Severe Trauma Quotes

Witty closing remarks have been replaced by massive head trauma and severe hemorrhaging.

The person who hurt you--who raped you or killed your family--is also here. If you are still angry at that person, if you haven't been able to forgive, you are chained to him. Everyone could feel the emotional truth of that: When someone offends you and you haven't let go, every time you see him, you grow breathless or your heart skips a beat. If the trauma was really severe, you dream of revenge. Above you, is the Mountain of Peace and Prosperity where we all want to go. But when you try to climb that hill, the person you haven't forgiven weighs you down. It's a personal choice whether or not to let go. No one can tell you how long to mourn a death or rage over a rape. But you can't move forward until you break that chain.

Although humans rarely die from trauma, if we do not resolve it, our lives can be severely diminished by its effects. Some people have even described this situation as a “living death.

I have met many, many severely distressed people whose daily lives are filled with the agony of both remembered and unremembered trauma, who try so hard to heal and yet who are constantly being pushed down both by their symptoms and the oppressive circumstances of post traumatic life around them.

The contrast with the scans of the eighteen chronic PTSD patients with severe early-life trauma was startling. There was almost no activation of any of the self-sensing areas of the brain: The MPFC, the anterior cingulate, the parietal cortex, and the insula did not light up at all; the only area that showed a slight activation was the posterior cingulate, which is responsible for basic orientation in space. There could be only one explanation for such results: In response to the trauma itself, and in coping with the dread that persisted long afterward, these patients had learned to shut down the brain areas that transmit the visceral feelings and emotions that accompany and define terror. Yet in everyday life, those same brain areas are responsible for registering the entire range of emotions and sensations that form the foundation of our self-awareness, our sense of who we are. What we witnessed here was a tragic adaptation: In an effort to shut off terrifying sensations, they also deadened their capacity to feel fully alive.

Trauma occurred when we consistently betrayed ourselves for love, were consistently treated in a way that made us feel unworthy or unacceptable resulting in a severed connection to our authentic Self. Trauma creates the fundamental belief that we must betray who we are in order to survive.

when children were hospitalized for treatment of severe burns, the development of PTSD could be predicted by how safe they felt with their mothers.31 The security of their attachment to their mothers predicted the amount of morphine that was required to control their pain—the more secure the attachment, the less painkiller was needed.

Marginalized peoples—excluded, minimized, shamed—are traumatized peoples, because as we’ve discussed, humans are fundamentally relational creatures. To be excluded or dehumanized in an organization, community, or society you are part of results in prolonged, uncontrollable stress that is sensitizing (see Figure 3). Marginalization is a fundamental trauma. This is why I believe that a truly trauma-informed system is an anti-racist system. The destructive effects of racial marginalizing are pervasive and severe.

Saskia groaned again. She threw back her bed covers, the last vestiges of sleep leaving her. It would be evening in Lyon. Clarissa would be expecting to hear from her. A call-in at least once every 24 hours was part of several protocols Clarissa had established. The instruction at the end of the conversation, “Give the dogs a pat for me”, reassured Clarissa that all was well. Leave the words out, replace any one of the words in the sentence with another or not place a call in a 24-hour period, and Clarissa would alert authorities. In her younger years, Clarissa had served in the British army. Her experiences in those years had caused the trauma she now lived with, though she used her expertise by teaching her three partners basic self-defence, how to operate firearms and how to wield weapons. She also programmed their watches and phones to enable her to constantly track their whereabouts, explaining, “I want to know that my three charges are safe”. Another protocol was to always check accommodation venues for listening devices. Saskia did this before calling Clarissa. “Clarissa. Ça va?” “What have you to report?

It makes perfect sense that if human beings are raised in warm, loving households; if they are brought up to believe that the world is a secure and decent place, then they will grow up with a healthy relationship toward themselves and other people. - able to give love freely and receive it in return. Conversely, if a person is severely mistreated from his earliest years, subjected to constant psychological and physical abuse, he or she will grow up with a malignant view of life. To such a person, the world is a hateful place where all human relationships are based, not on love and respect, but on power, suffering, and humiliation.

The primary driver to pathological dissociation is attachment disorganization in early life: when that is followed by severe and repeated trauma, then a major disorder of structural dissociation is created (Lyons-Ruth, Dutra, Schuder, & Bianchi, 2006).

The mental health system is filled with survivors of prolonged, repeated childhood trauma. This is true even though most people who have been abused in childhood never come to psychiatric attention. To the extent that these people recover, they do so on their own.[21] While only a small minority of survivors, usually those with the most severe abuse histories, eventually become psychiatric patients, many or even most psychiatric patients are survivors of childhood abuse.[22] The data on this point are beyond contention. On careful questioning, 50-60 percent of psychiatric inpatients and 40-60 percent of outpatients report childhood histories of physical or sexual abuse or both.[23] In one study of psychiatric emergency room patients, 70 percent had abuse histories.[24] Thus abuse in childhood appears to be one of the main factors that lead a person to seek psychiatric treatment as an adult.[25]

If however, a person is also afflicted by ongoing family abuse or profound emotional abandonment, the trauma will manifest as a particularly severe emotional flashback because he already has Cptsd. This is particularly true when his parent is also a bully.

Denying the reality of my experience—that was the most harmful. Not being able to trust anyone was the most serious effect. . . . I know I acted in ways that were despicable. But I wasn’t crazy. Some people go around acting like that because they feel hopeless. Finally I found a few people along the way who have been able to feel OK about me even though I had severe problems. Good therapists were those who really validated my experience.

Whether we are speaking of a flower or an oak tree, of an earthworm or a beautiful bird, of an ape or a person, we will do well, I believe, to recognize that life is an active process, not a passive one. Whether the stimulus arises from within or without, whether the environment is favorable or unfavorable, the behaviors of an organism can be counted on to be in the direction of maintaining, enhancing, and reproducing itself. This is the very nature of the process we call life. This tendency is operative at all times. Indeed, only the presence or absence of this total directional process enables us to tell whether a given organism is alive or dead. The actualizing tendency can, of course, be thwarted or warped, but it cannot be destroyed without destroying the organism. I remember that in my boyhood, the bin in which we stored our winter's supply of potatoes was in the basement, several feet below a small window. The conditions were unfavorable, but the potatoes would begin to sprout—pale white sprouts, so unlike the healthy green shoots they sent up when planted in the soil in the spring. But these sad, spindly sprouts would grow 2 or 3 feet in length as they reached toward the distant light of the window. The sprouts were, in their bizarre, futile growth, a sort of desperate expression of the directional tendency I have been describing. They would never become plants, never mature, never fulfill their real potential. But under the most adverse circumstances, they were striving to become. Life would not give up, even if it could not flourish. In dealing with clients whose lives have been terribly warped, in working with men and women on the back wards of state hospitals, I often think of those potato sprouts. So unfavorable have been the conditions in which these people have developed that their lives often seem abnormal, twisted, scarcely human. Yet, the directional tendency in them can be trusted. The clue to understanding their behavior is that they are striving, in the only ways that they perceive as available to them, to move toward growth, toward becoming. To healthy persons, the results may seem bizarre and futile, but they are life's desperate attempt to become itself. This potent constructive tendency is an underlying basis of the person-centered approach.

It's a shame I'm going to be forced to commit severe testicular trauma upon that boy

…is methodical abuse, often using indoctrination, aimed at breaking the will of another human being. In a 1989 report, the Ritual Abuse Task Force of the L.A. County Commission for Women defined ritual abuse as: “Ritual Abuse usually involves repeated abuse over an extended period of time. The physical abuse is severe, sometimes including torture and killing. The sexual abuse is usually painful,humiliating, intended as a means of gaining dominance over the victim.The psychological abuse is devastating and involves the use of ritual indoctrination. It includes mind control techniques which convey to the victim a profound terror of the cult members …most victims are in a state of terror, mind control and dissociation” (Pg. 35-36)

I must have wondered if the police were right, if the entire story was a figment of my imagination. This is the worst impact of severe trauma: the victim loses faith in the evidence of her own senses. And this is the great gift Paul Macone gave to me. He believed what I told the police back then. He believed me enough to try to solve the case, and he did. Perhaps because I've sought out evil in this world, attempting to understand and tame it, I am particularly moved by goodness. There is a light that animates an act of generosity, when a person is kind - not to call attention to his own goodness, or to make a pact with God, but just because he feels it's right. I see this light in Paul Macone. Still, his kindness is almost too much to bear. I feel shy around him, despite this conversation. I even feel shy writing this down.

Abandonment is at the core of addictions. Abandonment causes deep shame. Abandonment by betrayal is worse than mindless neglect. Betrayal is purposeful and self-serving. If severe enough, it is traumatic. What moves betrayal into the realm of trauma is fear and terror. If the wound is deep enough, and the terror big enough, your bodily systems shift to an alarm state. You never feel safe. You’re always on full-alert, just waiting for the hurt to begin again. In that state of readiness, you’re unaware that part of you has died. You are grieving. Like everyone who has loss, you have shock and disbelief, fear, loneliness and sadness. Yet you are unaware of these feelings because your guard is up. In your readiness, you abandon yourself. Yes, another abandonment.

Some may not believe my account; they may think it was some kind of wish fulfillment during a point of severe trauma. I don't have to defend my experience. I know what happened to me. For those of us whose faith is in the reality of heaven, no amount of evidence is necessary.

Early traumatization is a major risk factor for more severe symptoms that persist over time. Thus childhood traumatization plays a central role in the development of trauma-related disorders in children and adults.

People with Complex PTSD suffer from more severe and frequent dissociation symptoms, as well as memory and attention problems, than those with simple PTSD. In addition to amnesia due to the activity of various parts of the self, people may experience difficulties with concentration, attention, other memory problems and general spaciness. These symptoms often accompany dissociation of the personality, but they are also common in people who do not have dissociative disorders. For example everyone can be spacey, absorbed in an activity, or miss an exit on the highway. When various parts of the personality are active, by definition, a person experiences some kind of abrupt change in attention and consciousness.

Research has demonstrated that severe and long-lasting stress, as well as depression and anger, cause the body to produce chemicals which block healing (both psychological and physical) and even reduce life expectancy.

In order to stay healthy, our nervous systems and psyches need to face challenges and to succeed in meeting those challenges. When this need is not met, or when we are challenged and cannot triumph, we end up lacking vitality and are unable to fully engage in life. Those of us who have been defeated by war, abuse, accidents, and other traumatic events suffer far more severe consequences.

Cheryl's growing awareness of her emotional difficulties was leading her to research multiple personality. As she had learned more about dissociation, she realised just how severe the abuse had been and how much she had been hurt. Her mind had dissociated to assure survival during the abuse by her father and it had been forced to dissociate by various researchers in government programmes.

Dr. Strange: 'That was--agh--smart of you, Logan.' Wolverine: 'Yeah? Which part?' Dr. Strange: 'You knew that severe physical trauma to the host body could--sss--cease a demonic possession.' Wolverine: 'Oh, uh, sure.' Spider-Man: 'He didn't know that. He stabbed you just to stab you.' Dr. Strange: 'Well, *argh* either way.

Most dissociative parts influence your experience from the inside rather than exert complete control, that is, through passive influence. * In fact, many parts never take complete control of a person, but are only experienced internally. * Frequent switching may be a sign of severe stress and inner conflict in most individuals.

This is why people who have experienced severe abuse and trauma often have difficulty explaining their experiences. They have a problem because clinicians, friends, and family often don’t have the concept of an immobilization defensive system in their vocabulary.

Each human being deals with hurt or resentment in a unique way. When you feel insulted or bullied, you may reach for a chocolate bar. In the same circumstance, I might burst into tears. Another person may put his or her feelings quickly into words, confronting the mistreatment directly. Although our feelings can influence how we wish to act, our choices of how to behave are ultimately determined more by our attitudes and our habits. We respond to our emotional wounds based on what we believe about ourselves, how we think about the person who has hurt us, and how we perceive the world. Only in people who are severely traumatized or who have major mental illnesses is behavior governed by feelings. And only a tiny percentage of abusive men have these kinds of severe psychological problems.

Victim-stancing - whereby the offender claims and believes that s/he is the real victim (one of the most prevalent sophistries in the false memory controversies)

I thought it obvious that she had suffered a severe trauma surrounding Gabriel’s death; and this silence was a manifestation of that trauma.

The term dissociation is ordinarily used to describe the phenomenon of compartmentalization or fragmentation of mental contents. It does not ascribe any particular mechanism by which the dissociative process occurs. Does dissociation occur as a result of automatic, nonconscious processes, or are there other specific mechanisms by which it occurs? Especially in the context of describing amnesia, the term repression is widely used in connection with several different mechanisms. As it is commonly used, it often implies how individuals may block our memories of uncomfortable or conflictual experiences. If done consciously, the mechanism is more accurately called suppression, which results from actively trying not to think about negative experiences.

Several psychologists (L. Armstrong, 1994; Enns, McNeilly, Corkery, & Gilbert, 1995; Herman, 1992; McFarlane & van der Kolk, 1996; Pope & Brown, 1996) contend that the controversy of delayed recall for traumatic events is likely to be influenced by sexism. Kristiansen, Gareau, Mittleholt, DeCourville, and Hovdestad (1995) found that people who were more authoritarian and who had less favorable attitudes toward women were less likely to believe in the veracity of women’s recovered memories for sexual abuse. Those who challenged the truthfulness of recovered memories were more likely to endorse negative statements about women, including the idea that battered women enjoy being abused. McFarlane and van der Kolk (1996) have noted that delayed recall in male combat veterans reported by Myers (1940) and Kardiner (1941) did not generate controversy, whereas delayed recall in female survivors of intrafamilial child sexual abuse has provoked considerable debate.

Other personalities are created to handle new traumas, their existence usually occurring one at a time. Each has a singular purpose and is totally focused on that task. The important aspect of the mind's extreme dissociation is that each ego state is totally without knowledge of the other. Because of this, the researchers for the CIA and the Department of Defense believed they could take a personality, train him or her to be a killer and no other ego stares would be aware of the violence that was taking place. The personality running the body would be genuinely unaware of the deaths another personality was causing. Even torture could not expose the with, because the personality experiencing the torture would have no awareness of the information being sought. Earlier, such knowledge was gained from therapists working with adults who had multiple personalities. The earliest pioneers in the field, such as Dr. Ralph Alison, a psychiatrist then living in Santa Cruz, California, were helping victims of severe early childhood trauma. Because there were no protocols for treatment, the pioneers made careful notes, publishing their discoveries so other therapists would understand how to help these rare cases. By 1965, the information was fairly extensive, including the knowledge that only unusually intelligent children become multiple personalities and that sexual trauma endured by a restrained child under the age of seven is the most common way to induce hysteric dissociation.

Years ago, I told myself that one day I would stop feeling this quiet but abiding rage about the things I have been through at the hands of others. I would wake up and there would be no flashbacks. I wouldn't wake up and think about my histories of violence. I wouldn't smell the yeasty aroma of beer and for a second, for several minutes, for hours, forget where I was. And on and on and on. That day never came, or it hasn't come, and I am no longer waiting for it. A different day has come, though. I flinch less and less when I am touched. I don't always see gentleness as the calm before the storm because, more often than not, I can trust that no storm is coming. I harbor less hatred toward myself. I try to forgive myself for my trespasses.

In my view, the spurning of DID is highly connected with knowing and not knowing about child sexual abuse. Side by side with denial of childhood trauma and of severe dissociation, is an unmistakable cognizance of dissociative processes as they are embedded in our language. We regularly say things such as, "pull yourself together", "he is coming unglued", "she was beside herself", "don't fall apart", "he's not all there", "she was shattered", and so on.

It is my contention that by its very nature our social and economic culture generates chronic stressors that undermine well-being in the most serious of ways, as they have done with increasing force over the past several decades.

Dissociation is the ultimate form of human response to chronic developmental stress, because patients with dissociative disorders report the highest frequency of childhood abuse and/or neglect among all psychiatric disorders. The cardinal feature of dissociation is a disruption in one or more mental functions. Dissociative amnesia, depersonalization, derealization, identity confusion, and identity alterations are core phenomena of dissociative psychopathology which constitute a single dimension characterized by a spectrum of severity. Clinical Psychopharmacology and Neuroscience 2014 Dec; 12(3): 171-179 The Many Faces of Dissociation: Opportunities for Innovative Research in Psychiatry

This vacillation between assertion and denial in discussions about organised abuse can be understood as functional, in that it serves to contain the traumatic kernel at the heart of allegations of organised abuse. In his influential ‘just world’ theory, Lerner (1980) argued that emotional wellbeing is predicated on the assumption that the world is an orderly, predictable and just place in which people get what they deserve. Whilst such assumptions are objectively false, Lerner argued that individuals have considerable investment in maintaining them since they are conducive to feelings of self—efficacy and trust in others. When they encounter evidence contradicting the view that the world is just, individuals are motivated to defend this belief either by helping the victim (and thus restoring a sense of justice) or by persuading themselves that no injustice has occurred. Lerner (1980) focused on the ways in which the ‘just world’ fallacy motivates victim-blaming, but there are other defences available to bystanders who seek to dispel troubling knowledge. Organised abuse highlights the severity of sexual violence in the lives of some children and the desire of some adults to inflict considerable, and sometimes irreversible, harm upon the powerless. Such knowledge is so toxic to common presumptions about the orderly nature of society, and the generally benevolent motivations of others, that it seems as though a defensive scaffold of disbelief, minimisation and scorn has been erected to inhibit a full understanding of organised abuse. Despite these efforts, there has been a recent resurgence of interest in organised abuse and particularly ritualistic abuse (eg Sachs and Galton 2008, Epstein et al. 2011, Miller 2012).

A healthy heart doesn’t pump at the same rate all the time. That would actually be a really unhealthy heart. The healthiest hearts are adaptable, and the quicker they adapt, the better. When you start running, your heart should ideally speed up quickly. Then, when you rest, it should slow down quickly. It’s the same for your emotions. When something really tragic happens, it would be weird if you were still happy, right? Or if you just sat there with no reaction. When something tragic happens, you should be there with that pain, feeling that sadness. When something unjust happens, you should feel how aggravating it is. And then, after you’ve sat with those feelings for the appropriate amount of time—and it could be an hour, or a day, or months, depending on the severity of what happened—then, you can go back to a state of rest. Or joy. Or whatever. Being healed isn’t about feeling nothing. Being healed is about feeling the appropriate emotions at the appropriate times and still being able to come back to yourself. That’s just life.

Besides stage magic props and settings, ritually abusing groups use technology, such as that described by Katz and Fotheringham. Military/political groups have the most sophisticated technologies, and much training or programming is now done with virtual reality equipment. Movies and holograms are used to deceive a child into believing in things that are unreal. When a client says to you “I don't know if it's real; how can it be real?” remember that there are several options, not just two: (1) It happened just as s/he remembers; (2) it did not happen at all; (3) something happened, but due to technology and/or trickery it was not what s/he thinks it was; (4) the thought that the memory must be unreal is itself a program, as described in Chapter Twelve, “Maybe I made it up." p55

Cheryl was aided in her search by the Internet. Each time she remembered a name that seemed to be important in her life, she tried to look up that person on the World Wide Web. The names and pictures Cheryl found were at once familiar and yet not part of her conscious memory: Dr. Sidney Gottlieb, Dr. Louis 'Jolly' West, Dr. Ewen Cameron, Dr. Martin Orne and others had information by and about them on the Web. Soon, she began looking up sites related to childhood incest and found that some of the survivor sites mentioned the same names, though in the context of experiments performed on small children. Again, some names were familiar. Then Cheryl began remembering what turned out to be triggers from old programmes. 'The song, "The Green, Green Grass of home" kept running through my mind. I remembered that my father sang it as well. It all made no sense until I remembered that the last line of the song tells of being buried six feet under that green, green grass. Suddenly, it came to me that this was a suicide programme of the government. 'I went crazy. I felt that my body would explode unless I released some of the pressure I felt within, so I grabbed a [pair ofl scissors and cut myself with the blade so I bled. In my distracted state, I was certain that the bleeding would let the pressure out. I didn't know Lynn had felt the same way years earlier. I just knew I had to do it Cheryl says. She had some barbiturates and other medicine in the house. 'One particularly despondent night, I took several pills. It wasn't exactly a suicide try, though the pills could have killed me. Instead, I kept thinking that I would give myself a fifty-fifty chance of waking up the next morning. Maybe the pills would kill me. Maybe the dose would not be lethal. It was all up to God. I began taking pills each night. Each-morning I kept awakening.

Dissociative Identity Disorder is borne out of trauma. Many individuals who survive severe trauma will later experience marked anxiety, which may or may not relate to triggers from the original trauma. Individuals with DID are highly likely to have a great deal of anxiety.

Severe early childhood trauma creates a child with equally intense coping mechanisms—these children are often seen as “mature for their age” and “old souls.” While maybe true, it often negates the fact that their innocence was taken away at an early age and they are in survival mode. —Azia Archer

People bearing trauma’s scars almost uniformly develop a shame-based view of themselves at the core, a negative self-perception most of them are all too conscious of. Among the most poisonous consequences of shame is the loss of compassion for oneself. The more severe the trauma, the more total that loss.

In 1973, Jan Erik Olsson walked into a small bank in Stockholm, Sweden, brandishing a gun, wounding a police officer, and taking three women and one man hostage. During negotiations, Olsson demanded money, a getaway vehicle, and that his friend Clark Olofsson, a man with a long criminal history, be brought to the bank. The police allowed Olofsson to join his friend and together they held the four hostages captive in a bank vault for six days. During their captivity, the hostages at times were attached to snare traps around their necks, likely to kill them in the event that the police attempted to storm the bank. The hostages grew increasingly afraid and hostile toward the authorities trying to win their release and even actively resisted various rescue attempts. Afterward they refused to testify against their captors, and several continued to stay in contact with the hostage takers, who were sent to prison. Their resistance to outside help and their loyalty toward their captors was puzzling, and psychologists began to study the phenomenon in this and other hostage situations. The expression of positive feelings toward the captor and negative feelings toward those on the outside trying to win their release became known as Stockholm syndrome.

The first time I heard Robert Anda present the results of the ACE study, he could not hold back his tears. In his career at the CDC he had previously worked in several major risk areas, including tobacco research and cardiovascular health. But when the ACE study data started to appear on his computer screen, he realized that they had stumbled upon the gravest and most costly public health issue in the United States: child abuse. He had calculated that its overall costs exceeded those of cancer or heart disease and that eradicating child abuse in America would reduce the overall rate of depression by more than half, alcoholism by two-thirds, and suicide, IV drug use, and domestic violence by three-quarters. 20 It would also have a dramatic effect on workplace performance and vastly decrease the need for incarceration.

Deprivation and attachment difficulties signal the baby’s brain and nervous system to implement life-protecting strategies. Depending on the severity and the duration of the nurturing disruptions, there is a progressive loss of the ability to attune to and express one’s needs. Along with the loss of attunement comes increasing autonomic dysregulation:

Although I do not mean to imply that all of these children will be severely “damaged” by these experiences, the most moderate estimates suggest that at any given time, more than eight million American children suffer from serious, diagnosable, trauma-related psychiatric problems. Millions more experience less serious but still distressing consequences.

The findings indicate that having higher levels of PTSD symptoms, such as being easily startled by ordinary noises or avoiding reminders of the traumatic experience, can be associated with increased risks of ovarian cancer even decades after women experience a traumatic event.” The more severe the trauma symptoms, the more aggressive the cancer proved to be.

Multiple personality usually develops in the presence of severe and repeated trauma, beginning at a very early age, when the personality is developing.

Trauma-related structural dissociation should be distinguished from more ubiquitous phenomena that are often termed dissociation, but likely have a different underlying process. Over the past several decades the original meaning of dissociation has been quite extended by the addition of other phenomena not typically considered to be dissociative. These include alterations in consciousness such as absorption, daydreaming, imaginative involvement, altered time sense, trance-like behavior, and “highway hypnosis” (e.g., Bernstein & Putnam, 1986).

The person who suffers from a severe trauma disorder must decide between surviving in a barely sublethal misery of numbness and frustration, and taking a chance that may well bring her a better life, but that feels like stupidly issuing an open invitation to the unspeakable horror that waits to consume her alive. And in the manner of the true hero, she must choose to take the risk. For

With this understanding of love’s meaning it is clear that more often than not slavery made it all but impossible for black people to love one another. When emotional ties were established between individuals, when children were born to enslaved mothers and fathers, these attachments were often severed. No matter the tenderness of connection, it was often overshadowed by the trauma of abandonment and loss.

Within the mental-health system in North America, the borderline victim of severe childhood trauma is usually blamed for her behaviour, which is regarded as having no legitimate basis and being self-indulgent; her trauma history is ignored and not talked about; and she is given as little treatment and follow-up as possible. At St Boniface Hospital in Winnipeg, many staff members expressed the opinion, in my presence, that borderlines and multiple personality disorder patients did not have a legitimate right to in-patient treatment, and the out-patient department would not accept patients with either diagnosis. (1995)

The only one of the early investigators who carried the exploration of hysteria to its logical conclusion was Breuer's patient Anna O. After Breuer abandoned her, she apparently remained ill for several years. And then she recovered. The mute hysteric who had invented the "talking cure" found her voice and her sanity, in the women's liberation movement. Under a pseudonym, Paul Berthold, she translated into German the classic treatise by Mary Wollstonecraft, A Vindication of the Rights of Women, and authored a play, Women's Rights. Under her own name, Bertha Papenheim became a prominent feminist social worker, intellectual, and organizer. In the course of a long and fruitful career she directed an orphanage for girls, founded a feminist organization for Jewish women and traveled throughout Europe and the Middle East to campaign against the sexual exploitation of women and children. Her dedication, energy and commitment were legendary. In the words of a colleague, 'A volcano lived in this woman... Her fight against the abuse of women and children was almost a physically felt pain for her.' At her death, the philosopher Martin Buber commemorated her: 'I not only admired her but loved her, and will love her until the day I die. There are people of spirit and there are people of passion, both less common than one might think. Rarer still are the people of spirit and passion. But rarest of all is a passionate spirit. Bertha Pappenheim was a woman with just such a spirit.

After administering several courses of electric shock, the researchers opened the doors of the cages and then shocked the dogs again. A group of control dogs who had never been shocked before immediately ran away, but the dogs who had earlier been subjected to inescapable shock made no attempt to flee, even when the door was wide open—they just lay there, whimpering and defecating. The mere opportunity to escape does not necessarily make traumatized animals, or people, take the road to freedom. Like Maier and Seligman’s dogs, many traumatized people simply give up. Rather than risk experimenting with new options they stay stuck in the fear they know.

The programme into which Cheryl was inducted combined all the different ways the intelligence community had learned could cause intense psychological change in adults and children. It had been learned through the use of both knowledgeable and 'unwitting' volunteers. They were subjected to sensory overload, isolation, drugs and hypnosis, all used on bodies that had been weakened from mild hunger. The horror of the programme was that it would be like having an elementary school sex education class conducted by a paedophile rapist. It would have been banned had the American government signed the Helsinki Accords. But, of course, they hadn't. For the test that day and in those that followed, Cheryl Hersha was positioned so she faced a portable movie screen. A 16mm movie projector was on a platform, along with several reels of film. Each was a short pornographic film meant to make her aware of sexuality in a variety of forms...

Jane snorted out in disgust. "Okay, the good news is spotting the saurus just got a hell of a lot easier. Plus we've got a ton of free bait." "The bad news?" Taggart asked. "Smart boy. Cookie for knowing that there's bad news." Jane eased her SUV across the worn divided line to drive along the berm. "Bad news, Pittsburgh beef cows are the meanest son-of-abitches." "So, we have to dodge several tons of pissed off sirloin while filming one hungry dinosaur?" "Welcome to Pittsburgh.

a counselor interrupted his meeting with faculty down the hall. "Frank, they need you," he said. "You need to go out there." Frank walked the hallway to the nave of the church, contemplating what to say. And again he faced the dilemma of how to act at the microphone. Several of his friends, and staff, too, had warned him not to cry again. "God, you're going to be in the national media," they said. "You can't show that, it's a sign of weakness." He had gotten away with it once, but the media would crucify him if they discovered he was buckling. The trauma specialists disagreed. These kids had been raised in a western mentality, they argued: real men fend for themselves; tears are for weaklings; therapy is a joke. "Frank, you are the key," one counselor advised him. "You're an emotional person, you need to show those emotions. If you try to hold your emotions inside, you're going to set the image for other people." The boys, in particular, would be watching him. DeAngelis felt. They were already dangerously bottled up. "Frank, they need to know it's all right to show emotion," the counselor said. "Give them that permission."... "I walked on that stage and I saw those kids cheering and the tears started coming down." This time he decided to address the tears. "Guys, trust me, now is not the time to show your manliness," he told them. "Emotion is emotion, and keeping it inside doesn't mean you're strong." That was the last time Mr. D worried about crying in public. p117-18

Secondary structural dissociation involves one ANP and more than one EP. Examples of secondary structural dissociation are complex PTSD, complex forms of acute stress disorder, complex dissociative amnesia, complex somatoform disorders, some forms of trauma-relayed personality disorders, such as borderline personality disorder, and dissociative disorder not otherwise specified (DDNOS).. Secondary structural dissociation is characterized by divideness of two or more defensive subsystems. For example, there may be different EPs that are devoted to flight, fight or freeze, total submission, and so on. (Van der Hart et al., 2004). Gail, a patient of mine, does not have a personality disorder, but describes herself as a "changed person." She survived a horrific car accident that killed several others, and in which she was the driver. Someone not knowing her history might see her as a relatively normal, somewhat anxious and stiff person (ANP). It would not occur to this observer that only a year before, Gail had been a different person: fun-loving, spontaneous, flexible, and untroubled by frightening nightmares and constant anxiety. Fortunately, Gail has been willing to pay attention to her EPs; she has been able to put the process of integration in motion; and she has been able to heal. p134

Looking at your own experience of abuse, many factors can influence the degree of traumatic impact you experience. Howe we handle stress in our lives varies; some of us have learned better coping strategies than others. The severity, intensity, frequency, and length of time the abusive episodes have lasted all strongly impact your response as well. Other powerful influences include the length of time your personal traumatic reaction lasts after your partner's abuse stops and your history, before you ever met your partner.

Cptsd is a more severe form of Post-traumatic stress disorder. It is delineated from this better known trauma syndrome by five of its most common and troublesome features: emotional flashbacks, toxic shame, self-abandonment, a vicious inner critic and social anxiety.

Extreme versions of DID occasionally develop in response to particularly horrific ongoing trauma (e.g., children exploited through involvement in years of forced prostitution), with so-called poly-frgamentation, encompassing dozens or even hundreds of personality states. In general, the complexity of dissociative symptoms appears to be consistent with the severity of early traumatiation. That is, less severe abuse will result in fewer dissociative symptoms, and more severe abuse will result in more complex dissociative disorders.

Some readers may find it a curious or even unscientific endeavour to craft a criminological model of organised abuse based on the testimony of survivors. One of the standard objections to qualitative research is that participants may lie or fantasise in interview, it has been suggested that adults who report severe child sexual abuse are particularly prone to such confabulation. Whilst all forms of research, whether qualitative or quantitative, may be impacted upon by memory error or false reporting. there is no evidence that qualitative research is particularly vulnerable to this, nor is there any evidence that a fantasy— or lie—prone individual would be particularly likely to volunteer for research into child sexual abuse. Research has consistently found that child abuse histories, including severe and sadistic abuse, are accurate and can be corroborated (Ross 2009, Otnow et al. 1997, Chu et al. 1999). Survivors of child abuse may struggle with amnesia and other forms of memory disturbance but the notion that they are particularly prone to suggestion and confabulation has yet to find a scientific basis. It is interesting to note that questions about the veracity of eyewitness evidence appear to be asked far more frequently in relation to sexual abuse and rape than in relation to other crimes. The research on which this book is based has been conducted with an ethical commitment to taking the lives and voices of survivors of organised abuse seriously.

certain incidents do more than just touch our raw spots or “hurt our feelings.” They injure us so deeply that they overturn our world. They are relationship traumas. In the dictionary a trauma is defined as a wound that plunges us into fear and helplessness, that challenges all our assumptions of predictability and control. Traumatic wounds are especially severe, observes Judith Herman, professor of psychiatry at Harvard Medical School, when they involve a “violation of human connection.” Indeed, there is no greater trauma than to be wounded by the very people we count on to support and protect us.

Metin Basoglu, a psychiatrist and trauma researcher, studied the psychological effects of torture on political POWs and war survivors from Yugoslavia and Turkey by comparing continuous versus intermittent torture. His findings showed that torture with breaks between abuses induced more severe psychological effects than continuous torture. Victims of intermittent torture had higher rates of depression, anxiety, and PTSD. The unpredictability and anticipation of more abuse heightened stress and anxiety, which then caused "learned helplessness," making victims feel powerless and passive over time. This increased compliance because resistance seemed futile." - p. 215

Childhood adversity increases depression risk via "second hit" scenarios - lowering thresholds so that adult stressors that people typically manage instead trigger depressive episodes. This vulnerability makes sense. Depression is fundamentally a pathological sense of loss of control (explaining the classic description of depression as "learned helplessness"). If a child experiences severe, uncontrollable adversity, the most fortunate conclusion in adulthood is "Those were terrible circumstances over which I had no control." But when childhood traumas produce depression, there is cognitively distorted overgeneralizations: "And life will always be uncontrollably awful.

CONSENSUS PROPOSED CRITERIA FOR DEVELOPMENTAL TRAUMA DISORDER A. Exposure. The child or adolescent has experienced or witnessed multiple or prolonged adverse events over a period of at least one year beginning in childhood or early adolescence, including: A. 1. Direct experience or witnessing of repeated and severe episodes of interpersonal violence; and A. 2. Significant disruptions of protective caregiving as the result of repeated changes in primary caregiver; repeated separation from the primary caregiver; or exposure to severe and persistent emotional abuse B. Affective and Physiological Dysregulation. The child exhibits impaired normative developmental competencies related to arousal regulation, including at least two of the following: B. 1. Inability to modulate, tolerate, or recover from extreme affect states (e.g., fear, anger, shame), including prolonged and extreme tantrums, or immobilization B. 2. Disturbances in regulation in bodily functions (e.g. persistent disturbances in sleeping, eating, and elimination; over-reactivity or under-reactivity to touch and sounds; disorganization during routine transitions) B. 3. Diminished awareness/dissociation of sensations, emotions and bodily states B. 4. Impaired capacity to describe emotions or bodily states C. Attentional and Behavioral Dysregulation: The child exhibits impaired normative developmental competencies related to sustained attention, learning, or coping with stress, including at least three of the following: C. 1. Preoccupation with threat, or impaired capacity to perceive threat, including misreading of safety and danger cues C. 2. Impaired capacity for self-protection, including extreme risk-taking or thrill-seeking C. 3. Maladaptive attempts at self-soothing (e.g., rocking and other rhythmical movements, compulsive masturbation) C. 4. Habitual (intentional or automatic) or reactive self-harm C. 5. Inability to initiate or sustain goal-directed behavior D. Self and Relational Dysregulation. The child exhibits impaired normative developmental competencies in their sense of personal identity and involvement in relationships, including at least three of the following: D. 1. Intense preoccupation with safety of the caregiver or other loved ones (including precocious caregiving) or difficulty tolerating reunion with them after separation D. 2. Persistent negative sense of self, including self-loathing, helplessness, worthlessness, ineffectiveness, or defectiveness D. 3. Extreme and persistent distrust, defiance or lack of reciprocal behavior in close relationships with adults or peers D. 4. Reactive physical or verbal aggression toward peers, caregivers, or other adults D. 5. Inappropriate (excessive or promiscuous) attempts to get intimate contact (including but not limited to sexual or physical intimacy) or excessive reliance on peers or adults for safety and reassurance D. 6. Impaired capacity to regulate empathic arousal as evidenced by lack of empathy for, or intolerance of, expressions of distress of others, or excessive responsiveness to the distress of others E. Posttraumatic Spectrum Symptoms. The child exhibits at least one symptom in at least two of the three PTSD symptom clusters B, C, & D. F. Duration of disturbance (symptoms in DTD Criteria B, C, D, and E) at least 6 months. G. Functional Impairment. The disturbance causes clinically significant distress or impairment in at least two of the following areas of functioning: Scholastic Familial Peer Group Legal Health Vocational (for youth involved in, seeking or referred for employment, volunteer work or job training)

It is important to recognize that the narcissist constructs a false, dark alternate reality in which he hands over his pathology to you. You will be labeled the crazy, oversensitive person throughout the relationship even while enduring mind-blowing verbal and emotional attacks from your abuser. The abuser enjoys employing gaslighting and projection techniques to essentially rewrite the history of abuse in the relationship and misplace all blame onto you. Since you are prone to cognitive dissonance, you will often start to blame yourself for the abuse and seek to deny or minimize the severity of the trauma you’re experiencing in an effort to survive and cope with the fact that the person you love and care for is a pathological abuser.

The reason for entering the struggle is a desire for more; a taste of what life and love could be if freed from the dark memories and deep shame. No one leaves the lethargy of denial unless there is a spark of discontent that pierces the darkness of daily numbness. To live significantly less than what one was made to be is as severe a betrayal of the soul as the original abuse.

What, in fact, do we know about the peak experience? Well, to begin with, we know one thing that puts us several steps ahead of the most penetrating thinkers of the 19th century: that P.E’.s are not a matter of pure good luck or grace. They don’t come and go as they please, leaving ‘this dim, vast vale of tears vacant and desolate’. Like rainbows, peak experiences are governed by definite laws. They are ‘intentional’. And that statement suddenly gains in significance when we remember Thorndike’s discovery that the effect of positive stimuli is far more powerful and far reaching than that of negative stimuli. His first statement of the law of effect was simply that situations that elicit positive reactions tend to produce continuance of positive reactions, while situations that elicit negative or avoidance reactions tend to produce continuance of these. It was later that he came to realise that positive reactions build-up stronger response patterns than negative ones. In other words, positive responses are more intentional than negative ones. Which is another way of saying that if you want a positive reaction (or a peak experience), your best chance of obtaining it is by putting yourself into an active, purposive frame of mind. The opposite of the peak experience—sudden depression, fatigue, even the ‘panic fear’ that swept William James to the edge of insanity—is the outcome of passivity. This cannot be overemphasised. Depression—or neurosis—need not have a positive cause (childhood traumas, etc.). It is the natural outcome of negative passivity. The peak experience is the outcome of an intentional attitude. ‘Feedback’ from my activities depends upon the degree of deliberately calculated purpose I put into them, not upon some occult law connected with the activity itself. . . . A healthy, perfectly adjusted human being would slide smoothly into gear, perform whatever has to be done with perfect economy of energy, then recover lost energy in a state of serene relaxation. Most human beings are not healthy or well adjusted. Their activity is full of strain and nervous tension, and their relaxation hovers on the edge of anxiety. They fail to put enough effort—enough seriousness—into their activity, and they fail to withdraw enough effort from their relaxation. Moods of serenity descend upon them—if at all—by chance; perhaps after some crisis, or in peaceful surroundings with pleasant associations. Their main trouble is that they have no idea of what can be achieved by a certain kind of mental effort. And this is perhaps the place to point out that although mystical contemplation is as old as religion, it is only in the past two centuries that it has played a major role in European culture. It was the group of writers we call the romantics who discovered that a man contemplating a waterfall or a mountain peak can suddenly feel ‘godlike’, as if the soul had expanded. The world is seen from a ‘bird’s eye view’ instead of a worm’s eye view: there is a sense of power, detachment, serenity. The romantics—Blake, Wordsworth, Byron, Goethe, Schiller—were the first to raise the question of whether there are ‘higher ceilings of human nature’. But, lacking the concepts for analysing the problem, they left it unsolved. And the romantics in general accepted that the ‘godlike moments’ cannot be sustained, and certainly cannot be re-created at will. This produced the climate of despair that has continued down to our own time. (The major writers of the 20th century—Proust, Eliot, Joyce, Musil—are direct descendants of the romantics, as Edmund Wilson pointed out in Axel’s Castle.) Thus it can be seen that Maslow’s importance extends far beyond the field of psychology. William James had asserted that ‘mystical’ experiences are not mystical at all, but are a perfectly normal potential of human consciousness; but there is no mention of such experiences in Principles of Psychology (or only in passing).

Men as Victims: Challenging Cultural Myths Judith Herman’s recent treatise on “complex PTSD" (Herman, 1992) is an extremely articulate and compelling analysis of some of the failings of the current PTSD diagnosis, and of some of the psychological legacies of prolonged, repeated trauma. However, there was one aspect of the article which concerned me and which I wish to address. Throughout the article, "Complex PTSD: A Syndrome in Survivors of Prolonged and Repeated Trauma," whenever reference is made by pronoun to perpetrators or "captors," the pronoun "he" or "him' is used. There are four such references. Whenever reference is made by pronoun to victims or survivors, the pronoun "her" or "she" is used. There are 11 such references. This is not simply an issue of the use of sexist language, which it is. By uniformly linking perpetration with males and victimhood with females, a misconception is perpetuated, one that is shared by the public and by mental health professionals. While there is evidence that most perpetrators of sexual abuse are male, and that there are more female victims of sexual abuse than male victims, it is not true that all perpetrators are male and all victims are female. In fact, in the article, some of the traumas from which Dr. Herman was deriving her argument—political torture, concentration camp survivors, for example—affect as many males as females. Even in the case of sexual abuse, there is increasing evidence that the sexual abuse of males is far more prevalent than has heretofore been believed. Research on male sexual victimization lags more than a decade behind that of female victimization, but several recent studies have reported prevalence rates near or above 20% (Finkelhor et at, 1990; Urquiza, 1988, cited in Urquiza and Keating, 1990; Lisak and Luster, 1992).

Since we began with a felt sense of safety this day, several neural streams are initially supporting the renewal of our connection. In our midbrain, the energies of the SEEKING system are animating the CARE system, which can both foster the good feelings between us and support offers of repair should we have a rupture (Panksepp & Biven, 2012). Once in connection, our ventral vagal parasympathetic system is affecting the prosody of our voices, our facial mobility, and the attentiveness of our listening, maintaining social engagement (Porges, 2011). Since ventral lateralizes to the right hemisphere, we more easily stay rooted in the right-centric way of attending that keeps us in connection with this moment and with each other (McGilchrist, 2009). In this intimacy, our brains are coupling in many regions, so there is an experience of social emotional engagement and embodied communication as we become a single system in two bodies (Hasson, 2010). Because we are trustworthy partners in this healing process, social baseline theory tells us that our amygdalae are calming just because we are together (Beckes & Coan, 2011). All of this is happening without doing anything, even without saying anything, in microseconds below conscious awareness because of the safe space we have cultivated over time. We can more clearly understand why Porges says, "Safety IS the treatment".

Northern European societies are among the few where people sleep alone or with a partner in a private room, and that may have significant implications for mental health in general and for PTSD in particular. Virtually all mammals seem to benefit from companionship; even lab rats recover more quickly from trauma if they are caged with other rats rather than alone. In humans, lack of social support has been found to be twice as reliable at predicting PTSD as the severity of the trauma itself.

In other words, traumatic experiences aren’t always obvious. Our perception of the trauma is just as valid as the trauma itself. This is especially true in childhood, when we are most helpless and dependent. Trauma occurred when we consistently betrayed ourselves for love, were consistently treated in a way that made us feel unworthy or unacceptable resulting in a severed connection to our authentic Self. Trauma creates the fundamental belief that we must betray who we are in order to survive.

One of the most telling statistics regarding multiples is that 97 percent of them have had a history of severe childhood trauma, often in the form of monstrous psychological, physical, and sexual abuse. This has led many researchers to conclude that becoming a multiple is the psyche's way of coping with extraordinary and soul-crushing pain. By dividing up into one or more personalities the psyche is able to parcel out the pain, in a way, and have several personalities bear what would be too much for just one personality to withstand. In this sense becoming a multiple may be the ultimate example of what Bohm means by fragmentation. It is interesting to note that when the psyche fragments itself, it does not become a collection of broken and jagged-edged shards, but a collection of smaller wholes, complete and self-sustaining with their own traits, motives, and desires. Although these wholes are not identical copies of the original personality, they are related to the dynamics of the original personality, and this in itself suggests that some kind of holographic process is involved.

Had she been able to listen to her body, the true Virginia would certainly have spoken up. In order to do so, however, she needed someone to say to her: “Open your eyes! They didn’t protect you when you were in danger of losing your health and your mind, and now they refuse to see what has been done to you. How can you love them so much after all that?” No one offered that kind of support. Nor can anyone stand up to that kind of abuse alone, not even Virginia Woolf. Malcolm Ingram, the noted lecturer in psychological medicine, believed that Woolf’s “mental illness” had nothing to do with her childhood experiences, and her illness was genetically inherited from her family. Here is his opinion as quoted on the Virginia Woolf Web site: As a child she was sexually abused, but the extent and duration is difficult to establish. At worst she may have been sexually harassed and abused from the age of twelve to twenty-one by her [half-]brother George Duckworth, [fourteen] years her senior, and sexually exploited as early as six by her other [half-] brother… It is unlikely that the sexual abuse and her manic-depressive illness are related. However tempting it may be to relate the two, it must be more likely that, whatever her upbringing, her family history and genetic makeup were the determining factors in her mood swings rather than her unhappy childhood [italics added]. More relevant in her childhood experience is the long history of bereavements that punctuated her adolescence and precipitated her first depressions.3 Ingram’s text goes against my own interpretation and ignores a large volume of literature that deals with trauma and the effects of childhood abuse. Here we see how people minimize the importance of information that might cause pain or discomfort—such as childhood abuse—and blame psychiatric disorders on family history instead. Woolf must have felt keen frustration when seemingly intelligent and well-educated people attributed her condition to her mental history, denying the effects of significant childhood experiences. In the eyes of many she remained a woman possessed by “madness.” Nevertheless, the key to her condition lay tantalizingly close to the surface, so easily attainable, and yet neglected. I think that Woolf’s suicide could have been prevented if she had had an enlightened witness with whom she could have shared her feelings about the horrors inflicted on her at such an early age. But there was no one to turn to, and she considered Freud to be the expert on psychic disorders. Here she made a tragic mistake. His writings cast her into a state of severe uncertainty, and she preferred to despair of her own self rather than doubt the great father figure Sigmund Freud, who represented, as did her family, the system of values upheld by society, especially at the time.   UNFORTUNATELY,

this reaction. This was on college campuses, exactly the kind of environment where I had expected curiosity, lively debate, and, yes, the thrill and energy of like-minded activists. Instead almost every campus audience I encountered bristled with anger and protest. I was accustomed to radical Muslim students from my experience as an activist and a politician in Holland. Any time I made a public speech, they would swarm to it in order to shout at me and rant in broken Dutch, in sentences so fractured you wondered how they qualified as students at all. On college campuses in the United States and Canada, by contrast, young and highly articulate people from the Muslim student associations would simply take over the debate. They would send e-mails of protest to the organizers beforehand, such as one (sent by a divinity student at Harvard) that protested that I did not “address anything of substance that actually affects Muslim women’s lives” and that I merely wanted to “trash” Islam. They would stick up posters and hand out pamphlets at the auditorium. Before I’d even stopped speaking they’d be lining up for the microphone, elbowing away all non-Muslims. They spoke in perfect English; they were mostly very well-mannered; and they appeared far better assimilated than their European immigrant counterparts. There were far fewer bearded young men in robes short enough to show their ankles, aping the tradition that says the Prophet’s companions dressed this way out of humility, and fewer girls in hideous black veils. In the United States a radical Muslim student might have a little goatee; a girl may wear a light, attractive headscarf. Their whole demeanor was far less threatening, but they were omnipresent. Some of them would begin by saying how sorry they were for all my terrible suffering, but they would then add that these so-called traumas of mine were aberrant, a “cultural thing,” nothing to do with Islam. In blaming Islam for the oppression of women, they said, I was vilifying them personally, as Muslims. I had failed to understand that Islam is a religion of peace, that the Prophet treated women very well. Several times I was informed that attacking Islam only serves the purpose of something called “colonial feminism,” which in itself was allegedly a pretext for the war on terror and the evil designs of the U.S. government. I was invited to one college to speak as part of a series of

Here is what one sexual abuse survivor told me about his practice: "I tend to go into these four-day funks of self- destruction. My therapist showed me a diagram with baseline emotions for people who have not suffered trauma, and superimposed over it a diagram of baseline emotions for pople who have. Apparently people who have suffered severe traume build neuropathways that lead them to predict traumatic events and then react to them, even if they aren't happening, and the fucks people up their entire lives. She believes it's my yoga practice and daily zazen that keeps my funks to four, maybe five days, instead of lasting for months, or even years. She went on to explain a bit about neurogenesis and studies being done right now about building new neuropathways. I think zazen is beneficial for trauma survivors because it instills in them enough calm and insight to not react in ways that have long-term self-destructive effects. On top of which it builds new neuropathways, rewiring conditioned reactions to trauma, both real and imaginary." We human beings generally subject our brains to a lot of abuse. WE create neural pathways where they are not needed by constantly rehashing pleasurable or painful experiences in order to more fully develop our sense of self.

My fellow resident Jeff and I worked traumas together. When he called me down to the trauma bay because of a concurrent head injury, we were always in sync. He'd assess the abdomen, then ask for my prognosis on a patient's cognitive function. "Well, he could still be a senator," I once replied, "but only from a small state." Jeff laughed, and from that moment on, state population became our barometer for head-injury severity. "Is he a Wyoming or a California?" Jeff would ask, trying to determine how intensive his care plan should be. Or I'd say, "Jeff, I know his blood pressure is labile, but I gotta get him to the OR or he's gonna go from Washington to Idaho---can you get him stabilized?

Original Statement by Hunger Strikers to Psychiatric Association, National Alliance for the Mentally Ill and the U.S. Office of the Surgeon General 1. A Hunger Strike to Challenge International Domination by Biopsychiatry. This fast is about human rights in mental health. The psychiatric pharmaceutical complex is heedless of its oath to “first do no harm.” Psychiatrists are able with impunity to: Incarcerate citizens who have committed crimes against neither persons nor property. Impose diagnostic labels on people that stigmatize and defame them. Induce proven neurological damage by force and coercion with powerful psychotropic drugs. Stimulate violence and suicide with drugs promoted as able to control these activities. Destroy brain cells and memories with an increasing use of electroshock (also known as electro-convulsive therapy). Employ restraint and solitary confinement—which frequently cause severe emotional trauma, humiliation, physical harm, and even death—in preference to patience and understanding. Humiliate individuals already damaged by traumatizing assaults to their self-esteem. These human rights violations and crimes against human decency must end. While the history of psychiatry offers little hope that change will arrive quickly, initial steps can and must be taken. At the very least, the public has the right to know IMMEDIATELY the evidence upon which psychiatry bases its spurious claims and treatments, and upon which it has gained and betrayed the trust and confidence of the courts, the media, and the public.21

I just want to know if you think I should.” “I think it would cause you severe stress,” Ruby says. “I’d worry the symptoms you described would become even more intense to the point where it would be difficult for you to function.” “But I’m talking on a moral level. Because isn’t it supposed to be worth all the stress? That’s what people keep saying, that you need to speak out no matter the cost.” “No,” she says firmly. “That’s wrong. It’s a dangerous amount of pressure to put on someone dealing with trauma.” “Then why do they keep saying it? Because it’s not just this journalist. It’s every woman who comes forward. But if someone doesn’t want to come forward and tell the world every bad thing that’s happened to her, then she’s what? Weak? Selfish?” I throw up my hand, wave it away. “The whole thing is bullshit. I fucking hate it.

I was afraid of anyone in a costume. A trip to see Santa might as well have been a trip to sit on Hitler's lap for all the trauma it would cause me. Once, when I was four, my mother and I were in a Sears and someone wearing an enormous Easter Bunny costume headed my way to present me with a chocolate Easter egg. I was petrified by this nightmarish six-foot-tall bipedal pink fake-fur monster with human-sized arms and legs and a soulless, impassive face heading toward me. It waved halfheartedly as it held a piece of candy out in an evil attempt to lure me into its clutches. Fearing for my life, I pulled open the bottom drawer of a display case and stuck my head inside, the same way an ostrich buries its head in the sand. This caused much hilarity among the surrounding adults, and the chorus of grown-up laughter I heard echoing from within that drawer only added to the horror of the moment. Over the next several years, I would run away in terror from a guy in a gorilla suit whose job it was to wave customers into a car wash, a giant Uncle Sam on stilts, a midget dressed like a leprechaun, an astronaut, the Detroit Tigers mascot, Ronald McDonald, Big Bird, Bozo the Clown, and every Mickey Mouse, Minnie Mouse, Donald Duck, Pluto, Chip and Dale, Uncle Scrooge, and Goofy who walked the streets at Disneyland. Add to this an irrational fear of small dogs that saw me on more than one occasion fleeing in terror from our neighbor's four-inch-high miniature dachschund as if I were being chased by the Hound of the Baskervilles and a chronic case of germ phobia, and it's pretty apparent that I was--what some of the less politically correct among us might call--a first-class pussy.

Prior to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the diagnosis of Dissociative Identity Disorder had been referred to as Multiple Personality Disorder. The renaming of this diagnosis has caused quite a bit of confusion among professionals and those who live with DID. Because dissociation describes the process by which DID begins to develop, rather than the actual outcome of this process (the formation of various personalities), this new term may be a bit unclear. We know that the diagnosis is DID and that DID is what people say we have. We’d just like to point out that words sometimes do not describe what we live with. For people like us, DID is just a step on the way to where we live—a place with many of us inside! We just want people who have little ones and bigger ones living inside to know that the title Dissociative Identity Disorder sounds like something other than how we see ourselves—we think it is about us having different personalities. Regardless of the term, it is clear that, in general, the different personalities develop as a reaction to severe trauma. When the person dissociates, they leave their body to get away from the pain or trauma. When this defense is not strong enough to protect the person, different personalities emerge to handle the experience. These personalities allow the child to survive: when the child is being harmed or experiencing traumatic episodes, the other personalities take the pain and/ or watch the bad things. This allows these children to return to their body after the bad things have happened without any awareness of what has occurred. They do this to create different ways to make sense of the harm inflicted upon them; it is their survival mechanism.

The prediction of false rape-related beliefs (rape myth acceptance [RMA]) was examined using the Illinois Rape Myth Acceptance Scale (Payne, Lonsway, & Fitzgerald, 1999) among a nonclinical sample of 258 male and female college students. Predictor variables included measures of attitudes toward women, gender role identity (GRI), sexual trauma history, and posttraumatic stress disorder (PTSD) symptom severity. Using linear regression and testing interaction effects, negative attitudes toward women significantly predicted greater RMA for individuals without a sexual trauma history. However, neither attitudes toward women nor GRI were significant predictors of RMA for individuals with a sexual trauma history." Rape Myth Acceptance, Sexual Trauma History, and Posttraumatic Stress Disorder Shannon N. Baugher, PhD, Jon D. Elhai, PhD, James R. Monroe, PhD, Ruth Dakota, Matt J. Gray, PhD

Several researchers demonstrate the ways people fail to label trauma as such or underreport traumatic experiences. In a sample of 1,526 university students, Rausch and Knutson (1991) found that although participants reported receiving punitive treatment similar to that of their siblings, they were more than twice as likely to identify their siblings’ experiences as abusive as they were to label their own in this way. The authors reported that participants were likely to interpret parental treatment toward themselves but not parental treatment toward their siblings as deserved and therefore not abusive. Other studies similarly indicate that those reporting abuse experiences often do not demonstrate a metaconsciousness of having been abused (Goldsmith & Freyd, in press; Koss, 1998; Varia & Abidin, 1999; Weinbach & Curtiss, 1986)." KNOWING AND NOT KNOWING ABOUT TRAUMA: IMPLICATIONS FOR THERAPY (2004)

A great paradox...red states are poorere and have more teen mothers, more divorce, worse health, more obesity, more trauma-related deaths, more low-birth-weight babies, and lower school enrollment....The gap in life expectancey between Louisiana (75.7) and Connecticut (80.8) is the same as that between the U.S. and Nicaragua....And the problem transcends race; an average black in Maryland lives four years longer, earns twice as much, and is twice as likely to have a college degree as a black in Louisiana. And whites in Louisiana are wrose off than whites in Maryland or anywhere else outside Mississippi. Louisiana has suffered many environmental problems too: there are nearly 400 miles of low, flat, subsiding coastline, adn the state loses a football field-size patch of wetland every hour. It is threatened by rising sea levels and severe hurricanes, which the world's top scientists connect to climate change.

Those of us who suffer from severe anxiety and PTSD, in my case due to inferiority complexes and repeated emotional, physical and religious trauma from a young age, know that the fear of being found out by family is terrifying. Combine that with the fear of God’s wrath (something I can never seem to shake off completely, despite becoming an atheist many years ago), the fear of being jailed in a country where being queer is illegal, and the fear that your partner will sooner or later realise that you’re this shaken shell of a human being and leave you because of it –it all creates this ultra-alert yet sad and anxious, broken robot. One with zero confidence and zero self-trust, and who is incapable of vulnerability or even allowing themselves to have wants and desires. I existed to please others, not myself. I existed to crave love so hungrily. I had a hole inside me that nobody’s love could fill because I never learned to love myself. I didn’t know how to.

Whatever a student hears in class or reads in a book travels these pathways as he masters yet another iota of understanding. Indeed, everything that happens to us in life, all the details that we will remember, depend on the hippocampus to stay with us. The continual retention of memories demands a frenzy of neuronal activity. In fact, the vast majority of neurogenesis—the brain’s production of new neurons and laying down of connections to others—takes place in the hippocampus. The hippocampus is especially vulnerable to ongoing emotional distress, because of the damaging effects of cortisol. Under prolonged stress, cortisol attacks the neurons of the hippocampus, slowing the rate at which neurons are added or even reducing the total number, with a disastrous impact on learning. The actual killing off of hippocampal neurons occurs during sustained cortisol floods induced, for example, by severe depression or intense trauma. (However, with recovery, the hippocampus regains neurons and enlarges again.)20 Even when the stress is less extreme, extended periods of high cortisol seem to hamper these same neurons.

It is also a part of "poisonous pedagogy" to impart to the child from the beginning false information and beliefs that have been passed on from generation to generation and dutifully accepted by the young even though they are not only unproven but are demonstrably false. Examples of such beliefs are: 1. A feeling of duty produces love. 2. Hatred can be done away with by forbidding it. 3. Parents deserve respect simply because they are parents. 4. Children are undeserving of respect simply because they are children. 5. Obedience makes a child strong. 6. A high degree of self-esteem is harmful. 7. A low degree of self-esteem makes a person altruistic. 8. Tenderness (doting) is harmful. 9. Responding to a child's needs is wrong. 10. Severity and coldness are a good preparation for life. 11. A pretense of gratitude is better than honest ingratitude. 12. The way you behave is more important than the way you really are. 13. Neither parents nor God would survive being offended. 14. The body is something dirty and disgusting. 15. Strong feelings are harmful. 16. Parents are creatures free of drives and guilt. 17. Parents are always right.

Colonialism intentionally disrupts this inherent relationship with the earth and replaces it with an ethos of domination and power that can be manipulated to sustain empires and generate wealth, rather than affirm life on its own natural terms. Severing humans from the wholeness of this relationship is the original rupture, the deepest trauma and most ravaging displacement, which has created space for every systemic and societal wound that has followed. It defiles our generational roadmap to good living rooted in agency and mutual care. The colonial wound creates a form of spiritual exile that dissociates us from the essence of life itself and displaces us from our cultural ways of affirming and stewarding it as a part of the living land that makes us. It shakes our sense of security and home in our own bodies and basics. These relationships are an objective truth that does not waiver despite these intentional disruptions, but we suffer to realize them as a result of them. By displacing us from the inherent connection we have with the earth as a kindred creative and material source of life and nurturance, we lose leverage with reality itself as it becomes reconstructed around something contrary and rootless—something oppressive and damaging to the earth itself, desecrated as we suffer in unison.

Wake up every day, expecting not to know what's going to happen, and look for the events to unfold with curiosity. Instead of stressing and managing, just be present at anything that pops up with the intention of approaching it with your best efforts. Whatever happens in the process of spiritual awakening is going to be unpredictable and moving forward, if you're just the one who notices it, not fighting or making a big project out there. •       You may have emotional swings, energetic swings, psychic openings, and other unwanted shifts that, as you knew, feel unfamiliar to your personality. Be the beholder. Don't feel like you have something to fix or alter. They're going to pass. •       If you have severe trauma in your history and have never had therapy, it might be very useful to release the pains of memories that arise around the events. Therapy teaches you how to express, bear witness, release, and move forward. Your therapist needn't know much about kundalini as long as he or she doesn't discount that part of your process. What you want to focus on is the release of trauma-related issues, and you want an experienced and compassionate therapist who sees your spiritual orientation as a motivation and support for the healing process. •       This process represents your chance to wake up to your true nature. Some people wake up first, and then experience the emergence of a kundalini; others have the kundalini process going through as a preparation for the emergence. The appearance happens to do the job of wiping out, so is part of either pattern. Waking up means realizing that whoever looks through your eyes, lives through your senses, listens to your thoughts, and is present at every moment of your experience, whether good or bad, is recognized or remembered. This is a bright, conscious, detached and unconditionally loving presence that is universal and eternal and is totally free from all the conditions and memories you associate with as a personal identity. But as long as you believe in all of your personal conditions and stories, emotions, and thoughts, you have to experience life filtered by them. This programmed mind is what makes the game of life to be varied and suspense-filled but it also causes suffering and fear of death. When we are in Samadhi and Satori encounters, we glimpse the Truth about the vast, limitless space that is the foundation for our being. It is called gnosis (knowledge) or the One by the early Gnostics. Some spiritual teachings like Advaita Vedanta and Zen go straight for realization, while others see it as a gradual path through years of spiritual practices. Anyway, the ending is the same. As Shakespeare said, when you know who you are, the world becomes a stage and you the player, and life is more light and thoughts less intrusive, and the kundalini process settles down into a mellow pleasantness. •       Give up places to go and to be with people that cause you discomfort.

In his book, Nothing Ever Dies: Vietnam and the Memory of War, Viet Thanh Nguyen writes that immigrant communities like San Jose or Little Saigon in Orange County are examples of purposeful forgetting through the promise of capitalism: “The more wealth minorities amass, the more property they buy, the more clout they accumulate, and the more visible they become, the more other Americans will positively recognize and remember them. Belonging would substitute for longing; membership would make up for disremembering.” One literal example of this lies in the very existence of San Francisco’s Chinatown. Chinese immigrants in California had battled severe anti-Chinese sentiment in the late 1800s. In 1871, eighteen Chinese immigrants were murdered and lynched in Los Angeles. In 1877, an “anti-Coolie” mob burned and ransacked San Francisco’s Chinatown, and murdered four Chinese men. SF’s Chinatown was dealt its final blow during the 1906 earthquake, when San Francisco fire departments dedicated their resources to wealthier areas and dynamited Chinatown in order to stop the fire’s spread. When it came time to rebuild, a local businessman named Look Tin Eli hired T. Paterson Ross, a Scottish architect who had never been to China, to rebuild the neighborhood. Ross drew inspiration from centuries-old photographs of China and ancient religious motifs. Fancy restaurants were built with elaborate teak furniture and ivory carvings, complete with burlesque shows with beautiful Asian women that were later depicted in the musical Flower Drum Song. The idea was to create an exoticized “Oriental Disneyland” which would draw in tourists, elevating the image of Chinese people in America. It worked. Celebrities like Humphrey Bogart, Lauren Bacall, Ronald Reagan and Bing Crosby started frequenting Chinatown’s restaurants and nightclubs. People went from seeing Chinese people as coolies who stole jobs to fetishizing them as alluring, mysterious foreigners. We paid a price for this safety, though—somewhere along the way, Chinese Americans’ self-identity was colored by this fetishized view. San Francisco’s Chinatown was the only image of China I had growing up. I was surprised to learn, in my early twenties, that roofs in China were not, in fact, covered with thick green tiles and dragons. I felt betrayed—as if I was tricked into forgetting myself. Which is why Do asks his students to collect family histories from their parents, in an effort to remember. His methodology is a clever one. “I encourage them and say, look, if you tell your parents that this is an academic project, you have to do it or you’re going to fail my class—then they’re more likely to cooperate. But simultaneously, also know that there are certain things they won’t talk about. But nevertheless, you can fill in the gaps.” He’ll even teach his students to ask distanced questions such as “How many people were on your boat when you left Vietnam? How many made it?” If there were one hundred and fifty at the beginning of the journey and fifty at the end, students may never fully know the specifics of their parents’ trauma but they can infer shadows of the grief they must hold.

For many, an explosion of mental problems occurred during the first months of the pandemic and will continue to progress in the post-pandemic era. In March 2020 (at the onset of the pandemic), a group of researchers published a study in The Lancet that found that confinement measures produced a range of severe mental health outcomes, such as trauma, confusion and anger.[153] Although avoiding the most severe mental health issues, a large portion of the world population is bound to have suffered stress to various degrees. First and foremost, it is among those already prone to mental health issues that the challenges inherent in the response to the coronavirus (lockdowns, isolation, anguish) will be exacerbated. Some will weather the storm, but for certain individuals, a diagnostic of depression or anxiety could escalate into an acute clinical episode. There are also significant numbers of people who for the first time presented symptoms of serious mood disorder like mania, signs of depression and various psychotic experiences. These were all triggered by events directly or indirectly associated with the pandemic and the lockdowns, such as isolation and loneliness, fear of catching the disease, losing a job, bereavement and concerns about family members and friends. In May 2020, the National Health Service England’s clinical director for mental health told a Parliamentary committee that the “demand for mental healthcare would increase ‘significantly’ once the lockdown ended and would see people needing treatment for trauma for years to come”.[154] There is no reason to believe that the situation will be very different elsewhere.

Which is actually good because we’re doing an AP Euro study group this week at the library—I mean good that it got canceled, not good that someone died—so I was wondering too if maybe I can use the car, so you won’t have to come pick me up super late every night?” Alma had been a wildly clingy kid, but now she is a mostly autonomous and wholly inscrutable seventeen-year-old; she is mean and gorgeous and breathtakingly good at math; she has inside jokes with her friends about inexplicable things like Gary Shandling and avocado toast, paints microscopic cherries on her fingernails and endeavors highly involved baking ventures, filling their fridge with oblong bagels and six-layer cakes. “I’m asking now because last time you told me I didn’t give you enough notice,” she says. She has recently begun speaking conversationally to Julia and Mark again after nearly two years of brooding silence, and now it’s near impossible to get her to stop. She regales them with breathless incomprehensible stories at the dinner table; she delivers lengthy recaps of midseason episodes of television shows they have never seen; she mounts elaborate and convincing defenses of things she wants them to give her, or give her permission to do. Conversing with her is a mechanical act requiring the constant ability to shift gears, to backpedal or follow inane segues or catapult from the real world to a fictional one without stopping to refuel. There’s not a snowball’s chance in hell that she won’t be accepted next month to several of the seventeen exalted and appallingly expensive colleges to which she has applied, and because Julia would like the remainder of her tenure at home to elapse free of trauma, she responds to her daughter as she did when she was a napping baby, tiptoeing around her to avoid awakening unrest. The power dynamic in their household is not unlike that of a years-long hostage crisis.

John Bradshaw, in his best-seller Homecoming: Reclaiming and Championing Your Inner Child, details several of his imaginative techniques: asking forgiveness of your inner child, divorcing your parent and finding a new one, like Jesus, stroking your inner child, writing your childhood history. These techniques go by the name catharsis, that is, emotional engagement in past trauma-laden events. Catharsis is magnificent to experience and impressive to behold. Weeping, raging at parents long dead, hugging the wounded little boy who was once you, are all stirring. You have to be made of stone not to be moved to tears. For hours afterward, you may feel cleansed and at peace—perhaps for the first time in years. Awakening, beginning again, and new departures all beckon. Catharsis, as a therapeutic technique, has been around for more than a hundred years. It used to be a mainstay of psychoanalytic treatment, but no longer. Its main appeal is its afterglow. Its main drawback is that there is no evidence that it works. When you measure how much people like doing it, you hear high praise. When you measure whether anything changes, catharsis fares badly. Done well, it brings about short-term relief—like the afterglow of vigorous exercise. But once the glow dissipates, as it does in a few days, the real problems are still there: an alcoholic spouse, a hateful job, early-morning blues, panic attacks, a cocaine habit. There is no documentation that the catharsis techniques of the recovery movement help in any lasting way with chronic emotional problems. There is no evidence that they alter adult personality. And, strangely, catharsis about fictitious memories does about as well as catharsis about real memories. The inner-child advocates, having treated tens of thousands of suffering adults for years, have not seen fit to do any follow-ups. Because catharsis techniques are so superficially appealing, because they are so dependent on the charisma of the therapist, and because they have no known lasting value, my advice is “Let the buyer beware.

All of a sudden (in 1938 I think), in order to extend its autarchy to the domain of cinema, Italy decreed an embargo on American films. It wasn’t a question of censorship: as usual the censors granted or denied permission to individual films, and nobody saw the ones that didn’t get it and that was it. In spite of the awkward anti-Hollywood propaganda campaign that accompanied the measure (right around that time the regime began to conform to Hitler’s racism), the true reason for the embargo was supposed to be commercial protectionism, in order to make room in the market for Italian (and German) productions. For this reason the four largest American production and distribution companies—Metro, Fox, Paramount, Warner—(I’m still relying on memory, trusting the accuracy of the registration of my trauma), whereas films by other American companies like RKO, Columbia, Universal, United Artists (which had also been distributed before then by Italian companies) continued to arrive until 1941, that is until Italy found itself at war with the United States. I was still granted some sporadic satisfaction (in fact, one of the greatest: Stagecoach [John Ford, 1939]) but my collector’s voracity suffered a fatal blow. Compared to all of the prohibitions and obligations that fascism had imposed on us, and to the even more severe ones that it continued to enforce in those years before and then during the war, the veto on American films was certainly a minor or small loss, and I wasn’t foolish enough not to know it. Yet it was the first to affect me directly, and I hadn’t known any years other than those of fascism nor had I felt any needs other than those that the environment in which I lived could suggest and satisfy. It was the first time a right I enjoyed had been taken from me: more than a right, a dimension, a world, a space in my mind; and I felt this loss as cruel oppression which embodied all the forms of oppression that I’d heard about or seen other people suffer. If I can still talk about it today like a lost privilege it’s because something disappeared like that from my life, never to return again. So many things had changed after the war was over: I’d changed, cinema had become something else, something different in itself and in relation to me. My biography as a spectator resumed, but it was that of another spectator who wasn’t just a spectator anymore.

Thus polyvictimization or complex trauma are "developmentally adverse interpersonal traumas" (Ford, 2005) because they place the victim at risk not only for recurrent stress and psychophysiological arousal (e.g., PTSD, other anxiety disorders, depression) but also for interruptions and breakdowns in healthy psychobiological, psychological, and social development. Complex trauma not only involves shock, fear, terror, or powerlessness (either short or long term) but also, more fundamentally, constitutes a violation of the immature self and the challenge to the development of a positive and secure self, as major psychic energy is directed toward survival and defense rather than toward learning and personal development (Ford, 2009b, 2009c). Moreover, it may influence the brain's very development, structure, and functioning in both the short and long term (Lanius et al., 2010; Schore, 2009). Complex trauma often forces the child victim to substitute automatic survival tactics for adaptive self-regulation, starting at the most basic level of physical reactions (e.g., intense states of hyperarousal/agitation or hypoarousal/immobility) and behavioral (e.g., aggressive or passive/avoidant responses) that can become so automatic and habitual that the child's emotional and cognitive development are derailed or distorted. What is more, self-integrity is profoundly shaken, as the child victim incorporates the "lessons of abuse" into a view of him or herself as bad, inadequate, disgusting, contaminated and deserving of mistreatment and neglect. Such misattributions and related schema about self and others are some of the most common and robust cognitive and assumptive consequences of chronic childhood abuse (as well as other forms of interpersonal trauma) and are especially debilitating to healthy development and relationships (Cole & Putnam, 1992; McCann & Pearlman, 1992). Because the violation occurs in an interpersonal context that carries profound significance for personal development, relationships become suspect and a source of threat and fear rather than of safety and nurturance. In vulnerable children, complex trauma causes compromised attachment security, self-integrity and ultimately self-regulation. Thus it constitutes a threat not only to physical but also to psychological survival - to the development of the self and the capacity to regulate emotions (Arnold & Fisch, 2011). For example, emotional abuse by an adult caregiver that involves systematic disparagement, blame and shame of a child ("You worthless piece of s-t"; "You shouldn't have been born"; "You are the source of all of my problems"; "I should have aborted you"; "If you don't like what I tell you, you can go hang yourself") but does not involve sexual or physical violation or life threat is nevertheless psychologically damaging. Such bullying and antipathy on the part of a primary caregiver or other family members, in addition to maltreatment and role reversals that are found in many dysfunctional families, lead to severe psychobiological dysregulation and reactivity (Teicher, Samson, Polcari, & McGreenery, 2006).

Kaffman (2009) described childhood victimization as a "silent epidemic", and Finkelhor, Turner, Ormrod, and Hamby (2010) reported that children are the most traumatized class of humans around the globe. The findings of these researchers are at odds with the view that children have protected status in most families, societies, and cultures. Instead, Finkelhor reports that children are prime targets and highly vulnerable, due principally to their small size, their physical and emotional immaturity with its associated lack of control, power and resources; and their related dependency on caregivers. They are subjected to many forms of exploitation on an ongoing basis, imposed on them by individuals with greater power, strength, knowledge, and resources, many of whom are, paradoxically and tragically, responsible for their care and welfare. These traumas are interpersonal in nature and involve personal transgression, violation and exploitation of the child by those who rely on the child's lesser physical abilities, innocence, and immaturity to intimidate, bully, confuse, blackmail, exploit, or otherwise coerce. In the worst-case scenario, a parent or other significant caregiver directly and repeatedly abuses a child or does not respond to or protect a child or other vulnerable individual who is being abused and mistreated and isolates the child from others through threats or with direct violence. Consequently, such an abusive, nonprotective, or malevolently exploitative circumstance (Chefetz has coined the term "attack-ment" to describe these dynamics) has a profound impact on victim's ability to trust others. It also affects the victim's identity and self-concept, usually in negative ways that include self-hatred, low self-worth, and lack of self-confidence. As a result, both relationships, and the individual's sense of self and internal states (feelings, thoughts, and perceptions) can become sources of fear, despair, rage, or other extreme dysphoria or numbed and dissociated reactions. This state of alienation from self and others is further exacerbated when the occurrence of abuse or other victimization involves betrayal and is repeated and becomes chronic, in the process leading the victim to remain in a state of either hyperarousal/anticipation/hypervigilance or hypoarousal/numbing (or to alternate between these two states) and to develop strong protective mechanisms, such as dissociation, in order to endure recurrences. When these additional victimizations recur, they unfortunately tend to escalate in severity and intrusiveness over time, causing additional traumatization (Duckworth & Follette, 2011). In many cases of child maltreatment, emotional or psychological coercion and the use of the adult's authority and dominant power rather than physical force or violence is the fulcrum and weapon used against the child; however, force and violence are common in some settings and in some forms of abuse (sometimes in conjunction with extreme isolation and drugging of the child), as they are used to further control or terrorize the victim into submission. The use of force and violence is more commonplace and prevalent in some families, communities, religions, cultural/ethnic groups, and societies based on the views and values about adult prerogatives with children that are espoused. They may also be based on the sociopathy of the perpetrators.