Monday, September 13, 2010

Early separation trauma

The hardest thing for me about Dr. Clancy Mackenzie's theory of early separation trauma for schizophrenia is in reviewing the way we lived our life when Chris was a baby. According to Dr. Mackenzie, he can tell from the way the person expresses pychosis, the age at which the separation trauma occurred. He links it invariably to separation from the mother, not the "mothering one."

Here's what Chris's early life was like from a separation point of view. When Chris was four months of age, I went back to work and we employed a woman to come into our apartment and take care of him while Ian and I were at work. We felt this arrangement was preferable to day care for us. After less than a year, "Gloria" was no longer able to continue and we employed her mother. When Chris was two and half years old, Alex was born and we moved to a house in the suburbs. We felt that Gloria's mother was too old to make the commute every day and we found a young live-in nanny. We employed a succession of live-in nannies until our youngest, Taylor, was in kindergarten.

Dr. Mackenzie would have a field day with the situation and the many caregivers. We honestly felt that   keeping Chris at home and not taking him out to daycare was the least disruptive option.

Dr. Mackenzie claims that he can pinpoint from observing someone by their behaviour, reality and feelings the age at which the trauma occurred. He relates how a woman came into his office and said she had schizophrenia for the past twelve years, and he said "no you don't. You have schizoaffective disorder." He believes that schizophrenia has its origins in the first eighteen months of life and he told her that her trauma happened at 20 months. (Her younger brother was born when she was 20 months old.) This was obvious to him because he felt she had too much warmth and affect for a person traumatized before twenty months. (While Dr. Mackenzie's schizoaffective/schizophrenia distinction is disturbing to people like me who don't care for labelling, I think I get where he is coming from.)

Dr. Mackenzie's trauma theory is compelling because he claims that the trauma is specifically within the first eighteen months and that it is separation anxiety. A quick reading of his website shows that he believes that the best expressed emotion is not low expressed emotion but zero expressed emotion, which means that the traumatized person has to break off all ties with the family while healing takes place. This sounds promising in that it has worked for other people, but how is this achieved in practice? We tried to encourage Chris to leave (for his own good!) two years ago and we got relapse in return. Where does someone go when they have no money or job skills?

Dr. Mackenzie may not have it all right, but he has made a good enough case to investigate further, which I will do when I am brave enough to follow up. Kris at Borderline Families is also getting the ball rolling on her blog post.

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