Sunday, March 30, 2014

Injury

    or Illness?
A soldier comes home from the war with post-
traumatic stress disorder, PTSD. He's not ill,
 he's injured. As much as if he had been hit 
by gunfire or an IED, there's physical 
damage and he's wounded.
Although the horror of war is our common 
context for the injury, it occurs in less 
obvious circumstances.


Verbal abuse, neglect, and exposure to a threatening environment can result in brain damage, a PTSD equivalent in a child that can persist for the rest of their lives. It can be especially harmful during the middle-school years of development.

... but bullying? It’s easy to think that, as painful as bullying might be, all it hurts is our feelings. New research into bullying’s effects, however, is now suggesting something more than that — that in fact, bullying can leave an indelible imprint on a teen’s brain at a time when it is still growing and developing. Being harshly ostracized by one’s peers, it seems, can throw adolescent hormones even further out of whack, lead to reduced connectivity in the brain, and even sabotage the growth of new neurons.

One thing we hear, especially when we talk to adult bullies or the parents of bullies, is that they feel this behavior is a “right of passage”. That “everyone grows up and gets over it”.

Perhaps it’s true that everyone grows up, but here we have evidence that bullying affects its victims' development and that they carry this trauma with them for the rest of their lives.

These neurological scars (physical damage to the brain), it turns out, closely resemble those borne by children who are physically and sexually abused in early childhood.


Consider the child who comes to school without the ability to respond to authority, without the ability to trust an adult, without the ability to shake off depression, all the result of neglect, verbal assault, and a hostile environment.  He, like the soldier, is not ill.  He has been injured, and the damage is more significant than we've previously understood.

The key element of verbal abuse is the persistent 'attack' focused on the individual, the intent to beat down.  Each of us is vulnerable.  In relationships that matter, we're the most vulnerable.  
  • a child can be wounded by verbal abuse from parents or siblings
  • a middle-schooler can be wounded by verbal abuse by bullying peers
  • a husband or wife can be injured by verbal abuse from their partner
  • an employee can be injured by verbal abuse in the workplace when they can't afford to leave.  A bullying supervisor is the same kind of harmful person, attacking the individual rather than dealing with tasks and performance.
While it's still a new understanding in the general population, the healthcare community has long known that persistent verbal abuse is injurious.  It doesn't just hurt your feelings and disappear; it does physical damage.  The damage can often persist for a lifetime.
NOTE: Interpersonal conflict is part of life, marriage, growing up, and business.  It's normal, often necessary, and not particularly troublesome as long as it stays focused on issues and not on personal assault.
It's worth noting that a verbal abuser is of the same heart and mind as the bully, the child abuser, the wife beater.  They've each chosen to deliberately do harm to another.  Not popular news, not popular at all.

Interestingly, the degree of our vulnerability to verbal abuse is tied to the degree our personal identity and worth depend on the abuser.  How much do we depend on the approval of others?  Can you guess who might be the least vulnerable or the most resilient?
Recovery is absolutely possible.

NIH-PTSD
NIH-Bullying
Workplace Law
The Bullied Brain
Complex Trauma

The medical profession works on a figure of about 25% of people developing PTSD after exposure to traumas such as a serious accident, physical or sexual assault, war or torture, or a natural disaster such as a bushfire or a flood,.
That said, here are best estimates of the incidence of post traumatic stress disorder for some specific populations:

30% of US Vietnam veterans
10% of US Desert Storm veterans
6-11% of US Afghanistan veterans
12-20% of US Iraq veterans

3%-6% of US high school students
30%-60% of US children who have survived specific disasters
2% after a natural disaster (tornado)
28% after an episode of terrorism (mass shooting)
29% after a plane crash
100% of US children who witness a parental homicide or sexual assault
90% of sexually abused children
77% of children exposed to a school shooting
35% of urban youth exposed to community violence

50% of UK sexually abused children,
45% of UK battered women,
35% of UK adult rape victims,
30% of UK veterans,
18% of UK professional fire-fighters

13% of suburban police officers
4-14% of US law enforcement officers
16.5% of US firefighters

37% of Cambodian refugees
3% 
of Cambodian civilians
86% of 
women refugees in Kabul and Pakistan
75% of Bosnian refugee women
60% of US female rape survivors
30% of those actually in the building or injured during the 9/11 New York City attacks.