Protecting the child in normal family

Bowlby: Human beings of all ages are happiest and

resourceful when they are confident that standing

behind them, there are one or more trusted persons

who will come to their aid should difficulties arise.

This attachment figure provide a secure base “

Quality of motheringQuality of mothering Trauma before 18 ( family illness, abuse, etc..)Trauma before 18 ( family illness, abuse, etc..)

Long term emotional development

More impact on the adult overt mental health

Experience of childhood

Understanding Childhood Trauma..

Family of Origin…

Adult Child of Alcoholics ( ACOA)

Adult Child of Family dysfunction

Adult Child of Neurotic Parents

Understanding Childhood Trauma

What you see you learned

What you learn you practice

What you practice you become.

Protecting the child in normal family

Anxieties is normal in children…

Disturbed behavior manifest as regression

Significance of TRAUMA in children

“Madness has begun…”

Symptoms and Primitive defences1. Splitting ….. a)latent Schizophrenia to Schizoid or b) True versus false self……. Different from Regression……….

Significance of Trauma in Children

Trust is the foundation on which the self is built.

Basic trust eroded when parents are not available…due to mental illness, untrustworthy, …etc

RESULT: primitive anxiety arose and yet no place to retreat to.

Worsened by Shame and Secrecy……

SIGNIFICANCE OF TRAUMA IN CHILDREN

Home no more a safe place…

Life becomes perverse and unpredictable

People do not outgrow early childhood experiences

Early anxieties repressed later to re-emerge

SIGNIFICANCE OF TRAUMA IN CHILDREN

The developing child incorporates the distortion caused by trauma

The experience is repeated Unable to communicate their distress except

through variety of symptoms

The helplessness and emotional dependence render them more vulnerable to parents’ behavior

SIGNIFICANCE OF TRAUMA IN CHILDREN

Child’s Defenses are more primitive- “splitting”

Cut off from reality and hard to involve in real relationship…. “latent Schizophrenia”

OR schizoid..superficially normal but break down, Withdrawn and psychotic under stress.

SIGNIFICANCE OF TRAUMA IN CHILDREN

Splitting also seen as creation of “false self”…appear as functioning well but lack spontaneity and initiative………..

Inwardly beset by feelings of futility…

How children cope

Distortions of normal development

Create ( primitive ) defenses… pain, fear, uncertainty, mistrust, anger, shame, loneliness..

Change their character..” “armor” Yet anxiety, depression and drug abuse break

thru.

Consequences of trauma

More psychiatric illness ( Depression and Anxiety)

Less mature psychological defence mechanisms

Prevailing moods joyless These primitive defense keep the person in a

state of struggle and chaotic level of functioning

Consequences of trauma

“ life is a longing”

Distortions of normal development

Defenses created to manage pain, fear, uncertainty. Mistrust, anger, shame and loneliness

“armor” themselves..yet anxiety, depression and substance abuse often break through

Consequences of trauma

Sell themselves short…in choosing their work or partners…

Own self-esteem

The ability to trust

Emotional stability

Consequences of trauma

Anxiety, depression, substance abuse

Physical problems and prone to illness, insomnia, obesity, headaches, GIT

Personality problems..narcissistic, schizoid, impaired self-esteem

Adult outcome of trauma

Anxiety, Depression, Substance abuse

Personality disorders----borderline, narcissistic, schizoid etc..

Unhappy, lack of engagement in life, little confidence

? Obesity, ? Headaches

Allyn & Bacon copyright 2000

20

Cluster A: Schizoid Personality Disorder

Overview and Clinical Features

Pervasive pattern of detachment from social relationships

Very limited range of emotions in interpersonal situations

LonersPreference for social isolation in

schizoid personality resembles autism

Allyn & Bacon copyright 2000

21

Borderline Personality Disorder Pattern of instability in mood,

interpersonal relationships, self-image Marked impulsivity, fear of abandonment Self-injurious behaviors, suicidal gestures

(but 3-9% commit suicide) Black/White thinking Common Dx in Psychiatric Settings Glenn Close in Fatal Attraction

Allyn & Bacon copyright 2000

22

Borderline Personality Disorder

Pattern of instability in mood, interpersonal relationships, self-image

Marked impulsivity, fear of abandonment

Self-injurious behaviors, suicidal gestures (but 3-9% commit suicide)

Black/White thinking

Glenn Close in Fatal Attraction

Allyn & Bacon copyright 2000

23

Narcissistic Personality Disorder

Pattern of grandiosity, need for admiration, arrogance

lack of empathy, sensitivity to others

Very sensitive to perceived criticism

Exaggerated sense of own importance

Allyn & Bacon copyright 2000

24

Avoidant Personality Disorder

Pattern of social inhibition

Feelings of inadequacy

Hypersensitivity to negative evaluation

Very similar to social phobia (degree of overlap is unclear)

Allyn & Bacon copyright 2000

25

Dependent Personality Disorder

Pattern of submissiveness and clinging behavior

Excessive need to be taken care of;

Requires others to make all decisions;

Often stay in abusive relationships

True SelfTrue Self False selfFalse self

GenuineAccepting of self &

others

Loves unconditionallyFeels feelings,

spontaneous, including current anger

Assertive

Un-genuineCritical, envious,

perfectionistConditional loveDenies or hide feelings

including long-held anger

Aggressive/ passiveOverdeveloped

parent/adult scripts; may be childish

The False self

True SelfTrue Self False selfFalse self

Needs to play and have fun

Vulnerable

Trusting Enjoys being nurturedSurrenders..Self-indulgent…simplifies

Avoids play and funPretends always to be

strong DistrustingAvoids being

nurtured…Controlling..Self-righteous…Complicates ; is

“rational”.

The False Self

True SelfTrue Self False SelfFalse Self

Wants to be real, connected, create and love..

Non-defensive, though may use ego-defensive..

Open to the unconscious

Free to grow

Accepting a loving God

Wants to be right, control and win

Defensive

Blocks unconscious material

Tends to act out unconscious often painful patterns repeatedly

Struggle to accept

The False Self

Clues to family of origin issues

1. fear of being rejected 2. Hard to forgive3. Tend to withdraw4. Secret addictions5. Try hard to suppress feelings6. Afraid to confide to other people7. Nervous around certain people

Clues to family of origin

a. You can’t explain your hurtb. Hard to show emotion , c. You have memory blockd. Can’t allow other people to feel ( controlling

)e. Childhood memories cannot rememberf. Lose control when angryg. People don’t understand how you feel

Clues to family of origin

I. You get easily offendedII. Miserable for no reasonIII. Easily offended /irritatedIV. Can’t accept other’s imperfectionsV. Frequent nightmares

Victim to “perpetrator”

Aspects of parents failing can creep into own childcare… without their knowledge……

Lacking spontaneity, inappropriate anger outburst, depression, anxiety, joylessness, unfulfilled aspirations, prone to personality problems, low self-esteem….

Their children suffer from diminished confidence, unhappy, taunting by peers, etc……

Adult struggle

Depression..fear of breakdown

Breakdown of the defenses

But The defense is the false self.

Exhausted from looking after herself----Ambivalence---Grieving process

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Stages of Healing

reaffirmationlossSTAGE 1

shockSTAGE 2

pain

STAGE 3 stuck

STAGE 4 strengths

“I can’t get going”

“I am stronger”

“I’m hurt!”

“I can’t believe it!”

Sexual Abuse in the family

Suicide, depression, substance abuse, hysterical symptoms, borderline….

Denial & silence of survivors

Sexual abuse in family

Perpetrator a trusted adult….

Ambiguity +++

Defined as loving by the abuser

Secret +++ and threats of reprisal if exposed

RESULT: CONFUSION

Beating the Odds

Begin with Love

Accentuate the positive

Encourage a favorite pastime

Nurture Friendships

Strengthen the non-abused parent

Beating the Odds

Share responsibility

Instill persistence

Inoculate against stress

Provide information

Impart hope

Sexual abuse in family

INTERNAL CONFUSION…don’t want to lose the attachment figure yet feels betrayed…

Shame and guilt…isolated and helpless

Disguised as neurosis, psychosomatic disorders and delinquency..

Sexual abuse in family

COPING by Dissociation……..

When Prolonged greater psychological damage…

plus helplessness, worthlessness and self-blame…

“He brought me out into a

spacious place.

He rescued

me because

he

delight in me.”

Psalm 18:19