.. . The Sins of the Father What happens to children severely traumatized or neglected during the first years of life? This is an infinite topic, so the focus of this exploration will be limited to three personality disorders. The symptoms of these personality disorders are diagnosed in adulthood, but their roots lie in the first 4 years of life. Erikson’s growth stages of trust vs.
mistrust and autonomy vs. self-doubt will form the foundation for understanding. When a child is exposed to abusive, pathological parenting during these development stages the result is often a personality disorder. Personality disorders are enduring patterns of perception, which are maladaptive and cause significant functional impairment and/or subjective distress according to the Diagnostic and Statistical Manual of Mental Disorders, edition 4. These disorders affect approximately 3% of our population and the number is probably significantly higher, except that many go undiagnosed. These people often suffer extraordinarily throughout an entire lifetime and cause a great deal of suffering to those who love and interact with them.
It is my intent to provide a general understanding of the people afflicted with these disorders. But more importantly, the causes that take place during infancy so that possibly some day the diseases can be eradicated. I will begin with the infant who is unable to be successfully fed and soothed at birth. Infants have very minimal needs but each need is crucial. The failure to meet any of these needs causes significant difficulty in adulthood. Infants are completely helpless; a tiny baby is unable to think for itself. Almost all feelings are intense and require adult intervention to help the infant manage the intensity.
Lastly, the infant has absolutely no physical ability to do anything for itself including any mobility. Take a moment to try and imagine total helplessness and dependency on another for everything, hunger, comfort, warmth, communication and even the ability to calm oneself. An infant is born in a symbiotic state in which it is unable to differentiate between itself and the primary care giver. This is the foundation of trust. The caregiver must anticipate the needs of the infant and be able to interpret non-verbal clues, since the infant has no verbal communication skills.
When a primary caregiver is unable to sense when the infant is hungry forces the infant into a panic. A pathological caregiver may either join in the infant’s panic or ignore it. Both of these responses produce a hysterical infant in physical pain and extreme psychological distress. If the caregiver is unable to respond to the infant, the feelings of helplessness become a predominant part of the infant’s experience. The infant cries and cries, or withdraws, forming the experiential belief that it cannot survive or find stability.
This is the very core of mistrust. The infant learns to mistrust the caregiver and internalizes the experience so as to mistrust itself. Remember the infant is unable to differentiate between the caregiver and itself. This is the foundation of significant distress and an inability to achieve a secure bond that in turn will be transferred to every relationship it has throughout life. The conflict of desperately needing to depend on another but being unable to trust another has begun formation. The conflict is then acted out throughout life in an attempt to resolve it.
This inability to form a confident reliance in a primary relationship produces the basic underlying pathology for borderline, narcissistic and paranoid personality disorders. Significant characteristics of the borderline personality disorder include patterns of unstable and intense interpersonal relationships, characterized by alternating between extremes of devaluation and over-idealization. A similar characteristic of the narcissistic personality disorder is continuous exploitation throughout the life of interpersonal relationships in order to achieve his or her needs with no concern for the needs of a partner. The narcissist also maintains a pre-occupation with fantasies of ideal love relationships and holds his or her partner responsible for all failures in the liaison. This pattern of an inability to trust is most predominantly displayed in the paranoid personality where interpersonal relationships, when they can exist, are marked by unjustified feelings of being exploited and constant doubt of a partners sincerity and loyalty with out justification Due to the very nature of the personality disorder these patterns are pervasive in the effected person’s life. Certainly the temperament of the infant must be taken into account before changes can be made in the infant’s external life that will alter, and encourage or discourage these pathologies.
It is imperative to meet the needs of an infant from 0-6 months to prevent this constant mistrust from becoming a prevalent part of the infant’s experiential life. As the infant increases in age and is more able to have physical mobility and verbal skills, the need for autonomy rises. A pathological parent, who, his or herself is too needy, is very likely to feel threatened by the child’s need to be separate. If the primary caregiver is overly anxious about the child trying tasks on his or her own the child internalizes this anxiety and becomes afraid also. This is an additional impairment in the child/caregiver relationship. The needs of the parent are being met but not the needs of the child. The child learns its purpose is to soothe the caregiver and subjugate itself into the service of the caregiver for survival. The other alternative is a parent who constantly rewards the infant who attempts tasks but fails to set any realistic limitations.
In either case the infant cannot begin to form realistic expectations in relationships where one person can depend on another. It is important to note that personality disorders are not formed from just one or two mistakes or traumatic events. Personality disorders are formed when the pathological interaction is omnipresent. This is the reason these people are later effected in all aspects of their lives. They literally see the world through eyes, which are continually distorted and reinforce the conflicts, which are already present.
Conflicts of trust vs. mistrust and autonomy vs. shame are so painful that the entire thrust of life is devoted to resolving this on going dilemma. Glen O Gabbard said a patient suffering from a borderline personality disorder once told him, “Life was just one enormous obstacle course after another.” Often a person suffering with the effects a borderline personality disorder is unable to contain his or her emotions and has massive mood shifts. These feelings are reactivated from infancy when the primary caregiver was unable to soothe the infant, which now leaves an adult unable to calm itself. The borderline constantly searches for an interpersonal relationship, which will provide the parenting they are so desperately in need of.
At the point a fragile bond forms, the borderline transfers all the fears of intimacy and the rage of being denied to the new partner. Desperate feelings of abandonment keep the borderline involved and the infancy conflicts of mistrust and shame get acted out and reinforced all over again. This only strengthens the pathology that already exists in the borderline personality. Intimate bonding is the primary drive of life so this pathological process continues. It is of key importance to realize that this is the only way the borderline knows to love. If all hope of resolving these “love” conflicts is lost, a state of total despair envelops the borderline and suicidal ideations are present.
This same conflict of a need to trust, but an inability to do so, is displayed quite differently in the narcissist. The narcissist operates with an insatiable appetite. The infant rarely experiences satiation due to a lack of limitations being put in place by a competent caregiver who can help the infant manage rage, the narcissist sees each potential interpersonal relationship as someone to feed off of. The narcissist has no ability to trust the potential mate. This pathology allows the narcissistic person to use a mate as a primary object much as the infant does a primary caregiver. The narcissist, like the infant, is incapable of empathy, and life and love become a feeding frenzy.
This is also an infant, in which no limitations were set during the developmental stage of autonomy, resulting in adult who is constantly seeking more. Sadly, the narcissist genuinely believes he or she deserves infinite power, praise, and love. All others are valueless and inconsequential. People are treated identically to objects and used purely as pleasure devices. Last is the paranoid personality, who projects an inability to trust onto every relationship.
These infants were not only left hungry but also usually neglected severely during the autonomous stage. They received no parental feedback other than possibly that of annoyance. The paranoid seeks minimal bonds but is never able to believe the other person to be anything but exploitive and disingenuous. They distort simple situations into plots against them. These beliefs perpetuate themselves reinforcing the paranoid’s belief that everyone uses everyone. They appear to have some autonomy but it is really resentment about being emotionally starved and neglected as an infant.
`These adults are quick to anger and unable to trust another enough to be soothed. They do not possess the ability to soothe themselves; therefore the paranoid indulges in his or her anger as a defense against the need for satisfaction and love. Treatment of personality disorders is long and tedious and demands the therapist have a strong self-identity. People who suffer from a personality disorder do not have a few traumatic events, which periodically interfere with their lives. They live a pervasive pattern of mistrust and shame.
They do not possess a sense of themselves that is comforting and reinforcing. They possess exactly the opposite, which is often transferred onto others and reenacted because they have very little separateness. Each type of disorder causes the effected person to constantly reenact the failures in an attempt to resolve the conflicts. The exact opposite usually happens reinforcing the dysfunction. These significant personality disorders can be corrected by providing receptive, emotionally available primary caregivers that teach the infant to trust and bond in a primary relationship. A secure adult caregiver allows the infant to find autonomy with limitations and the infant eventually begins to separate.
The infant begins to form empathy in order to achieve the closeness in bonding that it desires. This allows for healthy personality development, which is then reinforced throughout life. These disorders are infinitely more conducive to change during the formative years. Interactive therapy between caregiver, therapist, and infant can produce substantive and sustained changes which beak the sequence of psychopathology. If we as a society ever wish to eradicate these extreme forms of mental illness we must provide effectual parental education and make available therapeutic intervention without social stigma. Engineering Reports.