Trauma model of mental disorders
Encyclopedia
Trauma models of mental disorders (alternatively called trauma models of psychopathology) emphasize the effects of psychological trauma
Psychological trauma
Psychological trauma is a type of damage to the psyche that occurs as a result of a traumatic event...

, particularly in early development, as the key causal factor in the development of some or many psychiatric disorders (in addition to post-traumatic stress disorder
Post-traumatic stress disorder
Posttraumaticstress disorder is a severe anxiety disorder that can develop after exposure to any event that results in psychological trauma. This event may involve the threat of death to oneself or to someone else, or to one's own or someone else's physical, sexual, or psychological integrity,...

).

Trauma models are typically founded on the view that traumatic experiences (including but not limited to actual physical or sexual abuse) are more common or more serious than thought in the histories of those diagnosed with mental disorders. Such models have traditionally been associated with psychoanalytic approaches, notably Sigmund Freud
Sigmund Freud
Sigmund Freud , born Sigismund Schlomo Freud , was an Austrian neurologist who founded the discipline of psychoanalysis...

's early ideas on childhood sexual abuse and hysteria
Hysteria
Hysteria, in its colloquial use, describes unmanageable emotional excesses. People who are "hysterical" often lose self-control due to an overwhelming fear that may be caused by multiple events in one's past that involved some sort of severe conflict; the fear can be centered on a body part, or,...

.

John Bowlby
John Bowlby
Edward John Mostyn "John" Bowlby was a British psychologist, psychiatrist and psychoanalyst, notable for his interest in child development and for his pioneering work in attachment theory.- Family background :...

, who developed attachment theory
Attachment theory
Attachment theory describes the dynamics of long-term relationships between humans. Its most important tenet is that an infant needs to develop a relationship with at least one primary caregiver for social and emotional development to occur normally. Attachment theory is an interdisciplinary study...

, also describes many forms of mental illness as based on early childhood trauma. In addition there is significant research supporting the linkage between early experiences of chronic maltreatment and later problems.

In the 1960s trauma models also became associated with humanist
Humanistic psychology
Humanistic psychology is a psychological perspective which rose to prominence in the mid-20th century, drawing on the work of early pioneers like Carl Rogers and the philosophies of existentialism and phenomenology...

 and anti-psychiatry
Anti-psychiatry
Anti-psychiatry is a configuration of groups and theoretical constructs that emerged in the 1960s, and questioned the fundamental assumptions and practices of psychiatry, such as its claim that it achieves universal, scientific objectivity. Its igniting influences were Michel Foucault, R.D. Laing,...

 approaches, particularly in regard to understanding schizophrenia and the role of the family. Personality disorders have also been a focus, particularly borderline personality disorder
Borderline personality disorder
Borderline personality disorder is a personality disorder described as a prolonged disturbance of personality function in a person , characterized by depth and variability of moods.The disorder typically involves unusual levels of instability in mood; black and white thinking, or splitting; the...

. Extreme versions of trauma models have implicated the fetal environment and the trauma of being born, or have been associated with recovered memory
Recovered memory
Recovered memory is the description given to the apparent resurrection of the memory of events that had been forgotten or suppressed for a relatively long time. Retrograde amnesia secondary to physical or emotional trauma , or the suppression of painful memories from any cause, is an accepted concept...

 controversies.

More generally, trauma models highlight particularly stressful
Burnout (psychology)
Burnout is a psychological term for the experience of long-term exhaustion and diminished interest. Research indicates general practitioners have the highest proportion of burnout cases; according to a recent Dutch study in Psychological Reports, no less than 40% of these experienced high levels of...

 and traumatic factors in early attachment relations and in the development of mature interpersonal relationships. They are often presented as a counterpoint to a psychiatry claimed to be too focused on genetics, neurochemistry and medication.

History

In the 1940s, '50s, '60s and '70s some mental health
Mental health
Mental health describes either a level of cognitive or emotional well-being or an absence of a mental disorder. From perspectives of the discipline of positive psychology or holism mental health may include an individual's ability to enjoy life and procure a balance between life activities and...

 professionals proposed trauma models to understand schizophrenia: Harry Stack Sullivan
Harry Stack Sullivan
Harry Stack Sullivan was a U.S. psychiatrist whose work in psychoanalysis was based on direct and verifiable observation .-Life and works:Sullivan was a child of Irish immigrants and allegedly grew up in an...

, Frieda Fromm-Reichmann
Frieda Fromm-Reichmann
Frieda Fromm-Reichmann was a German psychiatrist and contemporary of Sigmund Freud who emigrated to America during World War II.-Life and work:...

, Theodore Lidz
Theodore Lidz
Theodore Lidz was an American psychiatrist best known for his articles and books on the causes of schizophrenia and on psychotherapy with schizophrenic patients...

, Gregory Bateson
Gregory Bateson
Gregory Bateson was an English anthropologist, social scientist, linguist, visual anthropologist, semiotician and cyberneticist whose work intersected that of many other fields. He had a natural ability to recognize order and pattern in the universe...

, Silvano Arieti
Silvano Arieti
Silvano Arieti was a psychiatrist regarded in his time as one of the world’s foremost authorities on schizophrenia. He received his M.D. from the University of Pisa but left Italy soon after because of Benito Mussolini's increasingly racial policies...

, R.D. Laing and others. They held that schizophrenia is induced by experiences in profoundly disturbed families, or by attempts to cope with a damaging society. In the 1950s Sullivan's theory that schizophrenia is related to interpersonal relationships was widely accepted in the United States.

The Diagnostic and Statistical Manual of Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
The Diagnostic and Statistical Manual of Mental Disorders is published by the American Psychiatric Association and provides a common language and standard criteria for the classification of mental disorders...

, or DSM, does not claim that the specific etiology of schizophrenia and other serious psychoses has been established. However, the psychogenic models proposed by these early researchers are no longer in vogue in the psychiatric profession. Since the 1960s pharmacological treatments became the increasing focus of psychiatry, and by the 1980s the theory that the family dynamics could be implicated in schizophrenia became a taboo in many quarters.

Before his death in 2001, aged ninety, Lidz, one of the main proponents of the "schizophrenogenic" parents theory, expressed regret that current research in biological psychiatry
Biological psychiatry
Biological psychiatry, or biopsychiatry is an approach to psychiatry that aims to understand mental disorder in terms of the biological function of the nervous system. It is interdisciplinary in its approach and draws on sciences such as neuroscience, psychopharmacology, biochemistry, genetics and...

 is "barking up the wrong tree". Like Lidz, Laing maintained until his death that the cause of both schizoid personalities
Schizoid personality disorder
Schizoid personality disorder is a personality disorder characterized by a lack of interest in social relationships, a tendency towards a solitary lifestyle, secretiveness, emotional coldness, and sometimes apathy, with a simultaneous rich, elaborate, and exclusively internal fantasy world...

 and schizophrenia was influenced by family relationships.

In 1975 Silvano Arieti won the American National Book Award
National Book Award
The National Book Awards are a set of American literary awards. Started in 1950, the Awards are presented annually to American authors for literature published in the current year. In 1989 the National Book Foundation, a nonprofit organization which now oversees and manages the National Book...

 in the field of science for his book, Interpretation of Schizophrenia, which advances a psychological model for understanding all the regressive types of the disorder. According to more recent research, child abuse
Child abuse
Child abuse is the physical, sexual, emotional mistreatment, or neglect of a child. In the United States, the Centers for Disease Control and Prevention and the Department of Children And Families define child maltreatment as any act or series of acts of commission or omission by a parent or...

 at home plays a causal role in depression
Clinical depression
Major depressive disorder is a mental disorder characterized by an all-encompassing low mood accompanied by low self-esteem, and by loss of interest or pleasure in normally enjoyable activities...

, PTSD, eating disorders, substance abuse
Substance abuse
A substance-related disorder is an umbrella term used to describe several different conditions associated with several different substances .A substance related disorder is a condition in which an individual uses or abuses a...

 and dissociative disorders.

The more severe the abuse the more probability symptoms will develop in adult life. In the psychiatric field it is hypothesized that child abuse is less related to the most serious psychoses, such as schizophrenia. However, some mental health professionals maintain that the relationship is stronger in psychoses than neuroses.

A common critical argument

Critics of the model, such as August Piper Jr., argue that the logic of the claim that childhood trauma causes insanity demonstrates a serious flaw. If the claim were true, critics contend, the abuse of millions of children over the years should have caused many cases of insanity; but no evidence exists.

Arieti had addressed this line of argumentation, stating that the only persons before whom young human beings are vulnerable are the ones to whom they are emotionally bonded
Human bonding
Human bonding is the process of development of a close, interpersonal relationship. It most commonly takes place between family members or friends, but can also develop among groups such as sporting teams and whenever people spend time together...

 in childhood. A passage of Interpretation of Schizophrenia, originally published in 1955, sheds light on the heart of the trauma model:

Psychohistory table

Psychohistorians
Psychohistory
Psychohistory is the study of the psychological motivations of historical events. It attempts to combine the insights of psychotherapy with the research methodology of the social sciences to understand the emotional origin of the social and political behavior of groups and nations, past and present...

 endorse trauma models of schizoid, narcissistic, masochistic, borderline
Borderline
Borderline or border line may refer to:*Border-In film:*Borderline , a film starring Paul Robeson*Borderline , a film noir starring Fred MacMurray*Borderline , a film starring Charles Bronson...

, depressive and neurotic personalities.

The chart below shows the dates at which gradual forms of child abuse are believed by psychohistorians to have evolved in the most advanced nations, based on accounts from historical records. The timeline doesn't apply to hunter-gatherer
Hunter-gatherer
A hunter-gatherer or forage society is one in which most or all food is obtained from wild plants and animals, in contrast to agricultural societies which rely mainly on domesticated species. Hunting and gathering was the ancestral subsistence mode of Homo, and all modern humans were...

 societies. It doesn't apply either to the Greek
Greece
Greece , officially the Hellenic Republic , and historically Hellas or the Republic of Greece in English, is a country in southeastern Europe....

 and Roman
Rome
Rome is the capital of Italy and the country's largest and most populated city and comune, with over 2.7 million residents in . The city is located in the central-western portion of the Italian Peninsula, on the Tiber River within the Lazio region of Italy.Rome's history spans two and a half...

 world, or the ancient Chinese
China
Chinese civilization may refer to:* China for more general discussion of the country.* Chinese culture* Greater China, the transnational community of ethnic Chinese.* History of China* Sinosphere, the area historically affected by Chinese culture...

 world where there was a wide variation in childrearing practices. The major childrearing types described by Lloyd deMause
Lloyd deMause
Lloyd deMause, pronounced de-Moss , is an American social thinker known for his work in the field of psychohistory. He did graduate work in political science at Columbia University and later trained as a lay psychoanalyst...

 are:



With the exception of the "helping mode of childrearing" (marked in yellow above), for psychohistorians the major childrearing types are related to main psychiatric disorders, as can be seen in the following Table of Historical Personalities:







































Childrearing Personality Historical Manifestations
Infanticidal Schizoid Child sacrifice
Child sacrifice
Child sacrifice is the ritualistic killing of children in order to please, propitiate or force a god or supernatural beings in order to achieve a desired result...

 and infanticide
Infanticide
Infanticide or infant homicide is the killing of a human infant. Neonaticide, a killing within 24 hours of a baby's birth, is most commonly done by the mother.In many past societies, certain forms of infanticide were considered permissible...

 among tribal societies, Mesoamerica, the Incas; in Assyria
Assyria
Assyria was a Semitic Akkadian kingdom, extant as a nation state from the mid–23rd century BC to 608 BC centred on the Upper Tigris river, in northern Mesopotamia , that came to rule regional empires a number of times through history. It was named for its original capital, the ancient city of Assur...

n and Canaan
Canaan
Canaan is a historical region roughly corresponding to modern-day Israel, Palestine, Lebanon, and the western parts of Jordan...

ite religions. Phoenicians, Carthaginians and other early states also sacrificed infants to their gods. On the other hand, the less abusive Greeks and Romans exposed
Child abandonment
Child abandonment is the practice of relinquishing interests and claims over one's offspring with the intent of never again resuming or reasserting them. Causes include many social and cultural factors as well as mental illness. An abandoned child is called a foundling .-Causes:Poverty is often a...

 some of their babies to death.
Narcissistic
Abandoning Masochistic Longer swaddling
Swaddling
Swaddling is an age-old practice of wrapping infants in swaddling cloths, blankets or similar cloth so that movement of the limbs is tightly restricted. Swaddling bands were often used to further restrict the infant...

 in the early Middle Ages, fosterage
Fosterage
Fosterage, the practice of a family bringing up a child not their own, differs from adoption in that the child's parents, not the foster-parents, remain the acknowledged parents. In many modern western societies foster care can be organised by the state to care for children with troubled family...

, outside wetnursing
Wet nurse
A wet nurse is a woman who is used to breast feed and care for another's child. Wet nurses are used when the mother is unable or chooses not to nurse the child herself. Wet-nursed children may be known as "milk-siblings", and in some cultures the families are linked by a special relationship of...

, oblation
Oblate (religion)
An oblate in Christian monasticism is a person who is specifically dedicated to God or to God's service. Currently, oblate has two meanings:...

 of children to monasteries and nunneries, and apprenticeship
Apprenticeship
Apprenticeship is a system of training a new generation of practitioners of a skill. Apprentices or protégés build their careers from apprenticeships...

.
Ambivalent Borderline Although the later Middle Ages
High Middle Ages
The High Middle Ages was the period of European history around the 11th, 12th, and 13th centuries . The High Middle Ages were preceded by the Early Middle Ages and followed by the Late Middle Ages, which by convention end around 1500....

 ended the abandonment of children
Child abandonment
Child abandonment is the practice of relinquishing interests and claims over one's offspring with the intent of never again resuming or reasserting them. Causes include many social and cultural factors as well as mental illness. An abandoned child is called a foundling .-Causes:Poverty is often a...

 to monasteries, "ambivalent" parents tolerated extreme love and hate for the child without the two feelings affecting each other. Enema
Enema
An enema is the procedure of introducing liquids into the rectum and colon via the anus. The increasing volume of the liquid causes rapid expansion of the lower intestinal tract, often resulting in very uncomfortable bloating, cramping, powerful peristalsis, a feeling of extreme urgency and...

s, early beating, shorter swaddling, mourning for deceased children, a precursor to empathy
Empathy
Empathy is the capacity to recognize and, to some extent, share feelings that are being experienced by another sapient or semi-sapient being. Someone may need to have a certain amount of empathy before they are able to feel compassion. The English word was coined in 1909 by E.B...

.
Intrusive Depressive The intrusive parent began to unswaddle the infant. Since infants were now allowed to crawl rather than being swaddled, they had to be formally "disciplined", threatened with hell; use of guilt. Early toilet training, repression
Psychological repression
Psychological repression, also psychic repression or simply repression, is the psychological attempt by an individual to repel one's own desires and impulses towards pleasurable instincts by excluding the desire from one's consciousness and holding or subduing it in the unconscious...

 of child's sexuality, end of swaddling and wet-nursing, empathy now possible, rise of pediatrics
Pediatrics
Pediatrics or paediatrics is the branch of medicine that deals with the medical care of infants, children, and adolescents. A medical practitioner who specializes in this area is known as a pediatrician or paediatrician...

.
Socializing Neurotic Use of "mental discipline"; teaching children to conform to the parents goals, socializing them. Hellfire and physical discipline disappeared. Rise of compulsory schooling
Compulsory education
Compulsory education refers to a period of education that is required of all persons.-Antiquity to Medieval Era:Although Plato's The Republic is credited with having popularized the concept of compulsory education in Western intellectual thought, every parent in Judea since Moses's Covenant with...

. The socializing mode is still the main mode of upbringing in the West.
Helping Individuated Absolute end of humiliation
Humiliation
Humiliation is the abasement of pride, which creates mortification or leads to a state of being humbled or reduced to lowliness or submission. It can be brought about through bullying, intimidation, physical or mental mistreatment or trickery, or by embarrassment if a person is revealed to have...

 to control the child. The helping parent tries to assist the child in reaching its own goals rather than socializing him or her into adult goals. Children's rights movement
Children's rights movement
The Children's Rights Movement is a historical and modern movement committed to the acknowledgment, expansion, and/or regression of the rights of children around the world...

, deschooling
Deschooling
Deschooling is a term used by both education philosophers and proponents of alternative education and/or homeschooling, though it refers to different things in each context...

.


According to psychohistory theory, each of the above psychoclasses co-exist in the modern world
Modern World
Modern World or The Modern World may refer to:*Modernity, a popular academic term.*The modern era, the age in which people today now live.*Modern World, a song by Wolf Parade from their 2005 album Apologies to the Queen Mary....

 today.

Recent approaches

In more recent years psychologist Alice Miller
Alice Miller (psychologist)
Alice Miller née Rostovski was a psychologist and world renowned author, who is noted for her books on child abuse by their own parents, translated in several languages...

, author of twelve books on mental distress and disorders, including non-psychiatric conditions like falling prey to cult
Cult
The word cult in current popular usage usually refers to a group whose beliefs or practices are considered abnormal or bizarre. The word originally denoted a system of ritual practices...

s, has informed future parents and former victims about the disastrous consequences of child abuse. Former schizophrenic patients, such as John Modrow, have also endorsed the views of the pioneers of the trauma models.

The "trauma model of mental disorders" is the name given by psychiatrist
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...

 Colin A. Ross
Colin A. Ross
Colin A. Ross is a psychiatrist of Canadian origin and professional training. Ross attended medical school at the University of Alberta, Edmonton, Canada and completed his training in psychiatry at the University of Manitoba, Winnipeg, Canada...

 to his specific model, which is presented as a solution to the problem of comorbidity
Comorbidity
In medicine, comorbidity is either the presence of one or more disorders in addition to a primary disease or disorder, or the effect of such additional disorders or diseases.- In medicine :...

 in the mental health
Mental health
Mental health describes either a level of cognitive or emotional well-being or an absence of a mental disorder. From perspectives of the discipline of positive psychology or holism mental health may include an individual's ability to enjoy life and procure a balance between life activities and...

 field. An information packet given to inpatients at the Ross Institute for Psychological Trauma
Ross Institute for Psychological Trauma
The Ross Institute for Psychological Trauma is a psychiatric hospital in Dallas, Texas in the United States founded by Colin A. Ross in 1991, treating adults suffering from depression, self-mutilation, suicide ideation, anxiety, dissociative schizophrenia, dissociation and substance abuse...

 describes the theoretical basis of his trauma model in commonsensical
Common sense
Common sense is defined by Merriam-Webster as, "sound and prudent judgment based on a simple perception of the situation or facts." Thus, "common sense" equates to the knowledge and experience which most people already have, or which the person using the term believes that they do or should have...

 terms:
In Schizophrenia: an Innovative Approach to Diagnosis and Treatment, Ross determines that some patients diagnosed with schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...

 have symptoms related to dissociative identity disorder
Dissociative identity disorder
Dissociative identity disorder is a psychiatric diagnosis and describes a condition in which a person displays multiple distinct identities , each with its own pattern of perceiving and interacting with the environment....

.

The family conditions during infancy are at present considered virtually irrelevant in the psychiatric profession. According to some critics, the goal of modern psychiatric treatment is not to understand how parents could have contributed to the problem or how it can be resolved by improving the relationship. The objective is how to reduce the burden of a psychotic crisis for the family through medication of the disturbed individual. As two trauma researchers have put it, "the ideology of biological reductionism
Mechanism (philosophy)
Mechanism is the belief that natural wholes are like machines or artifacts, composed of parts lacking any intrinsic relationship to each other, and with their order imposed from without. Thus, the source of an apparent thing's activities is not the whole itself, but its parts or an external...

" in psychiatry is "to exonerate the family."

In 2006 a UK researcher and a New Zealand clinical psychologist presented a meta-analysis of schizophrenia studies to psychiatric conferences which they claimed demonstrated that the prevalence of physical and sexual abuse in the histories of those with schizophrenia is very high and is being under-studied.

The researchers admit that not all schizophrenics suffered trauma, but they believe "the level of actual abuse may be an important difference". While conceding that genetics may still be a causative risk factor they maintain "other evidence shows that genes alone do not cause the illness." The review caused considerable debate

In the field of criminology
Criminology
Criminology is the scientific study of the nature, extent, causes, and control of criminal behavior in both the individual and in society...

, Lonnie Athens developed a theory of how a process of brutalization by parents or peers that usually occurs in childhood results in violent crimes in adulthood. Richard Rhodes
Richard Rhodes
Richard Lee Rhodes is an American journalist, historian, and author of both fiction and non-fiction , including the Pulitzer Prize-winning The Making of the Atomic Bomb , and most recently, The Twilight of the Bombs...

' Why They Kill describes Athens' observations about domestic and societal violence in the criminals' backgrounds. Both Athens and Rhodes reject the genetic inheritance theories.

Other criminologists such as Jonathan Pincus and Dorothy Otnow Lewis believe that, although it is the interaction of childhood abuse and neurological disturbances that explains murder, virtually all of the 150 murderers they studied over a 25-year period had suffered severe abuse as children. Pincus believes that the only feasible remedy for crime would be the prevention of child abuse.

See also

  • Attachment in children
    Attachment in children
    Newborn humans infants cannot survive without a caregiver to provide food and protection, and will not thrive without other types of support as well. While infants have relatively few inborn behaviors—such as crying, rooting, and sucking—they also come with many behavioral systems ready to be...

  • Biomedical model
    Biomedical model
    The biomedical model of medicine has been around since the mid-nineteenth century as the predominant model used by physicians in diagnosing diseases.It has four core elements....

  • Biopsychiatry controversy
    Biopsychiatry controversy
    The biopsychiatry controversy is a dispute over which viewpoint should predominate and form the scientific basis of psychiatric theory and practice. The debate is a criticism of a claimed strict biological view of psychiatric thinking. Its critics including disparate groups such as the...

  • Complex post-traumatic stress disorder
    Complex post-traumatic stress disorder
    Complex post-traumatic stress disorder is a psychological injury that results from protracted exposure to prolonged social and/or interpersonal trauma with lack or loss of control, disempowerment, and in the context of either captivity or entrapment, i.e. the lack of a viable escape route for the...

  • Dissociation (psychology)
  • Hearing Voices Movement
    Hearing Voices Movement
    Hearing Voices Movement is a philosophical trend in how people who hear voices are viewed. It was begun by Marius Romme, a professor of social psychiatry at the University of Limburg in Maastricht, the Netherlands; and Sandra Escher, a science journalist, who began this work after being challenged...

  • John Bowlby
    John Bowlby
    Edward John Mostyn "John" Bowlby was a British psychologist, psychiatrist and psychoanalyst, notable for his interest in child development and for his pioneering work in attachment theory.- Family background :...

     provides the theoretical platform on which the trauma model is built
  • Paraphrenia
    Paraphrenia
    Paraphrenia is described as a group of psychotic illnesses distinct from paranoia and from schizophrenia.. Paraphrenia as a separate disorder is not included in either ICD 10 or DSM IV and is likely to be classified as atypical psychosis, schizoaffective disorder or delusional disorder using these...

  • Psychohistorical views on infanticide
  • Refrigerator mother
    Refrigerator mother
    The term refrigerator mother was coined around 1950 as a label for mothers of children diagnosed with autism or schizophrenia. These mothers were often blamed for their children's atypical behavior, which included rigid rituals, speech difficulty, and self-isolation.The "refrigerator mother" label...

     - Psychogenic theory of autism

External links

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