EMDR

Brain Sculpting

 

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Did not do any EMDR yesterday as I was too exhausted still, a week after the previous session!

My wife was like this too, so very very tired until the day before the next session, the following week, so she was averaging one day in seven when she wasn’t knackered. It is hard work, I have to say, being this tired all the time.

I asked my therapist about this, she wasn’t sure why it is so tiring so we decided I would research it.

There is not much out there in the research about why EMDR is so tiring. Most research said EMDR was so much more rapid in getting positive treatment outcome than other “talk therapies”  so I guess there is a lot of soul surgery and healing which accounts for me being so tired.

I have had to put most of my life on hold which kinda annoys me. Part of my attachment disorder is always doing stuff to make myself feel better about my self. Much of my self esteem is attached be getting approval for being good at stuff, being talented.

I am often too busy being a human doing rather than a human being to quote one of my old counselers!

I buffer my sometimes fragile and sometimes low self esteem through various achievements such as research and running my own business.

Not being able to do this stuff to the same extent has been tough.

The last couple of days have been full of sadness and anger.

I am seeping out sadness from  my past and then being really angry about it.

It seems incredible I am healing stuff that has been eating away at my very soul for forty years!  It seems a colossal waste of time some days. Why so much suffering for so long?

I wish I had come across  EMDR decades ago. Maybe I wasn’t ready for it then?

Anyway I am full of grieving for a multitude of losses.

The loss of my mother who’s passing I have not really grieved in recovery, the loss a self defining part of me (now I gotta grow a new shell?) the losses that trauma, C-PTSD and my alcoholism and addictions have caused in my life, the loss of opportunity, choices such as having had a child with my wife as we kinda decided against this due to my rampant alcoholism,  addictions and at times chronic mental health.

I have to be careful of not slipping into shame and self pity. It is a balancing act, feeling the pain I have blocked out on one hand and not indulging in it on the other.

I have to be careful sadness does not slide into self pity. I have to remember I am not a normal person doing EMDR for PTSD related incidents. I am a chronic alcoholic in recovery who has to guard that the treatment of one disorder does not trigger off the other. Which is kinda why I am doing this treatment in the first place?

Equally I have to feel this stuff, the decades of pain, sadness, anger that I have numbed out, run away from. I have to fully experience and let it be part of me and who I am.

I have to let it be and not react. Instead of avoiding it, only for it to constantly seep through into my consciousness and trigger my emotionally overreactive behaviours.

I have still to get to the root of many of my behaviours, to the source of where they began.

I have hit a milestone moment for sure in therapy recently but there are other layers of this psyche onion to unpeel.

Many years of emotional pain seems to be seeping out, like a puss and I have to accept this, not run or avoid, as this has been my way of coping from the past, a maladpative coping mechanism.

I have also been grappling with my pride and shame.

I do not think I have been explaining fully enough the process of EMDR which is remiss of me and has made me feel a bit stupid.

Although I am fairly intelligent, I live in fear that my “stupidity” will be outed one day and every one will know the real me, the “not as bright as I would like to think I am” me. As my cleverness or otherwise is linked to my sense of self esteem, I feel pained when I do not research something properly. It feels like a self inflicted wound.

My sense of self is threatened even.

I have not described the process of reprocessing properly I believe.

When I had my major therapeutic breakthrough last week I did not clearly state that the reprocessing bit was when I acted as an adult to my childlike self, to my childlike sibling and then to my parents. I was in charge, in control with making things right, in consoling and comforting way to make sure everyone was okay, loved and comforted. This is what I mean by cognitively reprocessing the past.

I revisited a traumatic memory, the scene of a traumatic memory, I was desensitized to this memory to a large extent because I was acting doing the bi lateral stimulation, the watching of the therapist’s finger moving from left and right, left to right. This desensitization is supposed to happen as the amygdala, implicated in distress states,  is somehow calmed by this process so the brain and mind are not as distressed as normal, so the revisiting of a traumatic scene is not as usually distressing.

This allowed us to adaptively  reprocess this scene and traumatic experience on three levels. First we feel it on a physiological level, we become aware of our body sensations and where they are on the body and just observe them. Secondly we are aware of the emotions that accompany these sensations and the trauma experience.

We discussed these to understand the unprocessed feelings. Then we cognitively challenged these feelings. For example feeling guilty for doing something any child would have done or feeling guilty for something that was not one’s fault is achieved and the emotions are somehow quelled. Then cognitively we can think about what we would say or do in relation to this scenario, to the child or the others in the scene from the perspective of now as an adult.

I consoled my child, spoke to my mother and asked her to speak reassuringly and in a comforting way to my child, then I extended this invitation towards my sisters, then my father joined us and we were all consoled my older adult me, in a way no one was at the time of the trauma. This was in essence a cognitive reprocessing of the event.

The reprocessing means that this memory will now have a different  cognitive, emotional and physiological resonance for me from now on. It was lodged in more long term memory.

The memory is still there in a sense but it does not have the cognitive, emotional or physiological  charge as previously. Hence it does not have the same influence, impact or prompt to certain behaviours that it once had.

For me thus far, this desensitizing and reprocessing has altered a maladaptively processed memory in terms of physiology, emotion and cognition and made it adaptive i.e. it is processed in a way that can help me not cause further pain. The behaviours that now follow it are more likely to be adaptive and healthy.

Some researchers have suggested that the sate of consciousness that one goes into during bi lateral stimulation is akin to REM sleeping. Thus, as with REM sleeping, the brain is active in resolving conflict in the mind.

I will probably have to consolidate this experience again at a later date but have grown some sort of membrane over this painful gaping wound of a memory, this hole in the soul.

I feel differently about this now as a result. It affects me in a differently way to before.

Something changed, possibly for ever.

In terms of the Adaptive Information Processing Model, on which EMDR is based, in order for a memory or experience to be processed properly, according to this model, it has to be processed on these three levels of physiology, emotion and cognition.  I have taken a memory that was not processed in terms of body sensation which probably reflected a heightened stress chemical response, not processed it in terms of emotionally coming to terms with it and not processed properly in terms of my thinking about it, for example, I had not fully considered it’s repercussions from a cognitively perspective.

This third perspective was not missing from what I mentioned in earlier blogs, I simply discussed the two levels of physiology and emotion

That is my understanding of it in the present now anyhow. That may change.

I have come across a number of excellent papers on how EMDR works which I will either upload here on this blogsite or more likely on http://insidethealcoholicbrain.com/ as this therapeutic process is fairly amazing in that it seems to rapidly reorganise certain networks in the brain.

http://insidethealcoholicbrain.com/2016/03/11/adapting-the-maladaptive-how-emdr-reprocesses-the-past/

In fact it is like taking a new adaptive memory and inserting or stitching it in to where the maladaptive memory was or in more technical terms like delving into the coding script of memories and rewriting some of the code underlying these memories. Like removing by a massive defragging.

It is profound stuff either way.

Any way why so tired from EMDR? I think the answer lies in the fact that EMDR leads to this rapid neuroplastic reorganisation of the brain.

In simple words, these means that neural networks in the brain are quickly created, redirected to become more adaptive. For example one area implicated in PTSD is the hippocampus which plays a major role in memory (especially explicit, episodic memory) but also has a less known role in stress regulation.

It appears that even after only about 8 EMDR sessions that the hippocampal region of the brain can increase in volume by about 12%!

This is fairly rapid and immediate reorganising of neural networks to increase a role the hippocampus in explicit memory (perhaps as opposed to the implicit memory network of the dorsal striatum which is implicated in more automatic, reactive responding, or stimulus response activity, with distress often being the stimulus of emotionally overactive responding) and stress regulation.

If my brain is re-organising so rapidly in  a matter of weeks then the brain will be using up much energy, brain glucose,  in re-sculpting my my brain’s neural circuitry.

Which is kinda mind blowing.

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!

 

There is A Solution! To Complex Trauma

There is A Solution – To Complex Trauma

I suffered from my own active alcoholism for over twenty years and found a solution to my alcoholism via the rooms of Alcoholics Anonymous and their 12 step program of recovery. A program of recovery  I still, for a large extent,  follow today. I generally trust God, clean house and help others, the three basics.

This program has not only saved my life but helped me acquire a new sense of self and a way of life and manner of living that I never knew existed.

I have added to my program of recovery by coming to understanding my disorder of addiction as one of emotional dysfunction.

I have difficulty identifying, labeling and verbalising emotions and this can lead to impulsive behaviour, poor decision making and  at times distress via undifferentiated emotions. In other words, I am not always sure what or how I am feeling.

I often need to discuss my emotions with others so that I can cognitively process them and identify them as feelings.

It is in identifying what I am feeling that then leads to rational goal directed behaviours rather than distress based impulsive decisions and behaviour. Processing my emotions, so that I actually know what I am feeling, helps with subsequent emotion regulation so that I do not emotionally react as much I used to, I do not need to react as much via ego defense mechanism, I do not need to have a life shot through with fear and resentment.

I can now say this situation or person made me feel like this, e.g. they upset me and I can then act accordingly and adaptively rather having rampaging revengeful thoughts fueled by  resentments and reactive behaviour.

These are some of the reasons why I have ten years in recovery, I have learnt ways, coping skills for dealing with me and my emotions, usually my negative emotions.

Via this new attitude and behaviour my brain I  believe has changed for the better, via neuroplasticity prompted by the adaptive behaviours of more mature emotional regulation, as opposed to immature emotional responding, the regions of my brain that control emotional response have altered and recovered.

My brain is now wired in such a way as to encourage more effective emotion regulation. Even when i do take something personally it does not last a mere fraction of the time it used and the intensity of the negative emotional reactions is so small compared to early recovery and the succeeding years. I can now live life on life’s terms a lot better (although far from perfectly).

However, regardless of all this improvement in my brain and behaviours, in my stress and emotion regulation, there have been several times when my recovery has been threatened.

Six years into recovery I thought I was going to relapse. I did not want to drink but I was so distressed emotionally that it seemed inevitable at one point. The more distressed I got the more my brain was screaming at me to drink. I was understandably shocked and dismayed, frightened and upset by coming so close to relapse.

To learn that I have a brain that will lead me to drinking alcohol when I have not desired to drink again ever! I showed me what could possibly meant in my case by the Big Book when it states “the alcoholic at certain times has no effective mental defense against the first drink” !

The distress that led to me having scant mental defense against the first drink was not prompted solely by my alcoholism. It was my alcoholism, which is it seems a parasite that feeds on motivation and emotion, was feeding like a parasite on the distress caused by unresolved complex trauma from childhood. In fact the distress in this instance was at Christmas and I could not stop thinking and feeling very emotional about my parents, who are now both sadly deceased.

It was more than grief, however, it was traumatic distress I now understand.

Why was I so distressed. It was this distress that was so active and apparent in my alcoholic drinking, the unbearableness of this distress prompted many a drinking spree.

It took six years of recovery to realise that I was still very effected by something profound to do with my parents. I then in later months became aware of the fact I often dissociate in a variety of ways. So badly that I can almost return to real childhood experience, or rather the somatic re-experiencing of being a traumatized child.

On one occasion I was so worried that I had inadvertently hurt the feelings of some one in AA that  I was convinced it would lead to their relapse and  I kept saying to my wife that I thought this guy will relapse and die because of me and what I thought I had done, which was a minor incident blown up to extreme madness by my catastrophic and paranoid  thought processes. It became evident that this minor episode was a trauma trigger to another incident in childhood, still unresolved in my psyche after decades.

My reactions were not actually about this guy in recovery who was fine and oblivious to my mad thoughts or even what my crazy mind had convinced me I had done to hurt him. This smallest of triggers propelled me experientially back through time to early childhood experiences

Interestingly, what I thought at the time and what I now know to be true is that a misconstruction of what is going at one point in time can be internalised as the truth and live on in our bodliy and mental responses to similar episodes decades later. The past quite literally lives in our bones.

My miscontruction by which I mean I perceive or build up a picture of what is happening now based on what I have pictured in my mind as happening in similar episodes in the past.

Over the next few months and through year 7 of my recovery I was steeling myself to start therapy again. Then my wife had a car accident and ended up suffering PTSD herself. I then shelved my own treatment plans as my wifes’ condition needed more urgent attention. For the next year and a half I helped my wife recuperate and get steadily more mentally well.

She used this therapeutic process that I had read about called EMDR and which after much research I recommended to her although I wasn’t really sure it would work. It was more hope than faith.

Miraculously it did seem to work, in fact it seemed way to good to be true. The effects were so profound.

My wife would say that she felt like some vital part of her brain had been “plugged in again”

She had felt the trauma had pulled some plug out in her brain and it had led to a whole assortment of psychological difficulties such as hyper-vigilance and perceptual distortions, e.g. seeing Bees as flying zeppelins, or constantly seeing errors every where. She felt she had lost her mind, as life seemed to overwhelm her, there was too much information somehow which she struggled to mentally filter.

The part of the brain that supposedly deals with these things is called  the cingulate cortex, mainly the anterior cingulate cortex, wedged  between the neo-cortex and the limbic regions of the brain. it deals with among other things, attention, stress and emotion regulation, emotion processing, with monitoring error in the environment.

It seemed to have been overloaded and compromised by her trauma and the reactions of her brain afterwards to that trauma. amazingly for her and for me the EMDR therapy seemed to put it all back in place, got her broken brain working again.

I thought this amazing but remained cautious and at times skeptical about ti it. To be honest, part of me did not want it to be true, as it meant I would have to give it a go myself at some stage.

I researched and researched trying to find some holes in this miraculous therapy. All the studies universally said it worked well, that the patient outcomes were positive and long lasting.

Damn I thought.

How could reprocessing memories from the past lead to such a profound alteration in one’s consciousness. The cingulate  cortex is also said to be the seat of consciousness in the brain.

How could this be? All that was really happening, to me at least, in her therapy sessions was a therapist moving her finger from one side to the other  while her eyes tracked these fingers, and while simultaneously thinking about a trauma experience from childhood.

The therapist also supported this process  by prompting her to  talk about what she was feeling in relation to whatever came up in her mind in relation to this bilateral stimulation.

There is so much to this therapeutic process than this I can assure you  but I don’t want to go into details now – if you want the technical stuff please go to http://insidethealcoholicbrain.com/2016/01/14/how-the-brain-reacts-to-emdr/

to see what happens to the brain etc during EMDR.

Here I want to describe how it makes you feel and maybe even suggest how it works.

The reason I am disclosing all of this, the inner workings of my traumatized and healing brain is simple – this EMDR does seems to be miraculous in it’s healing potential

Admittedly I have only had one bilateral stimulation session but i think I had good results already.

I have been a thirsty man for psychic healing for nearly 45 years so you will have to excuse me being so overwhelmingly grateful and overjoyed to have finally found a solution to the problems I had years before alcoholism and addiction and which not only fed into these disorders but which could actually prompt relapse in these conditions.

I left the session thinking what came up in our therapeutic exchange prior to the bilateral stimulation touched on things I had heard a thousand times before from the mouths of hundreds of people in AA meetings.

Are the majority of us in AA actually traumatised? If not by childhood or other traumas but by the trauma of addiction itself, having addiction or having had to live with addiction?

Is trauma the main reason people relapse?

All these questions have become increasingly pressing and urgent.

What is the bilateral stimulation like? Well originally you think what the hell is a bit of finger and eye moving going to achieve but I have to say that, under my therapist’s expert guidance I seemed to go back and find roots of some of my traumas, the roots of the self loathing and low self esteem and concept, the reason for  not thinking I am lovable, some of the reasons why my family grew into the thorny bush of recrimination in the way it did, out of the rough ground of our shared family trauma.

All from sometimes singular events.

In revisiting and re-experiencing one particular trauma that involved my sisters and i it suddenly occurred to me in my heart why everyone in my family grew up to be how they are, how they were amazingly based to a large extent on how they reacted to the actual trauma incident. We all reacted to trauma in different ways and this could have led us to have views about ourselves in the present that are steeped in reactions from the past. It showed how brain mechanisms conjure neural ghosts that haunt us decades later.

Echos of the past are materialised in  jaundiced perceptions of ourselves in the succeeding minutes, hours, days and decades, throughout the rest of our lives.

It is a startling insight.

How reacting to an event leads to a distress so powerful that flows around in the brain memory networks to fester in our psyches ever since. It is like a splinter that one knows is there but can’t quite get at.

The splinter,  the more you try to get at it, the worse it festers and day on day it gets worse and worse, more poisonous. It pollutes how we feel about ourselves, for years and years.

All because of not emotionally processing what was going on at the time, in a time long long ago. How profound is that?

When you are tracking the fingers as they move, and thinking about a trauma it feels like your brain elevates as the brain is super stimulated by all the activity –  one can almost feel like one is free falling to quote Tom Petty , free associating and free falling through the past to childhood. Or it is coming up the other way?

Either way,  one is suspended in lived experience, the amgydala has been hypoactivated so it is not as stressful as it could be – the brain is not cognitively imprisoned in the moment but letting the brain free to be how it is. It felt like the Matrix losing it’s coding script.

I returned to events prior to a major trauma and left my amazingly fractured memory of the trauma to come to the surface of my mind. As I did so I discussed the emotions I was feeling, being mindful of the sensations, seeing the past in a new light.

Taking out or allowing the emotional poison to be poulticed. In scientific terms I was properly processing the emotion, exorcising the emotional ghost.

It is the negative emotion, the traumatic distress which screams it’s echo through our lives. In taking the sting out of the emotion and the emotion out of the memory, we can not only silence the scream but put it to bed.

As I left the therapy session I remembered what my wife had said about some part of her being plugged back in again. I felt that some part of me that had been replugged that hadn’t been plugged in properly plugged in  for 45 years.

Is this not the root of my troubles when it comes to relapse risk – this trauma.

Should we not treat co-morbidity as soon as possible in addicts with co-morbid conditions? Do the high relapse rates reflect also  untreated co-morbid conditions and the effect this lack of treatment has on relapse.

Alcoholics and addicts often relapse due to distress or overwhelming negative or crippling negative self concept, most of which are exacerbated by co-morbidity.

Doesn’t this co-morbidity simply makes one’s addictve behaviour more chronic more severe?

I left the therapy on cloud nine, all strangely at one and attached to the world and it’s people. It was a very similar feeling to the feeling I had after doing my step 5 when I had confronted some of the damage of my past by admitting my wrongdoing to another person. It had that same cleansing feeling. That feeling that something was being or had been put right.

It turns out that marvelous feeling was on the surface of one layer of this onion called me. No doubt there will be more peeling of the onion to come, more tears and more wonderful days like today.

I have a way to go for sure. But I have that wonderful precious gift of faith that this will work, that I will one day get past my past.

I walked for miles afterwards stopping to have full blown conversations with people I know and haven’t seen in years. The sun shun on our conversations.

It felt like my emotional thawing is well under way.

I noticed the majestic clouds you get when you live by the hills which roll to  a seaside. I was fascinated by clouds in early recovery. And there they were again – floating past like great fluffy elephants,  great to be looking up, not always looking down, your downward gaze heavy with the past.

So far so good. I am energised today, I  thought I would be exhausted – I may be tomorrow but that will be another day.

Wrapped up warm tonight in bed with the knowledge there is a solution! Like in the early days of recovery when the Big Book, near by sleeping head, reminded of that fact too.

A Safe Place To Visit

Just finished my third EMDR terapy session and thought I would write now otherwise I probably will not get around to it. I find I am so exhausted the next day that it is difficult to blog.

I am finding that I have a lot of therapeutic benefit already from the treatment.

Today we got into the EMDR  protocol which mainly looked at mechanisms we will adopt if I dissociate while doing the actual eye movement desensitization and reprocessing (EMDR) which we will tentatively start next week.

Essentially we spent 15-20 minutes learning the relaxing techniques and “safe place” techniques I will use if I dissociate as the result of the EMDR.

It is mainly to do with “safety of the client” protocols. I felt a great relaxing benefit from doing it today. I will practice the techniques once a day while I am doing this course of treatment.

We will also use smell as a way of coming out of dissociation if need be.

We may not need these techniques but they have to be put in place just in case.

My recent dissociation has been to do with feeling detached from “me” – my body and immediate environment. We discussed how we could deal with this possibility.

I have also dissociated to childhood on occasion and this was discussed too. This type of dissociation seems to take one back to the heart of the trauma. It is like a re-experiencing without having the memory associated  with it.  It is like being behind a wall on the other side of our life, aware of certain things but not able to see it clearly

I am not fearful of dissociating – I have a grasp now of what it is and how much I have been doing it over the course of my life.

I even research the brain regions involved in dissociation and it seems the parts that deal with self reference deactivate and there is a “coming away” from representations of self and associated memory.

I have the type of head that likes to know these things – you may have noticed!?

It is a disquieting, unsettling and stressful experience but is manageable I believe with these techniques.

I  have noticed how after only a few weeks my mind and behaviour has been tied to looking at photos of the past, my old friends and my family.

My nephew also contacted me out of the blue to say he wanted to visit  and I have resumed closer contact with one of my  sisters.

I have made it clear that I am doing therapy for trauma, whether my sisters need it too I am not sure. I am the youngest in the family and a boy so my circumstances might have meant I was more traumatised by events in my early childhood than others.

Interestingly I have found a school photo  of my sister and I which is a photo of us looking a bit shell shocked, in comparison to our smiling faces of the previous year’s school photo when we were beaming more confident, mischievous smiles at the camera. I am presuming this second photo was around the time of the major trauma(s) .

I also found a photo of me in my late 20s after a cocaine psychosis and I look haunted in the same way as the school photo.

I had presumed this was due to the psychosis which is not a very pleasant experience I can assure you. I now know where the phrase “climbing the walls” comes from after that experience I can assure  you!

Now, although the psychosis obviously affect me deeply I can also see trauma in this photo and many other photos of me. My wife told me I was very paranoid at the time too which is linked to psychosis but much of the paranoia linked clearly to what I had experienced in childhood.

It was not only alcoholism and addiction that ate into my soul like a parasite feeding on my troubled emotions,  in these photos of my emaciated drug using self but also complex post trauma.

Unresolved trauma too is like a parasite feed on one’s nerves too.

Then yesterday a person who married my cousin sent me a photo of me in a underage football team that  my dad and his friend organised. My dad is in the photo too of our team.   I suddenly realised how heart breaking it must have been for my dad, what happened to our family, my mothers breakdown and eventual Valium dependence. And the decades of consequence after.

My heart  went out o him. God bless him, he was a loving father, I miss greatly.

The plan now is to finish treatment – finish a novel I was writing for many years while drinking (which is 2/3s finished) and get my driving licence. I once passed the theory part but banged my head , got concussion and could not take the practical test.

So I will try again and then take time out, a month or so to travel back to Ireland and revisit my past and see some people I haven’t seen in many many  years.

Northern Ireland has been at peace for two decades but I have yet to call a complete ceasefire with myself and my past. Hopefully I will later this yer.

Recovery has given me so much and while others hit their mid life crisis I have barely begun living. I am a published scientific writer and want to follow that by the end of this year with a published novel too.

I have a very fragmented self, blow to bits by my traumatised mother and family and my traumatised, brutalised and war torn upbringing in Northern Ireland.

I can feel these disparate parts of self slowly and naturally drifting back into shape.

It will be a new me, the composite parts that make up me no doubt but it will have the same character I am sure.

I got lost thanks to trauma and chronic alcoholism and addiction. Ten years into recovery I am still beginning the amazingly exciting journey of uncovering, recovering, the person I am and the person I am supposed to become.

When the parts reunite I will be the fullness of me.

 

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.

 

Knowing It Is Different To Showing It

 

 

I am not a very good sponsor!

There you have it!

I have come clean – I have nearly ten years recovery but still struggle to be a good sponsor.

So many  things get in the way of me being a good sponsor.

I am also an Al Anon, someone who grew up in a family consisting of an alcoholic father  (who didn’t drink but did not have a 12 step program of recovery) and a mother dependent on Valium after suffering nervous breakdowns, hence I was a Alateen too at one time.

As my dad was effectively a dry drunk at times and my mother struggled to cope there were many traumatic domestic scenes to contend with as a small child.

My mother’s behaviour was emotionally, physically and mentally abusive at times and I grew with an insecure-anxious attachments towards her and a recurrent fear of abandonment/rejection.

There was a lack of appropriate supervision by my parents and my sisters and I often ran wild. Boundaries that define me and others were completely blurred.

I know enough about alcoholism to help a recovering alcoholic and I have enough love in my heart to help another alcoholic in recovery but something always gets in the way.

Me, I get in the way!

I have a need to fix people!

I grew up as a caretaker in my own family as my parents were often lacking in their parental direction. I thought their lives and how they acted were my responsibility that I could manage their lives too and then things would be okay. They wouldn’t have violent arguments and my mother would not try to force a dozen of two pills down her throat and terrorize her children.

I somehow thought her mock or real suicide attempts were to do with me, how I behaved, they were my fault, so I acted to make sure these things did not happen again.

I grew up too soon, never had the childhood others had.

Things around we were too volatile so I sought to control by any means available. I am a world expert in controlling others.

I have a severe case of Al Anon and Adult Child of an Alcoholic (and addict) that I am now only starting to address in my life and in my recovery.

I know exactly how you can recover from alcoholism but have difficulties letting people learn their own mistakes. I am too needy. Too eager for them to recover.

I rush sponsees, scare them off, demand too much from them.

I need to deal with my Al Anon issues before sponsoring anyone else.

The most alarming thing is that this childhood trauma sets you up to re-enact rejection situations throughout your life.

Your “inner child” has learnt that people reject you so you act in a manner, or pick people, to unconsciously ensure this will occur again, this re-enactment of childhood rejection.  You kinda control the rejection that will later occur!?

The acting out of trauma occurs repeatedly throughout ones’s life until the trauma is dealt with via some therapeutic means.

I was due to start EMDR therapy for my trauma but have had to postpone this until my wife is better, she suffers PTSD and anxiety disorder herself and is off work at the moment due to these mental health issues. I am supporting her at the moment. Times are tough at present for sure!

For now I have to stew in the painful emotional residues of my many traumas and hope to see a therapist in the near future.

I constantly have to talk through emotions I have no name for, they are so deep in my implicit memory. I no longer run away from these, at times, very unpleasant physical and emotional sensations but sit with them, and talk them out. This is a change in my approach, feelings do not kill, what we do with them sometimes does.

Sensations in our body from the past also propel our behaviours often without us consciously knowing so.

More on this in a later blog.

I cannot sponsor anyone for the foreseeable future. I even set myself up for failure with the very people I most want to help. This is trauma not alcoholism.

I will fill you in with other stressful events that are occurring in my life in the next blog.

So let’s end where we came in  – the simple fact that knowing it is different to showing it.

I have to get to recover the real me more before I help  anyone else. As I need help myself, I can’t fully help others at present.

Recovery is at times a process of finding out or discovering the other disorders and problems that we have other than alcoholism and addictive behaviours, it is also in finding out and discovering what issues and disorders fulled alcoholism in the first place. The trauma, the absue, the bereavements, etc

There are many layers of this metaphorical onion to peel and they all make you want to cry!

That is the way it is, acceptance of this is the key as always.

An old guy of over thirty years recovery told me that he sponsors by showing recovery not by preaching it.

I haven”t got there yet I am afraid. I know it but…

I also want them to succeed so much I scare them off, I become too intense!

I demand too much too soon, that is my default setting. Set myself up for failure as a sponsor.

I want them to “get it!” soon as possible to reduce the risk of relapse.

This is however flawed because it is fear based thinking.

I want them to get it before they relapse again, that is the truth. At some unconscious level I want them to “be saved” so that they do not try to kill themselves again with substances like my mother used to attempt to do. That terror drives my behaviour without me knowing it.

It is not borne out of Grace but fear.

The simple truth is that I do not trust God enough at times and try to fix hings myself. I have not fully forgiven God the many many things that I somehow believe happened on his watch, I guess?

In the end, I can only share my experiencence of recovery and let the rest be, let God take it from there. I know this in my head but my heart revolts.

My Al ateen/al Anon side takes over.

I want to make sure they get better, ASAP!

My motives seem good but they are warped. There is a bad motive in a sense under a good one.

I have to learn to increase my trust in the process.

Let others make their own mistakes and have patience when they do. Having love and tolerance of others is to let them be themselves, free to make there own conclusions, come to their own understandings.

I am  but the messenger, passing on  a message that has been passed on to me.

That is my role in this, not to fix but to allow someone else the space to make the same mistakes I did.

I can’t speed along someone’s recovery, they have to go at their own pace, otherwise it is frightening.

The good can be the enemy of the best.

I have this deep seated fear that whatever I do it is not enough so I make up for this by doing too much, too much….ending up manic and off-putting.

Ten years in and still a long way to go.

More, unfortunately, will be revealed…

God goes deep!