Complex PTSD

Chapter 6 – Fear Without Solution

This is part of a series called “The Bottled Scream” A Disease of Self – Understanding Addiction and Recovery. To go back to the introduction click here.

Trauma

My mother’s dependency on Valium didn’t help much. As I explained eralier, she had been prescribed Valium soon after I was born (possibly before) and was dependent on it all her life. This meant that she mothered me in an emotionally distant, inconsistent and, frequenty, dismissive manner. She spent much of my childhood in her bedroom, bluntly asking me to leave her alone. Leaving me with the feeling it was my fault this had happened to her. A fear embedded into my heart that she never assuaged, a fear without a solution. She never recognised or addressed my fears and they were left to grow, my anger to simmer and boil over into rage.

I believe this lack of attachment and also in earlier in the first weeks and months, after being born, contributed to later introceptive and emotion processing problems. But much of the damage to my later life was done in infancy (and childhood) I believe. A damage, I think, coontributed to later addiction and C-PTSD. As we grow from infancy, our close bonds to our primary care giver is crucial for future development of our brains and our abilty to regulate our emotions, stress and ultimately ourselves (self regulation). In the first few months of life, the emotion and social parts of the brain that regulate emotion and distress develop during this initial two way relationship between primary care giver, mother in this case, and baby, me, which models behaviour that successfully regulate emotions. The brain architecture for emotion (and stress) regulation did not get properly manufactured in my brain. It did not mature properly and this led to later emotional immaturity.

I feel I was born into trauma, an attachment trauma, that I never fully bonded with my mother, the primary caregiver and ended up with a insecure attachment, one they call disorganised attachment, an attachment that provokes a fear without solution. In other to understand this type of attachment disorder, we can imagine a mother and son playing in a room, the mother leaves and a stranger comes into the room. When the mother returns and the child is reunited with the mother, following this period of absence,  a child with disorganised attachment would experience inconsistent fearful reactions that never resolve themselves, such as approaching the mother initially, then stopping or falling to the floor, it is also called fear without solution. The child does not treat the mother as a secure attachment he can return or not, safe in the knowledge she is there when he needs her. He can return when he likes, he can explore, play or come back to her when he likes as she is there, cosistently available to his emotional needs.

The disorganised child is not sure that his mother, primary caregiver, is there in a consistent manner to care for him and his emotional needs, she is there sometimes, not always, she is inconsistent in her caregiving and he is insecure in his attachment to and bonding with her. His fear is not satisfactorily solved by his mothers caregiving. Her care and love seem conditional, based on her availabilty not on his emotional needs. This lays down a template in his mind about people and how available they are to him, it infuences his future reactions, an internal working model, that care and love are not always available or that they are available sometimes and not others. It leads to a fear of rejection.

A fear of not being deserving enough of unconditional love and care. It is a pattern of responding that can lead into later adolescence and adulthood. It can lead to a wide range of mental health issues, including C-PTSD and addiction, where “substances” become a type of “secure” attachment.

Unresolved fear.

Even in later in life I would phone her armed with a tin of beer and a spliff. She unsettled me at a profoundly deep level. I was never sure of her, or safe in her presence, I was always guarded against rejection. I never felt fully secure although I loved her dearly. I was also inconsistent in my behaviour to her, especially in later life when I would exact petty revenges on her which sometimes involved abandoning her to see how she liked it. I remember once leaving her for hours with a portrait painter, a complete stranger, who made he feel very uncomfortable and anxious with his awkward questions as he painted her. Abandonment was what I felt in relation to her, even when talking to her on a phone call.

I felt I received conditional love from her although I believe and feel she loved me. It was through an emotional haze, she wasn’t fully present. She wasn’t fully available. I waited for a love that I would never fully receive. I waited for her to come for me but she didn’t and I grew up feeling strangly rejected and abandoned.

I internalised this as being my fault most of the time, sometimes unconsciously, as this “not being worth it” and this became part of my view of myself in relation to the world. My negative self perception automatically retrieved rom my negative self schema. I wasn’t worth it, I was defective in some way, not worth the effort. I wasn’t worth saving! So what did I do with my distress and my everdyay negative emotions. I buried them, suppressed them , didn’t share them. Sharing how you felt increased the chance of having them rejected. It was too painful to have then ignored and dismissed so I started blunting my emotion resposnes. Sometimes I would demand to be heard and overreact and my mother would shout to my father to have me taken away from her, to stop bothering her.

Eventually I realised my mother heard what she wanted to hear and that was rarely the truth so I tried to not having emotions as they were too painful, when not shared or reciprocated.

This led to a toxic shame and a blunted awareness of my feelings. It was as if shame was prompted by having emotional needs that were thwarted. Shame then became the overriding feeling and took control of my life. My emotions almost became servents to this overriding shame, it was the master emotion provoking self pity, guilt, selfishness, self centredness, arrogance, intolerance, impatience, anger, rage, greed, gluttony, and in later years, lust. The very same emotions I list on my Step 10 inventory every nght. The shame based respsonding I have to life today and have had since eary childhood. Traumatic and toxic shame, the beating heart of all addictive behaviour.

Shame contributed to my alexithymia, the inability to recognize or describe my emotions too, the numbing of emotional repsonse. The fleeing from feelings. My feelings were troublesome and best not having. It was best to ignore them and take your mind off them instead, to live outside them. To act outside of yourself without realising, the internal shame was constantly animating your every action. I was fixing my feelings from an early age. I could run away from them but I couldn’t escape them. They would catch up with me one day.

I now know it wasn’t her fault. She was suffering from addiction but I never knew that fully at the time. We were all suffering from addiction as a family, but this realisation came decades later. For me anyway. It didn’t come for mummy, we never fully discussed it. She was dead by the time I came into recovery. So in the absence of an acknowlegement of the terrible effects of addiction I instead waited, in my own undiagnosed addiction and alcoholism, for some recognition of a shared but troubled past she couldn’t, or wouldn’t, recall and re-examine as it may have been too emotionally overwhelming or she couldn’t reconnect with as she was fully involved in it initially.

I am trying to square that troubled past now in writing this book, to exorcise the ghosts of the past. To liberate us from our past. Memory recall often depends on the clarity and intensity of emotion that accompanied the episode remembered. Blocked off emotions weren’t conducive to this recall. For mummy it was if the past almost happned to someone else. It didn’t really happen to her because she wasn’t fully present at the time.

When I asked about the past it brought out angry reactions in her. She castigated me for dragging up the past so I cannot say if she had painful memories or didn’t want to contemplate her son’s pained reaction to the past. Emotions seemed to threaten to overwhelm her, before a shrug of the shoulders seemed to send them off, floating away on a distant cloud. As if they weren’t her resonsiblity, didn’t belong to her.  She didn’t seem to care sometimes. It was as if she was about to have some emotional response then it would dissipate like passing clouds, the Valium wafting it away.

She made me feel sad, not deserving of anything more. Thre was no explanation or commiseration, no acceptance of even acknowledgement of my pain, no empathy. I never felt fully seen, fully felt in her unconditional love. There was no safe haven or resting place in her affection. There was no solution to my fear and emotional distress.

This made me feel strangely not worth the effort or time, somehow defective. She made me angry, raging even, especially in childhood. I dismayed she wasn’t like my friends’ mother. How come my mother was so odd, so detached? Or depressed and uncaring? So useless. Why didn’t she care about us enough to love us. Why did she have us in the first place if she didn’t want us? We were all a big mistake to her it seemed. Worthless. I sought attachment everywhere I could, of course. From my sisters, from  my aunts. Friends and later from girlfriends. Anywhere I could find a fleeting solace and a place to rest from my errant painful emotions, for a while at least.

But is was precarious, I constantly guarded against a rejection I somehow was sure would come. It always did eventually, I felt. Later in life I would finish relationship with girls and woman before they did, just in case. The only constant relationship I had, that never rejected me was with alcohol, that was it until it sent me mad and almost killed me. I am so lucky that alcohol spat me out too otherwise I would have died.

It was a chemical attachment, a fairly consistent safe harbour. A solution to the fear and self loathing. A very, and increasingly crude solution. A medication just like my mother’s Valium. Strange how I never took Valium in case I became addicted like my mother? All the while slipping into alcoholism.

Decades of unresolved fear and emotion knawing away at my psyche, propelling me further and further into addiction and distress. I thought I was runnng away from my problems instead of running more deeply into them. Past addiction and trauma, the fuel for my present alcoholism. The alcohol, over years of chronic drinking, increasing the fear without solution. The fear becoming psychosis. My sisters suffered from this insecure parenting too and all the family dysfunction as a result of my mother’s Valium dependency. We all came second. Although my sisters probably didn’t always see it that way.

They thought, in my mother’s conditional love, I came first as the youngest child and only boy. God knows how little they received in terms of maternal love, if they were jealous of the scraps I got? I probably got more conditional love than they did, if that makes sense? They didn’t seem to have the same insecure attachment as me and grew up with ambivalent or anxious attachments rather than my disorganised attachment.

I believe we all grew up in the trauma of neglect and emotional abuse but I am not sure they ended up with C-PTSD and it’s associated dissocative disorder. Perhaps my initial attachment trauma left me more vulnerable to being traumatised by later traumatic events, some of which they witnessed too? Perhaps it affected me more as I was the youngest? Perhaps because I had already suffered from trauma, attachment trauma? It is difficult to say. Mental health problems, like alcoholism, are often self diagnosed, often with the help of competent professionals or through recovery circles. Most trauma, in life, seems buried in denial. I didn’t self diagnose my chronic alcoholism until it practically killed me or my C-PTSD until ten years into recovery when it threatened me with relapse. I had thought many times and discussed with my wife on numerous  occasions that I had trauma issues but only I accepted my C-PTSD when I started to profoundly dissociate, on one occasion all the way back to childhood. I even spoke in a child’s voice on one occasion, spluttering out

“When I make mistakes people die!”

https://www.benzo.org.uk/support.htm

Trying to Find the Horror

 

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In most traumatic events there is an accompanying feeling of terrified helplessness. Whether it’s a soldier looking on helplessly as his fellow soldier gets killed or a fireman seeing person burn in a fire, just out of reach or someone looking on as a loved one tries to kill herself.

There is that feeling of falling into an abyss.  A moment of true wordless horror. This the moment of trauma that leads to a life of post trauma, to PTSD.

A moment that is so unbelievably bad and terrifying, that the brain and heart struggles to comprehend the extent of it, fails to process the magnitude of it, fails to lodge the event in their long term memory and script of their life. Instead it makes you roam your life like an emotional Steppenwolf, scared to ever return to the warm of common humanity.

It is like an explosion that detonates in the brain and blows holes in stress systems and lives on in fragmented, fractured memory and in heightened fearful emotional responses to the world which are somehow not explainable. They require post hoc and retrospective explanation because they seem inordinately over reactive to events that prompt them.

This event will haunt the future and appear to  live on in one’s very bones. It has not been exorcised so lives on as a neural ghost haunting one’s reactions to people, places and things.

I know what my explosion is but not the intimate details. I have asked one of my sisters to help me piece together the broken pieces and scattered  debris of my memories of the event but she has struggled to.

First she was sure she was right in describing it a certain way and now has changed her mind to describe it a different way. With a different sequence of events and characters. It has been frustrating not being able to transport oneself back in time and simply look at a previous event in one’s life but there are so many self defense mechanisms making that process extremely difficult.

Either way, we are still not convinced about the aftermath of the event. We seem to be looked at a charcoal penciled sketching of pictures of the past which often get scrubbed out and started over. We have tried desperately, for hours this weekend, to piece and glue our scraps of memory together to make a bigger, more fuller picture, like a collective collage.  We might do this for weeks and still not get a definitive picture and memory of what truly happened.

I spent a few years, many moons ago, trying to write fiction. In fact I wrote about my family and this incident but purely, I believed, from my imagination but mixed with some historical signposts. Looking back, this writing from the heart may be more accurate that our attempts to rescramble our collective memories?

I and my sister have been trying to get to the moment of horror. To look at it again as adults not children, traumatized children.

We are convinced that it happened only once, thank God but that it has had major consequence and repercussions on all my sisters and I.

It would not be outlandish to suggest that all our lives took a major redirection that day. I, when talking to my sisters, see now that the huge similarities we seen to have are all because we are traumatized by the same event. We have post trauma personalities.

How we reacted to the same trauma seems to have frozen us into certain personalities.

My sister who ran for help is still running, in her personal life she continues to trust no one.

My eldest sisters still pretends, that it did not happen  as she may have dissociated from the actual event when it was happening – not wishing to believe that it  could be happening.

My third sister still bristles with anger and hostility at my “scary monster” of a mother who scared the life out of her children over forty years ago by attempting to swallow a phial of pills.

I am not sure what tablets she tried to kill herself with or if she even consciously tried to kill herself but to her assembled children that is what it looked like and that is what it felt like.

It is hard to describe what this level of rejection  and devastation felt  like. I will try to explore it again tomorrow in my next EMDR sessions.

The problems with asking a sister to help you remember is that you not only view the same scene differently, depending on gender, emotional loyalities, age etc but that the effects the traumatic incident had on you still affects how you recall it.

For example, my sister who ran to get help, talks about the event in a skimming, superficial, running through it type of way. She still doesn’t want to delve deeper into it as it is still  too scary. She is still running with the ten year old shaky, adrenaline fueled legs that took her to my uncle’s house to get help, not knowing how bad her mother was and whether something monumentally terrible had and was occurring.

I was left with my mother after she had taken the pills, slumped on the bathroom floor, without an adult to tell me things were going to be okay?  God knows the feelings I had, being so helpless? The despair I must have gone through in this few minutes between my mother throwing the pills down her throat and my sister returning with help? It must have felt a bit longer than eternity?

I will find out more no doubt tomorrow

Interestingly I would say decades later that one of my major weaknesses in life is my ability to tolerate uncertainty about future events and to handle distress adaptively.

It has been the greatest issue in my recovery, it is tempting to speculate that this behavioural response started as the consequence of not knowing the future prospects for my strewn mother, lying with tablets dribbling out her mouth on the bathroom floor?

 

 

Almost Time?

Tomorrow I am set for my next EMDR session.

The one thing I haven’t mentioned about EMDR and I should really for any of you lovely people considering this excellent treatment and that is that the treatment is very exhausting.

I spent three days on an adrenaline high followed by three days of pure exhaustion.

This is worth noting as it certainly effects one’s ability to do the things they normally do, such as their job!

I run my own business, I am self employed and I am not convinced I could do this EMDR treatment if I was not self employed. My wife did it while on sickness leave from her work.

Although, equally, I know of other people who have had to hold down a job while having EMDR therapy and did so. I am only talking from my own experience. My experience is that by the time the next EMDR therapy session is about to begin I am still recovering from the last one.

I have been dog tired, way beyond how tired I normally get and I do get tired quite often as I have a tendency to over do things, well everything really.

In addition to running my business, I do academic research with two Professors in a UK University, I blog on two blogsites, and I am carrying our hard manual building at least twice a week on a regular basis which is physically taxing. Most of this I haven’t had the energy for, in the last couple of weeks of EMDR.

EMDR treatment is fairly quick in it’s ability to quickly positive outcomes compared to some treatments  but it does  have the price of being very tiring.

I am writing this because I do not want to give the impression that it is simply a case of rolling up to treatment, it being great and then back for some of the same the next week! It is not like that, as I say it is exhausting.

I have also had over ten years in recovery which has helped greatly. I am not sure how I could have coped with this level of exhaustion eight years ago? Maybe I could, it is difficult to say.

I am not saying this to put anyone off, I think EMDR works for people in recovery whatever their length of recovery. I am just stating that it is very tiring and this should be factored into one’s awareness about doing EMDR.

Obviously I do not like being this tired but it is part of it I guess?

I find this level of tiredness makes me a bit more snappy with people, not as able to cope with frustration as usual and also it can create a low or sometimes negative mood that is not really linked to anything in particular other than being very tired. I have panda black rings under my eyes.

Okay that’s me done. An unusually short blog from me this time (shows how tired I am, lol!)

I do try to write shorter blogs but it rarely happens. Things gush our of me a bit and then I have written a chapter rather than a blog!!

All grist to the mill as they say in the UK. I would like to put this writing in a book one day. Explaining what happens in the brain of recovery but also using personal stories of recovery like the blogs I am writing now.

I noticed in my other blogsite Inside the Alcoholic Brain   that the most popular blogs by far have been on the topics of PTSD and C_PTSD and the treatment thereof via EMDR.

I think many people in recovery catch on to the idea eventually that they actually suffer C-PTSD (and other co-occurring disorders) and also insecure attachment the longer they are in recovery.

Through time recovery is about more than not relapsing, more than addiction and becomes a voyage of discovery and a search for increased well being and quality of life – William White calls it “better than well!”

These factors are also prompting me to do EMDR and finally get past my past. A past that has troubled me for over forty years.

I want to fully engage in the now, the present, I want the past fractures to be mended and the love that  I know is scattered across different areas of past and present life to finally be reconciled. .

I have choice now, I never had when in active alcoholism and addiction.

What a wonderful thing, choice!

 

Well that’s the First Session Done!?

Just had my first session of therapy for my Complex-PTSD (C-PTSD) two days ago. Still a bit tired. It is good to have gotten the process going.

But it may take some time. I was hoping the therapist would say we should get this done in 20 sessions but it seems we will be in this process for quite a while.

Possibly most of this year!

My Complex PTSD is very complex and involves repeated traumas inside and outside the home so will take time to process my past.

The good news is that I really like and respect the therapist.

I like her as a person, she is nice and considerate which is important.

I have heard it mentioned that the relationship with the therapist is often key in these therapeutic sessions.

She looks like she knows her stuff and can help me get a bit healthier.

C-PTSD appears to fragment the self and the processing and reprocessing memories from the past also appears to be a process of unifying shattered fragments of the self at the same time. This is my intuition that this will occur anyway.

One of my main issues with C-PTSD is dissociation. I simply had not realised how much I  dissociate and have dissociated throughout my life. In fact, I have probably been doing this since very early childhood.

So what is dissociation?

In psychology, the term dissociation describes a wide array of experiences from mild detachment from immediate surroundings to more severe detachment from physical and emotional experience. The major characteristic of all dissociative phenomena involves a detachment from reality, rather than a loss of reality as in psychosis.

Dissociation is commonly displayed on a continuum.[5] In mild cases, dissociation can be regarded as a coping mechanism or defense mechanisms in seeking to master, minimize or tolerate stress – including boredom or conflict.

More pathological dissociation involves dissociative disorders – These alterations can include: a sense that self or the world is unreal (depersonalization and derealization); a loss of memory (amnesia); forgetting identity or assuming a new self (fugue); and fragmentation of identity or self into separate streams of consciousness (dissociative identity disorder, formerly termed multiple personality disorder) and complex post-traumatic stress disorder.

Disassociation is very common to PTSD and C-PTSD.

Obviously it is something that has bothered me. I have thought that maybe I have dissociated a few times in recovery under extreme distress but there appears to be smaller more moderate dissociations going on a lot of the time.

It is essentially a coping mechanism against  emotional distress and anxiety but also it seems to have become a coping mechanisms in terms of troubling emotions.

I have learnt to regulate my emotions in maladaptive ways. I dissociate and use other use immature ego defense mechanisms such as denial, rationalising, minimising, justifying, projection etc. I hasten to add that after 10 years in recovery I also have learnt to adaptively regulate emotions so this process has become more automatic as my brain as healed and my emotion regulation improved.

However, this ego defense mechanisms have been rife throughout most of my life.

Especially denial.

One of my first reactions to any extreme emotional disturbance is to deny it’s happening or has happened.

This is the main reason I have not entered into treatment for PTSD before. There is a large part of me that denies I was traumatized although the evidence is there in so many ways. Chronic dissociation, regression to traumatized childhood experience, explicit memories of trauma incidents  etc etc would suggest not only that I have been traumatized but on multiple occasions over a long period of time.

Regardless, my head tells me “are you sure this happened? But your parents loved you?” It is very similar to when I finally went into recovery after almost dying from alcoholism, my head would say “yeah but you didn’t drink that much?” This isn’t simply denying alcoholism it is also denying the fact I have lost control over me. My denial minimised and rationalised this so that it was not overwhelming. This is why we need to be careful accusing newcomers about being in denial about their alcoholism. We tell them our story and let them identify, this is much better as it does not scare them into even more denial as ego defense.

It was less about denying alcoholism than denying reality and actual lived experience. I will deny anything which I find threatening to my sense of self.  Without consciously knowing I am in denial.

Anyway, my dissociation also appears linked to very insecure attachment to primary care giver, e.g. a parent like one’s mother. It is particularly common among those with disorganised attachment styles and very much so with children how have reacted at a young age to their mother’s fear and trauma.

Basically when events are traumatic or overwhelming emotionally it is often common for children to dissociate. Also growing up in a extremely stressful outside environment and society can lead to using this coping mechanism to survive. So in essence a survival mechanism that was crucial to surviving trauma in childhood.

My dissociations over the years has covered so many emotional states. I grew up in a very violent society so dissociated to deal with physical threat. I could and still can dissociate into a “powerful alpha male” state when threatened with violence for example.

I can dissociate to the extent I have no idea who significant people are in my life are, can’t remember names, etc, can dissociate to the extent that I feel my body isn’t mine and so on. I can also dissociate in a way which somehow returns me to feelings of early childhood, almost like I am temporarily a child again which is very traumatic to re-experience. I discussed some of these with my therapist.

She was very enlightened about the subject. She said it was just as it is,  for now, it is neither good or bad. It was and is a coping mechanism.

It is not to be feared as it passes but we will become more aware of it’s triggers. It is good to know that it is not “Bad” it just is. It will be dealt with in due time. I liked how she took the “sting” out of my anxieties over it.

I actually dissociated prior to the therapist session, a couple of nights previously as it was obviously distressing me at some unconscious level, the idea of starting treatment, the idea of the emotional pain to come.

The other point that was discussed a lot was the overlap between guilt and shame.

I generally believe shame is a major controlling emotion with me but that I had dealt with my guilt a lot during my 12 steps, steps 4-9 in particular. I have since realised that this guilt over wrongdoings to others primarily as a result of my drinking is very different to post traumatic guilt. All the way through the session I had this knot of guilt in my heart so tightly wound up it felt like a chestnut.  I tried to talk about shame but the guilt kept getting in the way.

We discussed this. Essentially PTSD and C-PTDSD are linked, one affects the other. Essentially we have PTSD with complex other issues added on.

I had trauma incidents which would constitute PTSD diagnosis alone plus other things too.

When a person has experienced trauma,  one has an overriding feeling of terror and helplessness and a very strong feeling of guilt.

This guilt tells one that they are somehow to blame for everything happening as it did – it whispers that one could have somehow prevented it happening. The self balks against helplessness.

We may feel that it was our fault that it happened. For me this is one of the roots of my troubles.

I once dissociated back to childhood (regressed perhaps) and I suddenly said “when I make mistakes people die!” which is a very extreme thing to say and a statement obviously steeped in trauma.

This memory related response and  associated networks of memory still lives in me and it is this and other traumatic memory  associations which need to be reprocessed.

It may even be that there are memories preceding this that I cannot access in my memory at present but which will crop  up in my mind as all memories are linked in memory networks to other memories. It is in reprocessing certain memories that other memories appear in one’s mind too.

It may even be a “memory” of something that did not happen in the sense that I interpreted something as happening in a way it didn’t. For example, two parents having a violent argument in front of a child may lead to the child blaming himself instead of the parents as it would be too emotionally overwhelming to blame the idealised “perfect” parents. This is more interpretation of events rather than the actual events themselves.

This is called the encoding of a memory. Memories are often encoded emotionally especially if the memory was encoded during a moment of emotional distress. Mood congruent memories, for example, happen when we remember something from the past because we are in similar mood to when other memories were encoded, hence the emotion helps us retrieve this and similar memories.

The same happens with trauma memories. They are often retrieved during similar heightened distress or states of hyperarousal as when first encoded.

A problem with C-PTSD memories is that we cannot always consciously access them at times or sometimes we have little memory at all of traumatic events.

This does not mean they are not in our memory banks are that they do not have influence on our behaviours, they simply do so implicitly without much explicit and conscious representation in our minds.

They do still influence our reactions and behaviours regardless of being really recalled. I used to say they lived in our bones but they more accurately they  live in our nervous systems.

The guilt and helplessness is linked to shame in me. The situations of my trauma were exposed to the community I lived in – people in the surrounding area had to intervene  in certain traumatic episodes to help us and so knew about our crazy family.

My guilt has thus been compound by shame, by not only being guilt but my self-perceived “guilt” and it’s repercussions had been exposed to wider society. Everyone knew what I did and that I was to blame  for everything that happened. They knew it was all my fault and what I was really like. A secret I have kept hidden since then, decades later. So toxic shame is linked to traumatic guilt.

This fear that people die when I make mistakes has led to a chronic perfectionism for myself and those around me. If I am perfect then all will be well. All will be controlled and bad things will not happen and everyone will be not fighting.

I set the bar high for many other people too as well as myself. It is like I can’t afford to make mistakes and either can others, particularly men as I have obviously blamed my father for our shared traumas and assigned my mother as the victim of the trauma. Hence I am wary often of men and protective of woman.

In fact, I grew up too quickly because of this, to protect my mother and guard against my father.

Although I consciously love both and have forgiven both and myself for what happened in our shared traumatic past, the memories of the events live on and colour my responses to and views of the world, men and women, even today. My memories of decades ago are like a computer virus corrupting my data files.

I write all this to process my therapy but hopefully to connect with others who are experiencing this stuff too.

I need to write to understand exactly how I am feeling and also to make connections in my brain/mind.

Whatever happened prior to my trauma episodes from childhood which led I believed to a life and death situation in more than one occasion was not the fault of a child who was say 6-7 years old. A child does not affect the behaviour of adults in such a profound way.

What happened, as is common in PTSD, is a mis-appraisal of what happened, a levying of unfair guilt on the person who witnessed the event. This guilt,  that it was their fault or they could have done something, keeps the trauma going – it becomes post trauma but still lives on in one’s mind and body and behaviours.

It is the misinterpretation of events that is internalised and processed as memory. It is this mis-appraisal that gets embedded in memory as if it was the truth, as a true reflection and recollection of what actually occurred when it was not what actually occurred.

Sometimes the trauma is so profound that the child does not want to think his parents did not love him or would hurt him (why would the be acting the way they do if they did?) and takes the blame rather than face this overwhelming emotion.

It being his or her fault is more tolerable at the moment. This too lies on in inaccurately embedded memory. It is a memory that perpetuates a traumatic lie throughout our lives. It is this lie which lives on in our negative self concepts. Telling us untruths about ourselves, that we are defective, not good enough, that if people really knew US?

It is a poisonous, malevolent neural and mnemonic ghost which haunts us decades later.

It needs to be re-addressed and the memories need to re- encoded accurately instead, that way we allow them to rest, embedded in our long term memory.

Via this process memories are reconsolidated, all the fragmented parts of self, stored away from each other in faulty interpretations and falsehoods about ourselves, that we keep alive in our memory networks and listen to as if they were the truth.

This is how I think EMDR helps exorcise the past leaving a past reality closer to the truth.

More will be revealed…

 

Getting Past Your Past

 

For those of you who read this blog, you will know I start EMDR treatment this week for my Complex PTSD.

In order to follow my progress it may be useful to know a bit more about what I am letting myself in for therapeutically.

Below I simply use excerpts from a great paper by Dr Shapiro, the originator of EMDR treatment who explains more eloquently than I can how EMDR works in freeing oneself from one’s past, suggesting perhaps that the negative “voice” of the past, but which stalks our living present,  talks to us via unprocessed memories from the past.

This makes sense to me because without memory we cease to be our SELF. It seems reasonable to suggest then that ironing out the temporal  wrinkles of the traumatic past by physiologically re-experiencing them in EMDR therapy will free us from maladaptive influence they have on our self perception and for them naturally to be replaced by more adaptive and realistic views of ourself as reflected by our relationships with significant others and via our life achievements.

The negative voices of the self are neural ghosts which still haunt us because they contain emotional and cognitive information in memory networks – previous experience became stuck like ghosts in the machine and by reprocessing these memories to disentangle their emotional grip we can safely exorcise these neural ghosts from our representations of self.

Borne in trauma, these responses were the responses often of children to trauma, they were traumatised responding to traumatising events.

They are out of kilter reactions to these events which colour present responding to everyday events although these events are no longer traumatising in themselves.

Previous events continue to colour our emotional responses to others and to ourselves. The critical voice that previous events were somehow our fault continue to live in negative critical self talk.

In other words we continue to be re-traumatised in our reactions to the world and ourselves. The voices of the child traumatised is the voice we still hear in our minds as adults. We still listen internally to a traumatised child’s voice in leading us in our responses.

It is not dificult to see how this becomes maladaptive and pathological. We are acting on cues from the past rather than seeing reality in the present as it is.

The past exercises an influence in us via these memory networks – when they are reprocessed and embedded in long term memory, replaced with more adaptive memory of who we are now then the past exerts less of an negative influence in the present. And we begin to heal in the present having gotten past our sometimes traumatic pasts.

That’s my take on the theory anyhow.

Here’s Shapiro’s take on it.

“EMDR is a comprehensive psychotherapy approach that is compatible with all contemporary theoretical orientations. Internationally recognized as a frontline trauma treatment, it is also applicable to a broad range of clinical issues. As a distinct form of psychotherapy, the treatment emphasis is placed on directly processing the neurophysiologically stored memories of events that set the foundation for pathology and health.

The adaptive information processing model that governs EMDR practice invites the therapist to address the overall clinical picture that includes the past experiences that contribute to a client’s current difficulties, the present events that trigger maladaptive responses, and to develop more adaptive neural networks of memory in order to enhance positive responses in the future.

While clinicians from the various psychological modalities agree on the symptomatology of the well-known disorders, their ways of conceptualizing and treating them differ as a result of the specific theoretical paradigm to which they adhere (Barlow et al. 2005). For EMDR (Eye Movement Desensitization & Reprocessing), this paradigm entails the view that psychopathology is based on memories of earlier disturbing experiences that have been incompletely processed by the brain’s inherent information processing system.

Incomplete processing means that a disturbing event has been stored in memory as it was originally experienced with the emotions, physical sensations, and beliefs fundamentally unchanged. Regardless of how much time has elapsed or whether the person remembers it, the memory remains unaltered and provides the basis of current responses and behaviors.

Most mental health professionals would agree that current clinical issues are based at least in part, on previous life experiences. However, the hallmark of EMDR therapy is the emphasis on the physiologically stored memory as the primary foundation of pathology, and the application of specifically targeted information processing as the primary agent of change.

The Adaptive Information Processing (AIP) model (Shapiro 1995, 2001, 2002, 2007; Solomon and Shapiro 2008) guides the clinical application of EMDR…

EMDR’s three-pronged approach of past, present and future guides the clinician in identifying and processing, (1) the relevant past experiences that inform the client’s problems in the present; (2) the ongoing present experiences that continue to trigger maladaptive responses to current life demands; and, (3) templates of future actions to optimize the client’s capacity to respond adaptively given the current context of their lives. This article provides an overview of both the theory and practice of EMDR as a distinct integrative psychotherapy approach…

EMDR processing can eliminate the dysfunctional emotions and physical sensations inherent in the memory itself changing the client’s experience in the present. Similarly, the processing of pivotal memories has been reported to result in the normalization of attachment style in adults and children (Madrid et al. 2006; Kaslow et al. 2002; Wesselman 2007; Wesselmann and Potter 2009). It is important to emphasize that memories of even ubiquitous events appear to set the foundation for a wide range of pathologies…

… its overarching goal is to achieve an alteration of the underlying condition that is generating the dysfunctional response in the present as part of a comprehensive treatment effect. These outcomes are achieved by placing memory networks and information processing at the center of both treatment and practice.

Adaptive Information Processing Model

The theoretical foundation for the therapeutic application of EMDR is the Adaptive Information Processing (AIP) model developed by Shapiro (1995, 2001, 2002, 2007)…

According to this model, and consistent with neurobiological findings, one identifies and makes sense of new experiences within the context of existing memory networks. In addition, the information processing system functions to move disturbances to a level of adaptive resolution. What is useful is incorporated, what is useless is discarded, and the event serves to guide the person appropriately in the future…

…when an event is not fully processed, the experience remains stored in memory with the emotions, physical sensations, and beliefs that were part of the original event. As a result, the memory is not integrated with other memories that were successfully processed. Consequently, when a similar experience occurs in the future, perhaps involving an authority figure like an insulting teacher, it triggers the unprocessed memory, which then automatically colors the perception of the present experience.

When clients seek psychotherapy for current problems in their lives, they are often focused on their symptoms as the problem. Consequently, the clinician wants to understand what the client is actually experiencing in the present, i.e., negative thoughts and feelings, uncomfortable body sensations that are out of proportion to the situations that are triggering the negative responses. Additionally, similar to other approaches such as psychodynamic therapy, the EMDR clinician seeks to identify the relevant past experiences that are perpetuating the maladaptive patterns of response, resulting in the client’s clinical complaints. According to the AIP model, the pathology is not driven by the person’s reaction (e.g., belief, emotion) to the past event as is postulated in cognitive-behavioral approaches. Rather, the reaction itself is informed by the responses and/or perceptions inherent within a dysfunctionally stored memory or network of memories that are disconnected from networks containing adaptive information.

…Clients are often relieved to understand that their problems have a neurobiological basis, as well as the universality of their human experience as a counterpoint to the common belief that they ‘‘should have’’ been able to resolve their problems on their own. We suggest that the presence of these unmetabolized components of memory explains why clients will often describe their childhood traumas in the same kind of language and intonation they used when the event occurred, and demonstrate the emotions, postures and beliefs consistent with that developmental stage. They do not merely describe the feelings of shame and helplessness of the past, but actually experience these emotions and physical sensations in the present.

These unmetabolized components of memory are accessed in a systematic way during EMDR processing. The targeted memory that is ‘‘frozen’’ in time becomes ‘‘unfrozen,’’ and new associations are made with previously disconnected adaptive information related to survival, positive experiences, and one’s sense of identity…

…processing allows an unpeeling of the veil to reveal and then resolve the core emotional source of the imagery (Shapiro 2001; Wachtel 2002). As this assimilation occurs, new insights and emotions emerge and the earlier affect states and perceptions are generally discarded. With the foundation of the fully processed memory, clients are no longer subject to the same emotional volatility, distorted perceptions and intense somatic responses, and instead experience a new sense of self that is congruent with their current life situation…

The client’s experience is more informed by the present, allowing for greater flexibility in their reactions, thus increasing the likelihood of developing more adaptive patterns of response that are informed by the current context of their lives…

In addition, new memories can be successfully incorporated as the therapist assists clients to acquire the social learning necessary to fill in their developmental deficits. However, until the processing of the earlier memories is complete, the dysfunctional neural storage will hamper the desired personal growth…

While specific stabilization and affect regulation techniques may be effective and highly desirable in many cases (Schore 2003), the instability is often caused by the unprocessed memories that are contributing to the dysfunction.

The overall goal of EMDR, therefore, is to address the current problems of daily living by accessing the dysfunctionally stored memories that are being triggered by the client’s current life conditions, and engage the natural neural processes by which these memories are transmuted into appropriately stored memories (Shapiro 1995, 2001, 2007; Shapiro et al. 2007; Siegel 2002; Stickgold 2002, 2008; van der Kolk 2002). The end result is an assimilation of the new information into extant memory structures. When this has occurred, individuals discover that, while they are able to verbalize the event and what they have learned from it, they no longer experience the associated negative affects and physical sensations. It is this rapid form of learning (i.e., reprocessing) that is the essence of EMDR treatment.

If you link to this reference below it contains a case study of EMDR in practice.

Reference

  1. Shapiro, F., & Laliotis, D. (2011). EMDR and the adaptive information processing model: Integrative treatment and case conceptualization. Clinical Social Work Journal, 39(2), 191-200.

Simplifying the Complex?

complex-post-traumatic-stress-disorder

 

Well I have booked my first two EMDR counselling sessions for next week and the week after. I also spoke with my counsellor who seemed a lovely, capable person.

We needed to differentiate in our conversation about suffering from PTSD and Complex PTSD.

I suffer from C-PTSD although I also fulfill the symptoms of PTSD as do the vast majority of those who suffer C-PTSD.

“The current PTSD diagnosis often does not fully capture the severe psychological harm that occurs with prolonged, repeated trauma. People who experience chronic trauma often report additional symptoms alongside formal PTSD symptoms, such as changes in their self-concept and the way they adapt to stressful events.

Dr. Judith Herman of Harvard University suggests that a new diagnosis, Complex PTSD, is needed to describe the symptoms of long-term trauma (1).

Another name sometimes used to describe the cluster of symptoms referred to as Complex PTSD is Disorders of Extreme Stress Not Otherwise Specified (DESNOS) (2). A work group has also proposed a diagnosis of Developmental Trauma Disorder (DTD) for children and adolescents who experience chronic traumatic events (3).

Because results from the DSM-IV Field Trials indicated that 92% of individuals with Complex PTSD/DESNOS also met diagnostic criteria for PTSD, Complex PTSD was not added as a separate diagnosis classification (4). However, cases that involve prolonged, repeated trauma may indicate a need for special treatment considerations.

What additional symptoms are seen in Complex PTSD?

An individual who experienced a prolonged period (months to years) of chronic victimization and total control by another may also experience the following difficulties:

  • Emotional Regulation. May include persistent sadness, suicidal thoughts, explosive anger, or inhibited anger.
  • Consciousness. Includes forgetting traumatic events, reliving traumatic events, or having episodes in which one feels detached from one’s mental processes or body (dissociation).
  • Self-Perception. May include helplessness, shame, guilt, stigma, and a sense of being completely different from other human beings.
  • Distorted Perceptions of the Perpetrator. Examples include attributing total power to the perpetrator, becoming preoccupied with the relationship to the perpetrator, or preoccupied with revenge.
  • Relations with Others. Examples include isolation, distrust, or a repeated search for a rescuer.
  • One’s System of Meanings. May include a loss of sustaining faith or a sense of hopelessness and despair.

What other difficulties are faced by those who experienced chronic trauma?

Because people who experience chronic trauma often have additional symptoms not included in the PTSD diagnosis, clinicians may misdiagnose PTSD or only diagnose a personality disorder consistent with some symptoms, such as Borderline Disorder.”

I mention these points because I have found that my wife, who has PTSD, reacts in very different ways to me and has different symptoms although I have PTSD as well as part of my C-PTSD.

I have a history, for example, of disassociating when very very distressed or angry which is linked to C-PTSD not PTSD. It is a maladaptive survival strategy and coping mechanism from childhood which is not longer required today. It once allowed me to abruptly distance myself from emotional turmoil. To cut myself off from what was happening around me, as if it wasn’t happening. This is often done in the face of extreme trauma/abuse.

I have other symptoms different from my wife too.

If you have been following this blogsite you will have appreciated some of my constant subject areas such as insecure attachment, co-dependency, emotional dysregulation, negative self schemata, and emotion processing deficits.

It appears that much of this actually comes under the umbrella diagnostic criterion of C-PTSD. This is actually a good thing as I can seek treatment for much of the difficulties of my past at the same time. It may and probably will take longer than your average PTSD therapy but I am hoping it will be worth it.

“Cook and others describe symptoms and behavioural characteristics in seven domains:[13][14]

  • Attachment – “problems with relationship boundaries, lack of trust, social isolation, difficulty perceiving and responding to other’s emotional states, and lack of empathy”
  • Biology – “sensory-motor developmental dysfunction, sensory-integration difficulties, somatization, and increased medical problems”
  • Affect or emotional regulation – “poor affect regulation, difficulty identifying and expressing emotions and internal states, and difficulties communicating needs, wants, and wishes”
  • Dissociation – “amnesia, depersonalization, discrete states of consciousness with discrete memories, affect, and functioning, and impaired memory for state-based events”
  • Behavioural control – “problems with impulse control, aggression, pathological self-soothing, and sleep problems“
  • Cognition – “difficulty regulating attention, problems with a variety of “executive functions” such as planning, judgement, initiation, use of materials, and self-monitoring, difficulty processing new information, difficulty focusing and completing tasks, poor object constancy, problems with “cause-effect” thinking, and language developmental problems such as a gap between receptive and expressive communication abilities.”
  • Self-concept – “fragmented and disconnected autobiographical narrative, disturbed body image, low self-esteem, excessive shame, and negative internal working models of self”.

Adults with C-PTSD have sometimes experienced prolonged interpersonal traumatization as children as well as prolonged trauma as adults. This early injury interrupts the development of a robust sense of self and of others. Because physical and emotional pain or neglect was often inflicted by attachment figures such as caregivers or older siblings, these individuals may develop a sense that they are fundamentally flawed and that others cannot be relied upon.[7][15]

This can become a pervasive way of relating to others in adult life described as insecure attachment. The diagnosis of …PTSD do not include insecure attachment as a symptom. Individuals with Complex PTSD also demonstrate lasting personality disturbances with a significant risk of revictimization.[16]

Six clusters of symptoms have been suggested for diagnosis of C-PTSD.[5][17] These are (1) alterations in regulation of affect and impulses; (2) alterations in attention or consciousness; (3) alterations in self-perception; (4) alterations in relations with others; (5) somatization, and (6) alterations in systems of meaning.[17]

Experiences in these areas may include:[4][18][19]

  • Variations in consciousness, including forgetting traumatic events (i.e., psychogenic amnesia), reliving experiences (either in the form of intrusive PTSD symptoms or in ruminative preoccupation), or having episodes of dissociation.
  • Changes in self-perception, such as a chronic and pervasive sense of helplessness, paralysis of initiative, shame, guilt, self-blame, a sense of defilement or stigma, and a sense of being completely different from other human beings
  • Varied changes in the perception of the perpetrator, such as attributing total power to the perpetrator (caution: victim’s assessment of power realities may be more realistic than clinician’s), becoming preoccupied with the relationship to the perpetrator, including a preoccupation with revenge, idealization or paradoxical gratitude, a sense of a special relationship with the perpetrator or acceptance of the perpetrator’s belief system or rationalizations.
  • Alterations in relations with others, including isolation and withdrawal, persistent distrust, a repeated search for a rescuer, disruption in intimate relationships and repeated failures of self-protection.
  • Loss of, or changes in, one’s system of meanings, which may include a loss of sustaining faith or a sense of hopelessness and despair.”

 

As I research C-PTSD it seems this disorder describes many of my symptoms and behaviours very accurately and there is also reportedly a high co-occurrence with C-PTSD and alcoholism and addiction.

http://insidethealcoholicbrain.com/2015/12/13/do-the-12-steps-help-with-post-traumatic-stress-disorder/

I will be interested in how it “treats” my addictive behaviours too as I believe much of these addictive behaviours were borne out on childhood traumas and abuse.

In other words, the symptoms of C-PTSD and other related areas like attachment, co-dependency, abuse, maltreatment, neglect and other adverse circumstances appear to affect the human brain in similar ways and each contribute to an increase in addiction severity.

I wonder in some ways if I will be treating the “roots of all my troubles” in more ways than one.

I will keep you posted as best I can. It will no doubt be painful at times. I am glad to have made start anyway.

I will post before the first two sessions are done of the following areas

What is EMDR?

Treating C-PTSD with EMDR?

How does EMDR work?

 

Until then?

 

 

 

 

Original Link

http://www.ptsd.va.gov/professional/PTSD-overview/complex-ptsd.asp

References

  1. Herman, J. (1997). Trauma and recovery: The aftermath of violence from domestic abuse to political terror. New York: Basic Books.
  2. Ford, J. D. (1999). Disorders of extreme stress following war-zone military trauma: Associated features of Posttraumatic Stress Disorder or comorbid but distinct syndromes? Journal of Consulting and Clinical Psychology, 67, 3-12.
  3. van der Kolk, B. (2005). Developmental trauma disorder. Psychiatric Annals, 35(5), 401-408.
  4. Roth, S., Newman, E., Pelcovitz, D., van der Kolk, B., & Mandel, F. S. (1997). Complex PTSD in victims exposed to sexual and physical abuse: Results from the DSM-IV field trial for Posttraumatic Stress Disorder.Journal of Traumatic Stress, 10, 539-555.