DID: The ACE Study

A new and profoundly important paradigm for understanding overwhelming emotional pain has emerged over the last few years, with the potential to change the way we conceptualize human suffering across the whole spectrum of mental health difficulties. It is an evidence-based synthesis of findings from trauma studies, attachment theory and neuroscience, which offers new hope for recovery. It also presents a powerful challenge to the biomedical model of psychiatry in that it is based on scientific evidence that substantiates and attests to what many individuals with first-hand experience of mental health problems have always known — that the bad things that happen to you can drive you mad.

A New Paradigm for Understanding Severe Mental Distress

The CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study revolutionizes the way we think about the body and mind.

The ACE Study settles the question of whether we are shaped by genetics or the environment: we are shaped by both.  Nature Versus Nurture: Where We Are in 2017

The ACE study proves that child abuse causes enduring neurological damage that can affect a person’s health and quality of life throughout the lifespan.

The body of a frightened child floods with hormones and prepares to fight, run, or die.

In less than an instant, the amygdala sends an alarm to the hippocampus, which tells the adrenal glands to release adrenaline.

Adrenaline increases heart rate and breathing, oxygen goes to the muscles and brain, which increases hearing and sharpens eyesight.

Adrenaline wears off and cortisol takes over; cortisol is a longer acting stress hormone designed keep the body alert.

Illustration from Harvard Medical School
Understanding The Stress Response, Harvard Medical School

If a child fears for his life, he may freeze and go numb.

For a prey animal in the wild, numbing is a blessing.

For abuse survivors, it means gaps in memory

During the fight, flight or freeze response the brain inhibits the prefrontal cortex.

The prefrontal cortex is responsible for retrieving memories. 

The memory is there but the brain can’t retrieve it.

A chronically abused child lives in fear which damages the structure and
functioning of a the brain. Harvard University

The toll of chronic fear on physical health includes:

  • Immune system dysfunction
  • Endocrine system dysfunction
  • Autonomic nervous system alterations
  • Sleep/wake cycle disruption
  • Eating disorders

The toll of chronic fear on emotional health includes

The Pyramid of effects of abuse on the lifecycle
Abuse Affects the Life-cycle

It takes nine months for the fetus to become a baby that can survive beyond
the womb.

Between birth and the age of two, we have no words; for the first ten years of our  lives, we are helplessly dependent on our parents and communities for our physical and psychological well being.

Child abuse is a betrayal of unconditional trust.

You don’t just ‘get over it’.

People with dissociative disorders report the highest occurrence of abuse and childhood neglect among all psychiatric disorders. This suggests dissociation is the ultimate reaction to significant trauma. Links between Trauma, PTSD, and Dissociative Disorders

A 2018 review found changes in the structure of the brain in people with DID. These changes are complex and  include decreased limbic activity, increased frontal lobe activity, and changes in communication between these two regions.

An illustration depicting a little boy glaring at his drunken mother, passed out on the floor
Child Abuse Lasts a Lifetime

DID is something done to you, like the rapes and daily beatings.

One must accept what happened and make peace with it.

Acceptance means seeing what might have been and grieving the loss.

Acceptance means letting go of the idea that I brought it on myself, that I am shameful and not good enough, and it means not letting the dismissive arrogance I sometimes encounter gnaw at my soul.

Acceptance means holding abusers accountable for the messes they make.

Acceptance means believing the abuse will end.

I am not completely there.

How do I accept the evil of child abuse when the abuse never ends?

For now, broken but better is the best I can do.

DID: When Everything is a Trigger

Get Your ACE Score

(C)Rob Goldstein 2019

‘Child Abuse Lasts Forever” (C) Rob Goldstein 2019

All other graphics were found online and are used here for educational purposes.

The Status of the Past

The Status of The Past

A friend once told me that the painting of the Last Supper took decades to finish.

My friend said that the model used for Judas was the same model used by da Vinci for the face of Christ when the painting began.

The idea that the condition of the soul emerges as the body ages horrified and fascinated me.

I was 16, and spent hours comparing the pained compassion in the face of Christ to the cynical corruption in the face of Judas.

At the same time, the Picture of Dorian Grey caught my attention.

I read and re-read the novel until I was sure that I understood Dorian’s sin.

Dorian had innocently made a choice that lead to spiritual destruction and the hell of a lifetime of compulsive self alienation.

I concluded that innocence and guilt are twins, and that there is no such thing as perfect beauty.

These are my thoughts as I brush out my hair and check my face for the status of the past.

(c) Rob Goldstein  2015-2017 All Rights Reserved

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A Letter from Home: Dear Bobby

Dear Bobby,

You want to make it right with your Mother, but she is gone; so you look for her in other people.

You find people who are like her and try to make them love you.

The shadows you describe are a good sign, because it means you can see the replication before it is complete.

Your ability to see that you are in danger means that you are better able to protect yourself.

People yield to each other when they truly accept and love each other.

They yield by mutual consent.

What you are used to is love as warfare and you as hostage.

You look for emotional vampires.

You invite them into your life and they feed on you.

You will always have to guard against  your attraction to people who can’t love.

But no one has the right to judge your perception of the difference between right and wrong.

Not taking a stand against people who choose to harm others places us all at risk.

You are no better than anyone else is and no one else is better than you are.

Your awareness of the divine defines you; you see that life is magic.

Your innate awareness of this fills you with the love you struggle to express.

This spirit of love makes you hateful to the soulless.

But it’s not just you Bobby.

You survived a Mother who in her twisted love for you, wanted you dead.

You will have to remember the selfish ignorance that raped your body, it is horrifying, but we must do it.

With all of our problems and pain, we are lucky because you are our soul
and you are intact.

Adults bring the fruit of wisdom into the world.

That is our job and why we must get well.

Know that I love you and that I am here to protect you until you can protect yourself,

Sara

 

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A Letter from Home: When My Alternates Talk to Each Other

(c) Rob Goldstein 2014-2017 All Rights Reserved

Revised 2018

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