Non-State Torture – what is it? Is it Ritual Abuse?

“In abuse, the goal is to control a person. In torture, the intentionality is to destroy the sense of self of the person.” This is dissociation. “We know that soldiers who’ve endured torture, even if they didn’t dissociate as children, they’ll become dissociative as adults.”
– Linda MacDonald, http://nonstatetorture.org

Non-state torture is torture which is not committed by the state (i.e., government, or military leaders /dictatorships).
Ritual Abuse-Torture is one form of non-state torture.

Non-state torture is torture committed, for instance, by parents, spouses, other kin, guardians, neighbours, trusted adults, or strangers in the private sphere, for example, in homes, warehouses, cabins, rented buildings, in fields, or in various public and private places. 

Non-state torture is torture committed, for instance, by parents, spouses, other kin, guardians, neighbours, trusted adults, or strangers in the private sphere, for example, in homes, warehouses, cabins, rented buildings, in fields, or in various public and private places.

Torturers intentionally attempt to destroy the personality of the person they victimize. 

Torturers intentionally attempt to destroy the personality of the person they victimize.

Read the rest of the interview http://bornepress.com/naming-the-unspeakable-non-state-torture/

Related links

More info: http://traumadissociation.com
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Neuroscience and Dissociative Identity Disorder – 11 Pieces of Research from the last 10 years

Recently I watched a 60 minutes programme on Dissociative Identity Disorder (formerly known as Multiple Personality Disorder) which consists in part of some very dated minority opinions which lacked clinical research to back them up.

Below is an update on original clinical research from Neuroscience covering the last 10 years. Neuroscience is only one piece of information, so consider the following:

  • The research from treatment trials including the Treatment of Patients with Dissociative Disorders study (Top DD), including the patients own reports, decreased hospitalizations as treatment continues, a decreased need for psychiatric medication by those taking it, improved functioning including improved employment for those not originally able to work and patient satisfaction
  • The psychobiological and psychophysiological research which supports the Neuroscience and psychotherapy guidelines, including measures of heart rate variability, skin temperature changes and other objective measures
  • The lack of any autobiographies of people who claim their Dissociative Identity Disorder was caused by therapist malpractice and/or suggestion and/or fantasy, along with the universal autobiographies of people who have healed from DID caused by trauma
  • Neuroscientist A. A. T. S. Reinders has put a list of her research papers and an overview of the neuroimaging of DID on her website http://www.neuroimaging-did.com

Neuroscience and DID 2005-2015

Chalavi, S., Vissia, E. M., Giesen, M. E., Nijenhuis, E. R., Draijer, N., Cole, J. H., … & Reinders, A. A. (2014). Abnormal hippocampal morphology in dissociative identity disorder and post‐traumatic stress disorder correlates with childhood trauma and dissociative symptoms. Human brain mapping.
http://onlinelibrary.wiley.com/doi/10.1002/hbm.22730/full
(MRI)

Reinders, A. S., & Willemsen, A. T. (2014). Dissociative Identity Disorder and Fantasy Proneness: A Positron Emission Tomography Study of Authentic and Enacted Dissociative Identity States. In PET and SPECT in Psychiatry (pp. 411-431). Springer Berlin Heidelberg. doi:10.1007/978-3-642-40384-2_16
http://link.springer.com/chapter/10.1007/978-3-642-40384-2_16

Reinders, A. A., Willemsen, A., den Boer, J. A., Vos, H. P., Veltman, D. J., & Loewenstein, R. J. (2014). Opposite brain emotion-regulation patterns in identity states Of dissociative identity disorder: A PET study and neurobiological model. Psychiatry Research: Neuroimaging, 223(3), 236–243. doi:10.1016/j.pscychresns.2014.05.005
http://dx.doi.org/10.1016/j.pscychresns.2014.05.005

Schlumpf, Y. R., Reinders, A. A., Nijenhuis, E. R., Luechinger, R., van Osch, M. J., & Jäncke, L. (2014). Dissociative Part-Dependent Resting-State Activity in Dissociative Identity Disorder: A Controlled fMRI Perfusion Study. PloS one, 9(6), e98795.
http://onlinelibrary.wiley.com/doi/10.1002/hbm.22730/full

Schlumpf, Y. R., Nijenhuis, E. R., Chalavi, S., Weder, E. V., Zimmermann, E., Luechinger, R., … & Jäncke, L. (2013). Dissociative part-dependent biopsychosocial reactions to backward masked angry and neutral faces: An fMRI study of dissociative identity disorder. NeuroImage: clinical, 3, 54-64. doi:10.1016/j.nicl.2013.07.002
http://dx.doi.org/10.1016/j.nicl.2013.07.002

Savoy RL, Frederick BB, Keuroghlian AS, Wolk PC (2012) Voluntary switching between identities in dissociative identity disorder: a functional MRI case study. Cogn Neurosci 3:112–119
http://www.ncbi.nlm.nih.gov/m/pubmed/24168692/

Reinders AATS, Willemsen ATM, Vos HPJ, den Boer JA, Nijenhuis ERS (2012) Fact or Factitious? A Psychobiological Study of Authentic and Simulated Dissociative Identity States. PLoS ONE 7(6): e39279. doi:10.1371/journal.pone.0039279
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0039279
(rCBF regional & psychophysiological responses)

Glass brain” renderings showing the dissociative identity state main effects, both for the trauma-related identity state (TIS) and for the neutral identity state (NIS), for the dissociative identity disorder (DID) group (left) and the comparison of this group to the high (middle) and low (right) fantasy prone DID simulating controls (CH and CL respectively). Simone Reinders AAT, Willemsen ATM, Vos HPJ, den Boer JA, Nijenhuis ERS (2012) Correction: Fact or Factitious? A Psychobiological Study of Authentic and Simulated Dissociative Identity States. PLoS ONE 7(7): 10.1371/annotation/4f2000ce-ff9e-48e8-8de0-893b67efa3a4. doi:10.1371/annotation/4f2000ce-ff9e-48e8-8de0-893b67efa3a4

Glass brain” renderings showing the dissociative identity state main effects, both for the trauma-related identity state (TIS) and for the neutral identity state (NIS), for the dissociative identity disorder (DID) group (left) and the comparison of this group to the high (middle) and low (right) fantasy prone DID simulating controls (CH and CL respectively). Simone Reinders AAT, Willemsen ATM, Vos HPJ, den Boer JA, Nijenhuis ERS (2012) Correction: Fact or Factitious? A Psychobiological Study of Authentic and Simulated Dissociative Identity States. PLoS ONE 7(7): 10.1371/annotation/4f2000ce-ff9e-48e8-8de0-893b67efa3a4. doi:10.1371/annotation/4f2000ce-ff9e-48e8-8de0-893b67efa3a4

 

Sar V, Unal SN, Ozturk E (2007) Frontal and occipital perfusion changes in dissociative identity disorder. Psychiatry Res Neuroimaging 156:217–223
http://www.psyn-journal.com/article/S0925-4927(07)00003-0/abstract
(rCBF)

Vermetten, E, Schmahl, C, Lindner, S, Loewenstein, R, Bremner, J.D. Hippocampal and Amygdalar Volumes in Dissociative Identity Disorder Am J Psychiatry 2006 Apr 163:630-636
http://www.ncbi.nlm.nih.gov/pubmed/16585437
(MRI)

ELZINGA, B. M., ARDON, A. M., HEIJNIS, M. K., De RUITER, M. B., VAN DYCK, R., & VELTMAN, D. J. (2006). Neural correlates of enhanced working-memory performance in dissociative disorder: a functional MRI study. Psychol. Med., 37(02), 235. doi:10.1017/s0033291706008932                                                                      http://www.ncbi.nlm.nih.gov/m/pubmed/17018171/?i=3&from=/24168692/related

Reinders AA, Nijenhuis ER, Quak J, Korf J, Haaksma J, Paans AM, Willemsen AT, den Boer JA.   Psychobiological characteristics of dissociative identity disorder: a symptom provocation study. Biol Psychiatry. 2006 Oct 1;60(7):730-40.
http://www.ncbi.nlm.nih.gov/pubmed/17008145
(rCBF measured by PET – positron emission tomography )

Mindfulness protects adults from physical, mental health consequences of childhood abuse, neglect

ACE study – Mindfulness helps protects adults from the consequences of childhood abuse & neglect
Find your Adverse Childhood Experiences Score at http://www.acestudy.org/ace_score

About the Adverse Childhood Experiences Study
http://www.cdc.gov/violenceprevention/acestudy/about.html

Adverse Childhood Experiences Pyramid

ACE pyramid

This blog is based on the following research

Whitaker, R. C., Dearth-Wesley, T., Gooze, R. A., Becker, B. D., Gallagher, K. C., & McEwen, B. S. (2014). Adverse childhood experiences, dispositional mindfulness, and adult health. Preventive Medicine, 67, 147–153. doi:10.1016/j.ypmed.2014.07.029

Full paper
http://www.pubfacts.com/detail/25084563/Adverse-childhood-experiences-dispositional-mindfulness-and-adult-health.

ACEs Too High

Aeye2Fact #1: People who were abused and neglected when they were kids have poorer physical and mental health. The more types of ACEs (adverse childhood experiences) – physical abuse, an alcoholic father, an abused mother, etc. – the higher the risk of heart disease, depression, diabetes, obesity, being violent or experiencing violence. Got an ACE score of 4 or more? Your risk of heart disease increases 200%. Your risk of suicide increases 1200%.

Fact #2: Mindfulness practices improve people’s physical and mental health.

Now, says Dr. Robert Whitaker, a pediatrician and professor of pediatrics and public health at Temple University, there’s one more important fact: People who are mindful are physically and mentally healthier, no matter what their ACE scores are.

This study, to be published in the October issue of Preventive Medicine, is the first to look at the relationship between ACEs, mindfulness and health. And it…

View original post 1,865 more words

Collective trauma – how can a traumatized community recover?

Commentry on Rebuilding community resilience in a post-war context: developing insight and recommendations – a qualitative study in Northern Sri Lanka, published by the International Journal of Mental Health Systems.

How can traumatized people recover when individual ‘talking therapy’ isn’t always possible because of a lack of availability? And when a significant proportion of the population is suffering from the adverse effects of traumas that almost the entire population was subjected to to some degree? This is the situation which often results from civil war, mass natural disasters like the Asian tsunami and military/political oppression by a previous or current government.

image

North and East Sri Lanka has experienced all of these, and the political/military oppression continues – is it safe, or even possible to speak about trauma at the hands of the authorities when still oppressed at the hands of the same individuals/group? In these circumstances would disclosure put victims/survivors and professionals at serious risk?

Added to this are practical consequences for internally displaced populations (IDPs) including loss of employment, physical disability from war injuries, the break up of communities and extended families, some still unable to return to their home, and some of those able to return finding their homes and buildings destroyed, and cultivated land damaged.

The consequences go way beyond the direct effects of trauma and negatively affect social environments, indirectly leading to greater amounts of interpersonal trauma including violence, domestic and child abuse. The This is a summary of events in Sri Lanka and their mental health consequences:

Individuals, families and communities in Sri Lanka, particularly in the North, the East and so called border areas of Sri Lanka, have undergone twenty five years of war trauma, multiple displacements, injury, detentions, torture, and loss of family, kin, friends, homes, employment and other valued resources [7]. In addition to widespread individual mental health consequences [82,83], such as PTSD (13%), anxiety (49%) and depression (42%) in the recent Vanni IDP’s [84]; families and communities have been uprooted from familiar and traditional ecological contexts such as ways of life, villages, relationships, connectedness, social capital, structures and institutions[85]. The results are termed collective trauma which has resulted in tearing of the social fabric, lack of social cohesion, disconnection, mistrust, hopelessness, dependency, lack of motivation, powerlessness and despondency. The social disorganization led to unpredictability, low efficacy, low social control of anti-social behavior patterns and high emigration which in turn causes breakdown of social norms, anomie, learned helplessness, thwarted aspirations, low self-esteem, and insecurity. Social pathologies like substance abuse, violence, gender based- and child- abuse have increased.

The authors in this report state that collective trauma does not fit the model of PTSD:
“modern psychology and psychiatry as it has developed has had a western medical illness model perspective that is primarily individualistic in orientation[11]”. With many people in the area believing that counseling and psychosocial interventions are not allowed, the authors consider different community-based interventions, the value of traditional, cultural rituals in healing trauma and culturally appropriate ways to improve the mental health within the population.

The report also considers what is increasingly called Posttraumatic Growth – the positive adaptive changes and resistance shown, and makes recommendations for affecting the effects of such widespread trauma.

Read the full research paper: http://www.ijmhs.com/content/7/1/3

Warning: distressing experiences are described including suicide methods.

Research by Daya Somasundaram and Sambasivamoorthy Sivayokan.
Citation:
International Journal of Mental Health Systems 2013, 7:3  doi:10.1186/1752-4458-7-3 http://www.ijmhs.com/content/7/1/3

Copyright
The authors have stated that this article is published under a Creative Commons Attribution 4.0 license, which allows anyone to share or build upon it without charge.

Related links from our website http://traumadissociation.com
PTSD
Complex PTSD
Treatments

Trauma and Abuse

Using visualization for stabilization and safety in Dissociative Identity Disorder and OSDD

Phase 1 of Treatment

Phase 1 of treating both Complex Dissociative Disorders and Complex Posttraumatic Stress Disorder is establishing safety, stabilization and symptom reduction.

Guided Imagery

If you have ever looked at a holiday brochure and imagined yourself lying on the beach, in the sunshine or perhaps swimming in the warm water, or you have looked at a car and imagined what it might feel like to drive, then you have used guided imagery, often called visualization.

Containment of Trauma Memories

Dr Onno van der Hart, a psychologist and researcher specializes in the field of Trauma and Dissociative Disorders, and has written an interesting paper on the use of guided imagery for reducing PTSD symptoms and improving daily life functioning, most of which applies to Complex PTSD as well as Dissociative Identity Disorder and Other Specified Dissociative Disorder (formerly DDNOS).

This approach is also referred to in the Guidelines for Treating Dissociative Identity Disorder in Adults (p156-158) as an auto-hypnotic technique which has been well-proven in Phase 1 of treatment. It does not involve trance-like states or investigating amnesia/gaps in memory, but instead serves as a method of self-soothing, calming and containing distress. Because this is an auto-hypnotic technique it can be used outside therapy sessions, and whilst maintaining awareness of the present and current surroundings. Anxiety can also respond well to the use of guided imagery to aid relaxation.
Van der Hart suggests the following examples of guided imagery:

  • Imaginary protective gear (especially useful for emotionally younger ones)
  • Inner safe places
  • Containment of traumatic memories
  • The imaginary meeting place (for dissociative parts/alters within DID)
  • Inner community building (for dissociative parts/alters within DID)
  • The inner source of wisdom

I would highly recommend reading the full article, this section starts at around the third page, under the heading ‘Guided imagery during phase 1 treatment. The book Coping with Trauma-Related Dissociation also includes helpful exercises including creating an inner safe place.

van der Hart, O. (2012). The use of imagery in phase 1 treatment of clients with complex dissociative disorders. European journal of psychotraumatology, 3. (full article)

Related links

Guidelines for Treating Dissociative Identity Disorder in Adults Journal of Trauma & Dissociation, 12:115-187, 2011 (Institute of Trauma and Dissociation – large file)

Dissociative Identity Disorder (traumadissociation.com)

Treatment of Dissociative Disorders Study Results (July 2014, traumadissociation.wordpress.com)

Forging a Deeper Understanding of Flashbacks Part I  (Paul F. Dell, understandingdissociation.wordpress.com)

Structural dissociation: Division of the personality (traumadissociation.wordpress.com)

Phase I: Overcoming the phobia of dissociative parts (traumadissociation.wordpress.com)

Flashback Worksheets for Trauma Survivors (ritualabuse.wordpress.com)

Attachment-based therapy (crazyinthecoconut.co.uk)