reactive’ (meaning anxious-ambivalent).
[xxvi] See Chapter 6 of the present book, which describes ‘the interoceptive Windows Model’, which integrates thoughts, emotional feelings, body sensations, and body-mind processes.
[xxvii] I never advocate the taking of psychiatric medications, because they cannot solve the problem, and they normally have serious side effects, including long-term dependence addiction.
[xxviii] Banschick, M. (2015) ‘Somatic experiencing: How trauma can be overcome’. Psychology Today blog; 26th May 2015. https://www.psychologytoday.com/ gb/blog/the-intelligent-divorce/201503/somatic-experiencing. Accessed: 29th June 2020.
ABC Counselling and Psychotherapy, Hebden Bridge 