Presented by:Robert Rhoton PsyD

Psychological Health and Wellness

Family Dysregulation:

Where it comes from: Characteristics.

“anything that interrupts or interferes with normal developmental processes is traumatic” 1. Sociallly2. emotionally3. Physiologically4. Cognitively5. Language and communication

acquisition

Depression Mood disorders Anxiety Suicidal ideation Physical health Aggression Impulsiveness Delinquency Hyperactivity

Obsessive-compulsive disorder

High rate of truancy Vandalism Alcohol use Running away before

the age of 15 Substance

dependence Antisocial behaviors

Trauma activates stress-response systems in the brain

Severe or chronic stress prevents the brain from returning to relaxed state

Traumatized children are in constant fight, flight, or freeze mode

Children are “taught” how to behave by trauma

the more any neural system is activated the more a neural system changes

piano:- hear - visual - motor speech:- auditory - understand - motor written word - seen - thought about - spoken

The Brainstem is the first region of the brain to develop before birth. Directly connected to the spinal cord.

The brain stem doesn't do the glamorous work; it simply keeps the body pumping, breathing, and controls most of the basic functions of survival. These functions include regular heart rate, blood pressure, temperature regulation, and respiration. (Teicher, 2002).

This section of the brain also controls the production and release of some neurotransmitters, and abnormalities which are associated with psychiatric disorders such as depression and psychosis

The memory stored in the brainstem is "state memory". The brain remembers the optimal temperature range, the needed heart rate and rate of respiration to meet the needs of the organism

1. Breathing rate increases 2. Breath volume decreases 3. Galvanic skin conductance increases4. Heart rate increases5. Pupil constriction6. Increased adrenocortical hormone release in

blood 7. Suppression of immune system8. Changes in blood flow.

More focus on survival without clearly defined reasons to be aroused.

Over-reactive to mild stressors Emotional volatility Poor ability to learn from experience

In this region of the brain is found the regulation of important body functions.

Motor regulation and the body's ability to negotiate its environment.

The diencephalon also regulates the critical functions of arousal, appetite and the regulation of sleep patterns. In some respects this region is the Energy Czar

The memory stored in the diencephalons also includes motor functioning (muscle memory). Physiological arousal like hunger, thirst etc.

Aspects of dysregulation This Dysregulation effects

serotonergic, opioid, dopaminergic, glutamatergic, thyroid and gabergic function. There are detrimental effects of glucocorticoid (GC) hypersecretion which occurs chronic activation

Obesity, Depression and Anxiety Disorders

Constantly consuming food even when not hungry, particularly high calorie, fatty foods (mammal scarcity diet)

Lowered energy levels, fewer movements, less physical activity (preserving calories)

Increased depression Restrict release of Endogenous opioids

(feel good hormones) “endorphins”

Limbic System is the amygdala (vital to emotional regulation), hippocampus (vital to forming and retrieving verbal and emotional memories

Often referred to as the emotion center of the body. Emotions are a very complex combination of perception, experience and memory, and body chemistry. It is the function of the limbic system to regulated these components.

There are other very complex aspects of the body controlled by the limbic system that involve survival.

Reproduction and sexual behavior. Attachment. Memory stored in the limbic area is primarily

affective experience.

Specifically, the hippocampus is involved in verbal and emotional memory.

The hippocampus is very vulnerable to traumatic stress due to how slowly it develops and the density of its cortisol receptors (McEwen, 2000).

Some emotional memory is more available than others depending in part on the type of early experience.

The limbic system regulates arousal, emotions and behavior

This limbic system has been called the CEO of the social-emotional brain

It is common for traumatized individuals to have arrested emotional maturity around the age of abuse.

Some adults abused as children regress to childhood emotional responses when facing severe stress.

When trauma affects the arousal and emotional response of the body to stress, the impact on the individual can be pervasive.

Neurotransmitter depletion is diminished motivation, clinical depression, and a decline in optimal functioning.

Depletion of some neurotransmitters can result in over-dependence on other people, feelings of “I can’t make it without you,” (dependency) or in the opposite, an unrealistically independent (counter-dependent) stance of “I don’t need anyone; I can make it on my own”

Agitation and irritability Sadness, grief, depression Feeling hopeless (nothing they do will make

things better) Feeling numb (poor or little recognition of

emotions) Suspicious/untrusting (constant testing of every

relationship)

Emotional outbursts (screaming, yelling, crying, etc)

Self-soothing or distracting behaviors Poor communications (not effective and

responding to feedback well, or making behavioral changes based on feedback)

Social withdrawal

Social isolative behaviors (doing things to create distance)

Poor Attachment (repeated failures to effectively engage in a relationship, or maintain relationships)

Pre-occupation with objects or environmental elements

Pre-occupation with stressors

Difficulty concentrating, focusing or attending Appears inattentive or distracted Difficulty making decisions Difficulty following through on decisions to

accomplish goals Engages in pointless lies, deceptions or partial

truths to avoid

Nightmares Anxious behaviors Worry about pleasing others Physical complaints and mystery pain Suppression of emotion Tremors, pseudo-seizures Acting much younger (emotionally) than age

Magical thinking Aggression and violent acts

Reasoning and logic as a “COOL” system

Emotions, instinct and survival behavior as a “HOT” system

The two systems should operate in parallel, with the cool system encoding the contextual panorama and the hot system contributing a “highlighting” of emotional aspects of the experience.

When the systems are not working in parallel then the visual, auditory, kinesthetic, emotional and recognition of environmental feedback is skewed.

There are five general environmental factors that contribute to the Personality Disorders besides, poor care, poor nutrition, prolonged hospitalization, separation from caregiver, serious accidents and all forms of abuse. These are factors that interrupt and interfere with normal social-emotional development:

Based on the work of Jeffery E. Young Schema Therapy: A Practitioner's Guide 

1.  ABANDONMENT /  INSTABILITY2. MISTRUST / ABUSE3. EMOTIONAL DEPRIVATION

Deprivation of Nurturance:  Absence of attention, affection, warmth, or companionship.

Deprivation of Empathy:  Absence of understanding, listening, self-disclosure, or mutual sharing of feelings from   others.

Deprivation of Protection:  Absence of strength, direction, or guidance from others.

4. DEFECTIVENESS / SHAME 5. SOCIAL ISOLATION / ALIENATION

DEPENDENCE / INCOMPETENCE VULNERABILITY TO HARM OR ILLNESS  ENMESHMENT  /  UNDEVELOPED SELF   FAILURE - The belief that one has failed,

 will inevitably fail, or is fundamentally inadequate . Often involves beliefs that one is stupid, inept, untalented, ignorant, lower in status, less successful than others, etc.

When expectations about the self interfere with the ability to separate, survive, function independently, or perform successfully.

Deficiency in internal limits, responsibility to others, or long-term goal-orientation.

Leads to difficulty respecting the rights of others, cooperating with others, making commitments, or setting and meeting realistic personal goals.

Unstable relationships, serial relationships and low levels of accountability in a relationship

An excessive focus on the desires, feelings, and responses of others, at the expense of one’s own needs.

Take actions and engage in behaviors in order to gain love and approval, maintain one's sense of connection, or avoid retaliation.  

Usually involves suppression and lack of awareness regarding one's own emotions and natural inclinations.

An excessive emphasis on suppressing spontaneous feelings, impulses, and choices.

Meeting rigid, internalized rules and expectations about performance and ethical behavior -- often at the expense of happiness, self-expression, relaxation, close relationships, or health.

 

Victim Stance1. Blame others for not meeting responsibilities

2. Blames others for their inappropriate behavior

3. Always have a ready excuse

4. Fight for the right to be a victim

5. Resist efforts to appropriately solve problems that are causing them distress

6. Focus away from assuming responsibility

Sense of Injustice

1. View normal expectations as unfair

2. Refuses to follow “unfair” directions

3. Refuse to meet “unfair” expectations

4. Complain that the consequences for any of their actions that bring negative feed back or correction is unfair

Uniqueness (Grandiosity)

1. Claim that they are different or unique and should have a different set of rules and expectations

2. Demand others understand them

3. Accuse others of not understanding them or making adequate efforts to understand them

4. Focus on how they are not understood rather than resolving problems or conflicts

One way boundaries

1. Demands respect and privacy in inappropriate ways

2. Violates others privacy

3. No reciprocity in respecting the rights of person or property

4. Behaves suspiciously and then becomes enraged when those behaviors are questioned

Communications are skewed – high use of: Sarcasm Name calling Put Downs Rude comments hostile critical judgmental controlling overbearing intimidating Being angry when others attempt connections

Communications are passive Refusing to express feelings, act, or decided

because it MIGHT cause you problems Making excuses for others hurtful behavior and not

dealing with them about it Overly-polite Acting more out of sense of obligation (fear based) Over-committed: doing to much for too long for too

little. Avoid decisive action for fear of hurting another

Overthrow or defeat rules

1. Sees rules, guidelines, and restrictions as obstacles that must be overcome

2. Manipulate others by being charming or compliant in order to avoid being held accountable to the rules

3. Focus on one-way rights (seeing their own rights and not the rights of others)

Pride in Negativity

1. Enjoy showing off their knowledge of negative or inappropriate things

2. Gets power from negative behavior or ideas

3. Places high value on learning and knowing things that are hurtful, hateful, evil or demeaning to others

Anger that is instrumental /Predatory

1. Loses control to get their own way

2. Trains others to avoid them when angry or else

3. Claim that they “lost control” after and aggressive, destructive or abusive incident

4. Uses anger to have power in a situation

5. Others become timid and “walk on eggshells” when they have to discuss problems or responsibilities

One way training

1. Uses inappropriate behavior to train others to give in to them

2. Uses inappropriate behavior when their wishes are opposed or resisted

3. Resists attempts to problem-solve and be re-directed

Wishing1. Has unrealistically high opinion of their own skills

and abilities

2. Talks about how things will be but avoids goal setting or commitments designed to achieve goals

3. Acts as if talking about it is the same as doing it

4. Constantly put off activities or tasks which are perceived as “responsibilities”

5. Respond with anger when pressed to perform in a timely manner

Dishonesty and misinformation

1. Use omission and vagueness to confuse or avoid

2. Pretend to have misunderstood

3. Keep secrets for no apparent reason

4. Tell others what they think the other wants to hear

5. Say yes and agree to avoid further feedback

6. Act confused when challenged on an inappropriate comment or behavior

False Apologies

1. Apologizes without acknowledging actual wrong doing

2. Blame others while apologizing

3. Say “I’m sorry” without taking responsibility

Turnaround

1. Put others on the defensive when they are clearly wrong

2. Put others on the spot so that they wind up explaining themselves rather than focusing on resolving a problem

3. Use statements like “you don’t love me” “you don’t trust me” “ you don’t appreciate me” as away to avoid dealing with an issue and deflect away

Partialization

1. Do incomplete work and feel like that should be good enough

2. Expect full rewards for partial completion

3. Acts angry when reminded of full expectations of responsibility

4. Enraged when denied a reward for a minimal efforts or partial completion