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The "trauma model" of mental disorders is an expression coined by psychiatrist Colin A. Ross as a solution to the problem of comorbidity in the mental health field *. An information packet given to inpatients at the Ross Institute for Psychological Trauma describes the basis of the trauma model in commonsensical terms:

“The problem faced by many patients is that they did not grow up in a reasonably healthy, normal family. They grew up in an inconsistent, abusive and traumatic family. The very people to whom the child had to attach for survival, were also abuse perpetrators and hurt him or her badly * The basic conflict, the deepest pain, and the deepest source of symptoms, is the fact that mom and dad’s behavior hurts, did not fit together, and did not make sense”.

In Schizophrenia: an Innovative Approach to Diagnosis and Treatment (2004), Ross determines that some patients diagnosed with schizophrenia have symptoms related to Dissociative identity disorder (pdf).

Before Ross, in the 1940s, 50s, 60s and 70s other mental health professionals, mostly psychiatrists, proposed trauma models to understand schizophrenia: Harry Stack Sullivan, Frieda Fromm-Reichmann, Theodore Lidz, Gregory Bateson, Silvano Arieti, Ronald Laing and others. They held that schizophrenia is induced by experiences in profoundly disturbed families. In the 1950s Sullivan’s theory that schizophrenia is related to interpersonal relationships was widely accepted in the United States. Though the Diagnostic and Statistical Manual of Mental Disorders or DSM does not claim that the specific etiology of schizophrenia and other serious psychoses has been established, the psychogenic models proposed by these early researchers are no longer in vogue in the psychiatric profession. Since the 1960s pharmacological treatments gradually displaced the psychological approaches; and by the 1980s the theory that the family dynamics could be implicated in schizophrenia became a taboo (Hahlweg et al 2000). Before his death in 2001, aged ninety, Lidz, one of the main proponents of the “schizophrenogenic” parents theory, expressed regret that current research in biological psychiatry is “barking up the wrong tree” *. Like Lidz, Laing maintained until his death that the cause of both schizoid personalities and schizophrenia was influenced by family relationships.

In 1975 Silvano Arieti won the American National Book Award in the field of science for his book, Interpretation of Schizophrenia, which advances a psychological model for understanding all the regressive types of the disorder.*. According to more recent research child abuse at home plays a causal role in depression, PTSD, eating disorders, substance abuse and dissociative disorders (Kendler et al 2000). The more severe the abuse the more probability symptoms will develop in adult life (Mullen et al 1993). In the psychiatric field it is hypothesized that child abuse is less related to the most serious psychoses, such as schizophrenia. However, some mental health professionals maintain that the relationship is stronger in psychoses than neuroses (Read et al 2004; Davis and Burdett 2004).

Critics of the model argue that the logic of the claim that childhood trauma causes insanity demonstrates a serious flaw. If the claim were true, critics contend, the abuse of millions of children over the years should have caused many cases of insanity; but no evidence exists. Decades before Ross, Arieti had addressed this line of argumentation, stating that the only persons before whom young human beings are vulnerable are the ones to whom they are emotionally bonded in childhood. A passage of Interpretation of Schizophrenia, originally published in 1955, sheds light on the heart of the trauma model:

“First of all we have to repeat here what we already mentioned *, that conditions of obvious external danger, as in the case of wars, disasters, or other adversities that affect the collectivity, do not produce the type of anxiety that hurts the inner self and do not themselves favor schizophrenia. Even extreme poverty, physical illness, or personal tragedies do not necessarily lead to schizophrenia unless they have psychological ramifications that hurt the sense of self. Even homes broken by death, divorce or desertion may be less destructive than homes where both parents are alive, live together, and always undermine the child’s conception of himself”.

In more recent years psychologist Alice Miller, author of twelve books on mental distress and disorders, including non-psychiatric conditions like falling prey of cults, has informed future parents and former victims about the disastrous consequences of child abuse. Former schizophrenic patients, such as John Modrow, have also endorsed the views of the pioneers of the trauma models Psychohistorians also endorse trauma models of schizoid, narcissist, masochist, borderline, depressive and neurotic personalities. [http://primal-page.com/ps2.htm

Presently, the family conditions during infancy are considered virtually irrelevant in the psychiatric profession (Johnstone 1993). According to some critics, the goal of modern psychiatric treatment is not to understand how parents could have been contributed to the problem or how it can be resolved improving the relationship. The objective is how to reduce the burden of a psychotic crisis for the family through medication of the disturbed individual. As two trauma researchers have put it, "the ideology of biological reductionism" in psychiatry is "to exonerate the family" (Aderhold and Gottwalz 2004).

Biological psychiatry dismisses sole trauma models, with most mainstream psychiatrists instead believing that complex genetic factors interacting with environmental factors trigger mental disorders.

See also

References

  • Aderhold, Volkmar and Evelyn Gottwalz, “Family therapy and schizophrenia: replacing ideology with openness” in Read et al, Models of Madness (Routledge, 2004).
  • Arieti, Silvano, Interpretation of Schizophrenia, p 197 (Aronson, 1994).
  • Davies, Emma and Jim Burdett, “Preventing ‘schizophrenia’: creating the conditions for saner societies” in Read et al, Models of Madness (Routledge, 2004).
  • Hahlweg, K. et al (2000), "Familienbetreuung als verhaltenstherapeutischer Ansatz zur Ruckfallprophylaxe bei schizophrenen Patienten", in M. Krausz, D. Naber (eds.) Integrative Schizophrenietherapie (Freiburg: Karger).
  • Johnstone, Lucy (1993), "Family management in ‘schizophrenia’: its assumptions and contradictions", Journal of Mental Health 2:255-69.
  • Kendler, K. et al (2000), Archives of General Psychiatry 57:953-9.
  • Modrow, John, How to Become a Schizophrenic: The Case Against Biological Psychiatry (Writers Club Press, 2003).
  • Mullen et al, British Journal of Psychiatry 163:721-32.
  • Read, John; Fred Seymour and Loren Mosher, “Unhappy families” in Read et al, Models of Madness (Routledge, 2004).
  • Read, John; Lisa Goodman, Anthony Morrison, Colin Ross and Volkmar Aderhold, “Childhood trauma, loss and stress” in Read et al, Models of Madness (Routledge, 2004).
  • Ross, Colin, Schizophrenia: An Innovative Approach to Diagnosis and Treatment (Haworth Press, 2004).

External links

Child abuse | Anti-psychiatry | Psychiatry

 

This article is licensed under the GNU Free Documentation License. It uses material from the "Trauma model of mental disorders".

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