Adverse and traumatic experiences in childhood have been linked to a number of symptoms, including dissociation. We provide an overview of the theoretical and scientific literature on the relationship between antecedent trauma and dissociation. Further, we discuss the effects of disrupted attachment and dissociation on emotional, cognitive, and neurobiological development. Within treatment and research settings, high dissociation and its comorbid conditions can impact retention and alter treatment outcomes, making it crucial that clinicians and researchers understand methods of assessing, treating, and studying dissociation. We review the assessment and treatment of dissociative conditions, including the dissociative subtype of posttraumatic stress disorder and the dissociative disorders. Finally, we highlight areas for future research.
It wasn’t until college that Susan realized the level of dysfunction in her family. There were signs earlier in her life but the pieces were never put together until she stumbled on the word narcissism. Then, it was as if a dense fog was lifted and everything became clearer. Everything the family did catered around her narcissistic mother. Her mom was a successful politician who spent continual hours on the phone, in meetings, holding press conferences, attending dinners, fundraising, and pandering to the needs of her constituency. Her absence from family gatherings, sporting events, and doctor’s visits was always excused by her dad. From a young age, Susan was taught that her mom was important and therefore she did not have to conform to normal maternal expectations. In an attempt to glean some understanding of her dysfunctional family dynamic, Susan dissected the narcissism and then reconstructed her childhood. It took some time and quite a bit of energy, but in the end she learned
POSTTRAUMATIC STRESS DISORDER (PTSD)
Acute Stress Disorder
Acute stress reaction (also called acute stress disorder, psychological shock, mental shock, or simply shock) is a psychological condition arising in response to a terrifying or traumatic event, or witnessing a traumatic event that induces a strong emotional response within the individual. It should not be confused with the unrelated circulatory condition of shock/hypoperfusion. Acute stress reaction (ASR) may develop into delayed stress reaction (better known as PTSD) if stress is not correctly managed. ASR is characterized by re-living and avoiding reminders of an aversive event, as well as generalized hypervigilance after initial exposure to a traumatic event. ASD is differentiated from PTSD as a disorder that precedes it, and if symptoms last for more than one month, it will develop into PTSD. It can thus be thought of as the acute phase of PTSD.
Traumatic experiences in childhood have been linked to increased medical conditions throughout the individuals’ lives. The Adverse Childhood Experiences (ACE) Study is a longitudinal study that explores the long-lasting impact of childhood trauma into adulthood. The ACE Study includes over 17,000 participants ranging in age from 19 to 90. Researchers gathered medical histories over time while also collecting data on the subjects’ childhood exposure to abuse, violence, and impaired caregivers. Results indicated that nearly 64% of participants experienced at least one exposure, and of those, 69% reported two or more incidents of childhood trauma. Results demonstrated the connection between childhood trauma exposure, high-risk behaviors (e.g., smoking, unprotected sex), chronic illness such as heart disease and cancer, and early death.
Dissociation is often seen in children with histories of complex trauma. When children encounter an overwhelming and terrifying experience, they may dissociate, or mentally separate themselves from the experience. They may perceive themselves as detached from their bodies, on the ceiling, or somewhere else in the room watching what is happening to their bodies. They may feel as if they are in a dream or some altered state that is not quite real or as if the experience is happening to someone else. Or they may lose all memories or sense of the experiences having happened to them, resulting in gaps in time or even gaps in their personal history. At its extreme, a child may cut off or lose touch with various aspects of the self. Continue reading “Dissociation”
Physical Health: Body and Brain
From infancy through adolescence, the body’s biology develops. Normal biological function is partly determined by environment. When a child grows up afraid or under constant or extreme stress, the immune system and body’s stress response systems may not develop normally. Later on, when the child or adult is exposed to even ordinary levels of stress, these systems may automatically respond as if the individual is under extreme stress. For example, an individual may experience significant physiological reactivity such as rapid breathing or heart pounding, or may “shut down” entirely when presented with stressful situations. These responses, while adaptive when faced with a significant threat, are out of proportion in the context of normal stress and are often perceived by others as “overreacting” or as unresponsive or detached. Continue reading “Effects of Complex Trauma”
The importance of a child’s close relationship with a caregiver cannot be overestimated. Through relationships with important attachment figures, children learn to trust others, regulate their emotions, and interact with the world; they develop a sense of the world as safe or unsafe, and come to understand their own value as individuals. When those relationships are unstable or unpredictable, children learn that they cannot rely on others to help them. When primary caregivers exploit and abuse a child, the child learns that he or she is bad and the world is a terrible place.
The majority of abused or neglected children have difficulty developing a strong healthy attachment to a caregiver. Children who do not have healthy attachments have been shown to be more vulnerable to stress. They have trouble controlling and expressing emotions, and may react violently or inappropriately to situations. Our ability to develop healthy, supportive relationships with friends and significant others depends on our having first developed those kinds of relationships in our families. A child with a complex trauma history may have problems in romantic relationships, in friendships, and with authority figures, such as teachers or police officers. Continue reading “Complex trauma can affect children”
The loyalty bind with a narcissist is different than other loyalty binds, in that it requires the individual involved with the narc to choose between the narcissist and herself. And of course, when you’re the child of the narcissist it is no contest. The child will choose her parent’s desires every time. One woman explained to her therapist when he asked her to visualize her abusive mother as a lion and put her in a cage. The therapist wanted his client to realize she could walk away safely from her mother, whom the client perceived as dangerous. What the therapist failed to comprehend was the plight of a narcissist’s child’s experience with regard to the loyalty bind. This woman explained to the therapist, “As a child of a narcissist, I will get inside the cage with the lion.” This grown “child” has been indoctrinated, brainwashed, conditioned, trained, and programmed to do whatever her parent wants – no questions asked. She has learned well that she is to be loyal to her parent,
Manipulators are everywhere – in homes, schools, churches, the work place. You name it; manipulators can be found wherever people are. What are some of the tactics manipulators use? Some are blatant; others are less obvious: Bullying. This is the strong-arm approach, and not so subtle. The underlying message is, “If you don’t do what I want, you’ll wish you had.” Sense of Obligation. This tactic involves “shoulds:” You should do this in order to be a good person. You should meet my needs. You ought to ________________. You owe me… The underlying message is that if you don’t do what you “should” you are mean, unreliable, disloyal, a bad _________________ (wife, husband, son, daughter, friend, etc.) Sarcasm or Cutting Humor. This comes in the form of a joke, and when you call out the other person he claims, “You’re too sensitive. Can’t you take a joke?” The underlying message is loud and clear: “Be who I want you to be or I will jab you with my words.” Play the Victim. The manipulator