By Dr David Laing Dawson
Childhood deprivation and childhood trauma, severe and real trauma, can lead to a lifetime of struggle, failure, depression, dysthymia, emotional pain, addictions, alcoholism, fear, emotional dysregulation, failed relationships, an increase in suicide risk, and sometimes a purpose, a mission in life to help others. But not a persistent psychotic illness. On the other hand teenagers developing schizophrenia apart from a protective family are vulnerable, vulnerable to predators and bullies. So we often find a small association between schizophrenia and trauma, but not a causative relationship.
The human brain/mind has a large variety of mechanisms to protect itself when under threat: Avoidance, denial, withdrawal, anger, rage, fainting, fantasy, suppression, repression, derealization, depersonalization, and dissociation. Some of these may appear to be brief psychotic episodes, but they are not the same thing as persistent psychotic illness. In fact, as I have witnessed many times through the past forty years, well meaning therapists who push their patients emotionally, who “dig for underlying traumas and conflicts”, who try emotionally-laden or unstructured group therapy with patients who suffer from severe psychotic illness, invariably cause a relapse in the illness. And a relapse in schizophrenia or bipolar illness is not a benign event. This was often justified by the old psychoanalytic dogma “they have to get worse before they can get better.” Again no, no, no.
Having a psychotic illness, in itself, and the consequences of that illness, can be traumatic to both the sufferer and his or her family. People with psychotic illness do not need someone probing the wells of their psychic discomfort; they do not need (no matter how well-intended) a therapist scouring their childhood memories in search of an unhealed wound. They need support, safety, security, grounding, and satisfying routine before they can get better. And good medical treatment.
Mind You Reflections on mental illness, mental health and life 
Another senssible post.
Well said !
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I agree.. Great article! It demands a wider public audience. It should be published in major media. Globe and Mail and Toronto Star take notice..
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What about birth trauma or trauma in the womb?
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I was really just addressing that surprisingly persistent belief that some kind of childhood experience (trauma) can cause schizophrenia. No. But taking the discussion beyond that may require some definitions of terms used. If you are asking if it is possible that some fetal intrauterine experiences (subviral, viral, hormonal, nutritional, chemical) might contribute to the later development of some forms of psychotic illness, then I think the answer would have to be yes. And I think if you are asking if an extended period of anoxia during childbirth could be a contributing factor then the answer is again yes.
These are all risk factors, which means that, whereas, say, 1 out of two hundred kids born after perfectly normal intrauterine experiences and births develop “schizophrenia” later, but 1 out of 100 who were anoxic at birth develop schizophrenia. So anoxia at birth is clearly not a specific cause of later schizophrenia but it may increase the risk of those vulnerable.
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http://post.queensu.ca/~forsdyke/schizoph.htm I wrote this in the mid nineties. Myths persist and some psychologists still go in with a two ton truck trying to dig up imaginary traumas to explain schizophrenia. they cause havoc and further harm the primary sufferer and their families. Thank you Dr. Dawson, but will it change the mind set of those who often are involved with setting policies. Let us hope that sooner or later myths will vanish then maybe appropriate treatment will be delivered.
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Again Dawson states what needs to be said. Thank you. Unfortunately some not all psychologists peddle that childhood trauma is the cause of schizophrenia. These so called therapist often go in with a two ton truck and make things worse for families and those who have the medical condition. Myths persist ! See my series on schizophrenia from the nineteen nineties.
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Funny thing – I remember speaking to two patients who asked about my Masters research into staff views of mandatory enquiry about past abuse… One, a male, replied “well I can tell you the moment my schizophrenia started – that was when I walked in on my step father having sex with my sister”, and the other. an elderly lady, explained how the walls in the house where she grew up were very thin, and she could hear her mother clearly tell her father when he was interested in sex, to go and tuck his daughter into bed for the night.
Clearly sexual abuse occurs in a context, and often (usually…) this involves betrayal, boundary violations and use of actual of implicit force. Can it really be that these occurrences are not potentially able to undermine normal relational competence, and lead to chronic immersion in a psychotic world?
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Dr. Dawson, how do you account for this study? And how can you claim that trauma cannot be causative of schizophrenia?
https://www.sciencedaily.com/releases/2012/04/120419102440.htm
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I suspect that psychologists and psychiatrists who believe in the trauma/abuse root cause of Schizophrenia are on what I call the “objective anosognosia spectrum”. I wonder if the damaged or disordered brain functionality that causes anosognosia in people who have psychosis-spectrum disorders – can be disordered in “well” people who believe that trauma or abuse causes Schizophrenia. What I am suggesting is a defect in reasoning. Thank you so much for writing this article. I finally thought of just the right key words for the web search that returned your blog. duejusticeproject.net
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It doesn’t really matter what you Luddites believe about the link between childhood trauma and psychosis – but you’d be better clinicians if you took note if the evidence: “Childhood Trauma Is Associated With Severity of Hallucinations and Delusions in Psychotic Disorders: A Systematic Review and Meta-Analysis” https://academic.oup.com/schizophreniabulletin/advance-article-abstract/doi/10.1093/schbul/sbx161/4782519
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And that is because anything that has happened to a person in life, all of their exposures past and present, belief systems…anything, becomes fodder for psychosis. Just because these experiences influence the content of the hallucinations and delusions does not mean that they caused the anomalous neural networks, the electrochemical abnormalities (hardware/software) that cause the development of delusions and hallucinations. Continuing to hold fast to folk psychology on the nonsense of Freud is hurting people. It is holding back scientific discovery and it is deforming social policies – that end up causing philosophically innocent people to be punished under the law.
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Unfortunately, you are confused about the proximate effects of these past traumas (symptoms) with the causes… As you well know, the effects on both central and autonomic nervous systems of trauma are reflected in differences in brain structures.
An analogy I find useful is the rubbish left behind a flood – analysis of this debris will never assist in understanding the causes of floods…
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