Trauma is a distressing experience that is above and beyond the person's ability to control. It may be human related which is intentional or non-intentional such as sexual, emotional, physical abuse or neglect or it is non-human related such as natural disasters. One event is traumatic however repeated events such as ongoing sexual, emotional or physical abuse is complex trauma. The traumatic event can be physically and psychologically distressing.
Trauma symptoms can range from feeling safe to complex post traumatic stress disorders. Therefore, not all people who have been through trauma need treatment. However, the earlier the treatment the better.
Treatment can help improve traumatic symptoms such as lack of concentration, hyperactivity, impulsive behaviour, oppositional behaviour, dissociaiton, lack of self-esteem, flashback of the traumatic event through intrusive memories, negative thinking, feeling the world is unsafe, unhealthy physical symptoms, lack of trust in others and more. Therefore, the traumatic event if left untreated can continue to effect the person's life.
While a person's sense of self can become shattered, through the the right support can heal and rebuild. If left untreated, the symptoms may harm the survivor and those around through aggression, anger, anxiety, dissociation and an inability to live a full and healthy life.
A longitudinal, epidemiological study of over 17,000 adults by American companies Kaiser Permanent and Centres for Disease Control and Prevention studied adverse childhood experiences (ACE) otherwise known as childhood trauma. Participants were recruited between 1995 and 1997 and continue to be monitored to measure mortality and morbidity rates.
Participants completed surveys to indicate the number of adverse childhood experiences they experienced when young, which included:
The study found that adults who have experienced four or more adverse childhood experiences had 4 to 12 fold increased health risk of alcoholism, drug abuse, depression and suicide attempts. The more categories of ACE a person had been through, the more health risk factors and other risks in later life they encountered. Moreover ACE was common as approximately two-thirds of participants reported at least one ACE and 87% of those experienced more than one.
The above list is not exhaustive but provides some risk factors that can occur when a child has unhealthy life experiences. The study indicates the value of ensuring a healthy environment for children as it creates a healthier society.
The study sends an important message of what adversity when young can do when the child grows up, as well as the value of ensuring a healthy environment when raising children.
Below is the pyramid that illustrates how adverse childhood experiences influences health and lifestyle risks across the lifespan.
On a last note, I have noticed there are many online quizzes that help measure the amount of your ACE and your risk factors you may experience later in life. I would not endorse any as they may cause you unnecessary worries as there are many other factors that need to be considered, such as how you have coped when growing up (e.g., getting help or social support), and other positive life experiences which can help you build resilience.
Therefore, even though you may have been through adverse life experiences when young, you are not doomed to many risk factors. The support you received is key to a healthy life trajectory. Trauma-informed therapies are one way toward a healthy lifestyle after adverse childhood experiences.
Source: Centres for Disease Control and Prevention, https://www.cdc.gov/violenceprevention/acestudy/about.html
Felitti, Vincent J et al (1998). Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults. American Journal of Preventive Medicine , 14(4 ), 245 - 258.
An exercise to Improve Attention
Improving attention through visualisation is easy and will help you improve your ability for selective attention and focusing. Improving your attention will also help improve your memory. All you have to do is focus your attention on one thing. This thing can be a pen, a visual image, or anything else. Keep your attention on the object or image and notice all aspects of it. Notice the colour, texture, shape, function and meaning. When ever your attention becomes focused on something else other than the object or image, just gently bring your attention back. You can start with 2 minutes of focusing and then gradually increase the session over time. This exercise will help your ability to maintain attention in conversations, on your task and on your goals. Don't forget to do this exercise in a comfortable position, such as sitting on the floor, pillow or chair and to use a meaningful object or image.
Benefits of Improving Attention
Self-awareness and being self aware of others is an important aspect in maintaining focus. Improving your attention will help you will learn to identify how you feel, to trust yourself, and to know your strengths and limitations. When you need to focus on group work or to maintain a conversation you will learn about the other person's likes, dislikes and goals without judgement but full acceptance because your attention will stay with what is in front of you rather than shift to another topic, idea or object.
Learning about healthy relationship with self and others is conditioned from past experiences, meaning that parents and other caregivers can unconsciously demonstrate to people they care for about being anxious, disorganised (wanting to be close, but move away due to fear) or avoid relationships. In turn, the person (such as you) may then meet a partner or friends that support and maintain the unhealthy style (e.g., if you are submissive your partner will be controlling). Therefore the style can last for generations. It is important to be the change so you can then demonstrate to people you care about (and work with) about how to treat yourself and others well.
A lot of research as been implemented in the caregiving role as it is an important aspect in the ageing, mental health and disability community. Carers put a lot of selfless effort into their role because they just want to to be there for the people they love and care about. Their role is probably the most difficult because usually they will have to put their life on hold to care for others. It is not something that is planned, but an unplanned experience that comes with its own lot of challenges and personal growth for the carer.
Here are some quotes from carers who care for people who have cognitive decline or dementia, while the carers themselves adjust in their new and unplanned role. The quotes are from a book called "Family Caregivers: Disability, Illness and Ageing". The book contains information about a longitudinal research program about the carer's role and their health while caring to influence policy and intervention changes.
"They are not the person that you have known as a child, so you are adjusting to having a stranger in your house."
"It's terrible, it's soul-destroying, watching someone that you love go downhill."
"Our relationship has changed. Before he got sick our marriage wasn't too close because he was away a lot and we grew apart. All of a sudden he got sick and we were thrown together... I had a terrible lot of resentment because just as we should be starting to enjoy life, I had to stay at home and look after him."
"He's never asked me to do anything in all our 35 years of married life and now he finds that he's got to and that's the worst thing."
"A man caring for his wife felt that 'if you're feeding them three times a day, and you're standing there for two hours every meal, you start getting very uptight yourself."
As you can see the adjustment to the new caring role can be frustrating and challenging while you put on a brave face to cope. Sometimes you may need to crumble, sometimes cry, and sometimes resent your new role. But ultimately as I have experienced with many carers you will cope because you are strong, the most loving type of people I have ever met and the most giving. Just don't feel bad if you don't feel strong for the moment, because it is only a moment in time and you are not alone.
Systems theory suggests that every person lives in a system which cannot be considered linear as many different situations causes an effect. Therefore when one person is treated badly, there will be various circumstances that can explain the outcome. The circumstance may be that the person causing the treatment may be feeling bad themselves but need to see it in someone else, which was caused by their own past. It could also be that the person who feels that they are treated badly lacks assertive skills and is not sure how to manage the interaction. Therefore you would have to look at the needs of the system itself (such as system at the workplace or family structure, which is also known as second-order) and the needs of the individual (which is also known as first order) and create a balance.
Using systems theory is also helpful in the workplace, as interactions and behaviour is caused by the system in the workplace. Therefore considering one particular situation may not be as helpful as considering various aspects. As example, suggested by Ms Smith-Acuna, an employee was having trouble with a colleague and felt anxious, unsupported and was too apologetic, however her own way of conducting the meeting (fitting in the with system) needed improvement and she needed to improve her assertive skills (changing the individual) to improve how the meetings functioned, while her colleague needed to change her behaviour as she was critical and impatient. If the change-agent was to only look at the two people, then important details would have been missed. Details of how the meetings were run (system of the organisation) and how the individual fit within the system (second-order system).
Another example is family therapy using systems therapy. A teenager was always angry, but when he was able to manage his anger, another teenager in the family started playing up. It was discovered that the children were expressing the anger that the parent needed to express (of the marriage). However, once the parent realised what was really going on (a system that may have lasted generations and can be resistant to change), the dynamics of the whole family started to change. Systems theory can also help understand that change in behaviour can cause change in systems, however systems need to be considered in two parts - the rules, roles and boundaries that support the system which always works toward maintaining homeostasis and the structure of the system. It is also important to remember that systems also has sub-systems (e.g., department in the workplace) which need to be considered.
In summary, behaviour is often reinforced by the system the person is in as it is providing feedback. You will need to ask is the system causing me to behave, feel or think in this way or do I need to change to fit in the system. What needs to change to create a balance? Often, in the workplace it is usually the latter as some people may fit in the system and some may not and either need to change or move out. You would have to look at the whole picture, and its different parts, to understand the causes.
Source: Systems Theory in Action - Application to individual, couples and family therapy by Shelly Smith-Acuna.
The conundrum of human behaviour. It can be playful, rewarding, hurtful, encouraging, and comforting. Can it be judged by what you see at first sight? I don't think so. Sometimes you need to interact for a while to find out the truth. Sometimes, people will use their social skills to manipulate or use desirable or undesirable qualities to achieve a conscious or unconscious goal that may be hurtful or helpful to others. Moreover, others will seek out vulnerable qualities to take advantage of another person to achieve their own goal. Do you remain on guard or trust completely. Do you work with your head or your heart only. I'd say both.
If you have a mind that looks for patterns and consistencies, sometimes a person will thwart what you assumed. They will do something completely the opposite to what you expected. The evidence before you suddenly changed. Or is it what you only wanted to see, and the evidence before you no longer supports what you perceived? Remember, that perception is filtered from your belief system. What about if you are value driven, do you change your values or change what is around you or just accept without judgement? It's a conundrum, surely.
Carl Rogers used person centred therapy on a client who he found out told a lie the whole time because the client realised he could get away with it. He took advantage of the situation. The therapy was to provide unconditional positive regard conditions in the treatment room. To accept fully what the client had said, without judgement. Whereas in contemporary counselling, the therapist will look for inconsistencies to challenge the client so they will be aware of their words and actions. The strategy is to help them grow out of a dysfunctional pattern and create conditions for change. Carl Rogers' technique is today mainly used to build a rapport with the client and as part of the treatment, not the treatment itself.
In the end, every day is a learning experience. The test is to use each experience as a chance to grow yourself. To realise that you cannot change others and that if they did indeed choose to use your vulnerabilities as a chance to manipulate you, that you have learned from the experience and to grow from it. It is also a chance to realise that yesterday no longer exists, but was part of your wonderful experience. Today is a gift and to be open enough to learn from what you have been presented with and tomorrow is a day you will never know, as they say a mystery.
Therefore human behaviour is a conundrum, but I'm guessing that it is meant to be. That it enables life to be a classroom, where we learn from each other. To accept others fully, to not be so judgemental but to learn that there is the good, the bad, and that each will bring out what we need to be challenged in order to grow into a better person.
I just want to add, that for those who have Autism, ADHD or are highly intelligent that human behaviour is more of a challenge because you find shifting perspective a challenge, you continually look for patterns and that you think more with your head than emotionally. You also notice detail more, highly sensitive and the outside world can be exhausting. But if you learn the skills, learn more about yourself and how to manage what you find too difficult sometimes, such as change, you can become a master at learning about differences and that when something unexpected thwarts you that feeling completely uncomfortable is part of the growth process. Just be okay with it and continue to grow. It would be easier living in a bubble and to only use your mind, but life experience will teach you more than a book, a classroom or the internet. Sometimes it will hurt, sometimes it will be joyful, but staying the same won't help either.
During research for psychology, before you can test whether the data you have is significant or not, an assumptions test has to be made. An assumptions test includes locating outliers as they can create problems for the outcome. Therefore the data that has been collected needs to be normally distributed. So the outlier, which is a person who has characteristics not normally distributed such as age or the way they answered, needs to either be:
The point to this story is what if your personality is considered an outlier. What if you are considered so different that you or somebody else in your life has adjusted your personality so you resemble everybody else, you felt like deleting yourself because you wanted so much to be like everyone else that you either felt ashamed or embarrassed or you believed that you were not a problem, embraced your individuality and felt comfortable to express your true self. You do all these things so everybody's assumptions and opinion becomes significant to you. It matters. No matter how unhappy you feel, you want to fit in and become accepted to the norm. You don't want assumptions violated.
So how do you know you are an outlier -
What to do:
Notice the signs. If you are feeling disrespected, depressed or empty then you are most probably not being true to yourself. Understand that you are not like the norm, that your different personality has a special place in society, learn about what that is, embrace it and develop your gifts. Show off your gifts, shout out to the world that you are you and proud of you. Don't even think about deleting yourself or adjusting yourself to fit the norm but shine!
Intermittent explosive disorder (IED) is characterised as extreme outbursts of aggressive behaviour that can lead to damage or destruction of property and physically injuring animals and/or people within a 12-month period and the behaviour is out of proportion to the circumstance. The behaviour is short-lived and impacts social and vocational aspects of the individual’s life. One example of IED behaviour is road rage as mentioned in the psychological literature.
Over the years, research for IED has found that the disorder in the Diagnostic Statistical Manual I - IV was too narrow and each manual therefore broadened the disorder. Initially the disorder excluded individuals who had generalised aggression between the explosive acts (DSM II), whereas in the DSM-5 it does allow these symptoms. The implication for allowing generalised aggression between the explosive acts is that more people are able to become diagnosed and therefore receive appropriate treatment. Another important change includes symptoms classified as severe to less severe meaning that IED is dimensional. The challenges that researchers have found when reexamining the disorder was that there are over 200 meanings for aggression causing a lack of precision in creating measurement tools for research and that low prevalence rates did not provide enough participants for research purposes.
Intermittent Explosive Disorder is not a part of another mental disorder but can be diagnosed in addition if it occurs when the other disorder is not present. Individuals with IED show characteristics of impatience, hostility, trait-anger, being assaultive and resentment. They also have greater prevalence of mood disorder and higher levels of state and trait anxiety. Individuals with IED tend to console their victims after the attack as they did not want the outburst to occur and became remorseful.
Research has found that individuals who have symptoms of IED are often in the correctional system and tend to miss out on treatment. It is important to understand an individual's aggressive outbursts from a therapeutical point of view to correct the behaviour with the appropriate treatment.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author, 2013.
Baron, R. A., & Richardson, D. R. (1994). Human Aggression (2nd ed.). New York: Plenum Press.
Coccaro, E. F. (2010). A family history study of intermittent explosive disorder. Journal of Psychiatric Research, 44, 1101-1105.
Coccaro, E. F., Kavoussi, R. J., Berman, M. E., & Lish, J. D. (1998). Intermittent explosive disorder-revised: Development, reliability, and validity of research criteria. Comprehensive Psychiatry, 39(8), 368-376.
Galovski,, T., & Blanchard, E. B. (2002). Psychological characteristics of aggressive drivers with and without intermittent explosive disorder. Behaviour Research and Therapy, 40, 1157-1168.
Saha, A. (2010). A case of intermittent explosive disorder. Industrial Psychiatry Journal, 19(1), 55-57. doi: 10.4103/0972-6748.77639.
To obtain interpersonal competency you need to think about what you value and the cost and rewards the interaction is going to give you.
Interdependence Theory suggests that we consider the cost and rewards when mixing with other people. When considering the cost and rewards we will consider if the person can satisfy our highest value. The value is interchangeable and is used to compare, which means that I can choose to interact with somebody because they are confident but they talk too much. I value confidence highly and willing to overlook verbosity, therefore I am willing to compensate. The cost of "confidence" will provide me with rewards of positive energy: I am investing in good energy. To do this I will provide the other person with silence so they will be heard as they prefer being verbose. Therefore we are okay communicating as we are willing to compensate. Over time, the way I think will change because I realise that verbose people aren't that bad. Even though Attachment Theory suggests that the way we think is stable (some theorists do say it can change over time) Interdependence Theory says it is susceptible to change, depending on whether we are willing to compensate so we can gain the necessary rewards: the rewards is far greater than the cost.
In a nutshell, what Interdependence Theory suggests is that we are always assessing other people's styles because of the outcomes it produces. The outcomes will provide internal satisfaction (and exceed it). If the value the other person is not as satisfying then we will feel discontent and look for alternatives. We are also willing to compensate by overlooking styles that we don't really value as other parts of the person provides high intrinsic value; making us more flexible.
On the other hand we can become dependent (rather than remaining interdependent) on the other person, and overlook a quality that does not match our value. This is why some people choose to stay in abusive relationships or work with abusive colleagues. Even though they may value respect, they don't have enough or relevant education to get out of it and therefore feel they have to put up with it. To overcome this possibility, always consider what you value. If the person doesn't match it and leaves you feeling unhappy and dissatisfied, then consider what is the cost and rewards you are gaining. If the cost is your happiness and the reward is financial dependence/convenience, then decide is it really worth what you are missing out on and can you get that reward elsewhere. Interdependence Theory suggests that people start to explore opportunities for more satisfying outcomes by considering the rewards and costs. What is the reward going to cost you? Realise you have the power to decide what is best for you, especially after you learn what you value.
Source: Blackwell Handbook of Social Psychology: Interpersonal Processes, Edited by Garth Fletcher and Margaret Clark. Blackwell Publishing, 2003, USA.
Information on latest research and strategies to improve mental health, trauma symptoms and trauma-informed care for children, young people and adults.