"I'm Glad My Mom Died" by Jennette McCurdy

[futureapppsy2]

Anyone else read/listen to this? It's a memoir by a former actress who was on an extremely successful live action tween show (ICarly) from 2007-2011. She talks a lot about how emotionally and sexually abusive her mother was to her and her siblings (as well as doing things like chasing her dad around the kitchen with a knife on a frequent basis), and her mom teaching her how to be anorexic at the age of 11, which later became severe bulimia (multiple binge-purge sessions a day, etc). It's surprisingly well written and spent several weeks at #1 on the NYT best seller list.

Some thoughts:
-Her mom sounds *incredibly* cluster B (NPD/BPD), as does her maternal grandmother.

-She talks about making choices almost exclusively based on what would keep her mother emotionally regulated from a very young age and not knowing what to do when her mom died, because she had never made any choices on any other basis from childhood to young adulthood.

-She's very critical of child acting and the industry around it, because it forces children to try to play a manipulative, intense, and complicated "game" (showbusiness) designed for and by adults, especially if they don't have extremely clued in and protective parents. She says that the creator of her big show pushed the cast to get drunk underage, among other things, and the network offered her hush money (framed as a "thank you gift") to not talk about him (she declined).

-At one point, her mom sends her an email where her mom calls her a fat, disguisting slut, disowns her, and says that she no longer considers her her daughter, because she... went to Hawaii with an older boyfriend and got papped. Her mom unironically ends the email with "ps. Send money."

-She talks a lot about getting therapy for her ED and seems to have really, really liked and responded well to CBT (she mentions all the worksheets, heh).

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[PsyDr]

Honestly: this sounds like some weak abuse. There are a ton of rich kids going through worse.

 

[futureapppsy2]

Honestly: this sounds like some weak abuse. There are a ton of rich kids going through worse.

Eh, if you read the book, it becomes clear how insanely constant the emotional abuse was (and she was with her mom 24/7–homeschooled or working—until she was 18, so no respite) plus sexual abuse (“inspecting” her genitals from childhood well into her teens, etc).

 

[wysdoc]

Eh, if you read the book, it becomes clear how insanely constant the emotional abuse was (and she was with her mom 24/7–homeschooled or working—until she was 18, so no respite) plus sexual abuse (“inspecting” her genitals from childhood well into her teens, etc).

I’ve read about her life experiences too and this was a very exploitative and abusive relationship

 

[PsychJustice]

Honestly: this sounds like some weak abuse. There are a ton of rich kids going through worse.

Does it matter? Unless you only choose to read or pursue non-fiction literature based on the severity of the abuse endured by the victim.

 

[BuckeyeLove]

I’m honestly amazed this girl came out without full blown BPD. Every possible thing to make a borderline personality disordered individual, she had thrown at her. Some serious resilience.

 

[WisNeuro]

I’m honestly amazed this girl came out without full blown BPD. Every possible thing to make a borderline personality disordered individual, she had thrown at her. Some serious resilience.

Take a gander at the Rutter and similar longitudinal literature, resilience is the modal response for children in fairly adverse circumstances.

 

[futureapppsy2]

Take a gander at the Rutter and similar longitudinal literature, resilience is the modal response for children in fairly adverse circumstances.

I mean, she did have a pretty severe ED and some alcohol use problems (not sure if it would meet the criteria for full-blown AUD), so would she even count as “resilient” in the literature?

 

[WisNeuro]

I mean, she did have a pretty severe ED and some alcohol use problems (not sure if it would meet the criteria for full-blown AUD), so would she even count as “resilient” in the literature?

Depends on the outcome being measured, and how resilience is defined, as it has varied in the past literature. In a general sense, they usually look at functional outcomes and/or moderate to severe chronic psychiatric issues. But there's some other stuff generally looking at positive outcomes, relatively speaking. But, I would say that most would not consider the presence of any psychiatric disorder at some point not indicative of resilience. Though, if you consider the PTSD lit, the overwhelming number of people exposed to criterion A events do not go on to develop PTSD or other disorders due to the exposure.

 

[futureapppsy2]

Depends on the outcome being measured, and how resilience is defined, as it has varied in the past literature. In a general sense, they usually look at functional outcomes and/or moderate to severe chronic psychiatric issues. But there's some other stuff generally looking at positive outcomes, relatively speaking. But, I would say that most would not consider the presence of any psychiatric disorder at some point not indicative of resilience. Though, if you consider the PTSD lit, the overwhelming number of people exposed to criterion A events do not go on to develop PTSD or other disorders due to the exposure.

I can’t see her falling in the “resilient” category in most operational definitions, given the severity of her bulimia, tbh. But I have some issues with the resilience literature in general, in large part because I’ve seen people become so obsessed with being “resilient” that that weren’t willing to admit or get treatment for their issues, even when they were causing functional impairment.

 

[smalltownpsych]

Not all victims of childhood maltreatment will develop BPD and not all people with BPD have experienced severe abuse. This stuff is correlated so we do frequently see connections and those are real, but the exceptions to these patterns are not exactly rare so we should be on guard against mistaken assumptions. Don’t want to be like the plethora of midlevel counselors out there. 😁

 

[WisNeuro]

I can’t see her falling in the “resilient” category in most operational definitions, given the severity of her bulimia, tbh. But I have some issues with the resilience literature in general, in large part because I’ve seen people become so obsessed with being “resilient” that that weren’t willing to admit or get treatment for their issues, even when they were causing functional impairment.

Fair critique, particularly with some of the 90's work that intersected with the mess that is positive psych. My point was more in line with we shouldn't be surprised when people come out of adverse experiences doing fairly well, as that is the norm.

 

[futureapppsy2]

Fair critique, particularly with some of the 90's work that intersected with the mess that is positive psych. My point was more in line with we shouldn't be surprised when people come out of adverse experiences doing fairly well, as that is the norm.

I just wish that people (including clinicians and researchers) could better handle the dialectic of "If you experience adverse/traumatic things, you can come out without psychopathology, and if you experience adverse/traumatic things and develop psychopathology as a result, you aren't a "weak" person because of it."

 

[ClinicalABA]

I just wish that people (including clinicians and researchers) could better understand that handle the dialectic of "If you experience adverse/traumatic things, you can come out without psychopathology, and if you experience adverse/traumatic things and if you develop psychopathology as a result, you aren't a "weak" person because of it."

Exactly. I took the liberty of editing your comment to make another related point.

 

[WisNeuro]

I just wish that people (including clinicians and researchers) could better handle the dialectic of "If you experience adverse/traumatic things, you can come out without psychopathology, and if you experience adverse/traumatic things and develop psychopathology as a result, you aren't a "weak" person because of it."

I agree, we definitely need to do a better job at not iatrogenically over-pathologizing experience to traumatic events, as well as validating those that do need some extra help in adjusting. I may be biased, as in the course of my work, I see far too much of the former.

 

[bcliff]

Unrelated to the thread, but I had a conversation about PTSD with an educated friend who does not work in healthcare, and they were *shocked* to learn that there were specific diagnostic criteria for PTSD -- "You mean, not everyone who experiences trauma develops PTSD? You mean, people can develop conditions other than PTSD after trauma? PTSD isn't just what you call distress that occurs after something traumatic happens?" -- It was... illuminating. It also gave me a renewed appreciation for our skillset and perspective as a field. Although, I think it goes without saying that there is also *a lot* of misunderstanding of PTSD and its associated EBPs within our field, too, which is frustrating.

 

[erg923]

Unrelated to the thread, but I had a conversation about PTSD with an educated friend who does not work in healthcare, and they were *shocked* to learn that there were specific diagnostic criteria for PTSD -- "You mean, not everyone who experiences trauma develops PTSD? You mean, people can develop conditions other than PTSD after trauma? PTSD isn't just what you call distress that occurs after something traumatic happens?" -- It was... illuminating. It also gave me a renewed appreciation for our skillset and perspective as a field. Although, I think it goes without saying that there is also *a lot* of misunderstanding of PTSD and its associated EBPs within our field, too, which is frustrating.

I think this has long been a consequence of the development of the PTSD diagnosis. The most common pathology due to trauma is good ole mood disorders/dysregulation and anxiety, rather than the specific criteria and symptoms of PTSD.

 

[WisNeuro]

I think this has long been a consequence of the development of the PTSD diagnosis. The most common pathology due to trauma is good ole mood disorders/dysregulation and anxiety, rather than the specific criteria and symptoms of PTSD.

We have the studies on this as well, especially in military populations, luckily, most people still do not develop any sort of mood or PTSD disorder after a criterion A trauma.

 

[cara susanna]

Unrelated to the thread, but I had a conversation about PTSD with an educated friend who does not work in healthcare, and they were *shocked* to learn that there were specific diagnostic criteria for PTSD -- "You mean, not everyone who experiences trauma develops PTSD? You mean, people can develop conditions other than PTSD after trauma? PTSD isn't just what you call distress that occurs after something traumatic happens?" -- It was... illuminating. It also gave me a renewed appreciation for our skillset and perspective as a field. Although, I think it goes without saying that there is also *a lot* of misunderstanding of PTSD and its associated EBPs within our field, too, which is frustrating.

Yup, I read web comics and I've seen a lot of lay people comment after a character experiences a traumatic event that they have "PTSD." I'm like, no, right now it's still a normal acute trauma reaction.

 

[Sanman]

Yup, I read web comics and I've seen a lot of lay people comment after a character experiences a traumatic event that they have "PTSD." I'm like, no, right now it's still a normal acute trauma reaction.

On the flip side, I have a guy that has had nightmares on and off for 20 years following an traumatic incident and does not believe it could be PTSD because that was not the diagnosis given to him following the trauma 20 years ago and the symptoms wax and wane.

 

[Shiori]

I have clients that prefer to keep their mild and moderate PTSD symptoms. They are okay giving up sleep and some joy to live as the "sheepdog" amongst friends and family. I tell them about the pros and cons and let them decide what matters more to them right now. I've plant the seed that they can have something different and what that process looks like. I've also taught them that these symptoms have been adaptive and useful so they stop walking around thinking they're broken. It's a much easier place to work from when they're ready for a change.

This book is on my reading list, and my audible credits just refreshed!

 

[cara susanna]

I have clients that prefer to keep their mild and moderate PTSD symptoms. They are okay giving up sleep and some joy to live as the "sheepdog" amongst friends and family. I tell them about the pros and cons and let them decide what matters more to them right now. I've plant the seed that they can have something different and what that process looks like. I've also taught them that these symptoms have been adaptive and useful so they stop walking around thinking they're broken. It's a much easier place to work from when they're ready for a change.

This book is on my reading list, and my audible credits just refreshed!

Yup, it's all about the pros and cons. If avoidance is working for them, cool. It's not what I'd recommend, but it's their choice.

 

[futureapppsy2]

Yup, it's all about the pros and cons. If avoidance is working for them, cool. It's not what I'd recommend, but it's their choice.

It's important to explore what "working for them" means and if it really is (MI style), of course. PTSD treatment can be scary and intially difficult, and that can build resistance to tx/admitting how much impairment there really is, even when there's substantial functional impairment.

 

[cara susanna]

It's important to explore what "working for them" means and if it really is (MI style), of course. PTSD treatment can be scary and intially difficult, and that can build resistance to tx/admitting how much impairment there really is, even when there's substantial functional impairment.

Oh, of course, and long term vs. short term effectiveness.

 

[PsychPhDone]

I have clients that prefer to keep their mild and moderate PTSD symptoms. They are okay giving up sleep and some joy to live as the "sheepdog" amongst friends and family. I tell them about the pros and cons and let them decide what matters more to them right now. I've plant the seed that they can have something different and what that process looks like. I've also taught them that these symptoms have been adaptive and useful so they stop walking around thinking they're broken. It's a much easier place to work from when they're ready for a change.

This book is on my reading list, and my audible credits just refreshed!

Am listening on audible, am a fan of this format. I really like when the author does the recording and is actually a pleasure to listen to.

 

[NewNeuroDemic]

Honestly: this sounds like some weak abuse. There are a ton of rich kids going through worse.

Dude, you are insufferable. Is there a single topic on this forum for which you don't have something inane and vaguely caustic to say?

 

[PsyDr]

Dude, you are insufferable. Is there a single topic on this forum for which you don't have something inane and vaguely caustic to say?

So which part of your ad hominem question that unrelated to the subject is neither inane nor caustic?

I’m literally a professional at talking smack. Sometimes I encourage people to make money, so I can make more. Nice try.

 

[smalltownpsych]

On the flip side, I have a guy that has had nightmares on and off for 20 years following an traumatic incident and does not believe it could be PTSD because that was not the diagnosis given to him following the trauma 20 years ago and the symptoms wax and wane.

Some of why patients of mine haven’t wanted to acknowledge long standing and pretty clear PTSD is because of the ridiculous stuff about “trauma“ in the media and general public or people using it as an excuse or free ride.

 

[smalltownpsych]

I am not sure of the specifics and I have definitely heard worse stories of abuse, and I am doubtful that this patient would have the level of physiological symptoms as much as they would be having maladaptive interpersonal patterns. Since we don’t really have a diagnosis that directly describes how unstable childhoods produce some of these types of problems later in life and these types of childhoods often have abuse in the mix, then it makes some sense for people to call it all abuse. I help my patients sort it out for themselves and emphasize that whether or not they have PTSD, that parent sounds pretty crazy and it probably affected you.

 

[smalltownpsych]

Also, my patients like this might attribute every problem or aspect of their personality to the negative stuff in childhood so part of the process is helping them to sort that stuff out. Also, there might be positive aspects of parenting and childhood that this young lady would want to integrate. This kind of stuff is where I lean a little more into the Object Relations side of me.

 

[icomeheresometimes]

Anyone else read/listen to this? It's a memoir by a former actress who was on an extremely successful live action tween show (ICarly) from 2007-2011. She talks a lot about how emotionally and sexually abusive her mother was to her and her siblings (as well as doing things like chasing her dad around the kitchen with a knife on a frequent basis), and her mom teaching her how to be anorexic at the age of 11, which later became severe bulimia (multiple binge-purge sessions a day, etc). It's surprisingly well written and spent several weeks at #1 on the NYT best seller list.

Some thoughts:
-Her mom sounds *incredibly* cluster B (NPD/BPD), as does her maternal grandmother.

-She talks about making choices almost exclusively based on what would keep her mother emotionally regulated from a very young age and not knowing what to do when her mom died, because she had never made any choices on any other basis from childhood to young adulthood.

-She's very critical of child acting and the industry around it, because it forces children to try to play a manipulative, intense, and complicated "game" (showbusiness) designed for and by adults, especially if they don't have extremely clued in and protective parents. She says that the creator of her big show pushed the cast to get drunk underage, among other things, and the network offered her hush money (framed as a "thank you gift") to not talk about him (she declined).

-At one point, her mom sends her an email where her mom calls her a fat, disguisting slut, disowns her, and says that she no longer considers her her daughter, because she... went to Hawaii with an older boyfriend and got papped. Her mom unironically ends the email with "ps. Send money."

-She talks a lot about getting therapy for her ED and seems to have really, really liked and responded well to CBT (she mentions all the worksheets, heh).

I thought it was a great memoir -- the way that she broke it out into smaller, bite-sized sections made it a super quick binge-type read, and it's honestly a pretty riveting story in my opinion. I also was a big fan of her talking about her experiences with therapy. The first therapist she writes about seemed like they were more on the "life coach" end, but the confrontation she had with her and the subsequent therapy dropout nonetheless seemed to have a big effect on her thinking. Whether that early confrontation (therapist suggesting/pushing that her mother was clearly abusive) was more positive vs. negative is maybe an interesting question. It does seem like the ED focused CBT treatment was more on the level she could engage with while coming to terms with recontextualizing her relationship with her mom. The way she contextualizes and talks about her past and her current struggles reflects someone with pretty great emotional awareness and insight at this point imo, which was also really great to see -- it seems like it could definitely at least in part be attributed to positive experiences with therapy.

 

[Spydra]

I thought it was a great memoir -- the way that she broke it out into smaller, bite-sized sections made it a super quick binge-type read, and it's honestly a pretty riveting story in my opinion. I also was a big fan of her talking about her experiences with therapy. The first therapist she writes about seemed like they were more on the "life coach" end, but the confrontation she had with her and the subsequent therapy dropout nonetheless seemed to have a big effect on her thinking. Whether that early confrontation (therapist suggesting/pushing that her mother was clearly abusive) was more positive vs. negative is maybe an interesting question. It does seem like the ED focused CBT treatment was more on the level she could engage with while coming to terms with recontextualizing her relationship with her mom. The way she contextualizes and talks about her past and her current struggles reflects someone with pretty great emotional awareness and insight at this point imo, which was also really great to see -- it seems like it could definitely at least in part be attributed to positive experiences with therapy.

Well maybe she'll sell the rights to Lifetime so I can watch the movie version. I'm sick of reading lol.

 

[futureapppsy2]

Well maybe she'll sell the rights to Lifetime so I can watch the movie version. I'm sick of reading lol.

The audio book is good!

 

[Shiori]

I just finished the audiobook.

Oof. My thoughts on the book are still forming, but I'm glad there has already been some discussion about it here.

 

[DynamicDidactic]

Every possible thing to make a borderline personality disordered individual, she had thrown at her.

I've never seen any empirical/quantitative research on the etiology of BPD that I thought was pervasive persuasive. Any resources you could share that led to this statement?

 

[smalltownpsych]

I've never seen any empirical/quantitative research on the etiology of BPD that I thought was pervasive. Any resources you could share that led to this statement?

Did you mean persuasive?
Alao, I think Buckeye was just being a bit loose and colloquial and glad you called him on it a bit. It is tough because it seems clear that we have multiple pathways to many of our disorders and it is why I say that a diagnosis is a part of case conceptualizing and not the result.

 

[futureapppsy2]

I've never seen any empirical/quantitative research on the etiology of BPD that I thought was pervasive. Any resources you could share that led to this statement?

In general, the literature points to a combination of genetic vulnerability and a chronically invalidating environment in childhood, which may or may not include abuse.

 

[DynamicDidactic]

In general, the literature points to a combination of genetic vulnerability and a chronically invalidating environment in childhood, which may or may not include abuse.

Again, I would love to see high-quality (or even medium-quality) research indicating the invalidating environment. I know this is the prevalent theory but it seems to be low on empirical support.

 

[cara susanna]

I've never seen any empirical/quantitative research on the etiology of BPD that I thought was pervasive persuasive. Any resources you could share that led to this statement?

Mary Zanarini does a lot of longitudinal studies with BPD. She generally found that you have a very emotional child and then a parent who doesnt know what to do with said child, which results in invalidation (again, not necessarily abuse).

 

[DynamicDidactic]

Mary Zanarini does a lot of longitudinal studies with BPD. She generally found that you have a very emotional child and then a parent who doesnt know what to do with said child, which results in invalidation (again, not necessarily abuse).

I tried a quick search and didn't find any of her research relevant to etiology (mostly course of BPD). Can you provide the citations for this? I would love to see how all this was measured.

 

[Mad Jack]

Honestly: this sounds like some weak abuse. There are a ton of rich kids going through worse.

It's enough to make most people maladapted messes. This isn't like, the abuse Olympics. I've seen the psyches of children crumble under far, far less. What can be learned from it is important- that sometimes parents aren't great people, and it's okay to not love them when they aren't. Far too many people never learn this lesson and let the dynamics of their past drag them down until the day they die

 

[PsyDr]

It's enough to make most people maladapted messes. This isn't like, the abuse Olympics. I've seen the psyches of children crumble under far, far less. What can be learned from it is important- that sometimes parents aren't great people, and it's okay to not love them when they aren't. Far too many people never learn this lesson and let the dynamics of their past drag them down until the day they die

We have created a very hard cut definition for "trauma" in the DSM. We also have the resiliency literature, which reflects the idea that some people do not, to use your words, "crumble" in the face of trauma. Then we have a literature base regarding how "abuse" produces psychopathology, even though abuse is generally poorly defined.

The reasoning is interesting: we can define one construct, but not another; we can assume one well defined construct causes a psychiatric diagnosis, assume some poorly defined constructs causes other psychiatric diagnoses, and then assume that bad outcomes to a poorly defined construct are only related by the individual's personality. There is a quality of competition to that.

 

[WisNeuro]

We have created a very hard cut definition for "trauma" in the DSM. We also have the resiliency literature, which reflects the idea that some people do not, to use your words, "crumble" in the face of trauma. Then we have a literature base regarding how "abuse" produces psychopathology, even though abuse is generally poorly defined.

The reasoning is interesting: we can define one construct, but not another; we can assume one well defined construct causes a psychiatric diagnosis, assume some poorly defined constructs causes other psychiatric diagnoses, and then assume that bad outcomes to a poorly defined construct are only related by the individual's personality. There is a quality of competition to that.

I'd say "most" instead of some here in relation to the resiliency literature.

 

[Shiori]

We are talking about averages when the book is about a specific person who describes, in detail, her life experiences. These experiences were often horrifying. I think it makes sense that, in a fairly colloquial setting, someone can express awe regarding this individual's ability to tell their story and reflect on it in an insightful manner despite consistent and pervasive invalidation of her own feelings. Her perspective is clear-eyed, raw, and authentic in ways many people, with or without trauma, have a hard time articulating. Instead of getting lost in yet another discussion about what is or is not trauma, it might be helpful to examine this person's story for what it actually is. There is no diagnosis of BPD. She does not tell a story through the lens of "this is my trauma." If anything, it's more about grief and making meaning following the loss of someone overwhelming and very complicated in her life. She deeply loved her mother despite awful behavior. The book is an exploration of that.

 

[cara susanna]

I tried a quick search and didn't find any of her research relevant to etiology (mostly course of BPD). Can you provide the citations for this? I would love to see how all this was measured.

Sorry, I don't. She explained this to me herself when I met her.

 

[futureapppsy2]

We are talking about averages when the book is about a specific person who describes, in detail, her life experiences. These experiences were often horrifying. I think it makes sense that, in a fairly colloquial setting, someone can express awe regarding this individual's ability to tell their story and reflect on it in an insightful manner despite consistent and pervasive invalidation of her own feelings. Her perspective is clear-eyed, raw, and authentic in ways many people, with or without trauma, have a hard time articulating. Instead of getting lost in yet another discussion about what is or is not trauma, it might be helpful to examine this person's story for what it actually is. There is no diagnosis of BPD. She does not tell a story through the lens of "this is my trauma." If anything, it's more about grief and making meaning following the loss of someone overwhelming and very complicated in her life. She deeply loved her mother despite awful behavior. The book is an exploration of that.

And she was originally rather resistant to the idea that anything her mom did, including chasing family members around the house with a weapon, teaching Jeanette how to be anorexic or sexually abusing Jeanette and her siblings was abusive at all.

 

[Mad Jack]

I'd say "most" instead of some here in relation to the resiliency literature.

And yet we have things like the ACE study which clearly demonstrated that adversity and trauma can have profoundly negative effects that are clearly demonstrable at the population level over the long term, both psychologically and physically. Genetics and environmental factors that are largely out of control of the person suffering from adverse experiences largely determine whether they'll be one of the lucky ones or one of the ones that ends up a mess. If most were fine, such strong statistical evidence would not exist.

 

[BuckeyeLove]

Get ready for comments highlighting methodological problems of the ACE in 3, 2, 1….

 

[WisNeuro]

And yet we have things like the ACE study which clearly demonstrated that adversity and trauma can have profoundly negative effects that are clearly demonstrable at the population level over the long term, both psychologically and physically. Genetics and environmental factors that are largely out of control of the person suffering from adverse experiences largely determine whether they'll be one of the lucky ones or one of the ones that ends up a mess. If most were fine, such strong statistical evidence would not exist.

No one ever said that adverse events cannot have profound impacts. The assertion, backed up by decades of literature, literature much more methodologically sound than the ACE stuff, suggests that the majority of people who are exposed to adverse events and/or trauma do not, in fact, develop things like PTSD. Some people will, of course. But, most won't.

 

[Mad Jack]

No one ever said that adverse events cannot have profound impacts. The assertion, backed up by decades of literature, literature much more methodologically sound than the ACE stuff, suggests that the majority of people who are exposed to adverse events and/or trauma do not, in fact, develop things like PTSD. Some people will, of course. But, most won't.

PTSD is a specific response to trauma, which in my opinion is far less important than maladaptive coping skills, tendencies toward substance use, emotional dysregulation, unhealthy lifestyle habits, and epigenetic changes that stem from significant, and particularly chronic, stressors. If you've got some compelling literature on resilience I would love to see it, honestly. Most of what I've read is centered around specific events such as war or terrorism which likely have different effects upon individuals than the more common sorts of chronic stress and adversity that are often perpetuated by caregivers, family dynamics, and trusted individuals that is more insidious and difficult to quantify and study. People are quite resilient to specific traumatic events, that is clear (unless these events consume much of their lives, such as in the study of former Ugandan child soldiers, in which the great majority had trauma symptoms). But resilience in the face of other adverse experiences is more what I would be interested to know if there is any outcomes research, particularly in the more common context of these events occurring at the hands of a trusted/loved one over a prolonged period of time.