The Importance of Therapy and Support Networks.

When dealing with mental health issues of any kind, it is so important to talk it through with a recognised professional and/or your support network. Talking through difficult and painful emotions (of depression or anxiety for example) with someone you trust is vital for mental wellbeing and balance.

If you are lucky to have a good, stable support network, utilise it. Your friends and/or family are so important in promoting happiness and keeping you well, so long as they are a calming, stable influence on you. Positive support promotes wellness in all of us.

Whether it’s one friend, a family member or an extended support network on or offline, talking to those you love and who care for you is vital. If you need further support there are health charities like the Samaritans who are always on hand to listen on their helpline. Mind charity are also a brilliant support and resource, as are Rethink Mental Illness. All promote a non-stigmatised view of mental illness and a listening ear.

Don’t suffer in silence. Tell someone you trust how bad you are feeling. Share your thoughts with a professional who can help you unpack the difficult emotions you are feeling.

Whether its one-to-one talking therapy, cognitive behavioural therapy (CBT) or psychotherapy, there is something to help you if you are struggling with mental health issues. It doesn’t matter what issue, disorder or behaviour pattern you need help with, there will be a therapy to help you back to wellness!

 

At the Brighton Wellness Centre, we offer a range of therapies including Skype sessions to help those struggling with mental health issues. Please click here for our details or email Jessica Valentine to find out more.

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Art Therapy

Art therapy helps clients find an outlet for often complex and confusing emotions, which they may not necessarily be able to express verbally. I mainly use this method with younger children who may not be able to define emotions or feelings.

There is a consistent foundation of wellbeing that we will develop together to ensure the outcome of happiness from any goal(s) that you set for yourself.  I believe that people can achieve success and happiness by creating and achieving short-term and long-term goals as well as practising the art of wellbeing. If you would like to learn more about how counselling can help you please contact me. I practice counselling in Brighton (and in Hove).

Psychotherapy

Psychotherapy is a type of therapy used to treat emotional problems and mental health conditions.  It involves talking to a trained therapist, either one-to-one, in a group or with your wife, husband or partner.  It allows you to look deeper into your problems and worries and deal with troublesome habits and a wide range of mental disorders.

Psychotherapy can help you to discuss feelings you have about yourself and other people, particularly family and those close to you.  In some cases, couples or families are offered joint therapy sessions together.  Read more about how psychotherapy works.

Talk Therapy

Talk therapy can help you work out how to deal with negative thoughts and feelings and make positive changes. They can help people who are feeling distressed by difficult events in their lives as well as people with a mental health problem.

Talking about your thoughts and feelings can help you deal with times when you feel troubled about something. If you turn a worry over and over in your mind, the worry can grow. But talking about it can help you work out what is really bothering you and explore what you could do about it.

Talking is an important part of our relationships. It can strengthen your ties with other people and help you stay in good mental health. And being listened to helps you feel that other people care about you and what you have to say.

Cognitive Behavioural Therapy (CBT)

Cognitive behavioural therapy (CBT) is a talking therapy that can help you manage your problems by changing the way you think and behave.  It is most commonly used to treat anxiety and depression, but can be useful for other mental and physical health problems.

CBT cannot remove your problems, but it can help you deal with them in a more positive way. It is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle.

CBT aims to help you crack this cycle by breaking down overwhelming problems into smaller parts and showing you how to change these negative patterns to improve the way you feel.

Unlike some other talking treatments, CBT deals with your current problems, rather than focusing on issues from your past. It looks for practical ways to improve your state of mind on a daily basis.  Read more about how CBT works.

Dialectical Behavioral Therapy (DBT)

The goal of DBT is to help you learn to manage your difficult emotions by letting yourself experience, recognise and accept them. Then as you learn to accept and regulate your emotions, you also become more able to change your harmful behaviour. To help you achieve this, DBT therapists use a balance of acceptance and change techniques.

What does ‘dialectics’ mean?

In a nutshell, ‘dialectics’ means trying to balance opposite positions and look at how they go together. For example, in DBT, you will work with your therapist to find a good balance between:

  • Acceptance – accepting yourself as you are.
  • Change – making positive changes in your life.

You might eventually come to feel that these goals are not as conflicting as they first seem. For example, coming to understand and accept yourself, your experiences and your emotions, can then help you learn to deal with your feelings in a different way.

On Self Confidence: Being your true, authentic self.

What is self confidence? Confidence is something that can only be developed over time and often comes about after one has either taken a hard knock or experienced something wonderful, such as a success. Both wonderful and negative experiences can break us apart so that we are left with our true selves. And from finding our true identity, we can then grow and grow in confidence. Often the difficulties in our lives can cause much pain and a lack of self confidence. We cling to the vestiges of our lives, unsure of who we are, where we are going and what will happen to us.

I very much believe in the idea of creating the life you love, the life you want and to be the person you want to be. Often limiting beliefs can hold us back  such as ‘I am not good enough’  , ‘I can’t do this’ , ‘This is going to go wrong’ . These beliefs, if we let them, can take over our entire lives. They can often be formed by traumatic events, other people in our lives or even a negative comment from someone you love or someone you barely know. It is important to unpack and question these limiting beliefs because it is only when we learn and grow and move forward, that we will find self confidence.

I know that for me, self confidence has been a battle. However, I am learning how to develop positive thinking and positive affirmations. Affirmations are statements eg ‘ All is well’ or ‘I can conquer the world’ , which set out our positive intentions to the world. Experts recommend we write and read these affirmations daily so that they become part of our subconscious mind. This is something I am aiming to do.

It is incredibly important to be true to who you are, your real authentic self. It is only by showing up and showing our light to the world, who we are, that everything can flow. We feel better when we create and write from a place of who we really are.  Whatever you love, pursue it. Follow your passions. Whatever that passion is. Don’t be afraid to be the person you are and the person you want to be. Act ‘as if’ and it can happen, but make sure too that you look after yourself.

I recommend the following books that have helped me on my self development journey:

Light is the New Black’- Rebecca Campbell

”You are a Badass: How to stop doubting your greatness and live your most authentic life’– Jen Sincero

 ‘The Universe has your back’- Gabrielle Bernstein

These books all talk about shining your light and being the wonderful, bright, creative individual you are.  If you are struggling with a crisis in confidence, it can help sometimes to speak to a therapist or supportive family member, who can guide you on your journey to your true self.

How to overcome negativity and manifest positivity in your life

Brighton Mental Health and Wellness Centre

Growing up in America we were taught by my parents to work hard and to play hard. My sister, brother and myself grew up having that mentality especially. No matter what obstacles or challenges we faced, we overcame them with our heads’ held high. We worked hard in school and through out our lives while exploring careers. We established social circles that began developing in primary school, continued through out secondary school, university and so on. We are a very social family who isn’t afraid to push up our sleeves, put our heads down and get to work.

Now, some psychologists would explain the causes to such dexterity as a) environmental causes b) personality and/or c) upbringing. I would like to say in my instance it was a little bit of all three. My mother worked two jobs to be able to send us to a really good private school…

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PTSD After Sexual Trauma: Vulnerability and Resilience

This article will explore a range of psychological research investigating the factors that can contribute to one’s vulnerability and resilience to post-traumatic stress disorder (PTSD) after experiencing sexual trauma.

Trigger warning: Sexual trauma can be a distressing and uncomfortable topic; you may want to consider this before reading as a note of caution.

Definition and Consequences of Sexual Trauma

Sexual trauma is defined as “one or multiple sexual violations that invoke significant distress”, and any lasting emotional, psychological or physical symptoms that result from this. This can result from rape, incest, molestation, physical assault or any kind of force or pressure into sexual activity.

The consequences of sexual trauma can manifest in a multitude of ways, and many are ‘normal’ reactions. One reason why some experience PTSD after sexual trauma while others do not is that they go on to experience a wide range of other mental health problems other than PTSD, such as depression or substance abuse; however, they can and often do occur co-morbidly. Further consequences might include difficulty trusting others and establishing intimate relationships. Because of the diverse nature of PTSD, it is important to use an integrative, person by situation interactional model when analysing vulnerability and resilience to the disorder.

The current criteria as provided in the Diagnostic and Statistical Manual of Mental Disorders (DSM V) for PTSD (adapted for the context of sexual trauma) are as follows:

A: Exposure to sexual trauma e.g. rape, sexual assault, incest, molestation…

B: Intrusion Symptoms e.g. repeated thoughts / memories of the assault, nightmares, flashbacks…

C: Persistent avoidance of thoughts, feelings and situations associated with the sexual trauma

D: Negative alterations in cognitions and mood that are associated with the traumatic event

E: Alterations in arousal and reactivity associated with the trauma e.g. difficulty sleeping or concentrating, jumpiness, irritability…

F: Persistence of symptoms for more than one month

G: Significant symptom-related distress or functional impairment that is not due to any other factor than the trauma itself

H: Symptoms not due to medication, substance misuse or illness

Prevalence of PTSD After Sexual Trauma

It can be difficult to determine the exact prevalence of PTSD after sexual trauma as many incidences go unreported. However, there is still a considerable amount of research suggesting that sexual trauma is the most likely to induce PTSD. Women are more likely to experience PTSD after sexual trauma than men, and this is not accounted for by differences in perceived threat to life or injury. However, many more women than men are subject to sexual violence – a figure that is likely influenced again by lack of disclosure on mens’ behalf. Reported rates of PTSD in rape victims vary from 30 to 65% depending on how and when symptoms are assessed.

History of Sexual Abuse

 

There is significant evidence that a history of childhood sexual abuse can be a contributing factor increasing an individual’s vulnerability to PTSD after a sexual traumatic event when they are adults. Sexual abuse in childhood can cause chronic genital pain, which can make sexual assault or contact in future more physically traumatic and is linked with PTSD symptoms. Those who are sexually abused in childhood are twice as likely to be assaulted as adults, so any consequences of childhood abuse such as feelings of guilt, lack of perceived control and low self-esteem that are very common in these cases can carry on into adulthood and predispose someone to experience PTSD after future sexual traumatic experiences. Therefore, those who are more resilient to PTSD are less likely to have experienced such events in childhood.

Event Characteristics

In a representative sample, 58% of women who had experienced PTSD named sexual assault to be the worst traumatic event they had experienced, suggesting that there is something specific to sexual trauma that makes people particularly susceptible to experiencing the disorder.
It might be that the personally intrusive nature of sexual trauma both during and after the assault could be a factor making one more vulnerable to experiencing PTSD. For instance, rape victims with PTSD are more likely to have been attacked by a stranger, where they experienced a threat to their physical and personal integrity, or were injured or subjected to substantial verbal and physical force. Further, aspects of the medical environment such as the use of invasive medical instruments can bring about or exacerbate distressing symptoms. However, even when event characteristics are controlled for, sexual trauma alone predicts unique variance in the risk of one developing PTSD, suggesting there are other factors at play.

Neurobiology of Trauma: HPA Axis Dysregulation

The hypothalamic-pituitary-adrenal (HPA) axis is involved in the control of stress responses, and its dysregulation is strongly implicated in the development of PTSD. This has been observed in survivors of sexual trauma. Cortisol (stress hormone) is a major facet in the HPA axis, released when stimulated by corticotropin releasing hormone (CRH) and inhibited via negative feedback acting at the hypothalamic and pituitary levels. Its dysregulation leads to inappropriate fear responses. Intense psychological trauma such as sexual abuse can disrupt this HPA axis by increasing levels of CRH. The following diagram illustrates this process in patients with and without PTSD:

Increased CRH = thick black line
Decreased adrenal release of cortisol = thin black line
Increased negative feedback inhibition of HPA axis by cortisol = thick red lines (diagram from Yehuda, Hoge, MacFarlane, Vermetten, Lanius, Nievergelt, Hobfoll, Koenen, Neylan & Hyman, 2015)

Genetic Factors

Depending on a particular variation of the FKBP5 gene involved in the HPA axis, one can either be genetically predisposed, or provided with more resilience to PTSD.

Based on twin and adoption studies, the heritability estimate for PTSD is 30 to 40%. This is linked with heritable neurobiological endophenotypes, such as lower hippocampal and prefrontal cortical volume and increased amygdala (fight-or-flight) activity, because dysregulation of the HPA axis can interact with other impairments of neurological functioning, such as in the hippocampus, which plays a critical role in emotional memories. This might explain PTSD intrusion symptoms like flashbacks and nightmares.

Cognitive Functioning

To turn to an earlier point on history of sexual abuse, women who were abused in childhood tend to have lower hippocampal volume, which when coupled with a dysregulated HPA axis can result in poorer cognitive functioning, resulting in less effective coping strategies and thus a higher risk of PTSD symptoms.

Higher prefrontal cortex volume (associated with strategic thinking, will to live) is found in those who experience trauma but not PTSD. This is linked with high IQ, which is found to be the greatest factor for resilience to PTSD as it is associated with more effective coping mechanisms. On the other hand, maladaptive beliefs and attributional styles that a victim of sexual trauma might have when interpreting the assault can exacerbate feelings of powerlessness that can contribute to the manifestation of PTSD.

Attributing blame in a way that focuses on the past and believing that one is powerless in their recovery is also associated with poorer outcomes in PTSD. For instance, believing that the world is “completely dangerous”, that one is “entirely incompetent”, or that some entity had vicarious control over the event can lead to a sense of mental defeat. It is this state of mind that can lead to one becoming highly vulnerable to PTSD.

Social Influences

Social influences are critical in shaping outcomes resulting from sexual trauma. Lack of social support is highlighted as the most important risk factor in PTSD. If a victim of sexual trauma does not have a supportive network with whom they can disclose the abuse and make sense of what has happened to them in a secure and trusting relationship, they are much more likely to go on to experience PTSD.

After sexual trauma, many people can experience secondary victimisation, where negative or stigmatising reactions from others can lead to an increased risk of PTSD, as they might also blame themselves for what happened to them, or believe that the incident has permanently transformed them or their reputation. Some of these reactions are perpetuated by rape myths, such as the idea that people often lie about being raped or that men cannot be raped. This is why it is important for victims to turn to professionals or helplines specialising in sexual trauma.

Racial, Ethnic and Cultural Influences

Symptoms of PTSD are found across races, ethnicities and cultural groups. However, the ways in which trauma and PTSD symptoms, such as dissociative or somatic symptoms, are interpreted are culturally constructed and can have a profound influence over the extent to which an individual discloses their sexual traumatic experience. This in turn impacts the extent to which they are at risk of experiencing PTSD.

Sexual assault victims of ethnic minorities tend to report more negative social reactions from others. In a triethnic study, Hispanic rape victims were shown to be the most psychologically distressed by their traumatic experience, followed by Black and finally White victims. This might be in part due to the fact that Hispanic female victims tend to engage in more avoidance behaviours and feel more shame regarding sexual trauma. This latter point will be discussed further with regard to religion*.

Resilience to PTSD After Sexual Trauma

“[Resilience is] efficacious adaptation regardless of significant traumatic threats to personal and physical integrity” (Agaibi & Wilson, 2005)

Resilience and recovery can be defined in many ways; I took this definition from Agaibi and Wilson. However, resilience is multifaceted and includes many processes that evolve over time. In the event of sexual trauma, resilience is comprised of elements of the individual and their environment that can serve as protective factors. Post-traumatic growth is a term that refers to positive psychological changes that one can experience after a trauma. This is more effective for people with certain temperamental characteristics, such as extroversion and openness to experience.

All considered, it is important to remember that resilience is complex, and having these protective factors will not necessarily generate positive or adaptive responses to sexual traumatic experiences. What may be considered resilient in one context or in one individual may not be so in another.

Some important factors to recovery as reported by survivors of sexual trauma include:

– Disclosing the abuse

– Positive self-perception

– Religion or spirituality

– Community cohesiveness

– Self-efficacy (Read more on self-efficacy in my article, here)

– Having a creative outlet

– Developing prevention strategies

*Religion can be a double-edged sword in this case, because as much as it can be a source of comfort for some people, it can also be a source of guilt; for example in Catholicism, which might explain the aforementioned fact that Hispanic women feel a lot more shame and guilt following sexual abuse. In terms of prevention strategies, recent research highlights the benefit of empowerment self-defence – an intervention proven to reduce attempted assault by 50% within a year, influence community and social norms, facilitate social support, increase autonomy and promote active coping mechanisms.

Conclusion

There are a range of biological, psychological and social factors that interact and can cause an individual to be more vulnerable or resilient to PTSD after a sexual trauma. Knowledge of these influences can serve as a vital framework for improving post-sexual-traumatic outcomes. Successful recovery is subjective, but can be measured by whether the survivor regains control of his or her life and experiences overall better functioning.

If you would like to share your views, experiences or thoughts surrounding this topic, I would love to hear from you. Please leave a comment or send me a message:

Works Cited

Agaibi, C. E., & Wilson, J. P. (2005). Trauma, PTSD, and resilience a review of the literature. Trauma, Violence, & Abuse6(3), 195-216.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition: (DSM-5) (American Psychiatric Association, 2013).

Anderson, K. M. (2006). Surviving incest: The art of resistance. Families in Society: The Journal of Contemporary Social Services, 87(3), 409-416.

Anderson, K. M., & Hiersteiner, C. (2008). Recovering from childhood sexual abuse: Is a “storybook ending” possible?. The American Journal of Family Therapy36(5), 413-424.

Bennice, J. A., Resick, P. A., Mechanic, M., & Astin, M. (2003). The relative effects of intimate partner physical and sexual violence on post-traumatic stress disorder symptomatology. Violence and victims18(1), 87-94.

Binder, E. B., Bradley, R. G., Liu, W., Epstein, M. P., Deveau, T. C., Mercer, K. B., … & Schwartz, A. C. (2008). Association of FKBP5 polymorphisms and childhood abuse with risk of posttraumatic stress disorder symptoms in adults. Jama299(11), 1291-1305.

Bogar, C. B., & Hulse‐Killacky, D. (2006). Resiliency determinants and resiliency processes among female adult survivors of childhood sexual abuse. Journal of Counseling & Development84(3), 318-327.

Bolstad, B. R., & Zinbarg, R. E. (1997). Sexual victimization, generalized perception of control, and posttraumatic stress disorder symptom severity. Journal of anxiety disorders11(5), 523-540.

Bownes, I. T., O’Gorman, E. C., & Sayers, A. (1991). Assault characteristics and posttraumatic stress disorder in rape victims. ActaPsychiatricaScandinavica83(1), 27-30.

Bradley, R., Greene, J., Russ, E., Dutra, L., & Westen, D. (2005). A multidimensional metaanalysis of psychotherapy for PTSD. [Review]. American Journal of Psychiatry, 162, 214-227.

Brand, B. L., & Alexander, P. C. (2003). Coping with incest: The relationship between recollections of childhood coping and adult functioning in female survivors of incest. Journal of traumatic stress16(3), 285-293.

Brewin, C. R. (2011). The nature and significance of memory disturbance in posttraumatic stress disorder. Annual review of clinical psychology7, 203-227.

Carson, D. K., Council, J. R., & Vole, M. A. (1989). Temperament as a predictor of psychological adjustment in female adult incest victims. Journal of Clinical Psychology, 45(2), 330- 335.

Chivers-Wilson, K. A. (2006). Sexual assault and posttraumatic stress disorder: A review of the biological, psychological and sociological factors and treatments. Mcgill journal of medicine9(2), 111.

Dass-Brailsford, P. (2005). Exploring resiliency: academic achievement among disadvantaged black youth in South Africa:’general’section. South African Journal of Psychology35(3), 574-591.

Frazier, P. A. (2003). Perceived control and distress following sexual assault: a longitudinal test of a new model. Journal of personality and social psychology84(6), 1257.

Hughes, V. (2012). The roots of resilience. Nature490(7419), 165.

Lefley, H. P., Scott, C. S., Liabre, M., & Hicks, D. (1993). Cultural Beliefs About Rape and Victims’ Response in Three Ethnic Groups. American Journal of Orthopsychiatry63(4), 623-632.

Lira, L. R., Koss, M. P., & Russo, N. F. (1999). Mexican American women’s definitions of rape and sexual abuse. Hispanic journal of behavioral sciences21(3), 236-265.

Lorentzen, E., Nilsen, H., & Traeen, B. (2008). Will it never end? The narratives of incest victims on the termination of sexual abuse. Journal of sex research45(2), 164-174.

McCauley, J., Kern, D. E., Kolodner, K., Dill, L., Schroeder, A. F., DeChant, H. K., … & Bass, E. B. (1997). Clinical characteristics of women with a history of childhood abuse: unhealed wounds. Jama277(17), 1362-1368.

National Collaborating Centre for Mental Health (UK. (2005). Post-traumatic stress disorder: The management of PTSD in adults and children in primary and secondary care. Gaskell.

Ozer, E. J., Best, S. R., Lipsey, T. L., & Weiss, D. S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychological bulletin129(1), 52.

Radan, A. (2007). Exposure to violence and expressions of resilience in Central American women survivors of war. Journal of Aggression, Maltreatment & Trauma14(1-2), 147-164.

Resnick, H. S., Kilpatrick, D. G., Dansky, B. S., Saunders, B. E., & Best, C. L. (1993). Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women. Journal of consulting and clinical psychology61(6), 984.

Rothbaum, B. O., Foa, E. B., Riggs, D. S., Murdock, T., & Walsh, W. (1992). A prospective examination of post-traumatic stress disorder in rape victims. Journal of Traumatic stress5(3), 455-475.

Sarkar, N. N., Sarkar, R. (2005) Sexual assault on woman: Its impact on her life and living in society. Sexual & Relationship Therapy, 20 (4), 407-419 Database: Academic Search Premier

Seal, K.H., Bertenhal, D., Miner, C., Sen, S., & Marmar, C. (2007).  Bringing the war back home.  Mental health disorders among 103788 US veterans returning from Iraq and Afghanistan seen at Department of Veterans Affairs Facilities.  Archives of Internal medicine, 167, 476 – 482.

Silva, R. R., Alpert, M., Munoz, D. M., Singh, S., Matzner, F., & Dummit, S. (2000). Stress and vulnerability to posttraumatic stress disorder in children and adolescents. American Journal of Psychiatry157(8), 1229-1235.

Stein, Murray B., John R. Walker, and David R. Forde. “Gender differences in susceptibility to posttraumatic stress disorder.” Behaviour research and therapy 38.6 (2000): 619-628.

Stein, M. B., Jang, K. L., Taylor, S., Vernon, P. A., & Livesley, W. J. (2002). Genetic and environmental influences on trauma exposure and posttraumatic stress disorder symptoms: a twin study. American Journal of Psychiatry159(10), 1675-1681.

Tedeschi, R. G., & Calhoun, L. G. (1996). The Posttraumatic Growth Inventory: Measuring the positive legacy of trauma. Journal of traumatic stress9(3), 455-471.

Ullman, S. E., & Filipas, H. H. (2001). Predictors of PTSD symptom severity and social reactions in sexual assault victims. Journal of traumatic stress14(2), 369-389.

Valentine, L., & Feinauer, L. L. (1993). Resilience factors associated with female survivors of childhood sexual abuse. American Journal of Family Therapy21(3), 216-224.

Vera, Hazvinei A., “Resilience theory and trauma theory applied to adult women incest survivors” (2013). Theses, Dissertations, and Projects. Paper 601.

Wilkes, G. (2002). Introduction: A second generation of resilience research. Journal of Clinical Psychology, 58, 229– 232.

Yehuda, Hoge, MacFarlane, Vermetten, Lanius, Nievergelt, Hobfoll, Koenen, Neylan & Hyman, 2015

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Do Violent People Have Low Self-Esteem?

It is a widely held belief that low self-esteem triggers violent behaviour, the origin of which is unknown. Baumeister, Bushman and Campbell (2000) conducted a study investigating this view; the following article attempts to summarise the ideas stated in their paper, entitled ‘Self-esteem, narcissism, and aggression: Does violence result from low self-esteem or from threatened egotism?’.

People with low self-esteem are generally portrayed as risk averse, easily influenced and deficient in self-confidence. These characteristics are incongruous with aggression – even likely to dampen or inhibit it –  given that hostile behaviours are intrinsically risky.

Low self-esteem is correspondent to a lack of confidence in achievement, whereas aggression is typically executed with an expectation of overpowering another person.

Most pertinently, those harbouring low self-esteem are doubtful in their self-identity, whereas aggression is likely carried out to uphold high self-regard. For instance, Baumeister et al. point out,

“Violent men seem to have a strong sense of personal superiority, and their violence often seems to stem from a sense of wounded pride. When someone else questions or disputes their favorable view of self, they lash out in response.”

When large groups diverge in levels of self-esteem, those with greater self-esteem are typically more violent. Violent individuals such as murderers, rapists and wife beaters are all discernible by their firmly held convictions of self-dominance.

Moreover, manic depressive individuals tend to show more aggression throughout a manic phase, indicated by a highly positive self-view, than during a period of depression, which is characterised by low self-esteem. Being drunk is also shown to temporarily enhance self-esteem, in tandem with a propensity for violence.

Based on these data, should we jump to the reverse assumption, that high self-esteem triggers aggression? Baumeister et al. think not.

They suggest we should first determine whether especially nonviolent people also have high self-esteem.

To that end, an important distinction is made by the authors between stable and unstable self-esteem. In their study, they found that people whose self-esteem is high and stable are least inclined to be hostile, while those with high and unstable self-esteem are the most hostile.

Narcissism

Research shows a strong association between narcissism and elevated but volatile self-esteem. Narcissism is therefore conceivably linked to aggression and violence, particularly during an encounter in which a narcissist is faced with mistrust or challenge to their excessively flattering self-view.

Narcissists are deeply devoted and attached to such views, and they wish for others to agree with them. Therefore, when their self-view is threatened, they feel they must defend it.

That said, Baumeister et al. emphasise that narcissism should be understood as a risk factor rather than a direct cause of aggression, and that the more threatening sides of narcissism lie in feelings of superiority and entitlement rather than mere vanity or arrogance.

At this point, a frequent question introduced is whether outward egotism is simply a method of concealing deep-seated insecurities. For example, perhaps wife beaters actually feel inferior to their wives, using aggression as a cover-up.

In response to this question, Baumeister et al. ask,

“How can hidden low self-esteem cause aggression if non-hidden low self-esteem has no such effect?”

Studies too have discarded this view. For the most part, playground bullies and gang members do not have covert low self-esteem. Likewise, practically all studies show that narcissists have high self-esteem.

Overall, Baumeister et al. suggest it is time to put an end to the search for straightforward links between self-esteem and aggression. Research has refuted the age-old view that low self-esteem leads to violence, while the opposing view incriminating high self-esteem is overly simplistic. High self-esteem is a trait of both aggressive and non-aggressive people, and so endeavours to make direct predictions are unconvincing. By and large, it seems redundant to suppose any direct link between self-views and aggression.

 

Works Cited

Baumeister, R. F., Bushman, B. J., & Campbell, W. K. (2000). Self-esteem, narcissism, and aggression: Does violence result from low self-esteem or from threatened egotism?. Current directions in psychological science9(1), 26-29.

Baumeister, R. (1993). Self-esteem. New York: Plenum Press.