Search This Blog

Above: Lake Geneva, Switzerland. At Montreux.

Fodderize v.t. 1. To break down individual components; to make fungible; to disregard difference; to render one easily substituted for another 2. To impose sub-quality goods or services upon, with little recourse 3. To cap role choices, hinder access to resources regardless of merit, and so avoid competition 4. To manage perception by propaganda-spin techniques, while concealing dispositive facts 5. To manipulate, lure, exploit, deceive

Translate

Thursday, June 2, 2016

Effects of pain and stress on the brain: trauma, poverty and PTSD in children

Example of another form of PTSD.
 Adults operated upon as babies before 1986 without anesthetic:
 Do they show more fear, stress, anxiety, acting out, behaviors than others.

1.  Poverty has joined the list of traumas, stresses that negatively impact on brain development, see http://www.nytimes.com/2016/05/04/nyregion/studying-how-poverty-keeps-hurting-young-minds-and-what-to-do-about-it.html?_r=0.  Brute force is not needed for the PTSD effect, is that so?  The common theory looks at stress releasing the cortisol hormone, triggering fight-or-flight and changes in the prefrontal lobe, executive functioning in the brain; and the hippocampus, needed for fact memory,  where there is chronic stress frequently found in poverty (and elsewhere): "neglect, abuse, maternal depression, parental discord".  Genes also react to stress, see site. Needed: caring relationships with adults, consistency, in order for cortisol levels to decrease.

The brute force pain may be easier to study, but add the steady drumbeat of poverty where combined with stresses.

2. Follow the trails regarding preverbal physical pain:

Infants before about 1986 were subjected to even major surgery without anesthetic, see http://www.nytimes.com/1987/12/17/opinion/l-why-infant-surgery-without-anesthesia-went-unchallenged-832387.html/. Testimonials are increasing about the experience, by adults claiming PTSD because of it. Search for no anesthetic before 1986 surgery infants, for example. There is research now, but the information is not always generally available.  Does the DMS IV or IV pending, address the preverbal trauma in PTSD, see Diagnostic and Statistical Manual, IV, V Pending.  Without that authentication, any perceived disordered behavior in a child or adult claimed to be from trauma will be dismissed by professionals as a disembodied, cause-less personality trait, to be addressed as it is -- only as to the specific individual in therapies. And easily ignored as to accountability, or even changing any behavior of the adults surrounding. 

1.  Research.  Some material on the topic, or that appears to be, is not available except for a charge, see The Impact of Unintentional Pediatric Trauma:  A Review of Pain, Acute Stress, and Posttraumatic Stress, see http://www.pediatricnursing.org/article/S0882-5963%2807%2900297-7/abstract?cc=y=  Will someone read and review, preferably someone in the medical field.  Note this is not intentional infliction of trauma -- or is it where the child has no clue -- a different issue of PTSD where caregiver, for example, is fear source as well as comfort source. 

PTSD in the older child or adult, from childhood trauma?

Research on pain and how it operates already addresses children, and their brains:  See psychological and cognitive effects of pain as a topic taught to nurses, see http://www.nursingtimes.net/nursing-practice/clinical-zones/pain-management/understanding-the-physiological-effects-of-unrelieved-pain/205262.article. Scroll down to the effects of unrelieved pain on the brain, Psychological and cognitive effects. 


Another article deals with chronic pain and PTSD, also a different matter.

At issue for now, however, is a significant incident, or series of incidents, particularly at a preverbal stage, not the older person's chronic condition. See Conceptualizing and Treating Comorbid Chronic Pain and PTSD, at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684116/

2.  Breadth of topic.  The issue is broader than whether adults should change how we deal with children, to avoid trauma to them in their interest. Some pain in medical care is unavoidable, with worse risks in not acting at all. At issue for any survivor is the dignity of the child in learning there are roots to his behavior, not just random fault on his part somehow.  If his ADD, ADHD, ongoing flares of something, are symptoms and not flaws, is that easier to deal with.
  • This causation supposition is not a leap from common sense.  Where there is traumatic stress of very early childhood, even in a baby-infant, there already appears to be evidence that here is sufficient memory of that pain couched somewhere, that continues to shape and narrow the individual's thinking, judgment, safety, threat everywhere, perception of himself and his world.  Is there ongoing anxiety, ADD, ADHD, flight and fight reactions triggered but more objectively to a present situation; and that does not reflect badly on the supposedly flawed child. 
  • Noxious stress. Those old enough to be verbal are privileged. They talk. Their experience will get a name. Some experience no such durability of ill effect.  They can snap out of it.  This is directed to the ones with shadow drivers at their wheel.
    • Others who were preverbal and experience the shadow driver at their wheel will never know what hit them.  Is that so? We do know that anesthetics for babies was not routinely administered until about 1986, and that there were competing reasons -- a greater harm to the brain from the anesthetic, for example. What was the research? Was that researched? So, begin with the pool of people with scars from baby operations, as an easy start.  Ask them. Ask their families. Then explore their traits, if anything is a dis.  Then comes the difficult part: cause and effect. Or is it all coincidence, random synchronicity.
3.  Symptoms
  • Issues of ability to relate appear to arise from infant-child fear and stress, affecting attachment patterns between child and caregiver.  Secure relationship, anxious-ambivalent, anxious-avoidant, disorganized when the source of comfort is also the source of fear:  See Trauma, PTSD, and Attachment in Infants and Young Children at http://www.ptsd.va.gov/professional/treatment/children/trauma_ptsd_attachment.asp. That article focuses on child abuse, child neglect, and in the nonverbal child.
4.  The long view of how we see pain.  The cultural entitlement to inflict pain hierarchy.

For the culture, what indeed does pain matter if noone hears or responds to its call? Traditionally, it matters not. Animals at slaughter mills, for example, or abused animals, children, adults. But we live by a hierarchy of privilege: we, the humans, are exceptional. We do as we want with animals, say some, because that is Biblical (wrong, misinterpretation and mistranslation of early texts, but not the issue here).

Slavery.  Cultural entitlement to inflict pain. Gynophobia.  Fear of women, so inflict pain on them, limit their autonomy, control them.  Rape:  inflict helplessness, pain, overwhelm an individual's autonomy,  PTSD risk



5.  Understanding affected adults, older populations, why they join what groups, for what safety. Find out. Do noxious experiences produce a muscle memory, a memory somewhere, that will be durable, shaping behavior into years that steer the person into a lifestyle designed to shield him from pain inflicted by others, as he may see it. Fear. 
  • In particular, does the population operated on as little children without anesthetic, big operations in particular, the abdominal invasions for example, show as a group a significantly higher incidence of ADD, ADHD, inability to focus, sudden rage (road rage?), or ongoing embedded fear and anxiety, low self-esteem despite abilities, and more fear. Do they seek out mentors, follow firm group requirements. Add to the list. 
  • Does that translate to a predilection to political parties in that age group, born and operated on without anesthetic before 1986, fear of expansion, fear of the new, fear of losing a control, a supremacism.  Ask. Find out. 
6.  Morality.  Recognizing the autonomous right of any living being to live its life with a minimum of inflicted pain and trauma. No gratuitous imposition of suffering, no assertion of supremacism based on a doctrine in the Widening Gap world.
7.  Action step, despite The Widening World of Hand-Picked Truths, see  NYTimes, Science, The Widening World of Hand-Picked Truths, opinion .  Individuals and government: Pay close attention to the environments and experiences of very little children. Promote and fund the benign, the assurance, the welcoming, the expansive. Protect against inflicted pain, blindfolding as to cause and effect of their condition, promote verbal understanding. What we do and omit to do shapes their very brains.  
How to explain that to the spare-the-rod-spoil-the-child mentored groups? That is part of the conundrum, balancing issues, the Widening Gap.  At least, identify the issue, so some in those groups may consider, quietly. No attack, no abandonment, it can work to be with those you disagree with, as Atticus Finch's life attests, in Go Set a Watchman, by Harper Lee.
    • And pay money to get it done. 
 =====================================================

Other sources 
DSM, Diagnostic and Statistical Manual.  DSM V pending, I think.
Symptoms: Anxiety, pain, hormonal changes, cognitive impairment, disorientation, mental confusion, low concentration, anxiety, depression, something called hypercortalism, constant vigilance, recurrent fear, insomnia. See nursingtimes site above; and Wood, 2003.

The stress response:

The stress response itself is not a disorder.  It is an ordered response to the absolute horror of the condition experienced: and has a history extending back to Herodotus, through experiences including war (the Herodotus topic), but also rape, genocide, and torture. How else do people survive?  It only becomes a disorder if life after is narrowed, interrupted, the person involuntarily subjected to its recurrence and lapses in judgment, because of it.
  • Expand the research more to include facets of child rape, and adult rape, where forcing oneself to stay still enhances survival, but then leads to the charge that she never fought, so wanted it; or the after-effects of centuries of skepticism re infant pain, that anesthetics were not used well into the 1980's, see The Infancy of Infant Pain, at http://www.ncbi.nlm.nih.gov/pubmed/23548489/.  What now-adults experienced this near-death, non-verbal trauma, torture, really. What are they like now?  Any commonalities from their PTS?  
Sub issues:

1.  Examination of trauma is expanding, but too slowly.

1.1  Research stirrings now include in the list of traumatizing stress an infant or toddler's experience of torture in un-anesthetized surgery as before 1986, see overview of that societal horror at http://www.nytimes.com/1987/12/17/opinion/l-why-infant-surgery-without-anesthesia-went-unchallenged-832387.html/.  
  • How many who are now adults experienced  post-traumatic stress related to that forced rigidity, unable to get away, flashbacks, droning fear, protect themselves from perceived annihilation, no options, terror unspoken; and what commonalities do those adults unknowingly share with older others whose trauma was conscious and responses later could be verbal. 
  • How many operated on without anesthetic, including major abdominal surgery as infants, are ruled by fear, easily led or closing down when it is introduced, and this affects their political loyalty, other functioning. It is not safe not to follow, is that so. Who will study what happened to all those babes and toddlers operated on in those ways, to support or argue against positions now in blogs, see http://ltinnin.com/2010/12/30/infant-surgery-without-anesthesia/; and https://myincision.wordpress.com/2011/02/05/doctor-starts-blog-about-infant-surgery-without-anesthesia/
 1.2  Commonalities of trauma.  Battle.  For each group, with its unique setting, there is a reformatting of the brain beyond language. How else can the body respond, except to remain vigilant to danger. Some therapies try, but terror does not leave.  Read Rachel Yehuda, Post Traumatic Stress Disorder, New England Journal of Medicine 2002 at http://www.nejm.org/doi/full/10.1056/NEJM200205093461913, cited at Notes FN 41, in The Evil Hours,  A Biography of Post-Traumatic Stress Disorder, by David J. Morris.  In children, time to refocus on them, see the British Columbia Medical Journal, http://www.bcmj.org/article/posttraumatic-stress-disorder-infants-toddlers-and-preschoolers

So:  Vex of the psyche. Circumstances.  Immobility, terror, followed by recalibration of the system.  Sum many sources:

  • recurring feelings of strangeness, 
  • dissociation from others,
  •  a marking, a setting one apart, 
  • a drive to wander, 
  • belonging no longer, 
  • not fully alive, not fully dead, each, both, neither. 
2.  What to do? Learning from it, deciding to grow, to snap out of it, is not enough.

 Epictetus, Greek stoic, sounds like a modern evangelical stereotypical preacher -- and found some positives in traditional ways of thinking, such as: "On the occasion of every accident that befalls you, remember to turn to yourself and inquire what power you have for turning it to use." Morris at page 256.

That mere growth "solution" is happy-happy, not a volitional as its advocates chirp, overused, the bar to following religious and philosophical geniuses for transformation too high, or off the mark for the individual. Growth, roses, rise sometimes, but growth as a catch-all is also demeaning as  a total response idea:  suggesting a flawed effort when the scarred person fails to turn around.

3.  Literature. Count the wanderers, the sufferers:PTSD in the classics.  Helplessness and PTSD.
  • Ulysses took 20 years go get home, and during that time wandered with drugs, license;  Gilgamesh, Civil War veterans heading west to wreak havoc, for some, and others rootless, see Morris at 74ff. War neuroses.  Study the wars, the electric shock treatments: and wisdom. 
  • One Dr. Rivers: "[T]he more helpless the patient felt, the more likely he was to be traumatized...."  Morris at 97.
    • That element echoes strongly in rape. 
    • Morris focuses on battle stress in his history, but also touches on rape.  Spend time with the Notes section, the footnotes.
    • In trauma, it is more often the powerless and disenfranchised who are so traumatized, suggests Morris at page 159.  Apply that to rape. What elements are psychiatric, pre-existing vunlerabilities; what elements are responses to situation.
 4.  Is rehashing helpful? Letting it all out, again and again?  What happens to secrets.

Is wartime or rape stress, coming to grips with extreme exploitation, immobility, absolute threat, mere "apophenia" -- from events that gain meaning only by looking back at them? What is the role of the uncanny, the idea of the doppelganger, heightened awareness, at p.105 - retrospective analysis, a forging of meaning. Imagination, the forge, into the spiritual.How else to put the puzzle of the broken mind together.

It is not an equal playing field. Many have interests in finding rugs to cover issues.

Not surprisingly, there has been resistance to normalizing PTSD in the military, where propaganda efforts had to be made to try to turn soldiers' narratives away from tha basal, I had to survive! to the party-line, patriotic I defended and fought for my nation's values.  That puts the push against the Vietnam Veterans Against the War,  see http://www2.iath.virginia.edu/sixties/HTML_docs/Resources/Primary/Manifestos/VVAW_Kerry_Senate.html, and to support instead the mainstream then-ostrichlike patriotic Veterans of Foreign Wars American Legion, the Disabled American Veterans, the Military Order of the Purple Heart,  see Morris at 147.

5.  Military-related trauma, becoming accepted as its own field of study.  It will only end when war ends.  Expand the idea.  Rape.  It will only end when supremacist entitlement ends.  Infant disregard.  That may be the only PTS behind us.  The others?  No hope?
.........................................................

* Photographs:  top, from Verona church, Italy;  bottom, from exhibit, Juliet's house, Verona.