Childhood trauma scars the brain and boosts depression risk

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Childhood trauma such as neglectful parenting causes physical scarring to the brain and increases the risk of severe depression, a new study has found.

For the first time, scientists have linked changes in the structure of the brain both to traumatic early-years experiences and poor mental health in later life.

Published in the Lancet, the study found a “significant” link between adults who had experienced maltreatment as children with a smaller insular cortex, part of the brain believed to help regulate emotion.

It focused particularly on a phenomenon known as “limbic scarring”, which previous research has hinted is linked to stress.

It involved 110 patients admitted to hospital with major depressive disorder who were then monitored for relapses over the following two years.

They were subjected to a detailed childhood trauma questionnaire, which retrospectively assessed historical incidents of physical abuse, physical neglect, emotional abuse, emotional neglect and sexual abuse.

The patients were then given MRI brain scans, which looked for changes to brain structure.

Dr Nils Opel from the University of Münster, Germany, who led the research, said: “Given the impact of the insular cortex on brain functions such as emotional awareness, it’s possible that the changes we saw make patients less responsive to conventional treatments.

“Future psychiatric research should therefore explore how our findings could be translated into special attention, care and treatment that could improve patient outcomes.”

The findings suggest that the reduction in the area of the insular cortex due to limbic scarring could make a future relapse more likely, and that childhood maltreatment is one of the strongest risk factors for major depression.

All participants in the current study, aged 18 to 60 years, had been admitted to hospital following a diagnosis of major depression and were receiving inpatient treatment.

Child Abuse May Change Brain Structure And Make Depression Worse

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A study of over a hundred people’s brains suggests that abuse during childhood is linked to changes in brain structure that may make depression more severe in later life.

Nils Opel at the University of Münster, Germany, and his colleagues scanned the brains of 110 adults hospitalised for major depressive disorder and asked them about the severity of their depression and whether they had experienced neglect or emotional, sexual or physical abuse during childhood.

Statistical analysis revealed that those who experienced childhood abuse were more likely to have a smaller insular cortex – a brain region involved in emotional awareness.

Over the following two years, 75 of the adults experienced another bout of depression. The team found that those who had both a history of childhood abuse and a smaller insular cortex were more likely to have a relapse.

“This is pointing to a mechanism: that childhood trauma leads to brain structure alterations, and these lead to recurrence of depression and worse outcomes,” says Opel.

The findings suggest that people with depression who experienced abuse as children could need specialised treatment, he says.

Brain changes can be reversible, says Opel, and the team is planning to test which types of therapies might work best for this group.

Journal reference: Lancet Psychiatry, DOI: 10.1016/S2215-0366(19)30044-6

How to Be There for Someone Who Survived a Horrible Trauma

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A recent series of tragic deaths has underscored how traumatic events can claim lives years after the fact. Three people affected by mass shootings—the father of a girl killed in the Sandy Hook Elementary School shooting in December 2012 and two students who survived the Marjory Stoneman Douglas High School shooting in February 2018—have died of apparent suicides.
In the wake of these incomprehensible losses, it’s clearer than ever that trauma can lead to years-long suffering. If somebody you love has survived a traumatic event, be it public (like a natural disaster or terrorist attack) or private (such as a sexual assault), you may not be sure how best to be there for them on this journey. While survivors can have very different responses to trauma, interpersonal support is one of the core pieces of recovery, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
Here, several trauma counselors and one trauma survivor explain how to help a friend or family member who has been through something horrible. Exactly what they need from you will depend on your relationship and evolve throughout their recovery, but the suggestions below are a good place to start.

1. Validate their trauma.
“Acknowledge that what has happened to them is terrible,” Daniel A. Nelson, M.D., advisory board member of the USC National Center for School Crisis and Bereavement (NCSCB) and medical director of the Child Psychiatry Unit at Cincinnati Children’s Hospital Medical Center, tells SELF.
You can do this by saying something like, “This is a truly horrible thing that has happened. I can see you’re in an incredible amount of pain.”

It might feel like you’re saying something obvious, but this affirmation can be reassuring. “It’s about articulating that you see they are in pain and that you are OK with holding that pain,” Katherine Marshall Woods, Psy.D., a Washington, D.C.-based psychotherapist in private practice and adjunct professor of clinical psychology at George Washington University, tells SELF.
This was helpful for Manya C., 53, who was sitting in the bleachers across the street from where the first of two bombs exploded at the Boston Marathon in 2013. She appreciated when people confirmed that it really was a devastating event. “Just letting me know that they [understood] that … was validating,” Manya, who advocates for and speaks about those who are psychologically impacted by trauma, tells SELF.
2. Listen.
You might feel a natural urge to fill the silence when you want to help but don’t know what to say, says Dr. Nelson, who has counseled survivors of traumatic events including the Oklahoma City bombing of 1995, the September 11 terror attacks, and the Marjory Stoneman Douglas High School shooting. This typically comes out of wanting to “fix” the situation, Dr. Nelson says.

But you can’t “fix” someone’s trauma, especially not by talking non-stop. It’s better to be present as they work through their feelings. “It’s really hard to mess up if you’re just intent on listening,” Dr. Nelson says.
Manya remembers breaking down sobbing, seemingly out of nowhere, while at dinner with a friend a few weeks after the bombing. Her friend remained calm and stayed with her until she was done crying before asking Manya where her tears were coming from. “She didn’t tell me, ‘Don’t cry,’ or offer me advice. She just listened and was present,” Manya recalls.

3. Admit that you don’t understand.
Survivors are often reluctant to open up because they’re afraid a loved one will not have the emotional capacity to understand, says Marshall Woods, who has counseled active military personnel and their families in the Middle East and natural disaster survivors through the American Red Cross. Unless you’ve been through a very similar trauma, you don’t get it. And that’s fine. What matters most is that you’ll be there anyway.
Say something like, “I cannot begin to imagine what you’re going through right now, but I am here for you whenever you are having a hard time.” This kind of statement acknowledges the reality—that you don’t understand—while reinforcing your willingness to be there. “It’s a piece of security that can really help them feel safe,” Marshall Woods says.

Manya remembers how helpful it was when a friend expressed this. “Hearing her honestly say, ‘I don’t know what to do to help you, but I’m here’ was huge for me,” Manya says. “I didn’t know what I needed either. But I knew she was there to listen, and that started a really great conversation.”

4. Accept if they don’t want to talk.
It’s not unusual for survivors to prefer not to talk about their feelings, even with some of the people closest to them. Discussing trauma with someone who doesn’t understand can be draining. “There are things I don’t have to say to a survivor, for example, because they get it—things I would have to explain to a friend,” Manya explains.

While it’s OK (and encouraged) to ask if your loved one feels like speaking, respect that they may not want to, Dr. Nelson says. Part of being a good support system is being there for them regardless of how much they will or won’t share.
If your loved one is still navigating how much they’re comfortable sharing, Marshall Woods recommends figuring out a verbal or non-verbal cue they can give you to back off when they need space, no questions asked.

5. Keep checking in.
Survivors often get a lot of support immediately after the traumatic event, but attention from the media, the public, and loved ones tends to dwindle soon after. “It feels like other people have gone on living their lives normally as if the trauma has not even happened, when it’s still very much alive for them,” Marshall Woods explains.

Let the person you love know that you’re still continuing to think of them by checking in accordingly. “Knowing that someone has their eyes on them can be a real source of support and security,” Marshall Woods says. She also suggests offering to sit in silence with the person if they don’t feel like talking but don’t want to be alone.
Manya’s family members called her every day for longer than she expected after the attack. The conversations weren’t long, but the constant reminder of their presence and concern was comforting. “It meant a lot to me just to get those calls,” she says.

6. Offer to help limit news coverage.
If your loved one has been through a highly publicized trauma, such as a mass shooting, the early deluge of media coverage may continually retraumatize them. If you think they’re having this problem, you can ask if they want help limiting their media exposure. You can do this by changing their news alerts and muting certain hashtags or words on Twitter, for instance. This helps some people feel safer throughout the recovery process, Marshall Woods says.
But it’s possible your friend may want to stay up with the news coverage because it helps them feel less alone. “They [may be] grateful that people are taking notice of the pain they’re experiencing and that people are grieving with them,” Marshall Woods explains. So, even if your friend is visibly upset by news stories about what happened, keep in mind that this may be a part of their healing process.

7. Avoid clichés.
Looking for a silver lining can be great in many situations. The aftermath of a trauma usually isn’t one of them. “When someone is feeling this pain, you need to meet them there,” Marshall Woods says. “You want them to feel better now, but that is not the reality of where they are.”

Urging your friend to be optimistic or not “dwell” on the tragedy communicates that you’re not accepting how they’re feeling. What you mean as an expression of hope (“Things will get better!”) can come off as a dismissal of their suffering and make them feel misunderstood. “Usually when the individual hears something like that, they think ‘You’re trying to fix me, and you don’t know the first thing about what’s wrong,’” Dr. Nelson explains.

8. Help them find mental health support.
If you’re concerned for your loved one’s well-being—like if they are struggling to eat, get out of bed, go to work, or otherwise function months after the event—you can offer to help connect them with some professional resources like a therapist or support group, Dr. Nelson says. (Even if they are currently receiving mental health treatment, if it doesn’t seem effective, you may be able to help them find a better option.)
This is also a good idea if you begin to feel overwhelmed with the level of support they need from you. “Sometimes it’s really hard to hear these stories,” Dr. Nelson says, “and it’s important to have the proper tools to metabolize it.” Friends and family of survivors can even experience secondary trauma, according to SAMHSA. It’s OK to be mindful of your limits and communicate those needs in a compassionate way.
In that situation, Dr. Nelson suggests saying something like, “What you’re telling me sounds like it really deserves the appropriate level of support, and it may be more than I know what to do with. I would love to know you’re with somebody who really knows what they’re doing. Can we hit pause and work on finding you that help?”

9. Be patient.
The aftermath of trauma is complex, evolving, and inscrutable at times—not just to outsiders, but also to the people who are in it. “Trauma generally is an experience of something that is so chaotic that our brains really struggle to … make meaning out of what has happened,” Marshall Woods explains.

Be prepared for emotions to be intense and fluctuating, Dr. Nelson says. Also keep in mind that your loved one may struggle to understand why they are feeling the way they are, or to even know what it is they’re feeling. This was Manya’s experience in the first few months after the bombing, before she was diagnosed with post-traumatic stress disorder. “At the time, ‘I was thinking I should be better, I shouldn’t feel like this,’” she says.
You can’t speed up the recovery process for your loved one, but you can remain a steady, patient, and adaptable source of love throughout. “It can be a rollercoaster,” says Manya. “But people should understand it’s normal to feel this way and that they can heal.”

This May Be The Best Way To Help Kids Who’ve Been Through Trauma

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Why do some children who experience trauma seem to recover naturally over time whereas others develop symptoms of post-traumatic stress disorder and even depression? A new studypublished in the Journal of Child Psychology and Psychiatry has identified one key factor: seeing their own emotional reaction as “not normal.”

Researchers assessed over 200 kids between ages 8 and 17 who’d experienced a traumatic event, such as a car crash, assault, or medical emergency. They interviewed the kids twice, once two to four weeks after the event and again two months after the event, asking them questions about how they’ve been coping with what happened. The kids also completed a survey about what their general emotional well-being and cognitive skills were like before the event had ever happened.

What does a “normal” healing process look like?

The study found PTSD symptoms were actually pretty common earlier in the recovery process, at the two- to four-week mark. “Symptoms of PTSD can be a common reaction to trauma in children and teenagers,” said Richard Meiser-Stedman, a clinical psychology professor at the University of East Anglia in England who led the study, in a news release. “These can include distressing symptoms like intrusive memories, nightmares and flashbacks. Health professionals steer away from diagnosing it in the first month after a trauma because, rather than being a disorder, it’s a completely normal response. … These initial reactions are driven by high levels of fear and confusion during the trauma.”

Generally speaking, though, the majority of the kids healed naturally over the course of the two months without any professional help or interventions.

How much social support they had in their lives and the presence of other life stressors didn’t actually affect their likelihood of having lingering PTSD symptoms. What did? It was the tendency to view their own response to the trauma as being abnormal, a sign of weakness, or a sign that they were “permanently damaged.” That self-judgment was the key predictor of PTSD.

“The young people who didn’t recover well, and who were heading down a chronic PTSD track two months after their trauma, were much more likely to be thinking negatively about their trauma and their reactions—they were ruminating about what happened to them,” Meiser-Stedman explained. “They perceived their symptoms as being a sign that something was seriously and permanently wrong with them, they didn’t trust other people as much, and they thought they couldn’t cope.”

That means one of the biggest ways we can support young people who are recovering from trauma is to normalize their pain. It’s vital to make sure they know that there is nothing wrong with feeling deeply distressed by what’s happened to them and that it will likely take some time before those emotions settle. Trauma certainly can change you, but it by no means “permanently damages” you.

The difference between ruminating and grieving.

Importantly, the study also found that “overthinking” the trauma was also linked to worse PTSD: “The children who didn’t recover well were those that reported spending a lot of time trying to make sense of their trauma. While some efforts to make sense of trauma might make sense, it seems that it is also possible for children to get ‘stuck’ and spend too long focusing on what happened and why,” Meiser-Stedman explained.

Past research has shown our minds generally have a tendency to ruminate on negative events, and that rumination can be disastrous for our mental health. The researchers were hesitant to give any recommendations related to how to process trauma since the risk of “overthinking” can lead to worse outcomes, but at the same time, not processing your pain at all is generally a ticket to growing up with unresolved emotional issues that lead to more reactivity, relationship problems, and poorer health as an adult.

Transformation coach Sheryl Paul offers a good way to understand the difference: Replaying scenes over and over from the negative events in our lives and thinking about why they happened isn’t necessarily the same as emotionally processing your trauma.

“Ruminating isn’t grieving. Thinking isn’t grieving,” she writes at mindbodygreen. “Grieving is an embodied experience that moves the pain out and through, whereas ruminating is a ‘head’ experience that keeps the pain stuck. Ruminating—that is, obsessively going around and around in your mind on one particular storyline, like thinking about what you or the other person did ‘wrong’—creates mental stagnation and prevents the grief from moving through you, thus preventing you from moving on.”

To help kids (or anyone) heal from trauma, make sure they know it’s OK to sit with their pain and feel it. They shouldn’t spend all their time dwelling on what happened—it’s important to be able to also resume life’s activities to be able to access a brighter mood again and reconnect with their other emotions—but normalizing the grieving process is absolutely necessary.

38 Daily Affirmations For Healing Your Childhood Emotional Neglect

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38 Daily Affirmations For Healing Your Childhood Emotional Neglect

Childhood Emotional Neglect (CEN): Happens when your parents fail to respond enough to your emotional needs as they raise you.

Growing up with your parents under-responding to your feelings throughout your childhood sets you up to under-respond to your own feelings through your adulthood. Essentially, you are trained to ignore, minimize, and perhaps even be ashamed of, your own feelings.

But the good news is that Childhood Emotional Neglect is not a lifelong sentence. You can heal it. And it’s not as difficult or complicated as you might think.

By beginning to pay attention to yourself and your own feelings, you can begin to honor your deepest self; the self that was so ignored as a child. The more you focus on yourself, your own feelings and needs and wants, the better you can take step after step through the CEN healing process.

Why You Need Affirmations

As a psychologist who specializes in treating Childhood Emotional Neglect, I have walked hundreds of people through the 5 stages of CEN recovery. And I have watched motivated people slip off-track, distracted by the demands of their everyday life or discouraged about their inability to make it happen fast enough.

One thing I know from going through this with so many CEN folks is that the ones who succeed, who really change their lives, are the ones who never give up.

The best thing you can do to heal yourself is to keep your goals in your mind as you go through your day. And to help you do that, I am sharing with you daily affirmations in every area of your recovery: healing yourself, healing your marriage, parenting your children, and coping with your emotionally neglectful parents.

Once you get started, you may want to use some from all 4 areas, because once you start to see yourself through the lens of CEN, you may reflect differently on every important person in your life.

How to Use The Affirmations

I recommend you read through all of the affirmations below. As you do so, you may notice that certain ones jump out at you. These are the ones that you likely need the most right now.

You can use these affirmations in two different ways. You can say them to yourself when you need them, to keep you on track, remind you of what’s important, and strengthen you. And you can also use them as starting points to help you think about, or meditate on, what’s important in your healing. I hope you will use them, and use them well.

Special Note: To learn how to repair Emotional Neglect in your most important relationships see the book Running On Empty No More: Transform Your Relationships With Your Partner, Your Parents & Your Children. Childhood Emotional Neglect can be subtle and unmemorable so it can be hard to know if you grew up with it. To find out Take The Emotional Neglect Test. It’s free.

38 Daily Affirmations/Meditations For Healing Your Childhood Emotional Neglect

FOR HEALING YOURSELF

My wants and needs are just as important as anyone else’s.

My feelings are important messages from my body.

My feelings matter.

I am a valid human being with feelings and needs.

I am worth getting to know.

I am a likable and lovable person.

I am the only person responsible for getting my own needs met.

It is not selfish, but responsible, to put my own needs first.

Asking for help is a sign of strength.

Feelings are never right or wrong. They just are.

I am proud to be a deeply feeling person.

All human beings make mistakes. What matters is that I learn from mine.

I deserve to be cared for.

My feelings are walled off, but they are still there, and they are important.

Every feeling can be managed.

FOR PARENTING YOUR CHILDREN

My children’s feelings drive their behavior. Feelings first.

I can’t give my children what I do not have myself.

My child is important, but so am I.

The better I care for myself, the better I can care for my child.

I don’t need to be a perfect parent. I just need to pay enough attention to their feelings.

I will give my child what I never got from my parents.

The best way to do better for my children is to do better for myself.

FOR HEALING YOUR MARRIAGE

I matter, and so does my husband/wife.

My partner cannot read my mind.

It’s my responsibility to tell my partner what I want, feel and need.

My partner and I each have hundreds of feelings each and every day.

It’s okay if my partner’s feelings are not the same as mine.

The facts are less important than my partner’s feelings.

When it comes to my marriage, sharing is key.

My partner needs me to talk more and ask more questions.

FOR COPING WITH YOUR PARENTS

I did not choose to grow up emotionally neglected.

My parents could not give me what they did not have.

My parents are not capable of seeing or knowing the real me.

I am angry at my parents for a reason. They failed me in a very important way.

I can spend time with my emotionally neglectful parents. My boundaries will protect me.

I don’t have to be validated by my parents. I validate myself.

If my parents are not able to see me, I will see myself.

It’s my responsibility to give myself what my parents couldn’t give me. And I will.

Childhood Emotional Neglect can be subtle and unmemorable so it can be hard to know if you have it. To find out Take The Emotional Neglect Test. It’s free.

To learn much more about how Emotional Neglect happens and how to heal it, see the book Running On Empty: Overcome Your Childhood Emotional Neglect.

How Childhood Trauma Teaches Us to Dissociate

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What is dissociation?
Dissociation, sometimes also referred to as disassociation, is a term commonly used in psychology that refers to a detachment from your surroundings, and/or physical and emotional experiences. Dissociation is a defense mechanism that stems from trauma, inner conflict, and other forms of stress, or even boredom.

Dissociation is understood on a continuum in terms of its intensity, and as non-pathological or pathological in regard of its type and effects. An example of non-pathological dissociation is daydreaming.

From here on we will talk about pathological dissociation.

Some examples of pathological dissociation are the following:

Feeling that your sense of self is not real (depersonalization)
Feeling that the world is unreal (derealization)
Memory loss (amnesia)
Forgetting identity or assuming a new self (fugue)
Separate streams of consciousness, identity, and self (dissociative identity disorder, or multiple personality disorder)
Complex post-traumatic stress disorder
Dissociation is closely tied to stressful states and situations. If a person has an inner conflict, they may start dissociating when thinking about it. Or if they are terrified of social situations, they may experience dissociation when around people.

Some people report severe dissociation and panic attacks after doing certain drugs. Dissociation can sometimes occur when we experience distortion in or an impairment of our senses, for instance, while having a migraine, tinnitus, light sensitivity, and so on.

Trauma and dissociation
Dissociation is a common response to trauma. The experience of being present and in the moment when we are severely abused and feel powerless is incredibly painful. This is when our psyche self-protects and makes us disconnect from what’s happening to us in order to make it more tolerable to endure.

That’s why many abuse victims, especially those who suffered sexual abuse, say that they felt like they were watching themselves be abused from the third person’s perspective and it seemed like they were watching a movie rather than being a participant.

Since dissociation is often an aftereffect of trauma, it can routinely reoccur until the emotions related to the trauma are resolved. Regardless of how often you experience it, dissociation can be incredibly unpleasant, terrifying, and debilitating.

Some people describe dissociation as their most horrifying experience. Moreover, experiencing dissociation can create new symptoms or aggravate other underlying problems, and in doing so, make the person’s mental condition even worse.

Childhood trauma and dissociation
Commonly, dissociation experienced as an adult is rooted in one’s childhood.

Since a child is dependent on their caregivers and their brain is still developing, they are unable to deal with their trauma by themselves. However, their caregivers are often unable or unwilling to comfort the child and help them overcome it without severe aftereffects.

Not only that, the child’s caregivers may even be the ones who traumatize the child. It’s not to say that it always happens out of spite, but even when done with good intentions or out of ignorance, the effects on the child’s psyche are as they are.

So what does a child do when they experience stress and trauma? Since they can’t resolve it by themselves, they dissociate. This usually occurs early and routinely. Not every trauma is “big” and evident, but even things that don’t seem like a “big trauma” can be very traumatic to a child.

So, we experience many traumas and “microtraumas” as children. And since a common reaction to trauma is dissociation, we dissociate. And over time, two main dissociative behaviors are the result. One, we may suffer from episodes of dissociation (generally, PTSD and C-PTSD).

And two, we learn to deal with emotional distress by participating in dissociative behaviors, such as addiction to food, sex, drugs, TV, the Internet, attention, sports, and anything else that helps us repress our painful emotions.

Moreover, a child can’t attribute responsibility for their trauma to their caregiver since they need them to survive, so they learn to blame themselves for it, which creates a myriad of other problems, but we won’t talk about those in this article.

People’s stories about dissociation
Recently on my website’s Facebook page, I shared two posts about dissociation. One was a picture with a quote explaining what it is (added here), and the other was a quote from my book Human Development and Trauma:

“Many abused children dissociate and unconsciously warp their perception of reality in order to survive. Naturally this requires that they justify the abusive behavior of their caregivers.”

Under those posts, some people shared their experiences and thoughts regarding dissociation, so I would like to add them to this article.

One person writes this:

“I permanently dissociated, my development was arrested at 13 years when my aunt accused me of trying to seduce her husband who was lusting for me. I spent most of my adult year feeling like a 13-year-old. Healing has allowed for a shift from that state to feeling more adult-like.”

This person shares their dissociation experience starting as early as 3 years old:

“I remember leaving my own body at night from the age of 3ish as my parents would be beating each other to death downstairs. I grew up thinking I really could fly. I only learned of disassociation last year.”

Another person says this:

“Sleep has always been an issue. If I did manage to sleep it was full of vivid horrid dreams. I had two regular dreams all my life. I was always a big reader. Escaping into books I was guaranteed a happy ending. I had to. I was exposed to awful things as far back as I can recall.”

For this person, as for all of us, repressed trauma manifested itself in nightmares:

“I remember that every time something traumatizing happened in my family, right before sleep in my bed I tried to convince myself that It didn’t happen and after that I used to have nightmares of being chased by a horrible monster in an abandoned factory or something. Now after a lot of studying I realized that it was my brain entering REM mode in order to storage the traumatic experience deep in my subconscious so I can consciously forget about it.”

This person feels dissociation when having an aural migraine, which I can confirm from my personal experience too:

“I don’t want to reduce this by any means because this may not be seen as traumatic to others however, this happens to me when I get migraines. I don’t know if it is part of the migraine symptoms or if I am disassociating because they hurt so much for such a long period. I feel far away, muffled, floaty kinda dreamlike. I respond slower cause I feel that people are not talking directly to me. My speech is slow and I feel like I am watching a TV show or like if I am drunk/stoned. It’s weird. This happened throughout my life because I have migraine with aura/fainting spells. It’s a scary uncontrolled feeling.”

And this person’s comment explains very well how dissociation is both terrifying and necessary to cope with enormous emotional and psychological pain:

“The most unreal experience of my life, literally. Would never want to experience it again. As distressing as it was, it was a relief as well. The feeling of being outside of oneself and everyone else, the inability to connect to reality, is the most distressing, but the inability to do that gives you a break from the current trauma, and there’s relief in that.”

Do you have any stories about dissociation you would like to share? Feel free to do so in the comments below!

Is Your Childhood Blueprint Holding You Back?

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Do you find you don’t deal with situations or relationships as successfully as you’d like? Do you feel depressed, anxious, or think negative things about yourself, others or the world? If so, it could be that your blueprint is holding you back.

You can think of your blueprint as everything you felt, saw, thought, touch, tasted, laughed or cried at. Millions of experiential data points creating your unique map of how the world works. But a map created before you are cognitively mature enough to understand or handle difficult situations.

Because this blueprint comes from the cause and effect on a child mind there can be limitations on how we now see the world. If we had good mentoring, a stable view of ourselves, and satisfying relationships, then it’s likely we’ll have a healthy blueprint. However, if we experienced poor mentoring, a negative view of ourselves, with less than stable relationships, then our blueprint could be more dysfunctional. Leading us to see the world as unpredictable, uncaring and even traumatic.

These are simplistic extremes for sure, and most people’s lives are far less black and white. However, the point is the same: no matter how the creation of our blueprint happened, it will influence our adult decision-making for the rest of our lives. If this blueprint is mostly dysfunctional, it can leave us vulnerable to mental health issues unless we take steps to change our reoccurring unhealthy responses.1

Our blueprint is important because it plays an integral part in everything we do. Without being aware of it, every day your brain is constantly using your blueprint to predict your environment by following pre-programmed, default responses for familiar tasks2 :how you cook dinner, how you eat, drive, order your coffee, etc. It doesn’t matter the situation, you’ll have a response ready: In this situation you will = think this, feel this, and act like this. And most of the time this is okay. But what happens when we come across a situation that our younger self couldn’t deal with in a healthy way?

Let’s say you had difficulties feeling worthy and appreciated as a child and one day at work your boss shouts at you in front of your colleagues? How do you respond? Well, that’s up to your old blueprint. In less than a second your brain is accessing how you managed similar situations in the past. Maybe it accesses the time you were 12 and a teacher shouted at you in front of the class. You cried and the shame you felt was painful. So, now in front of your boss, your blueprint tells you to “stay quiet and shut down your feelings.” So, that is exactly what you do. Your old responses leaving you helpless in the face of an aggressive other.

If you think you don’t manage certain situations or people well, it might be time edit your old blueprint. To do this, I encourage you to reflect on any given situation you struggle with. Once you have a situation, park any preconceived notion you have about yourself. It doesn’t matter if the situations were wrong, or unfair, the goal is to examine your thinking, feeling, and behaviors analytically. You want to discover whether your blueprint helps or hurts you. What responses you want to keep and which to replace.

Here are six questions to get started.

  1. Is this my typical response in this situation?
  2. Have I reacted this way before (i.e. is this habitual responding)?
  3. What event from my past does this situation/person remind me of?
  4. Does my current reaction help me or hurt me?
  5. How would I prefer to respond/react to this challenging situation?
  6. What do I tell myself that stops me from responding in this healthier way?

Now you have this new information, you can get to work on practicing your new responses. With time, effort, and practice, these new habitual responses will happen naturally. But be aware, you might have another hidden habitual response that stops you from making these changes “just in case” things get worse. And it’s this cycle of wanting to change but fearing change that keeps many people stuck in the same blueprint.

It is worth acknowledging a lot of our old blueprint emerged as self-protection. Created during a time when being turned down by someone you had a crush on hurt to the core. Or when kids laughing at you felt like the most shameful experience you could ever imagine. As children a lot of things seemed like the end of the world, but as adults they’re not even close. If a person you like turns you down, that’s okay. If other people laugh at you for making a mistake, you’ll survive just fine. You really don’t have to follow the same program over and over, you can change it.

Breaking old habits is hard, but creating a new adult blueprint will help make you more confident and robust in the face of all life’s challenges.

Does Anxiety Cause PTSD or Does PTSD Cause Anxiety?

Author Article

This question came up in conversation when I was speaking with someone who has experienced severe panic attacks to the point of calling them “debilitating”, requiring inpatient care.  As they were sharing about the ordeal, they told me that when they contemplate the time spent seeking treatment and the aftermath, it ramped up both the anxiety and PTSD symptoms. Even as a career therapist with decades of experience treating people with stand-alone anxiety, with no overt PTSD symptoms, I had not considered that remembering the anxiety was re-traumatizing. I have heard clients share that anticipating panic attacks was in and of itself anxiety provoking. For this person and so many others, it is hard to determine the line between the two.

As is the case for many who struggle with this condition, they experienced body memory, flashbacks and tremors, as if the events of the past were recurring. Reminding themselves, “I am here and now, not there and then,” alleviated some of the more intense indicators.

This person is also intent on taking on challenges and resilience is one of their superpowers. Overcoming life changing physical conditions were part of the symbolic exercise equipment that helped them to become stronger and more flexible. They were aware that life events happen, unbidden at times and all they can do is ride the waves, sometimes treading water, until things settle back into place. Having solid support from family, friends and professionals keeps them afloat.

Although it might be hard to acknowledge an upside to anxiety or trauma, this person and others I have encountered in both personal and professional realms have been grateful for accompanying lessons. Keep in mind, that no one is sugar-coating it, nor are they denying the pain. They are making a conscious decision to face what comes their way. Paradoxically, the one certainty of life is uncertainty. A catch-22, since anxiety thrives on unpredictability.

The field of Positive Psychology, which offers a strengths-focused perspective to recovery from traumatic experiences, was pioneered by psychologist Martin Seligman, who directs the Positive Psychology Center at the University of Pennsylvania. One concept in this approach is post-traumatic growth, which reflects counterintuitive responses to horrific circumstances. Research from Lawrence G. Calhoun and Richard G. Tedeschi of the University of North Carolina Charlotte found that survivors of trauma often experienced profound healing, a stronger spiritual faith and philosophical grounding. One powerful reframing is referring to the outcome as Post Traumatic Growth.

The 21-item Post-Traumatic Growth Inventory examines responses to painful event in five areas:

  • Relating to others
  • New possibilities
  • Personal strength
  • Spiritual change
  • Appreciation for life

When survivors view themselves in that light and additionally as thrivers who give back or pay it forward, rather than as victims who have no choice but to feel as they do, healing is possible. One such thriver is Michele Rosenthal, a keynote speaker, award-winning blogger, award-nominated author, workshop/seminar leader and certified professional coach. Michele is also a trauma survivor who struggled with posttraumatic stress disorder (PTSD) for over twenty-five years. She calls herself Chief Hope Officer (CHO) of Your Life After Trauma, LLC.

Her trauma came in the form of a condition called, ToxicEpidermal Necrolysis Syndrome (TENS), which she describes as “a freak allergy to a medication that turned me into a full-body burn victim almost overnight.” This horror was followed by a series of physiological and psychological conditions that would flatten even the strongest of people. It took years of determination to recover that led her to be symptom free and now she guides others to overcome their own trauma-trials.

What helped her see her way clear to the other side of suffering is what she refers to as a “healing rampage.”

Rosenthal says, “It is an approach to recovery that is, 1) committed — we keep going no matter what; 2) consistent — we work at it every day; 3) creative — we look for new options and healing opportunities; and, 4) complex — we do the deep work rather than skim the surface as we seek relief.

These are important resiliency building skills regardless of diagnosis or symptomology, whether it falls under the umbrella of anxiety or PTSD.

  • Learn relaxation and breathing techniques to center yourself in the here and now.
  • Do grounding exercises such as walking barefoot on the grass or sand or tapping the bottoms of your feet.
  • If possible, avoid people, places or things that may overtly trigger reaction. Some PTSD survivors may steer clear of fireworks or large numbers of people if loud noises or crowds are related to the initial events.
  • Contemplate an exit strategy if you get inadvertently triggered.
  • Breathe in relaxing aromas, such as lavender, chamomile, vanilla or bergamot.
  • Listen to music that is soul soothing.
  • Seek support from family and friends who may understand your situation and if not, offer a listening presence.
  • Engage in therapy with a licensed professional.
  • If medications are indicated, work with a Psychiatrist or CRNP (Certified Registered Nurse Practitioner) who can prescribe.
  • Attend a self-help group.
  • Utilize the therapeutic modality of EMDR (Eye Movement Desensitization and Reprocessing).
  • Exercise, whether it is in a gym, or a dance floor or basketball court assists in moving the energy. I think of emotion as ‘e-motion’ or ‘energy in motion’.
  • Spend time in nature which is restorative.
  • Dig in the dirt, and plant seeds for new beginnings.
  • Avoid self-medicating with drugs, alcohol, gambling, work, shopping or food.
  • Indulge in healthy hobbies, such as reading, crafts, music, playing board games, putting together puzzles or models.
  • Volunteer your time in your community.
  • If you have a spiritual practice, use it as an additional therapeutic modality.
  • Determine your passion and live it as fully as you can.
  • Spend time with children and learn how to be silly from them.
  • Lighten up by experiencing Laughter Yoga.
  • Enjoy a pampering therapeutic massage.

Childhood Trauma Exposure Is All Too Common

Author Article

A long-term study of 1,420 people finds that childhood trauma is more commonplace than is often assumed, and that its effects upon the transition to adulthood and adult functioning are not only confined to post-traumatic stresssymptoms and depression, but are more broadly based.

These conclusions were reported on November 9, 2018, by a team led by 2009 BBRF Young Investigator William E. Copeland, Ph.D., of the Vermont Center for Children, Youth and Families at the University of Vermont. He and his colleagues are part of the Great Smoky Mountain Study, a study of children in 11 mainly rural counties in North Carolina.

Beginning in 1993 and continuing through 2015, the study annually observed 1,420 children, selected randomly from a group of 12,000 local children, through age 16, and again when they reached ages 19, 21, 25 and 30. Results are based on analysis of over 11,000 individual interviews. The sample was designed to over-represent frequently overlooked rural and Native American communities.

One striking perspective emerging from the study is that “it is a myth to believe that childhood trauma is a rare experience that only affects few,” the researchers say. Rather, their population sample suggests, “It is a normative experience — it affects the majority of children at some point.” A surprising 60 percent of those in the study were exposed to at least one trauma by age 16. Over 30 percent were exposed to multiple traumatic events.

“Trauma” for the purpose of the study included violent events (e.g., the violent death of a loved one, physical abuse or harm, war or terrorism, captivity); sexual trauma; witnessing a trauma that caused or could have caused death or severe injury; learning about a traumatic event involving a loved one; and other traumas, such as diagnosis with a serious illness, serious injury, or fire.

“Our study suggested that childhood trauma casts a long and wide-ranging shadow,” the researchers say, associated with elevated risk for many adult psychiatric disorders affecting many “important domains of functioning,” with impacts in the form of diminished health, financial and academic success, and social life.

The impact of trauma across the lifespan has been noted in many past studies. The newly reported study, appearing on the website of the Journal of the American Medical Association (JAMA), differed, because it followed children from year to year. Prior studies relied upon memory-based reports of childhood events made by participants during their adulthood, which tend to be less accurate. The new study also statistically compensated for the presence of other childhood factors that often co-occur with childhood trauma, such as poverty and family instability or dysfunction.

The researchers say their results are consistent with an “accumulation” model of trauma that assigns increased lifetime risk of psychosocial impact with each additional traumatic exposure during childhood. While they do not shed light on the question of which children are more likely to experience trauma, the team hopes the results will inform public policy, via “interventions or policies that broadly target this largely preventable cluster of childhood experiences.”

The research team included: E. Jane Costello, Ph.D., 2009 Ruane Prizewinner and 2007 BBRF Distinguished Investigator; and Edwin J.C.G. van den Oord, Ph.D., 2002 BBRF Independent Investigator.

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