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.

Ten Tips for Blogging With DID

Here are my top 10 tips for blogging with DID.

  1. Never leave a negative comment on someone’s blog.
  2. Never make a commitment you can’t keep.
  3. Never apologize for speaking your truth.
  4. Take responsibility when you are wrong.
  5. Learn as much as you can and keep learning.
  6. Thank people when they visit your blog.
  7. Be grateful for having followers.
  8. Always treat other bloggers with respect.
  9. There are jerks out there:  ignore them.
  10. Be yourself, especially when who you are seems improbable.

Rob Goldstein 2016-2019

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A Moment of Chronic Pain

I have a gizmonic exercise bike I found on the sidewalk last year.

I say ‘gizmonic’ because it has a computer that monitors heart rate and caloric output.

It also has games.

I brought it home and slipped some batteries into it and
nothing.

It looked like the computer was broken.

The fix was simple.

The springs that held the batteries in place weren’t making contact
with the batteries.

I stretched them and Bingo!

A fancy exercise bike for the time it took me to stretch
some springs.

My favorite game is the  ‘Calorie Destroyer.

The faster I pedal the more ammo and mobility my gun has.

Last week I raised the seat for better leg extension.

Bad idea.

As I reached level four I felt a twinge of pain in my lower back.

Did that stop me? Of course not!

I was taught to ignore pain.

The twinge became a sharp pain.

The next day I felt stiff.

Friday I walk across the City to therapy.

I began to dress.

There’s  a small chair in front of the door to bedroom closet.

I needed a jacket so I moved the chair and felt something pop; a jolt
of pain raced up my spine and down my legs.

Did I decide not to walk over five miles to my therapist, most of it up hill?

Of course not!

I was in so much pain that when I got home I took two aspirin and a double dose of ‘Clonopin.’ Most docs use benzos to treat severe spasms of the lower back. (I don’t advise anyone else to ever do this without consulting a doctor.)

I laid down and entered the world of pain.

Survival in the world of pain means finding the ‘right’ position: a way to arrange one’s body to cut severe pain.

Finding the ‘right’ position and holding it for as long as possible was the focus of all of my energy and concentration.

I’d find a position only to have to find another position five minutes later.

This meant having more pain to find respite in less pain.

For all my emotional pain I have never had to deal with severe medical pain.

After it was over I had a deeper appreciation for the suffering and courage of
people in chronic pain.

Rob Goldstein 2015-2018

First published November 2015
Revised November 2018

Happy Anniversary Robert Goldstein

from Looking For The Light

Looking For The Light

I heard this song yesterday, Robert instantly came to mind, his enthusiasm for the band reminds me of how I felt hearing them for the first time.

Robert, I’m sending my love as you celebrate 27 years, thick, thin, rich, poor, sick, sicker and still in love!      M

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