On This Day … 14 April

People (Deaths)

  • 2010 – Alice Miller, Polish-French psychologist and author (b. 1923).

Alice Miller

Alice Miller, born as Alicija Englard (12 January 1923 to 14 April 2010), was a Polish-Swiss psychologist, psychoanalyst and philosopher of Jewish origin, who is noted for her books on parental child abuse, translated into several languages. She was also a noted public intellectual.

Her book The Drama of the Gifted Child caused a sensation and became an international bestseller upon the English publication in 1981. Her views on the consequences of child abuse became highly influential. In her books she departed from psychoanalysis, charging it with being similar to the poisonous pedagogies.

Life

Miller was born in Piotrków Trybunalski, Poland into a Jewish family. She was the oldest daughter of Gutta and Meylech Englard and had a sister, Irena, who was five years younger. From 1931 to 1933 the family lived in Berlin, where nine-year-old Alicija learned the German language. Due to the National Socialists’ seizure of power in Germany in 1933 the family turned back to Piotrków Trybunalski. As a young woman, Miller managed to escape the Jewish Ghetto in Piotrków Trybunalski, where all Jewish inhabitants were interned since October 1939, and survived World War II in Warsaw under the assumed name of Alicja Rostowska. While she was able to smuggle her mother and sister out, in 1941, her father died in the ghetto.

She retained her assumed name Alice Rostovska when she moved to Switzerland in 1946, where she had won a scholarship to the University of Basel.

In 1949 she married Swiss sociologist Andreas Miller, originally a Polish Catholic, with whom she had moved from Poland to Switzerland as students. They divorced in 1973. They had two children, Martin (born 1950) and Julika (born 1956). Shortly after his mother’s death Martin Miller stated in an interview with Der Spiegel that he had been beaten by his authoritarian father during his childhood – in the presence of his mother. Miller first stated that his mother intervened, but later that she did not intervene. These events happened decades before Alice Miller’s awakening about the dangers of such childrearing methods. Martin also mentioned that his mother was unable to talk with him, despite numerous lengthy conversations, about her wartime experiences, as she was severely burdened by them.

In 1953 Miller gained her doctorate in philosophy, psychology and sociology. Between 1953 and 1960, Miller studied psychoanalysis and practiced it between 1960 and 1980 in Zürich.

In 1980, after having worked as a psychoanalyst and an analyst trainer for 20 years, Miller “stopped practicing and teaching psychoanalysis in order to explore childhood systematically.” She became critical of both Sigmund Freud and Carl Jung. Her first three books originated from research she took upon herself as a response to what she felt were major blind spots in her field. However, by the time her fourth book was published, she no longer believed that psychoanalysis was viable in any respect.

In 1985 Miller wrote about the research from her time as a psychoanalyst: “For twenty years I observed people denying their childhood traumas, idealising their parents and resisting the truth about their childhood by any means.” In 1985 she left Switzerland and moved to Saint-Rémy-de-Provence in Southern France.

In 1986, she was awarded the Janusz Korczak Literary Award for her book Thou Shalt Not Be Aware: Society’s Betrayal of the Child.

In April 1987 Miller announced in an interview with the German magazine Psychologie Heute (Psychology Today) her rejection of psychoanalysis. The following year she cancelled her memberships in both the Swiss Psychoanalytic Society and the International Psychoanalytic Association, because she felt that psychoanalytic theory and practice made it impossible for former victims of child abuse to recognise the violations inflicted on them and to resolve the consequences of the abuse, as they “remained in the old tradition of blaming the child and protecting the parents”.

One of Miller’s last books, Bilder meines Lebens (“Pictures of My Life”), was published in 2006. It is an informal autobiography in which the writer explores her emotional process from painful childhood, through the development of her theories and later insights, told via the display and discussion of 66 of her original paintings, painted in the years 1973-2005.

Between 2005 and her death in 2010, she answered hundreds of readers’ letters on her website, where there are also published articles, flyers and interviews in three languages. Days before her death Alice Miller wrote: “These letters will stay as an important witness also after my death under my copyright”.

Miller died on 14 April 2010, at the age of 87, at her home in Saint-Rémy-de-Provence by suicide after severe illness and diagnosis of advanced stage of pancreatic cancer.

Work

Miller extended the trauma model to include all forms of child abuse, including those that were commonly accepted (such as spanking), which she called poisonous pedagogy, a non-literal translation of Katharina Rutschky’s Schwarze Pädagogik (black or dark pedagogy/imprinting).

Drawing upon the work of psychohistory, Miller analysed writers Virginia Woolf, Franz Kafka and others to find links between their childhood traumas and the course and outcome of their lives.

The introduction of Miller’s first book, The Drama of the Gifted Child, first published in 1979, contains a line that summarises her core views:

Experience has taught us that we have only one enduring weapon in our struggle against mental illness: the emotional discovery and emotional acceptance of the truth in the individual and unique history of our childhood.

In the 1990s, Miller strongly supported a new method developed by Konrad Stettbacher, who himself was later charged with incidents of sexual abuse. Miller came to know about Stettbacher and his method from a book by Mariella Mehr titled Steinzeit (Stone Age). Having been strongly impressed by the book, Miller contacted Mehr in order to get the name of the therapist. From that time forward, Miller refused to make therapist or method recommendations. In open letters, Miller explained her decision and how she originally became Stettbacher’s disciple, but in the end she distanced herself from him and his regressive therapies.

In her writings, Miller is careful to clarify that by “abuse” she does not only mean physical violence or sexual abuse, she is also concerned with psychological abuse perpetrated by one or both parents on their child; this is difficult to identify and deal with because the abused person is likely to conceal it from themselves and may not be aware of it until some event, or the onset of depression, requires it to be treated. Miller blamed psychologically abusive parents for the majority of neuroses and psychoses. She maintained that all instances of mental illness, addiction, crime and cultism were ultimately caused by suppressed rage and pain as a result of subconscious childhood trauma that was not resolved emotionally, assisted by a helper, which she came to term an “enlightened witness.” In all cultures, “sparing the parents is our supreme law,” wrote Miller. Even psychiatrists, psychoanalysts and clinical psychologists were unconsciously afraid to blame parents for the mental disorders of their clients, she contended. According to Miller, mental health professionals were also creatures of the poisonous pedagogy internalised in their own childhood. This explained why the Commandment “Honour thy parents” was one of the main targets in Miller’s school of psychology.

Miller called electroconvulsive therapy “a campaign against the act of remembering”. In her book Abbruch der Schweigemauer (The Demolition of Silence), she also criticised psychotherapists’ advice to clients to forgive their abusive parents, arguing that this could only hinder recovery through remembering and feeling childhood pain. It was her contention that the majority of therapists fear this truth and that they work under the influence of interpretations culled from both Western and Oriental religions, which preach forgiveness by the once-mistreated child. She believed that forgiveness did not resolve hatred, but covered it in a dangerous way in the grown adult: displacement on scapegoats, as she discussed in her psycho-biographies of Adolf Hitler and Jürgen Bartsch, both of whom she described as having suffered severe parental abuse.

A common denominator in Miller’s writings is her explanation of why human beings prefer not to know about their own victimisation during childhood: to avoid unbearable pain. She believed that the unconscious command of the individual, not to be aware of how he or she was treated in childhood, led to displacement: the irresistible drive to repeat abusive parenting in the next generation of children or direct unconsciously the unresolved trauma against others (war, terrorism, delinquency), or against him or herself (eating disorders, drug addiction, depression).

The Roots of Violence

According to Alice Miller, worldwide violence has its roots in the fact that children are beaten all over the world, especially during their first years of life, when their brains become structured. She said that the damage caused by this practice is devastating, but unfortunately hardly noticed by society. She argued that as children are forbidden to defend themselves against the violence inflicted on them, they must suppress the natural reactions like rage and fear, and they discharge these strong emotions later as adults against their own children or whole peoples: “child abuse like beating and humiliating not only produces unhappy and confused children, not only destructive teenagers and abusive parents, but thus also a confused, irrationally functioning society”. Miller stated that only through becoming aware of this dynamic can we break the chain of violence.

Refugee Children & Adolescents and PTSD

Research Paper Title

Traumatic experiences of conditional refugee children and adolescents and predictors of post-traumatic stress disorder: data from Turkey.

Background

The researchers aimed to determine traumatic events, mental health problems and predictors of PTSD in a sample of conditional refugee children.

Methods

The sociodemographic features, chief complaints, traumatic experiences and psychiatric diagnoses according to DSM-5 were evaluated retrospectively.

Results

20.7% (n = 70) of children experienced the armed conflict or exposed to firefights at their country of origin. Most common diagnoses were anxiety disorders (n = 82, 24.3%), major depressive disorder (n = 52, 15.4%) and PTSD (n = 43, 12.7%). Age, number of traumatic experiences, explosion and sexual violence are the most important predictors for PTSD.

Conclusions

The results suggest that the number of traumas exposed as well as their nature predicted PTSD diagnosis. Refugee children have increased risk for psychiatric problems after migration and resettlement underlining the importance of an adequate follow-up for mental health and ensuring social support networks.

Reference

Yektas, C., Erman, H. & Tufan, A.E. (2021) Traumatic experiences of conditional refugee children and adolescents and predictors of post-traumatic stress disorder: data from Turkey. doi: 10.1080/08039488.2021.1880634. Online ahead of print.

Book: The Post-Traumatic Stress Disorder Sourcebook

Book Title:

The Post-Traumatic Stress Disorder Sourcebook, Revised and Expanded Second Edition: A Guide to Healing, Recovery, and Growth.

Author(s): Glenn R. Schiraldi (PhD).

Year: 2016.

Edition: Second (2nd).

Publisher: McGraw-Hill Education.

Type(s): Paperback and Kindle.

Synopsis:

The Post-Traumatic Stress Disorder Sourcebook, Revised and Expanded Second Edition introduces survivors, loved ones, and helpers to the remarkable range of treatment alternatives and self-management techniques available today to break through the pain and realise recovery and growth.

This updated edition incorporates all-new diagnostics from the DSM-5 and covers the latest treatment techniques and research findings surrounding the optimisation of brain health and function, sleep disturbance, new USDA dietary guidelines and the importance of antioxidants, early childhood trauma, treating PTSD and alcoholism, the relationship between PTSD and brain injury, suicide and PTSD, somatic complaints associated with PTSD, and more.

Book: Neurobiologically Informed Trauma Therapy with Children & Adolescent

Book Title:

Neurobiologically Informed Trauma Therapy with Children and Adolescents: Understanding Mechanisms of Change (Norton Series on Interpersonal Neurobiology).

Author(s): Linda Chapman.

Year: 2014.

Edition: First (1st).

Publisher: W.W. Norton & Company.

Type(s): Paperback and Kindle.

Synopsis:

The model of treatment developed here is grounded in the physical, psychological, and cognitive reactions children have to traumatic experiences and the consequences of those experiences. The approach to treatment utilises the integrative capacity of the brain to create a self, foster insight, and produce change. Treatment strategies are based on cutting-edge understanding of neurobiology, the development of the brain, and the storage and retrieval of traumatic memory. Case vignettes illustrate specific examples of the reactions of children, families, and teens to acute and repeated exposure to traumatic events.

Also presented is the most recent knowledge of the role of the right hemisphere (RH) in development and therapy. Right brain communication, and how to recognise the non-verbal symbolic and unconscious, affective processes will be explained, along with examples of how the therapist can utilise art making, media, tools, and self to engage in a two-person biology. 30 illustrations; 8 pages of colour.

Major Depressive Disorder & Childhood Trauma

Research Paper Title

Major depressive disorder with childhood trauma: Clinical characteristics, biological mechanism, and therapeutic implications.

Background

Major depressive disorder (MDD) is a main type of mood disorder, characterised by significant and lasting depressed mood.

Until now, the pathogenesis of MDD is not clear, but it is certain that biological, psychological, and social factors are involved.

Childhood trauma is considered to be an important factor in the development of this disease.

Previous studies have found that nearly half of the patients with MDD have experienced childhood trauma, and different types of childhood trauma, gender, and age show different effects on this disease.

In addition, the clinical characteristics of MDD patients with childhood trauma are also different, which often have more severe depressive symptoms, higher risk of suicide, and more severe cognitive impairment.

The response to antidepressants is also worse.

In terms of biological mechanisms and marker characteristics, the serotonin transporter gene and the FKBP prolyl isomerase 5 have been shown to play an important role in MDD and childhood trauma.

Moreover, some brain imaging and biomarkers showed specific features, such as changes in gray matter in the dorsal lateral prefrontal cortex, and abnormal changes in hypothalamic-pituitary-adrenal axis function.

Reference

Guo, W., Liu, J. & Li, L. (2020) Major depressive disorder with childhood trauma: Clinical characteristics, biological mechanism, and therapeutic implications. Journal of South Central University. 45(4), pp.462-468. doi: 10.11817/j.issn.1672-7347.2020.190699.

Major Depressive Disorder: Childhood Trauma

Research Paper Title

Major depressive disorder with childhood trauma: Clinical characteristics, biological mechanism, and therapeutic implications.

Background

Major depressive disorder (MDD) is a main type of mood disorder, characterised by significant and lasting depressed mood.

Until now, the pathogenesis of MDD is not clear, but it is certain that biological, psychological, and social factors are involved.

Childhood trauma is considered to be an important factor in the development of this disease.

Previous studies have found that nearly half of the patients with MDD have experienced childhood trauma, and different types of childhood trauma, gender, and age show different effects on this disease.

In addition, the clinical characteristics of MDD patients with childhood trauma are also different, which often have more severe depressive symptoms, higher risk of suicide, and more severe cognitive impairment.

The response to antidepressants is also worse.

In terms of biological mechanisms and marker characteristics, the serotonin transporter gene and the FKBP prolyl isomerase 5 have been shown to play an important role in MDD and childhood trauma.

Moreover, some brain imaging and biomarkers showed specific features, such as changes in gray matter in the dorsal lateral prefrontal cortex, and abnormal changes in hypothalamic-pituitary-adrenal axis function.

Reference

Guo, W., Liu, J. & Li, L. (2020) Major depressive disorder with childhood trauma:Clinical characteristics, biological mechanism, and therapeutic implications. Zhong nan da xue xue bao. Journal of Central South University. 45(4), pp.462-468. doi: 10.11817/j.issn.1672-7347.2020.190699.

Book: The ACOA Trauma Syndrome

300300

Book Title:

The ACOA Trauma Syndrome: The The Impact of Childhood Pain on Adult Relationships.

Author(s): Tian Dayton.

Year: 2012.

Edition: First (1st).

Publisher: Health Communications.

Type(s): Paperback and Audiobook.

Synopsis:

The ACoA syndrome is a post-traumatic stress reaction in which pain from the stress of growing up with parental addiction emerges years even decades later in adult relationships.

Adult Children of Alcoholics suffer from a post-traumatic stress created by their dysfunctional family situations.

Through insightful analysis and thoughtful examination, bestselling author and renowned psychologist Tian Dayton shows ACoAs how and why this family trauma has such a profound effect on adult relationships and provides the tools for marshalling resilience and restoring health and happiness.

Dr. Dayton explores how our brains and bodies process childhood trauma and how those traumas can become the catalyst for unhealthy, self-medicating behaviours including drug and alcohol abuse, food issues, and sex, gambling, and shopping addictions.

Readers who have experienced previous trauma will learn how they developed PTSD and how they can heal both personally and interpersonally.

Book: Child Psychology & Development for Dummies

Book Title: Child Psychology & Development for Dummies

Author(s): Laura L. Smith, PhD and Charles H. Elliott, PhD.

Year: 2011.

Edition: First.

Publisher: Wiley Publishing, Inc.

Synopsis:

Grasp a child’s cognitive development, detect abnormalities, and learn what to do next.

An essential guide for parents, teachers, and caregivers, Child Psychology & Development For Dummies provides an informational guide to cognitive development at every stage of a child’s life, as well as expert tips and guidance on how to diagnose, treat, and overcome the cognitive barriers that impede learning and development.

  • The nuts and bolts – delve into the soup of kids’ development, including biology, psychology, learning, environment, and culture.
  • What makes kids tick? – discover how heredity, environment, experience, and culture interact to determine a child’s physical and emotional development.
  • Watch them grow – get an understanding of what a “normal” childhood should look like from conception through adolescence, and the types of behaviours to anticipate throughout.
  • Learn to spot trouble – find out what can go wrong during a child’s development, from physical problems like chronic illness to psychological problems like autism.
  • Ask for help – get expert guidance on the therapies and interventions that work, and how you can collaborate with professionals for an even better outcome.

Childhood Trauma: Time, Trust, and Opportunities

Research Paper Title

Repairing the effects of childhood trauma: The long and winding road.

Background

  • What is known on this subject:
    • Domestic and family violence contributes to mental distress and the development of mental illness and can reverberate throughout a person’s life.
  • What this paper adds to existing knowledge.
    • Therapeutic work with people who experience domestic and family violence needs to take considerable time to allow the process to unfold.
    • Understanding the triggers that cause past traumas to be re-experienced helps people to recognise and change their conditioned emotional responses.
  • What are the implications for practice?
    • Time needs to be invested to develop a secure and trusting relationship to enable a person to work through childhood experiences that have the potential to overwhelm.
    • It is important for adults who have experienced childhood trauma to have an opportunity to process the abuse to help minimise its intrusion in their lives.

Reference

Palmer, C., Williams, Y. & Harrington, A. (2019) Repairing the effects of childhood trauma: The long and winding road. Journal of Psychiatric and Mental Health Nursing. doi: 10.1111/jpm.12581. [Epub ahead of print].

The Effects of Childhood Trauma on Increased Cortisol Levels in Patients with Glucocorticoid Resistance

Research Paper Title

Childhood Trauma, HPA Axis Activity and Antidepressant Response in Patients with Depression.

Background

Childhood trauma is among the most potent contributing risk factors for depression and is associated with poor treatment response.

Hypothalamic-pituitary-adrenal (HPA) axis abnormalities have been linked to both childhood trauma and depression, but the underlying mechanisms are poorly understood.

The present study aimed to investigate the link between childhood trauma, HPA axis activity and antidepressant response in patients with depression.

Methods

As part of the Wellcome Trust NIMA consortium, 163 depressed patients and 55 healthy volunteers were included in this study.

Adult patients meeting Structured Clinical Interview for Diagnostic and Statistical Manual Version-5 criteria for major depression were categorised into subgroups of treatment responder (n=42), treatment non-responder (n=80) and untreated depressed (n=41) based on current depressive symptom severity measured by the 17-item Hamilton Rating Scale for Depression and exposure to antidepressant medications established by Antidepressant Treatment Response Questionnaire. Childhood Trauma Questionnaire was obtained.

Baseline serum C-reactive protein was measured using turbidimetric detection. Salivary cortisol was analysed at multiple time points during the day using the ELISA technique. Glucocorticoid resistance was defined as the coexistence of hypercortisolemia and inflammation.

Results

The results show that treatment non-responder patients had higher exposure to childhood trauma than responders.

No specific HPA axis abnormalities were found in treatment non-responder depressed patients.

Untreated depressed showed increased diurnal cortisol levels compared with patients on antidepressant medication, and higher prevalence of glucocorticoid resistance than medicated patients and controls.

The severity of childhood trauma was associated with increased diurnal cortisol levels only in individuals with glucocorticoid resistance.

Conclusions

The researchers argue their findings suggest that the severity of childhood trauma experience contributes to a lack of response to antidepressant treatment.

The effects of childhood trauma on increased cortisol levels are specifically evident in patients with glucocorticoid resistance and suggest glucocorticoid resistance as a target for the development of personalised treatment for a subgroup of depressed patients with a history of childhood trauma rather than for all patients with resistance to antidepressant treatment.

Reference

Nikkheslat, N., McLaughlin, A.P., Hastings, C., Zajkowska, Z., Nettis, M.A., Mariani, N., Enache, D., Lombardo, G., Pointon, L., Cowen, P.J., Cavanagh, J., Harrison, N.A., Bullmore, E.T., Pariante, C.M., Mondelli, V. & NIMA Consortium. (2019) Childhood Trauma, HPA Axis Activity and Antidepressant Response in Patients with Depression. Brain, Behavior, and Immunity. pii: S0889-1591(19)30702-0. doi: 10.1016/j.bbi.2019.11.024. [Epub ahead of print].