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The Psychological Effects and Treatment of Child Abuse


Complex trauma occurs over time.  Experiences of chronic child abuse and neglect result in complex post-traumatic stress disorder. It’s not that one time being assaulted by your parent caused you trauma, it’s that your experience as a child was filled with recurring involvements of maltreatment, resulting in symptoms that are often diagnosed as ADHD (Attention Deficit Hyperactivity Disorder,) depression, anxiety, and other psychological maladies.  While these diagnoses may be accurate on some level, they do not address the origination of the problem.

Attachment trauma is another form of early childhood maltreatment that results in interpersonal relationship problems later in life. This occurs when a child is not properly attuned with, paid attention to, or acknowledged as an infant and in early childhood.  It is often hard to identify attachment trauma, and it is particularly difficult to identify the types of dis-attunement that may have happened to an individual during infancy.

Attachment trauma is often the birthplace of personality disorders.

When someone has been chronically maltreated during any portion of his or her life, he develops an inner propensity to manifest a variety of external symptoms in response. These include, “air headedness,” anxiety, somatic symptoms, dissociation, and depression.

Fragmentation of the Psyche:

When a person experiences trauma from an early age, he must protect himself in some way in order to cope.  One means of protection is to “split” off the part of oneself that is experiencing the trauma. In this case, the traumatized person ends up having a fragmented psyche.   This fragmentation is really a survival or protective strategy, which serves one well during traumatic experiences, but tends to be problematic during times of normalcy.

This is not necessarily a physical fragmentation that can be seen under a microscope or in a brain scan, rather it is as if the person develops different, developmentally stunted personas that are frozen in time deep within one’s unconscious memory.  Each “persona” or “mode” is rigidly committed to a lack of growth and causes a level of stunted emotional development within the individual.

Keep in mind, however, that these sub-selves are developed for protective reasons, and for no other. Their primary purpose is to protect the hurt child from the resulting emotional pain.  They become fixated at a certain time period in the victim’s life and remain firmly in place, even after their necessity is eliminated.


Schemas are inner working models comprised of emotions and deeply ingrained beliefs about self, others, and relationships.  Schemas are neurologically held as experiential or implicit memories.  Schemas are experienced viscerally.  For example, one type of schema could leave an internal felt message of, “I know I am not worthy of love; I just know it. I feel it in my being.”


Modes are responses to schemas and are comprised of the above mentioned personas created during traumatic or otherwise emotionally dysregulating experiences.  Modes are compensatory and are created mainly as protectors.  Some protectors are over-compensatory, such as in the case of narcissistic and anti-social traits. Others are in the form of avoidance, denial, being overly friendly, etc.

Modes are akin to personalities. The necessary personality shows up as needed in response to the trigger at hand.  Other terms for modes are, “ego states,” “sub-selves,” “internal family personalities.”

Everyone operates in modes.  Some people with minimal traumatic experiences in childhood have relatively “normal” modes, where triggers aren’t as devastating as in the case of those who come from extremely emotionally depriving childhoods. When particularly strong modes of relating are present, personality disorders are developed.

Dissociative Identity Disorder (DID) is the clinical term used for a person with distinct and separate personas developed as a result of childhood trauma.


Triggers usually have a connotation of something negative.  Of course, triggers can occur when you have been conditioned to experience something positive as well as negative; however, for this article, I am referring to those triggers that cause a person to maladaptively regress emotionally to an earlier time period in his or her life.

Triggers occur in the present when a person experiences something that reminds them unconsciously of a past traumatic or emotionally upsetting experience.  Once a trigger occurs, a schema is what is triggered and a mode is what comes in to play to protect the underlying, unbearable emotional pain.

Personality Disorders:

When threatened by a negative emotional experience, subconsciously, a schema is triggered and a mode comes to the rescue to protect the individual from the underlying emotional discomfort. Some of the threatened unbearable emotions include rage, shame, humiliation, desperation, fear, and emptiness.

For people with personality disorders, a common threat is the potential for warmth, nurturance, or closeness.  Personality disordered individuals send out personas (aka modes) to stop healthy interpersonal connection from happening.

Why is this, you may ask.  It is because the hope for love is threatening to a person with a personality disorder.  The “protector” shows up to stop this threat from becoming a reality.  You see, for a person with a personality disorder, the hope for attachment brings up the emotions of vulnerability, neediness, helplessness, powerlessness, and subjugation, among others.

If as a child a person did not experience consistent nurturance and reassurance when feeling helpless, needy, or vulnerable, but instead experienced abandonment and abuse, then dissociation and over-compensatory measures occurred. Over-compensatory measures occur in the form of another personality, such as The Entitled, The Superior One, The Rager, The Detached Observer.  These modes are protective.

Think of the concept of a person having part of his personality stuck in an early developmental stage, such as age three. Now, think of the narcissist having a “rage attack.”  Doesn’t this rage attack in an adult person resemble a temper tantrum in a three year old?

This is an example of a trigger leading to an emotional regression. The rage attack is akin to the “protection” for the person. While it may be maladaptive, it is effective in many respects of protecting the person from feelings of vulnerability and helplessness.


One of the most helpful first steps for treating complex trauma is to identify the various modes within a person’s psyche.  Some people have a few very distinct personas, such as the ones mentioned above.  Others include personas with attributes fitting titles like, The Rebel, The Fighter, The Victim, The Seducer, The Liar, The Party Girl, and so on.  These personas are triggered by certain threats sensed in the environment which indicate that danger is eminent.

It is useful to mention that some of these personas can be termed, “Apparently Normal Personas.”  These are the ones that are masterful at masking dysfunction. These modes are usually the ones that present to the world and can be likened to a mask. These apparently normal personas are protective in nature. It is helpful to identify one’s other, inner protectors as well.

A good therapist can help a person struggling with complex trauma identify his triggers, modes, schemas, and apparently normal personas, and can help the client learn to integrate these different parts into a cohesive whole. Keep in mind that it is not the goal of therapy to eliminate a person’s protectors, but to embrace them and incorporate them into the person’s sense of oneness.

Integration succeeds differentiation. Once the different parts are identified, the therapist can help the client ascertain the primary underlying threatening schemas residing in the client’s psyche.  Once these underlying schemas are pin-pointed, then triggers make sense. Challenging the underlying maladaptive beliefs helps the victim of complex trauma begin to assess the damage caused during his childhood.


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The Psychological Effects and Treatment of Child Abuse

Sharie Stines, Psy.D

Sharie Stines, Psy.D. is a recovery expert specializing in personality disorders, complex trauma and helping people overcome damage caused to their lives by addictions, abuse, trauma and dysfunctional relationships. Sharie is a counselor at LIfeline Counseling & Education Inc., in Southern California (www.lifelinecounselingservices.org). Lifeline Counseling is a non-profit organization 501(c)(3) corporation. Sharie is also an abusive relationship recovery coach - therecoveryexpert.com


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APA Reference
Stines, S. (2018). The Psychological Effects and Treatment of Child Abuse. Psych Central. Retrieved on July 18, 2018, from https://pro.psychcentral.com/recovery-expert/2018/04/the-psychological-effects-and-treatment-of-child-abuse/