Trauma model of mental disorders

The “Trauma model” of mental disorders is an expression coined by psychiatrist Colin A. Ross as a solution to the problem of comorbidity in the mental health field. An information packet given to inpatients at the Ross Institute for Psychological Trauma describes the basis of the trauma model in commonsensical terms:
 * “The problem faced by many patients is that they did not grow up in a reasonably healthy, normal family. They grew up in an inconsistent, abusive and traumatic family.  The very people to whom the child had to attach for survival, were also abuse perpetrators and hurt him or her badly [...] The basic conflict, the deepest pain, and the deepest source of symptoms, is the fact that mom and dad’s behavior hurts, did not fit together, and did not make sense”.

In Schizophrenia: an Innovative Approach to Diagnosis and Treatment (2004), Ross determines that some patients diagnosed with schizophrenia have symptoms related to Dissociative identity disorder (pdf).

Before Ross, in the 1940s, 50s, 60s and 70s other mental health professionals, mostly psychiatrists, proposed trauma models to understand schizophrenia: Harry Stack Sullivan, Frieda Fromm-Reichmann, Theodore Lidz, Gregory Bateson, Silvano Arieti, Ronald Laing and others. They held that schizophrenia is induced by experiences in profoundly disturbed families. Though the Diagnostic and Statistical Manual of Mental Disorders or DSM does not claim that the specific etiology of schizophrenia and other serious psychoses has been established, the psychogenic models proposed by these early researchers are no longer in vogue in the psychiatric profession. Before his death in 2001, aged ninety, Theodore Lidz expressed regret that current research in biological psychiatry is “barking up the wrong tree”. Like Lidz, Ronald D. Laing insisted that the cause of both schizoid personalities and schizophrenia was influenced by family relationships.

In 1975, Silvano Arieti won the American National Book Award in the field of science for his book, Interpretation of Schizophrenia, which advances a psychological model for understanding all the regressive types of the disorder. Critics of the model argue that the logic of the claim that childhood trauma causes insanity demonstrates a serious flaw. If the claim were true, critics contend, the abuse of millions of children over the years should have caused many cases of insanity; but no evidence exists. Decades before Ross, Arieti had addressed this line of argumentation, stating that the only persons before whom young human beings are vulnerable are the ones to whom they are emotionally bonded in childhood. A passage of Interpretation of Schizophrenia, originally published in 1955, sheds light on the heart of the trauma model:
 * “First of all we have to repeat here what we already mentioned [...], that conditions of obvious external danger, as in the case of wars, disasters, or other adversities that affect the collectivity, do not produce the type of anxiety that hurts the inner self and do not themselves favor schizophrenia. Even extreme poverty, physical illness, or personal tragedies do not necessarily lead to schizophrenia unless they have psychological ramifications that hurt the sense of self.  Even homes broken by death, divorce or desertion may be less destructive than homes where both parents are alive, live together, and always undermine the child’s conception of himself”.

In more recent years, psychologist Alice Miller, author of twelve books on mental distress and disorders, including non-psychiatric conditions like falling prey of cults, has informed future parents and former victims about the disastrous consequences of child abuse. Former schizophrenic patients, such as John Modrow, have also endorsed the views of the pioneers of the trauma models. Presently, psychohistorians also endorse trauma models of schizoid, narcissist, masochist, borderline, depressive and neurotic personalities. 

Biological psychiatry dismisses sole trauma models, with most mainstream psychiatrists instead believing that complex genetic factors interacting with environmental factors trigger mental disorders. Though not a biological psychiatrist, Colin Ross maintains that the DSM classification could be grouped into three categories: neurological disorders (e.g. mental retardation), mixed neurological-trauma disorders and trauma disorders.