Traumagenic Neurodevelopmental Model of Psychosis — Revisited

Kermit Cole
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The traumagenic neurodevelopment model of psychosis, introduced in 2001, highlighted similarities between brain abnormalities found both in people who have been abused and those who are diagnosed with schizophrenia – at the time a radical shift in thinking.  This article in Neuropsychiatry by John Read, Roar Fosse, Andrew Moskowitz, and Bruce Perry reviews the research findings since then, and finds that both direct and indirect support for the model has grown.

Article →
Read, J., Fosse, R., Moskowitz, A., Perry, B.; The Traumagenic Neurodevelopmental Model of Psychosis Revisited. Neuropsychiatry. February 2014, 4(1)65-79. doi:10.2217/npy.13.89

Of further interest:
Review finds that childhood trauma can lead to psychosis (Medical Xpress)

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected]

9 COMMENTS

  1. Wow, this is a very significant summary of recent research about how trauma impacts one’s biology and can contribute to altered experiences! Many of us have long thought that trauma is one of the most significant causes of mental health pain and difficulties. I think now more than ever, we need to address trauma, in all it’s forms, when we provide treatment and peer support for individuals in recovery. Trauma informed peer support is one of the best models out there. I have also found that having a caring, person-centered therapist who helped me make sense of my suffering and work my way through emotional pain helped tremendously.
    Thank you for posting this important study!

  2. “similarities between brain abnormalities found both in people who have been abused and those who are diagnosed with schizophrenia”

    The focus on the brain hear is misplaced and the whole problem with the approach.

    If a steam roller rolls over a pea and flatens it. Exploring the properties of pea skin, its properties and how it evolved and came to be be skin, how it is transformed by being steamrollered is to totally miss the point that it is the steam roller that is the problem….it is the steamroller that should be the subject of investigation….not pea skin.

    • You are right, of course. However, this kind of research is essential to peeling off some of the folks who are married to the paradigm that “everything is caused by the brain.” If it’s shown that supportive relationships change the brain in a positive direction, this supports those arguing for relationship-based interactions as the primary healing modality. And it also validates those who have experienced these heightened states that it’s not just because their brains are messed up – it’s because of what happened to them.

      Admittedly, there is a lot more that could have been said, but I am glad this has been published, because it really undermines the idea that “schizophrenia” is a “disease of the brain,” especially when those who are not so labeled appear to have undergone a similar process as those who are.

      I long for the day when we start talking about the steamroller instead of the pea. But at least this acknowledges that there was a steamroller involved!

      —– Steve

  3. Here is what gives me hope and why I copied off the article. In the last section labeled Clinical Implications it states:

    “Individuals experiencing psychosis should be offered evidence-based PSYCHOLOGICAL therapies designed to address the social causes of their difficulties and, where appropriate, with a focus on regulating stress responsitivity. The fact that the psychological sequelae to childhood abuse, neglect and loss have biological concomitants DOES NOT IMPLY THAT THE BIOLOGICAL CHANGES ARE INDICATIVE OF A BRAIN DISEASE THAT HAS LITTLE OR NO BASIS IN LIFE HISOTRY AND THAT REQUIRES EXCLUSIVELY OR PREDOMINANTLY MEDICATION. NEITHER DOES IT IMPLY THAT THE BRAIN CHANGES ARE IRREVERSIBLE. Indeed, recent studies suggest that psychotherapy can enhance the ability of the HPA axisto respond to stress, in both children and adults.”

    Capitalization for emphasis is mine. One more nail to put in the lid of the coffin for biopsychiatry and the toxic drugs!

  4. I knew that this was true in my own life. Bullying and abuse make you hypervigilant — alert and reactive to small things. You begin to react to small threats and stresses in excessive ways. You develop a tendency to react with a mindset of paranoia, without every realizing that that’s what it is happening. You believe your reactions are reasonable. And then, at some point in adulthood, you encounter some new source of stress, and you believe that your own bizarre and extreme thoughts are reality — and that’s how you go over the edge into madness. I have never seen the case laid out like this. I don’t understand half the references to different structures of the brain (I’m still learning!), but I can see the common theme. Abuse, followed by the brain adapting to it, followed by an inability to deal with new stressors. Thanks for confirming empirically what I knew in my gut had to be true.