Contempt, Blanket Training, And Complex-PTSD, Oh My

Lissa Rankin, MD
9 min readNov 17, 2023


In couple’s therapists John and Julie Gottman’s work on the “ Four Horsemen Of The Apocalpyse ,” they name the four behaviors that kill marriages, namely criticism, contempt, defensiveness, and stonewalling. Contempt, they say, is the single most dangerous behavior, and it’s the highest predictor of divorce.

Oxford dictionary defines contempt as “the feeling that a person or a thing is beneath consideration, worthless, or deserving scorn.” It’s an emotional mash-up of disgust, shaming, rage, dehumanization, and abject hatred.

I cringe just reading the definition. A young part of me remembers the way my mother would mock me and look at me like I was as disgusting as a roach if I failed to clean the attic perfectly enough on a sunny Saturday when my friends were all out riding bicycles and climbing trees. A medical school-aged part recalls being scowled at and spit upon (while we were scrubbed in under allegedly sterile conditions) during surgery by a medical school professor when I couldn’t remember the right name for a small branch of the femoral artery. An older part of me remembers the way a former partner would hurl sarcastic barbs at me and treat me with extreme verbal abuse. When I inevitably started crying, he’d roll his eyes and say in a fake baby voice, “Ooh widdle baby girl can’t stop blubbering” right before the fist slammed into me. A pandemic part of me will never forget the online haters who used to be my fans, who came after me for promoting public health guidelines with the most bitter disgust and abusive contempt, as if I’d betrayed them by wearing masks and getting vaccinated and recommending others do the same and as if I didn’t deserve to live (the death threats were real.)

Contempt. These people dehumanized me and thought I was disgusting if I made a mistake or wasn’t a perfect enough or compliant enough housekeeper, medical student, wife, or mind-body influencer.

Fortunately, I didn’t get too much contempt hurled my way in childhood because I’d figured out early on a strategy to be mostly perfect enough and pleasing enough to win the very conditional approval of my perfectionistic mother. But some kids aren’t so lucky. No matter how hard they try, it’s never good enough to stop the toxic spread of contempt. And that can destroy an innocent little kid.

The Use Of Contempt To Control Kids

My partner was one of those kids who got coercively controlled with contempt. He was a child growing up in Indiana among member parents, the Bill Gothard-led cult starkly exposed in the Shiny, Happy People documentary about the TV-famous Duggar family from “19 Kids and Counting,” who were also cult members and child abusers. As adherents of the teachings of the cult, my partner’s parents used contempt, shaming, verbal abuse, dehumanizing withdrawal of connection and comfort measures, rigid control of every aspect of daily life, and corporal punishment to “break the will” of their children.

The IBLP teachings were formally taught at his family’s church, and the principal at their church instituted Bill Gothard’s character training in the local elementary school as well.

IBLP teachings were all about breaking the will of the child and emptying out the vessel of the human so it could be filled with pure Holy Spirit. Contempt was a frequent tool used to break the will, as was “blanket training.” The Shiny, Happy People documentary details how the will of children is broken from infancy on using this technique, which comes from a book called To Train Up a Child — Child Training for the 21st Century . Written by Michael and Debi Pearl, it was used as a parenting guide by evangelical Christians to teach obedience to “willful” (aka “normal”) children.

My partner’s mother would do things like buy him super fly Christmas presents- a truck with a tractor trailer. He’d enthusiastically prepare to play with the toys, only they’d have no batteries. Or the truck wouldn’t match the trailer. It was confusing for his young parts, how desire was both lit up and then thwarted, and if he protested, contempt was used to destroy his self esteem, while corporal punishment was used to terrify him, squelching his natural willfulness and torturing him into obedience.

The Horrors of Blanket Training

When I heard my partner tell me about blanket training, intended to break an infant’s rebellious spirit, I become viscerally ill.

In Michelle Duggar’s 2008 book The Duggars: 20 And Counting, she wrote, “I would focus on blanket training, calling out ‘Okay, boys! It’s blanket time! Oh, isn’t this fun? Come pick a toy so we can have blanket time…Some days we might practice blanket time three or four times; Other days we only got it in once. But gradually, it became a common practice. The boys learned to spread out their own blankets, then they eagerly chose a special toy to play with… ‘We’re gonna practice. Obey mama. Sit really still and look at me with big ol’ smiles. I wanna see that smile now. No wiggles, be still.’”

The practice of blanket training includes putting an infant on a blanket and then tempting the infant to reach for a rattle or shiny toy just off the boundary of the blanket. If the infant reaches for the toy and crosses the edge of the blanket in an attempt to get the toy, the child is smacked and punished. Over time, the child learns that desire is unsafe, that reaching for what you want is a punishable offense, and that obedience is rewarded, even if that obedience is really learned helplessness and traumatized resignation.

Anyone who knows anything about healthy childhood development would know that blanket training could harm a child for life, forcing obedience and compliance while stifling curiosity, autonomy, sovereignty, and a natural desire to engage with the world. When you add verbal abuse on top of blanket training and convince a child that they’re evil or the spawn of Satan or defective in some way, you compound the developmental trauma. This typically results in complex- PTSD, which then puts those kids at risk of growing up perfectly groomed to “fawn” and bow down to narcissists.

Complex PTSD

In Complex PTSD, Pete Walker writes, “Many dysfunctional parents react contemptuously to a baby or toddler’s plaintive call for connection and attachment. Contempt is extremely traumatizing to a child, and at best, extremely noxious to an adult. Contempt is a toxic cocktail of verbal and emotional abuse, a deadly amalgam of denigration, rage and disgust. Rage creates fear, and disgust creates shame in the child in a way that soon teaches her to refrain from crying out, from ever asking for attention. Before long, the child gives up on seeking any kind of help or connection at all. The child’s bid for bonding and acceptance is thwarted, and she is left to suffer in the frightened despair of abandonment. Particularly abusive parents deepen the abandonment trauma by linking corporal punishment with contempt. Slaveholders typically use contempt and scorn to destroy their victims’ self-esteem. Slaves and children who are made to feel worthless and powerless devolve into learned helplessness and can be controlled with far less energy and attention. Cult leaders also use contempt to shrink their followers into absolute submission after luring them in with brief phases of fake unconditional love.”

Contempt In The Hospital

It’s not just culty families that use contempt to encourage conformity and shut down self-protection, free will, and rebelliousness. The hospitals I worked in were laced with contempt, especially between doctors and nurses and between senior medical staff and medical students or residents. When you’re abused with contempt day in and day out, it can’t help bleeding into other areas of your life.

I’ll never forget the day I had been up for 72 hours straight delivering over 30 very high risk pregnancies and I was at the end of my rope. All that was standing between me and my bed was the teenage kid at the grocery counter who couldn’t figure out how to ring up my yoghurt. I grew increasingly impatient as he scanned and rescanned and pressed call bells, to no avail. Suddenly, I found myself looking at his as less than human, and I heard myself say, in horror at myself even as I said it, “If I did my job the way you did your job, there’d be dead people everywhere.”

The day before I had heard one of my OB/GYN physician colleagues scream at a nurse, “Let’s play a little game. I’ll play doctor. You play nurse. I give the orders, and you FUCKING FOLLOW THEM.”

The hospital had become an abuse chamber, and I had just taken it out on an innocent teenage boy who was probably new on the job. That was the day I realized I needed to quit practicing medicine.

Parts That Carry Contempt

Contempt is a sneaky little bugger. Sometimes I notice contemptuous thoughts arising, unbidden, aimed at someone I genuinely love. Those parts are typically trying to “one up” me and “one down” the other. They usually arise when I’m feeling helpless, powerless, overpowered, controlled, and dominated. They want to even the playing field, but another part of me typically smacks down those contemptuous parts, for fear of hurting someone else or losing the relationship. I have the thoughts that my parts processing partner Emma and I call “inside thoughts.” But I try not to give them free rein to just level someone as part of a power move.

I also notice contempt arising when I’m working on something I consider important and someone else can’t seem to do their job competently. In those moments, if I’m under enough pressure, the task becomes more important than humanizing the person who is failing to achieve the task. Then this part comes in, dripping with contempt, and feeling an intense mixture of frustration, rage, impatience, and scorn towards the person who is thwarting my task management part. As if shaming someone ever made them more competent, parts that carry contempt may show up to try to pressure someone into doing a better job. Which works 0% of the time and often retriggers childhood wounding among those of us who were treated with contempt when we were young.

Compassion For Contemptuous Parts

John and Julie Gottman put a hard stop on contempt, which is fair. If you want to have healthy relationships with loved ones, work colleagues, or your kids, contempt has no place there. We have to have good boundaries with ourselves and others, and contempt needs to be contained, even if some of our bullying parts might be tempted to pull it out as a tool to gain power.

But it also doesn’t help to just hate on parts of us that were treated with contempt or parts of us that have internalized the contempt and aim it at others. All around, compassion is key.

We don’t have to have compassion for others who treat us with contempt. We can just set boundaries, refuse to tolerate abuse, and get away from those people if they can’t stop dehumanizing us. But it does help to extend compassion to ourselves if we notice ourselves getting paralyzed when contempt comes flying at us or self-hating when we have contemptuous inside thoughts about others.

If we can get to know parts that were hurt by contempt and parts that might be tempted to hurt others with contempt, we can gain insight into what those parts need from us, so we can Self-lead those parts, heal self esteem issues in the parts that were taught that we’re not good enough, and contain parts of us that might use contempt to abuse others.

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Lissa Rankin, MD

Lissa Rankin, MD, New York Times bestselling author of Mind Over Medicine, The Fear Cure, and The Anatomy of a Calling.