Saturday, December 20, 2014

Christmas of 1983

Christmas 2014:  The following essay is off topic for this blog; it has nothing to do with Complex PTSD, really.  However, I enjoyed writing it and want to share it with you "just for fun."  We all need some fun in our lives!  Enjoy!  Wishing you all the best for the season and healing in the New Year. 
  
 
 
 
 (St. Nicholaus checking to see who is naughty and nice.) 
 

Some Christmases are more memorable than others. I remember some Christmases because they were outstandingly good, and I remember others because they were outstandingly bad.  Wait a minute—a bad Christmas?  How can such a joyful day be bad?  Let me tell you—a bad Christmas is not hard to come by.  Christmas of 1983 is a case in point.  That was one bad Christmas!  Or was it?

By Christmas of 1983, I had officially been divorced for three months, and I was busy adapting to my new legal status, that of a divorced, suddenly-single mother.  I was raising a daughter and was struggling to get my feet on the ground after having spent twenty years in a difficult marriage.  At the beginning of the divorce process, my husband and I had owned two homes, one with a mortgage and one that we owned outright and were using as a rental.  I was allowed to choose which of our homes I wanted, so I chose the home in town with the mortgage. 

Thus, I became sole owner of the home on L Street in Centralia, Washington.  Once the divorce papers were finalized, I sold the rolling pasture land that fronted on the Skookumchuck River to my neighbor and paid off the mortgage.  Because I had lost my job in 1981 and was supporting my daughter and me on unemployment checks, child support,  and the generosity of the Salvation Army food bank where I worked as a volunteer, I needed to reduce my monthly outgo. My neighbor wanted the pasture for her horses, and I needed relief from the mortgage payments.  The sale, then, was a good deal for both my neighbor and me.

After selling my pasture, I investigated the possibility of taking out a home improvement loan through the Farmers’ Home Administration because my house, built early in the 1900s, needed a lot of work.   I applied for the loan and was accepted into the program.  Since it was a government loan for low-income home owners in rural areas, I could afford the monthly payments.  My home had been built at a time when many homes in the area were built using post and pier construction and were not built upon concrete foundations.  Thus, the first task of the contractor was to put a concrete foundation under my house.  In the early part of December, then, my neighbor, a licensed contractor named Fred, started on the foundation.

This process was slow because Fred had to jack the house up in order to do his work beneath it, and the house had to be high enough to accommodate the foundation work he did around the perimeter.  When he jacked the house up, he exposed its underbelly to the elements, so he had to close up the crawl space at the end of each workday by placing sheets of plywood along the lower margins of the outside walls.  The plywood kept out the cold and the wind and also most of the nocturnal creatures that came up from the nearby gully each evening.  There was, however, one evening when Fred forgot to protect the underside of my house, the evening of December 23rd. 

On December 23rd, we had a terrific cold snap, unusual for the Chehalis River valley.  That night the temperature dipped to about ten above zero, and as I slept, the cold air entered the unprotected crawl space.  I awoke to a big surprise—water had frozen in all the rusty old pipes beneath the house, no water came from any taps, and we could not flush the toilet.  My son was home from college at the time, so he and his sister drove to my ex in-laws’ home south of Chehalis to spend the holiday.  I knew they would be welcome there even if I was not.

I was left by myself, then, to feed our pets, tend the frozen pipes, and spend Christmas Eve and Christmas Day in a house with no running water and no drainage—not the usual Merry Christmas situation.  In the process of overcoming life’s adversities, however,  I had learned to favor the glass- half-full approach to life,  and I determined to have as merry a Christmas as possible under the circumstances.  After all, I had two wonderful children, a roof over my head, sufficient groceries, and it was Christmas!  I considered myself fortunate.

 

Thanks to the folks at the Salvation Army, I had a small Christmas tree and one of the Salvation Army’s Christmas food baskets.  My tree was about four feet tall and scrawny, but it had lights on it and lots of home-made decorations.  Under the lowest limbs were three presents, one from my ex mother-in-law, one from my son, and one from the Salvation Army.  So not only did I have a tree, but I had some presents and the makings of a nice Christmas dinner, complete with a roasting hen, fresh vegetables, a few oranges and apples, some instant stuffing mix, various canned goods, and some candy.   As I surveyed my tree with its presents and thought about the special dinner I would cook on Christmas Day, I felt happy with what I had.  Some folks in Lewis County had a lot less than I did.

The afternoon of December 24th arrived with no letup in the cold.  I planned to sing in the choir at St. John’s Episcopal Church for the Christmas Eve service, and I needed to be at the church by about 8:30 that night.  I fixed myself some dinner, put on my dress, pantyhose, and shoes, and donned my long raincoat.  By around eight in the evening I was on my way, hoping to make it to the church in time for the pre-service choir warmup before the late-night service.  The church was about twelve blocks from my home, but the night was clear, so the prospect of the walk didn’t bother me.

I was about halfway to the church, walking past the Rock Street Apartments, when it happened—I felt something around my waist shift dramatically, and my pantyhose suddenly slithered down my hips, past my thighs, and to my knees, hobbling me as surely as if I were Farmer Jones’ favorite mare.  I managed to remain upright despite suddenly being rendered immobile, and I was able to put my hands into my raincoat pockets, hunch down, and pull my pantyhose up high enough so I could walk. 

I repeated this procedure the rest of the way, and when I reached the church, I slipped into the restroom unnoticed, reefed mightily on the errant hose, and prayed they would stay put.  Yet to come were the choir procession, the service, and the recessional, but I was not too worried, for the ugly old ankle-length black robes we wore would, I knew, hide whatever might happen.  One way or another, I would get through the service.

All went well during the service, and when it was over, I took off the hose and started for home.  I did, however, make one change in my route.  I decided to reward myself for a job well done by stopping at the convenience store on Tower Avenue and treating myself to some chicken and jo-jos, food I had heard about but had never tried.  I wasn’t sure the store would be open late on Christmas Eve, but I decided to at least check to see.  It was open!  Never before had the aroma of deep-fried chicken and fried potatoes been so welcome!  A heavy-lidded young man with red hair wrapped my chicken and Jo-jos, I paid for them, and I left, wishing him a Merry Christmas but knowing that he was probably finding Christmas Eve at the Stop-N-Go a lot more boring than merry.  I reached home before eleven-thirty, and after changing into my nightclothes, I turned on the television to Seattle station KING so I could watch the Christmas Eve service broadcast from St. Mark’s Cathedral and enjoy my greasy treat.

And then the improbable happened:  Exactly on the stroke of midnight, just as the choir at St. Mark’s began processing toward the altar for Holy Communion, I heard a loud “whoosh” come from somewhere under the house.  I ventured cautiously outside to investigate and discovered that we had had a sudden Chinook which had warmed the air, even the air under the house, and had caused a mighty thaw that had cracked the ancient pipes and released a flood of water.  I ran back into the house and grabbed my huge pipewrench and  prybar, and then I ran back outside, pried  the concrete cover from the water main by the street, and turned the bolt that shut off the water.  Since there was nothing more I could do about the plumbing situation, I trudged back into the house, watched the rest of the service from St. Marks, finished my chicken and jo-jos, and went to bed.

 

On Christmas morning I awoke to a cold, dark, rainy day.  Determined to have my coffee on that special morning, I put on my boots, grabbed a relatively clean plastic bucket from the utility porch, and traipsed through the soggy grass to the faucet at Fred’s horse barn.  I filled the bucket and returned home to make coffee .  As I drank my coffee and ate the sweet rolls I found in my Salvation Army box, I forgot the mess under my house and the fact that I couldn’t flush the toilet or get a shower and simply enjoyed the peace and quiet of Christmas. 

Later, I roasted the Salvation Army chicken and enjoyed Christmas dinner in front of the television as I watched the old version of “Miracle on 34th Street,” the one starring young Natalie Wood, my favorite.  I indulged myself and slept on the couch that night so I could watch movies until I fell asleep, something I normally did not do.  Sometime that night, one of the cats, back from a hunting trip, left me a still-squeaking mouse on the kitchen floor.  I awoke long enough to gently deposit the mouse on the grass outside the carport, and then I went back to sleep. 

The plumbing situation got a temporary fix the day after Christmas, my kids came home, and life resumed its familiar pace and rhythm once more.  A few days later, when I looked back on  my Christmas, I realized that it had not been so awful.  After all, I had been able to sing in the choir and eat jo-jos on Christmas Eve.  I had also enjoyed my well-lit Christmas tree, had watched the sentimental old holiday movies I loved, and had eaten a great Christmas dinner.  The plumbing disaster and being hobbled by my pantyhose seemed like minor irritants, mere flickers of bad luck in the total scheme of things.  No, that Christmas of 1983 hadn’t been so bad after all!

                                   

Monday, December 8, 2014

C-PTSD Doesn't Exist??? Cowboy Makes a Vow . . .





Cowboy, that ego state within me who flies into action when action is called for, has made a vow:  She is determined to spread the word that C-PTSD is real, that it does certainly exist, and that it can be, given the right circumstances, healed!  So--why would Cowboy feel the need to spread the word regarding C-PTSD? Of course, C-PTSD is real!  Those of us who have been diagnosed with the condition and those wonderful therapists who help people heal from C-PTSD all know that the condition/disorder exists!  Why the need to convince anyone?  Don't all mental health professionals accept the fact that C-PTSD exists??  The short answer to this last question is a resounding "No!"  And how do I know this? 

As my readers are aware, I relocated a year ago from Portland, Oregon, to a small town in Oregon's northern neighbor, the state of Washington.  Actually, I now live in Lewis County, Washington, in the town of Chehalis, to be exact.  If you look on a map, you will see that the area where I live is directly north of Portland, on I-5.  The trip to Portland by train takes about two hours, and the trip by car is about the same.  As you see, Lewis County is physically not very far from Portland, but the miles between the two places represent a huge disconnect when it comes to the attitude of professionals toward C-PTSD. 

When I lived in Portland, I had no problem finding a therapist who treated clients suffering from psychological trauma damage, and I had little trouble finding a therapist who gave me an accurate diagnosis of C-PTSD.  The "Psychology Today" list of Portland professionals treating PTSD and trauma-related conditions is almost thirty pages long.  In contrast, when I did a search today in the same data base but typed in "Lewis County, Washington" rather than Portland, Oregon, a list of nine therapists came up.  Of those nine therapists, four actually had their offices in Lewis County.  The others had offices in neighboring counties.  

Of the four therapists who were actually local therapists and who were listed as treating PTSD and trauma, all listed short-term behavioral therapy, DBT, and CBT among their modalities of preference.  None listed EMDR or Ego State Therapy.  And EMDR is a treatment accepted by the Veterans' Administration as being effective in treating PTSD!  Where several of the therapists in nearby Thurston county said they treated C-PTSD, none of the four therapists in Lewis County listed C-PTSD as a condition they treated.  Why??  The answer is very simple:  C-PTSD is not a disorder found in the DSM-V!  PTSD is in the book, but C-PTSD is not.  And if it's not listed in the DSM, the disorder doesn't exist--for all practical purposes.  Or, well, C-PTSD exists in Portland, but it doesn't exist in Lewis County, Washington.  Odd, isn't it, that the disorder can exist in one location but not in another?? 

I know Lewis County's population is small (75,081 souls) compared to that of Portland (2,314,854 metro area), Oregon, but aren't there any people in Lewis county who have C-PTSD and need therapy for it?  According to the listing, it would appear that there are no people who have this condition in Lewis County and there is no need for therapists who are trained to treat the disorder.  However, if we prowl around beneath the surface, the picture looks a bit different.

When I arrived in Chehalis last December, I began a casual survey of the therapists here.  First, I sent out flyers to every therapist listed in Chehalis and Centralia, the two major population centers in the county.  On the flyer I advertised myself as being willing to speak from experience on the topic of C-PTSD and the healing process, and I made sure to add that I would charge no fee for doing this.  Of the fifteen or so flyers I sent out, I received one response.  That came from the head of one of our major public mental health clinics.  She responded that the modality of choice at her clinic is short-term behavioral therapy, CBT.  She added that if she encounters a person with obvious trauma damage, then she refers that person to somebody outside her clinic, usually.  Public funding does not normally cover the long-term therapy that trauma work requires.  She added that she would keep my offer in mind for the future. 

Her response was the sole response I received.  I was disappointed, of course, to receive just the one response, but at least I then had some idea as to which way the wind blew. I concluded, probably accurately, that the government does not want to pay for long-term therapy, and from my own experience with C-PTSD I know that short-term behavioral therapy would not have helped me get to the roots of my trauma damage and heal.  Also, others who blog on their journey to heal C-PTSD normally have been engaged in the process for a long time, and they talk about the complexity of their process, the necessity of a trusting and long-term relationship with a competent therapist, and all the ups and downs of their process.  In other words, for these other bloggers, a short-term DBT or CBT approach would not really meet their needs anymore than it would have met my needs. 

Not a person to give up easily once I "get the bit in my mouth"--pardon the rural and equine reference!--I took my survey further and went through the phone list of therapists in Lewis County.  I decided to limit my inquiry to only those therapists who were able to answer my call in person--I'd had too many experiences with failed call-backs to trust that leaving a message would get results--and of the four therapists I talked to, three did not treat trauma patients at all.  One therapist told me that she did not have the time to treat trauma patients/people with C-PTSD, and she referred those people to a clinic in neighboring Thurston county, a county with a larger population and a higher average education level than Lewis County.  Well, at least she allowed for the possible existence of C-PTSD.  That was encouraging! 

Curious, I looked at the list of therapists in the Olympia area and discovered that there are several therapists who treat C-PTSD in Olympia.  Not only that, but there is actually a clinic that specializes in treating people with PTSD and C-PTSD.  So C-PTSD exists in Thurston County and is deemed treatable in Thurston County, but it does not exist in Lewis county?  Interesting!  Yes, very interesting, in fact!  From this discovery and from the informal information-gathering I have done, I can probably conclude with some accuracy that 1. in larger population areas where the income and educational levels are higher than in Lewis County, there is more likelihood that people with Complex PTSD can find appropriate help, and 2. there is a huge need for education among professionals and non-professionals here in Lewis county regarding the causes, symptoms, and healing of Complex PTSD.  I can also conclude that I'm damned lucky to have found the help I needed and to have healed to the point that I have healed BEFORE moving to Lewis County!!   Amen to that!! 

 Why do I believe that, despite the refusal of most professionals here to admit to the existence of C-PTSD, there are people here who are suffering the effects of the condition?  For one thing, if Judith L. Herman, M.D. ("Complex PTSD: A Syndrome in Survivors of Prolonged and Repeated Trauma."  Journal of Traumatic Stress, Vol. 5, No. 3, 1992) is to be believed--and I do believe her!--suffering prolonged child abuse and also being victimized for years in a domestic violence situation often leads to a person's developing Complex PTSD.  Common sense and the fact that no fewer than five agencies are listed when I searched for county agencies that help domestic violence victims tell me that there are plenty of residents here who possibly are long-term victims of abuse.  Child sexual abuse?  When I lived here in 1981, a professional who worked for the local Department of Social and Health Services told me that Lewis County, Washington, ranked seventh in the nation for the reported cases of incest.  Unreported cases??  No figure available.  Presently, this county and neighboring Cowlitz County, both what might be called "rural" counties, are hotbeds of drug abuse, particularly hotbeds of meth production and use.  And along with meth abuse come child neglect/abuse and domestic violence. 

With the above in mind, then, I wager that plenty of people here in Lewis County are wandering around suffering the symptoms of a disorder that is not recognized as legitimate by the bulk of the professionals in the county: "C-PTSD is not in the DSM-V;  it doesn't exist;  why would or should we treat it?"  Of course, there is the practical reason for not treating C-PTSD:  If it is not specifically listed as a disorder in the DSM, then there may be no reimbursement by insurances.  But folks in more urban areas are treated for C-PTSD, and their treatment is paid for by their insurance, including by Medicare.  All I can say with certainty is that I have been diagnosed as having C-PTSD, I received the long-term help I needed, and that help was paid for by Medicare and my Medicare supplement.  Other people I have known with the diagnosis of C-PTSD have had their therapy paid for by their private insurance.  But these people have not lived in rural areas! 

No, the general attitude here in Lewis County is that C-PTSD does not exist as a legitimate diagnosis and, therefore, nobody has the disorder.  When I asked the head of the largest public mental health facility here how she would have treated me had I presented with the symptoms of C-PTSD, she replied that I would have been medicated and given short-term behavioral therapy.  When I asked her if she would have given me a diagnosis of C-PTSD, she just stared at me and did not reply.  As I said earlier, I'm damned glad I did not relocate to this area until AFTER I had been treated for C-PTSD! 

So is there anything I can do to help bring about a change in the way people here in Lewis County regard--or disregard!--Complex PTSD?  As a nonprofessional but also as a person who has been diagnosed with Complex PTSD and who has been successfully treated for the disorder, all I can do is tell people about my own individual experience and hope that at least a few of my listeners and any local readers of my blog take me seriously enough to find out for themselves that C-PTSD does indeed exist.  Maybe these people will wonder, as I do, why they are stonewalled when they bring up the subject with local professionals.  This is a sad, sad situation, and I can only pray that eventually it will change.

There is one huge step that can be taken, however, that will do more than anything else to bring about change in the local attitude regarding the existence of C-PTSD:  Include C-PTSD/DESNOS in the DSM-VI!!  That would be the logical first step!  The second step would be to make education and training in effective methods for treating C-PTSD/DESNOS available to local therapists.  I'm almost seventy-six years old and may not be alive to see the day C-PTSD is included in the manual or to see any of the local therapists who do not believe the disorder exists accept that it does exist and receive training in its treatment, but if that day ever comes, I can guarantee that there will be clients right here in Lewis county to keep those therapists as busy as they want to be! 

As I stated at the beginning of this post, I plan to do as much as I can to educate people in this community regarding Complex PTSD.  I know, at the same time, that what I have to say will fall on a lot of deaf ears.  However, in the hope that maybe a few people will listen, become interested in the topic, and do some local investigating, making the effort to educate is worth my expenditure of energy.  This time next year I'll let you know what results from my efforts!  Have a wonderful holiday season and a great New Year! 


Note:  My 2012 post of this same topic should appear below this post.  Same general topic--different information.  Important reading for all you who have been diagnosed with C-PTSD!  And for anyone who knows a person with the diagnosis. 





Complex PTSD: Does It Exist?

Please Note:  I first published this post in 2012, a time when the DSM-IV was being revised prior to publication of the DSM-V.  Unfortunately, C-PTSD/DESNOS was not accepted into the DSM-V as a distinct diagnosis.  As a result, the existence of this disorder has been denied by some professionals, and people who may be suffering from the disorder are having a tough time getting the treatment they need in order to heal.  Today, December 8th, 2014, I wrote a followup to this article and described what I have discovered as I have become aware of the prevailing attitude held by professionals here where I am living now, a small town in a rural area in Washington state.  As I see it, the only thing that will bring about a more general acceptance of C-PTSD/DESNOS and will possibly lead to more effective treatment of people who have abuse-caused C-PTSD is inclusion in the next edition of the DSM, DSM-VI.  If you can do anything to insure the inclusion of C-PTSD/DESNOS in the manual, please do it!  As you will read in the post I wrote today, I am going to try my best to help the cause.  Please join me in any way you can!  Thank you .  .  . Jean


April, 2012

The other day I read an article by Bessel A. van der Kolk M.D. titled “The Assessment and Treatment of Complex PTSD.” * The article was long and somewhat difficult for me to read because I am not a trained mental health professional and am not used to reading articles written in APA style by high-powered researchers and doctors, but I did my best to get through it with some understanding of its main points. Since Bessel A. van der Kolk is a pioneer in the field of PTSD research and treatment, I read his articles with interest whenever I come across them. *(To find this article, type the title into Google.)

Bessel van der Kolk's article interested me for several reasons, among them 1. the fact that the people who put together and publish the DSM have not listed Complex PTSD as a diagnosis in itself but are presently considering including “Complex PTSD” as a separate diagnostic category in the DSM V and 2. the fact that many people with symptoms and histories that indicate the presence of Complex PTSD must presently be given a diagnosis of PTSD or “prolonged PTSD” when the Complex PTSD diagnosis might more accurately describe their condition. Here is the Wickipedia definition of C-PTSD: “Complex post-traumatic stress disorder (C-PTSD) is a psychological injury that results from protracted exposure to prolonged social and/or interpersonal trauma with lack or loss of control, disempowerment, and in the context of either captivity or entrapment, . . .” (To find the complete Wickipedia definition and other definitions, type “complex ptsd definition” into Google.)

After I finished reading the van der Kolk article and had some time to reflect upon the reading, I experienced sadness, a sadness of the sort that happens when one might see himself or herself described so clinically in writing. Bessel van der Kolk had described certain aspects of my psychological makeup better than I could describe them—the low self-esteem, the tendency to overreact internally to certain interpersonal interactions that don’t seem to bother other people, my past tendency toward self harm during times of high stress due to interpersonal interactions, all the common PTSD symptoms, and so forth. I wrestled with the sadness for a few days, and then it lifted. I was left wondering if maybe reading journal articles on PTSD should be written into my list of “things NOT to do.” However, I know that the next time I see an interesting-looking article on PTSD, I’ll probably read it, especially if it is written by Bessel A. van der Kolk. My desire to know always trumps potential discomfort.

Another person whose articles I usually read is Judith Lewis Herman, M.D. A few days before I read the van der Kolk article, I had read Herman’s article titled “Complex PTSD: A Syndrome in Survivors of Prolonged and Repeated Trauma.”* Judith Herman and Bessel van der Kolk state many of the same points in their articles, but they state them differently. I found Judith Herman’s article easier to read because it is written using somewhat less clinical terminology and a more narrative style than that of Bessel van der Kolk. However, both authors make a point of emphasizing the fact that the presence of Complex PTSD, in the past often associated mainly with people returning home from battle, is also frequently found in people who have never seen a military battlefield but who have experienced prolonged neglect and abuse on the “family battlefield” as children and then possibly later as battered spouses, members of a cult, or prisoners. According to both van der Kolk and Herman, a few of the factors that appear to lay the foundation for Complex PTSD on this non-military “battlefield” are the prolonged nature of the abuse; the ongoing and overwhelming sense of powerlessness and hopelessness experienced by the victim; a prolonged state of being held captive, whether the captivity be in a concentration camp, a cult, or a family setting; and chronic repeated traumatization. *(Judith Herman’s article is also available if you type the title into Google.)

As one might imagine, treating a person suffering from Complex PTSD (C-PTSD) is, according to both authors, more complicated than treating PTSD brought on by a single traumatic occurrence. Van der Kolk, in his article, presents a list of steps used in treating PTSD and then presents a revised list that includes similar steps with modifications for treating C-PTSD. The complex nature of C-PTSD, of course, was no news to me! I’ve been chewing away at the treatment process now for decades, much of the time trying to do the job on my own—for the most part, futility in action, I discovered. Now that I have found a therapist with the skills and experience necessary to help me, I realize the impossibility of trying to “fix” myself without knowing how and without help. A person with C-PTSD or PTSD must have skilled help; the job is not a do-it-yourself project nor is it a project that should be left to therapists who do not have the skill or knowledge base necessary to effectively treat C-PTSD/PTSD victims!

After reading the two articles and recognizing my own history and symptoms in both, I have a clearer understanding of where I am and where I need to go. Frankly, I’m not sure that I will “get there” before I die, a disconcerting reality to face! Can I repair the damages of the first forty years of my life in just, say, five years? Probably not. However, any progress I make in the process of trying to repair the damages is to the

good and will make my life better in some way. I believe that. I must believe that! I do have evidence for the truth of this belief because since I’ve been in therapy, I can stay in the moment, usually, when somebody acts out on public transportation. A year ago that was not the case. Since I have no car and must, therefore, use public transportation to get from one place to the other, I am really happy that this part of my life has improved!

To return to the original question as posed in the title to this article—Complex PTSD: Does It Exist?—my short answer is “Certainly it does, and I have the marks to prove it!” Obviously, Bessel A. van der Kolk, Judith Lewis Herman, and a host of other experts also believe that Complex PTSD not only exists but exists as a diagnosis in itself, a condition that has many of the same characteristics as PTSD but yet is not exactly like PTSD in certain important respects. Perhaps establishing a diagnostic category called C-PTSD isn’t important to everyone with PTSD, but it is important to me. If I am going to be diagnosed and labeled, I want my diagnosis and label to describe my condition as accurately as possible. Thus, I hope to see Complex PTSD listed as a diagnostic category in the DSM V when it is published in 2013.

Saturday, November 15, 2014

What's my life like after therapy for Complex PTSD?

It's hard to believe that I have been here in my new home in Chehalis, Washington, for almost a year, now.  It's been a while, a couple of months, since I last took the train to Portland, Oregon, and visited my therapist in her office, and it's been almost a year since I have had regularly-scheduled in-person sessions.  For a while, beginning in about February or March of this year, my therapist and I met once a week for a Skype long-distance session.  By July or August, we were meeting via Skype less frequently, and now we have an "as needed" agreement.  How do I feel about this arrangement? 

It rocks!  That's how I feel.  Since I have been living in this small Western Washington town, I have not really felt the need for therapy sessions.  In fact, when my therapist and I were doing our weekly scheduled Skype sessions, those sessions became a burden to me because I disliked having to stay home on Thursdays.  I had other things I really wanted to do.  However, I respected my therapist's belief that tapering off our sessions was better than going "cold turkey."  And she was right--several matters came up that I needed to spend time discussing with her.  So I am glad I hung in there. 

Five years ago, my inner life was so painful and so turbulent that I had given up leaving my apartment unless absolutely necessary.  It seemed that no matter where I went or who I was with, I was constantly having to deal with PTSD triggers.  Separating and hiding my inner life from my outer life took so much of my energy that I was ready to give up.  Fortunately, I don't give up easily, and I made one last attempt to find a person who had the knowledge and experience to help me.  Bingo!  After contacting the former head of the psych department in a well-known local research hospital, I got the name of a therapist who was able to diagnose me accurately and then offer me the help I had been trying to find for the past thirty-some years. 

Now, I have always been a person for whom having a personal goal is essential when I engage in an activity that is important to me.  My goal when I began seeing my therapist in 2010 was to do the work I needed to do in order to reduce and manage my PTSD symptoms so that I could enjoy the final part of my life.  Well, I worked my tail off in therapy, and I achieved that goal.  I hung in there, forced myself to go to my sessions even when I didn't want to go, spent hours and hours at home working on my Ego State Therapy dialogue, and now I'm finished.  My reward?  A state of inner peace I have never had before in my life and what I would call a relatively normal life--normal for a 75-year-old senior living in a small town, that is.  Even more:  I am able to manage any distress I feel before it gets to the point where symptoms might recur. 

Yes, I've learned in therapy how to gather my ego states together so that we might iron out any difficulties that could cause distress.  For that, I don't really need a therapist's help now.  Five years ago, I did! 

Oh, yes, I need to define my new "normal" life here in a small Western Washington  town of about eight thousand souls.  I'll tell you about this life.  You may not find it appealing, but I'm so happy to have it!  First, I sing in my church choir at St. Timothy's Episcopal Church.  I also sing in the female "barbershop" group that one of our choir members put together.  We call this group "Joyful Noise," and the name fits.  Sometimes it's more noise than music, but we are working on it.  Our choir now has tee shirts with St. Timothy's logo on them to wear on December 13th when we participate in one of the community Christmas events.  The children's choir is going to join us, and I bet they steal the show!  So I look forward to that event.

Recently, I've begun volunteering at our local community college, something I love doing!  I'd forgotten how much fun it is to work one-on-one with a student.  I'm helping twice a week in a post-ESL class, giving students individual help.  In addition, once a week I will be facilitating an English conversation session with students who want to practice their speaking skills in English.  For me, this work is fun, and I'm just happy that my head is peaceful enough so that I can use it for other things now instead of therapy. 

Overall, I'd say my life now, post-therapy, is pretty typical of the lives led by many women my age (75).  I don't feel a need to explain myself, as I used to, because I feel that I blend in with everyone else.  I no longer feel that I am a freak or even that I am weird--whatever those terms mean!  "Quirky" I may be, but not freaky.  Now that I no longer have a war taking place in my head, I am able to simply be a part of life and enjoy the experience--the bad and the good of life.  I like knowing that now I can usually roll with the punches and not experience flashbacks and other symptoms when the going gets difficult.  That new feeling is awesome!

Will I stop posting to my blog now that life has settled down for my ego states and me?  No!  But I won't post as often as in the past.  I'm simply going to be too busy living!  So now you know what I will be thankful for this Thanksgiving and now you know that my greatest Christmas gift will be from me to me, the experience of living without the daily torment of PTSD symptoms.  At the Thanksgiving table this year I will say a prayer of thanks for my therapist and all her help, and I will thank God and the powers of the Universe for giving me the stamina and the powers of insight needed to do my work in therapy. 

To conclude, below is a British saying adapted to fit our American Thanksgiving: 


 
(Google Images)
 
Have a wonderful Thanksgiving, and don't forget to thank the Universe for
being there for you!  You exist--now take the next step! 
 
 
 
 
 


Friday, August 1, 2014

I’ve had lots of therapy—But has it helped?


 

Meet Cowboy, the ego state that has helped me hang in there through life and through therapy!

 
 
The past few years since I’ve been maintaining this blog, I have encouraged you, my readers, to seek competent help in healing your Complex PTSD.  I thought about this as I drank my morning coffee today, and it occurred to me that even though I have used this blog to describe much of my own healing process as I have gone through it, maybe I need to actually provide a more left-brained and analytical  overview and evaluation of my own therapy process.  Perhaps by doing this I could give you a clearer idea as to just exactly how I have benefited from therapy.  Maybe then, if you are still trying to decide whether therapy is for you, you will have more specific information to help you make a decision. 

Now, in order to tell you how I have benefited from therapy for Complex PTSD, I must look at the matter from a perspective that differs from my usual perspective.  I need to step back from my process and observe it much as a scientist observes a lab experiment.  I’ll do my best, but it won’t be easy.  Describing the process as I went through it was relatively easy for the  most part.  I simply let you watch me connect dots, respond to my experience, and then place the results of my work into the whole context of my life.  Now, in order to put into words just how I have benefited, I will need to see my therapy differently, and I don’t know how well I can do that.  I’ll try!  At least, today I will make a start at this project.  

First of all, I am still transitioning from being a person in therapy to being a person who is not in therapy.  Over the years, I have discovered that for me, at least, life is filled with processes—big ones and little ones.  In 2010, I went through a process to find a competent therapist.  That process was blessedly short, thank goodness.  Then establishing a working relationship with her was another process, a process that occurred side by side with the process of actually getting into the therapeutic process so I could heal.  Now, finally, my mind has said, “That’s it, at least for now.”  The therapeutic process/healing process has wound down to the point where now I can just “live” and experience life without the therapeutic process taking so much of my head space.  This is a natural ending to the process.   

In the past, I have had to shut down the therapeutic process/healing process deliberately, like turning off a water faucet, because external circumstances have forced me to do that.  Deliberately stopping the therapy process is difficult!  But this time, the process is ending on its own, naturally.  And it’s ending easily.  Now I am truly beginning to reap the benefits of all my hard work.  Where do I start in discussing these benefits?  I’ll first describe one major benefit that is making a tremendous difference in my life right now, and  as time passes, I will be aware of more benefits and will tell you about them.   

Benefit #1:  I am able to see myself in relation to others now with more accuracy, I believe.  I am better able to see how I fit into society in general.  Now I know that I DO fit into the complex tapestry that we call humankind.  In the past, before entering into this latest therapeutic round, I felt like a freak, as if I didn’t belong anywhere.  Maybe some of you have experienced this feeling throughout your lives.  Now, however, after this past round of therapy, I realize that I fit as well as most people, and I am not a freak.  I’m not sure just how I have arrived at this insight, but I have.  Before I began the work in 2010, I felt like a freak; now, after the work, 2014, I do not feel like a freak.  I can legitimately conclude, I believe, that the work I have done in therapy has brought this new concept about.   

This benefit, then, is HUGE!  From the time I was four years old and was sexually assaulted, I have felt isolated, a failure as a human being.  When I was a little girl, in fact, and learned about lepers in Sunday School and how they had to ring a bell and cry “Unclean!” to warn others of their presence, I decided that I needed to withdraw from others so as not to contaminate them with my wickedness, the “wickedness” of being a victim of violent child sexual abuse.  I made this conscious decision to withdraw myself from other people when I was seven or eight, and I have withdrawn all my life.    

Now I don’t feel this way.  I know now that the abuse really had nothing to do with me but was all about my abuser.  I was convenient for her, a handy potential victim who could be groomed to meet her needs. It wasn’t about me or my perceived wickedness at all!  Now, after isolating myself for some seven decades,  I’m beginning to feel as if I’m part of the tapestry of humanity rather than a dangling and loose thread that needs to be trimmed off.  What did I do in therapy that brought about this change in my perception and feelings about myself?  Having a reliable, mutually respectful, and deeply human relationship with my therapist, doing Ego State Therapy work, and discharging trauma energy through EMDR work are all factors in bringing about this change.    

So what difference has this insight made in my life?  I feel more confident now when I interact with others.  I feel as if what I have to contribute is worthy of other people’s attention.  Until now, I had never felt that way in my whole life!  Mind you, this is a beginning.  I’m not all the way there yet with this concept.  But I’m entertaining the possibility that I am worthy as a human being and that I am valuable.  Never before could I truly say this with any conviction.   

In addition to the above insight, I now can feel the grief as I awaken to the realization of what my abuser took from me—my innocence and my sense of my own value as a human being.  Now I “get it.” I also “get” the fact that I experienced my childhood abuses through the mind of a child, and I took personally that which I would not have taken personally as an adult.  If I had been an adult with a fully developed brain and a sense of self worth at the time I was abused, I would not have allowed myself to be abused.  I would have seen the situation for what it truly was, another person’s attempt to act out her sickness on anyone who was handy, and I would have likely gone to the police and reported her behavior.  But I was a little girl who loved to be cuddled and loved attention and who got none of that at home, so I fell prey to a person who took advantage of my need.  Sad, sad, sad!  As an adult, I am ANGRY!  And that’s good.  I have spent many decades of my life using the energy of my anger to drive constructive behavior.    

How will I put this new concept of my self worth to use?  Now that I realize that I am valuable and that what I do may be valuable and useful to other people, I have several projects in mind.  One is to use YouTube to explain the process of therapy I have been through—to demystify my therapy, in other words, in order to make the prospect of therapy in general appear less daunting.  Another is to speak to groups using my own story as a means of illustrating how child abuse changes the course of a life and can limit a child’s potential for growth.  Yet another project I have in mind is publishing my blog posts in book form.  Because my head isn’t so busy processing material related to the therapeutic process now, my “internal hard drive” has more space to do other things, and I have these projects in mind.  However, I also want to enjoy simply being a person, a real person who has fun and enjoys reading and does iconography and sings in the church choir and goes to parties and has friends.  I can do all this finally!  And I can enjoy doing these things.   

Coming next:  Benefit #2.  I’m not sure yet what this will be.  Stay tuned.   

May your day be filled with blessings
Like the sun that lights the sky,
And may you always have the courage
To spread your wings and fly!
Celtic Prayer

 

 

 

 

 

 

 


Sunday, July 27, 2014

Tribute to a Fellow Blogger!

This morning as I was going through my email messages, I noticed that I had received a post from a blogger who calls herself Cat’s Meow.  I follow her blog because she is describing her experience as she heals from Complex PTSD, and she is working much as I have worked—with her personality parts, ego states.  Here is the link to her blog and the post I read this morning: http://livingwhilehealing.wordpress.com/2014/07/26/telling-the-untellable/.   

All along, I have been amazed at the candor and the courage of this blogger.  She takes her reader by the hand and leads the person through her therapy sessions, revealing not only her pain resulting from horrendous childhood abuse but also giving her reader a picture of her interaction with her therapist.  As I have followed her posts, I have been able to witness her healing, and this witnessing has given me inspiration as I have struggled on my own healing journey.  I can only believe that others have benefited as I have from reading Cat’s posts.   

Cat’s Meow has come a long, long way in the year or two I have been following her blog, and I have faith that she will, as I have, reach a point where she will know she is ready, finally, to “just live” and not need the support of formal therapy.  This day will come for her, I am certain, for she has persevered and “kept on keeping on” through times that would lay many people so low they would give up.   

I highly recommend this blog to you if you are considering getting help healing from childhood sexual abuse.  To get the most help and inspiration from Cat’s posts, it might be useful to begin reading her early posts and progress through them to her present posts.  This will help you get a sense of the progress she has made over time, and you will also understand why I say she is such an inspiration for others who are making the same journey.   

Also, you might find it helpful to read the following information on ego state therapy, parts therapy, to gain some understanding of the parts concept: http://www.esti.at/index.php/about-ego-state-therapy.  Here is another article that you might find useful: http://www.clinicalsocialwork.com/overview.html.   

For those of you who are considering getting help but have not yet done so, for those who are in the process of healing, for those who have reached a point where you no longer feel the need for therapy, and for everyone who feels the need for protection and comfort, I will share with you this Celtic circle prayer I found while looking for information on the Celtic saint, St. Cuthbert--

 Circle us Lord,

Keep love within, keep hatred out.

Keep joy within, keep fear out.

Keep peace within, keep worry out.

Keep light within, keep darkness out.

May you stand in the circle with us, today and always.



See more at: http://kathwilliamson.blogspot.com/2009/10/celtic-spirituality-circling-prayers.html#sthash.WRG2PcWX.dpuf

 


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sunday, July 13, 2014

Of Therapy Ending, Granny Bullies, and Small Miracles: The Warp and the Weft of It All


The Chambered Nautilus:
One of Nature's Miracles



If somebody were to ask me to describe my life in one sentence, I might, depending on my mood, reply, “My life is a series of sucker punches, unexpected events that may knock me off my pins at the time but which later become inextricably a part of the old, familiar tapestry I call ‘life.’”   

At first glance, this description of my life may not make much sense or it may seem shallow or incomplete.  But the more I reflect on my statement, the more I see its truth.  For example, when I consider the matters of ending therapy, dealing with grannies who are mean-spirited bullies, and recognizing and appreciating miracles, I know that while these three matters may seem disparate and be, each in its own way, a shock to my system at the moment, I will soon understand why they are important and how they relate to one another.  And then each will find its place in the warp and the weft of my life’s tapestry, and the tapestry will be made all the richer. 

In my previous post, July 6th, I discussed the matter of ending therapy.  I indicated the reasons why it was time for me to end my therapy sessions and mentioned that my therapist and I would come to an agreement on this topic when I had my July 10th session.  Now, ending therapy is not a step to be taken lightly, as you probably know if you have been in therapy for PTSD or C-PTSD.  I know this for certain because I have ended therapy with many therapists—16 total!   

However, this time the process of ending therapy has been different from all the other times.  Why?  This time I am ready to end therapy!  There is a huge difference between ending therapy because  it’s simply time to end therapy and ending therapy for other reasons.  This time I have known intuitively that I am ready for formal therapy to end, and ending has been easy.  My therapist and I have formulated a plan together.  I have a session scheduled for late August, and in between now and then, I am on an “as needed” basis.  But I really doubt that I will need a session before late August.  I’ve checked my body for a response to this decision, and the only perceptible reaction is a slight twinge of anxiety in the pit of my stomach when I think about stopping my formal sessions.  The twinge is no more intense than the twinges I get when I know I have to speak to an audience, and I know that as time passes, the twinges will fade.   

When I have ended therapy with other therapists, I have not really been ready, and not being ready has made ending difficult.  For example, I ended therapy with my first therapist because she retired and moved away.  I grieved the loss of this relationship for years until the memory faded and drifted to find its place in my life’s tapestry.  This therapist and I had been close.  She was there for me when my psyche fragmented into bits and I couldn’t put myself back together.  She was the person who helped me through the process of turning my husband over to the police when I caught him violating our daughter.  She was there for me as I filed for divorce and endured the usual nastiness of the legal battle.  And just before she left, she was there for me as I began a new job and embarked on a new path for my life.  What neither of us knew, however, was that our work together was merely the beginning—I was not ready for an ending, for in 1983 Complex PTSD was a diagnosis yet to be discovered.  I had a lot of work ahead of me!   

I ended therapy with other therapists for various reasons,  mostly because I relocated or they relocated.  I left a few because they were unprofessional and caused me harm.  I wonder why none of those therapists, such as the one who slapped me and the one who became angry at me because I did not appreciate the way she touched me,  accepted responsibility for her behavior and apologized to me.  When I ended therapy with these therapists, I felt relief but also pain from unresolved issues with them.  Because they had not apologized to me for their contribution to my pain, I was left to clean up the messes they made in my psyche.  A few times, I had to see somebody just to get help repairing myself after having been abused by therapists.  I doubt that any textbook mentions this reason for seeking mental health help.   

So now I am truly ready to end therapy—I feel it in my bones, and I also know it in that part of my mind where rational thought resides.  And I have proof that I can manage my life without needing therapy.  For one thing, I have been tested and have passed/am passing the tests—and this is where the “granny bullies” enter the picture.  

Because I am seventy-five years old and rely on Social Security and my small teacher pension for my income, the HUD people consider me to be a “very low income” person and eligible for subsidized housing.  I have lived in six housing complexes for low-income seniors, and of those complexes, three were HUD-related subsidized complexes and three were what is known as “affordable housing” complexes.  Rent at the “affordable” complexes rose alarmingly, so I have made peace with the fact that I will probably spend the rest of my days in HUD subsidized housing where my rent will never be more than 30% of my adjusted income.   

As I have relocated and moved from one housing project to another, I have done a casual sort of research project on the phenomenon that I call “granny bullies,” elderly women who spend their time gossiping about other tenants and bullying those tenants who appear most vulnerable and least able to defend themselves.  In general, I have found that the places where I have paid the least rent are the places where the bullies are most active and most vicious.  When I lived in Sherwood, Oregon, a pack of “granny bullies” delighted in tormenting tenants who were on disability due to mental health problems.  These elderly women also sold their pain medication to earn extra income.  I’ve heard psychologists say that if you want to know how a person will behave in the future, look at past behavior.  If there is any truth to this guide, then I can imagine that the bullies at the Sherwood complex have been bullies all their lives.   

How did I handle the Sherwood bullies?  I did my best to avoid them.  I was scared and lacked confidence in my ability to defend myself.  The level of my fear rose one evening when I came home from choir practice.  I lived in a second-floor apartment, and my door opened onto my balcony.  From there, I had to share the stairs with the woman across from me.  On this night, I reached the landing of the stairs and was confronted by my elderly neighbor who blocked my way.  She told me that she would allow me to pass if I told her that I would join her and her bully friends in tormenting another tenant, one who had a psychiatric diagnosis.  I told her there was no way I would participate in bullying, pushed past her, and entered my apartment.  I considered calling the police, but I was too afraid she and her pals would retaliate if I did that, so I just let the incident go and began searching for a new place to live.   

Fast forward to the present, the summer of 2014.  Again, in my present complex, the “granny bullies” are alive and active.  One has chosen to pick on me.  She pounded on my door and ranted one Sunday because my friend who brings me home from church was parked in the fire lane.  A lot of people park temporarily in the fire lane, but she chose to rant at my friend and me.  Luckily, my friend is an extrovert and an expert at dealing with obnoxious people, so she ranted right back.  The bully will be back, however, because I ignored her the other day when she came to my door.  She wanted me to sign a petition, and I was on the phone and let her know I didn’t have time for her and her petition.  Bullies do NOT like to be ignored, and she will let me know that, I’m sure.  But this time, I’m not afraid of her or the others in her circle of bullies.  Bring them on!  I have confidence now that I did not have when I lived at Sherwood, and whatever the bullies may do, I will take care of the matter fully and legally.  I realized in therapy that I am smart and resourceful, and I can deal with whatever the bullies dish out.   

As far as I’m concerned, I’ve passed the “ending therapy” test and know that I can handle my life without needing to schedule therapy sessions.  My reward for staying with therapy, gaining new confidence, and ending therapy?  The reminder that yes, life is filled with miracles, little gifts of love that help me continue to grow.   

I was part of one such miracle last Thursday.  For weeks, I have had to contend with the cigarette smoke from my upstairs neighbor’s apartment.  Every time she has smoked in her living room, her smoke has drifted through my open living room window.   As a result, I have fretted and stewed about this.  Should I risk knocking on her door and asking her if she could please keep her smoke to herself and hope that she did not explode in my face?  Or should I simply bypass her and talk to the manager?  I’ve lived here for six months, now, and my upstairs neighbor has remained an unknown quantity.  But last Thursday, when the smoke was particularly noticeable, I made my decision.  I decided to make the trip up the stairs, knock on her door, and ask her if she could help me solve the smoke problem.   

When I knocked, the woman came to the door carrying her little dog.  I told her that her smoke was coming through my window and into my living room and explained that I’m allergic to cigarette smoke.  As I talked, she began to cry.  I asked why she was crying, and she told me that she was so relieved that I had come to her rather than take my complaint to the gang of “granny bullies” who sit at the round table in our front yard.  After I replied that I would never, ever go to the bullies for that reason, she explained that at one time, she had been part of their clique but they had been so nasty to her and another lady who smoked that she felt like a leper.  Now she is so afraid of those women that she seldom leaves her apartment.   

When I left my neighbor, we parted in peace.  I told her that I would appreciate anything she could do to minimize the smoke, and she assured me that she would try her best.  I let her know that I don’t expect perfection, but I’ll be happy if she can at least cut down the amount of smoke.  So far, so good.  I don’t know what she is doing, but I’m not getting nearly as much smoke in my apartment as I have in the past.  I plan to let her know that I appreciate her efforts.  I also will reinforce the fact that others I have met here feel the way I feel about the women who sit at the table in the yard.  My neighbor is not alone.   

What, exactly, is the miracle?  I went, unafraid, to ask my neighbor to help solve the problem.  My attitude was not accusatory or blaming—I simply wanted her help to solve a problem that was clearly partly hers.  The miracle was that I decided to approach her directly and with love and courage rather than with fear and trembling.  And she was grateful!  We both gained from the experience—she received my assurance that I was not going to attack her or bully her, and I received her cooperation in reducing the cigarette smoke coming through my living room window.   

I see my neighbor differently now.  I no longer see her as a malevolent person who is trying to make my life miserable with her smoke.  I see her now as a person who needs to be reminded that not all the people who live here are against her and that she is no more a leper than those women whom I call the “granny bullies.”  And difficult as it is to admit—the incident has reminded me, also, that inside each bully resides a person who is possibly just as scared as the victims of her bullying.  I say that this is difficult to admit because in seeing bullies this way, I am forced to admit that even bullies need my compassion.  For some reason, it’s easier to be angry than to have compassion at times.   

While this experience may not seem like a miracle to others, it is a miracle for me.  As I was making my decision to approach my neighbor directly, I remembered Christ’s command in the Book of John, King James Version:  A new commandment I give unto you, That ye love one another; as I have loved you, that ye also love one another.  In the past, I have not usually called upon the principles I learned as a child in Sunday School, but now that my mind and my heart are not so distracted by my therapy, I am more inclined to think about and apply those principles to my everyday life.  In this case, I am so glad I did!
 
Following is a quote about miracles that is attributed to Albert Einstein by many people but is not attributed to Albert Einstein by other, more skeptical, people.  Frankly, I don't care who wrote it; I choose to see the miracles in life and to let them lead me. 
 

“There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.”