hmmm...this is the place I will work through some of the more personal aspects of my journey through ptsd. Some are not polite or pleasant,--hence the anonymity--but they are mine. Everybody's different. Maybe you will relate, maybe not. I am not a professional, I am just offering my own experiences.
Saturday, December 24, 2005
Fell off the blogosphere....
If I don't get to posting tomorrow, I hope you have a warm and safe holiday with people you love and that love you. G'night.
Sunday, December 11, 2005
grounding exercises for ptsd symptoms
First look around and see five things present where you are, naming them -- out loud if possible (the naming out loud is supposed to help, but sometimes I would cheat and do it under my breath, too). Anyway, name specific things, in detail, as you see them. For example, I see a picture of my old dog with a wet nose; I see a black computer speaker; and so on. Then name five things you can hear, like the humming of a fan, cars passing by, the dishwasher running, and so forth. Then name five things you can feel. I had a hard time with this first, because I thought it refered to emotions, feelings, but that's not what I was supposed to be after. Its the sense of touch, so I feel jeans against the skin of my left thigh; I feel the soles of my feet on the floor, and so on. If you get stumped, its ok to repeat things, just concentrate on actually sensing them in the present. Then repeat the whole process for sight, hearing and touch four times, then three, then two, then one. You get extra bonus points if you become so wrapped up in your senses that you lose count. Generally, this would bring me back a little. I would still be miserable most of the time and in pain, but the memory part would subside and sometimes the worst symptoms of a flashback would recede.
[n.b.: updated 12/8/08 to replace broken links with new ones]
This isn't the only way to do it, just a very simple and easy to learn one that worked for me if you need it. About.com has some simple suggestions. The Mental Health Matters web site breaks it into three options: accept it and go through with it, learn to control it, or escape it. It is not always a matter of choice though. Their methods of coping are the same for whichever option you choose (or which chooese you!), including one that I tried during the worst of the flashbacks at the behest of counselors in the PTSD treatment center I was in. They had me hold two liter bottles of frozen water (ummm, I think they call it ice :), one in each hand to bring me back. I melted the ice in both and still didn't come back...they were about to send me off to the hospital, but I managed to get a handle on things after about a four hour flashback. Possibly the worst few hours of my life. Cold, the site explains, activates some reflexes that slow down the heart and exert a calming influence. Finally, you can read a more academic but still enlightening and useful treatment of coping techniques in the book Rebuilding Shattered Lives by James Chu.
What's this betrayal stuff got to do with ptsd anyway?
Carnes maps out "five main ways promises are used to betray:"
- Betrayal by seduction: "High warmth with low intention. . . . Relationships are manipulative and exploitive. Agreements are ill-defined, unclear, or tentative. Feelings are anxious and intense. Trust depends on exaggerated or unreal promises. Rewards are in the future and are often conditional. Risk is often one-sided." Most importantly, the seducer is deceptive about all these things in order to lure the other person into the relationship. People with family histories of abuse or trauma are particularly susceptible because they have never learned to protect or take care of themselves in important ways. A traumatized person's "picker" is often broken. Trauma shame creates doubt of one's intuitions. And there is a neediness that allows the person to ignore warning signs
- Betrayal by terror: If seduction fails, terror might work. Fear "deepens attachment" in ways that can be addictively intense, especially when coupled with seduction. Cults work this dual betrayal very well. They promise vulnerable people what they want, whether that be wealth, friends, spiritual growth, or whatever, but then withdraw support or even rip a person's life apart if they question things. This is the "love bomb" followed by the terror of abandonment. Often the result of betrayal by terror is guilt and shame on the part of the victim. According to Carnes, only seven percent of women who have been sexually assaulted, often by someone they know, report the offense. That is why Holly's work is so important.
- Betrayal by exploitation of power: Sexual harrassment often falls under this category, where women (or occasionally men) are in a position at work where to challenge the abuse would threaten their job because the abuser has more power. Incest relations are another example. They are "exploitation by people in power of those most vulnerable to them. If you're not equal in power, then by definition you're vulnerable. And that vulnerability is critical to trauma bonding."
- Betrayal by intimacy: In its strongest form this is emotional blackmail by someone you trust. Somebody does something wrong and the other person won't turn him in because she would be affected too. The cult abuse/'support community' that ripped up my life did this by trying to stop me from pursuing legal actions because of the ramifications it would have throughout the community.
- Betrayal by spirit: The most publicized version of this form of betrayal has been the sexual abuse scandals within the Catholic church over the past few years. Not limited by denomination, numerous televangelists have been undone by their sexual betrayals in the past few years too. Carnes thinks the reported cases are only the tip of the iceberg. He doesn't talk about it, but somewhat amorphous New Agey cultish groups also commit these spiritual betrayals. That is part of the story of how my life got ripped apart. And outside institutional religion, "spiritual" abusers often frame what they are doing as "God's will" or some such happy horseshit ("I like to think it happened for a reason"). Whatever the source, spiritual betrayal is doubly damaging, because beyond the abuse, the betrayal cuts off a primary resource for recovery, at least in the twelve step model. Such spiritual betrayals are part of why I don't do step programs any more. Maybe my belief in spirituality was just an illusion anyway. I might be better off, less deluded and vulnerable, without it.
Again, any combination, or even all of the above may be present.
Let me know if you read this by leaving a comment, ok?
All the quotations and information not otherwise attributed above comes from Patrick J. Carnes, The Betrayal Bond: Breaking Free of Exploitive Relationships (Deerfield Beach, Fla.: Health Communications Inc., 1997), 47-72.Saturday, December 10, 2005
The roots of ptsd: how trauma affects people over time
Patrick Carnes lists eight ways trauma affects people over time:
- trauma reaction
- trauma arousal
- trauma blocking
- trauma splitting
- trauma abstinence
- trauma shame
- trauma repetition
- trauma bonds
Most traumatized people will display some combination of these rather than just one.
The information above comes from Patrick J. Carnes, The Betrayal Bond: Breaking Free of Exploitive Relationships (Deerfield Beach, Fla.: Health Communications Inc., 1997).
Friday, December 09, 2005
betrayal bonds: trauma repitition
The key to understanding trauma repetition is that "in part, trauma repetition is an effort by the victim [or insome cases, the victim/perpetrator] to bring resolution to a traumatic memory. " It is a way of coping with old traumas, but instead of resolving the past, it creates new wounds, compounding and multiplying the problem. This is where complex ptsd comes from -- the continued repetition and compounding of some earlier trauma. For me that was childhood emotional, physical, and sexual abuse in a a family run by a raging alcoholic father and a classically co-dependent mother. It was a large family, and traumas inflicted on older siblings would then be reenacted on the younger ones.
Unfortunately, one form of trauma reenactment is "to victimize people in the same way they victimized you." While not all trauma repetition is perpetration (unless you want to count self-perpetration, which is sort of a contradiction of terms), all -- or nearly all -- perpetration is a repetition of some kind of trauma that the perpetrator also lived through. One perpetrator often victimizes many people, so the effects get spread widely. I reenacted things by somehow managing to always find relationships with abusive people, allowing both them and me to re-create traumatic experiences in a sick relationship.
According to Carnes (and I'm mostly but not exactly quoting), trauma repetition is characterized by repeated self-destructive (or destructive) behavior, usually of a repetition of some childhood trauma; reliving a story from the past, engaging in abusive relationships repeatedly (this was my pattern -- I thought abuse was normal, and couldn't even recognize it as such until I got in a non-abusive relationship and got help); repeating painful experiences, including specific behaviors, scenes, persons, and feelings; doing something to others that you experienced as an early life trauma.
All the quotations and information not otherwise attributed above comes from Patrick J. Carnes, The Betrayal Bond: Breaking Free of Exploitive Relationships (Deerfield Beach, Fla.: Health Communications Inc., 1997), 24-26.
Thursday, December 08, 2005
betrayal bonds: more on trauma shame
Really said:
I'm very conscious that you have been through a lot and I don't want to make matters worse.I guess from reading this stuff, I have been through a lot, but don't worry, as long as people are respectful and talking about their own experience, its fine. I didn't put this stuff up for sympathy or advice so much as to wonder if other people have been through the same sorts of things with their ptsd.
I've worked through a good deal of the shame issues I talk about in the post, very much along the lines you map out. One other thing I learned was that taking on other people's shame is a way of trying to gain control of the traumatic events. If its me, I have an explanation, and maybe even a solution: If its my fault, it might be under my control to change it somehow.
Of course, this is an illusion, one that gets reinforced by 12-step work, which encourages people to always look within for the source of our troubles: The only way it makes sense is if I am just somehow utterly broken goods towards whom such behavior is natural. This was reinforced by my abusers big time (who were, not coincidentally, all associated in one way or another with 12-step forms of recovery), and opting out of that illusion has been key to getting better. It is very tempting to revert to it though, in order to have a reason for things other than that people who I trusted and believed in were malicious and untrustworthy. Its a perverse sort of way of maintaining my old view of the world and denying the betrayals that took place.
When this self-shaming takes place now, I am usually aware enough to take a step back, separate myself from my abusers, and recognize that I am trying to make sense of things in a self-destructive way. The betrayals and abuses were real, and they are not mine. As you say, that then leaves me more freedom to deal with the strong emotions connected with the events, which though they may not be pleasant, they are at least somewhat healing.
I guess sometimes I still shy away from dealing with these emotions because when they all came out at once, it was totally overwhelming and destabilizing, so I need to have support and stability to let go of the shame. While it may be a dysfunctional and ultimately self-destructive way of coping, I needed to recognize that coping is what it was about, not some defect on my part, which of course would only reinforce the shame.
Tuesday, December 06, 2005
betrayal bonds: trauma shame
In the non-traumatic reltionship I had managed to get in, I was sure that if my partner found out about the Internet porn she would leave. She did find out...I finally told her when I thought I was going crazy. It really hurt her, but she immediately saw the connection with trauma that I couldn't and basically stayed with me, even as my mental health went completely to hell. That was a real lesson...she could see things in me that I could not and thought I was worth sticking around for. I figured I had better start to see some of those things in myself too, and I am slowly learning. Releasing myself from the shame and secrecy also undid the hold the compulsive acting out had on me. I started to deal with what had actually happened instead of my shame-distorted views of a whole series of traumatic events that stretched back to childhood.
Trauma shame tends to make some people overcompensate with unrealistic goals followed by more shame at failure in a classic binge/purge cycle. For people with ptsd, all experiences are tend to be processed by the brain as extremes, all black or white, with no grey. The loss of "the ability to operate in a balanced way...further adds to shameful feelings." Shame based people also have a tendency to re-create childhood traumas in adulthood. This was certainly my pattern anyway.
Trauma shame can result in obsessive self-hatred, worse than feeling unlovable or depressed, which can lead to self-destructive, even suicidal thinking and behavior. I made an attempt, but failed, and ended up in a loony bin for three weeks. Never got near addressing any of the causal issues and left basically promising myself not to make another attempt -- I had had my chance -- but still feeling suicidal. I felt suicidal for the next nine years, obsessively self hating and managing to stuff all my feelings, and the memory of traumatic events until everything just fell apart.
In the paragraph that follows, my comments are in parentheses, the rest is quoted from Carnes. Some signs of shame, according to Carnes, are: "feeling ashamed because you believe trauma experiences were your fault; loneliness and estrangement from others because of trauma experiences; self mutilating behaviors such as cutting or burning (when things were at their worst for me, I would literally rip chunks of flesh out of my stomach, the backs of my hands, and other places, I still have problems with self harm sometimess but not as bad); self destructive behaviors, enduring physical or emotional pain that most people would not accept, avoiding mistakes at any cost; feeling that you should be punished for the trauma event and being unable to forgive yourself (I experienced this as the result of cult abuse, where they ripped apart my life and then blamed me for it); feeling bad when something good happens (good things happening still make me anxious); having suicidal thoughts, threats, and attempts; possessing no ability to experience normal emotions such as sadness, anger, love and happiness (one thing I learned was not to trust anything. I couldn't feel anything but a ripping feeling in my stomach and a lump in my throat for a long time, then rage as I realized what had really happened. Slowly I've gotten some of my emotions back, but I have difficulty trusting happiness or anything good, even today -- its just asnother setup, I think); having a deep fear of depending on people (my partner said I tested her all the time, trying to figure out if she was dependable); feeling unworthy, unlovable, immoral, or sinful because of trauma experiences; perceiving others always as better, happier, and more competent (I saw this as a problem with envy. My abusers got off scot free with ripping up my life, and even seemed to benefit from it and it drove me mad for a while); having a dim outlook on the future; avoiding experiences that feel good, have no risk and that are self-nurturing. "
I would have never made the connection between trauma and shame without help, including Carnes' book. I had basically repressed memories of the traumatic events and just thought I was a crazy, no good mixed up, broken person, even as my life on the outside appeared to be very successful. Learning the connection between trauma and shame was a real life-saver for me, making sense of something that seemed utterly senseless to me.
Another thing I learned along the way is that there is a healthy role for shame. When someone does something bad, shame is an appropriate response. What happens in trauma bond situations is -- and let me just shift to first person here -- I took on my abusers' shame. They are the ones that should have felt shame, but in a trauma bond situation, perpetrators shuck it off onto their victims, compunding the abuse. Learning that this shame was somebody's, but not mine, was healing.
- A little more on trauma shame is here.
All the quotations and information not otherwise attributed above comes from Patrick J. Carnes, The Betrayal Bond: Breaking Free of Exploitive Relationships (Deerfield Beach, Fla.: Health Communications Inc., 1997), 21-24.
betrayal bonds: trauma abstinence
Carnes talks about trauma abstinence in conjunction with addiction, saying the two go hand in hand. I experienced this as getting one area of my life under control only to see another part go out of control. To me its like that game in the amusement park where you swat at gophers as they pop up out of holes. A soon as you get one, two more pop up and they are never under control...which of course is the "rush" of the game.
What are some of the behaviors associated with trauma abstinence? Carnes says (and I'm mostly quoting him with my own thoughts thrown in): Compulsive debtors, people who deny basic needs like groceries, avoid any sexual pleasure or feel extreme remorse over sexual activity, hoard money and avoid spending it on legitimate needs, work in under-achieving jobs and make unwarranted sacrifices at them, spoil success opportunities (this is the one I relate to most), have periods of no interest in eating (for a while when things were bad I didn't eat hardly at all. I'd eat a little because my partner would make me. Lost 40 pounds. Meds put it all back on...drat.) attempt diets repeatedly, see comfort, luxuries, and play activities as frivolous, skip vacations to work on unrewarding tasks, avoid normal activities because of fears (hmmm...I might still do this some...I tend to hide out when left to my own devices), have difficulty with play (I don't have a problem with this:), be underemployed, vomit food or use diuretics to avoid weight gain.
I think where it shows up in my life is in everyday neglect...not wanting to shower (but I do...so don't worry about the blog smelling bad:), not bothering to eat or eating badly when my partner isn't around, that type of thing. I may have it around some sexual stuff, but its hard to sort all that out. Sex is a real trigger for my ptsd. My partner is also a survivor, and since my ptsd messed up our sex life, we tend to avoid having sex on any regular basis. I don't know if its abstinence or just that freaking out isn't really fun or pleasurable for either of us. I'll talk more about that some other time.
All the quotations and information not otherwise attributed above comes from Patrick J. Carnes, The Betrayal Bond: Breaking Free of Exploitive Relationships (Deerfield Beach, Fla.: Health Communications Inc., 1997), 17-21.
Saturday, December 03, 2005
betrayal bonds: trauma splitting
It can take the form of amnesia. I had no memory of what happened at the time when some of the trauma and betrayal stuff happened for years afterward. When it came back I was overwhelmed with flashbacks and stuff, so splitting was an attempt to protect myself from that I guess. I would not be able to remember what day it was or how long ago the flashbacks were either, so I guess that was dissociation too. It can also take the form of splitting from one's body, maybe flying around the room, or detaching and looking down on the scene from above. Sometimes different personalities form during splitting. This gets called multiple personality disorder or dissociative identity disorder (DID).
Addictions often have a component of splitting. Addictive behavior, whether in the consumption of a drug, obsessive or compulsive sex, gambling, or even religious or artistic preoccupation, can be a form of splitting, of creating a fantasy reality that ignores the real state of things. Lots of addicts talk about a "Jekyll and Hyde" experience of having one set of values and behaviors they believe in and another personality, the out of control addict, that seems intent on destroying these.
Some signs of dissociation are spacing out as a response to painful memories, confusion and forgetfulness because of preoccupation, resorting to a fantasy world when things get tough, feeling separate from the body as the result of a flashback, amnesia, preoccupation, having compartments to your life others don't know about, living a double life, obsessing around addictive behavior, losing yourself in romantic fantasies, or using marijuana or psychedelic drugs. All of us space out sometimes, the problem is when it becomes a way of life.
All the quotations and information not otherwise attributed above comes from Patrick J. Carnes, The Betrayal Bond: Breaking Free of Exploitive Relationships (Deerfield Beach, Fla.: Health Communications Inc., 1997), 14-17.
betrayal bonds: trauma blocking
Often trauma blocking alternates with trauma arousal. A person will engage in high-risk, high shame behavior such as compulsive sexual activity followed by numbing out with food alcohol or something to numb out the shame. Another example would be an addict alternating between ice and alcohol, the former for arousal and the latter to numb out afterwards. When I was using, I used to do speed with alcohol and depressants in order to be "normal!" Not quite.
All the quotations and information not otherwise attributed above comes from Patrick J. Carnes, The Betrayal Bond: Breaking Free of Exploitive Relationships (Deerfield Beach, Fla.: Health Communications Inc., 1997), 12-14.
betrayal bonds: trauma arousal
All the quotations and information not otherwise attributed above comes from Patrick J. Carnes, The Betrayal Bond: Breaking Free of Exploitive Relationships (Deerfield Beach, Fla.: Health Communications Inc., 1997), 9-11.
betrayal bonds: trauma reactions
All the quotations and information not otherwise attributed above comes from Patrick J. Carnes, The Betrayal Bond: Breaking Free of Exploitive Relationships (Deerfield Beach, Fla.: Health Communications Inc., 1997), 6-9.
Friday, December 02, 2005
more on betrayal bonds, aka trauma bonds
At the treatment center I went to for ptsd I was introduced to the concept of a trauma bond. They shared portions of a book, Patrick Carnes' The Betrayal Bond: Breaking Free of Exploitive Relationships, with me. I immediately bought the whole thing, and it remains about the only self-help type book that I have managed to work all the way through. It transformed my understanding of what was going on in my life, why I kept repeatedly getting involved in traumatic relationships even after getting clean and sober, why I was unable to "just get over it," and finally, what made these relationships so powerful in my life.
The place to start is with betrayal. What is it? Carnes starts his book by saying it is "a breach of trust. Fear. What you thought was true -- counted on to be true -- was not." ReallyNotImportant, in his blog on Zen and PTSD, describes it nicely when he says that "the world is suddenly a very strange place. Nothing makes sense. Nothing is clear-cut, everything has nuances. All the certainty is gone." The world becomes unsafe. It may fall away from beneath your feet at any moment. But its not all a lie. According to Carnes, "there was just enough truth to make everything seem right. . . . a little truth with just the right spin." The rest was exploitation and a harsh form of abandonment, which he connects to the core of addictions and shame. It is worse than neglect, being purposeful, in my case even intentionally cruel. And "if severe enough, it is traumatic," he concludes, creating "a mind numbing, highly addictive attachment to the people who have hurt you," leading to self-distrust and self-abandonment.
Because of my history of abuse and trauma, I managed to stack up a series of these betrayal bonds with god-awful results. Carnes notes that "adult survivors of abusive and dysfunctional families struggle with bonds that are rooted in their own betrayal experiences." He concludes that "Loyalty to that which does not work, or worse, to a person who is toxic, exploitive, or destructive to you, is a form of insanity." So I guess I was insane, at least for a while. That is how it felt, too.
He has a test on his website that you might take if you think you are in the grips of a betrayal bond. Some of the signs are "misplaced loyalty, inability to detach, and self-destructive denial." Then comes the punch line, the part that explained why everything could still go crazy even nine years after I had extricated myself from these relationships: " You will never mend the wound without dealing with the betrayal bond." Time won't heal it, compulsive or addictive behaviors won't numb it away, therapy won't cure it, spirituality won't work...none of it will unless you confront the trauma bond itself.
In what sort of contexts do they occur? Carnes gives a list of likely candidates:
- domestic violence
- dysfunctional marriages
- exploitation within the workplace
- religious abuse
- litigation
- kidnapping
- hostage situations
- cults
- addiction (alcohol, drugs, gambling, sex, high-risk behavior
- incest and child abuse
Half of those things happened to me in the span of a couple of years, and a couple more had happened earlier. Any of these are complex issues, and Carnes says "an unraveling must occur." There is no simple, quick fix.
He maps out abuse along two axes, from once or seldom to frequent or constant on the one hand, and from low trauma to high trauma on the other. That explains why someone who has a series of moderately traumatic events can have many of the same symptoms as someone who has a single highly traumatic event. While the symptoms are the similar, it seems to me that the unraveling is a little different for everyone.
He then lists eight ways trauma affects people over time, one of which is the betrayal bond. I'll go into those in the next few posts. Most often, a person who has been traumatized will be affected in more than one, perhaps even all of the ways listed.
As usual, if you got this far, let me know in a comment!
All the quotations and information not otherwise attributed above comes from Patrick J. Carnes, The Betrayal Bond: Breaking Free of Exploitive Relationships (Deerfield Beach, Fla.: Health Communications Inc., 1997).
Thursday, December 01, 2005
ptsd, flashbacks, and "pseudo-seizures"
BTW, grounding exercises can help a little with flashbacks, so if what I describe below is familiar try them out. They don't make the flashbacks tolerable or make them go away, but they helped bring me back to the present a little sooner when I could do them.
I just want to talk about what are called "pseudo-seizures." They are a particularly nasty kind of ptsd flashback. When I first came upon the name in therapy, I was relieved that there was even a name for what I was undergoing, namely half-hour to hours long episodes in which I would become a tautly curled up shaking sobbing mass of pain, followed by major disorientation...I often would not know what day it was or if and how long ago the thing had happened. I had hundreds of these over the space of a few months, utterly terrifying and exhausting, doubly so when I didn't know what they were. I just thought I was going crazy. So unlke ReallyNotImportant, who dismisses the labels as not very helpful, I found having a name for what I was experiencing comforting to some degree. At least I was not alone. This was within the range of human experience, even sane experience.
If you are having these things, which doctors are now starting to call "non-epileptic siezures" because sufferers have understandably negative and invalidated responses to the "pseudo" part of the label, I truly feel for you and hope you will get help however you can to get through it. There is another side, as far away and impossible as that may seem. I didn't think so either but there is, so plz hang in and get help. There is nothing pseudo about the experience at all. It is horrible.
I tried to think what I might have called them if I didn't know what they were...When I was able to contain them to when no one was around, I invalidated them as just me being dramatic -- though never with an audience. I just tried to minimize, hide, and wish them away. Ultimately, they outed me and that is when I got help from my wonderful family of choice. I thought they would think I was crazy and just discard me like my abusers had when they were done with me.
I guess "crazy" or "insane" were my descriptors once the cat was out of the bag. And they would have been correct I suppose if I hadn't been so fortunate as to be able to get help and support. I looked and felt battered and emptied out of all humanity, only able to feel pain and not able to get rid of it for a moment. No relief.
I still get shadows of them today. Sometimes I shake badly. Sometimes like today I feel like I am hitting the top of an elevator all day, an unsteadiness in the pit of my stomach. It serves as a reminder of worse times, but it is nowhere near the intensity of before...I have been "pseudo-seizure" free for a couple of years now. They slowly worked their way out of me. So if you have 'em, please don't let them get that last little bit of you that you hang on by, even if you have to fight tooth and nail and act all unseemly and cry alot. I needed medication as part of my solution...Geodon was the key one for me, though I know others who hate it.
So if you are having these sorts of intense, seizure-like flashbacks, or have had them in the past, leave a comment and let me know I am not the only one in the blogosphere to have had them!