Trauma Bonding - The Ties That Bind

As I mentioned in a previous post, I couldn't connect to my feelings. This past couple of weeks, however, have uncovered some intensely painful feelings. I discovered that shame has taken root in me like a hundred year old tree. It is insidious. "Shame is a sickness of the soul. It is the most poignant experience of the self by the self, whether felt as humiliation or cowardice, or in a sense of failure to cope successfully with a challenge. Shame is a wound felt from the inside, dividing us both from ourselves and from one another" (Kaufman 1996). Shame results in feelings of isolation, loneliness, depression, anxiety, self doubt, perfectionism, and hopelessness.People with post traumatic stress disorder, PTSD, don't believe they deserve to be happy, because we're bad people. Even if we are happy for a moment then it isn't going to last because eventually the other shoe will drop.... these are typical thoughts, trauma bonds, in the minds of most trauma survivors. Last post, I was fearful I wouldn't be able to connect with the feelings surrounding my trauma. This past week, I wish I hadn't.

I expressed to my therapy group that I didn't deserve to be with them, because in my opinion, they had suffered traumas much worse than mine. My childhood wasn't really that bad in comparison to what they experienced. They compassionately and adamantly kept telling me, trying to convince me that that wasn't the case. Trauma is trauma. They wanted me to see the truth, so I could move on, so I could become "unstuck" in the past, and yet the voices that told me for forty years, in order to cope, "that my life isn't so bad", my voice; and the voice that told me I wasn't worthy of compassion, understanding or having my needs met, my father's voice, and how could my father be wrong, prevailed again, and again, and again making it impossible for me to accept what they were telling me. This is one of my many trauma bonds, my unhealthy or toxic relationship with myself. Again, I am trapped in my past. I'm very depressed now. I rejected the support I was being offered, and depression is the result of not having one's needs met. I needed that support, and rejecting support is a form of self harm which is also common to PTSD survivors. Substance abuse, cutting, starving, or simply not giving yourself what you need are forms of self harm. It saddens me deeply to realize that I think so little of myself when my heart knows I'm worthy, but my mind has been poisoned to believe otherwise.Some symptoms of toxic shame as indicated in my program:

*  Believing I am a bad person.
*  Constantly belittling of one's self or others
* A compulsion to rescue hurting or needy people.
*  Excessive sensitivity and defensiveness to imagined or actual criticism or rejection
* Habitually putting one's own needs or welfare last
* Rarely buying anything nice for one's self or going on special trips
* Deflecting compliments
* Chronically giving time and energy to others and getting little or nothing in return
*  Repeatedly choosing, justifying, tolerating toxic relationships or situations.
* Not setting and enforcing holistically healthy boundaries with self and others
* Self-sabotage: setting one's self up for failure
* Choosing a direct-contact human-service profession i.e. clergy, medicine, education, law enforcement, social worker etc.

When I told my therapy group that my father had devoured my heart with his ungodly actions and hateful words, and that I was incapable of love, they again were surprised at my comment and told me I had repeatedly demonstrated I was an extremely thoughtful person always supporting others, showing compassion and kindness whenever it was needed and without hesitation, but they also observed I never do those things for myself. Instead, I beat myself up for not doing enough. I couldn't hear those words either. I wanted so badly to believe what they were telling me, to hear them, but it goes against every core belief I was ever taught which is that I'm a bad person. I broke down and cried at the realization. Shame is a major symptom of PTSD whether the trauma is related to combat, policing, or childhood abuse. We often feel "I could have done better", "if only...", "it was all my fault" when in actuallity none of that is true, if we could only objectively examine the facts... another example of our toxic relationship with ourselves, our trauma bond, we remain attached, tied to our trauma and our pain.

Attachments are a normal much needed part of our development. We can learn healthy attachment or unhealthy attachment even as adults where you may have been held captive or felt trapped for a long period of time. Some survivors are so traumatized and hurt that they feel they don't need anyone, so they isolate which leads to major depression and possibly suicide. The unhealthy attachments we learned are what we look for throughout our lives because it is familiar, thus we victimize ourselves over and over again, if we don't break that bond.

I'm terrified of making a shift in my beliefs even if those new beliefs are healthier, but that is the nature of a trauma bond. We fear the unknown, change, unpredictability, we need to feel in control, and we become very anxious if we don't feel we are in control, so we would rather stick with what is familiar, shame, unhealthy relationships, isolation, toxic work environments, playing our role as rescuer or care giver to our own detriment even though we KNOW these behaviours are unhealthy. Some of you might be saying, "come on, just make the choice to believe differently." Easier said then done. For example, suppose evidence came to light that perhaps God doesn't really exist and then asking a Christian to accept that truth.Not only is it preposterous in the Christian's mind, but the very thought of even trying to make that shift causes such suffering that it would hurt them deep within their souls.

We all wear masks. When asked "how are you?" we almost always respond "good, fine, great"... not always true, but easier than explaining how we're really feeling. The mask worn by trauma survivors isn't always easily hidden. Sometimes we just seem numb, unable to connect emotionally, or sometimes we seem angry for no reason, irritable, hot-tempered, sad,  and have no idea why. Many can't even identity their emotions, because the only one they ever feel is anger and justifiably so. Why? Because we are stuck in the past, we are stuck in the moment or time our trauma occurred. Naturally, the feeling at that time was anger and that's where we remain stuck for years in some cases, four decades in my particular case. Anxiety is another feeling we live with because we're stuck. We're in a low grade "flight or fight" response all the time.We don't know frustration, giddiness, disappointment, cheerful, joy, sorrow, aggravated, reticent, apprehension, caution, and the list goes on and on. The possible spectrum of emotions we can experience is completely unfamiliar to us, so in my treatment program, I am being taught to practice identifying my emotions, not an easy task when you've been faking it all your life.

The trauma bonds are strong, my core beliefs, my attraction to people who need help, my tendency to get involved with people or situations that hurt me. They're like a demon clutching your soul in its claws, you're too afraid to move, because you know it's going to hurt like hell if you do. However, if we are to heal, if we are to recover, if we are to become unstuck so that we can live life in the present, enjoy and be grateful for what's right in front of us without subconsciously poisoning it with our past, then we need to fight that demon and break those bonds or at least begin recognize them. Damned if you do, damned if you don't, right? Well, if I'm going to hurt anyway, then it might as well be with the hopes of living life in the present not in the tragic past.

If you feel you might have been exposed to trauma, if any of this sounds familiar to you,  there are tests on line to assist you if you might  be concerned about PTSD. Even if you don't do the tests, talk to your doctor about your symptoms and possibly your trauma. Help is available, and you deserve to be happy just as much as anyone else.

That's the view from here right now.... I'll keep you posted on the remainder of my journey. Thanks for stopping by. :)

Kaufman, Gershen. (1996) The Psychology of Shame 2nd Ed., Springer Pub. New York

Post Traumatic Stress Recovery - Phase 1

Psychobabble

Phase 1 - The assessment phase. This is to prepare us for what is to come in phase 2, and how to deal with it. Some may not be ready to move on to phase 2 of the program, because they still haven't completely grasped the "tools" they will need to handle the intense emotions that will arise in phase 2. So the last couple of days, Saturday and Sunday included, have been oriented toward understanding and creating "safety" and familiarizing ourselves with some of the terminology which will be used throughout the remaining seven weeks. 

Safety

Safety, all my life, has meant if I'm not being physically assaulted, but it's much more than that and integral part of PTSD recovery. Most of us who suffered some form of abuse, especially as children, have a pretty low standard for safety, I've come to realize, as it's much more subtle than my definition would imply. Safety is the cornerstone to recovery because without it, there is no trust, no opening up, no trying to connect with feelings that have long since been buried. First and foremost, we each sign an agreement that we will never divulge the names of other patients or even share their experiences anonymously with anyone, so everything you read here are my feelings, experiences, and reactions and mine alone.

Secondly, we are taught how to keep ourselves "safe" which is easier said then done, because of the trauma, we never learned what our own needs were or how to identify our feelings because they were repressed. All control was taken from us, even something as simple as being allowed to feel your feel feelings was not permitted. Whenever we feel uncomfortable, uneasy, agitated, threatened, and not prepared to deal with feelings in an open and confident manner, we are encouraged to take steps to regain our sense of security and control whether that means breathing or grounding techniques, holding a safety object such as a photo or for some, a crucifix, or even if it means excusing ourselves from the situation altogether until we can stabilize our feelings then returning; we must always feel that we are in control, and we can make our own choices, something our trauma did not allow us to do and that was terrifying. Whenever a trauma survivor's sense of control is being compromised or threatened, even after the trauma, they undergo a re-enactment of the trauma and feel the same feelings they felt then, and this is only one of the ways we re-enact our trauma.

Re-enactments

We live what we learn and experience. We re-enact our traumas every day in our occupations, relationships, circumstances, feelings, reactions and on and on by playing one of the three roles in the victim trauma triangle; victim, rescuer or care-giver, or abuser.  Trauma survivors seem to have chaos follow them wherever they go, because that is what they consider "safe" or familiar. I've always jokingly said "if there isn't any chaos in my life then I will create some", I had no idea how profoundly true that was. For example, if you were a care-giver during your trauma, which I was, I took care of my three younger siblings much of the time, I attempted to protect my mother from being beaten by my father, and I saved her life once too, then you are likely to re-enact that role throughout your life. As a trauma survivor, you might have also chosen an occupation where you provide for others such as a doctor, day care provider, teacher, nurse, police officer, to name a few or you might constantly be trying to solve others' problems in your personal and intimate relationships while giving very little attention to your own problems. You might look for people to rescue, or if in the victim role, you might be looking for someone to rescue you. You constantly look for "your knight in shining armour" only to find he's a mere imperfect mortal. You might feel a great amount of self pity and inability to change anything in your life, because of your trauma and your victim role. Finally, you can play the abuser as well, yes, you the victim can be the abuser by causing self harm, by not attending to your own needs, or by taking your deep seated and justified anger out on someone who doesn't deserve it. We can fluctuate between all three of these roles everyday not even knowing that our subconscious mind is re-enacting our trauma and not understand why our relationships are so unstable. Why? Because that is what we know best, that is what we ironically consider "safe", familiar, and finally somehow we think by playing those roles out over and over again, we can change the outcome. This time things will be different. They never will be until we come to understand what is really happening in our everyday lives and choose differently.

Triggers, re-enactments, and flashbacks are all aspects of post traumatic stress disorder. We are being taught how to identify when those are happening, so that we can be aware and respond to the present and not to the past. Ironically, these things, along with dissociation are so habitual that not only are they almost an every day occurrence, but we aren't even aware, for the most part, they are happening, and that is what we are being taught, how to recognize them. One trigger for more is when a man become aggressive or angry, my heart starts racing, my chest becomes tight, I have shortness of breath, and I have this overwhelming fear that something bad is going to happen because that what happened with my Dad. I am not responding to the present I am responding to the past and being aware of that will have me have better control of my emotions.

Phase one will end on Tuesday for some of us, and we will continue on to phase two where we will go into group therapy and start digging up some of these feelings and how they affect us in our present lives. Not sure I'm looking forward to that....

Post Traumatic Stress Disorder - Do I Really Want to go Back There?

As I was telling some friends, with less than 48 hours to go before I return to the mental health hospital I was in last Fall for a mood and anxiety treatment program, I find myself feeling very reluctant. Why? Because this program is for PTSD, post traumatic stress disorder. For those of you who may not know what that is, it is a disorder usually caused by a traumatic event in a person's life where he/she felt that his/her life or the life of a loved one was at risk for being seriously harmed or even destroyed. Many war veterans and police officers suffer from PTSD for obvious reasons, but serious car accidents, a life threatening illness, sexual abuse, domestic violence, child abuse, rape, burglary, being threatened with a weapon, natural disasters, and robbery to name only a few can also result in PTSD.

In my particular case, the psychologist labelled my PTSD as "severe and complex" which means it was ongoing and repeated (severe), and it began before the age of 8 years (complex). Apparently, when the trauma occurs before the age of eight, it is much more difficult to address since many of the memories are buried. When I was being assessed for possibly having PTSD, in the first section of the survey were twelve questions where each question ended with the statement ".... where you felt you or a loved one were under threat of being seriously harmed or killed"... I answered "yes" to seven of the twelve questions. I had to stop there when filling out the survey, because seeing it all on paper made me realize just how sad it truly was, and I began to cry. Before then, "it was just my life", "that's just the way the cookie crumbled", "the cards I was dealt", "nobody has it easy" kind of thing, but looking at it on paper made it real, it could not be avoided or overlooked any longer, I could see how wrong it was especially considering I knew my abuser, someone who was supposed to protect me and keep me safe during those very early formative years. I had two other abusers later in my life as well, we tend to be drawn to what is familiar. You can imagine how that warped my entire view of the world, who to trust, whether anyone was really safe, or how to view alleged "loving" relationships. So what I did as a result, a coping mechanism, was become so independent that I needed no one, there was no need to trust anyone or ask for help only to be disappointed, because I could take care of myself, the same way I always took care of my siblings as well as myself. A very lonely existence which put a great deal of pressure on me that resulted in depression, insomnia, hyper-vigilence, unexplained fears, difficulties with relationships, and isolation.

So, the closer it gets to my admission date, the more afraid I become. I'm so scared of going back there, not to the hospital, but the place where all this pain began, my childhood. Pain I haven't even really felt, but I know I'm going to feel. I find myself crying a lot because I don't want to go there, I don't want to be that little girl without any control or power again, I don't want to feel what she so skillfully buried and kept hidden as a means of survival. I'm not strong like everyone thinks. I don't want to remember what happened, I just want it to stay where it is, in that box in the back of my mind labelled "toxic- do not open".... but I know it will help me live a better life in the long run, a happier life. Treatment for PTSD has been known to improve so many other conditions which I've already named, conditions like depression, which can be fatal, so for that reason, I must find the strength.

I've decided, as well, that as I learn about my PTSD while in the hospital, I'm going to share what I've learned with you the readers. Not everyone gets the opportunity, as terrifying as it may be, to be admitted to an eight week treatment program, so I am going to do my best to post my experiences, feelings, revelations, and hopes while I am in this program beginning this week. I hope you'll come back to see what the view from the inside is like.... it is my hope you will find it helpful. It is my hope that you will seek treatment for your own mental health problems.

What Does my Depression Look Like?

It looks very much like this commercial, and I thank Bell for doing such a great job depicting what "depression looks like" in both their PSA's.

Many believe people with depression are weak, not able to handle it, they need to be stronger. If I could choose to be stronger while in the throws of a depressive episode, I absolutely would! If you look at this woman's face, you will see not only sadness but guilt and shame for not being able to do what so many do everyday unless they're medically ill, contagious. She wishes she could be stronger too. The fact is, however, it's impossible for her to go to work, like the other 500,000 Canadians that are absent each day due to mental illness, because she may cry without cause, she will not be able to focus, concentrate, or make decisions due to lethargy and fatigue, and the anticipation of the stress she will experience at work creates such anxiety in her that she is terrified she might be taken away in an ambulance if things become too much, and they will become too much. Stress is the number one aggravator of depression or any mental illness. Again, I can't know for sure this is what the character is experiencing, but it looks very familiar, because it's what I experience.

I am still recovering from my last depressive episode which began in approximately October 2011.  I say approximately, because I didn't know it was happening, most don't, they just begin to slowly slip into a darkness, a hopelessness that leaves them asking "why bother living?" I say October, because it was around that time that colleagues and friends began to comment on my behaviour, my mood. They would say "you don't smile as much anymore", "you seem sad", or ask "are you ok?" I would reassure them that I was just under a lot of stress and when this or that was finished, I would feel better. When this or that was finished, I didn't feel better and then another "this or that" would come along, and I would attribute my change in mood to that. Yes, I was denying my own signs of depression, because I too carry the stigma of mental illness. I didn't want to appear weak, and I felt terribly guilty for not being able to perform my duties as well as I should, so I would forge on pretending everything would get better. The very fact that I forced myself to continue without respite only made my depression worse. As if I had a "bug", continuing to work only sustains the illness when in fact you should be going home to recover, right? A bug, however, can be seen in sniffles, coughing, palor, no one can see I'm ill, so I really shouldn't be staying home.

Finally, after five months of forcing myself to do all the things I normally do, I had a collapse, a crisis. I was walking down the hall of my workplace, and I began to cry. People walked by and looked at me curiously , but I couldn't stop. I walked straight to my supervisor's office and sat there crying for another hour until I was finally able to drive myself home, and that was my last day of work, April 16th, 2012, I haven't been back to work since. With everything my GP tried, my depression continued to worsen. It takes a while to find the right medication for each individual with depression, what works for one person does not necessarily work for another, in fact, it can make things worse. I was anorexic (the medical term for no appetite) and losing weight fast, I lived on "Ensure". At my lowest I was down to 104 lbs. I went to see my psychiatrist, and he asked me "what do you need me to do?". My response was "put me in the hospital, because I'm afraid of what I will do to myself if you don't". He couldn't do that, because the hospital would only admit me if I actually attempted suicide, another shortcoming of the health care system in dealing with mentally ill patients. I said "I can do that" at which time we created my "safety plan". I was obviously not taking care of myself, I hadn't showered in four days, I wore the same clothes to bed that I wore during the day which were now quite soiled, I would sleep at least five hours a day as well as at night, and the simplest task was overwhelming and created intense anxiety. Most people who suffer from depression also experience anxiety to some degree, mine is particularly bad. Even going to his office that day, the traffic and possibility of an accident terrified me when any other day, I would be fine. I went to Walmart to get a few groceries and as soon as I walked into the store, I was overwhelmed by the sights and sounds, just like you see in the movies when the character is hearing and seeing everything in an amplified way. I was able to pick up a few things and stood in line for about five minutes but couldn't take it anymore. I broke down sobbing, leaving my 13 year old daughter with my debit card to pay for the things we needed, and I rushed out of the store. You can imagine how she must have felt. This continued on for another couple of months till we found a medication that began to work, but my body had been so physically weakened that it took another month to regain at least a modicum of strength. The simplest activities exhausted me, and I still had to nap every day for a couple of hours.

Although I was beginning to feel the effects of the medication, I could not return to my previous life of work or even daily domestic responsibilities, I was still recovering and this was now ten months after people had begun to comment on my behaviour. I told my doctor "I can't go back there again" meaning to the depths of depression I had just experienced, "because I may not make it out next time". At that point, my doctor feared for my safety and agreed silently as he made a referral to a mental health hospital where I was admitted for two months in the "mood disorders program". Depression, especially if it is a bipolar depression which they think I might have, gets worse as we age, so hospitalization was a must to help me better manage my illness.

So that's what depression looks like. It looks like an illness that can have a profound physiologically effect caused by a serious imbalance or malfunctioning of neurotransmitters, and this creates an uncontrollable mood imbalance, but because most people can't see that mood imbalance, we're very good at hiding it, we have to be, it's perceived as being "weak", "lazy", "over-reacting" or being "hypersensitive" which apparently is only a state of mind that can be controlled. Not so. That's the view from here.

Support Bell's Let's Talk Feb.12 letstalk.bell.ca
Read my post about the campaign and how you can support someone you love who has mental illness http://theviewfromhere1.blogspot.ca/p/blog-page_1.html  

My next blog will address the lack of resources for the mentally ill especially for children.