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Memories Of Child Abuse, Other Traumas Hide In The Brain; Changing Patient State Of Mind May Help Retrieve Them

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This is a reblog from medical daily. You can find the original text here: Medical daily

trauma
Scientists discover a brain process that explains why some fear-related memories may not be accessible to traumatized patients. TraumaAndDissociation, CC by 2.0

While some victims of trauma too easily remember what causes their pain, other victims suffer tremendous anxiety for no apparent reason whenever they’re in some innocuous-seeming place — a room in their grandparents’ house, for example. Some mysterious event clearly happened there, yet no memory exists. In a new study (conducted on mice), scientists discovered a brain process that explains why some fear-related memories may not be available.

“Distinct neurobiological mechanisms can explain why some trauma victims go on to remember and re-experience their trauma, whereas [other victims] develop dissociative amnesia (an inability to consciously access a stored memory),” Dr. Jelena Radulovic, principal investigator and a professor at Northwestern University Feinberg School of Medicine, toldMedical Daily in an email.

Scientists have long understood that there’s more than one pathway through the brain to the storage closet of memory. Now, Radulovic and her colleagues track a unique trail directly related to trauma. In fact, the microRNA-GABA pathway they describe in their new study may also indicate how susceptible each of us is to developing amnesia after a traumatic event.

They discovered this pathway by exploring a special phenomenon of learning.

What Influences Memory?

Learning is a state-dependent process, which means that when we learn something new in a particular situation or state of consciousness, we’re able to remember it best when we place ourselves back in the original circumstance or state of mind. Students, then, who learn information in one room will get higher scores if they are tested in the same room. Not only place, but time of day as well as common drugs also influence memory abilities. If students learn something while drinking coffee, for instance, they will remember it best when they return to their original caffeinated state.

Based on this phenomenon, various researchers have used drugs to try and access hidden memories. But while some pharmaceuticals may return the brain to the state of consciousness that occurred during encoding — the first step in memory storage — they haven’t done well in excavating traumatic memories. A drug targeting different processes in the brain, then, would be necessary for fear-based recall.

So, Radulovic and her colleagues focused on two amino acids in the brain: glutamate and GABA. These work in tandem to control levels of excitation and inhibition in the brain, and, under normal conditions, remain balanced. Hyper-arousal, however, which occurs when we are terrified, causes glutamate to surge.

Glutamate, is known as the excitable amino acid; it’s also the primary chemical that helps store memories across distributed brain networks. GABA, on the other hand, is calming and partly works by blocking glutamate and its excitable actions. Synaptic GABA receptors, in particular, will balance glutamate receptors in the presence of stress. Yet, extra-synaptic GABA receptors also exist. These work independently, responding to levels of a variety of neurochemicals, including sex hormones and micro RNAs.

Between the drugs amobarbital and diazepam, only amobarbital, which binds to all GABA receptors is able to stimulate memory recall — diazepam is ineffective, due to the fact it only binds to synaptic GABA receptors. Knowing this, Radulovic and her colleagues hypothesized the ability to remember stressful experiences might be mediated by the extra-synaptic GABA receptors.

For its experiment, the research team injected the mice with gaboxadol, a drug that stimulates extra-synaptic GABA receptors. Next, they placed the mice in a box and gave them an electric shock. When the mice returned to the same box the next day, they moved about freely and without fear. Clearly, the rodents did not remember the electric shock.

Then, the scientists injected the mice with the drug once again and returned them to the box. This time, the rodents froze in anticipation of another shock.

Rerouting Painful Memories

When extra-synaptic GABA receptors were activated by a drug, the researchers said, the brain used completely different molecular pathways and neuronal circuits to store the memory. The brain rerouted the memory so that it couldn’t be accessed. The researchers say their findings imply that in response to trauma, some people will not activate the glutamate system but instead the extra-synaptic GABA system.

This system is regulated by a small microRNA: miR-33. Some patients with psychiatric illnesses have different levels of miR-33 compared to healthy individuals.

The power of any memory lies, to a large extent, in the amount of processors within the cells creating a pathway through the brain, explained Dr. Vladimir Jovasevic, lead study author and a former postdoc in Radulovic’s lab.

“The role of microRNAs is to fine-tune the amount of the processors, so they can function at optimal level,” said Jovasevic, and “miR-33 sets the optimal amount of processors involved in state-dependent learning.” But when levels of miR-33 change, this “results in an increased predisposition to psychiatric disorders caused by improper processing of state-dependent memories.”

Evidence from the new study, Radulovic and Jovasevic said, may lead to new treatments for patients with psychiatric disorders who cannot recover unless they gain conscious access to the memory of what caused their trauma.

Source: Jovasevic V, Corcoran KA, Leaderbrand K, et al. GABAergic mechanisms regulated by miR-33 encode state-dependent fear. Nature Neuroscience. 2015.

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Out of the narcissistic fog

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I have been in a fog. Swimming through it, trying to see clear. It has felt like being in my nightmares, where I drive without seeing anything. Trying to not crash.

Narcissistic Personality Disorder is a serious condition which affects an estimated 1% of the population. Narcissism is characterized by an extreme self-interest and promotion with an accompanying lack of concern for the needs of others.

Narcissism is named after the mythological Greek character Narcissus, an extremely handsome young man who rejected the love of Echo and, as punishment, was condemned to fall in love with his own reflection in a pool of water. Unable to obtain he object of his desire, he died there in sorrow.

Narcissists often use Fear, Obligation, and Guilt (FOG) in Relationships
FOG is a type of emotional blackmail, which ruins relationships.

FOG works in the dark. It resides in the land of emotion, not logic. At the heart of it is this flawed reasoning: “It is permissible for me to push your buttons to get my needs met, but ifyou try the same thing, I’ll make sure you will regret your selfishness.”

That’s right: the emotional blackmailer’s reasoning is illogical; he lives by a double standard. That’s why emotional blackmail is never discussed outright: the minute you try to shine a light on it, by discussing it or asking pointed questions, it will scurry away like a cockroach. If you try to pin a blackmailer down—“Are you saying you will pout if I refuse to go to the party with you?”—he will project the FOG back onto you, deny its existence; or try to distract you by changing the subject, being dramatic, or getting angry. The supposed anger may have nothing to do with the particular topic—a combination of anger with a request to change the subject is designed to throw you off-balance.

Here are some other examples.

  • Grant is fully aware that his wife is having an affair with a man named Trent. He knows because she talks about him and compares them sexually. But he’s afraid if he demands that she stop seeing Trent, she’ll just leave him. That’s fear.
  • As an adult, Susan tries to avoid her mother’s rages, complaints about others, and contagious sour moods. But Susan feels compelled to call her mother Judith back when she leaves a message on the answering machine. If she doesn’t, eventually Judith will reach her and demand to know, “Where were you?” Judith has been living alone since Susan’s dad finally left, and Susan likes to think of herself as a “good person.” For her, this means that she has a tendency to put the needs of others above her own— something Judith is counting on. This is obligation.
  • Jack and Ramona have a teenage daughter they think is borderline. She’s totally out of control; normal discipline doesn’t work. They don’t know where she goes at night, and they’re afraid she’ll get pregnant—or worse, contract AIDS. But they just can’t put their own daughter in a residential treatment center. She would hate it. Down deep, Jack and Ramona are worried that something they did caused their daughter’s disorder. They feel guilty.

We have all been in the space between light and dark. Trying to see what`s there, trying to get out of the fog. Sometimes the only thing we can do, is to look at our feet and remember that we are still here, no matter if we can`t see anything around us.

Out of the FOG Support Forum – Support for family members and loved-ones here at Out of the FOG.

Emotional blackmail by Susan Forward: How to get out of the FOG

Walking into the light and out of the fog

Narcissism

Daily prompt

foggy

 

Protected: The Sound Of Pushing The Limit

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Half of me

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Have you ever felt split in two?

You know me. I’m the life of the party. Beautiful people around me, everybody falling in love

But that’s just the half of it

Rihanna- Half of me

We are wear masks. We hide parts of us that we think won’t be accepted. The funny thing is, when somebody else takes off that mask, especially people we admire, we feel relief and sympathy. When Rihanna was abused and released the pictures of her swollen face, her fans only gained more respect for her. She sings about her pain, and we wish we were brave enough to do the same. But we don’t dare, because we fear the consequences. What if people don’t like what they see? If they see the dark and ugly parts of us, that we so wish we didn’t have.

You saw me on the television

And I guess you saw me stealing, but you’ve got no idea what I’ve been through

That’s just the half of me

This is the life I live

Rihanna – Half of me

Stigma is like a cigarette burn, scarring us and stifling our need to feel free from the pain we keep inside. It leaves holes in our soul, and since we hide them, there is nobody there to fill them with their love. Some people hurt themselves physically or emotionally, some keep working until they almost burn out from exhaustion. Because taking time to ourselves, would mean that we have time to think and feel. And thinking feels dangerous, because maybe we will have to look our feelings instead of avoiding them. We are so scared of ourselves, until we are reminded of the fact that nobody is perfect. Everyone have things they rather hide, and if we only knew that, maybe we could take off our mask, and show our different faces. Because behind the scared and angry parts of us, lies the parts of us we miss. The face full of love, volnerable and beautiful.

We are beautiful, no matter what they say. Words can’t bring us down.

Christian Aguilera – beautiful

Maybe you shouldn’t work so hard on splitting your good sides from the bad ones. Doing so takes a lot of energy that could have been used however you want. By opening up to the world, by letting the can of worms free, you can finally dig yourself out of the grave of sorrow.

One of me is stronger. One of me is wiser. One of me is a fighter. And there is a thousand faces of me.

So I’m gonna rise up

I’m gonna rise up

For every time you broke me

There’s an army. Army of me

Christina Aguilera – Army of me

The brain of a serial killer

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Warning: If you have been abused this post might be triggering. The picture underneath offers a lot of information based on science and knowledge gathered over time. It is easy to understand, and might help us in understanding what contributes to psychopathy. It also created some questions: Why is psychopathy more prevalent in USA and in white people? Evolutional theorists have discussed it psychopathy is relatively rare because psychopathic behavior would be “discovered” and for that reason not lead to any evolutionary advantages. USA and other individualistic countries are known for becoming more “egoistic”, and USA is known for more lenient attitudes towards weapons. This is just loud thinking on my part, so don`t take it as truths.
The Brain of a Serial Killer

 

The picture is reproduced from this link: http://www.stumbleupon.com/su/1cXNdb/:2mHUbAkb:TeSCEaSC/www.bestcounselingdegrees.net/serial-killerhttp://www.stumbleupon.com/su/1cXNdb/:2mHUbAkb:TeSCEaSC/www.bestcounselingdegrees.net/serial-killer

Protected: The sound of rape 

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The uncontrollable 3-year old inside 

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She was an unpredictable beautiful 20 year-old girl. Fire within her, that was often quenched by rain from thunderous clouds. Others didn’t know how to be with her, as it felt like playing Russian roulette. They wanted to be there, to love her. But when her inner 3-year-old awoke, they ran away in fear. 

She sang:

You can see my heart beating. You can see it through my chest. That I’m terrified, know that I must pass this test. 
So just pull the trigger, as my life flashes before my eyes. I’m wondering, will I ever see another sunrise? 

But it’s too late to think of the value of my life.

Warm hands, touches she never would feel again. She couldn’t think, as thoughts were drowned by memories she rather keep away. She tried to do the right thing, but 3-years-olds haven’t learned what the right thing is yet. 

She felt like little Colette, singing alone in her castle in the clouds. 

In a castle where no one could reach her.  

  

Child Sex Trafficking Victims Easily Missed by Doctors and Social Workers

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Victims ‘hide in plain sight,’ experts say, and survey finds more training is needed.

Child Sex Trafficking Victims Easily Missed by Doctors, Social Workers: Study

TUESDAY, March 17, 2015 (HealthDay News) — Most health care workers may lack the knowledge, awareness and training to identify potential victims of child sex trafficking, a new study suggests.

“We need to become more aware that trafficking exists and [more] educated about what we can do to identify and provide resources to victims,” said study author Dr. Angela Rabbitt, an assistant professor of pediatrics at the Medical College of Wisconsin in Milwaukee.

Sex trafficking occurs when a child engages in any sexual act, including stripping or engaging in pornography, in exchange for something of value, which could include money, drugs, food, shelter or other survival needs, Rabbitt explained. This legal definition does not require proof of coercion because minors are legally incapable of consenting to sexual activity.

Rabbitt and her colleagues distributed approximately 500 surveys about sex trafficking to doctors, nurses, physician assistants, social workers, and patient and family advocates at hospitals and clinics in urban, suburban and rural parts of southeastern Wisconsin. Of these, 168 were completed, primarily by social workers and physicians.

The survey asked the respondents to read and answer questions about two vignettes, which were scenarios about potential sex trafficking victims. Only half the respondents correctly identified the child in the first scenario as a sex trafficking victim. In the second scenario, 42 percent correctly identified the child as a sex trafficking victim in addition to being a child abuse victim.

The findings were published online March 16 in the journal Pediatrics.

One expert noted the importance of the findings.

“We need more individuals — especially doctors, teachers, youth leaders, coaches, etcetera — to help identify when a child is either at risk for trafficking or currently being exploited,” said Nicole Levy, research project director at the Institute on Domestic Violence & Sexual Assault at the University of Texas at Austin.

“Runaways and homeless youth, youth in the foster care system and youth who have left home due to neglect or abuse are especially vulnerable to trafficking,” she said. “Traffickers and pimps are aware of these vulnerabilities and prey upon such youth — they provide food, shelter, attention and affection.”

Common misconceptions about sex trafficking are that it involves smuggling, transportation or movement across borders or being held against one’s will, Levy said, adding that the average youth’s age of introduction to trafficking is 13.

In the survey, one in five respondents said lack of awareness was a barrier to identifying sex trafficking victims, and about a third said lack of training was an obstacle. Of those surveyed, 63 percent had never received training.

Those with training, however, were more likely to have encountered a victim in their practice, to be more confident about identifying victims, and to say sex trafficking was a major problem in their area.

It’s difficult to determine how many victims of child sex trafficking exist in the United States, Rabbitt said. An estimated 100,000 to 300,000 children and teens under 18 may be at risk. But no centralized database collects reports, research is limited, and victims are often afraid or unwilling to identify themselves or are never asked, she said.

“Trafficking often hides in plain sight — we know that there are trafficking victims whose cases never come to light,” Levy said.

Red flags signaling a possible victim include a history of multiple reproductive or violence-related health problems, such as prior pregnancies, multiple tests for sexually transmitted infections or suspicious injuries, Rabbitt said.

The study authors also reported that 10 percent of providers classified a child victim as a “prostitute” instead of a sex trafficking victim. This reflects “community beliefs that children involved in the sex trade are responsible for their victimization,” the authors wrote.

“I think when the community sees a victim of domestic sex trafficking, their first thought is that he or she is a prostitute who chose that lifestyle,” Rabbitt said. “There is now a growing awareness that many ‘prostitutes’ start out as children or as young adults who were forced into the sex trade, and now, due to fear, addiction or many other reasons, find it very hard to get out of the life.

“For the general community, the best way to prevent a child from becoming a victim of trafficking is to help them develop healthy coping skills and confidence when they are very young, and then continue to support them as they grow,” she said. Volunteering for youth mentoring programs and reporting suspected child abuse and neglect are two ways people can help, she added.



Visit UNICEF External Links Disclaimer Logo    for more on sex trafficking.

A Sheriff And A Doctor Team Up To Map Childhood Trauma

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Alachua County Sheriff Sadie Darnell (left) and Dr. Nancy Hardt, University of Florida.

Alachua County Sheriff Sadie Darnell (left) and Dr. Nancy Hardt, University of Florida.

Bryan Thomas for NPR

The University of Florida’s Dr. Nancy Hardt has an unusual double specialty: She’s both a pathologist and an OB-GYN. For the first half of her career, she brought babies into the world. Then she switched — to doing autopsies on people after they die.

It makes perfect sense to her.

“Birth, and death. It’s the life course,” Hardt explains.

A few years ago, Hardt says, she learned about someresearch that changed her view of how exactly that life course — health or illness — unfolds.

The research shows that kids who have tough childhoods — because of poverty, abuse, neglect or witnessing domestic violence, for instance — are actually more likely to be sick when they grow up. They’re more likely to get diseases like asthma, diabetes and heart disease. And they tend to have shorter lives than people who haven’t experienced those difficult events as kids.

“I want to prevent what I’m seeing on the autopsy table,” Hardt says. “I’ve got to say, a lot of times, I’m standing there, going, ‘I don’t think this person had a very nice early childhood.’ ”

Back in 2008, Hardt was obsessing about this problem. She wanted to do something to intervene in the lives of vulnerable kids on a large scale, not just patient by patient.

Hardt’s Map Of Medicaid Births

The deep blue and red spot on the left shows the Gainesville area’s most dense concentration of babies born into poverty — to parents on Medicaid.

Medicaid birth map

So, by looking at Medicaid records, she made a map that showed exactly where Gainesville children were born into poverty. Block by block.

Right away she noticed something that surprised her: In the previous few years, in a 1-square-mile area in southwest Gainesville, as many as 450 babies were born to parents living below the poverty line.

It just didn’t make sense to her — that was an area she thought was all fancy developments and mansions.

So Hardt took her map of Gainesville, with the poverty “hotspot” marked in deep blue, and started showing it to people. She’d ask them, “What is this place? What’s going on over there?”

Eventually she brought the map to the CEO of her hospital, who told her she just had to show it to Alachua County’s sheriff, Sadie Darnell.

So Hardt did.

And, to Hardt’s surprise, Sheriff Darnell had a very interesting map of her own.

Darnell had a thermal map of high crime incidence. It showed that the highest concentration of crime in Gainesville was in a square-mile area that exactlyoverlaid Hardt’s poverty map.

“It was an amazing, ‘Aha’ moment,” says Darnell.

“We kind of blinked at each other,” Hardt says. “And — simultaneously — we said, ‘We’ve got to do something.’ ”

The hotspot is dotted with isolated, crowded apartment complexes with names like Majestic Oaks and Holly Heights. The first time she visited, on a ride-along with Sheriff Darnell’s deputies, Hardt tallied up all things that make it hard for kids here to grow up healthy.

Dr. Nancy Hardt's free "clinic on wheels," parked in December at an apartment complex in Gainesville, Fla., gets about 5,000 visits from patients each year.

Dr. Nancy Hardt’s free “clinic on wheels,” parked in December at an apartment complex in Gainesville, Fla., gets about 5,000 visits from patients each year.

Bryan Thomas for NPR

There’s a lot of poorly maintained subsidized housing. Tarps cover leaky roofs. Mold and mildew spread across stucco walls. Sherry French, a sergeant from the sheriff’s office, says lots of families here have trouble getting enough to eat.

Hardt added hunger to her list and substandard housing. And she noticed something else: almost a total lack of services, including medical care.

She mapped it out and determined that the closest place to get routine medical care if you’re uninsured — which many people here are — is the county health department. It’s almost a two-hour trip away by bus. Each way.

This was a problem a doctor like Hardt could tackle. She would bring medical care to the hotspot, by rustling up a very large donation: a converted Bluebird school bus, with two exam rooms inside.

Hardt organized a massive crew of volunteer doctors and medical students from the University of Florida, where she teaches, and raised the money to hire a driver and a full-time nurse.

The “clinic on wheels” first made it out to the hotspot in 2010, parking right inside one apartment complex there. Patients could walk in without an appointment and get treatment free of charge, approximating the experience of a house call. Today, the mobile clinic gets an average of 5,000 visits from patients per year, in under-served areas all over Gainesville.

Physician assistants and undergraduate care coordinators treat patients in the mobile clinic parked at Majestic Oaks, a low-income apartment complex in Gainesville.

Physician assistants and undergraduate care coordinators treat patients in the mobile clinic parked at Majestic Oaks, a low-income apartment complex in Gainesville.

Bryan Thomas for NPR

But the clinic is really just one piece of the puzzle.

Because after the day that Hardt and the sheriff matched up their maps, they kept digging into the data. And, a few years later, Hardt made some new maps. They showed that the crime in the hotspot included the highest concentration of domestic violence, child abuse and neglect in Gainesville.

Childhood Trauma Maps

The reddish pink spots on these maps of the Gaineseville area, indicate an increased density of reports of child abuse and neglect (top map) and domestic violence (bottom). Deep blue indicates the highest concentration.

two maps of crime

That revelation brought Dr. Hardt back to her original mission — to head off bad health outcomes in the most vulnerable kids. So she teamed up with Sheriff Darnell and other local groups and grass-roots organizers from the neighborhood. They collaborated to create the SWAG (Southwest Advocacy Group) Family Resource Center, right in the Linton Oaks apartment complex.

The SWAG Center opened in 2012. Kids can come play all day long. There’s a food pantry, free meals, a computer room, AA meetings. A permanent health clinic is slated to open up across the street next week.

All the resources here are designed to decrease the likelihood of abuse and neglect by strengthening families.

“I think we knew it intuitively — that health issues are associated with crime, [and] crime is associated with health issues and poverty,” Darnell says. “But seeing that direct connection literally on a map … it helped to break down a lot of walls.”

Child abuse and domestic violence are still serious problems, but there has been a small drop in the numbers of such calls over the past few years, according to the data.

Hardt says that investing in families and health now can help kids grow up healthy — and save money in the future.

“Conservatives or liberals, everybody gets that,” she says. “That we have limited resources and we need to really spend them wisely. I think the maps — the hot spot maps — just tell us policywise, where we need to be going and what we need to be doing.”

Hardt’s next goal is to make more people aware of the links between health and early education. Last summer, the county got a new superintendent of schools. Hardt has been to visit him three times already — maps in hand.


This story is part of the NPR series, What Shapes Health? The series explores social and environmental factors that affect health throughout life. It is inspired, in part, by findings in a poll released this month by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health.

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