‘A difficult youth is a stress factor for life’
In her inaugural lecture, Professor of Stress-related Psychopathology Bernet Elzinga calls for more attention for the effects of a difficult youth on the development of disorders. Freud had a point, even though he did not work it out very well.
You are arguing that current psychological treatments fail to take into account the effect of early-life events. Why is this problematic?
‘The cognitive behavioural therapies which are at present most frequently offered to treat symptoms focus on the here and now. Psychologists try to modify the mechanisms that help maintain the symptoms, and are less concerned with mapping the history of these symptoms. But the way in which adults view themselves and others is strongly coloured by their experiences in the first years of life. There is a lot of research literature on this topic – think for instance of the negative effects of insecure attachment – but this knowledge plays no role in treatment.
‘Physical and sexual abuse, but also emotional neglect. This is about parents who do not pay enough attention to their child, and systematically leave it to its own devices emotionally. It is important for a child to feel seen and understood, especially when he or she is sad, bullied, or has experienced something drastic such as abuse. If parents fail to react appropriately, the child may later suffer more from this lack of support than from the event itself.’
Freud was right in arguing that early-life experiences impact a person’s later life, but there is certainly no need to drag up his ideas about castration anxiety and penis envy. We know now that traumatic life events can lead to an individual’s stress system being wrongly tuned, and this can cause lifelong problems. Using fMRI we can look inside the brain: these individuals’ emotional centres are hypersensitive, and their prefrontal cortex – which is involved in decision-making and the suppression of impulses – functions less well than that of people who has not suffered abuse. This can partially explain why people develop symptoms of depression and anxiety.’
‘That’s why it’s important to detect the factors that determine a person’s resilience. Data from the NESDA (the large-scale Netherlands Study of Depression and Anxiety) shows that one-fifth of the participants were abused as a child, but developed no psychological symptoms as a result. It would be great if we could also map these protective factors. In the long run we must make sure that people are offered not a standard protocol treatment, as is the case now, but a personally-tailored treatment which takes into account their history and hyper-sensitive stress system. Hopefully this will allow us to provide people with better treatment, because approximately half of the people with depression and anxiety symptoms don’t get better from the current treatment.’
(4 June 2012 / Malou van Hintum)
- Clinical, Health and Neuropsychology
- New minor in child abuse (3 April 2012)
- No decline in child abuse (Dutch, 4 October 2011)
- Personal chair in ‘Stress-related psychopathology’ for Bernet Elzinga (3 May 2011)
Health across the Human Life Cycle is one of the six profile themes of research at Leiden University.