This second post about Posttraumatic Stress Disorder (PTSD) refers again to a book called Healing Trauma: Attachment, Mind, Body, and Brain – Hardcover (Jan 2003, W.W. Norton and Co.) by Daniel J. Siegel, Marion F. Solomon, and Marion Solomon, chapter 4 (pages 168-195) written by Bessel A. van der Kolk: “Posttraumatic Stress Disorder and The Nature of Trauma.”
Today’s post follows the November 28, 2009 post
+PTSD AND SEVERE CHILD ABUSE SURVIVORSHIP – PART ONE
PLEASE NOTE: Do not take anything I say as a reason to alter any ongoing treatment, therapy or medication you are receiving. Consult with your provider if you find something in my writing that brings questions to your mind regarding your health and well-being.
The following is taken from pages 172 of the above text. I will consider this information in my writing below:
It is now easier for me to work with this information because I have described my own version of an alternative way of thinking about the ongoing complications severe infant-child abuse and malevolent treatment survivors face as a direct result not only of the specifics of the actual horrific traumas they lived through, but also because of the very real physiological changes that surviving these traumas created in their infant-child growing and developing body.
(see yesterday’s November 29, 2009 post
+TRAUMA ALTERED DEVELOPMENT (TAD) – A NEW DESCRIPTIVE CONCEPT)
An accurate primary and initial assessment of TAD for those of us who are Infant-Child Severe Maltreatment Survivors would allow us to know immediately how the changes our body-brain had to make created us to be different from ‘ordinary’ people who do not have the history of trauma that we do.
In this TAD assessment two critical resiliency factors would also need to be assessed because these two resiliency factors (one primary, the other secondary) are known to have the ability to nearly completely modify and modulate the power that early trauma has to change our developing body-brain.
The presence of safe and secure attachment to some early primary caregiver is the most basic and important resource an Infant-Child Severe Maltreatment Survivor had. The current assessment tools available to assess adult secure and insecure attachment need to be simplified, refined and made accessible to the public.
Stemming from the degree of safety and security available through early caregiver attachment, the ability to play is a secondary but critical resiliency factor that impacts an Infant-Child Severe Maltreatment Survivor’s body-brain development. I believe that assessment criteria and tools to measure this critical factor consistently and accurately can be developed and also made available to the public.
NOTE: In our new age of technology, the public has the right to be able to access critically important information about themselves and how their early infant and childhood experiences impacted their development. At present this information remains ONLY available within ‘clinical’ settings, if even there.
As far as I am concerned, anything and everything that is currently lumped under so-called ‘psychological’ categories belongs to the sinking Titanic of dark age medical model thinking that I referred to in yesterday’s post.
Until Trauma Altered Development (TAD) is assessed at the bedrock level of how Infant-Child Severe Maltreatment Survivors changed at their own bedrock (molecular) level, any attempt to moderate so-called ‘symptoms’ remains a crap shoot in the dark.
TAD assessment can connect the consequences of early trauma to altered physiological changes that an Infant-Child Severe Maltreatment Survivor’s body was forced to make to best ensure continued survival in early malevolent environments,
Early caregiver attachment experiences from birth build the body-brain we will live with for the rest of our lives.
Van der Kolk (scanned text above) writes that it is not usually the symptoms of PTSD itself that brings those seeking help to a clinical setting. Rather, he says that it is “depression, outbursts of anger, self-destructive behaviors, and feelings of shame, self-blame and distrust that distinguished a treatment-seeking sample from a nontreatment-seeking community sample with PTSD.”
Through an accurate TAD assessment, any ongoing difficulty an Infant-Child Severe Maltreatment Survivor has with emotions and social interactions can be traced to inadequate early caregiver interactions in a malevolent environment that built for the survivor an entirely different early-forming right-limbic-emotional-social brain.
When the foundation of the early forming right brain is altered because of maltreatment, the Infant-Child Severe Maltreatment Survivor’s later developmental stages involving shame, guilt and embarrassment will also be off course from ‘ordinary and optimal’ and will cause altered patterns of development in the body-brain.
Van der Kolk states:
“The majority of people who seek treatment for trauma-related problems have histories of multiple traumas.”
OK, I can certainly understand this, but here again, as I mentioned above, I do not agree with applying so-called ‘psychological’ and ‘symptom based’ medical model diagnostic thinking used in the author’s next statements. I absolutely disagree with ever using terms such as ‘character pathology’ in reference to Infant-Child Severe Maltreatment Survivors!
“One recent treatment-seeking sample…suffered from a variety of other psychological problems which in most cases were the chief presenting complaints, in addition to their PTSD symptoms: 77% suffered from behavioral impulsivity, affect lability, and aggression against self and others; 84% suffered from depersonalization and other dissociative symptoms; 75% were plagued by chronic feelings of shame, self-blame and being permanently damaged and 93% complained of being unable to negotiate satisfactory relationships with others. These problems contribute significantly to impairment and disability above and beyond the PTSD symptoms….Focusing exclusively either on PTSD or on the depression, dissociation and character pathology prevents adequate assessment and treatment of traumatized populations.”
TAD assessments will clearly show that ‘impulsivity’, ‘affect liability’, most aggression, and dissociation are directly connected to changes in how an Infant-Child Severe Maltreatment Survivor’s nervous system, including their brain – and here, particularly their right brain – formed differently from ‘ordinary’ due to growth and development in trauma.
“Chronic feelings of shame, self-blame and being permanently damaged” are also directly connected to trauma through developmental changes an Infant-Child Severe Maltreatment Survivor’s nervous system, including their brain – and here, particularly their later forming (after age one) left brain – had to make while developing in an early malevolent, trauma-filled environment.
Rather than referring to these changes as ‘character pathologies’, which in my thinking is the maltreatment, abusive stance taken by the medical model toward Infant-Child Severe Maltreatment Survivors, a TAD assessment can accurately and specifically pinpoint the origin of these changes in the body-brain and describe the consequences of them.
Receiving an accurate TAD assessment will show us exactly how our body was forced to adapt during our development through trauma so that we could survive it. Yes, I do believe we KNOW we are different from ‘ordinary,’ but we are not ‘permanently damaged’. We ARE permanently changed.
The changes Infant-Child Severe Maltreatment Survivors experience are fundamental and profound! Everything about us was subject to adjustment for our trauma survival – our body, our nervous system and brain, our immune system, our mind, and our connection between our self and our self and between our self and the entire world around us. NOT facing the truth and discovering the facts through TAD assessment will NOT resolve the difficulties we face with our continued survival into adulthood.
The only long term solution societies have is to STOP Infant-Child Severe Maltreatment!!! Part of that solution is to provide the kind of TAD assessment Infant-Child Severe Maltreatment Survivors need, and to make available to us the resources necessary for us to live the best life we can in spite of the changes we had to make in order to stay alive because nobody STOPPED the Infant-Child Severe Maltreatment that happened to us.
It is the pathological character of the society we were born into that allowed what happened to us to happen at all, let alone allowed it to continue to the degree that trauma changed our physiological development. If there is any self blame to be had, it is on the level far beyond OURS as the Infant-Child Severe Maltreatment Survivors.
That the grand sinking Titanic of the archaic dark age’s medical model about Infant-Child Severe Maltreatment Survivors has at least THOUGHT about throwing us a life boat becomes apparent in van der Kolk’s next words:
“As part of the DSM IV field trial, members of the PTSD taskforce delineated a syndrome of psychological problems which have been shown to be frequently associated with histories of prolonged and severe personal abuse. They call this Complex PTSD, or Disorders of Extreme Stress Not Otherwise Specified (DESNOS).”
Great! A life boat full of holes! Gee, why are we NOT thankful for that?
“A syndrome of psychological problems” be damned! Infant-Child Severe Maltreatment Survivors do not suffer from a ‘syndrome’, and ours are not ‘psychological problems’! For all the reasons I have repeatedly described, we simply need a TAD assessment that will tell us HOW our little body adapted down to our molecular level during our development in the midst of, and in spite of, toxic malevolent trauma. Then we need resources that inform us how to live NOW with these profound trauma-caused changes that happened to us THEN.
The author continues:
“DESNOS delineated a complex of symptoms associated with early interpersonal trauma.”
Again, we don’t have ‘symptoms’. We have a different body-brain-mind-self that adapted to survival in a malevolent world and caused us to have Trauma Altered Development (TAD).
We don’t have symptoms, we have consequences. Every single item in the list of so-called ‘complex symptoms’ (see them in the page scan below) that van der Kolk describes are directly connected to our TAD. EVERY SINGLE ONE OF THESE ITEMS exist within us because of changes our body-brain was forced to make. They are consequences of the changes our body had to make through our TAD.
The only real progress in the right direction I can see – given to us like faulty patches to a sinking life boat thrown to us from a sinking ship – is that at least an association ‘with early interpersonal trauma’ is finally being considered in the current medical model thinking.
But this tiny droplet of hoped for healing balm offered by the creation of a construct named “Complex PTSD, or Disorders of Extreme Stress Not Otherwise Specified (DESNOS)” is not what we Infant-Child Severe Maltreatment Survivors need in my book.
We need our entire society to understand and accept the truth that the Infant-Child Severe Maltreatment that happened to me and others – and continues to happen to children around us today – is nothing short of a form of parental-selected genocide that did not fulfill its intent to completely destroy us. We are Infant-Child Severe Maltreatment Survivors because we are still alive, and we ONLY SURVIVED because we were able to adapt our body throughout our Trauma Altered Development to and within the malevolent environments that formed us.
The rest of van der Kolk’s words (below) simply bring into my mind the image of the author being like a modern day Paul Revere, whose horse’s hooves pound along the streets of our nation as he screams a warning. I am certainly not convinced, however, that even this author knows which message it is that most needs to be delivered.
The Trauma Altered Development that Infant-Child Severe Maltreatment Survivors experienced had no choice but to build itself into every part of who we are BECAUSE we live in a body, and our body had no choice but to change so that we could stay alive.
To describe any aspect of what happened to us in terms of a ‘diagnosis’ or a ‘symptom’, ‘complex’ or not, to call us ‘maladjusted’ or to tell us we suffer from any form of a ‘character pathology’ or ‘psychological problem’ is to continue to condemn us with stigmas and stereotyped prejudice which makes as much sense as applying all of the above labels to someone who is tall versus short, or who has red hair rather than blond.
If we wish as a society to remain in the dark ages about the consequences of Trauma Altered Development for Infant-Child Severe Maltreatment Survivors then at least we should have enough honor and common sense to admit it. If we are appalled by the ignorance that is still applied to our circumstances, today is the day we can enlighten ourselves and get on with the legitimate task of figuring out how to accurately assess Trauma Altered Development so that we can begin to live well as the changed, extraordinary Infant-Child Severe Maltreatment Survivors that we are.
Our Trauma Altered Development did not affect WHO we are in the world, but it absolutely changed HOW we are in the world. It is up to all of us to learn what that means.
The following is taken from pages 173 of the above text:
Again, it is not a picture of ‘long-term psychiatric impact’ nor a ‘diagnosis’ that Trauma Altered Development affected Infant-Child Severe Maltreatment Survivors need. We need to understand the changes our body had to make to guarantee our survival and specifically how those changes affect us, and specifically how to improve our quality of life and well-being in the world in spite of our TAD.
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