Saturday, August 19, 2006

Some thoughts on child abuse recovery counseling, AA, PTSD and related matters

One prescriptive tool a number of these counselors recommend is writing with one’s alternative, non-dominant hand in order to recover one’s “inner child.”

But, does this actually have any benefits?

First, Ph.D. psychologist counselors, as compared to M.D. psychiatrists, let alone Ph.D. neuroscientists and cognitive scientists, aren’t renowned for their attachment to empirical research rather than feel-good theorizing. That’s why I have “inner child,” whether advocated by such counselors, Alcoholics Anonymous members talking about their recovery ideas, or others, in scare quotes.

Personally, and having done moderate or more left-handed writing off an on over the past few years, I doubt it.

First, I think the idea of an “inner child” is a construct. That’s not to say the idea isn’t still useful. Nor is it to say that we don’t have some subself that is more childlike (regular readers have read my numerous posts on the idea of subselves), and that, in at least some persons among people who have had childhood traumas, this subself isn’t larger and more active than in the general populace. But that’s all.

Anyway, to the degree alternate-hand writing accesses a child self construct, even then, it is probably not accessing a lot of unconscious or subconscious thought from this subself. The idea probably works in one of two ways.

Some people may be malleable or pliable enough in personality to un/subconsciously incorporate this idea wholesale from their counselors. In that case, what nondominant writing is accessing is most likely what the people subconsciously thinks their counselors want to hear about their clients’ inner children. In other words, outside of affirmation and “strokes” from a therapist, in these cases, nondominant writing is pretty valueless.

In other cases, though, where people who recognize, whether more subconsciously or consciously, the nature of a “child self” as a construct are involved, they may be able to go with the flow and project this constructed child self into the nondominant hand. That’s likely more valuable, but in this case, then what we are getting is an acted role which our own “daily show” consciousness believes is what this “inner child” is like.

A couple of caveats here, too. First, if one is too conscious about this, any insights will be forced. Second, the insights, as noted, may well be from one’s daily consciousness, and not any interior source.

Now, back to the idea of a “child self” and the idea, promoted in drug and alcohol recovery as well as developmental psychology, that this “child self” gets “frozen” by childhood trauma and never develops. (This leads to some AAers, and possibly some counselors, saying that one must “start again at age 13” or whatever, and then one “recovers at one year per year,” implying the whole person (if there actually is such a thing) is ultimately all behind the age-development curve because of the “frozenness” of this “child self.”

Well, first, I simply don’t believe human development happens that way. Even if a child trauma is great enough to produce some sort of actual, “split” or “partially split” child self, that subself is going to continue to develop, whether up, down or sideways. The deeper it appears to remain “frozen,” it seems more likely this is a subconsciously willed (yes, the subconscious has will) decision than an artifact of the original trauma.

Now, someone else might claim that subconscious willing is itself an artifact of the trauma. I say no.

Rather, it reflects differences in personality types — differences with a fair-sized genetic component, as illustrated by differences in post-traumatic stress disorder susceptibility in adults, to adult traumas.

Neuroscience and cognitive science have demonstrated such differences being reflected in differences in brain architecture in the amygdala and elsewhere. And the genetic research, while still somewhat weak evidentiarily, is coming along.

Hence, treatment such as anti-PTSD drugs, along with new directions in PTSD talk therapy, are important.

Counselors, even especially those leaning heavily on warm fuzzies, need to become cognizant of the research in this area and modify their treatment accordingly. And, armchair psychiatrists in AA and elsewhere need to take a page from Wittgenstein and stop dispensing advice that is not only clueless but potentially harmful, or at least detrimental, if they don’t know, and don’t try to know, what they’re talking about.

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