Thursday, March 17, 2011

ABUSE AND THE BRAIN


Jewish Press - March 23, 2011




We may not want to accept it, but abuse occurs everywhere, even in our own communities. The effects of abuse are devastating and long lasting - not only on those individuals who are abused but on their families as well. Even one act of abuse against a person, regardless of age, can have a significantly negative impact that may last a lifetime.
The impact is often much worse when the abuse occurs to a child. People, especially children, who are abused can and often do develop a constellation of different mental health problems including anxiety, depression, suicidal ideas and acts, post-traumatic stress, eating disorders and a variety of other problems most notably character flaws referred to as personality disorders. We understand that abuse is wrong and harmful and should not be tolerated but we are not all that clear on why and just how severe abuses' bearing is on the most basic quality of life issues.
Recent neuropsychological research is beginning to explain why abuse can harm even the most resilient of individuals. What we are learning is that the old nature versus nurture controversy is simply a straw man. Both components - the genes we are born with and the nurturing we are provided - work together, virtually in equal measure, in forming who we are. This finding has led to an area of research entitled epigenetics. The epigenetic approach has found that the environment an individual is exposed to has an impact on both the expression of the underlying genetics a person is born with and can also actively alter the internal structure of genes themselves.
Not only genes but certain basic structures within the brain may be altered by the exposure to abuse. Two structures set deep within the brain, the hippocampus and the amygdala, have been found to be smaller in people abused in childhood as compared with people who were not exposed to trauma. The hippocampus is known to be involved in the process of learning, memory and depression. The amygdala helps to regulate emotions, mood, fear and sleep. It is no wonder, then, that traumatized people can suffer from so many problems. While the young, developing brain may be more vulnerable to these actual physical changes, trauma has been found to alter brain make up regardless of the age of the maltreated person.
What is most interesting is that just as the brain may be altered by horribly traumatic experiences, positive experiences may also alter the brain. Loving, nurturing, supportive and encouraging experiences help the developing brain make connections at the cellular level that enhance experiences later in life. A warm early life has been linked to the development of a resilient approach to life. People who are resilient tend to see challenges as opportunities and have a "can do" attitude about life. They have a healthy network of social and family support, are often very spiritual and have a religious perspective on the meaning of life.
Abused people are more likely to avoid social involvement and discount the spiritual aspects of life. Treatment is predicated on the concept of "plasticity." Just as the brain may be molded by traumatic experiences it may also be reshaped into a healthier functioning mode by the right therapy and the correct positive social and emotional experiences. For some people the process of change may take many years, even decades; for some the change may never come; but for many it may happen in just a few years.
Of course, one of the best ways to help stop the spiraling negativity and subsequent pathology that traumatized people experience throughout their lives is to stop their abuse and give them the social support and nurturing they so desperately need. That unfortunately does not seem to be a real possibility just yet. Abuse will probably continue and in most communities there is still an entrenched habit of blaming the victim.
While abusers are likely to have been abused themselves when they were young, only about 20 percent of those who were abused become abusers. The remaining 80 percent tend to lead internally troubled lives. Both these groups need to be identified and dealt with. There is not much clinical or research evidence that supports a treatment that successfully stops abusers from continuing their abusive behaviors there are however ways to contain abusers so that they no longer hurt others.
Unfortunately, there has been little attempt in most communities to do so. This is doubly unfortunate because if there were an active attempt to contain abusers, not only would others not be traumatized by them, those who were abused in the past would be helped in their healing. They would see they are not discounted - or worse, blamed for the abuse they experienced. They would see a community that is empathetic and caring and they might just open up enough to begin the therapeutic process that allows them to begin their healing.
  
Dr. Michael Salamon, a fellow of the American Psychological Association, is the founder and director of ADC Psychological Services in Hewlett, New York and a board member of Ptach. Dr. Salamon was also a member of The Awareness Center's executive board of directors.  He is the author of numerous articles and several psychological tests. His recent books include The Shidduch Crisis: Causes and Cures, (Urim Publications) and Every Pot Has a Cover (University Press of America). His new book on abuse will be available later this spring.

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