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Ariel said, “We know from family studies that there is a strong genetic component to bipolar”

Family studies are methodologically faulted when looking for evidence of genetic components in mental health: The family that passes on the genes also most usually passes on it behaviour, thinking and social models. Where do you differentiate between a genetic and experientally passed on trait in behaviour such as mental health issues? You probably can not, with the exception of separated-at-birth-twin studies.

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1,2 me and 5 want to say a big thankyou to everyone here for having such a sensible debate on this subject.

I think some of what has been said could be very informative for health professionals accross all fields. I would suggest all doctors and nurses need a greater awareness in training. The place of CSA in the aetiology of all aspects of physical and mental health in the general population is underestimated and needs careful reconsideration. Freuds theories have to be ditched and his earlier ones revoked. Psychiatry and physical medicine need to be overhauled and brought into one metaphore: Two examples from physical medicine:

63% of infant abuse victims, in the only study I could locate by the Red Cross in Durban, needed surgery. Sphincters, pelvic floor repair, stomas etc. There are tens of thousands of people running around with “conversion disorder” and “somatization disorder” diagnosis with overlooked chilhood polytrauma and associated compensations. As the trauma was inflicted before the child was mobile they look normal having copied others around them for clues as to how to use their bodies as all infants do.

And no one has asked why, of the three groups in whom internal rectal prolapse is common, boys under three year old should be one. Simply: Childhood sexual abuse. It is the known cause of my own internal injureies … includsing internal rectal prolapse. And boys particularly: they don’t have vagina’s to penetrate.

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Still hope your statistics are very wrong.

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The abuse has been proven by physical findings. (thinned and scarred internal anal sphincter, muscular damage to my neck causing neurological problems, etc.)

So to answer your question Beakie, yes … you can forget completely and then remember later. But the key is not a therapist it is your own peace of mind: therapy may help.

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Beakie: Is there any evidence at all that victims of abuse forget their trauma to such an extent that it lies buried for years and years until the right therapist comes along with the key?

A therapist is rarely the key in my experience.

In 1994 I went and saw my GP and said I needed therapy. I told her I experienced a void of meaning inside that hurt. And she told me I was too sane to be helped.

I shopped around a little. Saw a few types. What a bunch of quacks. Even the highly regarded NHS Genius I saw privately - actually he was one of the worst.

In 1997 I suffered drug induced psychosis and was admitted to a mental health ward. I stayed a night and left because of what I consaidered to be their unhealthy interest in me. I had been (over) self-medicating with canabis to cope with my pain.

In 1999 I moved to a Buddhist centre and lived there for the next eighteen months. I meditated a lot under the instruction of Tibetain, Japanese and other masters. Nothing fancy, no visualisations, just lots and lots of sitting still and breathing and experiencing my still(ish) body and running mind. As my mind unwound over those eighteen months I started getting flashbacks. I started remembering being the rapes.

When I left in September 2000 I “knew” I had been abused. I still did not want to accept it. I thought it had started when i was about seven - I was wrong there by a mile. I had no concept of the fact that it was my body that was raped. That the fingers typing this were writhing in agony as I was repeatedly orally and anally raped for years from some time before my first birthday until I was twelve.

What this sort of abuse does, and it is the most common and pernicious kind, is to divide the self. This is particularly true when the trusted authority figures around you are abusing and enabling the abuse. How can you let daddy rape you again and again and then sit eating breakfast and playing happy families like it didn’t happen? And why the **** is mum not doing anything about this? I know she knows … Too many incongruencies and the sense of self is what shatters. Only if there is more than one self-contained personality inside one body is this situation liveable.

Dissociation from the events of the trauma becomes dissociation from the body (and I believe there are common learned musculoskeletal responses that inhibit neurology and allow this dissociation - hence the “psychological” sequelea may well be actually physically based in any case, at root). Dissociation from the body turns into dissociation into different personalities to cope with the ongoing horror. This becomes established as the child is socialised around the ages of 2 - 6 depending on when the abuse begins and other environmental factors. If the child is first abused later than about age six they probably will never split. They may not tell because of threats but they will always have known they were abused. This is not an absolute rule however and older children who are horrifically abused and threatened can split.

Thereafter the little boy or girl sitting down to breakfast with daddy is not the same one as the one daddy sneaks into bed with. That one may even learn to enjoy the sexual invasion and physical contact - after all it is all it has (and this is where paedophiles come from to answer Mental’s question - the harmful side, the hurt side becomes stronger than the human compassionate side in these people and they are thus rendered in control - Dissociative Identity Disorder left unchecked can turn into: paedophillia, schizophrenia etc). And rarely do abuse victims end up with only two personalities.

I was left with somewhere in the region of a hundred, is my best guess, age 18 when I went to Uni. They each had important roles to play in guarding me from the reality I had/was experiencing. I was an addict, a druggie, a drunk, sexually promiscuous and aggressive but brilliant. I left out of boredom with no degree and beame a very successful stockbroker. But inside there was this ominous hole …

… now I have resolved much of the trauma. Memories come back as the parts of me that separated decide its time to rejoin the pack. I can be triggered to switch into a different personality completely but this doesn’t happen too much. The hurt ones stay in the background by and large. I had five personalities left until about two months ago when another merged into adult me. That one brought certain emotional contents related to the abuse, I finally realised that it was this body, my body. that was raped and tortured by these experiences. I also regained something I can only describe as a sense of “joy at being” and a sense of being my own boss.

The four that are left have an interesting dynamic. Adult me has consistent memories of being from age twelve onwards. Everything that comes to me from before that comes in the blink of an eye from one of the other three. Slowly they are revealing to me their truth. It is not very nice for them or for me but we are all in agreement it is how we want to move forward.

Without painting the whole picture I know I was abused by fifty three men before I was twelve. I know the identity of about fifteen of these persons without counting. I have flashbacks to some of the earliest rapes age

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Take epilespy for example. Many people are born with the condition but I know of one woman who developed it as a result of a brain injury. But her treatment was standard - anti convulsants. No one ever suggested she should have therapy to address the trauma of the car crash, or suggested that if she did so this would have the effect of remitting her symptoms. No amount of talking would reverse the damage.

We know from family studies that there is a strong genetic component to bipolar, but we also know from twin studies that genetics does not explain the whole picture. As far as I know the only environmental factor for which strong evidence exists is death of the mother in the first five years of life (which leads to higher rates of psychosis in adulthood). The infant brain is still developing and it seems reasonable to assume that such a devastating trauma could damage the emotional centres of the brain and stop them developing properly. What I find hard to understand is how any amount of talking, years later, is likely to reverse this damage. And the resulting psychotic symptoms would still need to be treated.

If death of the mother can cause the kind of brain damage that results in psychosis then I see no reason why abuse or neglect in childhood might not have the same effect. But if the brain is damaged then no amount of talking is likely to repair it. I’m unclear as to what might be gained by getting the patient to talk about such distressing events, other than to put them under emotional stress, possibly to the point of actually precipitating an episode of psychosis.

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I think the evidence on ‘forgotten’ trauma is very debatable at the very least. I have seen people deny past horrors and claim not to remember things, though obviously they are simply unwilling to allow the memories room in their mind. Or at least that is the way I interpreted it.

If someone had suppressed memories so thoroughly that had, to all intents and purposes, forgotten how would we know ?

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Hence so many mothers who were abused, picking abusive partners and chosing to believe they “would never hurt” the kids, whilst upstairs daddy is off raping the little’uns.

There are four mental health victims for you just in this one (average) family and those families are everywhere. Later little Mary might get Schizophrenia whilst little Johnny ends up in prison on drug dealing charges. Mummy copes by popping a mixture of alcohol and pills all her life, to try and self medicate away the pain a) of her original suffering and b) the impossible situation she is in (yet does not recognise even though knowing it) until eventually going completely insane, or succumbing to the sweet relief of dementia. Once the kids have left home Daddy marries a girl about the same age as his daughter and starts a new family: a better family: one that has young kids in it again.

If you live in a big city there are children you see daily who are daily abused. When you are sleeping in your bed at night there are plenty of children being regularly raped with a short distance from the place you sleep soundly.

These facts are not nice. The aftereffects also drive a lot of people into a different form of sanity - one the “sane people” like to label “mad”.

Is this causing 10% of mental health problems? 20%? …. no one knows. But my estimation based on a fairly wide understanding of all the issues is that it is greater than 50% of mental health issues.

This is not to say that a man who receives a brain injury in later life was abused as a child or that there are no strictly organic mental health illnesses. Just that these are much less significant factors in the overall problem than invasive dehumanising torture in the name of someone elses sexual gratification.

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This probably needs to be drummed into nurses (doctors, others?) during their training to ensure it becomes a standard part of assessments. A quick:

Doctor: Did you have a happy childhood ?

Client: Yes I did. Uncle John hardly touched me up at all.

Doctor: Lets move on then.

Is plainly not enough. I know many nurses feel uncomfortable about asking some of these questions, I do, but it has to be done.

But that still leaves most people with mental health problems not having a history of abuse. If we look too hard we will find it where it does not exist:

Nurse: Have you ever been abused as a child ?

Client: No I had a lovely childhood. I got stressed at my school exams and became unwell.

Nurse: You are probably in denial about your abuse then …

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Despite the taboo it is rife in our society and alive and well. There are clubs you can join, brothels where kids are forced into sex slavery you may visit and etc, etc, etc. Aside from all the kids abused by daddy, uncle John and that nice bloke next door.

One of the main lies about Childhood Sexual Abuse is that it is perpetrated by lone “sick” people. A lot of Childhood Sexual Abuse victims are victims of group activity, well organised and well oiled: Business as normal: and entirely socially acceptable - amongst those who play the game.

These victims may be drugged and or so heavily traumatised they have no conscious recall.

It is impossible at the moment to tell accurately how much of an influencing factor Childhood Sexual Abuse is in mental health issues:

because 1) the taboo is only recently broken 2) there are thus many false assumptions and myths around and 3) because of traumatic forgetting of victims stats mean jack - hence their huge variance, but;

IT IS A BIGGER FACTOR THAN ANYONE WANTS TO ADMIT BECAUSE IT IS SHAMEFUL TO US ALL THAT SO MANY CHILDREN FACE DAILY RAPE AND TORTURE. WE DO NOT WANT TO ADMIT THE MESS WE ARE IN. BRITAIN AS A HIGHLY DEVELOPED AND REPRESSIVE SOCIETY IS ONE OF THE WORST IN THE WORLD:

You may have heard “the english disease” used for many things from laziness to losing at football … it’s original meaning? Coined by mainland Europeans during the 18th - 19th centuries the term referred to for the preference of touring Englishmen for having sex with young children.

Until we as a society wise up to the reality of Childhood Sexual Abuse, it’s prevelance and start doing decent well framed scientific research we will stay in the dark. Denial in one of it’s societal forms accounts for the fact that this research is not happening. This is not just something that affects mental health issues of course.

This debate is interesting and I hope stimulating people to thought. Hopefully some of the mental health workers reading this material will start being more aware in their practice - seek training - or whatever. But we won’t get to any real answers through this medium or in the near future.

It will be another 10 - 20 years before this subject is understood. We will look back at the late twentieth and early 21st centuries as a time of broken innocence and backward responses: we will look back and realise ourselves to have been barbaric.

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Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications

There is a link to the full text.

The figures seem to be at an average of about %50 for a fairly specific sample set. Will try and have a proper read of article soon … very busy for next few days though.

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It could be that the experience of child abuse coupled with a genetic inheritance/in utero acquisition of the kind of neurobiological differences that predispose to psychotic illness leads to particular presentations of that illness (I believe highly critical/abusive voices have been strongly associated with past child abuse)

This debate need not be so polarised. I find the idea that most mental illness can be traced to some form of child abuse is just another form of the old “blame the parents” school of thought that did so much damage in the 20th century.

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