trauma

One of the things people don't realise is that during their childhood and adolescents, many adults who grew up with one or both parents that had a (diagnosed or undiagnosed) mental illness were traumatised. The research contained in the following thesis explains the needs of such adults and why their unique needs should be met.

Abstract

This theoretical thesis attempts to make visible the needs of adult children of parents with a severe mental illness (ACOPSMI), a population which has attracted little scholarly attention to date. It employs a methodology in which established trauma and alternative grief theories are applied to existing multidiscipline, scholarly and lay ACOPSMI literature. The thesis attempts to broaden the definition of ACOPSMI to include non-disordered, competent individuals. It argues that the unique, trauma-based needs of ACOPSMI are not being adequately met within existing family-focused policies and practice, which focus on the needs of parents with an SMI to the potential detriment of their adult offspring. Limitations, implications, and recommendations of this research are outlined.

The full thesis is available through the University of Melbourne ePrints Repository:

http://hdl.handle.net/11343/37852

Comments from Readers on the thesis (and articles):

“Your paper is important and does address a seriously ignored group of traumatised people. Let me reassure that I think you have identified a treatment group that has been neglected. One might even say that your group is a subset of the wider trauma group”.

- Dr Joseph Schwartz, PhD. Author of: Einstein for Beginners (1990), The Creative Moment: How Science Made Itself Alien to Modern Culture (1992) and Cassandra's Daughter: A History of Psychoanalysis in Europe and America (1999). Former experimental physicist (University of California); psychoanalysis (New York/London); supervisor and training therapist at The Bowlby Centre, London; and founding editor of the journal Attachment - New Directions in Psychotherapy and Relational Psychoanalysis (published by Karnac) which seeks to make a contribution to attachment approaches to clinical work.

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Suzette's work contributes to the trauma literature.

We can safely assume that the population Suzette researched, competent, non-disordered adults of parents with a severe mental illness, were to varying degrees traumatised. I agree with Dr Joseph Schwartz (PhD), supervisor and training therapist at The Bowlby Centre, London, U.K. who believes she is the first to have identified a treatment group, i.e., a subset of the wider trauma group, that has been neglected.

In her thesis, resource website and clinical-practice workshops, Suzette shares what she has learnt from her training in loss and grief and her treatment and studies of traumatized individuals across their lifespan in a clear, straightforward way. Without losing her audience, Suzette highlights the importance of adopting multiple perspectives regarding their struggle to be recognised as a traumatised population, not only at policy and practice levels but also to themselves as individuals. Her work helps the confused therapist and the suffering individual.

Suzette’s trauma-informed research has international clinical applications. These clinical implications include a better understanding of the grief that such individuals face. I suspect her work will influence or shape the way therapists might relate to our patient's/client's lived experiences; adding to the way we might understand and view how their trauma may have impacted on their lives across their lifespan and across generations.

Suzette's research is compatible with my co-authored book The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization as the foundation of her approach is to support the clinician towards a better understanding of the various obstacles that interfere in the trauma recovery of adult survivors of parents with a severe mental illness. I agree with her when she once told me: “We live in a world that expects and anticipates little drops of resilience to conquer early trauma in an instant”. In my opinion, any over-emphasis on resilience would certainly interfere in the trauma recovery of adult survivors of parents with a severe mental illness.

Often competent non-disordered survivors attempt to hide their distress beneath the common strategy of engaging with a facade of normality. Therapists can feel confused by their presentations and not fully appreciate their trauma-based issues hiding beneath, what Suzette has referred to as 'their mask'. In her thesis, Suzette unmasks their legacies. At the same time, she reveals the obstacles they face not only internally, as a result of their traumas, but also as a result of the type of policies and practices that fail to recognise what working with the lasting trauma for adults raised by parents with a serious mental illness implies.

Suzette Misrachi’s work will be of interest to current and future clinicians, students of clinical psychology, psychiatry, social work, as well as to researchers and policy-makers, including all those interested in survivors of chronic child abuse and neglect, who in their well-camouflaged demeanour, would otherwise remain ‘invisible’ and ‘silent’”.

- Onno van der Hart – Emeritus professor of psychopathology of chronic traumatization, Utrecht University, Utrecht, The Netherlands.

* * *

“I was extremely impressed by your thesis, which certainly highlights a lacuna not only in the counselling and psychotherapy literature, but in the policies and services which could potentially pertain to this group. While the ACE Study includes `parent with a mental illness’ as a specific category, the dynamics to which it gives rise are not well known and the hidden costs of this – which you elaborate with skill – would indeed seem to be high.

The way in which you organised your material (historical perspective; `waves’ of research; progression to discussion of the implications from varied angles) was also impressive. Building on the work of pioneers who have researched this largely `invisible’ cohort, you illuminated many facets of their experience which you persuasively argued to be not so much dismissed as not recognised as significant in the first place.

Throughout the course of your analysis, you also make a number of observations and suggestions which, based on the analysis you present, would seem to merit not only consideration by health professionals, policy makers and service-providers, but potential implementation. That the now familiar categories of `competence’, `resilience’ and `high functioning’ can serve to conceal both the existence and enormity of ACOPSMI (internal) experience which may be very contrasting is a single powerful illustration of the many you cite.

I took many notes from my reading of your thesis, and will certainly reference your work in this area as appropriate. Thank you so much for the opportunity to read your thesis; I have benefited greatly from doing so”.

[Below, follow up email: 17 January, 2022].

"I reacquainted myself with your MA thesis towards the end of last year [2021] and was impressed all over again by the fine work you have done in a still neglected area (although good that having a parent with a SMI is one of the adverse experience categories of the fabulous ACE study)."

- Dr Pam Stavropoulos, PhD. former Head of Research and Clinical Practice at Blue Knot Foundation:https://www.blueknot.org.au/ Formerly known as Adults Surviving Child Abuse (ASCA), Sydney NSW Australia.

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Context: The following quote is an emailed response (19/12/08) in reference to a conversation with Dr Paul Valent, 4th August, 2002 lecture on 'Child Survivors of the Holocaust' by the Australasian Society for Traumatic Stress Studies (ASTSS) at Mindful. The question related to the grief and trauma associated with being a child of parents with mental illness and how, in Dr Valent’s opinion, this type of trauma could be compared with Holocaust survivors was asked.

“I remember that conversation. I had long ago been struck by the trauma of incestuous sexual abuse of children resembling those of child survivors of the Holocaust, and arguably being even greater, because the abusers were their own fathers. They were their Nazis.

Analogously, children who grew up with psychotic mothers/fathers suffered multiple abuses from infancy, and again the “Nazis” were their own parents. Child survivors of the Holocaust knew at least on one level that their parents were their allies and rescuers and were loved and valued by their parents”.

-Dr Paul Valent, psychiatrist, traumatologist, researcher and child Holocaust survivor.

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Here’s a link to a podcast called "Social Workers, Rise! It is an interview by an unlikely worker about my research. Adam Read is "an experienced multifamily construction superintendent comfortable with managing $50-80M projects" who has taken my research on an unacknowledged trauma and grief to the construction industry in the USA. Hear it here:

https://podcasts.apple.com/us/podcast/social-workers-rise/id1494944697?i=1000555454636

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"Overall, I found this Masters research by Misrachi to be quite remarkable. It investigates an under-studied topic, non-disordered, competent adult children of parents with a severe mental illness (ACOPSMI). The thesis is articulate, extremely well-referenced (with an amazing 30+ pages of single spaced references), - organised, and cogent in its objective of making the case for more research attention being given to ACOPSMI. The thesis also presents solid arguments about why ACOPSMI needs to be more fully appreciated in counselling circles and among policy makers. In this latter regard, the work begins to redress a paucity of concern among Western governments and relevant authorities about children who experience significant trauma associated with their parents’ mental illness.

I was most impressed by the organization of the thesis, including the helpful personal commentaries, overview, and limits section. The thesis appeared to represent quite well relevant literature in areas such as traumatology, grief and bereavement, and attachment theory. As a scholar working in the area of loss and trauma, Misrachi’s work focuses a spotlight on a phenomenon that is barely recognized in extant loss and trauma literature. She does an excellent job in connecting ACOPSMI to concepts such as trauma and grief and in reviewing the modest available literature on these linkages. I was particularly interested in what she refers to as Third Wave Research on this topic, emphasizing the adult children’s own accounts and phenomenology of being in homes in which the parents’ mental illness dominated relationships and experiences. I think that this type of research approach would be fruitful would Misrachi go further at some later point in collecting qualitative evidence about ACOPSMI.

In terms of the criteria presented in the “Standards of examination” statement, I believe that Misrachi’s thesis:

1. Demonstrates superbly an advanced learning in research skills and mastery of appropriate techniques associated with ACOPSMI.

2. Demonstrates quite well specialist knowledge in the area of ACOPSMI research.

3. Presents in great detail and with scores of citations the results of research incorporating these findings in such a way as to eloquently lay out needed future theory, research, and policy endeavours.

4. Demonstrates an understandings of, and commitment to, research ethics or code of practice.

In sum, Misrachi writes with great passion and reason in giving voice to adult children of parents with severe mental illness. The thesis and her related web site should advance our understanding of ACOPSMI [i.e., Adult Children Of Parents with a Severe Mental Illness], as well as related mental health policy. In my opinion, the work would qualify a doctoral level document at universities where I've taught over the last 40 years in the U.S."

- Thesis examiner: Professor Emeritus, John H. Harvey. Editor for Journal Of Loss & Trauma and Author of: Odyssey of the heart: The search for closeness, intimacy, and love (1995). New York: W.H. Freeman. 1997 Translated into Japanese by Japanese Publisher Kawashima Shoten. 1999 translated into Croatian by Zagreb Press; Embracing their memory: Loss and the social psychology of story-telling. Needham Heights, MA: Allyn & Bacon; Harvey, J.H., & Fine, M. (2004). Children of divorce: Stories of loss and growth. Mahwah, NJ: Lawrence Erlbaum Associates. 2nd ed. 2010 NY: Taylor & Francis.

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“This is an extremely well written and presented thesis, which addresses a topic instantly recognisable to practitioners and academics in health and social care. As Suzette argues, the ACOPSMI issues are not fully understood from a theoretical, and subsequently a policy perspective.

It is always refreshing to read a thesis that is ‘meaningful’. Suzette’s enthusiasm is threaded through the work and has a most infectious quality. Suzette demonstrated considerable knowledge of the research topic and successfully integrated a wide range of literary sources, from disparate fields, in an effort to compensate for what Suzette saw as the limited ‘scholarly attention to date’. That the study was not empirical did not detract from its value. Indeed, by providing a putative theory Suzette laid the necessary foundations for any future empirical study.

In the early stages of reading I wondered why Suzette had not been encouraged to pursue a doctoral dissertation such was her commitment to the topic and background knowledge. I found the thesis to be highly original and would wish to congratulate her on the work. I am sure that this will not be the end of her ACOPSMI research story”.

- Thesis examiner: Professor Phil Barker, PhD. Honorary Professor, School of Medicine, Dentistry and Nursing, University of Dundee, Scotland; nursing theorist, teacher, therapist, and UK’s first professor of psychiatric nursing practice (University of Newcastle).

* * *

"Thank you so much for the acknowledgment and the opportunity. It is an excellent thesis. I would strongly suggest developing a series of articles based on the thesis -- aim some for thanatology journals (I would love to see one for Omega) as well as psych journals".

- Professor Ken Doka Editor of Omega: The Journal of Death and Dying and Journeys: A Newsletter for the Bereaved. Prolific author of journal articles and books including: “Disenfranchised grief: Recognising hidden sorrow" (1989)

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"[Suzette] you are an excellent practitioner that has great interpersonal skills, is hardworking and shared invaluable knowledge to me and my family during our sessions; which has helped me and others take the steps that need to be taken in order to overcome and better deal with trauma. You were great to work with as well. I couldn't thank you enough. We need more people like you. You are a brilliant practitioner. Good luck with your writings and keep sharing your knowledge with the world".

- Ex-Client (Anonymous)

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"I read your article, 'The parents who never were: Grief over an illusion of a functional upbringing.' I saw the article on LinkedIn. You captured many of my experiences and feelings. I created my own illusion of having a caring mother in order to have a sense of security as a child. And, yes, the illusion is 'co-authored' by society, as a whole".

- Anonymous

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"Suzette, Thank you for your kind inspiring words. It means so much to me from a person like you who not only supported me in in my endeavours and who I’ve been influenced by to be a change maker but that of a person who has great knowledge and understanding of the human condition.

I know I haven’t always been understood by many but my work was always concerned for everyone including the providers of services to people as they are much apart of how we all make the world a better place now and for future generations".

- Margaret Cook. Practicing artist, grandmother and former Adviser: Telethon Kids Institute Research Project on Children of Parents who have a Mental Illness, Western Australia.

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"This thesis is timely. I am beginning to 'come unstuck' on the very issues you discuss here and it is so nice to know that there is in fact some literature and support out there. I always figured there was, but as you would know, being the 'carer' rather than the 'cared for' means that you don't seek help. So your thesis will be my support - knowing that I am not alone and that some of my experiences are shared by others.

Of course, everyone's journey and experiences are unique so I would not expect that there be a significant overlap, but that there is any overlap at all is comforting. (And I know that you argue that this issue does not receive the attention it should, and I agree with that, but my need to read your work is a bit more personal than that - it is simply to read other people's stories so that I know that I am not alone).

I have a PhD in Psychology, and a Postdoc in Social Policy (specifically, child protection issues), so grief, loss, trauma, emotional abuse, mental illness etc., are not new to me. But they have always been addressed in the theoretical - and that ‘detachment’ allow you to function quite normally while still addressing your personal/psychological needs.

But since having a baby, things have been very different. My capacity to put the distance I need between myself and my mother has now become impossible. My mother, in my opinion, has undiagnosed borderline personality disorder, bipolar disorder and Munchhausen, and has had episodes of diagnosed major depression in the past involving violent suicide attempts, the two most dramatic being burning herself with petrol and then being hospitalised for a year when I was 14, and then swallowing 130 sleeping tablets a year later - surviving both. The emotional control and manipulation that is typical of these disorders is now manifesting in the way she grandparents. And the unintended effect of emotional abuse, now across two generations (including possibly Munchhausen by proxy), is beginning to make me very tired.

Anyway ... I am sharing this to let you know that you have explored an important topic and I am glad to know that it is getting some air time ... For we certainly are the unseen, just plodding along.

Thank you for conducting this research".

- Academic psychologist (Anonymous)

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"In the relatively short time I have known Suzette I have never felt that someone has been able to understand what impact the role of my parents influenced my life. I had already identified that my childhood, teenage years and early adulthood were not fulfilled by the loving nurturing parents that everyone desires. I had already identified traits in my siblings that were just not normal and realised they were just not nice human beings... even into early adulthood they were narcissistic, selfish, liars, who would manipulate and use people for their goodness and then criticize and humiliate them. However, partly due to wanting to be ignorant, I realised these were the traits of my mother also. It didn't really hit home until I had my own child and I realized I did not want my child to be surrounded or influenced by people who had these traits. So I have kept my distance to not be continually hurt and disappointed with what you expect from a relationship from a mother and siblings. My mother thinks there is nothing wrong with her and would never seek help, let alone accept a diagnosis of a mental health issue. Until meeting Suzette I thought I was just unlucky to have had a family like that and that there was no one in the world that could relate to me.

Meeting Suzette has helped me immensely. She had opened my eyes further as to the fact that there are many children out there who grew up in a home with a parent who had a mental health issue. And she has help me identify and label what was / is going on. I have just started reading her research (Lives Unseen: Unacknowledged Trauma of Non-Disordered, Competent Adult Children of Parents with a Severe Mental Illness) and realised this problem is a widespread issue that needs so much work and intervention in order to prevent the generations from continuing the same patterns and continuing this horrible cycle. She has awakened me as to how the affects of being a child of a parent with a mental illness is affecting my marriage and other relationships.

I'm uncovering that her work is ground breaking and is undoubtedly touching and helping many people's lives. I feel that there is a sense of urgency that people need to know about this work as it could help people immensely to improve, heal and facilitate fulfilling their lives. It needs further exposure to a wider population so it's effects can help and start healing.

Suzette's contribution to my life thus far has been a profound one and I hope many, many more people are able to be helped the same way.

Thanks Suzette so much for awakening me as to what the issue really was with my life".

- Physiotherapist (Anonymous); in multiple countries.

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"I came upon your thesis and then website on ACOPSMI while doing research in an attempt to understand and soothe myself one evening. I wanted to say thank you. Your work not only labeled for me for the first time a situation which I rationally knew I could not be alone in but nonetheless believed myself to be (a non-disordered adult child of psmi), but also reassured me of the importance of certain actions I was taking at the time (particularly getting distance from my parent).

When I first found and read your thesis I convinced myself not to reach out to you even though I referred back to it and your references a few times. I guess what I mean to say, is just how difficult it is even writing an email acknowledging myself as someone who identifies with your studies can be, and also thanking you for your work. Now months later I’ve come across your articles on medium.com while researching the incomprehensible guilt I experience at times. It’s amazing how reading what you write can give so much clarity… I have consulted with a few psychologists, therapists & counselors and none have been able to so clearly express to me certain ideas. Your piece on “Matilda” echoes what my last psychologist (specialized + experienced in dealing with adult children of schizophrenic parents) explained to me in sessions, but with sensibility, compassion and a deeper understanding and care for the actual meaning than my doctor ever could.

I hope you don’t mind me sharing this experience. I would just like for you to know the importance and impact, at least for me, that your work and research has had".

- Anonymous

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“Suzette, as a result of your posting a comment at the end of the recent NICABM Treating Trauma Master Series lectures, I read your 2012 thesis and then other articles you have written on Medium. Since first stumbling upon the concept of complex trauma, in books by Gordon Turnbull and Bessel van der Kolk, some four years ago, I have hungrily sought further understanding of complex trauma through reading and consulting trauma therapists, which was why I was watching the NICABM lecture.

I'm so glad I found your thoughtful and clearly written thesis, because your ideas resonate so strongly with me and have given me a fresh window on trying to manage my daily struggles. I identify with your concept of a competent child of mentally ill parents whose trauma is invisible, overlooked and often denied by others because outwardly I've coped so well in life.

I went from a destructive and miserable childhood, in which I was not permitted to be a child but spent all my time catering to my parents’ needs, straight into a destructive and miserable marriage in which I took over the parenting of my husband from his mother. Although I'd already figured that out in recent years, it was gratifying to read about “parentification” in your thesis, how this comes about and how damaging it is. Always giving, Never the recipient of acknowledgment, kindness or caring (let alone love) given back. Just always giving into a bottomless maw of angry entitlement, infantile behaviour, cruelty, contempt and need.

The fact that I managed to function as an accomplished lawyer, despite everything, goes to your class of 'competent' people. I know, at least in theory, that I have managed to escape my dreadful family of origin and painful marriage and that I've raised two sons by myself since they were little, while also gaining two more degrees and having a successful career as a lawyer.

However, more real to me than any of that is the continuing daily struggle to maintain a degree of equilibrium, the vivid nightmares that wake me so often and the knowledge that, in retirement at the age of 70, I am consciously cutting myself off from people because I cannot bear the cruelty of the world. Witnessing even mild disagreements distresses me hugely.

Over the years I have worked so hard, including years of psychoanalysis in my 30s, subsequent sessions with my analyst and other therapists to manage various crises and, in recent years, sessions with one not-so-good trauma therapist and one excellent trauma therapist. I have worked so hard and yet I continue to feel fearful - I've never felt safe - and, I now recognise, I continue to grieve for a life that was fundamentally destroyed before it began so I have lived in isolation and sadness for the full span of my years.

Reading your thesis was central to my deciding to try to reframe my 'depression' as normal grief, to focus on ways to manage that understandable grief, and to escape from being constantly medicated with anti-depressants. I know I'm old but I could live another 15 to 20 years and it would be so good to live a life with less fear and more peace in it.

As for your suggestion regarding writing. I could not possibly write a book about my struggles. First, my memory for my life is so fragmented and always has been so fragmented that there is no coherent story. I remember in adolescence feeling as if I were a scrap of paper being blown hither and thither. I had no substance and no place to belong. I have no way to place events or people and large sections of my life are a complete blank, except for isolated moments of feeling.

When I was eight and walking home from the school bus I was thinking that it would be ten more years until I would be 18 and able to escape my family and I saw my life as this endless pitch-black tunnel stretching away from me as far as I could see behind me and in front of me. That memory has never left me. But as to what else happened when I was eight, I have no idea. None. Except of course, that stepping into my home at age eight, as at all other ages, was like stepping over a knife edge into a darkly dangerous place where I was stiffly hyper alert every second.

Secondly, a sustained effort of writing would, I fear, be like scraping a large raw scab off my whole body every day. I could not do it.

However, when I was in psychoanalysis in the early 1980s, I wrote poetry that seemed to come fully formed from my mind and it was life saving to be able to express my feelings in words. Once I left analysis and was in the public world working as a lawyer I could not afford to reach those feelings again and stay stable, so I stopped. But recently I took out those old poems and, with my new knowledge of trauma and its effects, I can see how clearly that is what I was expressing. In those days, neither I nor my analyst had any way of framing what I was saying in that fashion. In fact my analyst once said to me that what I described of my relationship with my father could not be true because otherwise I would not be like I was - i.e. bright, highly competent, studying law, raising my children, responsible, stable. Is not this just the invisibility you describe? I have certainly not forgotten a remark that seemed to deny my reality so absolutely. One of the poems I wrote seems to me to be addressing this feeling of invisibility and denial of my reality.

Out of rage

my words are wrought

to bind my pain

in parcels

and hurl it into the void,

and hearing no echoing splash

yet have the courage

to know

it was real, I am.

Maybe there's somewhere I could publish poems that may resonate with others. I'll give that some thought. Indeed maybe I should try writing poetry again with my newfound knowledge of trauma and its effects. It's the brevity and conciseness of poetry, the lack of need for a coherent story, that makes it possible for me.

I feel something akin to relief to learn that your writings have struck such a chord with so very many people. It makes me realise that although day to day I feel immensely lonely, the issues I struggle with are shared by many other human beings on this earth. Knowing that takes away some of the solitariness somehow. And gives me a feeling of hope that I can perhaps, in what time is left to me, and with the help of people who understand these struggles, continue to make progress in easing the grief and feelings of unfulfilled longing and loss in my life.

What a wonderful thing you have done to have identified, and to keep on researching and teaching about, such a crucial need for so much barely visible, acute and lasting suffering to be recognised and treated. Some people give dis-proportionally to others and you are doing that. I know I feel very grateful for what I have already taken from your writings and your quick response to me. I'm not used to being told I've given something precious to anyone!

I know I generally present as a happy, smiling and friendly person, which people take at face value, but I said to my GP years ago, in a period of despair, that I felt I had a hidden disability and people had no idea how much energy I had to put into keeping going day to day despite that disability. If only I could have put all that energy into living fully. But I also know I've achieved a great deal to have kept going as long as I have, living a stable, responsible life and being able to care for others.

So, you see, contact with you and your work has already been good for me - to be able to articulate that and smile as I do so. Anyway, you've given me a lot to think about Suzette. Thank you again, very much”.

- Retired lawyer, NSW, Australia.

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“I have read large parts of your thesis so far (still have to read it further from policy part and later reread it etc) and was blown away by how much I recognise myself in large parts of your writing on ACOPSMI. It is such a blessing to read so much confirmation that this is an issue many more are facing with often quite similar experiences. It is very good to read that someone has written an excellent thesis. It confirms so much of my experience

I am a child of a mother who is diagnosed with bipolar disorder (bipolar 1) and yes this has shaped my childhood quite a bit. I knew from a relatively young age she had this and of course it has shaped my childhood quite a bit. However only in my early 40’s, just after all my children were born, I started understanding more and more how it has shaped me and what exactly happened with me. Up till that time I had always thought it was no big deal and pretty normal. In my opinion I wasn’t physically or verbally abused so everything was fine. Only I had these problems with myself that slowly got worse. I am much more enlightened now about how my own problems arose, processing it etc... Thank you for your thesis. I am doing much better myself thanks to a number of years of psychotherapy but reading your thesis helps again on feeling acknowledged in my experience of all my losses and the grief around it. Thankfully there are people who get it and who want more people to get it through writing and publishing on it etc!

Thank you again for making your thesis publicly available and your efforts in trying to make your thesis known!”

- Anonymous, New Zealand.

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"Suzette, I cried buckets for days after reading your work with grief my grief that had been caged by the mental health system as a diagnosis and madness when all along it’s been loss, grief and PTSD and chronic anxiety that has now been diagnosed. I’m up for the fight to continue the justice for all people including providers who in my mind want the best who are not complicit I know who they are as well.

You have taught me so much more over the past few months. I’m still percolating a lot of it. I’m growing all the time and coming to terms with my ‘fur balls’ so to speak I’m not perfect, so far from it. However, it was after I’d come into contact with you that I started the process of becoming “real”, as in the story book: “Velveteen Rabbit”. It goes something like this: “it does not happen all at once the rabbit tells the boy. It’s when all your fur has rubbed off...”

Your thesis gave me permission to stop this family charade that I’ve tried to escape from but was bullied by all members because they knew I was breaking their masks and molds as well. There is always one member who is used as a scapegoat in the family. However I feel I now have the strength, and I hope the ability, to bring my family through this because I do not want the dysfunction to be continuous across generations.

However, I am totally heart broken for my kids with my grief for them, as I know not only my pain but theirs too. Education was one thing that could help my kids. I knew this as I had no education and knew this was an impediment in my life and always has been due to being abused and taken advantage of more easily. My 18 year old grandson is doing a Law and Business Degree. Thank God.

So now I’m in the last few years of my life travelling with cancer and lung disease. I want with all my heart, to have my children gain peace by knowing that they did nothing wrong. Because all my life I’ve felt I was the problem to my mother, my father, my sister, my husband and the world. And I really have had a hard job finding the will to go on. Then I read your thesis and I gained my strength again. It’s like an injection of inspiration for me. I’m ok. I’m real. My feelings are ok, they are NORMAL for what has happened to me. This is the truth and that is the problem; people cover up reality and if they did not cover up reality then life could be less of a guessing game. No wonder people respond to you as they do. You have so much more integrity than other professionals.

Denial is a comfortable place to rest in for those who can’t even recognise it. There are so many kids, like I was, like my kids and my grandchildren who are growing up in a world where they might be confused and in so much pain and without knowing why. There will be so many more suicides, many more gamblers, drug addicts, people in prisons, domestic violence and people escaping via the likes of FaceBook and via other unhelpful means. Until people look, read and take seriously people, like you, who are sharply and acutely aware and know the nuances of what people’s lives are really like – not the nirvana land where we have been led to try and convert to, like a packet of pretzel’s in the supermarket.

This is not just because of me, it’s about principles, about everyone in my position, that’s how I look at things now. It’s the big picture.

Thanks Suzette, I mean it with all my heart, it was when I could finally get angry and not angry against myself but the people who really abused me, like the institutions who never believed me. Today, (December, 2018) I’m spending time unexpectedly, with both my kids together with their families for the first time. That is, it's my first time to be with all of my adult children together along with all my grandchildren – first time in 18 years. I even got asked to have a photo of me with all of my six grandchildren. The eldest has just turned eighteen. Yes, first time at Christmas for us to be all together. But I truly wonder if serving the homeless would have been more simple. I would have fitted in with them because I feel and I am without my own home. I am homeless".

Suzette, you saved my life when I was at a period in my life when I thought I would give up altogether. It was when I found you and your work I knew that there was someone who really got it, really genuinely knew and who really understood. It was then when, again, I got a new will to fight the good fight for all".

- Margaret Cook. Practicing artist, grandmother and former Adviser: Telethon Kids Institute Research Project on Children of Parents who have a Mental Illness, Western Australia.

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This is the trouble with looking OK. That is, when you’re ‘too functional’ to have your mental health taken seriously, people say you’re looking really great. And there you are feeling like you want a hole in the ground to open up right there, right now, underneath you, so you can disappear. There you are with this look you’ve done since childhood. You’ve had to. This was the way in your household. ‘Mum must not see any sadness’ or dad for that matter. You may have been told this often enough by everyone in the family and anyone who met them, including medical professionals. It happened to me. I was told you and your twin sister were the problem for your mum’s mental illness and you must keep her happy. This became our daily mantra. ‘You must show yourself to the world to be perfect. Anything less and you are worth nothing’. It gets repeated to you so often throughout your life. It shows up in your life in nuances that people have no knowledge of. So the shape of you, the one you adjusted to decades ago, struggles in two worlds.

Yes this is what some adults, who cover up trauma, who have grown up in a family where a parent has a mental illness, and where the other parent is not supportive experience. When we look as though we have just stepped out of a fashion shoot we are using the old patterns we used in our childhoods. We learnt to protect others and ourselves from the deep shame we feel. I did not excel at school but boy did I excel at the life we had. I had no choice but to FAKE it. To keep every one happy except my self. There is so much more to my story that would make anyone wonder how I’m still alive. According to the stats I should be dead.

I went for years believing I was a social defect not only because of what the mental health system had given me, i.e., a label, but by the way that I had been rejected by so many. That was until I came across Suzette Misrachi. I read her work. I cried and cried. There was someone out there who got it and who really understood the nuances and the reality of growing up with a parent who has a mental illness.

Although I grieve daily I’m not depressed – never have been. I realised this even more since being involved in the fine arts for the past 3 years. I cried and grieved so many losses. Losses due to being so unaware of that what I was actually feeling was buried grief and the fact that I had been advised that it was depression and bi-polar and Post Traumatic Stress Disorder (PTSD). Yet I did not behave in ways that the books alluded to in the medical model of the disorder. I saw people in the throes of these episodes and wondered why I’d been considered to have such a label as I had never ever behaved in such a way… Current systems have a lot to answer for because I now know why and what these feelings are. They are all normal.

I have spent the past 25 years as a consumer consultant trying to inform the system, i.e., government policies, that just because a child presents SMILING it does not mean that they are coping. 20 or 30 years later it, i.e., being raised by one or both parents with a mental illness, still affects them just like it has done for me, my twin sister and also our adult-children. This issue is an epidemic. I know because I meet other consumer parents. We all grieve daily because no one believed us until Suzette came along. I knew in all my heart she got it. After reading her thesis multiple times, I cried and cried just like I am now. I cry because many of us are left bereft and unless this is fully investigated we will continue to have children grow up without love security and knowing who they are. Not only that. They will just become human doings going on to continue the family legacy.

There is still a lot to do to bring people out of the ‘dark ages’ in regards to children caring for parents who have a mental illness. I want for all of us to understand the reason why trauma can be transferred through the generations when children are raised by one or both parents with a mental illness. This is more than overdue. I just hope in my lifetime, and I’m approaching 72yrs this August, 2017, that people read Suzette’s messages in her research.

I do training to new staff of various organisations for all sorts of disabilities and mental illness. Often they say, ‘you look so well’.

- Margaret Cook. Practicing artist, grandmother and (former) Advisor: Telethon Kids Institute Research Project on Children of Parents who have a Mental Illness, Western Australia.

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"Your article [in the AASW National Bulletin Autumn 2015 – Volume 25, Issue 1, pp 20, 21] leapt out at me and touched me deeply.

Thank you so much for the work you have done, are doing, and the way you imparted the fruit of your research in your writing. Being an ACOPSMI myself and working as a therapist is an interesting combination. I know of other colleagues who have experienced trauma but none who have lived with a severely mentally ill parent that I am aware of. I’m sure they are out there but perhaps the sense of invisibility and silencing that I’ve experienced affect others too; maybe they too have felt shame and not been willing to ‘come out.’ This is the beauty of your research – that it offers normalization and a sense of visibility. It creates a voice when one can feel silenced and alone.

In addition to an experience of invisibility I have found it easy to second guess myself, especially in my professional life. My (late) mother had Schizo-Affective Disorder and I must say that this fact has rocked my confidence when I have sensed a whiff of similarity – I became scared of perfectly normal emotions or distress reactions and can now reassure myself that I am not unstable or odd.

But I think the biggest thing to rock confidence has been the side effects of trauma; this has been the hardest to explain and accept. However, I have done a lot of personal work over the years and feel more confident in myself and can now feel proud of how I work without second guessing myself so much. Incidentally I never intended to work in ‘mental health’ (avoided it like the plague!) but counselling fitted me like a glove and life has an interesting way of evolving.

Your article did offer me much validation. Thank you. Even though I have explored my own territory of distress I think it’s fair to say that my journey is still a work in progress. I hope other ACOPSMIs find validation in your article too and it does help workers to be more vigilant and not so dismissive about the lived experience (still) of ACOPSMIs. I have to say that your research title resonated with me in a very deep way Lives Unseen: Unacknowledged Trauma of Non-disordered, Competent Adult Children Of Parents with a Severe Mental Illness. Wow. That just says it all. I have often thought how strange it is that so much focus can be on children but what of when they grow up? I like the ASCA (Adults Surviving Child Abuse) website. But often the descriptions of dysfunction don’t fit me. I found a term Prolonged Duress Stress Disorder that fitted better but I still don’t have a disorder.

It has been with pride but strange disappointment that I have never been disordered (this does sound weird). My story is a doubled edged sword: on one side immense grief and shame; and the other side immense relief and pride that I was never overtaken with all I went through. Family members are incredulous, “You’re amazing. After all you’ve been through…” Yes, but there have been costs that only now in my mid-life have I been brave enough to explore. How do I respond to such compliments? It’s nice to know that I’m not another statistic – as I know full well how many children who live with severe mental illness do not fair well – but the buried sensory effects of trauma do not then get to be seen, known, and cared for in the way that they deserve.

A few years ago I learnt more about trauma. Complex Childhood Trauma to be exact. It was only then that I started to see the strong parallels with my own sensory experiences, doubt, and shame. By the way, I liked the AASW article picture because it conveys loneliness and shame – often a result of trauma - but it is a little too dark to embody an ACOPSMIs experience I think. I wonder if a more relevant image would be a dichotomous representation - a sad face behind a happy face - that sort of thing.

Thank you from the bottom of my heart the fact that you noticed and took action".

- CaN-ACOPSMI and Mental Health Social Worker, Adelaide, Australia (Anonymous)

* * *

"Thank you for your work, as it is truly very important and timeless. The things that you have written about, in my opinion, should have been woven into ancient texts long ago, as it would have made an enormous difference in how human history has played out.

Again some many months later, I was thinking about you and your work this weekend when I decided to see what there was of yours out there on the Internet. I quickly came across your masters thesis, and I read through about a quarter of it this afternoon.

The diligence with which you presented your thoughts and the care you took in deciding what exactly was and was not included in your thesis was extremely significant. I especially appreciate the fact that you are giving a substantial voice to what you call the Third Wave of literature, in particular, the ‘Competent, Non-Disordered’ individual. This part was extremely poignant:

"The subjective views of ACOPSMI are valid (Kinsella, et al., 1996) so they should be taken as able to speak authoritatively about their plight. Yet few studies seek the opinions or investigate the needs of ACOPSMI (Knutsson-Medin, Edlund, & Ramklint, 2007). The profile of Third Wave literature in this thesis is therefore elevated."

This is very meaningful, as what you are doing with this is making a strategic advance in breaking down the stigma of mental health. By targeting the Competent, Non-Disordered individual, you are allowing people to admit their struggles without admitting professional deficiency or incompetency.

This is huge.

As you’ve noted in your research, the study of psychology isn't limited to the traditional classroom setting and that, as you have coined in this field, "Third Wave" literature has some inherent authority to it as well simply because individuals have lived through this experience and not just studied it.

Intuitively, I would think that some of the mechanics of what is known about the ‘Stockholm Syndrome’ might very easily carry over into studies on ACOPSMI. The torqueing and twisting of emotions on the mind as one is forced to override the fight/flight response and remain in an a psychologically abusive environment because that is the only option could easily be compared to the repeated bending and fatiguing of a piece of thin metal. Eventually, both the mind and the metal deform, become very fragile and fatigue. In order to survive on a daily basis, the war time response of attacking an enemy has to be overridden and the rules of engagement have to be rewritten. The Stockholm Syndrome is very similar to this dynamic, and I would think that large portions of this area of mental health could be cut and pasted into the study of ACOPSMI.

It seems as if the hardest part of getting help is realizing and then admitting that we need it. It goes against the fierce grain of the empowerment and ego of independence, as admitting we are in need feels like we are showing weakness. In a case like this, it's almost as if you have to take someone through the process before you tell them what the intention of the journey was to begin with. Otherwise, they may never embark on it at all.

The analogies that many ACOPSMI make to war and yet the difficulty that exists in comparing the terms "parent" and "enemy" is an important issue. You also say in your thesis in a discussion of grief that what exactly ACOPSMI are grieving is unexplored. I imagine it would not be at all easy to be in a house with so few walls and so many clear windows, but at least those ACOPSMI who have the courage to read your thesis are likely to know it is a safe place to be.

I hypothesize that a presidential candidate who used a trauma-informed approach to his/her administration and used professionals in an organization as one of the primary sources for creating their domestic and foreign policies would be beneficial. I could easily see your work also being used for something like this. Instead of using individual therapy as a place for a discussion of CaN-ACOPSMl, assume that an entire people group has been culturally traumatized but that they are non-disordered and competent enough to bring their own Third Wave discussions to the table in an attempt to stop perpetuating their own culturally traumatic dysfunction and stabilize their own society. If I were a candidate, I think this is what I would do, but that kind of dialogue is so far from the norm in politics...a universe apart from what is allowed...yet right next door to where the current needs lie.

You introduced me to the important word "iatrogenic". Thank you again for your significant work in this area. I have yet to find anyone that packages and discusses relational trauma as you do. I have personally downloaded your thesis because I truly value what you have to say.

What I am also writing about is to see if I might have your permission to post a link to your thesis. There are many people these days that are in the mode of mental self-help, and your thesis goes a tremendous distance to acknowledge, in lay terms, the plight of people that are trying to be healthy, productive citizens but who have some really screwed up parents. As you point out, though, this is much more about being healthy than it is to point fingers, as many ACOPSMI have parents who are also ACOPSMI. These unfortunate family traditions may go back for generations. This area of study could even lead to a sociological study of generalized social anxiety and trauma that is perpetuated by some deeply held cultural beliefs and practices.

While I am obviously not a mental health professional, I believe your work is significant enough to warrant further publicity in the everyday channels of life and not just in the often sterile libraries of the practitioner. You have written it in an accessible enough manner that I believe most relatively educated individuals could gain a lot by reading your words.

One of the reasons I like your thesis so much is that it opens the door to the machine room of humanity. For me, this is where I see all of the gears of human behavior turning and meshing, and it reinforces what I have known for a long time but haven't had the vocabulary to describe. It stabilizes me greatly, and provides a significant (and healthy) challenge to know how and why to self-regulate, what defines competency, and what healthy attachment actually looks like.

Another thing that is so valuable about your work is that people DON'T have to have SMI parents to benefit from your approach. All of our own parents are messed up to some extent and we as parents will also make mistakes that will negatively affect our children. Your work acknowledges this at the extreme level, but the theories you use and the intuition from which it originates can be scaled back even to the everyday parent. Your work is relevant to the average individual simply seeking to stop even minor dysfunctional family traditions.

In lay terms, your specialty describes a subset of the population who are "normal people trying to recover from having a very screwed up parent or parents." While there is obviously much more to it than that, I find that your approach goes great distances to diminish the stigma associated with mental health simply by acknowledging the fact that your own personal experiences give you a voice that should be acknowledged and considered by the mental health community.

Of course, now that I am well into the parenting years myself, I tread much more lightly on the subject of parental dysfunction, lest my own children seek out advice on CaN-ACOPSMI themselves someday!

You know, when you write something from the heart as I believe you have done with your thesis, it resonates deeply with people in a very real way. I imagine that this is one of the reason why your thesis has been so popular.

I don't need to read your thesis in it's entirety at all because what I pick up on is your "trajectory of thought." It is the brush strokes, the colors, the shadows and hues of what you write that tell my mind that this is a safe place where I am understood and acknowledged.

As with most artists, they do not need to stand next to every piece of work and talk to the viewers for their artwork to be valuable and very meaningful. In fact, the majority of them will eventually buy your art because of its impact on them, take it home, and hang it on the walls of their minds to admire and reflect on as the years go by.

Not many out there can do what you do in the way that you do it.

I would also dare say that your work could warrant an academic major all its own both at the undergraduate and graduate level, as it could be expanded both in breadth and depth in many ways. You are speaking to such a widely affected audience. Rather than simply diagnosing a disorder, you are aiming at putting an end to a family tradition of dysfunction".

- Adam Read, Assistant Construction and Superintendent – Pennsylvania, USA

Owner of IatroGenesis, a LinkedIn Discussion Group

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“I’ve just finished reading through your thesis. It is a major work! I found it beautifully detailed, extensive, and a needed contribution for an underestimated issue. I also found some new references I wasn’t familiar with (such as, Lanius, et al., 2010).

I, too, find the trauma research to be needed. It is provides a remarkably comprehensive way of understanding emotional and other pain, as well as addictions and health issues of all kinds from mental to physical health and more. Your elucidation of this particular group of Adult Children of Parents with a Severe Mental Illness (ACOPSMI) is a great example of how subtle, invisible, unrecognized the role of trauma is, and how difficult it can be to identify by these individuals, as you describe, but also by a culture that doesn’t see it either.

I think that chronic illness may stem from similar experiences and that childhood trauma can come from even the most subtle of attachment disruptions and misattunements. I don’t think the more overt (and easier to recognize) experiences of experiencing childhood with parents with PTSD or severe mental illness is needed to influence risk for chronic illness.

The subtlety of emotional unavailability in the face of otherwise competent adult behaviour is part of why the effects of our own trauma can be so difficult to recognize. Many parents fit within what we think of as “normal” but experience tremendous unresolved and unrecognized pain. There may be no known overt abuse or mental illness in a family. Sometimes, however, you find trauma, abuse, great losses and more just a few generations back. This brings up the question of how far down the line the effects of SMI in one generation can impact the next. My sense is that they go much, much farther than we’ve ever imagined.

I’ve been exploring the role of trauma in the origins of chronic physical illness and find your work to be completely applicable to this group of people as well.

The role of type II (and even type I) trauma in chronic illness is unrecognized by most individuals who have a disease, as well as by providers of mental and physical health within the traditional medical model – despite research such as Felitti’s ACE studies.

Treatment approaches for chronic illness, similar to what you describe in the review of treatment options for ACOPSMI, does not consider trauma. Instead, people who have a chronic illness can be judged as lazy, weak-willed, or seeking attention when their behaviors actually reflect survival strategies. They may be shamed and blamed by their health providers, just as they were by their parents in childhood.

Another barrier to treating trauma in chronic illness is the way our culture has denigrated the concept of psychosomatics. When people with chronic physical illness are referred to psychotherapy, they often feel offended and unseen. They feel they are not being taken seriously. This happens in part because their health care providers really don’t see them. And because the medical model really does think it’s all in their heads rather than in their body-minds.

Suzette, your work elucidating the long-term effects of parental mental illness on children's lives, health, capacities to lead satisfying and productive lives is an important addition to the literature. We are growing our science and understanding that adverse life experiences influence the individual as well as future generations and that these effects are not "psychological." They are the result of epigenetic changes. The same is true in my own research identifying the under-recognized role of adverse life experiences - including parental mental illness - on risk for chronic physical illness. See: https://chronicillnesstraumastudies.com/

Dr Veronique Mead – somatic psychotherapist and physician specialized in family medicine (previous assistant professor at Dartmouth Family Practice Residency program teaching residents/medical students and providing full spectrum outpatient and inpatient community hospital care).

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"Your research was recently forwarded to me via a Facebook group called 'Sons and Daughters of Parents with a Mental Illness’. I am an Adult Child whose parent has paranoid schizophrenia, I am also a counsellor and I'm currently completing my MA. I have read your thesis and it’s extremely interesting, would you mind if I make reference to you and quote your research in my MA?"

Rada Graovac: Psychological Therapist, working for the National Health Service,

Child & Adolescent Mental Health , UK

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"I have read your thesis and would like to add my congratulations to the many already on your resource website list. I think you have written a stunning thesis which addresses a very overlooked area.

My PhD (working title: A narrative inquiry into the lives of adults who grew up with mentally ill parents) is now in the writing up stage and is research which explores the retrospective stories from ACOPMI. I belong to this group too and am writing reflexive aspects throughout the thesis. You are the first person I think who I have heard acknowledge the trauma which is something I feel strongly about, since I am sure my siblings and I have all had PTSD. Also, at the moment in the UK there is no similar resource website as yours".

-Zoe Cowie Phd (in progress) UK.

* * *

“I didn't thoroughly read your entire thesis; I skimmed through it, focusing on the parts relevant to me. I reluctantly read your paper the night before a session with my psychologist, I say reluctantly because my mother died about three years ago and I liked to think that any problems my mother caused me, ended when she died.

Obviously I must have absorbed the important facts to have broken down over it during counselling the next day. When talking to my psychologist, my mother was mentioned and I became quite agitated. In the end, after my psychologist prompted me to talk about my mother (till now discussions have centred on my ex-partner) I just said my mother was always very homesick and then I burst into tears.

I questioned why I didn't see the obvious sooner, especially given the fact that my mother and ex-partner were so similar. But on reading your resource website (i.e., before reading your thesis) I think the term 'parent diagnosed with a severe mental illness' threw me. Firstly mum was never diagnosed and secondly I never, ever saw her as having a severe mental illness. I just saw her as misogynist and abusive. I think severe mental illness conjured up the picture of a crazy axe murderer for me!

My main emotion after reading your paper was indignation - it’s not over yet, and irony - at least I'm high functioning. But mainly I was pissed off because a) my mother screwed up my life and b) no one would believe me.

Even saying that my mother screwed up my life causes conflict because we are supposed to take responsibility for our lives and not blame our parents for our losses and failures. As adults we are discouraged from using our parents for reasons to be dysfunctional. We are expected to ‘move on’. I needed my mother to [physically] die to ‘move on’. I finally owned my life – not the life she owned inside me.

Having a mother who abused me, clearly didn't like or love me, caused me to go through life thinking "even my own mother doesn't love me" and often feeling that I didn't even deserve to live. And then there is all that pressure to "be good to your mother".

I told my psychologist about your paper and she took it all in and suggested I extend my sessions into next year and focus on my mother. Just when I thought I was 'cured' dam!

So what I'm left with and what I wanted to pass onto you, because you might find it helpful, are two main points.

Firstly, I think your use of experiential accounts in your research, i.e., “Third Wave literature”, when discussing the parent with mental health issues is key and served as a trigger for me. Many of the authors were talking about their mothers. Society’s views of mothers centres on the notion that they love you, they care for you, they are self sacrificing, and lift mothers to an almost saintly status, and then there's Mothers Day.This made it impossible for anyone to believe that I was being abused by my mother.

It seems everybody else has been so brainwashed with the image of the ideal loving mother that nobody would believe me when I said my mother abused me – nobody including some of the counsellors whose support I was seeking! I even lost friends over it. Yet if I'd told people that my father abused me, they’d just believe it. They wouldn’t hesitate to validate that. So in your resource website under “TASKS for Recovery” I found “Task #1. Believe all your experiences did happen to you and were real” very helpful and validating.

Secondly, a woman growing up around an abusive mother creates a double whammy. This person is supposed to be your role model. There is supposed to be a special bond between you. Your mother is supposed to teach you how to become a woman, how to be a good wife and a good mother.

I will give my psychologist the links to your thesis and resource website at my next appointment, I'm sure she will find it helpful to her practice. I should also alert my GP because I have mentioned my mother’s emotional abuse to him over the years and he has always appeared incredulous, as have the many counsellors I have seen since becoming a mother myself.

I lived in absolute horror of turning out like my mother. Being told how much I resembled my mother caused me actual pain and I always felt insulted which in turn made me feel ashamed of myself. I used my father as a role model and told myself that mum was there to teach me how not to behave.

A female growing up with an abusive same sex parent carries many additional problems, you are less able to divorce yourself from your mother and, while everyone is only too willing to believe in abusive fathers, nobody, and I mean nobody will believe you when you say you are an adult and still being abused by your mother. You are simply dismissed and you never receive the validation that you need. We all wholeheartedly believe and support a victim of paternal abuse, addressing maternal abuse still appears to be very much taboo. Society still won't go there unless of course the abusive mother is a junkie or promiscuous. That's the generally held stereotype for an abusive mother.

The most frustrating part, in my lifelong attempts at having my problems with my mother validated, is that everyone brushed it off as a generational thing. They believed all women my mother’s age dispensed “tough love” and that supposedly made us strong.

I'm pretty certain that, like my ex partner, my mother was Borderline (i.e., had Borderline Personality Disorder) but my mother was never diagnosed. As far as my mother was concerned, any sign of mental health problems a person might suffer were regarded by her as a sign of weakness. For example she had no compassion for anyone suffering depression or anxiety.

I don't think I would have carried this around with me for as long as I have if my pain around my mother’s rejection of me, or the longing for her love and approval, would have been validated.

But I'm there now so thanks Suzette! It's really helpful to me to know why my mother treated me the way that she did, that it wasn't my fault (not even her fault, she had a mental health illness), that I was a good daughter and therefore, in turn, that I am a good person. Being a good person has always been paramount for me throughout my life, because my mother always challenged that.

So again, thank you, thank you, thank you for all your time and support – both rare and so very much appreciated”.

- Careers Counsellor (Anonymous)

* * *

"I've read through some of the comments about your research. Clearly you've made a great contribution on the trauma issue of competent adults with parents with mental difficulties. The issue is apparently very crucial today as modernity intrudes into every corner of the globe, connecting people with different background and difficulties, such as mental issues, together in every aspect of life. I assume the mental issue of parents do not only affect their children in a vertical way but also in a horizontal way towards their neighbours, friends, colleagues, etc.”

Libu Lakhi Phd (in progress)

* * *

"I think you opened up a field of study that no one had ever considered before, let alone know how to go about collecting information about it. Both from my practice and from personal experience, I would like to see more exploration and discussion on this topic. It's a context that needs to be provided, for I suspect there are many people who have no context within which they can feel validated, normal, and free to share their experiences, their feelings, and the burden they have been carrying alone."

Shoshana Hayman, parenting consultant and group facilitator, Neufeld Institute Intl.

* * *

“Thank you, Suzette. I like the quote by Felitti: "Time does not heal the wounds that occur in those earliest years; time conceals them. They are not lost; they are embodied". I think your writing touches upon a confusing aspect of being raised by a 'mentally ill’ parent. Often as a young child, we do not understand our parent's dysfunctional behavior. For me, it just felt like living with a 'crazy' person. I had no frame of reference in which to make sense of what I experienced. I think this is traumatizing in and of itself: the disconnect between what I understood to be 'normal' behavior exhibited by 'normal' people as opposed to what I experienced at home. Trauma is treated as a mental illness when there is no framework given to understand it as otherwise”.

Jennifer Mourrain Writer · Educator · Mental Health & Child Advocate

* * *

"It sounds like such a valuable contribution to the field, and your website is very user-friendly, and your thesis is very easy to understand and apply. I am so glad you are getting downloads on such an important piece of work."

Kylie Hickey, Social Work PhD (in progress)

* * *

“Thanks so much for sharing your Masters thesis. Your research of the topic is so comprehensive. You have written it so beautifully, with lovely quotes from other research that brings tears to the eyes.

Some of the quotes from children who had suffered trauma from parents unable to help them feel safe and loved, are so descriptive. This reminds me of stories I have heard from relatives and clients who had difficult childhood experiences. So I started to think about how this research might be good for some to read, to help feel validated. Perhaps I might use some of the quotes to help others who might resonate with their experiences, and help give expression to their own unhappy times. Meanwhile, I was personally moved by your work. Thanks.”

Julie Morsillo, PhD, psychologist and lecturer

* * *

"A first responder said to me recently, 'hurt people hurt people' and that is one of the reasons your work is so fundamentally important. If we can get to a point as a species where we give ourselves permission to pause from attacking one another....to take a momentary break from the barrage of aggression and conflict that continues to be seen, then maybe...just maybe...we might get a small glimpse of how far off course we really are and how we are more than likely fighting against the unrest in our own minds more than anything else.

My hope is that as people begin to educate themselves on topics such as attachment, emotional intelligence, restorative practices, restorative justice, etc., we will begin to corporately move past the heavy-handed, vertical authority models that have been in use for so many centuries. I believe greed is not a vice, but a secondary symptom of fear and of being terrified. Arrogance and narcissism are also defense mechanisms that say we do not feel safe enough to admit we are wrong. Rebellion is a form of self-defense, too, and we must be careful not to crush the virtuous desire for justice and equality by assuming that every form of rebellion is instead an act of insolence. Anger often masks hurt. Pride often masks insecurity; and revolutions are often an indicator that no one is listening. Yet we continue to preach immorality and depravity are to blame. This diagnosis is fundamentally inaccurate and may in part perpetuate some of the trauma due to its iatrogenic treatment of the true problem.

I believe even Freud also made a comparison at some point to the ability to assess large groups of people as if they are acting as one individual, with one common mind. In that regard, I believe your work has the ability to be scaled up to diagnose groups of people rather than just individuals. It is the same concept as an architect or engineer who draws a building at a scale where 1/4 inch on a page is equal to 1 foot in real life, so that a wall that measures five inches on the page is in fact 20 feet long on site.

Your work might also be compared to diagnosing a single celled organism (i.e., an individual person) that is surrounded by other single celled organisms, and the often traumatic effect that those other cells have on the one individual. What I am suggesting is that your same theories may apply very well to the interaction of multi-cellular organisms (groups of highly complex people, cultures that interact with groups within their own cultures or with other cultures, etc.), and this is where I believe the impact of your work may be logarithmic in its impact on society. Logarithmic graphs are ones where every point on the graph is the previous value, multiplied by some number, hence the suggestion that your audience might grow from 35 to 350, to 3,500, etc., (a logarithmic factor of 10)”.

- Adam Read, Assistant Construction and Superintendent – Pennsylvania, USA

Owner of IatroGenesis, a LinkedIn Discussion Group

* * *

"So glad I chanced upon you. You said you would carry a torch as we journeyed together and you did a marvelous job. You supported me as I gained perspective on my early life. I now realise I had no option but to problem solve as I did from a very early age. I feel wiser and more free moving forward and will be kinder on myself.

Heartfelt appreciation for your work Suzette".

- Client who also read the thesis (Anonymous)

* * *

“You have certainly made a major (trailblazing) contribution professionally. You have also touched the lives of many. Your findings have resonated so deeply with children of parents with mental illness.

Without a doubt, there is a wide spectrum of outcomes for children of mentally ill parents. While some are lucky enough to have supports to buffer childhood trauma and mitigate the impact of toxic stress, others deal with lifelong physical and mental health problems. Then, as your research shows, there are those of us—huge in number—who fall in the middle ground and fit the category of competent, functioning adult children of parents with serious mental illness.

I consider myself to be a non-disordered, competent adult child of a parent with mental illness. As such, your research findings hit home for me.

You write that nothing about us would stand out in an ordinary crowd. We demonstrate competency in society while masking internal struggles. You mention that many competent adult children function as chameleons. I know what playing chameleon feels like.

You note that such individuals “had professions, their own families, and were otherwise competent, even highly successful in some cases … They had rebuilt their existences as competent, non-disordered, useful citizens. But the impact of being raised by severely troubled parents contributed to their sense of desolation, physical and mental exhaustion—often involving deep shame and loneliness.”

Despite accomplishments in my professional life, I often felt like an impostor. I have no children of my own. I never heard the ticking of a biological clock. I attribute my childlessness to my tumultuous upbringing. Now, every so often, I feel a twinge of resentment. Maybe I lost out. I don’t dwell on my childlessness, though. I have a close relationship with my nephew, and I enjoy the time I get to spend with my step-daughters and grandchildren.

At the age of sixty-three, I still suffer from anxiety, which I trace back to my upbringing. But it is not debilitating.

Your research on competent adult children of parents with severe mental illness has yielded a wealth of insight. On a personal level, it has helped me put the pieces of my life together. Thank you”.

Alice M. Kenny, author of Crazy Was All I Ever Knew: The Impact of Maternal Mental Illness on Kids

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Hello Suzette,

I am a clinical social worker and author originally from the US but living in the UK.

I reached out to you because I was deeply moved by your article (published in the European Society for Trauma & Dissociation Newsletter) in which I felt my own experience was comprehended. I’m sure you’re familiar with the work of Alice Miller the Polish- Swiss psychologist who wrote so movingly about parental child abuse. Eons ago in graduate school I recall reading her with the feeling of: Oh yes, she gets it! I had a similar feeling when I read your work. So thank you for that.

Fortunately, I’ve been one of the lucky ones. I had two, as I call them “guardian angels,” who saved me as a teen — a biology teacher and a therapist. They were what Miller termed “enlightened witnesses.” Although it’s often been a struggle, I haves survived and am a survivor of a parent with undiagnosed mental illness. Sadly, both my other parental figure and a sibling died prematurely and I have no doubt, in part, due to the trauma of living in our family of origin and not having access to any therapy, let alone trauma informed therapy.

With gratitude,

Anonymous

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Dear Suzette,

[My partner] and i were just talking about you last night. how ironic i hear from you as i write this email i am a bit teary you have been an important person in my life.

sorry i just needed to say that and appreciate all you have done for my family and I.

to read you have retired is hard for me but you have no doubt left your mark on many and i am one of those! i am fortunate to have met you and fortunate to have survived unlike others that could not get help.

thank you for the [resources], websites and podcasts which help me understand my children just as you have, [i.e.] to be a better father.

being trauma informed helps me deal with me and only those who can understand the day to day triggers can really appreciate the loneliness in the trench, it is gut wrenching exhaustive and unfair, you have not resolved my pain but given me boots and the ladder to climb out of the trench, just knowing they are there is enough.

forever in my thoughts and simply thankyou!

- Former client who also read the thesis (Anonymous)

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To access a brief article entitled: “An Unacknowledged Trauma: The Adult Legacy of Growing up with a Mentally Ill Parent” click on this link:

https://www.linkedin.com/pulse/unacknowledged-trauma-adult-legacy-growing-up-ill-parent-misrachi?trk=prof-post

Here are other short articles I was invited to write in an E-publication designed to keep mental health practitioners up to date with psychiatric and psychological research and opinion from around the world. I've put these short articles on the following link for the general public:

https://suzette-misrachi.medium.com/

Last Modified: 11th Feb, 2017.