Wednesday 30 May 2018

Learned Helplessness and C-PTSD

In 1967, Martin Seligman, one of the founders of Positive Psychology and his research group carried out a fascinating, if somewhat morally dubious experiment in his quest to understand the origins of depression. In this experiment, three groups of dogs were confined in harnesses. The dogs in group 1 were simply placed in their harnesses then released after a period of time, but the dogs in groups 2 and 3 did not have it so easy. Instead they were subjected to electric shocks that could only be stopped by pulling a lever. The difference was that the the dogs in group 2 had access to the lever, whereas the dogs in group 3 did not. Instead, the dogs in group 3 would only receive relief from the shocks when their pair in group 2 pressed the lever, with the result that they experienced the shocks as random events.

The results were revelatory. In the second part of the experiment, the dogs were placed in a cage and again subjected to electric shocks, which they could escape by jumping over a low partition. The dogs from groups 1 and 2 did what any dog would be expected to do and searched for an escape root, but the dogs in group 3 did not, despite no other obstacles being placed in their way. Instead, they simply lay down and whined in a passive fashion. Because they had been habituated to thinking of the electric shocks as something over which they had no control, they did not even try to escape in the way they would have done without this acquired “training”. Indeed, trying to motivate the dogs with rewards of other forms of threat produced the same passive result. Only by physically prompting the dogs to move their legs and guiding them through the process of escaping could the researchers prompt the dogs to act in the normal fashion.

This experiment introduced to the psychological community the concept of “learned helplessness”. It goes without saying that designing a similar experiment for humans would cross the line between dubious ethics and outright illegality. However, we don’t need such a controlled experiment to observe the phenomenon of learned helplessness among humans; once you understand the concept you’ll find it everywhere. One of the things Seligman’s experiment shows us, perhaps, is that the irrational defeatism and despair that characterizes depressed individuals is not so much a product of our uniquely human brains, but a result of processes that are so deeply ingrained in our evolutionary makeup that we share them with dogs.

How to Think about Mental Health

The concept of learned helplessness also has great implications for the way we think about mental health — and mental illness — in general. One way of thinking about mental illness is to look at the brain as an extremely complicated, organic machine. If everything is working correctly, the result is a happy, balanced, and productive personality. If something is not, whether it has to do with chemical transmitters, neuron pathways, grey matter, or something else entirely, then the result is one or another form of mental illness.

One problem with this model is that our knowledge of the brain is not sufficient to use it as a guide to action. You may have heard, for instance, that depression is caused by “a chemical imbalance in the brain”, but in fact there has never been any real evidence for this claim and the psychiatric industry has quietly dropped it. There is a lot of evidence that antidepressants and other psychotropic medications work at combatting certain symptoms, but there is little agreement about how or why they do so.

However, there is a deeper problem: if we conceptualize the brain as a machine, why does it so frequently “go wrong”? It is true that some mental problems are caused by pathogens or injuries to the head, and others are the result of genetic causes, but most cases of depression or anxiety are responses to adverse life experiences. We often use the concept of “trauma” to explain the mechanism by which, for example, losing a loved one can lead to prolonged periods of depression. We have used the term for so long that we forget that it originated as a sort of metaphor. Trauma comes from the ancient Greek term for wound, so by using the term we are saying that traumatic events wound the brain and that symptoms which follow are the result of this wounding. We are coming to more and more appreciate the role that trauma, especially childhood trauma, plays in a wide range of common mental health diagnoses. By looking in the brain in this way, we are essentially subscribing to the view that the brain is not only an extremely complex machine, but an extraordinarily fragile one, so fragile, one might add, that it would appear a wonder that the human race has survived at all.

However, this is not the only way of looking at the issue. Let us return to the Seligman’s experiments with dogs. These experiments were far from being the first of their kind. Indeed, they had been a mainstay of psychological research for decades. Ivan Pavlov started when he demonstrated in 1901 that a dog who heard a bell ringing every time he was given food would start to salivate when he heard the bell even when no food was present. Subsequent research would demonstrate that dogs could be trained quite easily to perform a wide range of tasks through a structured set of rewards and punishments. What Seligman’s experiment showed is that the same kind of inputs can be used not to make a dog perform a particular task, but to make it entirely dysfunctional. “Learned helplessness” describes a state that comes not from a kind of metaphorical injury so much as a process of learning in which the dog learns that the world is random, cruel, and impossible to navigate through.

So too, victims of trauma should not be seen as possessing a brain that has been damaged by outside injury, but as having gone through a process of learning under unusual circumstances. While our knowledge of the brain remains incomplete, one thing we do know is that it is not a fixed entity which will fall apart if one part is altered, but a flexible organ that grows and develops in response to different stimuli. We call this phenomenon “brain plasticity” — the ability of the brain to reorganize itself. The enormous potential of the human brain to adapt to new circumstances is what has allowed human beings to adapt to a wide variety of different environments. One of the environments that humans have had to learn to survive is that of childhood abuse and even the most extreme symptoms of complex trauma or C-PTSD, such as dissociative episodes, lose their bewildering character when they are understood as part of the process of learning to survive under adverse circumstances.

However, though the brain is plastic, it is not infinitely so. Victims of complex trauma suffer immensely from having to live with patterns of thought that were necessary to help them survive, but are profoundly maladaptive in new circumstances. What is important to understand is that when these individuals go to therapy they are not healing a wound so as to restore a pristine brain that never existed, but starting a new learning process altogether. The dogs in the Seligman’s experiment could not simply “unlearn” their learned helplessness, they had to learn to be functional again. So, too, individuals who are suffering with the after effects of complex trauma have to undergo a new learning process which therapy facilitates.

The concept of complex trauma presents a profound challenge to the way we look at mental health issues, a challenge that is also an opportunity. After much debate, it was decided not to include Complex Post Traumatic Stress Disorder in the DSM V and though many in the profession see this as a tragic mistake it is understandable. C-PTSD is much more than another diagnosis that can be slotted into the nearly 300 already found in the DSM, it is a different kind of diagnosis altogether that transcends many well-established, symptom-based classifications, and may come one day to replace them. Even more that that, however, it points the way to a different and more realistic understanding of mental health, in which it is viewed not as a default state to be restored, but as the result of a process of learning and growth.

 

References

  • Sar, V. (2011). Developmental trauma, complex PTSD, and the current proposal of DSM-5 . European Journal of Psychotraumatology, 2, 10.3402/ejpt.v2i0.5622. https://ift.tt/2wfIP6v
  • Tarocchi, A., Aschieri, F., Fantini, F., & Smith, J. D. (2013). Therapeutic Assessment of Complex Trauma: A Single-Case Time-Series Study. Clinical Case Studies, 12(3), 228–245. http://doi.org/10.1177/1534650113479442
  • McKinsey Crittenden, P., Brownescombe Heller, M. (2017). The Roots of Chronic PostTraumatic Stress Disorder: Childhood Trauma, Information Processing, and Self-protective Strategies. Chronic Stress, 1, 1-13. https://doi.org/10.1177/2470547016682965
  • Ford, J. D., & Courtois, C. A. (2014). Complex PTSD, affect dysregulation, and borderline personality disorder. Borderline Personality Disorder and Emotion Dysregulation, 1, 9. http://doi.org/10.1186/2051-6673-1-9
  • Hammack, S. E., Cooper, M. A., & Lezak, K. R. (2012). Overlapping neurobiology of learned helplessness and conditioned defeat: Implications for PTSD and mood disorders. Neuropharmacology, 62(2), 565–575. https://ift.tt/2LHdpKo


from Psych Central https://ift.tt/2IZ0Rw1
via https://ifttt.com/ IFTTT

No comments:

Post a Comment