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A
combat veteran exposed to a loud noise 10, 20,
or 30 years after combat reacts in a predictable
way. Any event, sufficiently intense and similar
to earlier combat experience, can precipitate
a flashback or even a delayed Posttraumatic
Stress Disorder. The reaction is understood
because the initial combat experience was life-threatening.
Few realize that separation
from the mother to the baby can be more frightening
than war trauma to the soldier. For 150 million
years of patterning of the mammalian brain,
separation from the mother has meant death,
and thus the human infant is very sensitive
and easily overwhelmed by events that would
seem non-traumatic to the adult.
To the soldier, a loud noise
in the present precipitates a flashback to a
loud noise in the distant past. To the schizophrenic,
separation from a "most important person"
(husband, wife, girlfriend, boyfriend) - or
group - in the present, precipitates a flashback
to separation from the "most important
person" (mother) in the distant past. The
author has found that each initial
psychotic episode - if the history is known
- is precipitated by a separation from a most
important person (or group) in the present.
To the soldier, the flashback
is to combat experience, behavior and reality.
To the schizophrenic, the flashback is to infant
experience, behavior and reality. Each piece
of bizarre reality and behavior of the schizophrenic
matches in some way that of the infant at the
time/age of the original trauma.
Further evidence of this shift
to infancy is found in the counter-transference
relationship between the mental health worker
and the schizophrenic, which becomes a parent-infant
relationship. When the patient shifts to the
infant mind brain/reality, everyone treats the
patient as though he or she were an infant.
Infant reality and behavior
is so age-specific that the author, after more
than 30 years of matching symptoms/reality/behavior
with age of origin, clinically, is able to identify
the age that the original trauma occurred. The
primary measuring stick for this was the birth-of-a-sibling
trauma in patients born prior to the
advent of the working mother and prior to managed
health care. Separation trauma is worse after
good bonding, and earlier generation infants
in the United States had good bonding in the
first four to six months because mothers stayed
home and did not work. This caused the later
separation to be more traumatic. Mothers also
stayed five days in the hospital after delivery,
which produced more trauma in the infant/toddler
at home. Sometimes, when the mother returned
from the hospital, holding and feeding a new
baby, the older child was sent to the grandmother's
house. Few realized the devastating impact this
could have on the older child.
Because of the severity of
this trauma in the earlier generations studied
in the United States, and because of the high
incidence of schizophrenia this may have caused,
whenever a schizophrenic had a sibling less
than two years younger, the age of origin of
the disorder could be ascribed to the date of
birth of that next sibling.
This served as a guideline
for the identification of other infant traumas.
If one observed ten schizophrenics who experienced
the world in the same bizarre way, and if all
ten had a sibling 17 months younger, then the
next time a person was observed experiencing
the world in the same particular way, it could
be inferred that something happened to that
person at 17 months as well.
Approximately three chances
in ten, it was the birth of a sibling, and the
other seven out of ten chances it was one of
the many other separation traumas at that age.
This allowed for the discovery of the other
infant traumas, because it narrowed the search
to a particular age in months.
Research surveys confirmed
many years of cumulative observations. In the
first survey, 60 schizophrenics and 60 control
individuals were polled to find how many had
siblings 18 or fewer months younger. Twenty
of the 120 persons had the younger sibling in
the specified age range. Of the 20, three were
from the control sample and 17 were from the
schizophrenic group. Using the binomial equation
this reached the .001 level of significance.
In the next study, schizophrenic
along with psychotic and non-psychotic major
depressive patients with siblings less than
three years younger were polled to find how
many had siblings less than or more than 24
months younger. The hypothesis (based on 30
years of cumulative observations) was that schizophrenia
and psychotic major depression had their origins
prior to 24 months, whereas non-psychotic major
depression had its origin between 24 and 34
months. Based on the expected natality findings
of equal distribution in the two age groups,
the survey reached the .001 level of significance
with a mixture of the first 35 schizophrenic
and depressed individuals who had one sibling
less than three years younger. When the number
of schizophrenics in the survey reached 35,
that too reached the .001 level of significance,
and when the number of non-psychotic major depressive
patients reached 35, that also reached the .001
level of significance.
Sarnoff Mednick of the University
of Southern California tested the birth-of-a-sibling
trauma on 6,000 patients in the Finnish data
base on schizophrenia, and found it highly significant.
He stated that there was a substantial increase
in sibling births in the first two years of
life among those who later developed schizophrenia.
The traumas in the first two years of life,
which correlate with the later development of
schizophrenia, are the same traumas that correlate
with the later development of non-psychotic
major depression when they occur in the next
year of life. Thus, major depression and
schizophrenia share the same mechanism, with
schizophrenia activating slightly earlier developmental
regions of the brain and exhibiting slightly
earlier, and therefore more bizarre, behavior
and reality. All traumas have one common denominator
- a relative degree of physical or emotional
separation from the mother as experienced by
the infant or toddler.
Biological Psychiatry
Equally as convincing as the
delayed Posttraumatic Stress Disorder mechanism,
and the research survey data, are the biological
and neuropsychological research findings, which
confirm the delayed PTSD model. The combat veteran
flashes back to the adult brain structures he
was using during his combat experience, but
the schizophrenic shifts to phylogenetically
earlier developmental brain structures that
were active and developing at the time/age of
trauma during infancy.
The earlier developmental brain
structures produce proportionately more of the
neurotransmitters involved in the schizophrenic
process, and when reactivated, that is what
they do. Likewise, along with the activation
of the earlier developmental structures, there
is a relative deactivation of higher cortical
structures, and, as with any other part of the
body not used, there develops a disuseatrophy.
All biological changes and
neuropsychological changes can be seen in terms
of a partial shift in activity to the earlier
brain structures and functions. The initial
flashback, or the initial awakening of the earlier
mind, is a partial flashback to the entire earlier
gestalt (i.e., a partial flashback to the mind/brain/reality/feelings/behavior/chemistry/physiology
and neuroanatomic sites that were active at
the time/age of the original trauma), and it
is the author's opinion that all or nearly all
biological change is a result of this process.
Biological psychiatry has provided
valuable information in terms of proving the
Unification Theory of Mental Illness, particularly
since all biological change reflects physical
representation of the shift of brain activity
to phylogenetically earlier developmental brain
structures. If indeed, the biological change
is the result of the disease process,
then biological research alone cannot identify
cause and prevention. For this reason, it is
necessary to explore the unrecognized separation
traumas.
The Unification Theory of Mental
Illness, according to O. Spurgeon English, who
first suggested the name, is a marriage of psychological
and biological approaches, spanning the neuroses
and the psychoses, from infancy to old age.
It is presented in the textbook Delayed Posttraumatic
Stress Disorders From Infancy: The Two Trauma
Mechanism, by McKenzie and Wright, which
describes the above mechanisms in far greater
detail. It expands Posttraumatic Stress Disorder
to include possibly all serious mental/emotional
disorders. The textbook is available through
the author or through the University of Toronto
Press.
©1998 by
The American Academy of Experts in Traumatic
Stress, Inc. |
