FUNDAMENTAL
ATTRIBUTION ERROR
The tendency to overvalue dispositional or personality based
explanations for the observed behavior of others while
undervaluing situational factors.
This contributes to a tendency to blame.
Blaming reduces flexibility, as well as understanding.
FUNDAMENTAL
ATTRIBUTION ANSWER
The understanding we are all influenced by a wide range of
“situational” factors over which we have little to no control,
and often no awareness (or no remembrance).
This fosters, hopefully, an increased willingness to
understand others, and support their efforts to cope.
This involves a change in thinking about others, from “He/
She’s bossy” to “When was he/she cooperative.” This
involves an appreciation of context.
SITUATIONAL
FACTORS
This would include the myriad of influences, from adverse
childhood history, to genetic/biochemical factors, to
economic, to socio-cultural. One of the most powerful
influences is the relationship system of the family.
Temperament is a powerful influence on outcome, and is
only partially under our control.
The interaction of temperament and stress/trauma is a
critical area of inquiry.
ADVERSE CHILDHOOD
EXPERIENCES
This is a major longitudinal research study comparing
current adult health and well being to childhood
experiences decades earlier (Robert Anda at the CDC
in conjunction with Kaiser Permanente).
These experiences have cumulative effects, which are
not healed by time alone (greater numbers can raise
the risk of suicide up to 31 times).
ACE’s leave people vulnerable to chronic stress/
anxiety.
ADVERSE CHILDHOOD
EXPERIENCES
Finding Your ACE Score While you were growing up, during your first 18 years of life:
1. Did a parent or other adult in the household often or very often... Swear at you, insult you, put you down, or humiliate you?
or
Act in a way that made you afraid that you might be physically hurt? Yes No
If yes enter 1
2. Did a parent or other adult in the household often or very often... Push, grab, slap, or throw something at you?
or Ever hit you so hard that you had marks or were injured?
Yes No If yes enter 1
3. Did an adult or person at least 5 years older than you ever... Touch or fondle you or have you touch their body in a sexual way?
or
Attempt or actually have oral, anal, or vaginal intercourse with you? Yes No
If yes enter 1
4. Did you often or very often feel that ... No one in your family loved you or thought you were important or special?
or
________
________
________
Your family didn’t look out for each other, feel close to each other, or support each other? Yes
No
If yes enter 1 ________
5. Did you often or very often feel that ... You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you?
or
Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
Yes No If yes enter 1
________
6. Were your parents ever separated or divorced? Yes No If yes enter 1
________
7. Was your mother or stepmother: Often or very often pushed, grabbed, slapped, or had something thrown at her?
or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard?
or Ever repeatedly hit at least a few minutes or threatened with a gun or knife?
Yes No If yes enter 1
________
8. Did you live with anyone who was a problem drinker or alcoholic or who used street drugs? Yes
No
If yes enter 1 ________
9. Was a household member depressed or mentally ill, or did a household member attempt suicide?
Yes No
10. Did a household member go to prison? Yes
No
Now add up your “Yes” answers:
If yes enter 1
________ If yes enter 1
_______
092406RA4CR
_______
This is your ACE Score.
ACE PYRAMID
the dark alchemy
X
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X
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X
1943
X
X
m80
X
alc
vsxab
9/61
alc
d 90
sab
2/82
00
s
08
X
FUNDAMENTAL
ASSUMPTIONS
Evolutionary Psychology: Humans as social mammals
(mammals having evolved over 180 million years). The
social environment is comprised of particularly salient
stimuli. We have a heightened responsiveness to the
psychosocial, and this has been the primary selective
pressure on the human brain.
Family Systems: Based upon a deep appreciation of the
power of our families to influence us on multiple levels
throughout the life cycle. These influences can persist over
generations. The family is the unit of study.
MORE FUNDAMENTAL
ASSUMPTIONS
Diathesis Stress: Three factors come together to account for
symptoms, either at the level of physical, emotional, or
behavioral symptoms. These are 1) a preexisting
vulnerability, 2) stress/anxiety, and 3) a coping strategy.
Implicit memory: The emotional centers of the brain
register experience below the level of consciousness. These
memories, and their emotional components, can be
triggered by current stressors. This is particularly true for
stressors or traumatic experiences occurring in childhood.
IMPACT OF ANXIETY
Anxiety is easily transmitted in families, by what people react
to, attend to, or fail to attend to. Replication or
compensation are typical mechanisms. A parents anxiety
about self becomes anxiety about the child. Anxiety becomes
chronic.
Anxiety has predictable effects on cognitive functioning.
Perceptual horizons narrow (person may appear self
absorbed or preoccupied), thinking becomes more
‘dichotomous’ or polarized, and more rigid.
Anxiety has predictable effects on family functioning,
increasing the ‘togetherness’ forces: ie greater reactivity to
differences, projection, blaming, scapegoating. Decision
making aimed at relieving anxiety rather than based upon
principle, or a long term view.
Anxiety is predictable at nodal events (ie ‘entries and exits’),
but also triggered by those ‘vague points of familiarity’ (such
as having a child reach an age when abuse began for the
parent, or the parent reaching an age where a loss occurred).
It can be triggered even by a spouse distancing.
MECHANISMS OF
ACTION
Epigenetics: new area of research in genetics exploring
how methyl protein ‘tags’ can trigger genetic action (eg.
early history of child abuse and neglect can predispose
to depression, or even diabetes)
HPA Axis: can be disregulated by early childhood abuse
(Chas Nemeroff findings...history of abuse and/or
neglect can result in persistent, lifelong hyperreactive
CRF response. Elevated CRF found in depressed
patients (down regulation of receptors, in areas of brain
responsible for regulating mood).
MECHANISMS OF
ACTION CONTD
Oxytocin. Nemeroff also reports oxytocin, related to
affiliative behavior, is significantly reduced in direct
correlation to severity of childhood abuse and/or neglect.
Social learning. These experiences tend to ‘normalize’
behavior, and relationship patterns tend to persist.
COPING AND
RESILIENCE
Resilience is the capacity to cope with stress, allowing a ‘bounce
back’ to homeostasis, as well as providing resistance to future
negative events.
Just as ACE refers to cumulative risk factors, resilience refers to
cumulative protective factors, or processes.
relationship support is the primary protective factor
attributions, or how we think about, and make meaning, is
critical factor
RESILIENCE
Emmy Werner longitudinal study over 40 years, finding
one third of cohort displays resilience, even in spite of
cumulative risk factors.
Protective factors most important involve social support,
especially if child has one caring adult. Also important are
a range of personal, community, and cultural factors.
RESILIENCE CONTD
Excerpt from "Resilient Children" in Young Children by Emmy E. Werner
Those of us who care for young children, who work with or on behalf of them, can help tilt the balance from vulnerability to resiliency if we:
• accept children’s temperamental idiosyncrasies and allow them some experiences that challenge, but do not overwhelm, their coping abilities;
• convey to children a sense of responsibility and caring, and, in turn, reward them for helpfulness and co-operation;
• encourage a child to develop a special interest, hobby, or activity that can serve as a source of gratification and self-esteem;
• model, by example, a conviction that life makes sense despite the inevitable adversities that each of us encounters;
• encourage children to reach out beyond their nuclear family to a beloved relative or friend.
COPING AND
RESILIENCE
Social support. Use of both affiliation, and language to manage
emotional/stressful experience (higher cortical function to
manage lower cortical arousal). Is harder to access if people
feel any degree of shame (importance of how you think about
what you feel). Certain cultural messages hinder reaching out
for support (eg. ‘suck it up, get over it, move on, don’t cry over
spilt milk’ etc).
Outlets for frustration..exercise, physical activity, displacement
(sibling conflict a common manifestation).
COPING CONTD
Sense of control/self efficacy. A fundamental human need
(we even prefer contingent to noncontingent reward), but
must be appropriate (easier to feel guilty than powerless).
This is the belief (or attribution) of control, rather than the
actual exercise of control.
Predictability. Even in the absence of a stressor, loss of
predictability triggers a stress response.
ISSUES OF LOSS
All families experience losses throughout the life cycle,
which impact every family member.
Losses include “loss conditions,” in which conditions
necessary for growth and well being are continuously absent
over time.
Impact of loss is greater 1) the earlier the age 2) the amount
of stigma attached (eg losses associated with a workaholic
parent vs. an alcoholic or abusive parent) 3) multiple losses
(addiction as well as abuse) 4) the lack of social support.
IMPACT OF LOSS
CONTD
losses trigger emotions, as well as influence beliefs.
we don’t just feel, but we make sense of what we feel
the meaning we make is influenced by the family reaction
the family reaction is influenced by the amount of stress the
family is under
the family reaction is influenced by cultural forces (ie
‘memes,’ or attitudes/beliefs about ‘negative emotions’)
IMPACT OF LOSS
CONTD
Losses in the present trigger emotions connected to losses
in the past (implicit memory).
These emotions can be triggered by the ‘vague points of
familiarity.’
Unresolved loss from the past tends to create further loss
in the present.
People look to almost any remedy in coping with this
emotional pain.
RECOVERY FROM LOSS
Relationships are both the source of emotional pain, and also the
solution to this pain.
This leaves people in a quandary, as it is difficult to learn to
approach something you have been avoiding.
There are clearly defined skills in managing self in an important
relationship.
These skills are generally learned through modeling; if they aren’t
modeled, they aren’t learned.
Substance abuse is a substitute for relationships.
ROLE OF THERAPY
A relationship process in which past losses can be
acknowledged and explored in terms of their impact on self
over time.
An examination of beliefs formed in the context of these
losses, as well as the construction of a cohesive narrative.
An opportunity to identify needs, and learn new skills.
Coaching in learning how to move differently in the family.