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Winter Turns into Spring - The Blog

By Sylvie Rouhani 17 Apr, 2024
#SAAM - the Sexual Assault Awareness campaign is this month. I wish I could write such things as: "If you have experienced sexual assault or rape, please go to the Police, talk to someone, anyone who could help you though this." Sadly, I can't because the reality is the experiences of victims and survivors of SA are still being dismissed, minimised, if not used as opportunities to further hurt those who are seeking help.
By Sylvie Rouhani 08 Apr, 2024
Mental health services in the UK have always been hard to access. In the last past 5 years, they can no longer meet the needs of the increasing numbers of suffering individuals. The recuring question is "Why are more and more people diagnosed with depression/ADHD/ BPD? ETC" So, what is happening?
By Sylvie Rouhani 08 Mar, 2024
What I call " Chronic Loneliness", others calls it "Attachment trauma", is the heart breaking, gnawing feeling that I am all alone, and frightened - knowing fully well I am not wanted here. There is no love here. This is something I live with every single day of my life. Some days. it is barely noticeable, other days, it is overwhelming, but it is always there, within me. I've learned to accept it with tender loving care, I am not going to lie: it hurts.
By Sylvie Rouhani 18 Dec, 2023
The end of the year 2023 is near. While we are forced fed Christmas joy everywhere, some of us, victims and survivors of child abuse and ,estranged from their immediate family (parents and siblings), this time of the year can be very painful. The holidays can bring up so much Christmas tears, while everyone else is caught up in Christmas cheers.
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Many survivors of CSA have been told to "Let go of the past." The thing is, it isn't in the past! Everything that was done to us, whether we are aware of it or not, is registered in our brain. A brain that has been damaged by pain, terror and loneliness.  Today, I am trying to explain, in simple terms, what negative impact Child Sexual Abuse (and other childhood trauma) has on the brain and how it manifests as we become adults.


In the last few months, I did some research on how Child Sexual Abuse impacts our brain and how it manifests, as we grow up into adults. It certainly helped me to get a better understanding of myself, I hope it will help you too.  I also hope it helps in raising awareness about certain victim shaming myths going around, in psychiatric Units, in CMHTs and other local mental health teams. 

First, here is a list of parts of the brain that are most affected by Child Sexual Abuse (and other Adverse Childhood Experiences/ ACEs):                      

Corpus Callosum, the largest collection of white matter in the brain, filled with neuro pathways, allowing signals between left and right hemispheres. Child Sexual Abuse (and other ACEs) reduces the Corpus Callosum's size. The smaller it gets, the smaller the connection between the two hesmipheres the more damaged these pathways are, which results with the chlid experiencing problems with emotional regulation, self-control and many more other vital functions. This also means hormonal levels never fully returning to baseline (results of ACE's constant threats and fear of violence.), in other words, the survivors will have great difficulties in calming down after experiencing overwhelming stress and emotions.

The Pre-frontal Cortex,  is a part of the brain located at the front of the frontal lobe. It is vital for memory, attention and emotional regulation and behaviour regulation, as well as for inhibition, reasoning and abstract thinking. It is responsible for complex planning and decision making; self-control in the context of social behaviour; setting and achieving goals as well as impulse control. A smaller, damaged Pre-Frontal Cortex results in mental illness such as BPD and C-PTSD.

The Limbic System - located in the inner margin of the upper brain. It contains the thalamus, hypothalamus, hippocampus and amygdala. It is the most primitive part of the brain. It is the first to develop in a foetus. It overides portions of the brain automatic reactions. Damaged Limbic System results in
  •     Mental illnesses (BPD. C-PTSD, PTSD, Bipolar Disorder, DID..)
  •     Memory problems
  •     Problems with understanding complex information
  •     Hyperarousal
  •     Hypervigilance
  •     Chronic loneliness, helplessness, sense of danger
  •     Co-dependency/ Fawn response to danger.
Let's have a closer look at the Amygdala and at the Hippocampus, parts of the Limbic System most affected by CSA.

Amygdala:
  • Stores responses and memory of fear
  • 4Fs responses (Flight, fight, fawn and froze)
  • Remembers danger and emotions to dangerous events, so we recognise danger and react to keep ourelves safe. Regulate emotions
  • First part of the brain to perceive and to react to danger.
  • Releases signals to other part of the brain to get ready for 4Fs
Hippocampus:
  • Formation, organisation and storage of new memories, their triggers and emotions
  • Reduced, it has trouble consolidating memories 
  • Triggers responses - stimulies old trauma and old memories and old reactions to it triggered by somthing in the present.
This is only a very simple overview of the main brain areas affected by trauma, for more info, please refer to the resources at the end of this article.

All the above clearly highlights what I have suspected: yes, mental illnesses have their roots in our brain neuro-transmitters  and pathways, and medications can help with that. However, unless professionals are willing to also look into the causes of these miswired neuropathways, which are severe, prolonged child abuse and neglect, they are only masking the problems.

When people tell us: "It is all in in your head!", well it is really is!! It isn't just in our head though. It starts in the brain and it branches out to our entire body, in form of many physical illnesses, such as Rheumatoid Arthritis, Asthma, IBS, M.E, Fibromalgia,  and symptoms such as chronic muscle pain (localised to the areas that have been violated), chronic fatigue, forgetfullness ect (the list is endless) Because of its connection with the brain, the body has its own memory. This emphasised the need of treatments and support that take both the brain AND the body into account. One cannot be treated without the other.

CBT/ NLP/ MBT aren't good therapies for trauma: trying to "cure" or trying to completely negate "pathological" thoughts, beliefs and behaviour, without taking someone's entire (trauma) history doen't even scraps the tip of the iceberg. It can also backfire as it doesn't succeed in the long term. Patients who have experienced Child Sexual Abuse, for instance, might notice improvements in their behaviour at first in the course if therapy such as CBT or MBT, but, the real causes will sooner or later resurface. The client might just conclude something is wrong with them. This observation are based on my own experience of Mentalization Based Therapy I was referred to after I was misdiagnosed with Borderline Personnality Disorder. (Read: Child Sexual Abuse, When Therapists Got it all wrong)

It is nonsense to declare that our thoughts, feelings and emotions, as well as our mental (and physical) health have nothing to do with our enviroment and the people around us. As children, our physical and emotional well-being , our very survival, were totally dependent on our care givers and on our environement. An infant's brain is at its most malleable stage and absorbs everything! How can we not be deeply affected then?
 
I was shocked to read, in Bessel Van Der Kolk's "The Body Keeps the Score" that, in  April 2013, his researches on the link between childhood severe abuse and neglect with most mental illneses, and their results, were completly rejected by the professionals updating the Diagnostic and Statistical Manual of Mental Disorders' Fifth Edition (DMS-5).  DMS-5 is the The mental health diagnosis bible used worldwide by many professionals. What shocked me even more was when Bessel writes that the DMS-5 was never published as a reliable source for diagnosis!!! So how come it became such a big deal? Well, a lot of professionals make lots of money out of it and it creates a system in which people are being categoried in neat boxes, which in turn gives the illusion of control over many vulnerable individuals.

Bessel also reveals: "In June 2011, The British Psychological Society complained to the APA that the sources of the psychological  suffering in the DSM-5  were identified  as "located within the individuals" and overlooked the "undeniable causation of many such problems"" 

I looked at the latest research conducted by The British Psychological Society. The results shows there is an understanding of the causality of ACEs and Neglect but, as far as I have experienced within the NHS*, there is still a majority of professionals who ,unconscioulsy or not, end up blaming (and, worst of all, re-traumatizing) their patients for their perceived short comings and pathologies, which prevents them to be fully functioning members of society. Still, there has been no significant improvements in terms of understanding and of treating survivors.

We are all encouraged to seek help, to raise awareness and to fight to be heard, in our communities and in society at large. There have been progress, it isn't to be denied, but, as I discovered during my research, not enough people are willing to truly listen to what happened to us. Survivors are still being shamed and blamed for things that were/ are out of our control. Many people wants to tell us what is wrong with us. They want to cure us, to fix us. But no one listens. More than any talking therapies or taking medications, what survivors really need is a kind, loving, compassionate person to just listen to their experiences, feelings and emotions.

* I am not placing blame on the NHS. Its Mental Health services has been reduced to such an extend there is very little available for survivors or for anyone for that matter!! The issues brought up here are so much bigger than this.


You can also read:
Child Sexual Abuse and Addictions
Child Sexual Abuse, When Therapists got it Wrong

Please, take gentle care of yourselves during this difficult time.
Lots of Love,
Sylvie
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