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1. 00:01 as bessel vander kulk so famously put it the body keeps the score the title of his seinal work a great book recommended indeed the reservoir the repository of your trauma your abuse your pain your hurt the uncertainty the intermittent reinforcement the
2. 00:27 unpredictability the terror the shocks all these don’t go away they reside within your body and they transform your body in ways which are sometimes counterintuitive they render your body an enemy they estrange you from your body you feel alienated as if this body
3. 00:52 that you have inhabited sometimes for decades is no longer familiar to you and this is the topic of today’s video the video is divided in three parts is actually three different videos the first video the first part is a general introduction to somatization the second part is how
4. 01:16 narcissistic abuse specifically impacts your body and the third part is a sum summary with some additional insights it’s much shorter so visit any part of the video that fits you and get to know your body under the duress and the distress of narcissistic
5. 01:38 abuse the most egregious and extreme form of maltreatment known to humanity my name is sam vaknin i’m the author of malignant self- love and narcissism revisited the first book ever on narcissistic abuse i’m also a professor of psychology before we
6. 01:57 proceed to remind you i’m giving a seminar for three days about scientific
7. 02:07 evidence-based ways ways to heal and recover from narcissistic abuse all kinds of techniques and practices three whole days free of charge all you have to do is be there physically now there’s a link in the description of the video click on the link and you will have all
8. 02:26 the all the details where when how etc etc if you have any queries or any questions the link also leads to my email addresses and feel free to write to me i promise to respond for a change okay shim sha kim kidos and kets
9. 02:49 let’s delve right into your bodies as i said the first part of the video is a general introduction to what is known as somatic symptoms or somatization the second part deals with narcissistic abuse specifically with and describes all the impacts and effects that
10. 03:11 narcissistic abuse has on your body generally speaking we can divide the impacts of trauma and abuse in its various forms and definitely the impacts of narcissistic abuse uh in two parts sleep disorders and somatic symptoms sleep disorders as the name implies is when you’re having
11. 03:36 difficulties with sleep you may oversleep actually you may be ravaged by insomnia whichever the case may be sleep in sleep or in the absence of sleep your trauma and abuse try to manifest somehow to express themselves but this is not the topic of today’s video the topic of
12. 03:59 today’s video is the rest of your body apart from the sleep system sumatization according to the american psychological association dictionary somatization is the expression of psychological disturbance in physical bodily symptoms the first use of the word has controversially been
13. 04:21 attributed to vianese psychoanalyst wilhelm uh to describe what is now called conversion i’ll discuss conversion disorder or conversion symptoms in a minute some investigators continues the dictionary use the word in reference not only to the physical symptoms that occur
14. 04:40 in almost every type of anxiety disorder but also to the expression of symptoms in such psychosomatic disorders as psychoggenic asthma and peptic ulcers now i’m not going to discuss psychosomatic disorders in this video because they are not reactive they are
15. 04:59 not the outcomes of abuse they have a different ideology somatization disorder however is often the result or the consequence of extreme anxiety extreme tension stress duress distress and therefore has a place in this video again we revert to the
16. 05:23 dictionary of the american psychological association which defines somatization disorder this way in the text revision of the fourth edition of the diagnostic and statistical manual the dsm a somatoform disorder involving a history of multiple
17. 05:40 physical symptoms at least eight one of which must be a pseudonurological symptom of several years duration for which medical attention has been sought but which are apparently not due to any physical disorder or to the effects of a substance such as a medication the
18. 06:00 complaints are often described in vague yet colorful or exaggerated terms by the patient who often appears anxious or depressed among the common complaints are feelings of sickliness difficulty in swallowing or walking malaise blurred vision abdominal pain nausea diarrhea
19. 06:21 painful or irregular menstruation sexual sexual indifference painful intercourse pain in the back or joints shortness of breath palpitations heart palpitations and chest pain somatization disorder was eliminated from the fifth edition of the diagnostic and statistical manual and
20. 06:40 was superseded by somatic symptom disorder which is defined this way somatic symptom disorder is a disorder characterized by one or more significant bodily symptoms for example pain that cause distress or impair daily function and by excessive maladaptive thoughts
21. 07:02 rumination or preoccupation or excessive worry about the symptoms with or without the presence of a medical condition to account for the symptoms included in the di in in the dsm one of two this this diagnosis is one of two replacement diagnosis for
22. 07:23 hypochondriasis somatic symptom disorder is determined based only on this set of criteria and does not also apply to high health anxiety that occurs in the absence of significant somatic symptoms for example in illness anxiety disorder in other words what the dictionary is
23. 07:42 saying you have general worry or anxiety about health conditions and that is illness anxiety and you have the same kind of background anxiety and worry and so on which manifest through the body through bodily symptoms somatic symptom disorder also replaces
24. 08:03 such diagnosis as somatization disorder requiring only one or two symptoms for diagnosis rather than the much higher symptom count so four pain symptoms two gastrointestinal symptoms one sexual one psycho neurological let’s go back in history to the
25. 08:24 inevitable ziggman freud who came up with the idea or with the diagnosis of conversion disorder in the diag in the fourth edition of the dsm conversion disorder was described as a somatform disorder in which patients present with one or more symptoms or
26. 08:44 deficits affecting voluntary motor and sensory functioning and these symptoms suggest a physical disorder but there is no evidence of um a medical condition similarly there is evidence instead of a psychological involvement in other words the physical symptoms are there but
27. 09:08 there is no medical background medical condition to justify them only some kind of psychological involvement or psychological background these conversion symptoms are not intentionally produced says the dictionary they’re not feigned and they’re not under voluntary control
28. 09:26 symptoms in conversion disorder can include paralysis loss of voice blindness seizures globus fingial a lump in the throat disturbance in coordination and balance and loss of pain and touch sensations generally speaking we distinguish between motor conversion symptoms and sensory
29. 09:49 conversion symptoms i’ll come to it in a minute the formal criteria for the disorder in the fifth edition of the dsm um refer to it as functional neurological symptom disorder and they primarily emphasize that there must be clear clinical evidence of symptom
30. 10:10 incompatibility with recognized neurological pathology before we can make a diagnosis of fnsd functional neurological symptom disorder which is another name for conversion disorder that there may also be psychological involvement in the onset
31. 10:30 of the symptoms or that stress or trauma of any sort either psychological or physical may have ideological relevance is recognized as among associated features that if found support diagnosis the absence of faking the absence of pretending the absence of
32. 10:49 feigning however is no longer a required criterion for diagnosis due to the clinical challenge of reliably discerning its absence so it seems that ziggman freud’s conversion disorder with its con attendant conversion symptoms has become enshrined and embedded in the fifth
33. 11:10 edition of the diagnostic and statistical manual but with an emphasis on a neurological background the question is are all these symptoms the outcomes of some true neur neurological dysfunction or deformity or abnormality or in the absence of such an abnormality
34. 11:31 are they the outcomes of stress and distress is there some psychological background or involvement the dsm recognizes that conversion symptoms or functional neurological symptom disorder could be definitely the outcome or the consequence of stress anxiety distress
35. 11:56 which are common reactions actually to abuse and trauma so i’m giving you the background the diagnostic background for what i’m going to say in the second part of the video the second part i’m going to focus on you how your body reacts to narcissistic abuse but i want to ground
36. 12:16 it in the orthodoxy in the mainstream um psychiatric thinking i mentioned that there are two types of conversion symptoms um two type of neurological dysfunctions one is moto one type is moto conversion symptoms and the other type is sensory we start with a moto conver conversion
37. 12:39 symptoms the dictionary defines it as one of two types of symptoms of conversion disorder the other being sensory conversion symptoms examples of moto conversion symptoms include impaired coordination and balance paralysis or weakness confined to a
38. 12:57 specific area of the body or limb difficulty in swallowing aphonia loss of voice and urinary retention sensory conversion symptoms include loss of touch or pain sensation double vision blindness deafness tinitus and hallucinations let’s go back a bit into much older
39. 13:23 history as i mentioned wilhelm stake who was a german psychoanalyst was the first to introduce the term somatization another psychoanalyst paul bri was the first to characterize what is now known as somatic symptom disorder bri actually reported that several of
40. 13:44 his clients have been unwell most of their lives they’ve been complaining of a variety of symptoms in various organ systems and bri kept scheduling appointments hospitalization tests nothing has been discovered and the symptoms continued bri was forced into the
41. 14:05 conclusion and we are talking of 19th century bri was forced into the conclusion that there is something like a somatic symptom disorder by the way also known as bri syndrome the conversion disorder came a bit later it was formally it was a formally diagnosed
42. 14:25 psychiatric disorder initially people reported abnormal sensory experiences and involuntary movement problems during periods of high psychological stress it took freud to realize the connection individuals diagnosed with conversion disorder presented with highly
43. 14:46 distressing neurological symptoms and freud was a neurologist he noticed that these people report numbness blindness paralysis convulsions and he couldn’t find an organic cause he traced all of these to psychological triggers today we do the same when we diagnose functional
44. 15:08 neurological disorder a similar diagnosis as i mentioned however in functional neurological disorder in the fifth edition of the dsm there is no need in the criteria no need to prove that there is an antecedent psychological stress or you could diagnose functional and
45. 15:31 neurological disorder or neurological disorder even in the absence of psychological stress abuse and trauma that’s not that has not been the case with conversion disorder where a psychological intrusion or invasion or trauma or abuse or whatever has been a
46. 15:50 necessary diagnostic criteria without which you could not diagnose conversion disorder it is still though the mainstream thinking is still that functional neurological neurologic disorder the symptoms arise in response to stressful situations affecting the
47. 16:14 patients mental health even though this condition has been rem removed in actual clinical practice it has be it’s proven time and again that patients summatize their stress their anxiety their tension their dissonance their abuse their trauma their uncertainty their
48. 16:35 unpredictability their terror they summatize it they convert all these they speak through their bodies they use their bodies to communicate this extreme discomfort and possibly fear individuals diagnosed with conversion disorder have a greater chance of experiencing other
49. 16:55 psychiatric disorders such as anxiety disorders mood disorders personality disorders so people with clear cleancut neurological disorders are rarely comorbid they are they rarely present with mental health issues people with conversion symptoms amounting to a
50. 17:16 conversion disorder very typically also present with other mental health issues such as anxiety or depression or even a reactive kind of personality disorder situational personality disorder so while the icd11 and the dsm5 retained the essence of conversion disorder and
51. 17:41 renamed it functional neurological symptom disorder as i said fnsd in the icd by the way it’s called dissociative neurological symptom disorder introducing the element of dissociation which is a major defense against trauma and abuse we slice off
52. 18:00 the memory of trauma we forget about it we repress it we bury it that’s dissociation and so while these two diagnostic manuals actually retained most of freud’s work most of the conversion symptoms renamed them renamed it renamed the conversion disorder into
53. 18:19 something else what they have done especially the dsm they have taken away the psychological anomnesis the psychological background the psychological ethiology of the conversion disorder and that’s in my view a serious mistake i think it’s counterfactual actually in a desperate
54. 18:41 attempt to resemble medicine psychology is dumping critical insights that have been accumulated over more than a century y fnsd covers a similar range of symptoms found in conversion disorder as i said and the dumping the requirement for psychological stress or
55. 19:06 stressors to be present is in my view wrong as i just said as well the new criteria also dispense with the issue of faking or feigning or pretending you could fake and feain and pretend and still be diagnosed and there is also an issue with sexual functioning as you know freud was
56. 19:31 fixated on the sexual ethiology of many problems and disorders in his patients he first he first called it hysteria then he used other names and so on and echoes and and and traces of freud’s kind of obsession with sexual ethology do remain um in the in the fourth edition of the
57. 19:58 dsm for example one of the diagnostic criteria was a limitation in sexual functioning this has been removed in the fifth edition of the diagn of the dsm the icd11 classifies the classifies it as i mentioned um classifies dissociative neurological symptom
58. 20:20 disorder dnsd as a dissociative disorder with unspecified neurological symptoms icd therefore is much closer to reality as usual and reflects the latest knowledge as usual the dsm is antiquated and frequently wrong frankly speaking so the icd recognizes that in response to
59. 20:43 trauma and abuse one of the most typical reactions of the victim is to dissociate and this this dissociation this bearing of the trauma this repression of the trauma can erupt and manifest through the body in with especially with all kinds of unspecified neurological
60. 21:07 symptoms conversion disorder in freud’s work and later work presented with symptoms following exposure to a certain stress or typically associated with trauma or psychological distress the physical symptoms of the dis disorder affected senses or motion as i mentioned
61. 21:25 movement and common symptoms included blindness partial partial or total paralysis inability to speak deafness numbness difficulty to swallowing incontinence balance problems non-epileptic seizures tremors difficulty walking you name it these
62. 21:42 were all bodily manifestations today we know of many more and for those of you who want a comprehensive list i recommend that you watch the second part of this video dedicated specifically to narcissistic abuse uh phenomena such as shortness of breath chest pains are also today
63. 22:04 indicated as a part of conversion disorder part of conversion symptom even sleep paralysis is today considered to be a conversion symptom both sleep paralysis and epilepsy um can be ruled out in sleep tests in a laboratory and so when a neurological background is ruled out
64. 22:27 what is left is a conversion symptom something psychological when a medical explanation fails there’s no medical explanation for the conditions then what is left is freud’s work the conversion the idea of conversion symptoms of conversion disorder usually occur suddenly
65. 22:46 conversion disorder is typically observed in people between 10 and 35 and affects something like 0.5% of the general population we are not talking about a small number but all these numbers deal with endogenous endogenous symptom disorders in other words symptom disorders that
66. 23:06 are not reactive to the environment symptom disorders for example that are not the outcome of abuse or trauma and so on i believe although there are no definitive studies and no clear-cut evidence i believe anecdotally and from my three decades of experience working
67. 23:25 with victims of narcissistic abuse i believe that the percentage of victims who summatize who react with somatic symptoms bodily symptoms to abuse and trauma is way higher than 0.5% i would venture to say that they are the majority actually conversion disorder
68. 23:52 um is something that cannot be denied or
69. 24:00 ignored because so many victims have reported it over the years and decades and conversion symptoms typically do not conform to any known anatomical pathway physiological mechanism biochemical knowledge i mean there’s no way we can explain a conversion classical
70. 24:23 well-defined conversion symptom except by realizing that there has been some psychological malfeasants some abuse some trauma some torture it is sometimes been stated that presenting symptoms tend to reflect the patient’s own understanding of anatomy
71. 24:43 and the less medical knowledge a person has the more implausible and colorful the presenting symptoms that may be true it’s not a substantiated claim there’s not proof of this but there are there is some anecdotal evidence and this makes the idea of conversion symptom even more
72. 25:03 compelling the complaints of the patients who are victims of abuse and torture and distress and so on the complaints are so outlandish so not grounded in medical knowledge that clearly whatever is happening in their bodies has nothing to do with a medical condition it’s a
73. 25:22 psychological condition sexual dysfunction and and pain binismos and so on were also considered symptoms of conversion disorder but if a patient only has these symptoms they should be diagnosed as sexual pain disorder or pain disorder so this alone is not
74. 25:39 enough and this is of course where freud initially was wrong let’s go back to functional neurologic disorder or functional neurological disorder again as i mentioned it’s a condition where the patients experience neurological symptoms weakness movement problems
75. 25:55 sensory symptoms convulsions you name it it’s a functional disorder as the name implies so by definition no known disease process affecting the structure or the functioning of the body exist and yet the person experiences symptoms related to body functioning and keep
76. 26:16 complaining symptoms of this kind of disorder function functional neurological disorders are typically clinically recognizable but are not categorically associated with any definable organic biochemical or physiological disease so there is a contrast here between
77. 26:37 functional neurological problems and organic brain syndromes or traumatic brain injury where the pathology the disease process which affects the body’s physiology can be identified it is very lamentable that medical doctors and psychiatrists reject the accounts of
78. 26:59 victims of abuse pathize them with some concocted cockamini medical condition and send them home with pills it’s very very wrong to do that to refuse to recognize the psychological background of symptom disorders or somatic symptom disorders is wrong both diagnostically
79. 27:24 but also as a practice we invalidate the the victim by converting her into a malinger or a faker or into someone with a neurologically recognized neurological condition which does not exist in the vast majority of cases of victims of abuse medical tests yield nothing and
80. 27:50 there’s no reason to insist on reductionism everything is the brain everything is the body yes it manifests through the body yes it involves the brain but it’s not reducible to either it’s a psychological condition holistic and so today victims get very little suck and help
81. 28:13 and understanding and acceptance from the medical professions because there is a refusal to to acknowledge there is a denial of the pathway between psychology and body mind and body it’s as if the mind is nothing but a bodily function when manifestly and
82. 28:37 expressly and patently it’s not it cannot be reduced to the body only it can work through the body it can talk the mind can talk through the body the mind can manifest through the body but it’s not conccommittant it’s not coaxant it’s not the same as the
83. 28:57 body there are subsets of functional neurological disorders which include functional movement disorders and functional seizure seizures and functional sensory disorders it’s all very true and yes the doctor the medical doctor the psychiatrist who is also a
84. 29:13 medical doctor they have to invest a lot of effort in testing eliminating diagnosing writing down anesthesis exploring like detectives the ethiology perusing the symptoms constructing all kinds of tests to see how the patient functions in a variety of settings and
85. 29:33 circumstances and environments and reactions to other people and so they have to work hard they have to work hard because conversion symptom is a simulation conversion disorder is a simulation it’s an imitation the patient cannot verbalize sufficiently or doesn’t dare to
86. 29:54 acknowledge or to be conscious of what is happening to her the abuse the trauma the patient denies the abuse and trauma and so this hidden this hidden buried repressed knowledge has to manifest somehow has to be communicated somehow has to erupt somehow and what the
87. 30:15 patient does she imitates other conditions other conditions which are medical and have nothing to do with trauma and abuse thereby attempting trying to convince herself that the the problem is not trauma the problem is not abuse the problem is a brain the problem
88. 30:33 is a spine the problem is a whatever her body is a problem it’s a form of autoplastic defense it’s like the patient says um nothing bad is happening to me nothing wrong i’m being treated fairly and and squarely and nicely and you know it’s my my problem i’m the one i’m
89. 30:54 guilty i’m to blame my body my body is wrong is is working you know in all the wrong ways i’m defective i’m deformed i am the core of the problem not the solution and so it is displacing the blame and the guilt shifting it to the victim and the victim is the one who is doing this
90. 31:17 via somatic symptom disorders so as if the victim is assuming the responsibility and the accountability for the abuse internalizing it digesting it and letting it poison hers poison her body and the body rebels the body not only keeps it score but it
91. 31:39 rebels somatic symptom disorders is a rebellion an eruption of the body against this unjustified assumption of responsibility for being mistreated for being abused for being traumatized for being tortured for being tormented
92. 32:03 uh there are there’s a great number the problem with conversion disorders and somatic symptom disorders that the number of symptoms is huge because the patients or the victims are very creative and any any part of the body any organ any system any limb any surface area any
93. 32:25 anything can serve as a communication channel anything can be recruited to express the inexpressable to communicate and discuss the horror of abuse and trauma so the number of symptoms is literally unlimited in functional neurological disorders and conversion disorders
94. 32:49 somatic symptom disorders the symptoms are very real their experience is real they have impact on the impact adverse outcomes adverse impacts on the body but the origin the ethology is much more complex because it involves a dominant component dominant ingredient of
95. 33:09 psychology severe psychological trauma um the neurological dysfunction is idiopathic but the ideology is very often psychological the core symptoms are sensory and motoric but they still try to somehow symbolically communicate the trauma and abuse
96. 33:35 background which was freud’s initial insight that it is a language actually or limb weakness paralysis non-epileptic seizures movement disorders tremors donia spasms uh myoclonus jerky movements loss of vision double vision um dysphonia whispering speech slurred or stuttering
97. 33:59 speech sensory disturbances hemisensory syndrome altered sensation down one side of the body numbness inability to sense touch dizziness balance problems pain extreme extreme slowness and fatigue etc etc and of course sleep disorders it’s it’s an endless array and require very
98. 34:20 lengthy and profound investigations which many doctors assue because they don’t want to they don’t want to get involved they want to be invested they want to dispense pills and collect the commission on the side of course stressful life events and childhood
99. 34:34 neglect were found time and again in numerous systematic reviews and meta analysis time and again to be significantly more common in patients with functional neurological disorders than in in the general population patients with functional neurological
100. 34:51 disorder conversion disorders somatic symptom disorder call it as you will patients with somatization with somatic symptoms there is almost invariably a background of adverse childhood experiences stressful life events childhood neglect childhood
101. 35:12 abuse even when the patients report counterfactually and erroneously no stressors they have buried and denied what’s happening to them to the extent that they’re happy golucky you say “my partner is the best partner in the world.” when we’re talking about a
102. 35:29 narcissist an abusive narcissist or i’m to blame i’m constantly sick and so on he’s he’s a saint for having stayed with me and they deny there’s a lot of denial denial of course is a psychological defense mechanism somatic symptom disorder somatform disorder somatization disorder
103. 35:49 it’s is chronic in in conditions of abuse and trauma as long as the abuse and trauma continue the somatic reaction is likely to endure and it involves not only the body in the vast in the majority of cases of somatization we find we find excessive and maladaptive
104. 36:14 thoughts emotions behaviors connected to these symptoms it’s a maladaptations the symptoms are not deliberately produced they’re not faint they’re not faked and um they don’t coexist with a medical ailment so they are they go hand in hand with cognitive impairment cognitive
105. 36:36 distortions emotional dysregulation all the parameters and clinical features of of personality disorders for example cluster b manifestations of somatic symptom disorders are variable symptoms can be widespread specific fluctuated i i mentioned this before but they
106. 36:53 correspond to the way an individual views and reacts to symptoms rather than to the symptoms themselves the individual who is subjected to torture and abuse and trauma on a recurrent basis there’s no escape the individual develops a relationship with the
107. 37:12 symptoms a relationship with the body because the symptoms are relief valves they allow the individual to obtain relief from the impossible environmental conditions the symptoms become friends while the body becomes the enemy it’s a very bizarre triangle where the patient
108. 37:34 encourages the symptoms uh hones the symptoms dotes on the symptoms loves the symptoms nurtures them develops them elaborates them and so on even as the patient resents her body for tormenting her and putting her through u all the symptoms that she has to endure the body
109. 37:57 therefore becomes unconsciously identified with the abuser whereas the symptoms become unconsciously identified with the victim and it is this dichotomy between relatedness to the body and relationship with the symptoms which is the greatest diagnostic and
110. 38:17 clinical indication of a symptom disorder somatic symptom disorders may develop of course also in people who have chronic illnesses or medical conditions and so on but we should always rule out we should always study and ask and insist on ascertaining
111. 38:36 whether there is a psychological background whether there is something behind the scenes that may provide a better explanation than the medical condition um to wrap it up in the fifth edition of the diagnostic and statistical manual somatopform disorders have been modified
112. 38:59 and now they are called somatic symptom and related disorders there other modifications the criteria in the dsm5 involve one or more somatic symptoms which are distressing or result in substantial impairment of daily life the b criteria include excessive thoughts
113. 39:17 feelings or behaviors regarding somatic symptoms or corresponding health concerns manifested by disproportionate and persistent thoughts about the severity of one’s symptoms although anyone summatic symptom might might not be consistently present one’s state of
114. 39:35 being symptomatic is continuous and typically lasting more than six months the dsm5 includes five descriptions five distinctions of somatic symptom disorders these include somatic symptom disorder with predominant pain uh which used to be called pain disorder by the
115. 39:54 way as well as classifications for mild moderate severe symptoms and so on you can find all this in the dsm5 the international classification of diseases includes bodily distress disorder which bears similarities to somatic symptom disorder so bodily distress disorder involves
116. 40:12 somatic symptoms uh but it appears to be more strongly associated with the experience of physical symptoms whereas somatic symptom disorder is more closely linked to psychological distress so in the icd11 bodily distress disorder is actually probably some kind of
117. 40:36 neurological or medical condition and therefore we should not use bodily distress disorder to diagnose conversion disorder if we want to do that we can use somatic symptom disorder in the dsm5 or other diagnosis in the icd1 patients that meet the criteria for
118. 40:58 both diagnosis tend to exhibit greater symptom severity across various psychosocial domain so um this is where we stand nowadays as i mentioned studies have found coorbidities especially with major depressive disorder generalized anxiety disorder phobias and so on so forth
119. 41:24 somatic symptom disorder and functional pain syndromes like fibromyalgia irritable bowel syndrome and so on they’re all very common dual diagnosis and it all leads to poor functioning interpersonal issues unemployment or problems at work financial strain
120. 41:46 excessive health care visitations it all leads to pervasive dysfunction in the in the life of the of the patient or the victim of abuse the cause the ethology of somatic symptom disorder is still hotly debated as i said uh maybe in some cases there
121. 42:07 is a heightened awareness of specific physical sensations in other cases there’s a problem with the interpretation of experiences as signs of medical ailment what used to be called hypochondriasis or illness anxiety but still the majority they have a psychological background
122. 42:30 and to ignore this psychological background would be wrong one of the key features of somatic symptom disorder is the inconsistent history of symptoms the patient complains complains the victim of abuse complains makes one type of complaint on on wednesday and another type of
123. 42:56 complaint on friday and sometimes they’re mutually exclusive the symptoms are in flux all the time they’re protein they keep changing shape and phase and presentation and this can never happen in a true medical condition additional signs include interpreting
124. 43:15 normal sensations for medical ailments avoiding physical activity or constriction being disproportionately sensitive to medication side effects and seeking medical care from several physicians for the same concerns manifestation of somatic symptom disorder are very variable so
125. 43:36 recurrent ailments usually begin and then abate and then begin again with totally different symptoms most patients have a multiplicity of symptoms to choose from it’s like a library they lend different books at different times others experience only one symptom consistently
126. 43:56 and again probably there’s a psychological background for this the severity fluctuates but the symptoms rarely go away completely for long periods of time symptoms might be specific regional pain localized sensations or they might be general
127. 44:12 fatigue muscle aches malaise you name it the sufferers the victims the patients experience recurring and obsessive feelings rumination constant thoughts concerning their own well-being and these thoughts escalate all the time there’s an element of catastrophizing negative
128. 44:35 affectivity and so severe anxiety sets in and it leads to misinterpretation of normal sensations as severe illness there is a belief that the symptoms are dangerous and life-threatening even when the when doctors tell the patient that there’s no such thing
129. 44:55 uh many patients develop paranoid ideiation they claim that medical doctors and medical evaluations and medical treatment have been inadequate or criminally negligent and they fear that engaging in physical activity will harm the body or spending a
130. 45:12 disproportionate amount of time um uh thinking about the symptoms while avoiding actual medication somatic symptom disorders pertains to how how an individual interprets and responds to symptoms not to the symptoms themselves it is therefore a form of cognitive
131. 45:32 distortion which of course is very common in victims of abuse cognitive distortion is one of the main mechanisms that victims of abuse deploy and employ in order to cope with every possible condition with the entrapment the trap they found themselves in somatic symptom
132. 45:53 disorders can occur um and do occur whenever the patient feels the need to rearrange reality to reframe it to build an alternative theory about the world about the intimate partner about relationships in general and so on in this process of reconstructing cognition and cognitive
133. 46:16 cognitive processes in this process cognitive distortion is a distinct possibility when you’re trying to make sense of senseless abuse of meaningless trauma of crazym of acting out of insanity when trying to make sense of all this of the misbehavior of your intimate partner of
134. 46:38 uncertainty unpredictability intermittent reinforcement fantasy crazy situations you know maternal projections when you’re trying to make sense of all this you’re bound to get some things wrong and when you get these things wrong you engage in phys in cognitive
135. 47:00 distortions this you’re losing your reality testing becomes impaired and the general idea is to provide relief from anxiety this kind of approach is anxolytic it reduces dissonance by falsifying reality in effect the reality out there and the reality in here with your
136. 47:23 body so these patients are usually unresponsive to treatment and unusually they so they’re usually unresponsive and you unusually sensitive to the side effects of drugs people with somatic symptom disorder um experience significant impairment
137. 47:44 even when they have a medical condition their reaction to the medical condition is hyperbolic and exaggerated so i want to make clear all studies show that such people have a background of childhood trauma insecure attachment negative psychological factors
138. 48:10 catastrophizing negative affectivity rumination avoidance health anxiety and a poor physical self-concept and all these psychological factors have a significant impact and in the development of problematic somatic symptoms up to the point of debilitation
139. 48:31 paralysis somatic symptom disorder always escalates as long as there is exposure to the psychological triggers like abuse and trauma the only way is to remove the victim or to remove the patient from the traumatizing and abusive environment people who experience more
140. 48:52 negative psychological characteristics inevitably regard medically unexplained symptoms to be more threatening they exhibit stronger cognitive emotional and behavioral awareness of these symptoms and they tend to falsify falsify reality falsify
141. 49:11 their relationship with their own body lie reframe selfdeception is a critical feature in this evidence suggests that negative psychological factors have a significant impact on the impairments and behaviors of people suffering from somatic symptom disorder as well as
142. 49:27 long-term stability of these symptoms so this is the general background now let’s head into the second part of this video which deals with how specifically narcissistic abuse typically affects your body i can’t say have
143. 49:48 fun my name is sam baknin um i’m a professor of psychology and the author of malignant self-love narcissism revisited and a series of other books and ebooks about personality disorders uh philosophy and allied topics i was very surprised recently when i
144. 50:09 found out that there’s a lot of material online numerous numerous innumerable videos and texts and articles and papers and on various forms of abuse such as sexual abuse and sexual assault verbal abuse mental abuse psychological abuse even financial abuse and legal abuse
145. 50:34 but there’s very little of substance in depth about physical abuse battering assault physical assault and so i rush to the bridge and in today’s video i will try to deal with two issues the first one what are the effects of physical abuse on the intimate partner on the victim
146. 51:05 and the second question is how does society react to physical abuse battering and physical assault when it is within the confines of the diet when it is within a couple when it’s in a marriage so issues such as marital rape a pretty novel idea only in the past few
147. 51:27 decades did we come to the realization that rape can take place inside a marriage issues such as where is the boundary where’s the limit between a reasonable expected expression of physical aggression and uh physical assault is there such a thing is there a legitimate
148. 51:50 way to express physical aggression what if i break objects smash things is that okay etc etc so how society views this issue is the second part of the video the first part of the video is the most recent knowledge about how physical abuse affects
149. 52:10 um the battered the assaulted party and i would like i would like to start with a with a quote from one of my favorite authors on the topic he wrote an a seinal essay called understanding the batterer in visitation and custody disputes his name is lambi bankrupt and
150. 52:31 he sums up the asymmetry in favor of the offender and this is what he says batterers people who are who physically assault others batterers adopt the role of a hurt sensitive man who does not understand how things got so bad and just wants to work it all out for the good of the
151. 52:53 children this man may cry and use language that demonstrates considerable insight into his own feelings he’s likely to be skilled at explaining how other people have turned the victim against him and how she is denying him access to the children as a form of revenge the
152. 53:14 batterer commonly accuses her his intimate partner of having mental health problems and may state that her family and friends agree with him that she is hysterical and that she is promiscuous the abuser tends to be comfortable lying having years of practice and so can
153. 53:35 sound believable when making baseless statements the abuser benefits when professionals believe that they can just tell who is lying and who is telling the truth and so these professionals fail to adequately investigate because of the effects of trauma the
154. 53:55 victim of battering will often seem hostile disjointed and agitated while the abuser appears to be friendly articulate and calm evaluators are thus tempted to conclude that the victim is the source of the problems in the relationship.” end quote land bankroft
155. 54:16 bankroft go online and find anything he has ever written but physical abuse physical assault including sexual assault if it is very violent and aggressive what does it do to the victim what does it do to the affected party i’m not going to focus on trauma ptsd
156. 54:42 cptsd there are other videos that i’ve made which deal with this aspect trauma is a delayed reaction it’s not immediate trauma is the outcome of processing the assault processing the violation of one’s boundaries of processing the invasion and processing the humili humiliation in
157. 55:03 some ways narcissistic injury or motification to the individual so trauma is a delayed reaction nor is trauma universal many people do not get traumatized um so trauma is highly idiosyncratic highly specific to certain individuals with predisposition for
158. 55:24 trauma we i’ve discussed all this in other videos today what i want to discuss is what physical abuse does to the relationship between the victim and her body there is one place in which one’s privacy intimacy integrity and inviability are guaranteed it’s one’s
159. 55:48 body one’s body is a unique temple a shrine a familiar territory of sensor sensory input and personal history what happens the assaulter the batter the the torturer is let’s let’s call a spade a spade repeated continuous physical abuse and sexual abuse
160. 56:13 aggressive violent sexual abuse and physical abuse physical assault that are coupled with intimidation intermittent reinforcement trauma bonding a hostage stockholm syndrome situation this is torture this is exactly what torturers do um on behalf of governments when they torture
161. 56:36 i don’t know terrorism suspects torture is exactly this the confluence the congruence and the collusion of a psychological dimension and a physical dimension where the physical is a mere reification or manifestation or expression of implied psychological signaling and messaging
162. 56:59 you are a nothing you are a non- entity you have no boundaries and no protection from me i can invade you at any time i can do anything i want to you it’s a horror film and so i’m going to use the word torture if you don’t mind the assaulter the batterer the torturer invades
163. 57:21 defiles desecrates this shrine the body and he does it usually publicly most domestic violence and family violence take takes place in the presence of witnesses usually children but not only children parents of the assaulted party friends of the assaulted party family of
164. 57:44 the assaulted party neighbors so most most of these attacks um take publicly take place publicly deliberately repeatedly and often sadistically and involve usually some sexual dimension or at least erotic dimension they contain an element of undisguised
165. 58:06 pleasure it’s not the pleasure in attacking the other party it’s not the pleasure in causing pain that would be pure sadism it’s the pleasure of omnipotence it’s the pleasure in in establishing a power hierarchy a power matrix the torturer the abuser the
166. 58:26 harasser the the batterer he’s on top he’s top dog it’s it’s the submissiveness of the victim that turns him on it’s a power play exactly like rape rape is not about sex it’s about power and so there’s an all pervasive longlasting and frequently irreversible
167. 58:47 effects and outcomes both to the victim and equally importantly to the abuser because physical abuse is habituating it triggers a dopamine loop in the brain it causes pleasure omnipotence is a pleasurable experience and so the abuser wants more he is incentivized by his own
168. 59:11 brain to abuse even more and more in a way the torture victim’s own body is rendered her worse enemy you see it’s it’s the abuser it’s the attacker that causes the pain but the corporeal agony is experienced by the body and in a way the victim begins to resent her
169. 59:38 body it’s it’s very childish there’s a lot of magical thinking here primitive thinking it’s like the abuser is angry at the body resents the body why do you cause me pain why don’t you resist the abuse effectively by not causing me pain it’s this agony that compels the sufferer to
170. 59:58 mutate the identity of the victim fragments her ideals and principles crumble the body becomes an accomplice of the tormentor accomplice of the abuser they both work together to cause the victim pain agony it is an uninterruptible channel of communication
171. 60:18 to the victim it’s a tresinous poison territory the body becomes a fifth column a traitor and so this this f fosters a humiliating dependency of the abused victim on the perpetrator she becomes dependent on the perpetrator you see in in in most cases
172. 60:41 of domestic violence and family violence bodily needs are denied for example many uh victims of physical abuse will tell you that they are afraid to go to sleep they’re afraid to fall asleep many of them avoid going to the toilet because they’re afraid to emerge
173. 61:02 to the unknown to the unpredictable to the capricious and arbitrary and and and horrorike film disjointed reality many of them forgo food because meals family meals are usually cause trigger for physical assault so many bodily needs the victim denies her bodily needs and they are
174. 61:26 wrongly perceived by the victim as the direct causes of her degradation and dehumanization as she sees it the the bo
175. 61:37 she is rendered bestial she’s rendered animalistic not by the sadistic bully her spouse or her boyfriend or whoever is not by the sadistic bully but by her own flesh and blood her own body betrays her turns on her turns against her she can’t trust her body anymore there’s a
176. 61:59 relationship of mistrust and distrust the very concept of body can easily be extended to family or to whom torture is often applied not only to the spouse but to kin and kith to children to the children to you know the spouse’s parents her brother siblings whatever even colleagues
177. 62:26 and the typical physical batterer the typical abuser intends to disrupt the continuity of surroundings habits appearance relations with others this quote that i just used is from the cia the cia being the savory organization that it is published a manual about
178. 62:48 torture where it advises torturers and tormentors um how to disrupt the continuity and therefore the identity of the victim a sense of cohesive selfidentity depends crucially on the familiar on the benevolent on the continuous you have to believe that people around you are
179. 63:10 essentially good yes they can behave immorally they can make mistakes they can even sometimes deceive you or betray you but essentially they’re good this belief is very often counterfactual when it comes to the abuser the abuser is not good is malicious malevolent by
180. 63:31 attacking both one’s physical body and one’s social body the victim’s psyche is strained to the point of dissociation and breaking there’s a um scholar by the name of beatatrice patalides and she describes this transmogrification in her war in her
181. 63:54 essay ethics of the unspicable torture survivors in psychoanalytic treatment she writes and quoting “as the gap between the i and the mi deepens dissociation and alienation increase the subject that under torture was forced into the position of a pure
182. 64:16 object has lost her sense of inter interiority intimacy and privacy time is experienced now in the present only and perspective that which allows for a sense of relativity is foreclosed thoughts and dreams attack the mind and invade the body as if the
183. 64:40 protective skin that normally contains our thoughts gives us space to breathe in between the thought and the thing being thought about as if this skin separates this skin falls falls away it separates between the inside and the outside the past and the present the me
184. 65:00 and the you and this skin was lost torture robs the victim of the most basic end of quote yeah torture robs the victim of the most basic modes of relating to reality it is the equivalent of cognitive death space and time are warped by for example sleep deprivation and by the
185. 65:27 lack of predictability we perceive our surroundings our environment via habits and via models in the brain models of cause and effect a leads to b if i do x i will get y physical assault physical battering they disrupt this continuity they disrupt the rationality they
186. 65:53 disrupt the reason behind the world the world becomes to use jordan peterson’s term chaotic there’s chaos the self the eye is shattered the tortured party have nothing familiar to hold on to not family not home not personal belongings not loved ones not language even some
187. 66:19 abusers physical abusers react when the victim uses her name it seems to trigger them for some reason gradually the victims lose their mental resilience their sense of freedom and who they are they feel alien unable to communicate unable to relate to
188. 66:39 attach to empathize with other people there’s a marked decline in empathy by the way among torture victims it’s very similar to people with chronic illness chronic illness is also perceived to be an attack on the body covid 19 is an attack on your body with which your body
189. 66:56 is collaborating torture splinters early childhood grandio narcissistic fantasies of uniqueness omnipotence invulnerability impenetrability and most importantly lovability that you can be loved but physical assault enhances the fantasy of merger with an idealized and
190. 67:22 omnipotent though not benign other the infltor of the agony that’s the sad irony trauma bonding stockholm syndrome it’s a sad irony the more you’re tortured the more you’re bullied the more you’re physically attacked the more you’re hurt the more you’re wounded
191. 67:38 the more you end up in hospital the more you get attached to the person who is doing this to you the twin processes of individuation and separation are are reversed by physical assault because it’s like the bodies merge the body of your attacker and your
192. 67:58 body are collaborating they become a single organism single entity of pain torture isn’t the ultimate act of perverted intimacy the torturer invades the victim’s body pervades her psyche possesses her mind deprived of contact with others starved for human
193. 68:24 interactions typically the prey the bond the victim bonds with the only person around the predatory assaulter the predatory attacker her abuser traumatic bonding akin to stockholm syndrome is about hope actually it’s about the search for meaning in the brutal and
194. 68:45 indifferent and nightmarish universe of the torture cell usually the family the family unit so the abuser becomes like a black hole at the center of the victim’s surrealistic galaxy the abuser sucks in the victim’s universal need for solace her suffering
195. 69:08 he feeds on her suffering the victim tries to control her tormentor to control the attacker by becoming one with him by merging and fusing with him by interrogating him and by appealing to the monster’s presumably dormant humanity and empathy and this bond bonding is especially
196. 69:32 strong when the torture and the tortured form a dieout when they are really attached to each other it’s a common myth that stalkers abusers batterers and so on are not attached to their prey they are even more attached than in a typical relationship hate
197. 69:53 aggression are a glue that is stronger than love and so the bonding is very strong and the diet is very powerful and so the victim seeks to collaborate in the rituals and acts and ceremonies of torture for example when the victim is coerced sometimes into selecting the torture
198. 70:18 implements and the types of torment to be inflicted or to choose between two evils or to participate in sex acts that she finds abhorent and and painful
199. 70:32 the psychologist shirley spitz offers this powerful overview of the contradictory nature of torture in a seminar titled the psychology of torture in 1989 i’m quoting “trulture is an obscenity in that it joins what is most private with what is most
200. 70:51 public torture entails all the isolation and the extreme solitude of privacy with none of the usual security embodied therein torture entails at the same time all the self-exposure of the utterly public with none of its possibilities for camaraderie or shared
201. 71:13 experience the presence of an all powerful other with whom to merge without the security of the others benign intentions a further obscenity of torture is the inversion it makes of intimate human relationships the interrogation is a form of social
202. 71:32 encounter in which the normal rules of communicating of relating of intimacy are manipulated dependency and its needs are elicited by the interrogator by the abuser by the attacker by the assaulter but not so they may be met as in close relationship but in order to weaken and
203. 71:55 confuse independence that is offered in return for betrayal is a lie silence is intentionally misinterpreted either as confirmation of information or as guilt for complicity torture combines complete humiliating exposure with utter devastating isolation the final products
204. 72:18 and outcomes of torture are a scarred and often shattered victim in an empty display of the fiction of power end
205. 72:30 quote obsessed by endless ruminations demented by pain and a continuum of sl of sleeplessness the victim regresses goes back to childhood shedding but all all but the most primitive defense mechanisms splitting narcissism dissociation projective identification
206. 72:51 introjection and cognitive dissonance all the rest are deleted in other words physical assault battery induces what we call decompensation the victim constructs an alternative world often suffering from depersonalization and derealization uh amnesiac amnesiac dissociation
207. 73:17 hallucinations ideas of reference delusions and even psychotic episodes sometimes the victim comes to crave pain crave pain mistically very much as self-mutilators do because it is a proof and a rem reminder of her individuated existence otherwise blurred by the
208. 73:38 incessant torture in other words the more physically you are attacked the more you are raped the more you are abused battered broken beaten the more sometimes you get addicted to the pain the more you crave the pain because it’s only when you when
209. 73:55 you are in pain in agony and anguish that you feel alive the rest of the time you feel dead or suspended or disanimated somehow in a vegetative state comes pain wakes you up pain shields a sufferer from disintegration and capitulation it keeps you keeps you
210. 74:14 alive and resistant it enhances resilience it preserves the veracity of her unthinkable and unspeakable experiences it proves to you that you are right the abuser is wrong pain is a certificate of virtue this dual process of the victim’s alienation and addiction to anguish
211. 74:36 this process complements the perpetrator’s view of his quarry as inhuman or subhuman the abuser the attacker the torturer assumes a position of the sole authority the exclusive found and source of meaning and interpretation the the fountain head of
212. 74:56 evil and good godlike torture is about reprogramming the victim to succumb to an alternative interpretation exaces of the world the abuser comes to the victim the attacker the batterer the bitter the wife be bitter comes to the to the victim and says “listen i’m
213. 75:22 going to use your body to alter your mind it is an act of deep indelible traumatic indoctrin indoctrination brainwashing the abused the victim also swallows whole and assimilates her attackers her abusers negative view of her and often as a result is rendered suicidal
214. 75:48 self-destructive self-defeating so torture has no cut off date once you are physically assaulted even in a single incident by the way let alone over many years the sounds the voices the smells the sensations the emotions attendant on that incident
215. 76:10 reverberate in your mind like e in an echo echo chamber long after the episode had ended you experience nightmares but also in waking moments the victim’s ability to trust other people to assume that their motives are at least rational if not necessarily benign this trust is
216. 76:31 irrevocably undermined shattered broken you know social institutions are perceived as precariously poised on the verge of an ominous kafka-esque mutations mutation when i say social institutions i mean also the family nothing is e either safe or credible anymore
217. 76:51 victims typically react by undulating oscillating between emotional numbing and increased arousal insomnia irritability restlessness attention deficits these are not these are not the result of numbing on the contrary they are the result of an excitatory state
218. 77:09 adrenaline infused body fight or freeze or fall recollections of the traumatic events intrude in the form of dreams night terrors flashbacks distressing associations the victim the tortured develop compulsive rituals to fend off obsessive thoughts intrusive thoughts
219. 77:30 other psychological squila reported include cognitive impairment reduced capacity to learn i’m talking about the victim yeah after she’s habitually sexually molested uh physically attacked or both so she develops cognitive impairment reduced capacity to learn memory disorders
220. 77:52 sexual dysfunction social withdrawal inability to maintain long-term relationships or or even mere intimacy phobias like agorophobias ideas of reference and superstitions delusions hallucinations psychotic micro episodes and emotional flatness depression and anxiety of
221. 78:11 course are very common these are forms and manifestations of self-directed aggression victim is very angry at herself for having placed herself in the tortured chamber the sufferer rages at her own victimhood and the resulting multiple dysfunctions she feels ashamed by her
222. 78:32 new disabilities and she feels responsible or somehow even guilty for her predicament and the dire consequences borne by her nearest and dearest her sense of self-worth and self-esteem are crippled sometimes for good in a nutshell victims of physical assault
223. 78:53 suffer from post-traumatic stress disorder or cptsd if if the assault takes place over protracted period of time and there many repeated incidents their strong feelings of anxiety guilt and shame are also typical of victims of childhood abuse
224. 79:10 domestic violence of other forms and and rape these victims feel anxious because the perpetrator’s behavior is seemingly arbitrary and unpredictable or mechanically and in inhumanly regular robotic victims feel guilty and disgraced because to restore a semblance of order
225. 79:31 to their shattered world and a modicum of dominion over over their chaotic lives the victims need to transform themselves into the cause of their own degradation and the accompllices of their tormentors they lie to themselves they say all this happened to me i made
226. 79:50 it happen i was the cause i provoked him i provoked him that’s why he’s misbehaving and you remember the videos i’ve made about mortification sometimes when you can’t accept when you cannot accept that you had been victimized you you compensate by telling
227. 80:10 yourself i have been victimized justly i deserved it i had it coming i made it happen that way you cheat yourself you deceive yourself into believing that you’re in control the aforementioned charitable organization the cia in its human resource
228. 80:28 exploitation training manual dated 1983 and reprinted reprinted in the april 1997 issue of harper’s magazine summed up the theory of coercion this way mind you it’s the cia the purpose of all coercive techniques is to induce psychological regression in
229. 80:51 the subject by bringing a superior outside force to bear on her will to resist regression is basically a loss of autonomy a reversion to an earlier behavioral level as the subject regresses her learned personality traits fall away in reverse chronological order
230. 81:13 she begins to lose the capacity to carry out the highest creative activities to deal with complex situations or to cope with stressful interpersonal relationships or repeated frustrations trust the cia to get it right inevitably in the aftermath of
231. 81:31 physical assault or torture the victims feel helpless powerless impotent and this loss of control over one’s life and body is manifested physically sometimes in erectile dysfunction or impotence binismos attention deficits insomnia and this is often exacerbated by the
232. 81:51 disbelief disbelief of many victims torture victims physical abuse victims battering victims uh victims and counter disbelief when they try to recount their experiences when they try to describe what had happened to them they are not believed
233. 82:12 they’re rejected especially if they are unable to produce scars and show scars or other objective proof of their ordeal this happens a lot to rape victims language cannot communicate such an intensely private experience as pain back to speech she makes the following
234. 82:33 observation pain is also unsharable cannot be shared in that it is resistant to language all our interior states of consciousness emotional perceptual cognitive and somatic can be described as having an object in the external world this affirms our capacity to move
235. 82:52 beyond the boundaries of our body into the external sharable world this is the space in which we interact and communicate with our environment but when we explore the interior state of physical pain we find that there is no object out there no external referential
236. 83:09 content pain is not off or for anything pain is and it draws us away from the space of interaction the sharable world inwards it draws us into the boundaries of our own body and so bystanders observers resent the tortured victim resent the victim because the
237. 83:31 victim makes them feel guilty and ashamed for having done nothing to prevent the atrocity the victims threaten people’s sense of security and their muchneeded belief in predictability justice rule of law and the benevolence of people the victims on
238. 83:48 their part don’t believe that it is possible to effectively communicate to outsiders what they have been through so there’s a gulf there’s an abyss between the two the torture chambers the the family setting where violence took place the marital or the conjugal bed where
239. 84:05 you’ve been raped that’s another galaxy this is how awitz was described by the author katnik in his testimony in the aikman trial in jerusalem in 1961 kenneth pope in torture a chapter he wrote for the encyclopedia of women and gender sex similarities and differences
240. 84:26 and the impact of society on gender so in this encyclopedia in the article on torture he quotes harvard psychiatrist judith herman the woman who came up with complex post-traumatic stress disorder so herman says it is very tempting to take the side of the perpetrator of the
241. 84:45 abuser all the perpetrator asks is that the bystander do nothing the abuser appeals to the universal desire to see hear and speak no evil you know the three monkeys the victim on the contrary is asking the bystander to share the burden of pain the victim demands action engagement
242. 85:10 remembering people don’t want that but more often continued attempts to repress fearful memories result in psychosomatic illnesses this is known as a conversion symptom the victim wishes to forget the the the assault to forget the rape to forget the torture to avoid
243. 85:29 reexperiencing the often life-threatening abuse and to shield her human environment from the horrors she doesn’t tell her children she doesn’t share with her parents or with her siblings or with her friends or with her neighbors or colleagues she hides her
244. 85:43 scars and the wounds you know the famous sunglasses the famous long sleeves the famous conspicuous scarves that physical
245. 85:57 abuse victims wear in conjunction with the victim’s pervasive distrust this is frequently interpreted as hypervigilance or even paranoia it seems that the victims cannot win torture is forever it is telling that precious few psychology and psychopathology textbooks
246. 86:16 dedicate an entire chapter to abuse and violence yes it’s a fact few psychology and textbooks have a chapter on violence and abuse even the most egregious manifestations such as child sexual abuse merit a fleeting mention usually as a subchapter sometimes a footnote in
247. 86:37 a larger section dedicated to paraphilas or personality disorders abusive behavior did not make it did not make it into the diagnostic criteria of mental health disorders and the psychonamic cultural and social roots of abuse were never explored in depth as a result of this
248. 86:59 deficient education and lacking awareness and denial denial most law enforcement officers policemen cops judges counselors guardians evaluators mediators they are worryingly ignorant about the phenomenon of abuse and especially physical abuse only 4% you heard it right 4% 4% of
249. 87:24 hospital emergency room admissions of women in the united states are attributed by staff to domestic violence the true figure according to the fbi is 50% so half of all women who are admitted to emergency rooms in hospitals were physically assaulted raped and battered
250. 87:46 half but the staff of the hospital misclassifies them and attributes only 4% to domestic violence one in three murdered women was done in by her spouse current or former the us department of justice pegs the number of spouses mostly women threatened with a deadly weapon at
251. 88:08 almost 2 million annually domestic violence erupts in a mind-boggling half of all american homes at least once a year and these are not isolated out of the blue incidents mistreatment and violence are part of an enduring pattern of maladaptive behavior within the
252. 88:25 relationship they are sometimes coupled with substance abuse abusers are possessive pathologically jealous dependent and often narcissistic invariably both the abuses abuser and his victim they seek to conceal the abusive episodes in their aftermath from
253. 88:41 family friends neighbors colleagues or authorities and this dismal state of things is an abusers and stalkers paradise this is especially true with psychological verbal and emotional abuse which leaves no visible marks and renders the victim incapable of
254. 88:57 coherence and so there’s no typical offender that’s true malt treatment crosses racial cultural social and economic lines and this is because until very recently abuse has constituted a normative socially acceptable condoned behavior it was okay to abuse in the in the law
255. 89:19 of the land in the united kingdom there were measurements as to the size of the stick that the husband can use to beat up his wife kidding you not abuse physical abuse against children and against spouse are still an integral part of many cultures and
256. 89:35 societies in for example in russia in russia they deleted they removed the law they had a law and they got rid of it a domestic violence law because they say it’s okay for a husband to beat up his wife it’s part of the socialization process in many muslim countries beating
257. 89:55 up women is an acceptable practice and children for the bulk of human history women and children were considered no better than property chhatelli indeed well into the 18th century women and children still made it into lists of assets and liabilities of the household
258. 90:14 one bed two desks one woman three children early legislation in america fashioned after european law both anglo-saxon and continental permitted wife battering for the purpose of behavior modification the circumference of the stick used specified the statute
259. 90:34 should not exceed that of the husband’s thumb inevitably many victims blame themselves for the dismal state of affairs the abused party may have low self-esteem a fluctuating sense of selfworth primitive defense mechanisms phobias mental health problems a
260. 90:50 disability a history of failure or a tendency to blame herself autoplastic defense to feel inadequate autotolastic neurosis this kind of victim may come from an abusive family or environment which conditioned her to expect abuse as inevitable and normal in extreme and
261. 91:09 rare cases the victim is a mazoist possessed of an urge to seek ill treatment and pain and gradually the victim victims convert these unhealthy emotions this background of mental health dysfunction and their learned helplessness in the face of persistent
262. 91:29 gaslighting they convert all this into psycho psychosomatic symptoms into anxiety panic attacks depression or in extremist suicidal ideiation and even suicidal gestures i want to quote from my book toxic relationships abuse in its aftermath the november 2005
263. 91:50 edition therapists marriage counselors mediators courtappointed guardians police officers and judges are all human may come as a shock to you some of them are social reactionaries others are narcissistic and a few of these people are themselves spouse
264. 92:11 abusers many things work against the victim facing the justice system and the prof psychological profession let’s start with denial i’m quoting from the book um toxic relationships abuse and its aftermath let’s start with denial abuse is such a horrid phenomenon that society
265. 92:30 and its delegates often choose to ignore it or to convert it into a more benign manifestation kind of narrative typically by pathologizing the situation or the victim rather than the perpetrator a man’s home is still his castle and the authorities are loathed to intrude and
266. 92:47 intervene most abusers are men most victims are women even the most advanced communities in the world are largely still patriarchal and chauvinistic misogynistic gender stereotypes superstitions biases prejudices strong therapists are not immune to
267. 93:06 these ubiquitous and age-old influences and biases don’t think they have a special lease on objectivity therapists are amidable to the considerable charm persuasiveness and manipulativeness of the abuser and his impressive thespian acting skills the abuser offers
268. 93:24 plausible rendition of the events interprets the events in his favor the therapist rarely has a chance to witness actually witness an abusive exchange firsthand and at close quarters in contrast when the abused victim comes to the therapist she is often on the verge
269. 93:42 of a nervous breakdown she’s harassed unckempt irritable impatient abrasive and hysterical confronted with this contrast between a polished a polished self-controlled suave groomed charming abuser and his harried casualties it is easy to reach conclusion that the real
270. 94:03 victim is the abuser or that both parties abuse each other equally the praise the victim’s acts of self-defense her attempts to be assertive her insistence on her rights are interpreted even by therapists as aggression liability or a mental health
271. 94:21 problem the profession’s propensity to pathize extends to the wrongdoers as well alas few therapists are equipped to do proper clinical work including diagnosis abusers are thought by practitioners of psychology to be emotionally disturbed the twisted
272. 94:39 outcomes of a history of familial violence and childhood traumas they are typically diagnosed as suffering from some kind of personality disorder an inordinately low self-esteem or codependence coupled with an all devouring fear of abandonment in example in the case of
273. 94:57 borderline personality disorder consumate abusers use the right vocabulary they feain the appropriate emotions and effects they display remorse they repent they regret they’re ashamed and guilty ostentatiously and they sway they sway the therapist and the
274. 95:18 evaluator’s judgment they’re good at manipulating that’s what they do best but while the victim’s pathology works against her especially in custody battles the culprit’s illness works for him as a mitigating circumstance especially in criminal proceedings the system ends up
275. 95:39 repathizing and retraumatizing the victim don’t forget
276. 95:50 that my name is sam baknin and i’m the author of malignant self love narcissism revisited we know what abuse and torture do to the victim’s soul to her spirit to her psychology but what are the effects on the victim’s body there is one place in which one’s
277. 96:12 privacy intimacy integrity and inviability are guaranteed and that is one’s body the body is a unique temple it’s a familiar territory of sensor and personal history the abuser invades defiles and desecrates this bodily shrine he does so usually publicly deliberately repeatedly
278. 96:40 and often sadistically and sexually with undisguised pleasure hence the all pervasive longlasting and frequently irreversible effects and outcomes of torture and abuse in a way the torture victim’s own body is rendered her worst enemy it is corporeal bodily agony and pain
279. 97:08 that compels the sufferer to mutate her identity to fragment her ideas and principles to crumble very few people can withstand pain the body becomes the accomplice of the abuser of the tormentor an uninterruptible channel of communication of pain a tresinous poison territory of
280. 97:35 writhing agony this fosters a humiliating dependency of the abuse on the perpetrator bodily needs denied such as sleep toilet food and water are wrongly perceived by the victim as a direct causes of her degradation and dehumanization as the victim sees it she
281. 97:58 is rendered bestial not by the sadistic bullies around her but by her own flesh and blood beatatrice patelis described this transmogrification in her ethics of the unspicable torture survivors in psychoanalytic treatment she says as the gap between the eye and the knee deepens
282. 98:22 dissociation and alienation increase the subject that under torture and abuse was forced into the position of pure object has lost her sense of interiority intimacy and privacy time is experienced now in the present only and perspective that which
283. 98:43 allows for a sense of relativity is foreclosed thoughts and dreams attack the mind and invade the body as if the protective skin that normally contains our thoughts gives us space to breathe in between the thought and the thing being thought about and separates between inside and
284. 99:03 outside past and present me and you this skin what as though it were lost repeated abuse has longlasting pericious dramatic effects s such as panic attacks hypervigilance sleep disturbances flashbacks intrusive memories and suicidal ideiation victims and survivors
285. 99:28 experience psychosomatic or real bodily symptoms some of them induced by the secretion of stress hormones such as cortisol so there is increased blood pressure racing pulse headaches excessive sweating and myriad self-imputed or as i said real diseases the victims endure shame
286. 99:53 depression anxiety embarrassment guilt humiliation abandonment and an enhanced sense of vulnerability cpttsd complex post-traumatic stress disorder has been proposed as a new mental health diagnosis by dr judith herman of harvard university to account
287. 100:15 for the impact of extended periods of trauma and abuse in stalking an overview of the problem authored by karen abrams and gail eric robinson in 1998 the authors write initially there is often much denial by the victim over time however the stress
288. 100:37 begins to erode the victim’s life and psychological brutalization results sometimes the victim develops an almost fatal resolve that inevitably one day she will be murdered victims unable to live a normal life describe feeling un stripped of selfworth and dignity personal control
289. 100:58 and resources psych psychosocial development social support preorbid personality traits and the severity of the stress may all influence how the victim experiences and responds to it victims stalked by ex-lovers may experience additional guilt and lowered
290. 101:18 self-esteem for perceived poor judgment in their relationship choices many victims become isolated and deprived of support when employers or friends withdraw after also being subjected to harassment or when they are cut off by the victim in order to protect them
291. 101:36 other tangible consequences include financial losses from quitting jobs moving and buying expensive security equipment in an attempt to regain privacy changing homes and jobs results in both material losses and loss of selfrespect surprisingly verbal
292. 101:56 psychological and emotional abuse have the same effects as the physical variety abuse of all kinds also interferes with the victim’s ability to work aberinson robinson wrote in another article titled occupational effects of stalking in 2002 being stalked by a former partner
293. 102:17 may affect a victim’s ability to work in three ways first the stalking behaviors often interfere directly with the ability to get to work for instance for example flattening tires or other methods of preventing leaving the home second the workplace may become an
294. 102:34 unsafe location if the offender decides to appear there third the mental health effects of such trauma may result in forgetfulness fatigue lowered concentration and disorganization these factors may lead to the loss of employment with accompanying loss of income security and
295. 102:53 status still it is hard to generalize victims are not a uniform lot in some cultures abuse is common place and accepted as a legitimate mode of communication a sign of love even or caring and a boost to the abuser’s self-image in such circumstances the victim is likely to
296. 103:15 adopt the norms of society and avoid serious trauma deliberate cold-blooded and premed premeditated torture has worse and longlasting effects than abuse me out by the abuser in rage and loss of self-control the existence of a loving and accepting social support network is
297. 103:34 another mitigating factor and finally the ability to express negative emotions safely and to cope with them constructively is crucial to healing typically by the time the abuse reaches critical and all pervasive proportions the abuser had already spiderlike
298. 103:53 isolated his victim from family friends and colleagues she is catapulted into a netherland cultlike setting where reality itself dissolves into a continuing nightmare when the victim emerges on the other on the other end of this wormhole the abused woman or more rarely men
299. 104:14 feels helpless self-doubting worthless stupid and a guilty failure for having botched her relationship and abandoned her family in an effort to regain perspective and avoid embarrassment the victim denies the abuse or minimizes it small wonder that survivors of abuse
300. 104:34 tend to be clinically depressed neglect their health and personal appearance and succumb to boredom rage and impatience many end up abusing prescription drugs or drinking or otherwise behaving recklessly some victims even develop fullcale post-traumatic stress disorder
301. 104:57 contrary to misconcept to popular misconceptions post-traumatic stress disorder ptsd and acute stress disorder or acute stress reaction are not typical responses to prolonged abuse they are the outcomes of sudden exposure to severe and extreme stressors stressful
302. 105:17 stressful events yet some victims whose life or body have been directly and unequivocally threatened by an abuser react by developing these symptoms ptsd is therefore typically associated with the aftermath of physical and sexual abuse in both children and
303. 105:36 adults and this is precisely why dr herman suggested the diagnosis of c ptsd complex ptsd as we discussed earlier
304. 105:49 so to summarize victims are affected by abuse in a variety of ways one’s or someone else’s looming death violation personal injury or powerful pain are sufficient to provoke the behaviors cognitions and emotions that together are known as ptsd even
305. 106:08 learning about such mishaps may be enough to trigger massive anxiety responses the first phase of ptsd involves incapacitating and overwhelming fear the victim feels like she has been thrust into a nightmare or a horror movie we sometimes call it gaslighting she’s
306. 106:28 rendered helpless by her own terror she keeps reliving the experience through recurrent and intrusive visual and auditory hallucinations known as flashbacks or in sleep while she sleeps in dreams in some flashbacks the victim completely lapses into a dissociative
307. 106:48 state and physically reenacts the event while being thoroughly oblivious to her whereabouts and surroundings in an attempt to suppress this constant playback and the attendant exaggerated startled response jumpiness the victim tries to avoid all stimuli
308. 107:07 stimuli associated however indirectly with the traumatic event many develop fullscale phobias agorophobia claustrophobia fear of heights aversion to specific animals objects modes of transportation neighborhoods buildings occupations weather and even
309. 107:25 people most post-traumatic stress disorder victims are especially vulnerable on the anniversaries of their abuse they try to avoid thoughts feeling feelings conversations activities situations locations or people who remind them of the traumatic occurrence these are known as
310. 107:46 triggers and it is this constant hypervigilance and arousal the sleep disorders mainly insomnia the irritability short fuse and the inability to concentrate and complete even relatively simple tasks it these erode the victim’s resilience utterly fatigued exhausted
311. 108:07 most patients manifest protracted periods of n numbness automatism and in radical cases near catatonic posture response times to verbal cues increase dramatically awareness of the environment decreases sometimes dangerously so the victims are described
312. 108:26 by their nearest and dearest as zombies machines robots or automata the victims appear to be sleepwalking depressed dysphoric unhide not interested in anything or they can find pleasure in nothing the victims report feeling detached emotionally absent estranged and alienated many
313. 108:48 victims say that their life is over and expect to have no career family or otherwise meaningful future the victim’s family and friends complain that she is no longer capable of showing intimacy tenderness compassion empathy and of having sex due to her post-traumatic
314. 109:06 fragility many victims become paranoid impulsive reckless self-destructive others summatize their mental problems and complain of numerous physical ailments all of them feel guilty shameful humiliated desperate hopeless helpless and hostile ptsd need not appear immediately
315. 109:30 after the harrowing experience it can and often does um delay by days or even months it lasts more than one month usually much longer sufferers of ptsd report subjective distress the manifestations of ptsd are egoistonic they don’t like it their functioning in various settings
316. 109:53 job performance grades school social ability deteriorate marketkedly the dsm diagnostic and statistical manual criteria for diagnosing ptsd are far too restrictive ptsd seems to also develop in the wake of verbal and emotional abuse in the aftermath of drawn out traumatic
317. 110:13 situations such as an estate divorce hopefully the text will be adopted to reflect this said and ubiquitous reality