Tag Archive: PTSS

Neglect versus Trauma

Is it Trauma or isn’t it Trauma

(c) Nique

‘Neglect’; a lack of attention or too much suffocating attention
versus
‘Trauma’; severe wounding, severe abuse or experiencing a very shocking event

Is neglect the same thing as emotional or psychological ‘abuse’ – you are nothing, you are a bad kid, you are a stupid kid, I don’t want you, you mess up my life, you weren’t born by my own choice, etc.) ?

                  • My answer to this question is: NO

Can neglect alone cause a PTSD or a Trauma related disorder such as SD – see small summary of SD ?

                  • My answer to that question is also: NO
                    Oeps

Lots of people have the habit of mixing words or concepts, and explaining things more difficult than they really are. Keep it simple to the meaning of the ‘word or a concept’. Think a little autistic like me (a smile can heal so much), because we (I’m not alone in this) don’t want to out-think academic’s, researchers, Dr.’s or Ph.D.’s, etc. we only want to straighten something out in order to understand ‘the clinical concept of Trauma’

We have two concepts which causes the most confusion in whether it is or isn’t Trauma related:

  1. Severe wounding, abuse or experiencing a very shocking events, can cause a trauma related disorder (complex) PTSD
  2. Severe neglect – a lack of attention or too much suffocating attention –  can cause severe psychological and or an emotional disorder (f.e. a severe attachment e.g. personality disorder)

Lots of people mix up those two concepts and that causes confusion and misunderstanding to the meaning of suffering a clinical Trauma related disorder such as a (Complex) Post traumatic stress disorder (PTSD) or a Trauma related structural dissociation of the personality (SD a Dissociative Disorder DD).

  1. You can have experienced a Traumatic event or suffered traumatic experiences  (clinical interpretation)
  2. Or you can ‘feel’ like Traumatized  (a Personal emotional interpretation)

So I want to give you all something to think about:

Neglect isn’t a traumatic event (severe wounding, severe abuse or experiencing a very shocking event). Although people can personally experience neglect as traumatic, it can lead to a very severe attachment or personality disorder. Let me give an Example: lots of people with a personality disorder feel emotionally abused, traumatized (a personal feeling). Very often this even comes as a symptom of a personality e.g. attachment disorder.  And also the term neglect stands to a mental explanation of ‘feeling neglected’. An infant is not (yet) able to make such a mental connection and reacts only by survival instinct.

But….. there is a little but
very severe neglect during infancy can lead to suffering psychical pain or wounding such as starvation or pressure ulcers, but than you also no longer speak of neglect but of ‘child abuse’. And child abuse can lead to a trauma related disorder.

And please keep in mind, we don’t discuss the severity of a disorder!
Because every emotional or psychological disorders causes agony in life, it’s all likewise ‘severe’ to suffer a disorder!

 

A Dissociative Disorder (DP/DR/DD/OSDD/DID) is a clinical ‘co-morbidity’ disorder. So there are more disorders that can cause a Dissociative Disorder. And please note, the abbreviation of a Dissociative Disorder is DD and not DID. DID is a DD, but DD isn’t a DID

Note:
The main 2 causes of a Dissociative Disorder (DD):

  1. Trauma; PTSD, complex-PTSD and very complex PTSD
  2. A personality or severe attachment disorder such as a Borderline disorder or other personality disorders

So we can say: DD a Plus + Plus: co-morbidity disorder

  1. DD + (C) PTSD or a trauma related disorder such as a structural dissociation of the personality (SD)
  2. DD + (C) PTSD (SD) a development disorder such as Autism or a other clinical disorder
  3. DD + a Personality disorder or other Disorder that causes the Dissociative Disorder (no trauma)
  4. DD + a Personality disorder + (C) PTSD (SD) = a personality disorder with trauma – OSDD

 

Published: 28 may 2014
This topic Blog will be discussed and therefore I make adjustments if needed and also if there are other explanations which saws wood. If this line is gone, the discussion of this topic has come to an end. (C) Nique

 

Summary of the structural dissociation


avroos100wpbb

A small summary of the structural dissociation
such as I already did explain in my own wordspic-levels

What do we have already…

SD    = Structural Dissociation
ANP  = Apparently Normal Personality
EP    = Emotional Part of the Personality
DD    = Dissociative Disorder
DID   = Dissociative Identity Disorder *

Keep in mind, every person presents only ‘one’ unique personality !

A Trauma related Dissociative Disorder (PTSD+DD) can occur throughout whole your life.
Trauma is Trauma.
DID is just one Trauma Type but it isn’t the only diagnose that goes with Trauma.  


A Dissociative Identity Disorder is a Dissociative Disorder (DD)
But not every Dissociative Disorder is a Dissociative Identity Disorder (DID)

Note:
If an ANP doesn’t suffer a personality disorder you although can suffer a type 1, 2 or 3 Trauma related Dissociative Disorder (DD)
A Dissociative Disorder (DD) is a clinical Disorder (Axis I, DSM-IV)

The three levels of a trauma related Structural dissociation of the personality (SD) a Dissociative Disorder (DD):

  1. Trauma type-I primary SD
    an apparently normal personality ANP and a traumatized emotional part of the personality EP
  2. complex Trauma type-II, Childhood Trauma, secondary SD
    an apparently normal personality that switches between different traumatized emotional personality states ANP + EP’s
  3. very complex Trauma type-III, Infant to Childhood Trauma. tertiary SD
    an personality that switches between ’emotional- and daily life task systems ‘ ANP‘s + EP‘s
    The tertiary structural dissociation is the only level that is related to a Dissociative Identity Disorder *
    I would prefer to call this a trauma related development disorder. But then again I’m not a clinical psychologist, neuropsychologist or Ph.D. to define such a thing. But I can give some explanation to the existence and on how a tertiary structural dissociation of the personality can occur

Normal integration

normal integrationNo structural dissociation of the personally

A human is not born with a unified personality, but instead infants have biological determinants that were meant to integrate through a process of experience and relationships.  To let that happen there are four autonomic emotional systems that are present at birth which include anger, pleasure, sadness and fear. Team players by nature. These systems integrate to develop into one unified task and emotional life system which ultimately shapes our own personality.

Leg of integration

trauma type-3Tertiary structural dissociation TSD
a type-III trauma

2 or more ANP’s + 2 or more elaborate and distinct EP’s

Note:
The parasympathetic nervous system and the limbic system are what actually convey feelings from the body to the brain and from the brain to the body. Without those you would never have actually had the feelings that needed to be dissociated.

In TSD an infant is traumatized prior to integration of the  autonomic emotional systems,  which then results in structural dissociation.  This is not splitting, but instead is a lack of integration.  The emotional systems stay separate and starts to develop as ANP-EP task and emotional action systems.  If there were no trauma in infancy then dissociative identity disorder would not occur.

The four autonomic emotional systems can partially integrate with each other.  For example, anger and pleasure integrate, and sadness and fear integrate resulting in two ANP – EP action systems.  Over time those systems become more dominant  eventually resulting in autonomic functioning ANP – EP action systems.  Later on in life, in TSD and very rare: if the current systems can’t handle the EP load another emotional system can split of to functioning also as an autonomic ANP-EP action system. To give an example of such a rare situation; Experiencing the emotional and physical pain during childbirth and becoming a mother can cause an EP overload. Sadness and fear – or – anger and pleasure, can still split.
Now we have more than two ANP-EP action systems.

trauma type-2Secondary structural dissociation SSD
a type-II trauma

complex PTSD (+ OSDD)
1 ANP + 2 or more semi-elaborate EP’s

This type of trauma becomes very close to a type-III trauma
SSD can result instead of TSD when there has been sufficient integration in early life of the four emotional systems. In this case structural dissociation results in only one ANP, but as with TSD there are always two or more EP, however the EP in SSD are less elaborate, emancipated and distinct than in TSD.

trauma type-1Primary structural dissociation PSD
a type-I trauma
A trauma related dissociative disorder, a PTSD.
1 ANP + 1 primitive EP

In this case the personality sufficiently integrated early in life, but later when a trauma occurs that cannot be integrated then structural dissociation occurs resulting in one ANP and one primitive EP.

This can occur as a full dissociation:
The ANP doesn’t remember a thing of the traumatizing experience (EP)

This can occur as a partial dissociation:
The ANP can remember parts of the traumatizing experience but it doesn’t feel like reality
or an own experience, the EP holds a part of the traumatizing experience.

(c) Nique, client at the Dutch TRTC trauma center Drenthe-Assen

I  explain by my own words the theory of the Structural Dissociation of the Personality such as given by:
Ph.D. E.R.S. Nijenhuis working at the Mental health care department Drenthe-Assen
Ph.D. Onno van der Hart, Psychotraumatologist
K. Steele, MN, cs

Book advise: The Haunted Self

Complex Trauma PTSDComplex Trauma Community ptsd vrij

Autonomic functioning ANP and EP’s

Someone asked me ‘can an ANP/EP systems finds its existence later on in life’?
autonomic ANP and EP
abuseMmmm good question.

Let me give you all something to think about…

Of course that is possible, because every person can be traumatized by a very nasty experience that the personality can’t handle without starting off to dissociate. But if the emotional systems were already synthesized to one autonomic functioning life system, than you can’t develop more than one autonomic handling system. But EP’s can develop itself unlimited during all sorts of nasty life events.

So ANP/EP systems don’t fall out of the blue sky by every new daily life task or nasty experience.

 

We are all born with biological determinants and four autonomic emotional handling systems (the 4 head emotions).

Emotional systems which immediately after birth are able to react by instinct or reflex. And although those emotional systems are autonomic by birth, they are by nature ‘team players’ so they start directly to interact with the environment and to synthesize with each other. And from there they build an own biological autonomic life system that is able to form an own normal identifiable autobiographic personality.

But how can you develop a level I or II of the structural dissociation? (Trauma type I and type II)
If your life starts out fine as a baby and all systems did synthesize normally, than it is still possible to develop a trauma related ANP/EP act system. But only with one ANP an apparently normal personality part because the autonomous emotional systems already did synthesize and can no longer start off an autonomic functioning – they already connected to each other during baby time.
So, yeah, it is possible that a normal synthesized life system (normal personality) starts to dissociate after a traumatic event. The traumatic experience which is to much for the personality to handle will not integrate and the personality starts to dissociate – we now have one ANP and one EP, a traumatized emotional personality part. We call the personality no longer normal, but  ‘apparently normal’ because it’s no longer a psychological healthy personality, although it acts normal. And there we have a clinical psychological disturbance of the personality after suffering a traumatic experience. A post-traumatic stress disorder, type-I, a primary structural dissociation of the personality (SD) level I.

And if there occurs all sorts of traumatic events over and over again during childhood which the personality can’t handle, then there will be more than one EP.  A complex post-traumatic stress disorder, type-II, secondary structural dissociation of the personality (SD) level II.

Do we now have two personality’s?
No, of course not

* * *

Let’s go back to the newborn little baby and the 4 head emotions.

abuseDirectly after birth a baby has emotional feelings and it reacts by instinct, or with a reflex to those feelings
  1. a baby can feel anger and it reacts by instinct, or with a reflex on this feeling (autonomous)
  2. a baby can feel pleasure and it reacts by instinct, or with a reflex on this feeling (autonomous)
  3. a baby can feel sadness and it reacts by instinct, or with a reflex on this feeling (autonomous)
  4. a baby can feel scared and it reacts by instinct, or with a reflex on this feeling (autonomous)

And again:
Right after birth those autonomic elements of nature start out to add themselves together. They synthesize with each other. And as healthy team players they interact on the environment and learn how to function together as one autonomic life system.

But what happens if those autonomic emotional birth systems don’t, or can’t, synthesize/emerge together because they are from day one continuously over-stimulated with nasty sensations and pain experiences. They don’t synthesize and they stay separated from each other. They don’t learn to function as team players of a bigger life system. They grow out to be separate emotional personality parts (EP’’s). Maybe two of them synthesize together like anger en grief. And also the two emotional systems stick together such as joy and fear. Than the little child starts off with 2 separate emotional handling systems. And those systems grow stronger and stronger until they are able to function autonomic.

Do we now have two personality’s?
No, of course not
We now have two apparently normal personality ‘parts’. Two ANP/EP handling systems

To explain with identifiable stable and recurring recognizable behavior (no mood swing):
The child can have a identifiable stable and recurring anger and rebellious behavior that also can switch in a instant to a totally different very sad and quiet behavior (2 emotional systems in one ANP handling system). And on the other hand the child can behave very joyful, call itself with another name, do things that it normally doesn’t dare to do and talks with another voice sound, but it also can switch in an instant to a very scared child (also here, 2 emotional systems in one ANP handling system).
Now we have two autonomic emotional life systems that take care of daily life emotions and tasks (ANP/EP act systems)
A childhood trauma type-III a Tertiary structural dissociation of the personality – a Dissociative Identity disorder.

The more traumatic experiences to store, the more EP’s finds its existence. So the system grows bigger and bigger. And if one of those two ANP/EP systems can’t handle more EP’s, than another emotional systems can split of and start out to function autonomic (they didn’t synthesize after birth so they can split) So than we have an ‘angry daily life system’, ‘a sad daily life system’, ‘a joyful but also fearful daily life system’. Now we have three daily life ANP/EP systems. And again the EP’s can develop itself unlimited during all sorts of nasty life events.

Those systems do function together as team players, but they didn’t synthesize with each other. We now have a disturbed and broken personality, but it appears normal at moments and tasks of daily life they are best in to handle. The ANP’s protect the personality against the influence of nasty EP’s. If a system doesn’t like an emotion, another systems jumps in and takes over. The personality gets a chaotic mix of life systems with all sorts of nasty emotions and memories (EP’s) that didn’t learn how to synthesize traumatic experiences.

When the system eventually gets more and more overloaded during life, the body and mental personality starts to react with all sorts of psychical en psychological dysfunction and disturbance.

We now have DID
I would call it a trauma related development disorder

 And now I dare to write

Very early traumatized autonomic emotional systems are responsible for not be able to synthesize traumatic experiences later on in life and during child development. And you all can go there with every theory and thinking you want, it fits all in there ! The missing piece of a very big trauma puzzle are those early stage traumatized 4 autonomic functioning emotional systems such as given by birth.

 It’s not likely that there can be more than 3 with a max  of 4 ANP/EP life systems within DID, the Dissociative Identity disorder – the tertiary structural dissociation of the personality such as explained and given by The Haunted Self and all those Janet’iaans pioneers of traumatology.
If those systems don’t synthesize in early stage of life, and don’t learn to function properly as team players of a big personal life system, they become survival systems (not life systems).
They don’t live, they survive!

Those four emotional life system are the big team players of our own personality.

 

SD00 SD01 SD02 Type 3