Freud believed that neurosis, anxiety and depression, were caused by sex. A whole industry grew up around this idea and there are many people who still believe that anxiety and depression are caused by unresolved unconscious conflicts. Sufferers of anxiety and depression could spend years and thousands of pounds on therapy trying to resolve these conflicts, often with not much of a result apart from for the bank balance of the therapist, cynics may say. More recently the trend has been to saying that anxiety and depression are caused by faults in thinking which has given rise to the cognitive behavioural approach. I am postulating that rather than unconscious conflicts or faulty thinking being the cause of anxiety and depression, the real causes lie in either acute or chronic trauma combined with underlying vulnerabilities.
There is great awareness now about Post Traumatic Stress Disorder (PTSD). PTSD is the psychological equivalent to an acute injury. It follows that there must be the psychological equivalent to an overuse injury where somebody is repeatedly exposed to low levels of stress over a long period of time. It is strange that that even though there is an awareness that issues such as psychological neglect can cause harm that there is no aware about what could be called CTSD, ie. Cumulative Trauma Stress Disorder. I think that the reason for this is that in the same way that physical overuse injury can easily be overlooked because of the distance between the cause and the injury, it is very easy to see the connection between an acute psychologically traumatic event and the ensuing distress but the connection between the levels of chronic psychologically less traumatic events over a long period of time is not quite as obvious or dramatic but the consequences could be the same, if not worse.
Injury can obviously cause anxiety, but I think that anxiety in itself may be a kind of injury – it may even be a kind of Repetitive Brain Injury. Injury is caused by either a major trauma (e.g. a car crash) or repeated minor traumas – e.g. in Repetitive Strain Injury. There is a spectrum of trauma between these extremes e.g. there is some evidence that the physical trauma associated with heading a football regularly over a long period of time may predispose footballers to dementia.
I have experienced anxiety since the age of about 16 and I put this down to a combination of genetic vulnerabilities, such as increased sensitivity, and minor and moderate traumas associated with feeling neglected during my upbringing and childhood. I think that in the same way that repeated or one-off physical stress/trauma can cause physical injury, repeated or one-off psychological stress/trauma can cause mental injury.
The model I am offering here is similar but different to the well known ‘stress vulnerability model’ because the latter does not make any connections with or apply any lessons from the parallel process operating with physical stress and disease and it does not highlight the role of repeated minor trauma. The stress vulnerability model also does not offer a systematic and logical approach to avoiding and reducing the effects of mental trauma through avoiding misuse and overuse of the mind and emotions.
I stated earlier that I thought that ‘Repetitive Strain Injury’ was not an adequate term for this condition, which is why I prefer the term ‘Cumulative Trauma Disorder’ (CTD). I also thought that once one is aware of this term, it is obvious that other mental conditions such as anxiety could also be understood in this light because they involve a kind of mental cumulative trauma. This then led me to conclude that the application of the principles that have helped me with physical CTD could also work with mental CTD, i.e. in my case anxiety. I think that we often draw a false and sharp distinction between mental and physical processes, even though mental processes occur within the brain which is a physical entity. So therefore there is good reason to assume that principles that apply to the body probably apply equally to the mind. The field of sports injury may offer insights into the treatment of mental injury.