@kristin
@kristin
Below is a researched piece I'm working on for publication.
I'm basically taking the data from several research projects and collating it in a way which is understandable to a non clinician. Such as myself.
I have found that understanding that there is actual physical damage done to various parts of the brain during the time of abuse there is a sense of relief that this is not volitional but a biological imperative.
This may not engender more control sadly, but it does take the edge off the issues of our self inflicted guilt and shame regarding condition based behaviours. It also explains them.
I don't know whether it will be helpful but I have found that even today as I'm very acute and struggling not to drown, knowing that it is a normal response for a damaged neural network at least short circuits the desire to blame myself for weakness of character. That is a massive consideration!
ABUSE SURVIVORS AND COMPLEX DIAGNOSES
Stress can set off a ripple of hormonal changes that permanently wire a child's brain to cope with a malevolent world (Teicher, 2002)
Traumatised children (and adult survivors) become increasingly responsive to relatively minor stimuli as a result of decreased frontal lobe functioning (learning and problem solving) and increased limbic system (amygdala) sensitivity (impulsiveness) (Streeck-Fischer & van der Kolk, 2000).
A study by Teicher et al. (1993) found a 38% increased rate of limbic abnormalities ('emotional brain') following physical abuse, 49% after sexual abuse, and 113% following abuse of more than one type combined (cited in Streeck-Fischer & van der Kolk, 2000)
For over a hundred and fifty years we have known that childhood abuse causes permanent negative changes in the brain. These changes are a formative consequence that survivors of childhood abuse must live with. These consequences often take the form of complex mental illness. Eg.Post-traumatic stress disorder,Panic attacks,Depression,Dissociation,Dissociative Identity Disorder,Bipolar,Schizophrenia,Eating disorders,Personality disorders.
Unlike in simple mental illness these illnesses often overlap and create a confusing and difficult to treat and manage confluence of symptoms.
Survival Stress is the trigger to this. It is well known that effects of this ongoing survival based stress become permanent. (Stress can set off a ripple of hormonal changes that permanently wire a child's brain to cope with a malevolent world (Teicher, 2002).)
So imagine, if you will, the perceptions and reactions of a child's permanently damaged neural architecture in the body and mind of an adult. Here we have a person who through no fault of their own or genetic predisposition have mental health issues that are difficult to diagnose and seemingly impossible to treat. So this person must then manage a condition which pervades so much of the life they are trying to live. Often desperately.
As abusers rarely limit themselves to simply one form of abuse, we find even more complex overlap of mental illness symptomology. So much research has been undertaken to recognise the links between early childhood abuse and complex mental illness that there is no doubt that the effects are real.
Efficacious treatments for these permanent conditions though, are the major gap in pharmaceutical and therapeutic research and development. Thus far people with a complex mental illness have few treatment options. The main barrier to treatment would appear to be the permanent nature of neural changes in the brain.
With a significant population of childhood abuse survivors, (2011-12, there were 252,962 notifications of suspected child abuse and neglect made to state and territory authorities (a rate of 34.0 notifications per 1,000 Australian children) (CFCA Fact Sheet— May 2013) there is an enormous group of people left without any hope for a traditional recovery.
So, what do we say to these people? What hope can we provide? Society as a whole has allowed this to happen. What will society do to try and make it right?
Like any permanent disability we cannot and should not speak in terms of rehabilitation to a former state of wellness. This is because there has never been a state of wellness.
So the best we can provide right now is intervention. Not so much for people currently experiencing these conditions but an early intervention targeted to the victims of the abuse itself. I know that this may be considered obvious. But as things stand in Australia even today, it is recognised that many victims fall through the gaps in our fragmented child protection system. (This recognition has seen the development of a National Framework for Protecting Australia’s Children 2009-2020 (Council of Australian Governments, 2009).)
It is a major concern that this significant population is still "falling through the gaps". A lack of understanding and empathy within the mental health and health sectors is having a negative impact on the holistic health of people with complex diagnoses. When many professionals talk about mental illness they are really only referring to simple mental illnesses. And when services are providing support they are thinking in terms of these noncomplex disorders. There appears to be a disconnect in the mindset and knowledge of service providers and this disconnect leaves them and their clients completely 'at sea' and neither one seems to know how to get un-lost.
