Lecture
Prolonged bullying or psychological abuse can leave serious consequences for the victim. The symptomatology of these consequences can be diverse and include physical, emotional, social, and psychological aspects. Here are some of the possible symptoms and consequences of prolonged abuse:
Emotional consequences:
Physical consequences:
Social consequences:
Psychological consequences:
A history of abuse, especially in childhood, apparently
is one of the main factors contributing to a person
becoming a psychiatric patient. A large proportion (40–70%) of adult
psychiatric patients are those who experienced abuse in
childhood. Briere (1988), studying psychiatric patients, reports
that people who experienced abuse in childhood significantly more often
show insomnia, sexual dysfunction, distractibility, anger,
a tendency toward suicide, self-harm, drug use, and
alcoholism, than other patients.
We have obtained experimental data on how traumatic
events of childhood are retained in children’s memory. An event such as
physical punishment is not registered at all in early, or
middle, or senior school age. However, at the age of twenty,
among the negative life-path events that surface in memory
are the punishments to which the person was subjected in childhood. The reason for such a delay
in these memories has yet to be worked out by us. Thus, it can
be asserted that no punishment inflicted in childhood passes
without a trace.
Repeated trauma
intensifies and contributes to the spread of the physiological symptoms
of PTSD. Chronically traumatized people are in an anxious and
agitated state without any signs of a basic state of
calm and comfort. From time to time they begin to complain not
only of insomnia and startle and arousal reactions, but they also
develop numerous somatic symptoms. Most often this is
headache, gastrointestinal disturbances, abdominal pain,
back and kidney pain. Survivors of abuse also often complain of
trembling, and sensations of nausea and vomiting. In clinical studies of
Holocaust survivors, it was found that psychosomatic reactions
occur in practically all cases.
The clinical literature also traces a link between
somatization disorders and traumas sustained in childhood. In a
study of 87 children under the age of 12 diagnosed with hysteria, Briquet
notes that one third of them “constantly experienced cruel or rough
treatment from their parents or were kept in constant fear”. Control
studies of 60 women with somatic disorders (Morrison, 1989)
found that 55% of them experienced sexual harassment in childhood,
as a rule, at the hands of their parents.
During prolonged confinement and isolation, some prisoners
develop within themselves the ability to enter a trance state, which
is usually found only in highly hypnotizable people, including the ability
to induce positive and negative hallucinations in themselves and
to dissociate parts of the personality: disturbances of the sense of time, memory, and
concentration of attention. Changes in the sense of time begin with
the obliteration of the future, but then gradually progress to the obliteration
of the past. The rupture of continuity between past and future often
persists even after the prisoner’s release from confinement. Outwardly he
looks completely normal and appears to have returned to ordinary time, but
psychologically he continues to remain bound to that timelessness
which he experienced during his confinement.
Operations of the fragmented mind.
In people who experienced abuse in childhood, such
dissociative capacities develop in their most extreme form.
Shengold (1989) describes “operations of the fragmented mind”, carefully
devised by children who were subjected to torment, in order to
preserve the “illusion of good parents”. He notes the “establishment of
an isolated, divided mind, in which the conflicting
images of the child himself and of his parents never
come together”.
There are people with a strong and secure belief system who can
withstand all the hardships of prolonged, harsh treatment and emerge from them
whole and unharmed, with unshaken convictions. However, such
people are very few. In most cases a person is left with the bitter
feeling of having been forgotten by both God and other people. Such devastating
psychological losses most often lead to a state of persistent
depression. The experience of prolonged trauma forms what Niederland
calls the “survivor triad” – insomnia, nightmares, and
psychosomatic complaints. The dissociative symptoms of PTSD merge with
the difficulties of concentration caused by depression. The paralysis of initiative,
caused by repeated trauma, combines with the apathy and helplessness
of depression. Ruptures in interpersonal contacts, associated with the trauma,
intensify feelings of isolation and remoteness (loneliness), feelings
of guilt, and hopelessness.
Characterological consequences of prolonged
abuse.
Pathological changes in relationships.
Methods of establishing control over other people are based on
the systematic, repeated infliction of psychological trauma. These
methods are designed to instil in the person, gradually and covertly,
a feeling of fear and helplessness, to destroy his self-awareness and his ties to
other people, and also to cultivate a pathological devotion to the perpetrator. Although violence is a universal method of instilling
fear, the threat of death or serious harm either to the victim herself or
to someone close to her is used far more often than
the actual use of violence. Fear is intensified by the
unpredictability of outbursts of violence and by the inconsistent
enforcement of numerous trivial demands and
petty rules.
In addition, the perpetrator seeks a way to destroy the victim’s sense of
autonomy. This is achieved by controlling the victim’s body and its functions.
Usually, in these cases the person is deprived of food, sleep, and shelter, and has no
opportunity to attend to personal hygiene or to find solitude. After
the perpetrator has established such a degree of control, he becomes
a potential source of comfort as well, in equal measure, of humiliation. In such
a situation, granting “small indulgences” can break down the victim’s psychological
resistance far more effectively than
coercion and fear can.
As long as the victim maintains contact with other people, the perpetrator’s power
is limited, and therefore he inevitably seeks a way to isolate
his victim. The perpetrator will look for opportunities to break, to destroy,
emotional ties with other people (“Sotnikov” by V. Bykov). The final
step in “breaking” the victim will not be taken until the perpetrator
succeeds in destroying the victim’s strongest attachments, forcing her
to act as a witness to, or participant in, crimes against other
people.
If the victim is in isolation, then her dependence on the perpetrator
constantly increases. This is related not only to survival and
the satisfaction of basic needs through the perpetrator, but also to
information and even emotional support. Prolonged existence
in fear of death and in isolation creates a firm bond of identification between
the perpetrator and the victim. This is the “traumatic bond” that is observed in
hostages who come to regard their captors as
their rescuers, while fearing and hating their liberators. Symonds
(1982) describes this process as an intensified regression to
“psychological infantilism,” which “compels victims to cling to
whoever endangers their life.” Such a
traumatic bond can be observed between a battered woman and her
abuser, or between abused children
and their parents. Similar reports are made regarding people who
become involved in various religious sects.
As dependency on the perpetrator increases, the victim’s
initiative and ability to plan for the future become restricted. Prisoners who
were not completely broken did not give up the possibility of active
interaction with their environment; on the contrary, they often carried out
small daily survival tasks with extraordinary resourcefulness and persistence. However, the scope of their initiative
was constantly narrowed to the limits dictated by the perpetrator. Prisoners
thought less about how to escape and more about how to survive or
how to make the conditions of their captivity more bearable. This narrowing of the range
of initiative becomes increasingly habitual the more
prolonged the captivity becomes, and it need not be forgotten after
the prisoner’s release.
Restriction of the possibilities for active interaction with the outside
world leads to increased passivity and helplessness. To battered
women and other chronically traumatized people, one can
in fact apply the concept of learned helplessness.” Prolonged captivity
destroys the habitual sense of a relatively safe sphere of
initiative in which there is room for trial and error. For a chronically
traumatized person, any independent action is
a breach of subordination that carries the risk of severe
punishment.
The enforced relationship (victim – perpetrator) monopolizes
the victim’s attention, becomes part of her inner world, and continues
to absorb her attention even after release. After release it is difficult
to restore contacts with the outside world as they were before
the release. All relationships are viewed through the prism
of extreme need. As the constraints on entering
relationships, or the risk of doing so, disappear, the survivor treats
every relationship as though matters of life
and death were at stake. She constantly oscillates between intense contacts and terrible
withdrawal from those around her. In people who experienced abuse
in childhood, disturbances in relationships with others are intensified.
Fluctuations in contact are observed, and unstable,
strained relationships are formed.
Studies of patients with borderline personality disorder
who experienced abuse in childhood have made it possible to describe
a specific picture of difficulties in relationships. Such patients
find solitude hard to bear, yet are also very wary of people.
They oscillate between two extremes: abject submission and furious
rebellion. Such patients strive to form relationships of “special”
dependency with idealized people who would show them
care, but in such a way that ordinary bonds are not present in them.
Pathological changes in personality
Relationships of coercive control give rise to pronounced
changes in the victim’s personality. All the structures of this
personality — the attitude toward one’s own body, the inner perception of other
people, the values and ideals that give meaning to existence – all
of this is systematically destroyed. In some totalitarian systems
(political, religious, sexual/domestic) the victim is stripped of her name.
Thus, Niederland (1968), in his clinical observations of people
who survived internment in concentration camps, notes that such
changes in personal identity are a characteristic feature
of survivor syndrome. Whereas most of his patients complained,
“I am a different person now,” most of those who had suffered
serious trauma said simply, “I am not a human being.”
In people who experienced abuse in childhood,
even more complex deformations of personality develop. Most often
the person feels contaminated, guilty, and senses that within them there is
something demonic. In addition, fragmentation in the
sense of self is often observed, reaching an extreme degree in
multiple personality disorder. S. Ferenczi (1933) describes
the “atomization” of the personality of a child who was subjected
to abuse.
Repeated injuries, which follow prolonged
abuse
In cases of prolonged and repeated trauma, survivors
are at risk of repeated injury, either through self-harm,
self-destruction, or at the hands of other people.
It has been established that self-mutilation and other
paroxysmal forms of harm to the body are more often observed in those victims
who experienced abuse in early childhood.
Large-scale epidemiological studies have made it
possible to obtain solid evidence that people who experienced abuse
in childhood are at increased risk of experiencing it again
in adult life. For example, the risk of rape, sexual
difficulties and abuse, although very high for all women,
is roughly twice as high for those who experienced sexual
abuse in childhood (Russell, 1986). One clinician has called
this phenomenon the “sitting duck syndrome” (Kluft, 1990).
In extreme cases, a person who experienced abuse in
childhood may go on to act as an abuser of others, or as a passive
bystander, or, much more rarely, as an offender. Abuse
in childhood apparently is a risk factor and contributes to
a person becoming abusive toward others, particularly
this applies to men. Women who witnessed
domestic violence or sexual abuse in childhood appear to have an
increased risk of later marrying a person who will be
abusive toward them. However, it should be noted that,
contrary to the popular claim about a “recurring cycle of
abuse,” most people who experienced
abuse in childhood do not feel any desire to abuse other
people. As a rule, such people mobilize all their resources to
provide their own children with the care and protection that they themselves lacked in childhood.
Prolonged abuse can have serious consequences for the victim, and the process of recovery can be difficult and lengthy. Support from professionals and loved ones can play an important role in helping victims cope with these consequences and begin the process of recovery.
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