Thursday, December 9, 2010

Psychological Regression

It is extremely common to encounter psychological regression in therapy. It's so common that it is often readily apparent in observing friends and co workers over time.
What is meant by psychological regression is that a person reverts to an earlier developmental behaviour in face of new challenge or under stress.
Psychological regression is commonly noted where trauma has been significant.
Probably the most common today though not always so is the psychological regression seen in men and women who have been sexually abused.
Watching the behaviour and interaction of a 40 yo you might say, they are behaving more like people who are in their 20's. Alternatively a 25 yo might be said to be sounding and acting like an 13 year old.
Indeed diagnostically there's often a behavioral 'tell' which is a fixation that occurred around the time of trauma. I usually pick this up in 'tonal' shifts or use of language and in the inappropriate laughter which would be alright if the person were the stated age but really 'fits' better with a much 'younger' person. It's downright eerie at times and often comes across as 'fake' because of the inherent falseness.
Trauma is commonly associated with dissociation. While most people think of war and violent rape when they think of trauma, it's well recognized that to the growing immature individual a lot of experiences, clearly not in the league of front line war or physically violent rape by strangers, but nonetheless traumatizing to the undeveloped individual do occur. These are what constitute the inclusion criteria for Post Traumatic Stress Disorder, near death experiences, experiences of crippling or threatened crippling, significant sexual abuse, but also death of a parent, divorce of parents, multiple moves in childhood, serious childhood illness. Much of the psychological impact of the trauma is a product of the age of exposure. A 5 year old sexually penetrated will have far more likelihood of psychological regressive phenomena than a 17 year old sexually penetrated in an 'unwanted' sexual experience. Similar divorce is perceived by a 7 year old very differently from a 20 year old. Age and experience tend to protect so that the 19 year soldier shooting a child by mistake is more likely to develop ptsd than a battle hardened 40 year old sergeant who has been through many campaigns.
Multiple personality disorder is a direct consequence of trauma and most commonly associated with early childhood sexual abuse. This level of regression, often a childlike character in the midst of many other separate characters, is the most extreme.
Regression is seen in lesser degrees but is a part of the dissociative process.
Trauma leads to a person having a 'split' reaction to reality, feeling like they're struggling with two or more people inside. Having internal dialogues where they feel others wouldn't be so divided.
Alcohol and drugs are so commonly associated with trauma that regression is the norm the worse the disease. Indeed dissociation is considered psychologically to be the fundamental process in just addiction without trauma, the drug and alcohol abuse being it's own trauma as it subjects the brain to what biologically is a full blown chemical assault.
What I notice in therapy is a 'baby like' quality or 'innocent' quality in a person mature enough to be less naive. They also commonly are insensitive and indifferent to the really caring people about them. Their choice of friends is often poor and while this is associated with with the shame that is associated with alot of trauma, the fact remains that they commonly seek advice from those who have a limited experience. They commonly look for agreement and react sometimes violently in that adolescent and pre adolescent way to any wise or mature advice.
When men return from war the dissociation and regression is seen in their return to adolescent male activities, excessive drinking, drug abuse, playing games, lacking interest in commitment or work and generally childlike behaviour. This is a feature commonly understood when the inner workings of Post Traumatic Stress Disorder are recognized.
A very big problem is an individuals lack of commitment to the present and future, living in past failures and believing that the past will recur in the future. Rather than try they perpetuate the false belief by self destructive tendencies and trying to prove their negative world view while blaming everything on the outside world because they're experiencing themselves and others from a regressed childlike position.
The work of analytic psychiatry developed an understanding of the unconscious process that a person was being controlled by and explained much of the background noise that to those close to a traumatized person was just plain 'irritating'.
One can imagine reading Freud and Jung's histories of some of their early patients, especially one famously sexually traumatized woman, those around her, would just say "grow up". Yet as those famous analysts showed she was afraid of life itself and ran from the present and the future by regressing to the pre trauma levels so that she acted silly and like a baby at times. Indeed to the external observer the patient was ridiculous, phony and immature but seen through the analytic lens the doctors recognised that she was dealing with the unresolved effects of trauma.
In a true history of the war, well represented in the movie Patton, the general is haranguing a shell shock soldier who is literally regressed to infancy, almost sucking his thumb as a result of war exposure. The general harangues him and abuses him such that subsequent official complaints almost lost Patton his generalship. Wiser minds than his understood the effects of trauma. Indeed it was in WWII building on the horrendous experience of WWI that it was recognized that 'everyone' had a breaking point in war and all (including General Patton) would collapse and regress and dissociate if they were exposed to (I believe 40 days and nights was the rough number) of days and nights of actual assault and threat. Ancients knew this and it was the basis of many defeats that followed long sieges. Trauma with it's tendency to nightmares damaged sleep and interfered with other reparative psychologic and physical processes.
Judith Herman, director of the Harvard University Trauma center, is a leading authority and her book Trauma and Recovery remains a classic decades after it's writing.
Regression has been seen as a 'generational' response and indeed some questionable elders wrote off the 60's hippy era as a collective psychological regression of young adults who had come through a cold war and now were threatened with conscription in the Vietnam war as the western world feared the expansion of that war to WWIII.
First Nation elders in Canada saw that their young were commonly psychologically regressed and unable to maintain commitments and marriages with more often than not the grandparents caring for the children because of the effects of residential school system sexual abuse on the community. Increasingly these young adults however as the community heals and returning to the normative and health producing, community building roles of child raising, work and longer stable relationships.
This is especially true in the AA and NA communities where drugs and alcohol and trauma were associated with the immaturity recognized by psychological studies as far back as the 30's. In recovery the flip side of the irresponsibility is the joy people take in the privilege of parenting and work. As one fellow said, "I'm thankful I can pay taxes today."
Indeed the move from narcissism to altruism is often seen as the key evidence of recovery from trauma. The person traumatized is often in survival mode and regressed to a self centered child but when she or he makes that critical decision the change occurs and the person begins really considering how their actions affect others, putting children first, or caring for old people, asking what benefit an action will have in the short term and long term rather than just thinking of the one night stand or the party.
What is so sad is that the 'regression' is so obvious to the adults in the community around the person. However only when the person is ready to give up the temporary and destructive false self soothing that comes with the almost masturbatory quality of the regression is there any hope of growth and recovery. This movement towards health is commonly seen when the adult turns to those more experienced, recovered alcoholics or addicts for instance, soldiers who have been to war had ptsd but got on with it, sexually abused therapists who have left the subsequent gender wars to go on and have successful marriages and raising children so they can talk seriously about recovery firsthand as well as from books, and seeing the elders of the community, the old people, those old elephants as it were who look like shit but have indeed been there, done, that and got the tshirt and ball cap to prove it. Sometimes the latter individuals are physicians, psychiatrists, priests and ministers. Sometimes they are not.
The key though is when the regressed individuals ask and follow advise from those more experienced rather than childishly wallowing in their own shit, making more muck and being what kids today call these men and women, "drama queens".
Indeed modern psychaitrisy, especially the work that has come from the pure laboratory of war zones, indicates that the longer the person is 'stuck' the more long term potential for growth is lost. Being 'stuck' in the past, living in the safety of the masturbatory " I'm alright, you're not" world, since alone and with those who agree with me " I'm right, you're not," is a nice safe suckling sort of zone. It's like people with elevator phobia. As long as they avoid elevators they're fine. But the longer they avoid , the sicker they become and the more difficult it is for them to get back on the elevator.
This was seen in the political gender wars of the 60's and 70's with the girls lining up on one side of the room in angry feminist camps while the boys lined up on the other side in indifferent playboy camps. One was in the classic tempertantrum regressive mode while the other was in the equally classic regressive pout mode. In the 80's and 90's the Sex in the City 'role reversal' occurred with the playgirls and the angry househusbands. This mirrored the political world of left and right before the real movement to the so called 'third corner' positions.
Without getting into the historic developments in modern and post modern psychiatry, group and marriage therapies or the developments in political science which is beyond the scope of a regression discussion, it's just worth considering the equivalent terms from other areas such as 'devolution' and "reactionary" and 'luddism."
Sometimes the regression is so obvious, the behaviour so plain that I find myself as a therapist listening to a 30 year old and asking "were you traumatized" at 5 or 6 and seeing them do that "how did you know' thing. Similiarly I ask the 50 yo 'playboy', were you in the Vietnam war and he tells me he was. It's not rocket science. It's just obvious when a person isn't acting their age but it's also true that no one who has ever really been there can 'snap out of it'. It's just that the sooner they do the sooner they get help and heal.

- Posted using BlogPress from my iPad


Anonymous said...

Dear William,

I was searching for articles on regression into childhood when I came upon your article.

I sometimes regress into childhood myself. At the moment I'm undergoing therapy and thus I want to know more about it.

I want to say that I'm not, as you put it, 'childishly wallowing in my own shit' as well as 'living in the safety of the masturbatory " I'm alright, you're not" world'.

I've got an issue and I'm working on it. And your words don't quite sound as words worthy of a therapist.

Jane Lipilina

haykind said...

Jane, I'm glad you're not. I trust your therapist will address your anger issues because it's rare for people these days to go there especially as too many therapists need to be wanted and loved by patients which really does limit what patients can do in therapy.
So often dissociation occurs not around the issues of 'victimship' but rather around the flight from the victimizer consequences. A third of the sexually abused go on to sexually abuse and therapy only 'works' for these when they come to terms with this and make amends if they can, directly or indirectly. But the mind, as the old wise therapists taught, protects us from those very aspects of ourself we're not yet ready to address. In time, it does.
As for 'your words don't quite sound as words worthy of a therapist', maybe you're right.

Anonymous said...

Astute article...good job.

Anonymous said...

Hello: Can you please comment on the ability for two people in a relationship who both have symptoms of regression and one who has started working on these and the other who has not? What happens when one person recovers? Is it possible to get the other person to behave as an adult just by acting as one and putting rules down or would the partner who has not acknowledged their issues be unable to change just through the relationship alone? would the partner be able to point out to the other aspects of regression/narcissim or would it be impossible to change or help the partner change? Would it be better for the person who has started to address the issue to get out of the relationship?

haykind said...

If one person enters into therapy and makes the changes learned "behaviourally' , not 'just intellectually' through the interaction with their therapist or therapy group, their positive change can cause a partner to grow and change in response. There is 'resistance'. Couples who do an old dance together have difficulties learning new steps. This is less likely to work if 'you point it out' to your partner. If I do that I'm 'making myself God'. However, if my partner shouts and I shout back and then I stop shouting, well we simply can't do disco anymore, can we. It's simply going to change to a 'foxtrot' in time because you are no longer 'reinforcing the behaviour'. Always invite a partner into therapy but beware of 'controlling' and 'manipulating' since these 'parentalism' are inappropriate in mature relationships of 'equals'.

Anonymous said...

I am currently in the midst of regression due a long line of highly traumatic events which have been a domino effect for nearly ten years now. I notice these changes however I am unable to process everything still and I do not know how else to cope and when I attempt to I.often break. Both of parents never taught me these skills as both are suffering from severe Ptsd and I also suffer from it. My regression became much worse when I became physically disabled and had to rely on others more. Also others treated me much more like a child and I fell into it. I honestly.didn't know that I was regressing until many asked if I was five. I am easily excitable, very friendly, have big emotions, and I cry when I am hurt. Still, I do not have temper tantrums and I do accept responsibility for my actions and I am accountable. I am uncertain if regression is really a bad thing but I also do want to be respected. It is a quandrum as I have friends who are teaching me things because I never learned them and when I do something wrong without knowing it, it is not as serious because they think of me as a child and do not expect too much from me. Truthfully, I do not know a lot of foundational skills and I am playing catch up to many things, including on retraining muscle memory. It is very difficult and I have regressed but I also don't know how not to. I do not do alcohol and drugs so this is how I cope. I watch cartoons, enjoy the small things, and act cute. I also have a young voice and this just adds to the issue. Honestly, I am not sure if the regression came first or I started regressing because I was treated like a child by others and realized that many key skills were missing from my life. Your thoughts and tips would be appreciated.

haykind said...

First we recognise regression, often done in therapy, then we address the hurdle or hurdles in life that caused us to turn back and stay at an earlier stage of 'competence'. With time, this becomes known and safe and we progress. Erik Erickson's 8 stages of Psychological Development coupled with Maslow's Hierarchy of Needs gives us some guidance or road map to what we need to address if we want a 'full' life. "Fullness" comes with emotional development. It's dimensional. Some people seem to have 'flat' existence and complain about 'depression' because their 'shallow' existence gives them no depth and/or essence. Life is like eating cardboard rather than really savouring and experiencing all that is possible. Moving forward people described greater capacity for joy but that comes with greater experience of pain. Safe feelingless existence is flat lining, no pain, but no gain, and without pain, a child might not grow, as learning to walk requires overcoming falls. This is true psychologically as well. Enjoy the journey. It doesn't have to be alone. This is what therapists/guides are for. I just hired a guide to see Istanbul and when I was younger I had a psychoanalytic therapist show me some of the sights on a similiar inner exploration. I feel richer for both experiences.

Anonymous said...

I was looking for articles on age regression and came upon this blog. Thank you for helping me stay sane. Just last night I thought I was going crazy because I got triggered and began to act like an eight-year-old.

Sheikh said...

This is so much help to me.. There are times that i would act like a child.. Days or even weeks would go on where i would consider suicide the only way out because i didn't understand what's going on.. Now I know.. I've acquired other "conditions".. But psychological regression is definitely one of those that is/was really very disturbing for me.. Thank you so much for writing this.. Hope others suffering from this find this..

Anonymous said...

After years of therapy and issues with regression, I later, started therapy again. I like my therapist-he's helped with things I assumed were impossible to address. I feel and get feedback from family and therapy group members thst I have really grown. But we are addressing shame along with the impact of my dad leaving at age 7 (all siblings much older and already out of the house). I have also had several losses in the last couple of years including my mother (died from s rapidly moving cancer), my body (competitive athlete until 2 yrs ago when I hurt my back pre-competition, and my ability to do even basic physical tasks. I also lost my job and was in s senior legal position at a Fortune 100 company. I've been on disability for months with little on progress on physical healing, I live alone and nearest family is halfway across the country from me.

Again, I'm finding that I'm getting stuck in a regressed state. I recognize it by feeling-not behavior. Others notice it by behavior, language, voice, neediness. Some very caring people have been patient enough to stick with me (I also tend toward borderline symptoms when under too much stress, and these are over the top, though they seem completely appropriate at the time), and I think that I should be grateful. I've been involved with terrible conflict with these same people who have been brave enough to confront me to help teach me. They acted out of love and had to deal with severe regression and just pure obnoxious behavior on my part until I could digest, which takes weeks with very careful assistance from my therapist. These experiences have been the most amazing breakthroughs, but I usually feel I will not make it through and have been abandoned. Despite profound movement forward (and I am very happy for that), I have so much further to go. And with the growth I've experienced, some in these exact issues, Im still almost constantly challenging my default drop into victim mentality and I have been feeling passive suicidal thoughts daily. I've reached out for support, but there is only so much of this a listener can take. And I'm very worn out , as I'm sure those on my support team are worn out, too, and will just leave/give up. For them to put so much energy into helping me and see me stay stuck is not very satisfying, I'm sure.

I feel like I've been in an almost constant state of intense regression for weeks, maybe months, and I don't know how to get out of it. The only time I feel a break is whine listening and responding to those in my therapy group-then I'm compassionate, focused, and not thinking of myself. Then when it's my turn to talk, I no longer know how to be productive. And I go back to feeling alone and wishing I would just disappear. Worse, I worry that I will just finally give up because I can't seem to "come to" and return to normal. Everything I read and therapists have told me about regression make it sound like it is rather straightforward to manage. Much like one of the other writers, I think I have lived from a regressed state as my natural state most of my life, taking all of the energy I have to "pretend" to be a grown up so that I can survive in an adult world long before I had a clue about anything. I was bullied and neglected as a child, and I tend toward isolation as an adult. I was doing much better with that until my back injury resulted in such difficulty getting out and my depression became such a constant pain-both emotional AND physical with hours of crying every day. I want to get through this, but if I can't, I don't see a future for myself at all.

Any advice? How does an adult grow up with an inner force (child) who refuses? I'm working on self parenting, BTW, but I've not been effective with this issue-the child is so strong she simply overwhelms the newly developing parent inside me.


haykind said...

Sometimes writing when you can't say the words. Groups are holding areas but one to one is where the negative transference is worked through. It's about trust. Hard in this knee jerk society. But relationships heal. New relationships overlay the past relationships. Gratitude lists daily are helpful. Focusing on the positive. Freud was afraid of the unconscious but Milton Ericsson embraced it. The child within is a kernel of growth and the one that acts out. So much of the acting out is adolescent whereas deeper is the healing growing one. Therapy is best in the context of work. Volunteer work where there is not remunerative work. We grow as adults when we serve. But well done, you are on the journey. You've turned around and you're going forward. It's just a little frustration waiting for the computer to reboot and the new programs to come on line.