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Delayed Posttraumatic Stress Disorders from Infancy The Two Trauma Mechanism:
The two trauma mechanism represents a new model for the study of mental illness in the field of psychiatry. My findings show that psychiatric illnesses are based on early trauma and follow a pattern of later activation precipitated by a major life crisis or significant stressor, and then multiple reactivations with little further provocation. This delayed posttraumatic stress disorder pattern of activation and reactivation holds true not only for schizophrenia, but also for mood disorders, anxiety disorders, psychoactive substance use disorders, eating disorders and more.
To the extent that early trauma are identifiable, it is possible through educational means to prevent a large number of early trauma from ever occurring, and to modify or attenuate the ones that can not be avoided.My research design, allows us to establish a peak age of risk for each emotional disorder or disease category related to early trauma. Based on 25 years of clinical observations, early trauma is expected to account for a large number of disease categories, and in particular the schizophrenias and the depressions. Because of the unique research design, the most likely peak age and age range of origin/vulnerability is identifiable for each disorder/symptom, as well as the relative degree of risk for each type of trauma.
Ultimately, large scale objective studies will reveal a precise mathematical peak age of origin for each symptom or disorder related to trauma. My studies have demonstrated statistically significant correlations between early experienced threats of separation and the later development of serious disorders, and based on cumulative observations it is possible to post-dict clinically the approximate age of origin of each symptom/disorder.This appears to be accurate to within a few months and soon will be tested in a clinical research setting. I do not yet have statistical data to validate all the clinical findings, but to not include the only set of predictions that exist-and which are based on 25 years of cumulative observations-would be falling short of the mark.
ORIGINAL INFANT TRAUMA REQUIRING PREVENTION OR ATTENUATION:
Early traumas largely have one primary common denominator: a relative degree of physical or emotional separation from the mother, which frightens the baby and may trigger primordial fears of abandonment and death. The cry response is present throughout the mammalian species. Mammalian infants need the mother for survival, and without the mother they would die. Absence of the mother elicits the cry response. This is a distress signal, and when the mother hears it, she quickly returns. Both the cry of the infant and the response of the mother are well entrenched in the mammalian brain. (MacLean, 1973, 1985) This has been necessary for survival in mammals since the ancestors of the duck bill platypus, and natural selection assures its perpetuation. Without this means of bringing the mammalian mother and infant together, infants would die and the species gradually would become extinct. Thus the fear of separation is "built in," and it is part of a primary survival mechanism. Separation, therefore, can be so frightening and can produce so much stress that it literally can lead to death. Anaclitic deaths among humans have been documented and this has been recognized in other mammalian species as well.
Since separation from the mother is closely linked with survival, we must pay particular attention to anything that can cause the infant to fear separation, as we explore the range of infant trauma and consider its prevention.Birth of a sibling has been recognized as a severe trauma having profound effects.I would estimate this may represent as much as one-third of severe infant trauma occurring after age nine months. The prevention of serious mental disorders through the prevention of initial trauma must take into consideration either the spacing of children, or special ways of attenuating the birth-of-a-sibling trauma in children who are born in close sequence.
If one chooses to space children close together, then great consideration must be given to the introduction of the new arrival. For a best case scenario vs. a worst case scenario (based in part on cumulative case histories but without statistical study), picture the infant who is totally dependent on the mother-who then suddenly finds the mother gone-and who even may be sent to a babysitter's house because the father is at work and is not available to care for the needs of a one or two year old. The baby is very upset at the sudden disappearance of the mother, is frightened, confused, cries in distress, and is desperate for her return. Then the mother returns, holding and feeding a new baby. Suddenly all fears may culminate in a dreadful realization; the first child experiences that it has been displaced; its whole world, its entire existence has been lost; without the mother to care for its needs, there is no life. The deepest fears of abandonment and death, developed over 150 million years of patterning of the old and the new mammalian brains, can be triggered. Few people realize the extent of this fear. Its meaning becomes lost and confused with such words as "sibling rivalry," "jealousy"-and other such attributes that have little or nothing to do with the absolute horror and terror that is being experienced. To seal the book for the worst case scenario, some infants or toddlers then are sent off to the grandmother's house when the newborn arrives.
To contrast this worst case scenario with a better way to handle the same situation, let us picture a family where the older child-as much as possible (depending on age)-is told about the new arrival and about the older child's future role in the family. The first child remains at home, with a close family member, when the mother (and father) is at the hospital. When the mother returns, she is NOT holding and feeding a new baby. She rushes to the first child, tells him/her how much she missed him or her, makes a great display of attention/affection over the first child, and then later introduces the subject: "Would you like to see your new baby brother or sister?" After the introduction, the mother again makes a big fuss over the first child and gives it gifts. Thus, by actions-that speak louder than words-the first is assured of its continued value and place in the family, and the threat of displacement and abandonment is substantially lessened.
This better case scenario was learned by the first author through an experience with puppies. We had an adorable Pomeranian puppy for three weeks and then decided it needed a companion. When the second arrived, the first snarled and pulled back. Instinctively I snatched up the first puppy, hugged it, made a big fuss over it, and when I set it down it wagged its tail and walked up to lick the face of the second. All it had needed was assurance of its own position before it could welcome the addition of the second puppy.
The worst case scenario was gleaned from histories of a number of patients who had schizophrenia or depression. The ideal is more hypothetical, based on practical experience and conjecture. While this does not represent scientific research, we must begin somewhere. If the trauma relates to the infant fearing separation, it makes sense to do whatever possible to increase the infant's sense of security, its sense of belonging and of feeling wanted.
About this Author
Dr Clancy McKenzie is a widely acclaimed authority on the understanding of origins, mechanisms and treatment of schizophrenia. He graduated from the University of Michigan School of Medicine in 1962, and then focused his attention on the study of the human mind. Dr. McKenzie has studied the relationship between trauma and Schizophrenia. Through the years he has dedicated himself to the evaluation, analysis and treatment of trauma and its immediate and long-range effects on behavior and mental health. Learn More: http://www.drmckenzie.com and follow his blog: http://www.drmckenzieblog.com
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