My Own Comments on “The Day I Stopped Dancing” . . .

If you have read “The Day I Stopped Dancing,” the essay I posted yesterday, you may have wondered why I wrote it.  More than that, you may have wondered why I posted it!  After all, the experience of being violently sexually abused at age four was so secret and so shame-ridden that I kept it to myself until I was in my early forties.  And the only reason I became aware of the abuse then was that the memory was forced upon me by a flashback.  As I stated months ago in my post titled “What Good Are Flashbacks?” flashbacks can serve to make a person aware of the need to get help, but they can also be as horrible to experience as the original traumatic incident from which they stem.  That is certainly true of this particular flashback.  So, frankly, until this morning, I was not sure myself why I wrote and posted “The Day I Stopped Dancing.”  This morning, though, I understood.

It’s been thirty-some years since I had the flashback that brought this abuse memory to my mind, and it’s been over seventy years since the abuse incident, and now I find myself getting angry—very angry!—at the thought of sexual predators who abuse kids and who are not subsequently prevented from re-offending.  I’m angry, too, at the people who refuse to believe that abuse can derail a child’s normal course through childhood and leave that child isolated, anxious, and unable to trust if he or she does not get competent help at the time of the abuse.
 
Before a child can get help, however, that child must tell somebody about the abuse.  How many children will do that?  I don’t know for certain, but I would guess that many, many children are like I was—too scared to tell anyone.  So they carry the shame and the guilt and the secrecy—the whole burden that really belongs on the back of the perpetrator—into adulthood.  And then one day the system breaks down, the child-grown-to-adulthood goes into crisis, and finally, if the person is lucky, he or she gets the help needed to come to terms with the abuse. 

In the meantime, a lot of life has gone by, and a lot of promising relationships may have been destroyed by toxic behaviors driven by the unresolved abuse issues festering deep in the victim’s psyche.  This is what happened to me, and I can name dozens of other people who have experienced what I have experienced as a result of being abused as children.
 
Given, then, that children often are too scared to report sexual abuse and other kinds of abuse, how do we know what actually happens in a child’s mind when he or she is traumatized by abuse?  I suspect that often an adult being treated for the effects of child abuse has difficulty describing in detail the effects upon him or her of abuse that happened decades previously.

 

Describing, for example, the dissociation I experienced immediately after the abuse incident has been as difficult for me as for anyone else, most likely, but ever since I experienced the flashback that led me to the memory, I have persisted in trying to put the experience into words.  I have thrashed about in my head for years, trying to find the right words, the exact words needed to describe the moment the fog came between me and the light.  I’ve remembered the feeling, that millisecond between brightness and dimness and the sense that the world outside my hiding place was not as it was before the fog came. 

But how to tell another person about the fog?  According to Robert Frost, “the fog comes on little cat feet,” but that wasn’t how the fog came to me at age four!  The fog that came to me then was more like a knife, suddenly severing my former connection to the world on the other side of the fog.  As I peered through the fog, my life looked different.  Suddenly, people with whom I had felt comfortable and happy became aliens, people covered in shadow.  Would they, too, exact a payment from me as Mrs. Greenleaf had done?  And so my life shifted from sun to shadow--the fairies no longer danced around the fairy rings all night and threw sparkles at the buttercups in the morning dew, and, as my mother said, I grew heavy on my feet and no longer danced. 

I understand now that the whole purpose in writing my post yesterday was to show through the eyes of my child self at age four how sexual abuse affected me so many years ago.  Something in me died as a result of the abuse—at least I thought it had died.  Now, however, I’m not so sure.  Maybe it didn’t die; maybe that little girl is coming out of the fog.  Maybe once again she—and I—will watch the fairies dance, see the buttercups sparkle in the morning sun, and maybe we will even dance.  Now, that’s a thought! 

It can happen—with patience, perseverance, and hard work, your adult self can bring that little child from darkness back into the sunshine.  If this is something you need to do, please do it.  You deserve to do it!  If you do it for you, you do it for the universe—for everyone.  Namaste.  Blessings. 

The Day I Stopped Dancing

 

The following essay addresses the violent sexual abuse I experienced when I was about five years old.  In this narrative, I describe the life-changing dissociative experience following the abuse.  This sexual abuse, coupled with other abuses, some inflicted by my parents, worked to change me from an outgoing, friendly, trusting little girl to a withdrawn, anxious little girl who felt as if she stood isolated and alone in the world. 

 

The abuse also was one event of many that contributed to my Complex PTSD, for the accumulation of abuses set my life on the course that led me to marry a man who perpetuated the victimization that began in my childhood. Long-term abuse and victimization lie at the roots of Complex PTSD, according to research studies, and in my case, I was a victim for the first 42 years of my life. I have spent the past 30 years trying to undo the damage, and I believe I'm finally beginning to see the end of my struggle.  Now that I have found a competent therapist trained especially to help people who have been traumatized over a long period of time, I am beginning to see daylight in this struggle.

 

Although I have done my best to describe the event without being graphic, the contents of this essay may be disturbing to you if you have had a similar experience.  In such a case, you might want to skip this essay.

"You were such a bouncy little girl; you were always up dancing on your toes.  I even considered sending you for ballet lessons.  But when you were about four or five, you changed.  You became heavier on your feet, and you didn't dance anymore.  I never understood what happened to you." 
  
My mother said those words to me when I was in my twenties.  At the time, I did not understand what had happened to me, either. Feeling that the words were significant, however, I stored them in that area of my mind where I store information that I suspect will be important in the future.  Later, when I was in my early forties, I had a disturbing flashback that enabled me to attach a memory to my mother’s words.  Since the flashback and the initial memory, I have been able to piece together the story beneath the memory and understand why, so long ago, I stopped dancing.
   
  By the time I was four, my mother had begun the practice of turning me outdoors to play after breakfast.  Most of the people at home in my neighborhood during the day were middle-aged or elderly women, so I suppose my mother thought I would be safe.  I would like to think she thought I was safe, at least.  After breakfast, I made my daily rounds, stopping first at the home of a neighbor who owned a little fox terrier named Brownie, and I took great delight in feeding Brownie his breakfast.  When I left Brownie's house, my next stop was at the home of the neighbor lady who sold cream.  She fed me cookies and let me talk until she lost patience and sent me on my way. My last stop was at the house of Mrs. Greenleaf, a widow whose grown son lived with her.

 Mrs. Greenleaf's house was right next to mine, and her kitchen window looked directly into my bedroom.  Because her house was so close, I visited her often.  I liked Mrs. Greenleaf, and I believed she liked me, for she let me sit on her lap and cuddle.  When I was four, I figured that anyone who let me sit on her lap and cuddle liked me.  Why would I not believe that?  After all, I had seen other little girls sitting on laps and cuddling, and in my young mind, people liked those little girls, so why would Mrs. Greenleaf let me cuddle with her if she didn’t like me?  The fact that my mother refused to let me sit with her and snuggle caused me to doubt that my mother liked me, and I would not have asked my father because I was afraid of him.  So I regarded Mrs. Greenleaf as a precious source of affection and spent a lot of time at her house.  I did not tell my mother about this aspect of my relationship with Mrs. Greenleaf; what I told my mother was that the neighbor fed me cookies and let me talk to her.  Since I was a very talkative little girl, I suspect my mother was relieved that she did not have to listen to me.

  Although I did not understand it at the time, Mrs. Greenleaf exacted a payment for allowing me to sit on her lap.  Each time I snuggled on her lap and put my arms around her, she put her hand inside my panties and fondled me.   Even at age four, I knew that something was happening to me that should not happen, but I didn't understand it.  I was confused because nobody else touched me in that place and in that way.  Because she let me sit on her lap, I thought she liked me.  Yet I didn't think that people who liked other people would put their hands where she did.

I continued to visit the neighbor lady, hungry for the closeness and affection I did not have at home, hoping each time I could snuggle with her and she would not bother me with her hands.  But each time she did.  She never talked about what she was doing to me, and I never did, either.  I didn't talk to anyone about it.  I wanted to tell my mother, but I was afraid she would be angry with me and spank me.  I knew that what happened when I visited the neighbor was bad because my mother and the Sunday school teachers had taught me that good little girls never let anyone see their underpants.  No, that part of my anatomy was off limits for all purposes except the most necessary and basic, but Mrs. Greenleaf did not seem to understand that.  So I knew that what happened when I cuddled with her was bad, and I also knew I was bad because I visited her and let her touch me in that place.  It did not occur to me that Mrs. Greenleaf was bad.

   One day my visits to Mrs. Greenleaf came to an abrupt stop.  When I look back, now, I associate that day so long ago with Good Friday.  In the church I attend, the Episcopal Church, on Good Friday the cross on the altar is covered with a piece of purple or black gauzy fabric that allows me to see the shape of the cross  beneath but prevents me from seeing the cross itself.  Each time I attend the Good Friday service, I feel a sense of deep loss, as if the light in my spirit has been dimmed, and I also feel a sense of panic, as if I have been separated from part of myself.  On Good Friday in the Church, however, I know Easter will come in two days, and I know that what I have lost will be returned to me.

    That last day I visited Mrs. Greenleaf was a Good Friday because a veil descended upon my heart and separated me from the light in my soul.  After Mrs. Greenleaf and her son had grabbed me and had held me down on the pull-out ironing board in her kitchen and she had pulled my panties down enough so her son could see my nakedness, she turned on the hot water tap in the kitchen sink, pulled my corduroy overalls and underpants all the way off, and then the two held the exposed part of me under the scalding hot water.

 I remember screaming and struggling to get away from them.  I remember tugging at the straps of my overalls, trying frantically to make them stay up.  And I remember Mrs. Greenleaf’s words as I tried to get out the back door: “I have magical powers, and even when you can’t see me looking into your bedroom, I can still see you and watch everything you do.  I can tell by watching you if you are telling anyone about what I did to you, and if you tell, I’ll find you and kill you dead. And what will your parents do with a dead little girl?  They won’t want you at all, and they will put you in a box and bury you in the ground.  So you had better not tell anyone!”  And I didn’t tell!  Not until I was age forty and remembered the incident when I had a flashback.

I was not badly damaged physically that day, but there was other damage.  I ran from Mrs. Greenleaf’s house and managed to sneak into my house and reach my bedroom without my mother knowing.  I remember that as I hid in the darkness beneath my bed, a fog enshrouded me and separated me from the rest of the world. The world beyond my hiding place was unchanged, but a veil of fog prevented me from seeing that.  In addition, I knew that I was bad and would never be a good girl again.  What I had lost that day would never be returned to me.  I experienced the Good Friday darkness and sorrow, but no Easter joy or hope of joy awaited me.

 Now, with my adult mind, I can look back to my childhood and trace the effects of that day in Mrs. Greenleaf’s kitchen.  The foggy veil that came between me and the joy, the dancing, and the light in my life has never completely dropped away, although after seventy-some years and after a lot of hard work in therapy I can say that at times the fog clears enough to allow me to glimpse the full light of Easter just long enough to know it exists.  I am patient.  I have a sense of my young life before the darkness and before the veil descended, and that sense sustains me and reminds me to stay on my path as I continue my journey toward healing. 
 

What Good Are Flashbacks?

If you have ever had a flashback, you probably wonder how flashbacks could possibly serve a good purpose.  If you have never had a flashback, count your blessings!  If you wonder what a flashback is, here is my definition of the term based on my own experience:  A flashback is the energy left by a horrible, traumatizing past event.  This energy has been trapped in the victim’s mind.  The energy, along with the memory of the past event, suddenly and randomly thrusts itself into the present in the form of a horrendous emotional sucker punch! The past becomes the present, and there is no future.  This is a flashback.  A person experiencing a flashback is momentarily trapped in that time warp, existing in the present but reliving the horror of the past event.

The above information is based, as I mentioned, on my own experience and on reading I have done in an attempt to understand my personal experience.  I have experienced my share of flashbacks, although they have been blessedly infrequent.  They have, however, been frightening enough to have caused me to seek help.  The flashback that drove me to seek therapy in 2009 took place while I was riding public transportation.  I had just left a person who presented herself as a spiritual advisor.  She had asked me a lot of questions, firing one right after another, and when I left her office, my mind was foggy and I was disoriented.  The fog continued as I rode the bus to the light rail station and caught the train.  Then, as I was sitting on the train and heading to downtown Portland, the past thrust itself into my present with a force that sent me mentally reeling!

Suddenly I was nine years old, crouched on the kitchen floor, and my father was roaring at me.  I tried to cover my ears, but when he saw me do that, he hit me.  Thus, I had no protection from the violence of his ranting.  And then he did the unthinkable:  To punish me, he picked my favorite cat up by the tail and bashed her against the kitchen wall.  I left--I simply left.  My nine-year-old self was there on that kitchen floor, but I wasn't in that self.  Later, after my father had left the room, I came back into my body and held my cat.  She was not permanently damaged, but I was.  I know that now.

The flashback had passed by the time I reached my destination, and when I got off the train, I was a bit disoriented but otherwise okay. I resolved that day to find a skilled therapist who could help me undo trauma damage.

Why did I have this flashback more than sixty years after the event? Maybe the flashback was triggered by the tone in which the woman questioned me or by the rhythm of the questions.  Maybe the rapid firing of her questions and the tone of her voice collided with the long-buried memory of my father’s rapidly-fired curses and caused the flashback.  I don't know.  Whatever the process, I was unaware of it until the sudden, explosive flashback. As a result, I searched for and found a therapist, but she and I were not a good match.  Luckily, I don’t give up easily. The person I now see is an excellent match, and I have new hope for a future without the distressing symptoms of PTSD.

So--what good purpose do flashbacks serve?  If they are as horrible as I have described them, how can they do any good at all?  If you have a flashback and recognize it as a flashback, then the good the flashback serves is to let you know you need help!  A flashback is a symptom, a signal to you that you need to find a therapist who is trained and experienced in helping people who have been traumatized.  Furthermore, modern approaches to trauma therapy have the advantage of helping a person in a shorter time than some therapies of  previous eras.  Modern therapies such as EMDR ( http://www.emdr.com/), Lifespan Integration (http://www.lifespanintegration.com/), and ego state therapy (http://www.egostatetherapy.com/) can provide the possibility of relief from PTSD symptoms in a much shorter time than some of the older therapies of the past.

We are lucky today to be living in an era when brain research has progressed to the point where scientists can understand the physical damage that trauma does to the brain and mental health specialists can design therapies that heal this damage.  If you experience flashbacks, please take the next step and find a therapist who can help you undo the damage of past trauma.  Your effort will pay off! 

For more authoritative information on flashbacks, here is a link to follow:  http://www.tag-uk.net/ra-article7.html  As I have said on my website (http://www.jfairgrieve.com/) and on this blog, I am not a mental health professional; I am just a writer who is trying to undo the damage of past abuse and alleviate my PTSD so I can spend my last years of life in relative freedom from flashbacks and other distressing symptoms.  I’m getting there, and you can, too!

Complex PTSD: From the Inside Looking Out

I check my stats page for this blog every day, and when I check, I look to see which articles seem to be most popular.  So far, the article titled “Complex PTSD: Does It Exist?” has been read more times than the others.  When I wrote the article, I didn’t expect it to be this popular.  In fact, I wasn’t sure that anyone would want to read it because it struck me as being somewhat dry and academic.  However, now I know that the topic appeals to you, my readers, and I will do my best to address the topic more often.  In the meantime, here are two articles I found recently which you might find helpful:
 
• http://knowledgex.camh.net/amhspecialists/specialized_treatment/trauma_treatment/first_stage_trauma/FirstStageTT_ch6/Pages/criteria_complex_ptsd.aspx
• http://drkathleenyoung.wordpress.com/2010/03/10/complex-ptsd/

If you read the two articles listed above, you will have a good idea as to the hallmarks of C-PTSD.  You will, at least, have a good idea as to the nature of C-PTSD as the practitioners and researchers see it.  You may not, however, get much of an idea from the articles as to how the problem appears to those who live with the disorder every day—those of us who find ourselves in a C-PTSD cage and are trying to get out and join the rest of the world.

Each person who battles C-PTSD experiences the disorder differently because each person is uniquely different from any other person.  Thus, when you read my description of my experience in the articles I’ve written for this blog, it’s important to remember that my experience of C-PTSD is unique to me.  There are, though, certain common threads that run through the tapestry of each person’s experience of the disorder.

One such thread is the presence of typical PTSD symptoms—flashbacks, dissociative episodes, numbing of emotions, etc.  The presence of these symptoms has interfered with my life to the point where I have long known I needed and wanted to do something to alleviate them.  That’s the main reason why I am presently in therapy, and it’s the main reason why I have attempted to get help in the past.  At present, I can say that I have actually tamed the symptoms to the point where they don’t bother me every day, and I can ride public transportation without being knocked off kilter by the symptoms.  Possibly, if I had the “non-C” PTSD, I would be finished with therapy by now.  I would be thrilled if I were ready to leave therapy because therapy is hard work that takes a lot of my time and thought.  That time, however, has not yet arrived.  I know it will arrive someday, but it is not here yet.

The problem is that C-PTSD is, as the name says, “complex.”  If my parents had wanted me, had been understanding and nurturing and had listened to me with empathy when I was a child, and if I had grown to be a mature adult with all the attributes of an emotionally mature adult and had been raped one night when I was in the wrong place at the wrong time, then very possibly I would have been diagnosed with PTSD.  I probably could have finished therapy a long time ago because I would have had sufficient ego strength to go through a course of EMDR or one of the other therapies found effective for healing PTSD.  I don’t know this for certain, but it’s likely.
 
In my case, though, the factors mentioned above did not apply to me.  I was not wanted, was not understood, was not given the parental attention I needed, was not treated with respect, and was sexually abused and abused in other ways.  When I reached the age of adulthood, I did not have the ego strength I needed to be an effective and mature adult.  And then I married a man who continued the treatment my parents gave me.  So over a long period of time, forty-two years in my case, I endured the sort of treatment that leads to C-PTSD and thought my life was normal, that every woman endured what I endured and that there was no alternative. The threads of prolonged exposure to abuse and neglect run through my tapestry as they run through the tapestries of most others who are trapped in C-PTSD.  The material from which the threads in my tapestry are spun may not be identical to that of other people who have C-PTSD, but the basic threads themselves are present.
 
So what, in my opinion, is the most telling factor, the factor that brings me up short and causes me to recognize and acknowledge the C-PTSD elephant in my own living room?  It’s the seemingly interminable nature of the healing process.  Like Sisyphus, I roll the stone almost to the top and think, “Success!  I’m there!” only to stand with mouth agape in amazement as I watch the stone roll back down and wait for me to roll it uphill again.  I manage to reduce the intensity of my PTSD symptoms, for example, only to discover in the process that I have some developmental gap that I need to investigate, understand, and fill if I am to truly enjoy relief from my symptoms. The process doesn’t seem to end, and that fact tells me that I’m dealing with C-PTSD and not the “non-C” PTSD.
  
If the process of breaking out of the C-PTSD cage seems so interminable and is so discouraging, why do I continue trying?  I continue because as I work in therapy, the bars are beginning to become less rigid and more flexible.  For example, I can sit on a bus calmly and without dissociating now when somebody gets on, tries to avoid paying the fare, and then argues loudly with the driver.  I may become irritated at the delay and the fact that somebody is so crass as to attempt to bully the driver into letting him ride free, but I don’t let the voices raised in anger and the menacing or threatening demeanor of the bully allow PTSD symptoms to take over my mind as I would have done a year ago.  My present response to a situation that in the past would have laid me low for the better part of a day tells me that slowly the cage bars are weakening and freedom is possible.  The little signs of progress comprise the carrot on the stick that causes me to plod along toward my goal, in other words.

What would I suggest a person have available to aid in his or her escape from the cage of C-PTSD?  Here is my list of necessary equipment:• A realistic VISION of what life may be like without the present constraints of C-PTSD;
• The necessary RELATIONSHIP with a therapist who specializes in trauma work;
• The MOTIVATION to do the job;
• COMMITMENT to one’s self and to one’s goal;
• A RECOGNITION of one’s progress, no matter how tiny the increment;
• The HOPE that springs from recognizing progress;
• A sense of HUMOR to help get one’s perspective back when times are bleakest;
• The FAITH in the process needed to keep plodding along no matter what!
 
The above is my list.  You will have your own list, no doubt, but maybe my list will remind you of something you forgot to put on your list.  And my list above may not contain everything I need, but it does contain the equipment most important to me right now. 

To conclude, I’m no learned expert on C-PTSD.  I’m not a trained mental health professional—I have a graduate degree in adult education and a graduate degree in rhetoric, neither of which qualifies me as an expert on C-PTSD.  I do, however, have something many of the experts may lack, a diagnosis of C-PTSD, and that diagnosis places me on the inside of the cage looking out.  I hope that whatever I say to you as I write “from the inside out” is useful and inspiring and facilitates your rending the bars of your cage and making your way to freedom. 

Peering Into the Pit

 There comes a moment in therapy, if a person stays with the process long enough and works hard enough, when that person can finally see the bottom of the pit, that place from which so many of one’s beliefs and feelings about one’s self have originated.  This is the place where I am in therapy right now.  It’s not a place where I want to be, but it’s where I am, and I know innately that my task is to make the most of this moment and this place.  For the work I do now will, I feel, be the foundation upon which I shape new and enlightened beliefs and feelings about myself.  That’s what I visualize the result of my efforts will be. Peering into the pit, then, is not only important, but it is essential to the future I want to build for myself.   

Again, I think of little Inger (Hans Christian Andersen's "The Girl Who Trod On A Loaf") and what happened to her when she selfishly and thoughtlessly trod on the loaf of bread in order to keep her shoes from getting dirty.  And there she was, suddenly at the bottom of the pit, dwelling amongst the snakes, toads, spiders and all the other monstrous creatures of her Hell.  Well, the difference right now between my situation and that of Inger’s is that I’m not actually IN the pit—I’m looking into it, but I’m not condemned to live in it the rest of my life.  Of that I am certain.  Inger did not have that certainty.  As far as she knew, she was in her pit until the end of time, and she had no choice in the matter.  Of our two situations, mine and Inger’s, I much prefer my own situation because I know that through my own efforts and with the support of my therapist, I can liberate myself.  That thought gives me hope, a hope that Inger did not have. 
  
So, now that I can see what lies at the bottom of the pit, what am I going to do with the information?  Well, I’ll no doubt spend a period of time recovering from what I have seen, from the horrors. For one thing, what I have seen at the bottom of the pit makes me angry!  How could grown adults have done what they did to me, a helpless infant and later a helpless child?  Their job was to help me be all I could be, to help me fulfill the God-given promise that dwelled within me at my birth!  Instead, they looked at me as a mirror in which they saw their own twisted images of themselves, and they tried to shape me to be like they were.  What they succeeded in doing was to shape my perceptions of myself, but they did not succeed in shaping me to BE what they were.  There is a difference, and I know that now.  My job is to erase the traces of their efforts, their twistedness, and to fill the mirror with my own image, a reflection of my own truth. 
  
After I have recovered sufficiently from the experience of peering into the bottom of the pit and understand the implications of my discovery, I will find a place to store the information, to quarantine it, where it will do no harm and will then begin the process of knowing and accepting reality, at least reality as I know reality.  Then I suppose I will be able to start the process of substituting reality for unreality—new beliefs for old beliefs.  Upon doing that, I will be starting to actually reshape myself.  Not that I haven’t already been working on that task for years. 

With the new understanding I have, however, I should be able to work more efficiently at the task.  Since I'm seventy-three years old, I hope the task doesn’t take longer than I have life to live, but if it does, at least I’ll die experiencing the process of my task.  It would be worse to die without experiencing that process, for in the process alone lie some of the rewards that go along with a new, untwisted and more realistic concept of self.  

The steps I’ve outlined above sound nice and neat and clearly sequential, I know, but I also know that as I move from one step to the next, the beginning and ending of each step will not necessarily be well marked.  That’s the way of this process.  It’s messy! Steps in the therapy process are not usually well defined, at least not for me.  Maybe for some people they are, but not for me.  Why is that?  For one thing, like other people, probably, I process on various levels.  While an issue may be taken care of on one level, that same issue may still be in process on another level and another level and another level . . .  

In my experience, I’ll think I’ve dealt with something and brought the matter to closure only to discover later that the same issue in a slightly different form needs to be worked on in another context or on another level.  How many levels are there?? 
  
I’ve been asking that question for a long time and still can’t answer it.  Wish I could.  That information might help anyone who is thinking about beginning the process.  It’s always nice to know the ins and outs of a task and how long it will take before one begins, but with therapy, that information is simply not available.  A person must, as I did, just begin and hope someday to see the end.  In my case, I hope to finish while I’m living so I can enjoy the result for a while before my life is over. 
  
On the other hand, as I said, I would much rather die in the process after having started it than not start it at all.  Of course, for me right now, that’s not a consideration because I am already in the process.  For you, though, it might be a consideration.  I do not regret having started the process, and I do not regret embarking on this stage of the process at age seventy-three.  Maybe those words will help you if you are trying to decide whether therapy is worth your time and effort.  I know it is, but that’s just what I know.  However, I pray that you may know it, too. 

“I’m Out of Here!”

Have you ever been tempted to say this when you have thought about all the hard work and money you put into therapy?  I have.  And I have actually quit therapy many times for one reason or the other, sometimes because my therapist and I were a bad match and I just didn’t seem to be getting anywhere.  At other times, I’ve quit because I’ve had to relocate.  Twice I’ve quit because a therapist has been abusive toward me.  One therapist slapped me because I wouldn’t stop crying, and another therapist wanted me to help her heal.  So, yes, I have thought more than a few times, “I’m out of here.” 

Doing work to heal Complex PTSD is not easy for therapist or client.  For one thing, it’s not possible, really, for a therapist to do what an orthopedic surgeon can do to nail down the cause for a problem.  An orthopedic surgeon can take x-rays or do other imaging tests to see for herself or himself what the inside of a knee looks like and then make an accurate diagnosis that will lead to a “cure.”  For the most part, science has not reached that point where issues of the mind are concerned.  It’s up to the client to thrash around in his or her psyche and present the information the therapist needs in order to help the client heal.  Where an orthopedic surgeon can make a diagnosis in one or two visits and then take measures to cure the problem, this is not usually the case with mental health issues, and this is especially not the case with Complex PTSD.
   
The therapist I have been seeing for almost three years specializes in helping people who have been dealing with the fallout from traumas incurred over many years.  She has worked so hard to understand me and to understand what my inner life must be like so that she can know how to help me.  I appreciate her efforts in this more than she can know.  Since most of my life people have made little or no effort to understand how I experience life, the fact that she cares enough to try helps motivate me to try.  And because she is so dedicated to helping me, I have helped myself. 
  
For me, my therapist’s dedication is essential to my healing.  For the most part, I have done the work of healing myself.  To a large extent, for instance, I have successfully toned down the magnitude of my symptoms—the flashbacks, space-outs, numbing, and the other manifestations of trauma damage that have plagued me daily.  I did this as I worked on my own with Ego State Therapy.  If my therapist had not expressed her faith in me and my ability to heal myself, I would not have been motivated to do the work.  That’s a fact.  Without the feedback and the support from my therapist, I would long ago have said, “I’m out of here!”  And if I had done that, I would still be struggling with intense PTSD symptoms every day. 

There is nothing like success to keep a person motivated.  Each tiny bit of success I have experienced in therapy has led to the next tiny bit of success, and those bits have added up over the years to a big improvement in the quality of my life.  When I entered therapy three years ago, my goal was to heal from my trauma damage and to improve the quality of my life so that I could enjoy these final years.  I’ve since revised my goal so that it is more realistic.  Now I simply want to tone down my symptoms, heal as I can heal, and experience more peace in these last years.  This revision is realistic.  I no longer expect to be completely healed, but I expect to be engaged in the process of healing for the rest of my life.  If I am engaged in the healing process, I can’t lose! 
  
Even now, though, I am sometimes tempted to say, “I’m out of here!”  Therapy is just plain old hard work!  And sometimes, when I don’t feel that my efforts are getting me anywhere, I am tempted to quit.  But I don’t.  I just keep slogging along, and then eventually I have an insight that leads to a healing moment, and I’m back on track.
 
If you are in a therapy situation in which you are making progress, the longer you stay with it, the more progress you make.  Your reward will be a more enjoyable rest-of-your-life!  So cherish the healing process and stick with it—one healing moment at a time.  Namaste.  Blessings.  Jean

Complex PTSD: Does It Exist?

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 2012.