COPYRIGHT CITY SANCTUARY THERAPY

No part of this website, including the blog content may be copied, duplicated or reproduced in any manner without the author’s permission.

Any information, materials, and opinions on this blog do not constitute therapy or professional advice. If you need professional help, please contact a qualified mental health practitioner.

What is Parentification?

In simple terms, parentification is when a child is given duties and responsibilities that are not age appropriate. Parentification can occur in two different forms- emotional and instrumental. Some people experience one of the other, while others experience both.  Emotional parentification is when the child provides emotional support to the adult, while instrumental parentification is when the adult assigns and ascribes adult roles and duties to the child. In practice, the adult may simply off load onto the child, confide in the child, ask questions about life situations, seek counsel, & solicit advice from the child. It can also occur when a child is given adult chores, and tasks  that are not age appropriate.  When this happens, there is a role reversal where the child becomes the adult, the provider of emotional containment to an adult (care taker), and an involuntary provider of practical support. Many a time parentification happens covertly, and the adult may not recognise their emotional and practical dependence on the child.  In any situation where there is parentification, there is neither sensor in the adult, nor a recognition of boundaries of what is appropriate, and what is not. Children do not only grow and develop physically, they also develop psychologically; they have certain milestones they need to reach and accomplish. Parentification interferes with the natural psychological development of the child, and impinges on the accomplishment of their own developmental tasks, as they are pivoted into adulthood.

When and why  does Parentification happen?

Parentification typically occurs in parent-child relationships, and it also occurs in families where where there is an older sibling  who has to look after the younger ones practically and/or emotionally.  What is typical is that in emotional parentification, the adult emotionally confides in the child, and speaks to the child about challenges they may be having in their life-for example financial difficulties, marital difficulties, health difficulties, relationship problems, and other  life situations. These things may seem insignificant to the adult, however, they are emotionally burdening the child who has no capacity to understand, make sense, or emotionally process them. Another way emotional parentification happens is when the child grows up in an environment where they have to tune into the adult’s emotions, in order to protect themselves and feel safe. This is likely to happen when there is one or both parents who is emotionally volatile, and where there are parents who engage in regular fights, leaving the child to intervene and become the peacemaker. The child has to deal with complex emotions and  put in the adult role when this happens, which becomes parentification.

With instrumental parentification, the child takes on and assumes adult roles. They are made to do things that are beyond their capacity as children, therefore not age appropriate. This may be as simple as dealing with household chores, looking after their siblings, cooking, shopping, or budgeting,  which undermines their own experience as a child. Some parents do struggle to distinguish healthy coaching of a child to do household chores with parentifying a child. While it’s not a bad thing to teach children life skills, it is harmful when they are made to do them repeatedly, and it becomes their duty.

Emotional parentification is very common in families where there are marital problems- divorce or separation, or any other marital discord. You find that either one or both parents use the child as a confidant of their problems, and share feelings about the marital issues or the other parent.  The parent relates to that child “as if” they are an adult. This phenomenon is also common in single parents with children who become a replacement of the lost partner, and used as a surrogate partner emotionally. In actual fact, the adult is committing emotional incest with a child, as they are not their partner, but a child.  Although the adult may not recognise the burden of  emotional dumping, it is the child who is impacted by it & needs to make emotional adjustments to accommodate the adults’ feelings, while neglecting their own. Children are very compliant, they simply shut off their own feelings, and look after the adult; the adult becomes complicit in neglecting the child’s feelings. In the child’s mind paying attention to the adult’s feelings is the right thing to do. However, it also means the child’s feelings are unattended to, and unprocessed, and this does create confusion in their minds.

Parentified children are likely to develop what Winnicott (1960) would term a “False Self” organisation. According to Winnicott, this False self is a defensive organisation which the child builds, as a result of the parents’ repeated failure to meet the child’s emotional needs (omnipotence). In compliance with the mother, the child develops this False self, which protects the True Self. The False Self is inauthentic and it is not as confident, as it is a defensive organisation which shields the more robust and authentic True self, which was never allowed to develop.

Parents who parentify their children are adults who are likely to be isolated & not have much support around them, hence their reliance on a minor for emotional and practical support.  The parent who parentified their children lack boundaries, and do not have the capacity to appraise what is right or wrong.

Signs of Parentification in adult life?

Parentification is a  hidden trauma, that can get easily missed, yet it has such a profound impact on the individual. Most of these difficulties create real challenges in interpersonal and romantic relationships. Parentification is not gendered, both men and women experience it. However there are certain cultures where some parents have more porous boundaries with their children, which lends them to being more easily parentified. Other socio economic factors also play a part in Parentification. For example it’s common practice in immigrant families for the older siblings to look after their younger ones, while the parents are at work.

Here are some of the signs that people who have been parentified display in adult life

• People who have been  parentified as children are likely to become adults who are insecure, and have an impoverished sense of self.  They lack confidence in themselves,  and find it difficult to advocate for themselves, and look after themselves, prioritising others-typical people pleasers. This is so because of the False self organisation as discussed above.
• People who are parentified are likely to have difficulties with boundary setting, and unlikely to honour their boundaries. This is so because their own boundaries were violated by their parents, and had their own needs neglected. They never learnt to develop healthy boundaries. Parentified adults are also likely to breach other people’s boundaries and jump in to “fix” other people’s problems, at times unsolicited. This is simply a repetition of what they grew up doing for their parents in their childhood.
• Parentified adults often experience difficulties defining their needs, and expressing them, as well as difficulties expressing their own feelings which are seen as secondary to others and insignificant. This is simply a manifestation of an internalised way of relating to other’s where other people’s needs takes priority- they emotionally looked after their parents or older adults around them, and they repeat the same.
• Adults who were parentified as children are likely to experience intense feelings around rejection, and they often hold onto to unhealthy relationships to avoid feelings of rejection and loss. This is so due to the poor sense of self as a result of the False self organisation.
• Emotionally parentified adults may be conflict avoidant. This is so because for them, serving others and not “rocking the boat” means they can maintain relationships, and this gets done relentlessly, to one’s own detriment. It’s as if they are buying love, at all costs. They do this because they have learnt to keep their environment in control and not to ‘rock the boat’. This way of functioning is harmful in interpersonal and romantic relationships. By avoiding conflict, conflict avoidant people are easily manipulated, abused and exploited in both romantic and non romantic relationships.
• Parentified adults tend to have insecure attachment styles -Avoidant or Anxious attachment (Bowlby, 1969). This is so because they had to detect the level of proximity with their care givers- in order not to be abandoned and at the same time, protect themselves. Anxiously attached people tend to engage in push and pull dynamics,  oscillation between intensity, and withdrawal. Avoidant people are likely to keep a distance from others, despite yearning for  connection.
• Parentified adults tend to become controlling of their partners or life in general. They like things to be under their control and done in a particular way. This is a way of mitigating anxiety of things going wrong. This role is familiar-they had to keep things under control for their parents and or siblings.
• Parentified adults engage in relationships where they emotionally and physically look after other people. This can lead to co-dependent dynamics or parents- child dynamics in romantic relationships. The parentified adult is likely to be the caretaker and infantilise their partners.
• Parentified adults are likely to experience anxiety and depression, because of the inability to fully express their feelings and emotions. Emotions make life colourful and rich, Without a heathy expression of emotions we tend to internalise our feelings. Certain feelings such as anger, frustration, and sadness, when internalised, become toxic and can lead to depression, anxiety as well as anger issues.

Should I confront my parents about parentification?

Revisiting the past and confronting one’s parent can be a double-edged sword. It depends on various things, including the quality of relationship with the person/s involved. It may evoke compassion and be a catalyst of a healing journey for both involved, or it can create friction. Parents tend to become defensive when they are made to feel like they failed, or they are being blamed.  If the emotional dumping and violation of boundaries continues in adulthood, one can mention this to the parent and have a “boundary conversation” where you as an adult are redefining your relationship boundaries with the parent. This does not have to be antagonistic, but a gentle conversation that can bring understanding, insight, and healing to both. The difference is that this time there are two adults, not a parent and a child. This may help the parent to start thinking about their own process, and their role which can make them change their behaviour and acknowledge its impact. In most occasions, these behaviours stem from a very unconscious place as these parents are people who had their own boundaries violated as children. Parents are people who were parented themselves, and once upon a time they were children. No one has  a blueprint for parenting. The parents may not be aware of this repetition, and the fact that they are simply re-enacting their own trauma with their own parents.  Having insight into this and acknowledging it is the onset of the healing and breaking these negative cycles.

Healing from Parentification

• If you suspect that you were parentified, the first thing is to reflect on the relationship with your parents, and significant others from your childhood. It is likely that in adult life these significant others may continue to violate the emotional boundaries, in the same way as they did.
• Where there was parentification in childhood, the adult tends to be drawn back into the caring role, and often these are adults became their parents’ own parent’s and develop co-dependent relationships. Healing could be as simple as stepping back from these relationships and creating space -this is indeed a form of self-care and breaking the unhealthy pattern. It could be simply saying no to certain things you would normally agree with or agree to do in-service of others. It could simply be doing the things that you like doing without worrying what others may think or say, or without seeking their permission.
• A key step towards healing lies in setting boundaries as an adult who understands things differently to the child and start learning to prioritise one’s own needs. Being able to recognise how one feels, validating those feelings, and beginning to express them without the fear of hurting the other person is crucial. Without doing that, we simply repeat the same cycle of looking after other’s needs, neglecting ours, to our own detriment.
• Therapy is the gateway to emotional healing where the trauma of parentification can be explored, understood and processed in a healthy and meaningful way.

References

Bowlby, J. (1969). Attachment and Loss, Attachment and Loss. Vol. 1: Attachment.  New York: Basic Books.

Winnicott, D.W. (1960). Ego distortions in terms of True and False Self: The Maturational Processes and the Facilitating Environment. Karnac Books: UK

Main Image Credit to Kamran Chi- Unsplash

COPYRIGHT CITY SANCTUARY THERAPY

No part of this website, including the blog content may be copied, duplicated or reproduced in any manner without the author’s permission.

Any information, materials, and opinions on this blog do not constitute therapy or professional advice. If you need professional help, please contact a qualified mental health practitioner.

Vacillators and Romantic Relationships

We all know that person who lives in La La land, who wants a fairy tale love story where they live “happily ever after”!  We all know that couple that is either madly in love, or fighting like cat and dog, blaming each other for anything and everything. Their relationship is either on the high or low. This way of relating and functioning describes vacillators- where either one partner or both are vacillators.  Vacillators are people who approach relationships in an idealistic, and romanticised fashion –“everything has to be perfect”. They deeply crave emotional connection & will do all they can to get it. This can be at the expense of them undermining their own needs, or emotionally manipulating their partners. Vacillators are emotionally demanding; they want to receive consistent love & undivided attention.

Vacillators set high standards for their partners, and the relationship. When they don’t get what they want -which is often the case due to unrealistically high expectations- it crashes them, provoking a huge sense of disappointment, and anger. These feelings are always targeted at their partner who is seen as having failed them. Vacillators sway between idealisation of their partner and the relationship, & denigration of the same – “I’m so in love with you and you are amazing” and “you are useless, l don’t need you” dynamic . There are intense highs are lows, and inherently viewing the world in black and white terms, with no in between. This leads to cycles of pushing their partners to love & connect with them, & angrily pushing them away. The lows can manifest in actual physical and/or verbal fights, while the highs are both exaggerated and superficial. This couple is typically in a trauma bond, where the early unresolved relational trauma is unconsciously played out, in a victim and abuser dynamic.

Underneath this behaviour is as huge sense of insecurity, and a deep seated fear of abandonment. This gets acted out in the relationship by creating the fairy tale relationship in the mind, which is difficult to sustain in real life. Consequently, being in a relationship with a vacillator can be both exhausting and confusing. The behaviour itself is indeed a trauma response, rooted in the past relationships with their care givers. Their partners are simply paying the price for their early life care givers’ failures. These behaviours are indeed transference manifestations (Freud, 1915).

Vacillators often find flaws in their partners, & want them to change in order to suit their phantasy of an ideal person and relationship. The more the partner gives in, the more they are likely to keep pushing for change. The changes are never enough, as they are based on an ideal and a phantasy, not on reality. If the partners  conform, they simply reinforce the power in the vacillator. If the vacillators partner changes accordingly, they are left feeling very small, fragile, insecure, and powerless.

Predisposition

Vacillators are people who are likely to have  disorganised attachment styles. They are likely to have grown up with parents who were inconsistent & unpredictable in emotionally connecting with them as children. Therefore, their attachment style is far from secure, but a disorganised one- as the word says “dis- organised”. Their parents would have made them feel insignificant, and that their feelings didn’t matter to them. They grew up with a constant fear of being abandoned and let down, yet they also experience intense love from then same parents.

We don’t talk much about vaccillators, or vaccillating in  relationship discourses, yet this phenomenon is very common. Being in a relationship with a vacillator can be damaging and being a vacillator can also lead to an inability to sustain long term, fulfilling  relationships. Partners can support each other to work through this dynamic, once the vacillator is able to acknowledge that they are indeed vacillating, and causing damage to their loved ones. Vacillators can also go into individual therapy to work on this early life trauma, secondary to adverse childhood experiences. Creating security in the relationship and boundaries is likely to help the couple, as the vacillating behaviour itself is stimulated by a fear of abandonment. Cycles of anger, and idealisation can cause huge damage to the relationship and to individuals in the relationship. The denigration erodes other positive qualities of the relationship.

Disorganised Attachment Style and Attachment Styles

The psychological health of an adult individual and relationship patterns  is directly linked re postulated to the quality of the relationship between the baby and their primary care giver, which shapes the attachment styles they built in infancy. These attachments styles are internalised ways or relating laid out in our formative years, which get reactivated in our adult relationships (Ainsworth et al, 1978; Bowlby, 1969).

Bowlby (1969) postulated that there are different types of attachment patterns which are:

1) Secure attachment is developed when they baby is able to develop a healthy attachment style with their care giver. The baby is able to play independently away from the mother, and run back to the mother, a secure base, when it needs to, and know that mother will be waiting in reverence. These parents would have had consistent boundaries and responded consistently. The parent was able to honour and respect the child’s boundaries and made them feel emotionally safe. The child was allowed to express themselves, and the parent remained emotionally connected to the child. In adulthood, these people are likely to have a secure sense of self, they can self validate and not seek validation from their partners and they can approach relationships from a mature place.  They are able to emotionally sooth themselves- conflict in the relationship,  partner’s temporary absence, or   a break down of  a relationship is not so emotionally crashing for them.

2) Anxious-Preoccupied   attachment is an attachment style developed when  the baby is unsure whether they are emotionally secure or not, mainly because they get ‘mixed messages’ from their care giver. The parents would have lacked boundaries, and struggled with emotionally regulating themselves. The parent would have not responded to the child’s needs and didn’t help the child with emotional regulation.  They may have dismissed, minimised, denied, or ignored the child’s emotional needs. In adult life, and in relationships, there is constant fear of abandonment, and hypervigilance to emotional sates. They may pick fights to stay close and the individual struggles with boundaries. The anxiously attached individual tends to be emotionally reactive, and to neglect themselves in relationships, to maintain proximity with their partner. They find it hard to deal with conflict as feelings becomes overwhelming and the threats of abandonment is costly to them.

3) Dismissive-Avoidant  attachment style is developed when the baby had parents who regularly shuts down, emotionally withdraw, or dissociates, leaving the child emotionally unattended to. These parents may also shame the child for who they are and tend to be authoritarian and perfectionistic.  As adults, the avoidant attached genuinely seeks connection but struggles with intimacy. They are likely to ghost, or abruptly end relationships. They also tend to be lone wolfs and cynical and critical of relationships. They may also lack empathy and struggle to understand other peopled viewpoints and needs that are separate to theirs. They are likely to remain single or push their partners away for self-preservation.

4) Fearful-Avoidant  attachment style is developed when in childhood, the baby was completely unable to relate, as they were unable to experience a secure base where they could run back to.  These children may have experienced abuse, neglect and violence from parents or witnessed it between parents. They are likely to have grown up in environments where there was poverty, and considerable lack of safety, shaming and the chid unable to be themselves. In these dynamics, the vital role of the parent as a reliable, trustworthy, consistent and solid care giver is lacking. In adulthood, these people are likely to cerate push-pull dynamics in relationships where they seek closeness and rejects. Romantic relationships can be highly triggering and overwhelming for them, leading to cynicism, and criticism of their partners. They may also re-enact their childhood trauma by setting their partners up into dramatic scenarios. They have unrealistic expectations of their partners and what a real relationship is.

The disorganised attachments are likely to be vacillators in relationships. All they are doing is re-anacting the early relationship template of having parents who are unreliable and untrustworthy. They do the same by creating idealised views of the world and relationships, and seeking others to meet their high standards.  Unconsciously, they tend to pick  partners who like being worshipped, and enjoy going through the emotional highs and the lows. The push- pull, and rejecting mimics what they felt in the care of their primary care givers.

As an individual and couples therapist, l have seen many people work through these unhealthy ways of relating, and develop healthier ways of relating.  I have helped both subjects and partners of vacillators and helped them repair these attachment styles and develop healthier and secure attachment styles. Attachment  styles are not fixed for a lifetime. They can be mended and repaired through good enough psychological work (therapy), and secure relationships with a partner who is securely attached themselves.

How to Heal

 Subject

-Knowing that this behaviour is a trauma response is important.

-Self-reflection is critical as it enables you to stop and think before reacting or doing things that are harmful to your partner

-Working on communication and boundaries is important. You may want to invite your partner to support you with working on this.

-Having therapy to work on the trauma is also important as it enables you to learn healthy ways of relating & work through the trauma.

Victim

-Learn to create boundaries and to understand that the behaviour is not to do with you specifically but your partners past trauma. This will enable the victim to separate what’s happening to them as something that’s not directly towards them.

-Communication and setting boundaries is important and being consistent in doing so.

-Be mindful of love bombing and suffocating affection that comes with vacillators, as it soon becomes rejection. Being aware of it makes it less painful.

-Seek therapy if you are struggling with a relationship with a vacillator.

References

Ainsworth, M.D.S., Blehar, M.C., Waters, E, and Wall, S. (1978). Patterns of Attachment: A Psychological Study of the Strange Situation. Oxford, UK

Bowlby, J. (1969). Attachment and Loss, Vol. 1: Attachment. Attachment and Loss. New York: Basic Books.

Image Credit- Moosa Maseneke- Unsplash

Four years ago, we relocated at a time we thought least harmful to our children: the youngest was starting primary school, the eldest junior school. They are now nine and 13. They are of mixed ethnicity and we wanted to live somewhere more multicultural, in a larger house in a less urban area. Our close family live outside England, so we thought moving nearer to extended family might provide some roots. The children settled well but contact with the extended family didn’t really happen.

Last year, going through the menopause, I became depressed and sought counselling. I recognised I’d been so focused on what might be best for the children that I’d disregarded what was right for me. I’ve always wanted to live by the sea and have become increasingly despondent about having missed an opportunity to move there four years ago. During lockdown my husband and I had time to reflect; he thinks our family unit will be stronger if we move again, before the children are any older. We both want our eldest settled before GCSEs. She is very empathic, knows I am unhappy and constantly asks why.

My mother died when I was a young woman and I’ve had little family support (no siblings, an emotionally unavailable father). I feel desperate to put roots down somewhere and create a supportive network of friends. My dilemma is whether to force another move on my children when they are settled here. This place has positive features for them; the place we’ve thought of moving to is less multicultural. Maybe I should just suck it up until they leave home. Mothers are supposed to put their children’s interests first, after all.

The core to resolving your dilemma lies in working out what’s within you and what are external factors. Too many people seek to change their surroundings (work, or partner, or home), while the issue within them remains unchallenged. They then wonder why the new place (or partner, or job) hasn’t made them happier.

I talked to psychotherapist Dr Joyline Gozho, who immediately noted your upbringing: “You probably had a lot of unresolved and unmet needs in childhood, and now that you’re a mother, they’re coming to the fore.” When you add in the menopause, which can be a time of great reflection (“What happened to me? What about my needs?” are questions often asked), and Covid, which is making so many people reprioritise, it’s not surprising you are in a dilemma. But you don’t need to do anything just yet.

The first thing both Gozho and I felt you needed was time to explore your own feelings, without thinking about family and future. “You need to have considered therapy that looks at your individual needs,” Gozho said. You mention seeking counselling but not whether you addressed these issues in it. “Your mother dying and your emotionally unavailable father – those are huge losses that may have left you feeling emotionally deprived.”

You rhetorically ask if a mother is supposed to put her children’s interests first. Not always, and certainly not if it makes the mother unhappy to the point of the children knowing about it, because they will then blame themselves. Gozho and I were concerned that your eldest knows how unhappy you are and wonder what internal narrative she may be establishing for herself. She shouldn’t be worrying about you when she is about to enter the turbulent waters of adolescence.

I want to move back to the UK. How can I convince my husband to give it a try?

Read more

You talk about being “desperate” to put down roots, while also talking about pulling them up. This contradiction makes me wonder how much of this need is within you, yet you constantly search for it externally. You need to home in on what it is you feel you are missing, and whether living by the sea will give it to you. The seaside is lovely, but when people talk about moving there in a certain utopian way, it strikes me as running away. That’s never a good basis for stability and growth.

Have you spent any time in the place you’d like to move to, winter and summer? Talked to people who live there? I would do this as soon as possible.

Making a flow chart and asking, “What if we do this, and what then?” can give great clarity. If you find the only good reason for moving to the seaside is that you want to, I wonder about putting yourself under that sort of pressure to make it a success.

 Every week Annalisa Barbieri addresses a family-related problem sent in by a reader. If you would like advice from Annalisa on a family matter, please send your problem to ask.annalisa@theguardian.com. Annalisa regrets she cannot enter into personal correspondence. Submissions are subject to our terms and conditions: see gu.com/letters-terms.

Image Credit- Elias Vicarios- Unsplash

COPYRIGHT CITY SANCTUARY THERAPY

No part of this website, including the blog content may be copied, duplicated or reproduced in any manner without the author’s permission.

Any information, materials, and opinions on this blog do not constitute therapy or professional advice. If you need professional help, please contact a qualified mental health practitioner.

Control is a form of abuse, so is other forms of coercive behaviours. Being in a relationship with a controller is unhealthy; it can be very damaging. Controllers dominate the relationship, leaving no space for their partners. The relationship itself is shaped by dominance & submission. Controllers do not only seek to control all aspects of the relationship, but  their partner as an individual, stripping them off their individuality. This can be depersonalising, and easily erodes one’s sense of self.

Control in Relationships

Many people in controlling relationships do not even recognise that their partners are controlling them. This is so because the controlling, and patronising behaviour is often coveted, and subtle.  It is often done in the name of love, which can be confusion to the victim, and difficult to pick up for anyone who has a poor sense of self.  It may take others to identify it, and highlight it for them. In some instances, controllers are aware of their behaviours, while others may not be cognisant of their behaviour as being controlling. Resultantly, they don’t realise how much harm they cause their partners.  The behaviour becomes normalised, yet incredibly harmful. This is why therapy is incredibly helpful for both the subject, and the victim. Nevertheless, it is the victim who suffers the most, where there is a controlling partner. This dynamic is typically a result of a trauma bond which is very difficult to disentangle, as the underlying trauma needs to be addressed.

As a therapist, l have worked with many people who experience control issues in their relationships-both controllers and victims. I am aware of how prevalent control  issues in relationships are, yet many people only become aware of them once they start therapy. This highlights how much damage control silently cause in relationships. Healthy relationships are created, they are not magical. It is therefore crucial that the discourse around romantic relationship dynamics  continues & the nuances of it unpacked.

Healthy relationships are nourishing, while controlling relationships are depleting, and damaging. Women and men are both prone to becoming controllers, or to be controlled in relationships, and it’s not exclusive to a particular coupledom. People in in same-sex relationships, polyamory, or heterosexual relationships all experience these issues. Controlling behaviour in relationships often coexist with verbal and or emotional abuse.

How to recognise control in a relationship?

Controllers are partners who:

• Monitor and/or dictate how you spend your time, and make you feel guilty about leaving them out.
• Monitor and/or dictate who you spend your time with make you feel guilty about it.
• Monitor and/or dictate how you spend your finances and make you feel guilty about it.
• Monitor or dictate what you wear & make you feel guilty about it.
• Morbid jealousy and accusations of cheating or betrayal.
• Intrude into your personal material such as going through your phone, bank statements etc.
• Blame you when things go wrong & being repeatedly made to compromise & give up what’s important to you.
• Make you feel your opinion is secondary & your reality is warped.
• Control how you should behave around others-edit your self.
• Gaslight and make you question your truth.
• Use their emotions to set the tone and control situations.
• Prone to use anger as a weapon to silence or frighten their partner.
• Undermine your needs, prioritising theirs.

Predisposition

Controllers are people who are likely to have grown up in environments where they had to emotionally take care of themselves from a young age, and become tough because they felt emotionally neglected, and vulnerable. A parent or any care giver needs to be emotionally available to a developing child in the formative years,  offering what Bion (1962) termed containment, where the emotionally attuned and receptive adult take on (introject) the child’s distressing emotional states and feelings, metabolises it, and hands it back in a detoxified manner. If there is emotional neglect, the baby never gets to learn to develop the capacity to process and regulate their own emotions. If this form of neglect happens throughout childhood, the child develops a defensive way of coping which protects that vulnerability. Becoming tough, in order to protect oneself is indeed a part of that protective mechanism. Emotional neglect is a form of abuse and if it happens consistently throughout the child’s life, it leaves long lasting scars.  Research (Bellis, et al, 2014) suggests that people who suffered emotional abuse (Adverse Childhood Experiences) are likely to grow up to become adults who have anger issues, other difficulties regulating emotions, have difficulties with interpersonal relationships, as well as develop frank mental health challenges.  Anger is a core feeling in controller’s lives, as it makes them feel powerful, yet they do not associate it with vulnerability. Deep down, controllers feel incredibly weak and powerless; controlling the other person makes them feel powerful. People who were bullied in their childhood are likely to become controllers to their partners, so is people who grew up witnessing their parents’s dysfunctional relationships.

The controlling behaviour itself is a trauma reaction, as one felt exposed and vulnerable as a child. We fight, flight or freeze as survival, instinctual reactions. One would consider controlling behaviour as part of the “fight” way of functioning. From a very young age, controllers’ only way of survival has been to be tough, and this becomes integrated as part of one’s personality, albeit pathological. Controllers often finds it difficult to relinquish power, and give up their position which is all they have known. Giving up the power also means exposing their vulnerability, and there is a threat of psychic collapse. This is why most controllers present to therapy with anger related issues, either in individual or couple’s therapy. They do not often view their behaviour as problematic, until the therapist points it out to them. Anger is what you see on the tip of the iceberg, while underneath it there is fear, anxiety, shame, worry, insecurity, guilt, and a lot of fragility.

Victims of controlling partners are likely to be people who have a very impoverished sense of self and lack a definition of themselves. They are therefore unable to fully articulate their needs since they do not know what they value, or not and the limits of how they should be treated. They often lack the ability to advocate for themselves, and depend on their partner, deferring to them to make decisions. People who are in this type of relationship are likely to be co-dependent on each other, one playing the role of the controller and the other the victim. Victims of controlling behaviours are likely to be people who grew up being made to feel like their neds were insignificant and secondary. They had to rely on others-parents, or older siblings, to make decisions for them. Being in the dynamic with a controller is a familiar place for them. Freud (1912) described this as a transference, where one relates to figures in their current life as if they are figures from their past. While this phenomenon is unconscious, there is repetition of the dynamics in these early relationships “there and then”, projected in the present “now” and there are similar feelings evoked. This is why people who are victims do not often realise it, as it is a repetition of something repressed, however familiar at an emotional level.  Freud (1912) argued that in repeating, remembering, and working through these early experiences, we are able to use the transference to unravel the past, and work through the early trauma that was repressed in the present. This is why therapy is significant in helping both victims and perpetrators of controlling behaviours in relationships. It is true that a big part of how we relate to our partners in romantic relationships is transferential. Some partners will unconsciously create  parent – child dynamics, while others will have sibling dynamics etc. These transferences are not always fixed &  get illuminated at different times- for example a partner can  easily become the critical mother, annoying sibling etc, or a simple argument can provoke a powerful response, as a transference response. The reaction is due to the familiarity of the experience & the feelings it evokes.

At unconscious level, what attracts us to our partners is the very thing that either we may have sought in our own parents, or see in our partners & want to regain & preserve it.

Couples can work through and heal from this form of abuse, if they put in the work through therapy. Individual therapy is also helpful in addressing control issues in relationships, for both victim and the controller. A big part of this behaviour is related to past trauma. Recognising that there is an issue is the first step into the healing journey, and developing empathy towards each other. It is true that some cultures normalise controlling behaviours in relationships, and women are often viewed as subservient to men. This is very harmful, as it often leads to other forms of abuse such as physical, verbal, and emotional abuse.

How to heal from controlling behaviour in relationships

Victim

• Recognising and accepting that you are being controlled is the beginning of the healing journey. When we acknowledge something in our lives, there is a huge transformation that already takes place.
• Learn to advocate for yourself and be firm & consistent.
• Make your partner aware of how their behaviour makes you feel and remind them that you are an adult, and you have the right to make decisions for yourself.
• Have meaningful relationships with your family and friends. Controllers like any abusers often alienate their victims.
• Seek professional help as some of these behaviours are deep rooted.

The Controller

• Learn to let go of the need to control your partner and the relationship.
• Understanding the source of the need to control and being able to reflect on it is helpful in managing this behaviour. Think about your past and when you were made to feel weak and vulnerable. Have compassion over your younger self and understand that is the past.
• Find ways of managing your anger, which is often at the root of controlling behaviours.
• Seek professional help individually and work through some of this childhood trauma that gets acted out in the relationship.
• Seek couples therapy & learn healthier ways of relating with your partner with their assistance.

References

Bellis, M.A., Hughes, K., Leckenby, N. et al. National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviours in England. BMC Med 12, 72 (2014). https://doi.org/10.1186/1741-7015-12-72

Bion, W. R. (1962). Learning from experience. London: Karnac

Freud, S. (1912). The Dynamics of Transference. – Strachey, J. (1958). The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XII (1911-1913): The Case of Schreber, Papers on Technique and Other Works. [Electronic version]. Retrieved from PEP Archive database. http://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib,cookie,url&db=pph&AN=SE.012.0097A&site=ehost-live

Freud, S. (1914). Remembering, Repeating and Working-Through (Further Recommendations on the Technique of Psycho-Analysis II). – Strachey, J. (1958). The Standard Edition of the Complete Psychological Works of Sigmund Freud, Volume XII (1911-1913)

Image Credit- Jonas Svidras- Unsplash

COPYRIGHT CITY SANCTUARY THERAPY

No part of this website, including the blog content may be copied, duplicated, or reproduced in any manner without the author’s permission.

Any information, materials, and opinions on this blog do not constitute therapy or professional advice. If you need professional help, please contact a qualified mental health practitioner.

Do you know someone who “wallows in self-pity”, or complains about their life/situation without doing anything about it?   They blame everyone else around them, but themselves. They lack any sense of responsibility or accountability over their own actions and overlook how they contribute to situations that they repeatedly complain about. People around them are quick to label them “energy vampires”, and you can only take them in small doses, because being around them is emotionally depleting. They bring you down, no matter how much you love them. The description l gave matches people who have victim mentality.

Victim Mentality

Victim mentality is one of the phrases/concepts that has emerged in this current psychobabble era;  its also a period where people are more open to talking about abuse in relationships. Victim mentality is harmful in any type of relationship-friendship, sibling, collegial, and other interpersonal relationships. It is even more harmful in romantic relationships where the power disparities are likely to get bigger, as a result of this way of functioning. If there is one partner who views themselves as a “victim” in every situation, it subconsciously puts the other partner in the perpetrator role. It then becomes very easy for the victim & their partner to inhabit these roles, and unconsciously enact them. Ironically, people who have victim mentality tend to pair up with “controllers”-people who like to control and dominate others. This means each partner adopt a fixed role & play it well.

Victims in Relationships

Victims are people who tend to be passive in relationships & simply let things happen around them. They allow their partners to get away with abusive behaviours, and let their boundaries pushed, without enforcing them. Victims feel that they can neither  speak up, nor advocate for themselves. So they simply complain, and complain, and complain , about the same situation. Since they view themselves as the victim, it’s safer for them to complain without doing anything about the issue they complain about.  At an unconscious level, this behaviour is a result of fear of abandonment, and lack of trust in themselves as lovable and deserving. Safety is an innate need. Our ancestors lived in batches for safety reasons. Abandonment meant being mauled by wild animals. We all have that inbuilt  and hard wired need for safety, and security, which is part of our evolutionary make up. Victims also lack a definition of themselves; any threat of loosing partners (by speaking up) will trigger extreme anxiety of loss of self and/or psychic disintergration. Therefore, the   dynamic where there is victimhood leaves the victim in this fixed position without making any effort to change things, due to the fear of abandonment. Things going well for long periods of time can also make the victim fearful and insecure. They may unconsciously trigger bad behaviours from their partners, in order to reinforce that victim role, as it gives them a sense of validation. These destructive cycles reinforce that victim role and perpetuates the destructive cycle.

Internal Experience

It’s easy to ignore the distress behind people who have the victim mentality, and simply view them as annoying, weak, irritating, or spineless people.

People who adopt the victim role often have:

• Low self esteem
• Depression
• Low confidence
• Impoverished sense of self
• Anxiety
• Insecurity
• Worriers
• Emotionally fragile

Predisposition

People who adopt the victim mentality are likely to have grown up in environments where they felt vulnerable and unprotected by their care givers. They were made to feel bad for  being themselves, or speaking up for themselves, & often had to tune into their parents’ feelings and emotions. They  were neither nurtured emotionally, nor allowed to develop what Winnicott (1960; 1965) called the True Self.  According to Winnicott (1960; 1965) the mother must be receptive to the baby’s emotions, and respond to them in a way that the baby can be more trusting of their own abilities and develop their True Self. In order for the True Self to develop, the mother has to be able to receive what Winnicott termed the baby’s “gesture”, which gives gives expression to a “spontaneous impulse”. The source of this gesture is the True Self.  When the mother is unable to meet these spontaneous gestures, by receiving the baby’s omnipotence, the baby complies with the mother’s defensiveness, which forms the origins of the False Self.  In order for the True Self to develop, the mother has to be able to  makes sense of the baby’s needs by being attune to the baby’s emotional needs, and respond with empathy. There has to be repeated experience of this nature, which the baby has to internalise.  Failure to do that, the baby creates a defensive- False Self – out of compliance, which hides the True Self. When the False Self becomes organised, it acts as a protector of the True Self,  albeit inauthentic, weak and fragile. In contrast, the True Self is playful, creative, and robust.  If the  True Self, was never cultivated, the False Self becomes dominant over the True Self.  In adult life, the False Self means an impoverished  internal world and weak ego.  Since the  False self is inauthentic, one will seek validation in others- victim mentality. The lack of development of the True Self is what is behind feeling “fake”, “wearing a mask”, “an imposter” or feeling detached from oneself, and the world. People who adopt the victim mentality role are likely to have never developed their True self and therefore have an organised False Self, which lacks confidence & agency.

From an attachment perspective, victims are people who are insecurely attached, therefore fearful of abandonment. Most people who have victim mentality have anxious avoidant styles. Following Bowlby (1969) formulation of anxious avoidant attachment style, anxiously attached adults are people who are likely to have had mixed messages from their care givers. They could not depend on them, they had to care for themselves by keeping a distance, in order to feel safe. Anxious avoidant people tend to repeat the same pattern in romantic relationships-they tend to be very clingy and submissive to their partners, which is what lends them into victimhood. Although they may play the victim role, they are sensitive  to rejection. They crave to feel wanted, and needed by their partners, hence the submissiveness & placating themselves- the “martyr”.

People who had a secure attachment with their care givers/ parents, in childhood, are likely to approach adult romantic relationship from a place of confidence, autonomy, and maturity and see themselves as an adult who has agency, not a victim. If one has an insecure avoidant attachment style, they are likely to play out the internalised way of relating by drawing their partners close by being needy, and seeing themselves as victims who need protection. They do so instead of them doing something about the situation.  The clinginess itself & passivity is what perpetuates the cycle. From an attachment perspective, care givers of the anxious avoidant child would have not provided them enough safety and security and they could not rely on the parent to meet their basic needs. The partner of the victim is dealing with unmet needs from the parents.

How to Heal from Victim Mentality

• Remind yourself that you are special & you deserve to speak up for yourself.
• Learn to put your needs first or at least consider your needs in any situation.
• Take risks and change the familiar patterns that you are stuck in for example apologising for things you haven’t done, taking the blame.
• Remember you are not to blame for who you are, however you have the responsibility to change the dynamic
• Seek individual therapy of you think you have victim mentality. Many a time we do not recognise how much of our behaviour is simply a manifestation of our way of relating, from the internal working models laid out in childhood. Not all these patterns are healthy & we have a duty to change them.

References

Bowlby, J. (1969). Attachment and Loss, Vol. 1: Attachment. Attachment and Loss. New York: Basic Books.

Winnicott; D.W. (1960). Ego Distortions in Terms of True Self and False Self. The Maturational Process and the Facilitating Environment: Studies in the Theory of Emotional Development. NY

Winnicott, D. W. (1965). “Ego Distortion in Terms of True and False-Self” in The Maturational Process and the Facilitating Environment: Studies in the Theory of Emotional Development 140. New York: International Universities Press

Image Credit- Anthony Tran- Unsplash

COPYRIGHT CITY SANCTUARY THERAPY

No part of this website, including the blog content may be copied, duplicated, or reproduced in any manner without the author’s permission. Any information, materials, and opinions on this blog do not constitute therapy or professional advice. If you need professional help, please contact a qualified mental health practitioner.

Adverse Childhood Experiences/Childhood Traumas

What are ACEs/Childhood Traumas

Adverse childhood experiences (ACEs), also known as childhood traumas encompass the big stressors ” big T traumas”, and any other events which undermines the child’s sense of safety & emotional well being -“small t traumas”.  We often overlook the significance of these events unless if we examine  their impact on the child (0-17), who has no emotional capacity to process them. These traumas are not only actual events, but non-events, and deficits, that have a negative impact on the emotional wellbeing of the child. Our experiences in early life shapes our physiology, and brain structure which is primary to the developing personality. Contemporary studies in Adverse Childhood Experiences (ACEs) suggest that individuals  suffer “disrupted neurodevelopment” and “social emotional and cognitive impairment” following exposure to adverse and traumatizing environments during their development, which is associated with later costs to both mental health and physical health (Peckham, 2023).

The medical model has historically neglected the impact of the environment in “psychopathology”, until recent years where there is an acknowledgment of the intersection between early life traumas, and the development of emotional and psychological problems in adulthood.  In contrast, psychotherapy, particularly the analytic approaches, have always  put greater emphasis on the early life  experiences in the formation of one’s personality, and the development of “psychopathology” in adult life.  I am quoting psychopathology as it implies scientific knowledge, and conceptualisation, which goes against the non scientific  model of trauma which l am subjectively in favour of. It is true that most people who seek mental health treatment, or psychological interventions have a history of complex trauma, or some form of early trauma/s.  This means, without acknowledging the significance of ACEs,  these individuals would have their suffering pathologized, and diagnosed as having some mental disorders, and subsequently medicated- they simply become commodities in a system that seeks to label and medicate.  The psychotherapy world is experiencing a paradigm shift,  to a trauma informed  approach– which is ecological rather than pathological framing. This approach privileges the impact of life experiences, over underlying “pathology“. The trauma informed approach gives weight to the early life experiences, in shaping ones adult way of functioning; it also seeks to de-stigmatize, and de-pathologize one’s suffering.

My work as a therapist, and mental health practitioner, as well as my own lived experiences has given me the full appreciation of the impact of our life experiences in the formative years, in shaping ones subjectivity, personality, ways of viewing the world, and relating to others. I fully endorse and subscribe to the trauma informed model- philosophically and as an approach to therapy. I strongly advocate for an ecological approach, rather than medical approach, which often gives people fixed labels, without a consideration of the contextual factors behind ones emotional and psychological suffering.  Emotional and psychological suffering should not be viewed as some form of pathology, that should require a fixed diagnosis.  I fundamentally believe that as therapists, by focusing on psychiatric diagnoses and labels, we are unintentionally shaming our clients, and objectifying them as simply a “psychiatric diagnosis”. This has the effect of invalidating their unique lived experiences and the traumas that is behind one’s psychological distress.  That said, l am not anti-psychiatry; l fundamentally believe that the medical model and the trauma informed approach can inform each other, and work collaboratively, resulting in a more holistic way of working. Having alternatives also mean clients are empowered; they have options to choose between the medical or trauma informed approaches to address their difficulties.

Many research studies have  demonstrated the negative impact of adverse childhood experiences on an individual. Neuroscience Research (Amann, 2022) has proven that having a combination of ACEs increases the likelihood of developing mental health and emotional difficulties in adult life; three times higher  than the average person. This study examined 93000 cases, and concluded that those who experienced childhood traumas are 15 times likely to be diagnosed with borderline personality disorder. BPD is a personality disorder where the sufferer experiences difficulties with regulating emotions and experiences the world in extreme (black and white) terms. This leads to intense highs and lows, as well as other self-destructive behaviours. People with BPD often have great difficulties building and maintaining healthy relationships, as well as emotional regulation.  The formative years are crucial to personality development and some people’s emotional challenges in adulthood are directly related to a combination of environmental and psychological factors in their upbringing. Other studies on ACEs have been carried out by Kaiser Permanente and the Center for Disease Control in the USA involving 17,337 adults and correlated the number of categories of adverse childhood experiences (ACEs) with physical and mental health outcomes.

Allan Schore’s (2000) research and  pioneering work highlights the likelihood of people who have experienced childhood trauma- which corresponds with brain development- experiencing mental health challenges in adult life. Like Fonagy, he puts emphasis on the developing child’s capacity to emotionally mature, enabled by their environment-the attachment  with mother and relationship with mother who is able to help the child to regulate affect.  Schore coins the term ‘relational trauma’ bound in the traumatogenic experiences happening within the ordinary transactions between parent and baby in the course of looking after the baby. Through the research work there is evidence that early trauma impacts the child’s brain development, attachment styles, capacity to mentalise, which are the hallmarks of emotional and mental health difficulties in later life. Martin Teicher  researches on child abuse and maltreatment argues that “Brain development is directed by genes but sculpted by experiences” (p652). These approaches are viewed by many as medical, as they conceptualise that trauma leads to physiological changes in the brain development and functioning, leading to psychopathology. The focus is on the link between physiology and pathology.

Among other vital research, Young Minds (2018) and Bellis et al, (2014) concluded that having a situational or cumulative ACEs led to poor mental health in adult life. ACEs affect the child’s emotional development, which translates to problems with relationship with themselves, others and the world as adults. Apart from experiencing mental health difficulties in later life, people who had a combination of ACE are likely to have drug and alcohol problems, have early or unplanned pregnancies, are likely to be involved in crime, and likely to end up in the criminal justice system. Aman (2022) concluded that ACEs were related to mood disorders, depression, PTSD, anxiety disorders, eating disorders, schizophrenia, and substance abuse. For every reported type of abuse experienced in childhood, a participant’s risk for PTSD increased 47%. Each cumulative trauma also increased one’s risk for making a suicide attempt by 33%.

Examples of ACEs are:

• Physical Abuse
• Verbal abuse
• Sexual abuse
• Emotional neglect
• Parental divorce/separation
• Parental sickness or ill health
• Having a parent who experienced mental illness
• Having a parent  who went to prison
• Living with a parent who abused drugs or alcohol
• Living with a sibling who has a disability or mental health challenges
• Exposure to parental conflict-family dysfunction
• Loss through death-parent/sibling or family member
• Loss of home-boarding school, foster care
• Loss of home- foster care/adoption, house moves
• Loss of home through emigrating and or house moves
• Childhood sickness & illness eg asthma, cancer, eczema etc
• Development issues eg stutter, dyslexia, bedwetting
• Bullying
• Relational Trauma in how the child is cared for by the parent
• Accidents-car/fires/etc
• Wars/conflict
• Parental Responsibilities

The Child and the Adult

It’s easy to overlook the significance of childhood ACEs unless if we unpack and understand their long-lasting impact on one’s way of relating to the self, others, and the world, as well as one’s overall personality. Many people come to therapy unaware of the fact that some of their experiences in childhood were adverse. At times it’s a defence (Klein, 1946) against the pain of acknowledging it, while others simply genuinely lack the understanding, or the language to express it. Having an awareness of how an experience that was adverse or traumatic is impacting on one’s current life is significant. Not only is it validating, but helps that person integrate the trauma, and work through it. Knowing something about ourselves, helps us develop a more intimate relationship with ourselves, and relate to ourselves in a more sophisticated way. It makes that problematic issue less scary and we can also approach it with compassion.

Trauma and Privilege

Having a privileged life does not mean one is immune to ACEs. Parents who can provide economically but  emotionally cold, cause significant psychological harm to the child. A child who has been send to boarding school (rupture from their care givers & emotional support) is no different to a child who is placed into foster care. The emotional impact is the same.  The only difference is one has an economically privileged life, while the other comes from poverty. In her book on Boarding School Syndrome Joy Schaverien writes, evocatively, about the trauma of the privileged child who is removed from home, and send away to an artificial environment (boarding school) away from the primary care givers (Schaverien, 2015). Bullying is rife in boarding schools, and the children are deprived of love, physical affection, and emotional warmth, something that they fundamentally need in these formative years. Drawing on real life stories from ex-boarders, she is able to demonstrate how people who went to boarding school earlier on in their lives tend to experience significant difficulties with intimacy, sustaining emotional connections, have an impoverished sense of self, and lack confidence in adult life. This creates secondary issues in relationships -both romantic and interpersonal. Many ex-boarders have been negatively impacted by the separation from their care givers at a young age, tend to feel a lot of guilt and shame, and that they have no right to complain about their parents for creating such a solid foundation for them. These contradictory feelings invalidates their trauma and leaves them feeling even more isolated in their pain.   It is always important to reflect on the experience from a child’s perspective, not an adult; the adult is able to make sense of a lot of things that the child was incapable of.

Immigration and Loss of Home

 Many people do not recognise the significance of rupture from one’s home, and the impact of not having consistency in childhood. Whenever there is a move, we experience loss of home- the environment- as well as the relationship we create with that home (environment) and other people in our lives. When children are moving from one place to the other, whether it’s a one off or repeated moves, there is an internal sense of loss they experience. There is a breakdown of attachments (emotional bonds) (Bowlby, 1969) they create with the home itself, their friendship groups, teachers etc. This leaves emotional scars where in adulthood, attaching to others is avoided as there was never a sense of permanence in their world; attaching also means experiencing loss, so their relationships remain very superficial albeit unfulfilling. In adult life it’s not unusual for these people to have difficulties building and sustaining long term relationships, and having deep emotional connections with others. Some may also have identity issues, and feel rootless at an emotional level, and untethered in life.

Parental Divorce/ Separation

Most of the ACEs listed above happen in the children’s home environments, where there is either one or both parents present. It’s obvious that any form of abuse negatively impacts on the child; parental divorce and separation also does. While it may be the best outcome for parents and the children,  children inevitably experience loss of a parental unit, a family unit, and a disruption of their lives. The parental situation is not something that they can inform, nor make a decision on- as a result children of divorcing parents tend to blame themselves for the divorce, or feel that they are a liability. The adults involved often overlook the meaning of parental divorce and separation on the children  as the focus is on themselves. Ongoing parental discord does compound this trauma, while healthy co-parenting mitigates some of the trauma.

Parentification

Another ACE to keep in mind is when the child is being given parental responsibilities, also referred to as parentification. It is not unusual for parents to give their children adult or parental responsibilities and to be put in that role. This is typically the oldest child who is made to look after their younger siblings, or becomes an emotional confidant for one or both parents. It can also be a child who is made to manage other household chores, budgeting, etc. this takes away the child’s innocence and right to be a child who does not have adult responsibilities. Often, we hear people say “she/he is very mature for his age” implying that its a good thing. What we do not recognise is that we are burdening a child with adult responsibilities, and the perceived maturity is the only way that child had to cope with the situation. People who were parentified often turn out to be adults who are not very good at prioritizing their needs and advocating for themselves. They also easily become people pleasers, and may struggle with recognising when they are being exploited.  This is because as children, they never learnt to fully take care of themselves, as the attention was on others. They also lack the sense of justice  and injustice- boundaries-as their own boundaries were infringed at a very young age.

Abuse

It is no surprise that children who experience any form of abuse-physical, emotional, sexual and neglect will develop some psychological and/or  mental health challenges in adult life. Healthy development of a child is highly dependent on an environment where there is emotional safety,  where the mother  or care giver is able to make both environmental and emotional provisions for the child. The care giver has to be emotionally available and attuned to the child (Winnicott, 1960). Any adverse experiences will interrupt the normal and natural psychological development of the child. Children do not simply mature physically, but emotionally-they have certain milestones that they need to successfully reach and succeed. Without his holding environment and the presence of ACEs mean that the development can be arrested at any time. This means a lack of psychological maturity which translates to mental health problems in adult life. Neuroscience confirms that the child’s brain develops differently where there is abuse.

Discord in Parental Relationships

Children who grow up exposed to parents’ fights are indeed being harmed by those experiences. It is adverse and damaging for the child to witness directly to have an indirect awareness of parental discord. Children need to grow up in an environment where there is emotional warmth and safety. Even if the fights are concealed from them, children are very sensitive and emotionally perceptive. Children do very easily blame themselves and adapt according to what they think is best for the parents, not for them. This means that the children end up looking out for the parents, and putting their own needs down. They mould their world around their parents’ not according to their own growth trajectory.  Many parents stay in dysfunctional homes “for the sake of the children”. What they do not realise is that, raising children in an emotionally volatile environment is more harmful, and damaging to them than having two happy and warm homes, they can spend time in. Some cultures promote the idea of staying in toxic relationships for the sake of the kids which is damaging for them. For any parents, recognising the different ACES, minimising the exposure to them, and cultivating a healthy environment where the child is nurtured emotionally, supported, and their wellbeing prioritised is key.

Therapy and Healing Trauma

Neuroplasticity

Neuroplasticity refers to the capacity of neural systems to adapt and change. Neuroscience suggests that neurons in many parts of the brain continue to undergo structural change not just through childhood and adolescence, but throughout life. This means that any new experiences, at whatever age, can cause the brain to physically alter its synapses and change. In other words, we are stable enough in our environment because our genetic inheritance has been sculpted by natural selection over many lifetimes, but we are “plastic” enough to adapt to our environment within our lifetime. Peckham (2023) argues that “For so many mechanisms of neuroplasticity to have evolved indicates that the capacity to learn from and adapt to past experiences and to better anticipate the threats and opportunities we may have in the future enhances inclusive fitness, survival, and reproduction in our environment. p.5.

Trauma informed approach therapy validates one’s lived experiences and acknowledges the link between presenting symptoms and early trauma-ACE/s.  Since our brains are capable of changing, we can recalibrate them, and re-adapt to new experiences. The new “new experiences” can be used to heal or mitigate the impact of previous experiences; psychotherapy being an obvious candidate for “new experience”. The intersubjective relational work done in therapy enable people to work through the ACE trauma. The trauma informed approach is anti-shaming- it is very easy to shame our clients in therapy and retraumatise them, which also re-confirms their trauma. If the “new experiences” contradict the old experiences, clients are able to develop new ways of relating and being. This is what defines healing. Repeated shaming experiences generate an anticipation of shame and the experiences that trigger it. This anticipation may be referred to as toxic or chronic shame where the shame experience organizes a person’s identity and life around avoiding the anticipated and feared shame experience. Shame-driven distress and suffering is common across experiences of trauma and adversity.  “Recovery can take place only within the context of relationships; It cannot occur in isolation. In her renewed connections with other people, the survivor recreates the psychological faculties that were damaged or deformed by the traumatic experience. These faculties include the basic capacities for trust, autonomy, initiative, competence, identity, and intimacy. Just as these capabilities are originally formed in relationships with other people they must be reformed in such relationships” (Herman, 2001, p101).  Herman’s words highlights  why therapy is a fundamental aspect of healing childhood trauma. Van Der Kolk one of the pioneers in the trauma gives emphasis to the neuroplastic nature of the brain and the ability for trauma to be worked through in therapy. He postulates that traumatized people experience incomprehensible anxiety and numbing and intolerable rage, and how trauma affects their capacity to concentrate, to remember, to form trusting relationships, and even to feel at home in their own bodies. This work can only be done in a therapy where there can be repair to the damage caused by trauma. For more on the trauma- The Body Keeps the Score by Bessell Van Der Kolk and The Myth of Normal by Gabor Mate are excellent copies on trauma and healing.

Attachment Styles- Secure Attachment

Bowlby’s work on attachments-internal working models – relationship templates we create in childhood suggests that they can be repaired throughout the course of life. ACEs  lead to people having unhealthy attachment styles-avoidant, anxious, disorganised.  This create difficulties in interpersonal relationships as the attachment style informed behaviours and distress responses get reactivated in adult relationships. However through therapy, we can heal  and redefine these ways of relating to more secure relational patterns. The relationship with the therapist is a strong conduit for these attachment working models to change, as we can learn to trust others as reliable consistent, nurturing, and trustworthy beings.  The therapist can be experienced as a reliable care giver, and the therapy space becomes  a secure base. Donald Winnicott would have viewed this as  providing “corrective emotional experience”.

Understanding the significance of ACEs helps us make sense of why some people experience emotional challenges and psychological distress in adult life. No one is damaged, we have the capacity to heal and heal others through our own healing.

References

Amann, B.,  (2022) Trauma During Childhood Triples the Risk of Suffering a Serious Mental Disorder in Adulthood, European Archives of Psychiatry and Clinical Neuroscience.

Bellis, M.A., Hughes, K., Leckenby, N. et al. National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviours in England. BMC Med 12, 72 (2014). https://doi.org/10.1186/1741-7015-12-72

Bowlby, J. (1969). Attachment and Loss, Vol. 1: Attachment. Attachment and Loss. New York: Basic Books.

Fonagy, P. and Target, M. (2000) Mentalisation and personality disorder in children: a current
perspective from Anna Freud Centre. In Lubbe, T. (ed.), The Borderline Psychotic Child, 69–89. London: Routledge.

Herman J.L. (2001). Trauma and Recovery: From Domestic Abuse to Political Terror. Pandora ed. New York, NY: Basic Books

Klein, M. (1946). Notes on Some Schizoid Mechanisms. International Journal of Psychoanalysis, 27, 99-110.

Peckham, H. (2023). Introducing the Neuroplastic Narrative: a non-pathologizing biological foundation for trauma-informed and adverse childhood experience aware approaches.  Journal of Frontiers Psychiatry,  Psychopathology Volume.

Schaverien, J. (2015). Boarding School Syndrome: The Psychological Trauma of the privileged child: Routledge, London.

Schore, A.N. (2000) Early relational trauma and the development of right brain. Unpublished invited presentation. London: Anna Freud Centre

Winnicott, D. W. (1960). The theory of the parent–infant relationship. In: The Maturational Processes and the Facilitating Environment (pp. 37–55). New York: International University Press, 1965.

Image Credit- Chen Mizrach Unsplash

COPYRIGHT – CITY SANCTUARY THERAPY

No part of this website, including the blog content may be copied, duplicated, or reproduced in any manner without the author’s permission. Any information, materials, and opinions on this blog do not constitute therapy or professional advice. If you need professional help, please contact a qualified mental health practitioner.

Why are some people emotionally sensitive than others, & why do some people experience emotional difficulties more than others? There are a range of personality tests, for example- the Myers Briggs, SAPA Project Personality Test, Helen Fisher Personality Test, and Ennegram Personality Tests. Each one of them reveals that we are all unique,  and we have varied traits and personality types. Even identical twins who grew up in the same environment, and had similar experiences throughout life will never have identical  personalities. Within these personality domains, we all have our strengths and weaknesses.  Having high intellectual abilities does not correlate with high emotional intelligence. Paradoxically, it is  often the case that people who are highly  intelligent struggle with understanding and making sense of their emotions. This may be because while they have developed their intellectual capabilities, their emotional abilities are not as developed. Personality is not something we acquire; it’s something we develop throughout our lives. The formative years are crucial to personality development and some people’s emotional challenges in adulthood are directly related to a combination of environmental and psychological factors in their upbringing.

Despite growing up in the same environment, siblings do not always turn out the same. Some turn out to be more emotionally buoyant and robust than others, who may be more sensitive or have difficulties managing emotions. We may have siblings who developed some mental health challenges-anxiety, depression, Emotionally Unstable Personality Disorders/Borderline Personality Disorder, or just struggle with regulating emotions. Or we are that person. It can be distressing to have a sibling who experiences  emotional difficulties, or to be that person who  suffers from mental health problems and or emotional difficulties. In some cases, it often leads to parents and siblings blaming themselves, or each other for causing these difficulties. Some parents tend to view their children developing emotional difficulties as a sign of failure in their parenting. This is a key reason why some people who may have been raised in homes where they had everything they needed environmentally and economically, struggle with seeking help. There is often a sense of guilt attached to their struggle, and they feel that they do not have the right to struggle. To them it also means they have failed or translates to their parents having failed. It’s as if they have no right to complain, struggle or suffer. Yet they are only human.  Children need more than just economic provision. Emotional warmth, nurturance, co-regulation with adults, emotional safety, and adults who are emotionally attuned to the developing infant are all key to how we develop our ability to emotionally regulate as adults.

How do we develop emotional difficulties in adulthood

1- Biology

Biology (genetics) plays a big part of our makeup. Epigenetics is the study of how changes in the external or internal environment impact gene expression.  Fonagy views our capacity to seek attachments as part of our biology and genetic inheritance. He considers that there is a gene- environment interplay which shapes how we develop biologically. The environment is the attachment relationship.   Neuroscience research proves that sensitive people have certain gene variations which create activity in certain brain regions. Martin Teicher  researches on child abuse and maltreatment argues that “Brain development is directed by genes but sculpted by experiences” (p652). This means that our genetic make up is shaped by our environmental experiences.

2-Psychological

Childhood trauma-abuse, neglect, prolonged stress in early life, childhood illness, early loss through death or separation. Research suggests that people who experienced adverse childhood experience are likely to struggle with their emotions and develop severe mental health difficulties in adult life (Young Minds, 2018; Bellis et al, 2014).   1 in 3 people with mental health problems had adverse childhood experiences. Read my blog post on Adverse Childhood Experiences where there is more information about ACEs. Though his pioneering work Allan Schore evidences that the brain development of people who are brought up in environments where there is trauma and maltreatment is significantly different to those who were raised in more nurturing environments. He considers the emotional relationship between child and caregiver as the environment for brain development and that brain development is an adaptation to that environment. Allan Schore’s (2000) research highlights the likelihood of people who have experienced childhood trauma experiencing mental health challenges in adult life. He terms this ‘relational trauma’ bound in the traumatogenic experiences happening within the ordinary transactions between parent and baby in the course of looking after the baby.

2- Environment

The environment we grow up in plays a huge part in how we manage emotions as adults.

Environments where children grow up with adults who are emotionally dysregulated themselves only lead to adults who are unable to regulate emotions emotionally. “You cannot speak a language you never learnt”.

Environments were adults invalidate the children’s feelings & the child is made to hide their true feelings (sadness/shame, anger etc) lead to adults who never learnt to bear difficult feelings.

Environments where the child has to constantly tune into the parents’ own emotions, ie disregarding their own emotions.

Environments where the parent is absent from the child’s emotional landscape -emotional neglect.

An environment where healthy emotional expression and emotional regulation was modelled is key to healthy emotional development and expression in adult life.  Psychological trauma also predisposes some people to having difficulties with their emotions. Psychoanalytic theories put greater emphasis on the ability of the parent to offer a form of emotional containment (Klein, 1946;  Bion, 1962). They  give value to a care giver who is emotionally attuned (good enough mother) and creates an environment (Winnicott, 1960) where the child can feel emotionally held by the parent. Without this, the child never develops the capacity to manage difficult emotions, which should be moderated by the parents, and handed back in a palatable and less toxic form- Bion calls this “containment”. Winnicott (1960) also uses the concept of mirroring where the baby develops reflective abilities through the mirroring of mother’s affective states and learn to emotionally regulate  as a result- omnipotence- and integrate the mother as a good object . The mother has to be attentive and attuned to the baby’s emotional states; in some cases the mother fails to facilitate the mirroring process which has negative consequences on the baby’s developing psyche.

Attachment and Affect Regulation

Through his scientific research work, Peter Fonagy proposes that we have an inbuilt biological evolutionarily advantageous potential for an interpersonal interpretive capacity: the capacity to ‘read’ and understand the mental states of others and our own (Fonagy, 2000). He terms this mentalisation. However this capacity can been diminished as a result of prolonged exposure and adaptation to an ongoing stressful caregiving relationship in childhood. This interruption often creates difficulties in understanding and attuning to other people’s affective states in adulthood- inability to mentalise, and difficulties with emotional regulating. This is indeed a form of relational trauma which stems from a mother not responding to the baby’s affective states, and therefore not developing the capacity to regulate affect.  Fonagy developed a therapy approach called mentalization which is essentially learning to develop  the capacity to reflect on one’s affective state and that of others. Fonagy’s  mentalization approach is commonly used in the treatment of BPD and it has demonstrated positive result. Most people’s struggle with emotions is due to their inability to emotionally regulate, and to reflect on their affective states, and that of others- mentalise.  This has a huge impact on interpersonal relationships, and managing one’s own emotional reactions. The capacity to mentalise is rooted in the child’s attachment relationship with their  care giver, and it is something that can change throughout one’s lifespan.

Neuroscience

Allan Schore’s work on brain development and emotional growth, highlights the significance of  affect regulation, which is developed in childhood. He views  the capacity to manage emotional states  as a neuropsychobiological developmental achievement, arising out of the early mother-infant relationship. In normal development, the child learns to regulate their own emotions, initially through a process of co-regulation with the (maternal) care giver . Schore considers the capacity to experience, communicate, and regulate emotions as key milestones in the development of the human infant, which is heavily dependent on the quality of the relationship with the care giver. Pathology develops when the child is left in heightened emotional states, leading them to develop maladaptive ways of coping with emotions, something that continues in adulthood. The interaction between brain development and the environment which is seen as key.  Schore links the infant’s right brain maturation- ability for affect regulation- giving significance to the early interpersonal affective experiences with care givers.  This development has an impact on other parts of the brain-limbic system- which deals with processing the processing of physiological and cognitive components of emotion. Schore centres human emotional development to the ability for the brain to self organise, and the infant to interactively regulate.

Alexithymia and Autism

Some people do not experience emotions at all, a condition called Alexithymia.  Some, but not all people who are on the autistic spectrum experience difficulties with experiencing certain emotions, such as empathy. Alexithymia and Autism are two distinct conditions; however some people who are Autistic can also be Alexithymic. Like Autism, Alethythimia has a spectrum. Some people may have the trait (primary) or secondary Alethithymia where it is situational- for example where there is trauma, PTDS symptoms may lead to the subject experiencing  difficulties identifying their emotions. Anyone who is Alexithymic  lives in a world where there are no emotions, and they rely on their cognition to make sense of the world.  They may be able to say “l love you”, ” l am sorry”, etc but they are not able to emote, or relate any of their life experiences to an emotion. Their bodies do not respond to any emotional states- for example anger means heart racing, anxiety means restlessness, sadness means tears etc.  This must make their world both obtuse and abstract. The lack of emotion creates a lot of challenges in interpersonal, and romantic relationships. Resultantly, people with Alexithymia are very vulnerable to having relationship problems, and depression.   Alethythimia is associated with trauma, and extreme emotional neglect in childhood. One may hypothesise that the emotional blankness may be a result of a defence the person created as a child, in an environment where there was emotional neglect or trauma (Klein, 1946). This defence then becomes part of ones personality, and remains present in adulthood.

Emotional sensitivity or having difficulties managing emotions is not a sign of weakness. Having relationships where our feelings are validated & checking in with oneself is crucial. Knowing one’s vulnerabilities- what’s likely to bring out the sensitivity can also help in mitigating it.

                                                  Logic of Emotions -Triune Brain Theory

Dr Paul McLean proposed the evolutionary brain theory back in the 1960s- see image below. Today, this theory is widely accepted in the field of psychology.  He viewed the brain as having three main layers, superimposed on each other, which developed at different stages in our evolution. Viewing the brain as an entity that is composed of these 3 layers, helps us understand why sometimes we do things that are contradictory to how we feel, and that defies our usual way of doing things. This is so because our behaviour is at times controlled by our reptilian brain (behaviour-reflex), or our creature brain (emotional response). Recent studies have concluded that neurons in many parts of the brain continue to undergo structural change not just through childhood and adolescence, but throughout life- any new experiences, at whatever age, can cause the brain to physically alter its synapses-a characteristic known as neuro-plasticity.

The Truine brain model also helps us understand why some people struggle with managing emotions, which means they have not nurtured, and not fully developed their emotional (middle) part of the brain. This can be done, and therapy helps. Today’s society values reason over emotion, people who experience difficulties regulating emotions are often left feeling alienated and misunderstood. Emotions have their own logic, quite distinct to the logic of intellect. Its vital that we comprehend the logic of emotions.

Triune Brain Illustration (Image credit to Dimitri Roman)

Reptilian/ Mammalian

This is primitive and innermost part of the brain which deals with instinct, survival, safety, territory and repetition. It’s the part that is reflexive and triggers the fight, flight, freeze, reactions when there is perceived or actual danger.  We inherit this brain from all the animals in the animal kingdom, which we are a part of. For example, if there is a loud bang, the mammalian brain triggers a response for us to either run (flight), freeze (hide) or find out where the bang is coming from (fight). This part of the brain is what creates most difficulties in interpersonal relationships, where people are reactive, not reflective.

Limbic Brain- Creature Brain

This covers the mammalian brain and is more sophisticated. Also called the creature brain, it is the part that emotes, and helps us make emotional connections to experiences. It helps us make sense of our senses-pleasure pain and enables us to nurture, experience humour, grief, playfulness and other social experiences.  It also handles our behaviours and motivations and helps us make connections between experiences and emotions. We experience a range of emotions through this part of our brain. It’s the part that is also able to make sense of the need to keep away from things that brings us displeasure and draws us to things that brings us pleasure. Using the example given above of hearing a loud bang-this part of the brain helps us recognise the feeling it evokes-fear, anxiety etc

Neo Cortex

This part of the brain is the recently evolved part, and it’s the part that deals with anything intellectual, logic and reasoning. It deals with facts- why, how and make sense of the world in a logical manner. This part is highly developed for many people as it can be developed through learning and exercising our intellectual abilities. Drawing on the example of the loud bang,  its the part that seeks to investigate what caused the bang, why, where and make sense of it.

Discussion- Therapy and Emotional Maturity

Using the Triune theory, people who struggle with emotions have not fully developed the emotional part of their brain and this could be for several reasons. The environment is primary to how we learn to relate to emotions, so is our biological  make up, although (l believe) this is secondary. In many cases, it also means that the intellectual part of their brain is very well developed, while the emotional part has not been sufficiently developed. The primitive part of the brain is something we cannot change. However, we can learn to tame it if we use the emotional, and intellectual part of our brain and make sense of situations that are perceived as threatening. This philosophy informs Cognitive Behavioural Therapy (Aaron Beck), as well as Mindfulness.

Peter Fonagy’s Mentalisation Based Therapy (MBT) approach which is based on developing the capacity to reflect on the affective mental states could also be seen as a way of expanding emotional repertoire, therefore developing an understanding of one’s emotional states in relation to others. Mentalisation Based Therapy (MBT) is a free standing therapy approach used to treat people with Borderline Personality Disorder (BPD)- where people experience huge difficulties regulating emotions and inability to reflect on their mental state and that pf others- mentalise. I believe that therapy per-se,  has some mentalisation aspects, where there is  fostering of the capacity to reflect on one’s emotional states and triangulation of experiences.

Regardless of modality, my view is that therapy as a reflexive process, helps people develop emotional maturity. It helps people nurture  and develop their emotional vocabulary & expand it. Therapy also helps with developing the capacity to mentalise- reflect on one’s mind, the mind of others, as well as regulate emotions. Therapy enables us to re-establish broken attachment patterns and restore healthy ways of relating (form a secure attachment), in a secure and safe way-this is why the relationship with the therapist is central. Neuroplasticity– the capacity for our brain to adapt and change over time throughout our life span mean that we can learn healthier ways of relating, and rebuild new pathways to emotionally responding to situations.  Therapy enables us to develop an intimate relationship with our emotions & own how we response to them. There is a difference between responding & reactivity- the former is healthier, while the later is a more primitive way of  handling emotions. If we learn that we have other options, and not simply repeat, but reflect on our feelings, we are indeed nurturing that emotional part of ourselves.

I always view therapy as a process where some people who feel strongly need help to understand their feelings and emotions, while others who understand need help to feel. Emotions enriches our lives-they make it colourful and beautiful.  Without emotions, our lives are grey and gloom- we wont feel joy, excitement, sadness, anger, anxiety, which makes us feel alive and shapes life. However they become problematic when they diminish the quality of our lives due to either overwhelm, lack of,  or inability to regulate them.

Interestingly, mildly stressful experiences of novelty, and complex enriched environments in childhood, can enhance our ability to cope with more complex emotions in adulthood,  -adaptive advantage- and help us build emotional resilience.

This paragraph is from Thomas Ogden’s Book Chapter- On Potential Space- in Spelman et al book referenced below. It highlights the mother-infant, and environment context and the functions of the mother in helping the infant regulate emotions.

“Within the context of the mother–infant unit, the person who an observer would see as the mother, is invisible to the infant and exists only in the fulfilment of his need that he does not yet recognise as need. The mother–infant unity can be disrupted by the mother’s substitution of something of herself for the infant’s spontaneous gesture. Winnicott (1952) refers to this as “impingement”. Some degree of failure of empathy is inevitable and in fact essential for the infant to come to recognise his needs as wishes. However, there does reach a point where repeated impingement comes to constitute “cumulative trauma” (Khan, 1963; see also Ogden, 1978). Cumulative trauma is at one pole of a wide spectrum of causes of premature disruption of the mother–infant unity. Other causes include constitutional hypersensitivity (of many types) on the part of the infant, trauma resulting from physical illness of the infant, illness or death of a parent or sibling, etc. When premature disruption of the mother–infant unity occurs for any reason, several distinct forms of failure to create or adequately maintain the psychological dialectical process may result: (1) The dialectic of reality and fantasy collapses in the direction of fantasy (i.e., reality is subsumed by fantasy) so that fantasy becomes a thing in itself as tangible, as powerful, as dangerous, and as gratifying as external reality from which it cannot be differentiated. (2) The dialectic of reality and fantasy may become limited or collapse in the direction of reality when reality is used predominantly as a defence against fantasy. Under such circumstances, reality robs fantasy of its vitality. Imagination is foreclosed. (3) The dialectic of reality and fantasy becomes restricted when reality and fantasy are dissociated in such a way as to avoid a specific set of meanings, for example, the “splitting of the ego” in fetishism. (4) When the mother and infant encounter serious and sustained difficulty in being a mother–infant, the infant’s premature and traumatic awareness of his separateness makes experience so unbearable that extreme defensive measures are instituted that take the form of a cessation of the attribution of meaning to perception. The dialectic of reality and fantasy becomes restricted when reality and fantasy are dissociated in such a way as to avoid a specific set of meanings, for example, the “splitting of the ego” in fetishism. (4) When the mother and infant encounter serious and sustained difficulty in being a mother–infant, the infant’s premature and traumatic awareness of his separateness makes experience so unbearable that extreme defensive measures are instituted that take the form of a cessation of the attribution of meaning to perception. Experience is foreclosed. It is not so much that fantasy or reality is denied; rather, neither is created. (These four categories are meant only as examples of types of limitation of the dialectical process. In no sense is this list meant to be exhaustive.) Pages 124-125

References

Bion, W. R. (1962). Learning from experience. London: Heine-mann. Reprinted by Karnac 1984, ‘’The K-link,” pp. 89–94. By permission, Karnac Books.

Klein, M. (1946). Notes on Some Schizoid Mechanisms. International Journal of Psychoanalysis, 27, 99-110.

Bellis, M.A., Hughes, K., Leckenby, N. (2014). National household survey of adverse childhood experiences and their relationship with resilience to health-harming behaviors in England. BMC Med 12, 72 (2014). https://doi.org/10.1186/1741-7015-12-72

Fonagy, P. and Target, M. (2000) Mentalisation and personality disorder in children: a current
perspective from Anna Freud Centre. In Lubbe, T. (ed.), The Borderline Psychotic Child, 69–89.
London: Routledge.

Ogden T. (2014)On Potential Space: in Spelman, M. B., & Thomson-Salo, F. (Eds.)The Winnicott tradition : Lines of development-evolution of theory and practice over the decades. Taylor & Francis Group.

Young Minds (2018). Addressing Adversity; Prioritising adversity and trauma-informed care for children and young people in England. Mental Health Review Journal.

Schore, A.N. (2000) Early relational trauma and the development of right brain. Unpublished invited presentation. London: Anna Freud Centre

Winnicott, D. W. (1960). The theory of the parent–infant relationship. In: The Maturational Processes and the Facilitating Environment (pp. 37–55). New York: International University Press, 1965.

Image Credit- Nathan Dimlao-Unsplash

COPYRIGHT CITY SANCTUARY THERAPY

No part of this website, including the blog content may be copied, duplicated, or reproduced in any manner without the author’s permission. Any information, materials, and opinions on this blog do not constitute therapy or professional advice. If you need professional help, please contact a qualified mental health practitioner.

In my role as a therapist, l have met many people who have friends, family members, or work colleagues who have experienced a mental health crisis, or a mental breakdown. At times this means one getting signed off work, and in extreme but not usual cases, admission into a psychiatric hospital. I have also met people who have lost loved ones who died by suicide, unexpectedly, and this was due to their poor mental health. Stories of this nature  dominate the media; there are many others that we do not hear about. For the family, friends, and colleagues of the person who has had a mental health breakdown, or died by suicide, there is often shock, despair and a lot of guilt attached to not having helped them, and  profound feelings of having let them down.

I have also worked with people who have experienced actual mental health breakdowns and crises, varying in nature, degree, and severity. Some may have had to take time off work, on their GPs orders, while others had to be admitted into psychiatric facilities due to risk to self, or for intensive treatment.  These are typically people who are very busy in their lives and make no time to rest, reset, pause, or make time for self care. The reason for this happening lies  in the delay in recognising that one’s mental health is deteriorating, and seeking help in a timely manner-early intervention.

I always remind my clients that “If you have a breakdown due to work stress, and burn out, they will hire a replacement tomorrow, and you only have yourself to fix, and you cant replace yourself either”.

This is a reality which we often forget, more so now, where the world we live in is centred around success, wealth, and status- capitalism. There is no room for emotions. Nature has cunning ways of bringing us back to basics.  Work stress and burn out are key factors in poor mental health, which can lead to attempted suicides, or completed suicides.  Most people who are struggling do not say it out loud even if they recognise it; that’s why suicide rates are high.

While mental illness is an internal experience, people who are struggling with their mental health often display certain signs and behaviours externally. If we are able to tune into what’s going on with people around us, we can detect any signs of mental ill health, and intervene early. Early intervention- diagnosis and treatment (therapy/medical) – lead to better outcomes. Again, l remind my clients that the best Doctors in life are: “Dr Rest, Dr Sleep, Dr Exercise, Dr Heathy diet, and Dr Hydration/Water”

People who are experiencing mental health difficulties may not recognise it subjectively. The onset can be mild, and the deterioration very surreptitious.  It may take others around them to pick up the signs, and changes that may be indicative of poor mental health, or a deterioration on one’s mental state.  If we become more conscious of the behaviours that are likely to manifest outwardly, we can do a lot to help, and support people may be struggling with their mental health. That also means we may safeguard some people who may end up suicidal, or even dying by suicide, something of concern in present day society.

“Early intervention translates to better outcomes”.

If you notice some of the signs of poor mental health  on your loved one, or colleague, do try and engage with them and/or notify other people around who may be able to intervene. Silence and ignoring that person is not an option. Rather give them flowers when they are alive, than take them to the hospital, or to their funeral.

Here are some of the signs of poor mental health:

1- Social Withdrawal & Self Isolation

Social withdrawal  & self-isolation from the world are some of the key  signs that someone may be experiencing some mental health challenges. This maybe due to lack of energy, loss of interest, not wanting to engage or simply giving up on life. The withdrawal and isolation may  be due to shame and a way of avoiding having to answer any questions that may reveal the person’s vulnerability.

2-Poor Hygiene & Poor Self Care

Poor hygiene is one of the noticeable signs of someone who may be having some mental health challenges, especially in depression. Poor self-care may be a sign of giving up on life, lack of energy, and lack of  motivation to look after oneself. A dishevelled look is always a give away.

3- Anger & Irritability

Anger and irritability (mood changes) can be related to underlying mental health challenges. It’s not unusual for people who are struggling to feel angry and irritable & at times easily snap or lash out. This often comes up in how they interact with others. Paradoxically, this is likely to negatively impact on relationships, leading to one becoming even more isolated, yet what they really need is company & support.

4-Hostile Behaviour

People who are struggling may behave in a hostile manner. This may be subconsciously a way of seeking attention, or expressing their feelings, however in an unhealthy way. Beneath that hostility is a lot of vulnerability. Hostility may be  unconsciously a way of keeping people away, yet consciously they need them the most.

5-Behaving out of Character

People who are struggling me start behaving in unusual manner. This may be behaviours that are not consistent with their usual selves. For example one may become very erratic & unusually chaotic. They may be even unaware of these behavioural changes. If they are, they may make excuses for these behaviours when asked.

6-Sleeping More or Nocturnally

People who are struggling may begin to sleep more, or have a reverse sleep pattern. This is a sign of not coping with life or lacking energy, apathy, or just social withdrawal. This may compound the poor self care and impact on productivity.

7- Poor Sleep

Most people who are struggling tend to have difficulties with sleep. If you notice that your loved one is unable to sleep, it may be a sign of them struggling with their mental health. Poor sleep leads to fatigue and feeds into the deterioration.

8-Eating More

Food plays a big part in emotional regulation, and people who are struggling tend to eat more as a way of regulating how they are feeling. This may lead to noticeable weight gain. In the long term this impacts on one’s confidence and self-esteem.

9-Eating Less

People who are struggling tend to eat less. This may be due to a loss of appetite, self-punishment and at times they have simply given up. This often leads to noticeable weight loss.

10- Mood Changes -Emotional Lability

Apart from showing signs of sadness, people who are struggling with their mental health may show some rapid mood changes where they may become tearful or emotionally hypersensitive. They can become easily triggered and can switch from being elated to tearfulness. These mood changes can happen throughout the day and at times diurnal.

11- Emotional Detachment

People who are struggling may become emotionally detached. They may seem stoic & unaffected by things. However deep down they are struggling & the stoicism/detachment is a defence. This is very common in suicidal people.

12- Overfamiliarity & Trauma Dumping

Despite sounding rather paradoxical, when struggling, some people may attempt to reach out to others in ways that are unusual to them & deemed imposing on others. However this may be their way of seeking some connection and making some form of emotional contact. If you notice someone who has suddenly started making more contact with you or talks about their difficult experiences each time you chat, do not dismiss or ignore them. Listen and tune in. Remember to signpost them to therapy is you feel burdened by them.

13- Personality Changes

People who are struggling may show signs of personality changes. For example someone who used to be gregarious and outgoing may suddenly become very distant and disinterested or highly anxious. This can happen over a period of time, not just daily. Do not be quick to judge. Check in if you can.

14- Excessive Drinking (alcohol) or Drug Misuse.

Excessive or regular alcohol consumption is one of the most common thing people who are struggling tend to do. This can be in social situations for example night out with friends or colleagues, or at home.  The drinking behaviour is a way of numbing feelings or escaping from an emotionally painful place.

15- Adopting a negative outlook to life, pessimism & dispondence.

When one is struggling with their mental health, they may give hints of their words view and how they view life. This is often in  negative & pessimistic terms, regardless of any good things that may be going on in their life. These good things may be meaningless to that person, hence why they describe their world in these negative terms. Listen and don’t judge.

16- Overspending & Compulsive Buying

People  who are struggling may find themselves compulsively shopping or overspending. This is even more problematic due to access to the Internet and online shopping. The compulsive buying is a way of trying to fill an emotional  void, and derive  happiness and pleasure  from material things.

17 – Hypersexual & Sexualised Behaviours

It is not unusual for people who are struggling with their mental health to start becoming hypersexual and having loads of casual sex. Sex is used as a soothing tool with no emotion attached  to it. This is the reason why so many people who struggle with their mental health are regular people who go on nights out  with their friends and colleagues & seem to be functioning normally. We often here about suicides or breakdown which seem unprecedented.

Image Credit to Mark Wielinga- Unsplash