Sanctuary for the Abused
Sunday, May 30, 2021
CHILDHOOD STRESS AND EMOTIONAL ABUSE ADD UP TO ILLNESS LATER IN LIFE
If you saw Laura walking down the New York City street where she lives today, you’d see a well-dressed 46-year-old woman with auburn hair and green eyes, who exudes a sense of ‘I matter here.’ She looks entirely in charge of her life, but behind Laura’s confident demeanour lies a history of trauma: a bipolar mother who vacillated between braiding her daughter’s hair and peppering her with insults, and a father who moved out-of-state with his wife-to-be when Laura was 15 years old.
She recalls a family trip to the Grand Canyon when she was 10. In a photo taken that day, Laura and her parents sit on a bench, sporting tourist whites. ‘Anyone looking at us would have assumed that we were a normal, loving family.’ But as they put on fake smiles for the camera, Laura’s mother suddenly pinched her daughter’s midriff and told her to stop ‘staring off into space’. A second pinch: ‘No wonder you’re turning into a butterball, you ate so much cheesecake last night you’re hanging over your shorts!’ If you look hard at Laura’s face in the photograph, you can see that she’s not squinting at the Arizona sun, but holding back tears.
After her father left the family, he sent cards and money, but called less and less. Meanwhile, her mother’s untreated bipolar disorder worsened. Sometimes, Laura says: ‘My mom would go on a vitriolic diatribe about my dad until spittle foamed on her chin. I’d stand there, trying not to hear her as she went on and on, my whole body shaking inside.’ Laura never invited friends over, for fear they’d find out her secret: her mom ‘wasn’t like other moms’.
Some 30 years later, Laura says: ‘In many ways, no matter where I go or what I do, I’m still in my mother’s house.’ Today, ‘If a car swerves into my lane, a grocery store clerk is rude, my husband and I argue, or my boss calls me in to talk over a problem, I feel something flip over inside. It’s like there’s a match standing inside too near a flame, and with the smallest breeze, it ignites.’
To see Laura, you’d never know that she is ‘always shaking a little, only invisibly, deep down in my cells’.
Her sense that something is wrong inside is mirrored by her physical health. During a routine exam, Laura’s doctor discovered that Laura was suffering from dilated cardiomyopathy and would require a cardioverter defibrillator to keep her heart pumping. The two-inch scar from her surgery only hints at the more severe scars she hides from her childhood.
For as long as John can remember, he says, his parents’ marriage was deeply troubled, as was his relationship with his father. ‘I consider myself to have been raised by my mom and her mom. I longed to feel a deeper connection with my dad, but it just wasn’t there. He couldn’t extend himself in that way.’ John’s poor relationship with his father was due, in large part, to his father’s reactivity and need for control. For instance, if John’s father said that the capital of New York was New York City, there was just no use telling him that it was Albany.
As John got older, it seemed wrong to him that his father ‘was constantly pointing out all the mistakes that my brother and I made, without acknowledging any of his own’. His father relentlessly criticised his mother, who was ‘kinder and more confident’. Aged 12, John began to interject himself into the fights between his parents. He remembers one Christmas Eve, when he found his father with his hands around his mother’s neck and had to separate them. ‘I was always trying to be the adult between them,’ John says.
John is now a boyish 40, with warm hazel eyes and a wide, affable grin. But beneath his easy, open demeanour, he struggles with an array of chronic illnesses. By the time he was 33, his blood pressure was shockingly high; he began to experience bouts of stabbing stomach pain and diarrhoea and often had blood in his stool; he struggled from headaches almost daily. By 34, he’d developed chronic fatigue, and was so wiped out that he sometimes struggled to make it through an entire workday.
John’s relationships, like his body, were never completely healthy. He ended a year‑long romance with a woman he deeply loved because he felt riddled with anxiety around her normal, ‘happy family’. He just didn’t know how to fit in. ‘She wanted to help,’ he says, ‘but instead of telling her how insecure I was around her, I told her I wasn’t in love with her.’ Bleeding from his inflamed intestines, exhausted by chronic fatigue, debilitated and distracted by pounding headaches, often struggling with work, and unable to feel comfortable in a relationship, John was stuck in a universe of pain and solitude, and he couldn’t get out.
Laura’s and John’s life stories illustrate the physical price we can pay, as adults, for trauma that took place 10, 20, even 30 years ago. New findings in neuroscience, psychology and immunology tell us that the adversity we face during childhood has farther-reaching consequences than we might ever have imagined. Today, in labs across the country, neuroscientists are peering into the once-inscrutable brain-body connection, and breaking down, on a biochemical level, exactly how the stress we experience during childhood and adolescence catches up with us when we are adults, altering our bodies, our cells, and even our DNA.
Emotional stress in adult life affects us on a physical level in quantifiable, life-altering ways. We all know that when we are stressed, chemicals and hormones can flush our body and increase levels of inflammation. That’s why stressful events in adult life are correlated with the likelihood of getting a cold or having a heart attack.
But when children or teens face adversity and especially unpredictable stressors, they are left with deeper, longer‑lasting scars. When the young brain is thrust into stressful situations over and over again without warning, and stress hormones are repeatedly ramped up, small chemical markers, known as methyl groups, adhere to specific genes that regulate the activity of stress‑hormone receptors in the brain. These epigenetic changes hamper the body’s ability to turn off the stress response. In ideal circumstances, a child learns to respond to stress, and recover from it, learning resilience. But kids who’ve faced chronic, unpredictable stress undergo biological changes that cause their inflammatory stress response to stay activated.
Joan Kaufman, director of the Child and Adolescent Research and Education (CARE) programme at the Yale School of Medicine, recently analysed DNA in the saliva of happy, healthy children, and of children who had been taken from abusive or neglectful parents. The children who’d experienced chronic childhood stress showed epigenetic changes in almost 3,000 sites on their DNA, and on all 23 chromosomes – altering how appropriately they would be able to respond to and rebound from future stressors.
'Kids who’ve had early adversity have a drip of fight-or-flight hormones turned on every day – it’s as if there is no off switch
Likewise, Seth Pollak, professor of psychology and director of the Child Emotion Research Laboratory at the University of Wisconsin at Madison, uncovered startling genetic changes in children with a history of adversity and trauma. Pollak identified damage to a gene responsible for calming the stress response. 'This particular gene wasn’t working properly; the kids’ bodies weren’t able to reign in their heightened stress response.,’
Imagine for a moment that your body receives its stress hormones and chemicals through an IV drip that’s turned on high when needed and, when the crisis passes, it’s switched off again. You might think of kids whose brains have undergone epigenetic changes because of early adversity as having an inflammation-promoting drip of fight-or-flight hormones turned on every day – it’s as if there is no off switch.
Experiencing stress in childhood changes your set point of wellbeing for decades to come. In people such as Laura and John, the endocrine and immune systems are churning out a damaging and inflammatory cocktail of stress neurochemicals in response to even small stressors – an unexpected bill, a disagreement with their spouse, a car that swerves in front of them on the highway, a creak on the staircase – for the rest of their lives. They might find themselves overreacting to, and less able to recover from, the inevitable stressors of life. They’re always responding. And all the while, they’re unwittingly marinating in inflammatory chemicals, which sets the stage for full-throttle disease down the road, in the form of autoimmune disease, heart disease, cancer, fibromyalgia, chronic fatigue, fibroid tumours, irritable bowel syndrome, ulcers, migraines and asthma.
Scientists first came to understand the relationship between early chronic stress and later adult disease through the work of a dedicated physician in San Diego and a determined epidemiologist from the Centers for Disease Control and Prevention (CDC) in Atlanta. Together, during the 1980s and ’90s – the years when Laura and John were growing up – these two researchers began a paradigm-shifting public-health investigation known as the Adverse Childhood Experiences (ACE) Study.
In 1985, Vincent J Felitti, chief of a revolutionary preventive care initiative at the Kaiser Permanente Medical Care programme in San Diego, noticed a startling pattern in adult patients at an obesity clinic. A significant number were, with the support of Felitti and his nurses, successfully losing hundreds of pounds a year, a remarkable feat, only to withdraw from the programme despite weight-loss success. Felitti, determined to get to the bottom of the attrition rate, conducted face-to-face interviews with 286 patients. It turned out there was a common denominator. Many confided that they had suffered some sort of trauma, often sexual abuse, in their childhoods. To these patients, eating was a solution, not a problem: it soothed the anxiety and depression they had harboured for decades; their weight served as a shield against undesired attention, and they didn’t want to let it go.
Felitti’s interviews gave him a new way of looking at human health and well-being that other physicians just weren’t seeing. He presented his findings at a national obesity conference, arguing that ‘our intractable public health problems’ had root causes hidden ‘by shame, by secrecy, and by social taboos against exploring certain areas of life experience’. Felitti’s peers were quick to blast him. One even stood up in the audience and accused Felitti of offering ‘excuses’ for patients’ ‘failed lives’. Felitti, however, remained unfazed; he felt sure that he had stumbled upon a piece of information that would hold enormous import for the field of medicine.
After a colleague who attended that same conference suggested that he design a study with thousands of patients who suffered from a wide variety of diseases, not just obesity, Felitti joined forces with Robert Anda, a medical epidemiologist at the CDC who had, at the time, been researching the relationship between coronary heart disease and depression. Felitti and Anda took advantage of Kaiser Permanente’s vast patient cohort to set up a national epidemiology laboratory. Of the 26,000 patients they invited to take part in their study, more than 17,000 agreed
Anda and Felitti surveyed these 17,000 individuals on about 10 types of adversity, or adverse childhood experiences (ACEs), probing into patients’ childhood and adolescent histories. Questions included: ‘Was a biological parent ever lost to you through divorce, abandonment or other reason?’; ‘Did a parent or other adult in the household often swear at you, insult you, put you down or humiliate you?’; and ‘Was a household member depressed or mentally ill?’ Other questions looked at types of family dysfunction that included growing up with a parent who was an alcoholic or addicted to other substances; being physically or emotionally neglected; being sexually or physically abused; witnessing domestic violence; having a family member who was sent to prison; feeling that there was no one to provide protection; and feeling that one’s family didn’t look out for each other. For each category to which a patient responded ‘yes’, one point would be added to her ACE score, so an ACE score of 2 would indicate that she had suffered two adverse childhood experiences.
To be clear, the patients Felitti and Anda surveyed were not troubled or disadvantaged; the average patient was 57, and three-quarters had attended college. These were ‘successful’ men and women, mostly white, middle-class, with stable jobs and health benefits. Felitti and Anda expected their number of ‘yes’ answers to be fairly low.
The correlation between having a difficult childhood and facing illness as an adult offered a whole new lens through which we could view human health and disease
When the results came in, Felitti and Anda were shocked: 64 per cent of participants answered ‘yes’ to having encountered at least one category of early adversity, and 87 per cent of those patients also had additional adverse childhood experiences; 40 per cent had suffered two or more ACEs; 12.5 per cent had an ACE score greater than or equal to 4.
Felitti and Anda wanted to find out whether there was a correlation between the number of adverse childhood experiences an individual had faced, and the number and severity of illnesses and disorders she developed as an adult. The correlation proved so powerful that Anda was not only ‘stunned’, but deeply moved.
‘I wept,’ he says. ‘I saw how much people had suffered, and I wept.’
Felitti, too, was deeply affected. ‘Our findings exceeded anything we had conceived. The correlation between having a difficult childhood and facing illness as an adult offered a whole new lens through which we could view human health and disease.’
Here, says Felitti, ‘was the missing piece as to what was causing so much of our unspoken suffering as human beings’.
The number of adverse childhood experiences a patient had suffered could by and large predict the amount of medical care she would require in adulthood: the higher the ACE score, the higher the number of doctor’s appointments she’d had in the past year, and the more unexplained physical symptoms she’d reported.
People with an ACE score of 4 were twice as likely to be diagnosed with cancer than people who hadn’t faced any form of childhood adversity. For each point an individual had, her chance of being hospitalised with an autoimmune disease in adulthood rose 20 per cent. Someone with an ACE score of 4 was 460 per cent more likely to face depression than someone with a score of 0.
An ACE score of 6 or higher shortened an individual’s lifespan by almost 20 years.
Researchers wondered if those who encountered childhood adversity were also more likely to smoke, drink and overeat as a sort of coping strategy, and while that was sometimes the case, unhealthy habits didn’t wholly account for the correlation Felitti and Anda saw between adverse childhood experiences and later illness. For instance, those with ACE scores greater than or equal to 7 who didn’t drink or smoke, weren’t overweight or diabetic, and didn’t have high cholesterol still had a 360 per cent higher risk of heart disease than those with ACE scores of 0.
‘Time,’ says Felitti, ‘does not heal all wounds. One does not “just get over” something – not even 50 years later.’ Instead, he says: ‘Time conceals. And human beings convert traumatic emotional experiences in childhood into organic disease later in life.’
Often, these illnesses can be chronic and lifelong. Autoimmune disease. Heart disease. Chronic bowel disorders. Migraines. Persistent depression. Even today, doctors puzzle over these very conditions: why are they so prevalent; why are some patients more prone to them than others; and why are they so difficult to treat?
The more research that’s done, the more granular details emerge about the profound link between adverse experiences and adult disease. Scientists at Duke University in North Carolina, the University of California, San Francisco, and Brown University in Rhode Island have shown that childhood adversity damages us on a cellular level in ways that prematurely age our cells and affect our longevity. Adults who faced early life stress show greater erosion in what are known as telomeres – protective caps that sit on the ends of DNA strands to keep the DNA healthy and intact. As telomeres erode, we’re more likely to develop disease, and we age faster; as our telomeres age and expire, our cells expire and so, eventually, do we.
Researchers have also seen a correlation between specific types of adverse childhood experiences and a range of diseases. For instance, children whose parents die, or who face emotional or physical abuse, or experience childhood neglect, or witness marital discord between their parents are more likely to develop cardiovascular disease, lung disease, diabetes, headaches, multiple sclerosis and lupus as adults. Facing difficult circumstances in childhood increases six-fold your chances of having myalgic encephalomyelitis (chronic fatigue immune dysfunction syndrome or CFIDS) as an adult. Kids who lose a parent have triple the risk of depression in their lifetimes. Children whose parents divorce are twice as likely to suffer a stroke later down the line.
Laura and John’s stories illustrate that the past can tick away inside us for decades like a silent time bomb, until it sets off a cellular message that lets us know the body does not forget its history.
Something that happened to you when you were five or 15 can land you in the hospital 30 years later
John’s ACE score would be a 3: a parent often put him down; he witnessed his mother being harmed; and, clearly, his father suffered from an undiagnosed behaviour health disorder, perhaps narcissism or depression, or both.
Laura had an ACE score of 4.
Laura and John are hardly alone. Two-thirds of American adults are carrying wounds from childhood quietly into adulthood, with little or no idea of the extent to which these wounds affect their daily health and wellbeing. Something that happened to you when you were five or 15 can land you in the hospital 30 years later, whether that something was headline news, or happened quietly, without anyone else knowing it, in the living room of your childhood home.
The adversity a child faces doesn’t have to be severe abuse in order to create deep biophysical changes that can lead to chronic health conditions in adulthood.
‘Our findings showed that the 10 different types of adversity we examined were almost equal in their damage,’ says Felitti. He and Anda found that no single ACE significantly trumped another. This was true even though some types, such as being sexually abused, are far worse in that society regards them as particularly shameful, and others, such as physical abuse, are more overt in their violence.
This makes sense if you think about how the stress response functions on an optimal level. You meet a bear in the woods, and your body floods with adrenaline and cortisol so that you can quickly decide whether to run in the opposite direction or stay and try to frighten the bear. After you deal with the crisis, you recover, your stress hormones abate, and you go home with a great story. For Laura and John, though, that feeling that the bear is still out there, somewhere, circling in the woods, stalking, and might strike again any day, anytime – that feeling never disappears.
There are a lot of bears out there. Chronic parental discord; enduring low-dose humiliation or blame and shame; chronic teasing; the quiet divorce between two secretly seething parents; a parent’s premature exit from a child’s life; the emotional scars of growing up with a hypercritical, unsteady, narcissistic, bipolar, alcoholic, addicted or depressed parent; physical or emotional abuse or neglect: these happen in all too many families. Although the details of individual adverse experiences differ from one home to another and from one neighbourhood to another, they are all precursors to the same organic chemical changes deep in the gray matter of the developing brain.
Every few decades, a groundbreaking psychosocial ‘theory of everything’ helps us to develop a new understanding of why we are the way we are – and how we got that way. In the early 20th century, the psychoanalyst Sigmund Freud transformed the landscape of psychology when he argued that the unconscious rules much of our waking life and dreams. Jungian theory taught, among other ideas, that we tend toward introversion or extroversion, which led the American educationalist Katharine Cook Briggs and her daughter Isabel Briggs Myers to develop a personality indicator. More recently, neuroscientists discovered that age ‘zero to three’ was a critical synaptic window for brain development, giving birth to Head Start and other preschool programmes. The correlation between childhood trauma, brain architecture and adult wellbeing is the newest, and perhaps our most important, psychobiological theory of everything.
Today’s research on adverse childhood experiences revolutionises how we see ourselves, our understanding of how we came to be the way we are, why we love the way we do, how we can better nurture our children, and how we can work to realise our potential.
To date, more than 1,500 studies founded on Felitti and Anda’s hallmark ACE research show that both physical and emotional suffering are rooted in the complex workings of the immune system, the body’s master operating control centre – and what happens to the brain during childhood sets the programming for how our immune systems will respond for the rest of our lives.
The unifying principle of this new theory of everything is this: your emotional biography becomes your physical biology, and together, they write much of the script for how you will live your life. Put another way: your early stories script your biology and your biology scripts the way your life will play out.
Unlike previous theories of everything, though, this one has been mind-bogglingly slow to change how we do medicine, according to Felitti. ‘Very few internists or medical schools are interested in embracing the added responsibility that this understanding imposes on them.’
With the ACE research now available, we might hope that physicians will begin to see patients as a holistic sum of their experiences and embrace the understanding that a stressor from long ago can be a health-risk time bomb that has exploded. Such a medical paradigm, which sees adverse childhood experiences as one of many key factors that can play a role in disease, could save many patients years in the healing process.
But seeing that connection takes a little time. It means asking patients to fill out the ACE questionnaire and delving into that patient’s history for insight into sources of both physical and emotional pain. As health-care budgets have become stretched, physicians spend less time interacting one-on-one with patients in their exam rooms; the average physician schedules patients back-to-back at 15-minute intervals.
Still, the cost of not intervening is far greater – not only in the loss of human health and wellbeing, but also in additional healthcare. According to the CDC, the total lifetime cost of child maltreatment in the US is $124 billion each year. The lifetime healthcare cost for each individual who experiences childhood maltreatment is estimated at $210,012 – comparable to other costly health conditions, such as having a stroke, which has a lifetime estimated cost of $159,846 per person, or type-2 diabetes, which is estimated to cost between $181,000 and $253,000.
Further hindering change is the fact that adult physical medicine and psychological medicine remain in separate silos. Utilising ACE research requires breaking down these long-standing divisions in healthcare between what is ‘physical’ and what is ‘mental’ or ‘emotional,’ and that’s hard to achieve. Physicians have been well-trained to deal only with what they can touch with their hands, see with their eyes, or view with microscopes or scans.
Just as physical wounds and bruises heal, just as we can regain our muscle tone, we can recover function in underconnected areas of the brain
However, now that we have scientific evidence that the brain is genetically modified by childhood experience, we can no longer draw that line in the sand. With hundreds of studies showing that childhood adversity hurts our mental and physical health, putting us at greater risk for learning disorders, cardiovascular disease, autoimmune disease, depression, obesity, suicide, substance abuse, failed relationships, violence, poor parenting and early death, we just can’t afford to make such distinctions.
Science tells us that biology does not have to be destiny. ACEs can last a lifetime, but they don’t have to. Just as physical wounds and bruises heal, just as we can regain our muscle tone, we can recover function in underconnected areas of the brain. If anything, that’s the most important take-away from ACE research: the brain and body are never static; they are always in the process of becoming and changing.
Even if we have been set on high-reactive mode for decades or a lifetime, we can still dial it down. We can respond to life’s inevitable stressors more appropriately and shift away from an overactive inflammatory response. We can become neurobiologically resilient. We can turn bad epigenetics into good epigenetics and rescue ourselves. We have the capacity, within ourselves, to create better health. We might call this brave undertaking ‘the neurobiology of awakening’.
Today, scientists recognise a range of promising approaches to help create new neurons (known as neurogenesis), make new synaptic connections between those neurons (known as synaptogenesis), promote new patterns of thoughts and reactions, bring underconnected areas of the brain back online – and reset our stress response so that we decrease the inflammation that makes us ill.
You can find ways to start right where you are, no matter how deep your scars or how long ago they occurred. Many mind-body therapies not only help you to calm your thoughts and increase your emotional and physical wellbeing, but research suggests that they have the potential to reverse, on a biological level, the harmful impact of childhood adversity.
Recent studies indicate that individuals who practice mindfulness meditation and mindfulness-based stress reduction (MBSR) show an increase in gray matter in parts of the brain associated with managing stress, and experience shifts in genes that regulate their stress response and their levels of inflammatory hormones. Other research suggests that a process known as neurofeedback can help to regrow connections in the brain that were lost to adverse childhood experiences.
Meditation, mindfulness, neurofeedback, cognitive therapy, EMDR (eye movement desensitisation and reprocessing) therapy: these promising new avenues to healing can be part of any patient’s recovery plan, if only healthcare practitioners would begin to treat the whole patient – past, present and future, without making distinctions between physical and mental health – and encourage patients to explore all the treatment options available to them. The more we learn about the toxic impact of early stress, the better equipped we are to counter its effects, and help to uncover new strategies and modalities to come back to who it is we really are, and who it was we might have been had we not encountered childhood adversity in the first place.
SOURCE
This is an adapted and reprinted extract from ‘Childhood Disrupted: How Your Biography Becomes Your Biology, and How You Can Heal’ (Atria), by Donna Jackson Nakazawa. Copyright © Donna Jackson Nakazawa, 2015.
Labels: abuse, ACONs, adrenal fatigue, adult children of narcissists, autoimmune, brain development, CFIDS, emotionally abusive mothers, fibromyalgia, illness, migraine, ptsd, toxic parents, trauma, unhealthy, woundedness
Monday, July 23, 2018
Sociopathy, Antisocial Personality Disorder & Psychopathy
But first of all, here is Cleckley's original list of symptoms of a psychopath:
1. Considerable superficial charm and average or above average intelligence.
2. Absence of delusions and other signs of irrational thinking
3. Absence of anxiety or other "neurotic" symptoms considerable poise, calmness, and verbal facility.
4. Unreliability, disregard for obligations no sense of responsibility, in matters of little and great import.
5. Untruthfulness and insincerity
7. Antisocial behavior which is inadequately motivated and poorly planned, seeming to stem from an inexplicable impulsiveness.
7. Inadequately motivated antisocial behavior
8. Poor judgment and failure to learn from experience
9. Pathological egocentricity. Total self-centeredness incapacity for real love and attachment.
10. General poverty ot deep and lasting emotions.
11. Lack of any true insight, inability to see oneself as others do.
12. Ingratitude for any special considerations, kindness, and trust.
13. Fantastic and objectionable behavior, after drinking and sometimes even when not drinking--vulgarity, rudeness, quick mood shifts, pranks.
14. No history of genuine suicide attempts.
15. An impersonal, trivial, and poorly integrated sex life. (i.e. casual sex, sex for sex's sake, no real emotional intimacy)
16. Failure to have a life plan and to live in any ordered way, unless it be one promoting self-defeat.
"...More often than not, the typical psychopath will seem particularly agreeable and make a distinctly positive impression when he is first encountered. Alert and friendly in his attitude, he is easy to talk with and seems to have a good many genuine interests. There is nothing at all odd or queer about him, and in every respect he tends to embody the concept of a well-adjusted, happy person. Nor does he, on the other hand, seem to be artificially exerting himself like one who is covering up or who wants to sell you a bill of goods. He would seldom be confused with the professional backslapper or someone who is trying to ingratiate himself for a concealed purpose. Signs of affectation or excessive affability are not characteristic. He looks like the real thing.
"Very often indications of good sense and sound reasoning will emerge, and one is likely to feel soon after meeting him that this normal and pleasant person is also one with -high abilities. Psychometric tests also very frequently show him of superior intelligence. More than the average person, he is likely to seem free from social or emotional impediments, from the minor distortions, peculiarities, and awkwardnesses so common even among the successful. Such superficial characteristics are not universal in this group but they are very common..."
"...It must be granted of course that the psychopath has some affect. Affect is, perhaps, a component in the sum of life reactions even in the unicellular protoplasmic entity. Certainly in all mammals it is obvious. The relatively petty states of pleasure, vexation, and animosity experienced by the psychopath have been mentioned. The opinion here maintained is that he fails to know all those more serious and deeply moving affective states which make up the tragedy and triumph of ordinary life, of life at the level of important human experience..."
Hare's Checklist
1. GLIB and SUPERFICIAL CHARM -- the tendency to be smooth, engaging, charming, slick, and verbally facile. Psychopathic charm is not in the least shy, self-conscious, or afraid to say anything. A psychopath never gets tongue-tied. They have freed themselves from the social conventions about taking turns in talking, for example.
2. GRANDIOSE SELF-WORTH -- a grossly inflated view of one's abilities and self-worth, self-assured, opinionated, cocky, a braggart. Psychopaths are arrogant people who believe they are superior human beings.
3. NEED FOR STIMULATION or PRONENESS TO BOREDOM -- an excessive need for novel, thrilling, and exciting stimulation; taking chances and doing things that are risky. Psychopaths often have a low self-discipline in carrying tasks through to completion because they get bored easily. They fail to work at the same job for any length of time, for example, or to finish tasks that they consider dull or routine.
4. PATHOLOGICAL LYING -- can be moderate or high; in moderate form, they will be shrewd, crafty, cunning, sly, and clever; in extreme form, they will be deceptive, deceitful, underhanded, unscrupulous, manipulative, and dishonest.
5. CONNING AND MANIPULATIVENESS- the use of deceit and deception to cheat, con, or defraud others for personal gain; distinguished from Item #4 in the degree to which exploitation and callous ruthlessness is present, as reflected in a lack of concern for the feelings and suffering of one's victims.
6. LACK OF REMORSE OR GUILT -- a lack of feelings or concern for the losses, pain, and suffering of victims; a tendency to be unconcerned, dispassionate, coldhearted, and unempathic. This item is usually demonstrated by a disdain for one's victims. (can focus on THEIR losses but usually blame others for the results of their actions)
7. SHALLOW AFFECT -- emotional poverty or a limited range or depth of feelings; interpersonal coldness in spite of signs of open gregariousness.
8. CALLOUSNESS and LACK OF EMPATHY -- a lack of feelings toward people in general; cold, contemptuous, inconsiderate, and tactless.
9. PARASITIC LIFESTYLE -- an intentional, manipulative, selfish, and exploitative financial dependence on others as reflected in a lack of motivation, low self-discipline, and inability to begin or complete responsibilities.
10. POOR BEHAVIORAL CONTROLS -- expressions of irritability, annoyance, impatience, threats, aggression, and verbal abuse; inadequate control of anger and temper; acting hastily.
11. PROMISCUOUS SEXUAL BEHAVIOR -- a variety of brief, superficial relations, numerous affairs, and an indiscriminate selection of sexual partners (prostitutes or people they barely know); the maintenance of several relationships at the same time; a history of attempts to sexually coerce others into sexual activity or taking great pride at discussing sexual exploits or conquests.
12. EARLY BEHAVIOR PROBLEMS -- a variety of behaviors prior to age 13, including lying, theft, cheating, vandalism, bullying, sexual activity, fire-setting, glue-sniffing, alcohol use, and running away from home.
13. LACK OF REALISTIC, LONG-TERM GOALS -- an inability or persistent failure to develop and execute long-term plans and goals; a nomadic existence, aimless, lacking direction in life.
14. IMPULSIVITY -- the occurrence of behaviors that are unpremeditated and lack reflection or planning; inability to resist temptation, frustrations, and urges; a lack of deliberation without considering the consequences; foolhardy, rash, unpredictable, erratic, and reckless.
15. IRRESPONSIBILITY -- repeated failure to fulfill or honor obligations and commitments; such as not paying bills, defaulting on loans, performing sloppy work, being absent or late to work, failing to honor contractual agreements.
16. FAILURE TO ACCEPT RESPONSIBILITY FOR OWN ACTIONS -- a failure to accept responsibility for one's actions reflected in low conscientiousness, an absence of dutifulness, antagonistic manipulation, denial of responsibility, and an effort to manipulate others through this denial.
17. MANY SHORT-TERM MARITAL RELATIONSHIPS -- a lack of commitment to a long-term relationship reflected in inconsistent, undependable, and unreliable commitments in life, including marital.
18. JUVENILE DELINQUENCY -- behavior problems between the ages of 13-18; mostly behaviors that are crimes or clearly involve aspects of antagonism, exploitation, aggression, manipulation, or a callous, ruthless tough-mindedness.
19. REVOCATION OF CONDITION RELEASE -- a revocation of probation or other conditional release due to technical violations, such as carelessness, low deliberation, or failing to appear.
20. CRIMINAL VERSATILITY -- a diversity of types of criminal offenses, regardless if the person has been arrested or convicted for them; taking great pride at getting away with crimes.
What Causes Antisocial Personality Disorder?
Donald W. Black, M.D.
The cause of antisocial personality disorder, or ASP, is unknown. Like many mental health issues, evidence points to inherited traits. Like father, like son. But dysfunctional family life also increases the likelihood of ASP. So although ASP may have a hereditary basis, environmental factors contribute to its development.
The TheoriesResearchers have their own ideas about ASP's cause. One theory suggests that abnormalities in development of the nervous system may cause ASP. Abnormalities that suggest abnormal nervous system development include learning disorders, persistent bedwetting and hyperactivity.
A recent study showed that if mothers smoked during pregnancy, their offspring were at risk of developing antisocial behavior. This suggests that smoking brought about lowered oxygen levels with may have resulted in subtle brain injury to the fetus.
Yet another theory suggests that people with ASP require greater sensory input for normal brain function. Evidence that antisocials have low resting pulse rates and low skin conductance, and show decreased amplitude on certain brain measures supports this theory. Individuals with chronically low arousal may seek out potentially dangerous or risky situations to raise their arousal to more optimal levels to satisfy their craving for excitement.
Brain imaging studies have also suggested that abnormal brain function is a cause of antisocial behavior. Likewise, the neurotransmitter serotonin has been linked with impulsive and aggressive behavior. Both the temporal lobes and the prefrontal cortex help regulate mood and behavior. It could be that impulsive or poorly controlled behavior stems from a functional abnormality in serotonin levels or in these brain regions.
The Environment
Social and home environment also contributes to the development of antisocial behavior. Parents of troubled children frequently show a high level of antisocial behavior themselves. In one large study, the parents of delinquent boys were more often alcoholic or criminal, and their homes were frequently disrupted by divorce, separation or the absence of a parent.
In the case of foster care and adoption, depriving a young child of a significant emotional bond could damage his ability to form intimate and trusting relationships, which may explain why some adopted children are prone to develop ASP. As young children, they may be more likely to move from one caregiver to another before a final adoption, thereby failing to develop appropriate or sustaining emotional attachments to adult figures.
Erratic or inappropriate discipline and inadequate supervision have been linked to antisocial behavior in children. Involved parents tend to monitor their child's behavior, setting rules and seeing that they are obeyed, checking on the child's whereabouts, and steering them away from troubled playmates. Good supervision is less likely in broken homes because parents may not be available, and antisocial parents often lack the motivation to keep an eye on their children. The importance of parental supervision is also underscored when antisocials grow up in large families where each child gets proportionately less attention.
A child who grows up in a disturbed home may enter the adult world emotionally injured. Without having developed strong bonds, he is self-absorbed and indifferent to others. The lack of consistent discipline results in little regard for rules and delayed gratification. He lacks appropriate role models and learns to use aggression to solve disputes. He fails to develop empathy and concern for those around him.
Antisocial children tend to choose similar children as playmates. This association pattern usually develops during the elementary school years, when peer group acceptance and the need to belong first become important. Aggressive children are the most likely to be rejected by their peers, and this rejection drives social outcasts to form bonds with one another. These relationships can encourage and reward aggression and other antisocial behavior. These associations may later lead to gang membership.
Child abuse has also been linked with antisocial behavior. People with ASP are more likely than others to have been abused as children. This is not surprising since many of them grow up with neglectful and sometimes violent antisocial parents. In many cases, abuse becomes a learned behavior that formerly abused adults perpetuate with their own children.
It has been argued that early abuse (such as vigorously shaking a child) is particularly harmful, because it can result in brain injury. Traumatic events can disrupt normal development of the central nervous system -- a process that continues through the adolescent years. By triggering a release of hormones and other brain chemicals, stressful events could alter the pattern of normal development.
Labels: abuse, antisocial, brain development, hormones, lack of empathy, moral development, psychopathy, sociopathy
Friday, March 23, 2018
Abnormal Cortisol Levels, Depression, Anxiety & PTSD = Signs of Long-Term Abuse & Psychological Trauma
Long-term emotional stress is a well-known culprit in the development of abnormal cortisol levels and consequent damage to the endocrine system of hormone-releasing organs throughout the body, most notably the adrenal glands that produce cortisol itself. Most of the research on this common health problem has been conducted in adults, but it turns out that abused children experience many of the same health effects seen in stressed out adults. Furthermore, studies are showing that chronic abuse can disrupt the balance of the HPA (hypothalamus-pituitary-adrenal) axis for many years or decades.
Child Abuse Triggers Abnormal Cortisol Levels
Researcher Kate Harkness looked at the relationship between cortisol levels and abuse and mental illness in children and found a strong connection. She believes that the high stress levels experienced in many children who are being physically, emotionally, or sexually abused drive up cortisol dramatically. Over time, the high levels of cortisol damage the brain in regions such as the hippocampus and hypothalamus. Chronically elevated cortisol also damages the endocrine system consisting of hormone releasing organs such as the adrenal and pituitary glands. Abnormal levels of cortisol have also been linked as a factor contributing to the development of many other health problems involving metabolic disorders such as diabetes, high levels of blood lipids, and low CoQ10 levels.
From Biological Links Found Between Childhood Abuse and Adolescent Depression:
“This kind of reaction is a problem because cortisol kills cells in areas of the brain that control memory and emotion regulation,” explains Dr. Harkness, a professor in the Department of Psychology and an expert in the role of stress and trauma in adolescent depression. “Over time cortisol levels can build up and increase a person’s risk for more severe endocrine impairment and more severe depression.”
Researchers analyzed measurements of urinary cortisol levels and collecting profiles of the children’s past histories of absence or presence of abuse and mental illnesses such as depression and anxiety spectrum disorders such as PTSD (Post Traumatic Stress Disorder). They noted that children displaying mild depression symptoms triggered by abuse often have elevated cortisol levels. But those who are severely depressed have often had their endocrine systems collapse and that typically results in low levels of hormones such as cortisol.
Symptoms of depression are usually more than just a low mood. They often include problems with focus and memory, weight changes, sleep and fatigue problems, loss of interest in formally interesting activities, withdrawal from social groups, and chronic pain. Depressive symptoms are often accompanied by high levels of anxiety from frequent worries or a pervasive sense of unease or discomfort all the way up to panic attacks and PTSD flashbacks.
Child Abuse Connected with Fibromyalgia and Chronic Fatigue Syndrome?
The observations of altered hormone levels in abused children is similar to the physiological phenomenon seen with patients suffering long-term pain and fatigue conditions such as fibromyalgia and CFS (chronic fatigue syndrome). These people often have pervasive endocrine system damage and low cortisol levels, too.
People who are suffering from chronic pain and fatigue disorders such as fibromyalgia and CFIDS (chronic fatigue immune dysfunction syndrome) should look back into their histories to evaluate whether some long-ago psychological trauma may still be impacting them severely today. Counseling or psychotherapy directed at resolving the psychological damage may be helpful in recovering from chronic pain and fatigue.
These conditions are not “all in the head” — there is real physiological damage to the body that is objectively seen via medical tests such as cortisol saliva tests and hormone blood tests. It’s important to realize that many such patients will need far more than just counseling. In particular, many of them need hormonal support for cortisol, pregnenolone, and DHEA via supplements and medications.
Normal Changes in Cortisol Levels Are Short-Term
Cortisol in and of itself is not a damaging hormone. Indeed, it’s normal for there to be short-term elevations in cortisol levels such as during an emergency or as a reaction to the impending birth of a baby or the adaptation to taking care of that baby.
From The Making of a Modern Dad:
The second hormone, cortisol, is well known as a stress hormone, but it is also a good indicator of a mother’s attachment to her baby. New mothers who have high cortisol levels can detect their own infant by odor more easily than mothers with lower cortisol levels. The mothers also respond more sympathetically to their baby’s cries and describe their relationship with their baby in more positive terms. Storey and her colleagues found that for expectant fathers, cortisol was twice as high in the three weeks before birth than earlier in the pregnancy.
Cortisol essentially sends a message to the body to prepare itself for stressful operations and to temporarily shut down or slow down some of the long-term repair mechanisms the body uses to keep itself healthy. The basic reasoning is that if you’re being chased by a lion intent on eating you, you would be better off with your body focusing on running away or fighting than on repairing buildup of plaque inside your arteries. If your cortisol levels spike under dangerous or stressful situations now and then and then fall back to normal levels within a few hours or days, probably there is no lasting damage from that. But when you are chronically stressed and cortisol is high all the time, eventually your body will be damaged in many areas because the normal healthy repair mechanisms slow or shut down.
Eventually, the damage may become so severe that the endocrine system organs responsible for making cortisol that the body simply can’t make much of it any more. The effect is most obvious in the adrenal glands that are making the cortisol, but the hypothalamus and pituitary also have much influence over the production of cortisol and appear to be damaged by long-term high levels of cortisol. So via some mix of damage to these organs, eventually the body isn’t able to muster the burst in cortisol you’d typically see from routine stressors such as waking up for the day or to deal with some pain or injury. As a result, you get aggravated symptoms of chronic fatigue and pain seen in many chronic medical conditions such as adrenal fatigue, fibromyalgia, and CFIDS. Some elements of this dysfunction may also be involved in other chronic pain and weakness conditions such as multiple sclerosis.
Using Pregnenolone, DHEA, and IsoCort or Other Cortisol Supplements
Low levels of pregnenolone, DHEA, and sometimes cortisol are common in people who have experienced chronic stress or abuse. Supplementing DHEA and pregnenolone is quite safe under most circumstances, the main possible exception being patients who are suffering from hormone-dependent cancers. One of the benefits of pregnenolone supplementation is that the body can convert pregnenolone to cortisol or to DHEA as needed. DHEA is needed for production of testosterone and testosterone is needed to make estradiol, one of the most common forms of estrogen.
Pregnenolone and DHEA are particularly helpful for people suffering from anxiety which is very common in those suffering from a history of abuse or stress. You can read more about that in Reducing Sedative and Addictive Side Effects of Anti-Anxiety Drugs Benzodiazepines (Xanax, Valium, etc.) with L-Theanine, Pregnenolone, and DHEA.
Cortisol supplementation is a more difficult area to address because it’s important to have an accurate picture of your daily varying levels of cortisol before you try to alter your cortisol levels. High and low cortisol levels both cause some similar symptoms and both can damage the body. So while you can get over-the-counter bioidentical cortisol via supplements such as IsoCort, it’s really important to get the proper tests to figure out where your cortisol levels are before supplementing with cortisol directly.
DHEA supplementation can also help boost low levels of testosterone seen in many people. But some men may still not be able to normalize their testosterone levels to those of the young and healthy because most of their testosterone is being converted to estradiol estrogen. They may need additional bioidentical testosterone or supplements or medications that impede this conversion. Particularly for older men who are overweight, some additional caution is needed regarding hormone supplementation because many of these men are suffering from very high estrogen levels because the fat in their bodies converts much of their testosterone to estradiol via activity of the enzyme aromatase.
It’s important to get a complete picture of your hormone status both before and during supplementation so you can understand if you may need additional supplements or medications to keep the added hormones in their most useful state. Otherwise, some men may find they inadvertently end up boosting their unhealthy estrogen levels even further when this could have been prevented if the appropriate supplements and medications were used along with the added pregnenolone and DHEA.
Labels: brain development, c-ptsd, CFIDS, childhood abuse, cortisol, depression, endocrine disorders, fibromyalgia, hippocampus, ptsd, stress
Sunday, December 17, 2017
Psychopathic Bullying
One of the most common misconceptions relating to the pathology is that psychopaths are deep down inside self-loathing and they project their inner hatred of themselves onto their victims. Nothing could be further from the truth. To imply this is to suggest that psychopaths are somehow self-reflective of their own pathology - as they would have to be, in order to come to this conclusion. The fact is that psychopaths adore themselves, period. What is being classified as self-loathing is in reality more akin to resentment and jealousy. They do not feel inferior to other people who enjoy the relationships, social life, careers and material goods which the psychopath covets - they just want to take these things away from the victims for the sake of it. A sick game of one-upmanship which can destroy another person’s life for a brief rush of energy in the psychopath.
This resentment is most commonly seen when psychopaths bully other adults, having first developed their craft as children. They begin to realise the value of bullying while still in school - however, they will continue to do this for the rest of their lives as bullying pays off for the psychopath on many levels towards their relationship, social and employment ambitions. Although a psychopath will implement a smear campaign or bullying campaign against another person at work or in an organisation in order to take over that person’s position - the underlying thrust is that the position the victim holds is what the psychopath desires for themselves. It’s nothing really personal against the victims as such - they just have to give up to the psychopath what they have. If this leads to the bullied victim resigning, transferring to another department or even killing themselves (murder-by-suicide) then so be it. Once they give up what the psychopath wants from them, they do not care one iota how the victim chooses to undertake this.
In his paper, Intelligence as a Person-Situation Interaction, Dr. Robert Sternberg lists five fallacies of thinking. He states, "There is another dimension to person-situation interaction: the extent to which particular situations elicit ’stupid’ thinking in intelligent people." All of his five fallacies which range from a sense of godlike indestructibility to extreme hubris occur mainly in the context of perceived power or dominance over others. Dr. Sternberg is one of many scientists who have discovered that the enjoyment of power and control over other people changes brain chemistry and behaviour. Some people are more prone than others to these effects of power and positions of influence - depending on personality type along with social and environmental factors. Psychopaths know no other way to live other than to gain and hold power over others constantly - similar to an addict seeking a drug fix - they are likewise subject to the above fallacies all the time and for all of their lives.
Neuroscientists have established that the human brain continues to grow and change long after the rapid developmental stage of early childhood. It is now well established that people who have been bullied as children by a psychopathic parent or another student at school, or as an adult at work - are much more likely to be depressed, anxious, and suicidal. The psychological torment that bullying victims experience is emotionally ravaging and visceral. Contemporary research into the psychological effects of bullying is now underpinning its emotional and psychological scarring as something with very real negative consequences for the victims. Bullying has now been shown to leave a lasting effect on a young person at a time when their brain is still developing - actually leading to reduced electrical connectivity within the brain, along with destroying the growth of new neurons. This very real neurological damage is identical to what is also seen in those who have been physically and sexually abused in childhood.
In the July 2010 edition of the American Journal of Psychiatry, in a paper by Martin Teicher, a neuroscientist studying the effects of children being verbally abused by adults and their peers presented some unsurprising data, which finally gave scientific legitimacy to what victims of psychopathic bullies have long known. In his study of more than 1,000 young people, he discovered that words were indeed as hurtful as "sticks and stones". Teicher’s participants varied in how much taunting, ridicule, criticism, shouting, and bad language they had been subject to in the past. What was uncovered found that victims of bullying had higher incidences of depression, anxiety, and other psychiatric disorders than the subjects who had not experienced bullying.
Those subjects who reported having been bullied by their peers had observable abnormalities in a part of the brain known as the corpus callosum which connects the right and left hemispheres of the brain, vital for visual processing, and very significantly from a psychopathic standpoint, clarity of memory. Victims of psychopathic relationships always have trouble recalling memories from the time their relationship with the psychopath commenced. Psychopaths will often say to their victims. "Do you recall when you said this…?" and so forth and the victim will often reply that they have no memory of doing and saying certain things which the psychopath claimed they said and did. Victims memories are impaired and this allows the psychopath to invent a fake past event(s) which the victim cannot readily dispute. This is why it is very common for psychopaths to target people who were victims of childhood abuse and bullying.
In another study Tracy Vaillancourt, a psychologist at the University of Ottawa, discovered that being bullied as a child can alter levels of cortical in victims - a hormone produced during times of stress. Vaillancourt’s findings showed that boys who have been bullied have higher levels of cortisol than normal - while bullied girls have abnormally low levels of cortisol. Weakening the victim’s immune system, sometimes destroying neurons leading to memory problems.
With verbal bullying, more and more studies are finding it is more akin to physical and sexual abuse than had been previously assumed. As psychopaths perform all three on their victims it becomes very apparent how a skilled psychopath can break down and psychologically destroy even the most rational and emotionally balanced person. If the target has been bullied as a child this creates a perfect opportunity for the psychopath to implement techniques such Gaslighting more effectively and much sooner into the relationship. The psychopathic child who is bullying other children at school, or the psychopathic parent bullying his/her own children can be viewed in the same context as a farmer planting an apple orchard to be harvested later on in life.
Labels: autoimmune, brain development, bullies, bullying, gaslighting, harassment, jealousy, memories, polite. psychopaths, projection, smear campaign
