Monday, 19 January 2015

Childhood Trauma

This post is dedicated to someone. I know that someone who will read it will know who that someone is.

A lot of mental illness is linked back to childhood trauma in the literature about it. I believe myself to be well classified by Borderline Personality Disorder, which is strongly associated with trauma. The question is, did I have childhood trauma?

What is trauma? I was not abused as a child. I didn't live in a war zone. I had one near-death experience when I was four or five but it isn't the least bit painful to remember or talk about, it's just a thing that happened to me. I would say that I did not experience trauma as a child.

On the other hand I clearly experienced the world as a terrible and hostile place. Recently I was thinking about people "wanting the best for their kids" in terms of getting them into good schools and so forth. My reaction is, "What difference does it make, school is an awful, wasteful experience and no school could really be better than any other." My default assumption is that everything will be rotten and there is no point in trying to make things better. Hoping for "the best" might as well be hoping for "the worst" because they aren't really different.

Well, I have to check that against reality a bit. It would be a foolish position to try to take seriously.

If trauma exists in your emotional reaction to your circumstances, rather than in the experience, then maybe school was traumatizing for me. But I guess I want to try to walk away from the word "trauma" because it is a hard label for me to take on myself. Like I said, I wasn't abused and I wasn't in a war zone. How can I take that word from people who have truly awful experiences and apply it to my own pretty benign experiences?

I've brought up my "legs-don't-work" model of mental illness before, but I don't think I ever do an adequate job of explaining it because people I talk to don't seem to understand it. Suppose you were born with non-functional legs. You have spent your whole life using mobility devices, mostly wheelchairs when in public.

I'm not going to imagine that I know what that would be like day to day personally. What I do know that it means you are living in a world with a broken interface. I probably live in one of the more accessible places in the world for people with mobility disabilities, but no amount of accessibility is going to get rid of the fact that the default setting for everything is wrong. Counters and shelves are too high, there are too many unnecessary changes in elevation, things aren't placed sensibly. You have to go way out of your way to get from one place to another on so many different occasions. A huge time and money tax are applied to your life.

It's a world in which you don't quite fit right. The new way of thinking about disabilities is that there is nothing wrong with the person with the disability, but rather there is something wrong with inaccessible environments. That's a great shift but it can never overcome the abled-by-default setting. That counter has to be one height or another.

What is your experience of that world as a person who cannot walk? Well, hopefully it isn't traumatic. Hopefully you don't feel systemically abused and left out. And for a person growing up in Toronto today I think that's a rational hope. But in many places and at practically all times in the past anywhere you went there were tremendous barriers that locked people with disabilities out of all kinds of participation in society. It was and is probably natural to become a loner and an outsider for many people with mobility issues. Imagine being unable to go to 99% of the stores in the city you live, or not being able to take a course in your high school because it is on the second floor, or not being able to go to school with the other kids at all. Whether you curse your legs or curse the stairs it doesn't really help. Depending on your personality, that could lead to all kinds of mental health problems for you as well, particularly depression.

So what about mental differences? People who are neurotypical are the people with the functioning legs. People on the autism spectrum are significantly more likely to be depressed. Just like the legs issue, I don't really know what it's like to be on the autism spectrum, but it seems pretty apparent that people on the autism spectrum also live in a world where the "counters are too high". It's probably invisible to most of us how much we rely on something simple like reading emotions in other people's faces and having our own faces read, but I'd wager it's critically important to the way we go about our lives. That's just one kind of stairs for those on the autism spectrum, and the stairs are everywhere.

And then on top of that, unlike the person in the wheelchair, no one around you can understand what the problem is. When a person in a wheelchair comes to a flight of stairs, at least someone who is paying attention can see that the person has no access to whatever lies at the top. With the autism spectrum, if you are high functioning, probably even your own parents don't see the barriers you encounter every day. Instead of support you get frustration and condemnation. If you do develop depression then even access to mental health services is "up the stairs" - mental health diagnoses are behavioural, and people on the autism spectrum display abnormal behaviours. A person may be suffering in exactly the same way a neurotypical person is, but not receive the same - or any - diagnosis because their behaviour doesn't match the criteria.

I don't want to characterize depression as a symptom of a problem, rather I want to characterize depression as a method of interfacing with the world. When the world doesn't work for you, you have to find a different way of dealing with the world that does work for you. Depression might not sound like something that works for anyone, but I think it's the best people can do under some circumstances. Commando crawling up a flight of stairs is a pretty lousy interface with the world for getting to the second floor, but I promise you that at some point a person has felt that was their only option.

Which brings me back to Borderline Personality Disorder and trauma. I don't think that I need to use the world "trauma" to describe my experience with the world. I think the counters not being my height is a much better way to describe it. If that doesn't sound severe enough to warrant a major mental illness, then perhaps crawling up the stairs on your elbows is a better metaphor.

We like to call people crazy, but these alternate interfaces are not crazy. The world is actually a really awful place in a lot of ways:
  • People are senselessly cruel to one another in day-to-day interaction
  • Living until tomorrow is governed hugely by randomness
  • Our society has deeply embedded unfairness that seems impossible to dig out

There's lots more. To me, taking how rotten things are in stride is what doesn't make sense. When I look at our world, it seems to me like people *without* serious mental illnesses are crazy.

So I'm going to save the word trauma to talk about acute traumatic experiences. Using my "interface" model of mental illness, it's easy to see how trauma results in mental illnesses. When children are abused they develop a world-interface that prominently incorporates being abused because that is a predominant feature of their world. That world-interface isn't going to be ideal for dealing with most of the world, and it doesn't magically right itself if the abuse one day ends.

But that isn't the only way to develop an atypical or problematic world-interface. We all need to either climb the stairs or give up on the stairs as a lost cause. Neither option is crazy.

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