Sunday, August 10, 2014

Childhood Abuse and Neglect - The Objective Effects and the Subjective Experience


The two articles below are complimentary in their description of the impact of childhood maltreatment (CM: abuse and/or neglect). The first is only available as an abstract (paywall, of course) and the second comes from Psych Central, a nice resource for lay readers in psychology.

Together these articles show the impact of CM on the function and structure of the brain and the subjective suffering that can result from CM years later. This is the "conclusion" of the first article:
Maltreatment was associated with decreased centrality in regions involved in emotional regulation and ability to accurately attribute thoughts or intentions to others and with enhanced centrality in regions involved in internal emotional perception, self-referential thinking, and self-awareness. This may provide a potential mechanism for how maltreatment increases risk for psychopathology.
In the adults molested as children (AMAC) clients I work with, I see these two processes playing themselves out in their lives every week. The limited affect regulation and the strong tendency toward inaccurate attribution of intentions to others creates a near-constant state of hypervigilance and a general sense of being unsafe with anyone, anywhere.

Likewise, the accentuated interior focus creates a self-sustaining cycle of anxiety, depression, self-blame, and rumination on past wounding. This too can be very debilitating. 


Full Citation:
Teicher, MH, Anderson, CM, Ohashi, K, and Polcari, A. (2013, Aug 15). Childhood Maltreatment: Altered Network Centrality of Cingulate, Precuneus, Temporal Pole and Insula. Biological Psychiatry; 76(4): 297–305. DOI: http://dx.doi.org/10.1016/j.biopsych.2013.09.016

Childhood Maltreatment: Altered Network Centrality of Cingulate, Precuneus, Temporal Pole and Insula

Martin H. Teicher, Carl M. Anderson, Kyoko Ohashi, Ann Polcari

Background

Childhood abuse is a major risk factor for psychopathology. Previous studies have identified brain differences in maltreated individuals but have not focused on potential differences in network architecture.

Methods

High-resolution T1-weighted magnetic resonance imaging scans were obtained from 265 unmedicated, right-handed 18- to 25-year-olds who were classified as maltreated (n = 142, 55 men/87 women) or nonmaltreated (n = 123, 46 men/77 women) based on extensive interviews. Cortical thickness was assessed in 112 cortical regions (nodes) and interregional partial correlations across subjects were calculated to derive the lowest equivalent cost single-cluster group networks. Permutation tests were used to ascertain whether maltreatment was associated with significant alterations in key centrality measures of these regions and membership in the highly interconnected “rich club.”

Results

Marked differences in centrality (connectedness, “importance”) were observed in a handful of cortical regions. Left anterior cingulate had the second highest number of connections (degree centrality) and was a component of the “rich club” in the control network but ranked low in connectedness (106th of 112 nodes) in the network derived from maltreated-subjects (p < .01). Conversely, right precuneus and right anterior insula ranked first and 15th in degree centrality in the maltreated network versus 90th (p = .01) and 105th (p < .03) in the control network.

Conclusions

Maltreatment was associated with decreased centrality in regions involved in emotional regulation and ability to accurately attribute thoughts or intentions to others and with enhanced centrality in regions involved in internal emotional perception, self-referential thinking, and self-awareness. This may provide a potential mechanism for how maltreatment increases risk for psychopathology.
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This article comes from Psych Central's World of Psychology blog.

Consequences of Emotional Abuse

By Archana Sankaran
August 1, 2014


I come from a family where abuse has had a generational continuity. My grandfather abused my grandmother. My grandmother abused her son, daughter-in-law and other people. (She threw food at me once.) My father bullies his wife and daughter. My mother is emotionally violent to me. I go crazy and can break stuff around my mother.

Overall it is a very disturbing home environment. No one knows how to get out of the situation and we continue to harm each other. At times it feels like a spiraling battle to death. My grandpa passed away recently, ending his part.

Abuse has many forms. Sometimes it involves power over decision-making, where some people’s opinions do not count in matters related to them. Sometimes the emotional reactions of one person are projected onto others, shifting responsibility. It also can be physically violent, involving breaking things, hitting or cutting. Gossip and social shaming was one of my grandmother’s favorite ways to get control over my father.

I think that abuse is basically a perverted mechanism for control when the healthy ways to influence people seem infeasible. Often with dysfunctional families there is a repetitive nature to these conflicts.

After a few weeks with my family, my body seems to be permanently ready for attack. My shoulder hunches up and there is constant fear in the pit of my stomach. It feels like every person around me who I let into my territory is out to harm me. And no one will choose to spend time with me if they know me fully.

For years the only places I could feel safe or relax in were ashrams and meditation halls. I spent a lot of time by myself in nature. That would eventually calm me down. I was greatly anxious in social interactions, even of a functional nature such as asking for a room to rent.

My father told me a few years ago that every man I am with would leave me. I could not believe that he had used those words on me, knowing that I hurt terribly on this topic. I had just come out of four dark years of matrimony-related sorrow. There was a sense of being boxed in and bashed up.

My father, in his anger, tuned into my wounds and stabbed me where it always hurt most. It took me a while to understand this. I reacted in shock, numbness, severe depression at times. At other times I screamed at him and he released more toxic words.

Always there was a need in me to go closer, to understand the abuse and resolve it. Not one situation resolved. I am being forced to see that there is no healthy closure available to these situations. It is wounded people reacting and damaging others from their woundedness.

Family dynamics harmed me even in less-dramatic situations. For example, I do not recall being able to relax at home with family as a child. Any time I sat down with people at home, I had to perform — an activity such as cleaning the table, or listening to a story or dreaming up projects to do.

That made me always tense when I sat down with people in social situations. How should I entertain them? Often in a group of friends this behavior of mine was not received as my insecurity but as my need to show off.

As a child, positive social stamping was extremely important to me. It was the one way to get attention from my father. I could get warmth and respect from my family and from society if I was a successful person. Social regard became a very important part of my psyche’s feel-good mechanism. I didn’t realize that they would turn completely against me if they perceived me as a failure, which happened later.

In India’s strictly traditional society, I remained unmarried. I was not able to dismiss the social rejection and shaming easily. It was a painful lesson — not only but my society is extreme. Arranged marriages still account for the majority of Indian marriages. Most of the population is married and there is little acceptance of any other choice of living.

I believe that life is a series of lessons that we have to learn and graduate from. Most of us remain broken, wounded individuals trying to cope with our ceaseless desires. May we awaken to an awareness of our wounds. May we find our path to wholeness.

~ Archana Sankaran is an artist and therapist who lives in south India. She writes on alternative health, psychology and gardening. Her blog is at http://energyclinic.wordpress.com
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