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Posts Tagged ‘trauma techniques’

I talked with Mama Bear about my “writing down a flashback” experiment and she pointed out a few things to me that I want to pass on.

First, when I mentioned to her that I did not record any emotions, just a bare description of the sensations that I was experiencing, she said that she thought that factor was a key component.

Second, starting a few days earlier, I had begun working on just writing down the thoughts/experiences/feelings of parts in an attempt to unburden my mind and give myself a place to contain what I otherwise was experiencing as chaos in my head. Once again, I did not engage or analyze what I was writing down, I just recorded. This previous experience probably was essential practice that allowed me to be successful in a flashback situation.

Third, Mama Bear believes this technique requires being able to approach the experience with “compassionate curiosity.” Now, that is a state that I all too often fall short of while I am under stress, but over the weekend I reached a conclusion that I need to just deal with myself exactly where I am, not where I think that I should be and not where I think someone else thinks that I should be. I think that shift is what allowed me to go into the writing with a mindset that was much closer to “compassionate curiosity” than I can normally manage.

All of that said, she agrees with me that the success basically boils down to the fact that I managed to use my brain in ways that were incompatible with trauma thinking. I disengaged my poor overworked amygdala and called on higher brain functions.

Oh, and I very much hope that this makes sense, because my brain is barely functional right now, but I wanted to write sooner rather than later.

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I want to throw out something new that I tried yesterday that turned out to be a surprisingly effective way to deal with a flashback. In general, I can’t do much of anything to reduce the impact of a flashback- even if I do my best to ground myself and am madly telling myself over and over, “I am here in my living room in 2013 and no one else is in the house; I am safe,” the part of me that is experiencing the flashback still is fully in that experience. My most successful approach to date has been prevention. I try to reduce my over all level of hyperstimulation, which reduces the likelihood of triggering a flashback in the first place.

When yesterday’s flashback started, I was about a 2 minute drive away from home and I was able to forestall things by saying, “This has to wait until I get into the house, it is just too dangerous otherwise.” In those couple of minutes, I still had shadows of sensations, but not the full impact, so I was able to think a bit about how to take care of myself when I got into the house. I have recently started “dumping” emotions/thoughts/experiences that belong to parts/self states in a journal and it occurred to me to try the same approach with the flashback.

As soon as I walked in the door, I grabbed my journal and sat down, wrapping myself up in a blanket for security, and started to write down the sensations that I was experiencing. I immediately experienced a drop in the intensity of the sensations. I believe that what happened is that I transitioned from experiencing the memories to reporting them. I wrote a few things down, paused, and then I started to write something else down and very briefly, but very intensely experienced it and then it was gone. I had a couple of follow up thoughts that I also recorded and then realized that I was done. I closed the journal and put it away on a shelf. I wish that I had thought to pay attention to the time, but the whole thing couldn’t have taken more than 10 minutes, most likely it was no more than 5 minutes. While I was driving home and the whole process first started, my thought was, “Uh, oh, this isn’t material that I am familiar with, it could be a bad one,” so being able to spend the rest of my afternoon doing other things, rather than recovering from a flashback was both unexpected and a huge relief for me.

I can’t readily remember what happened during the most intense part, which is OK with me, because I know that it is written down and I can readily access that information. I know from experience that as soon as I read what I wrote, the details will come flooding back. The information isn’t lost, but it has been contained in a place where it isn’t interfering with my ability to have a life with my family. Most likely, I will remember it in therapy when it’s appropriate, but otherwise, it’s there in writing for me when I need it. Mama Bear and I have tried various imagery for containing memories between sessions to do just this, but I suspect that the added power of physically writing it down, closing the journal, closing the clasp on the journal, and finally placing the journal high up on a shelf that is out of the way is what has made this technique so much more successful.

I cannot remember ever hearing/reading about writing down the details of a flashback while the flashback is occurring. However I do know that during flashbacks, the amygdala goes into overdrive and suppresses the higher brain functions because it perceives your being in a life or death situation at that very moment, rather than that you are reliving a memory of a traumatic situation. I have heard it said that one of the goals of therapy is to engage the frontal cortex, which then allows for a fuller processing of the event and draws you out of simply reliving the trauma over and over. My state of mind changed so significantly when I started to write in the journal that I suspect that I must have done something along those lines. I believe that there were several important components here: 1) I transitioned from being enveloped in the experience to thinking in a more linear fashion, 2) I pulled myself out of a helpless state and actively started to do something that might help myself, 3) I switched from only thinking in terms of sensations and emotions to using language to describe the what I was experiencing, and 4) the act of writing is a fairly complicated one that requires a certain level of concentration. All of these factors require higher brain functions.

I have no idea if writing down what is happening in a flashback would help anyone else, but I wanted to mention the idea, just in case it might spark something that would be useful to someone. I have to say that the next time I feel myself being drawn into a flashback state, I’m going to give it another try. Even if it only works 25% of the time, significantly curtailing reliving a trauma 25% of the time is a big step forward for me!

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I know that I frequently go pretty far into dissociative states in session, but I don’t think that I appreciated just how far until my last session. And frankly, I had thought that I sort of understood what was happening when I dissociated, but now I realize that I don’t understand it at all, and I am confused about what is going on…

Mama Bear proposed in this past session that we do a process similar to “mapping” my parts. I was so astonished to hear her proposal that I lost a lot of the details about exactly what she was proposing. Up until now, if anything, she has worked to de-emphasize my parts and pushed me to focus on grounding into the me of here and now. But it seems that she learned something at the workshop on treating Complex PTSD that she went to last week that has her re-evaluating her approach. (Plus, I am finally doing a better job of grounding myself in the now.) I pointed out that what she was talking about was a large shift and was surprising to me, so we needed to talk about a few related issues. At some point, I was talking from the point of view of a dissociated part, when Mama Bear asked, “What does your adult think about that?” She saw me start to struggle, “Is your adult around?” “Yes.” And the adult part of me was right there and I knew exactly what I would say, but I could not get the words to come out of my mouth. It was like the adult me was completely aware and engaged, but had no control over my ability to speak. And because I was so aware of how engaged that me was, I had no idea that that part couldn’t talk. So by the time I had “pulled” myself to a place where my adult could actually speak, it was like there was a thick gauze between me and what we had been talking about and I just couldn’t remember it. “Don’t push it… If you can’t remember it, it is OK..” Mama Bear reassured me, but it was frustrating, because I had known what I wanted to say but left it behind a dissociative barrier when “I” came out to speak.

About 2/3s of the way through the session, I found myself struggling to talk with Mama Bear about the effects of recognizing that “being taken behind the dumpsters” by some of the neighborhood boys was a big deal. “Can I ask you a favor? Can you please come and sit over here?” I asked, pointing to a spot near to the love seat that I was on. “Of course I will. You can ask me to sit anywhere you like: here, in that chair, over by the window, in the corner facing away. Whatever will be most helpful to you.”

She moved a chair to the spot that I indicated which is close enough for me to reach out and hold her hand, but not so close as to feel intrusive. Every time I ask her to move closer and she does, I feel the tension drain out of my body, because it feels so much safer having someone I trust right there. It’s like the parts of me that are too young to take in all of the words can take in the fact that someone who loves me is right at hand. I don’t ask her to move closer as frequently as some of me would like, because it guarantees that I will go into a child state. Then again, the times that I need to ask her to come closer are the times when the child states are very present anyways…

But this time, I didn’t think that I was much at risk of going into a completely traumatized child state, and I could tell how much that part of me needed someone right there, right beside me, right then. At some point, I took Mama Bear’s hand, and it was like for that child part, Mama Bear was a life line to here and now and safety. I don’t remember much of what we talked about until I asked, “It wasn’t my fault that it happened, was it?” She paused and asked me, “What answer does your adult have to that question?” I struggled to find the part of me who could answer and finally came up with, “No, it wasn’t my fault that I was vulnerable to being hurt.”

At that point, it was time to start transitioning back to being ready to go out into the world. Mama Bear could see how dissociated I was, so she held my hands on her open hands and told me to look at them. She reminded me that she is an adult and my hands are the same size as hers, so I can see that I am an adult too. And I sat there, breathing, and working at making those hands feel like they belonged to me for a several minutes. And as I started to ground, I suddenly realized that it wasn’t my “adult” who had answered whether it was my fault, because I was only then starting to feel like the adult me could connect through to the world.

“That wasn’t my adult who answered you.”

“OK, well, you have a helper part.”

I looked at my hands again, “I am starting to feel like my hands belong to me. That is a good sign, because they certainly didn’t before.”

She looked at me and commented, “Yes, you are very good at dissociating.”

So, now I am left confused about just what is going on? I had been thinking that the me that I am aware from is the “adult” me, but after realizing that the adult me had been nowhere around at all for part of the session, I’m not so sure. But there is always this common thread of awareness weaving everything together that I call “me.” I am always aware while things are happening, although I sometimes am fuzzy on exactly what happened afterwards. I may lose the details, but I never lose time. I’m not panicked about not understanding what is going on, but it certainly is disconcerting to realize just how much I don’t understand how my mind works.

I suppose that as we explore who the different parts are, I will start to develop a better understanding of exactly what it is that is going on inside of me.

How did those of you with parts develop an understanding of them? Are you as frustrated as I am by the limitations of words to describe an experience that pretty much defies words? I find myself using words and phrases that other people use to describe dissociation, because they are the only words that I can find, but I can’t help but wonder whether we are using the same words to describe substantially different experiences. I talk with Mama Bear about what is going on and she seems to understand, but how much can someone understand who doesn’t do a significant amount of dissociating? Just like I can’t pretend that I understand what it would be like to have fully developed alters, the way that people with DID do. How have you all found ways to bridge those gaps in understanding?

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I figured out something today that is likely to be obvious to everyone else, but it most certainly wasn’t to me. I have been going about grounding all wrong. Well maybe not all wrong, but I was just plain missing the first step.

Grounding is a primary tool while doing trauma work. What it means is that when I start to experience a split in consciousness, I pay concrete attention with multiple senses to my immediate environment in a structured manner, trying to ground myself in the here and now. When I first started to learn to do it, Mama Bear would say, “Name 3 things that you can see.” I’d look around and name them, sometimes with great difficulty. “Name 3 things that you can hear.” Sometimes I would have to think a bit more about that one, just because her office is generally quiet. “Name 3 things that you can feel.” This one often was the most useful to me, because I am naturally oriented to this sense. We would then go back around and do the cycle however many times it took, until I was more completely in the room. At home, I would do variations on this, “Name 3 things that are blue. Name three things that are round. Name three things that in the room that I made.”

I fairly quickly figured out that orienting to the things that I had made with my own hands was one of the most effective grounding tools. I would walk around the house, and I would talk through the creative process for whatever piece I was looking at. I would touch it and closely examine it. Anything to get me moving and thinking in the here and now in a way that was pleasant for me to be engaged in. I also suspect that part of the reason this technique was so useful was because I was connecting to something that happened in a time between when the abuse happened and now. It just helped to reinforce that the abuse was in the past, making it safer for me to more fully be in the now.

I scented it with essential lavender oil and took to carrying around some soft silk and merino yarn that I had spun, so I could examine the colors and feel how the ball would compress when it was squeezed and how very soft the fiber was. I often wore a silk scarf that I had dyed and would run my hands over it or rub it against my cheek at the first signs that I was starting to dissociate.

Sometimes I needed to ground myself because I had been triggered into a particular memory. Other times I was triggered into a distressed feeling state. Other times it was more generally that I was not “fully in the room” for some reason.

It was not at all easy for me to learn to do this. To me, it feels like I am trying to force myself out of one time stream into another and it can involve an uncomfortable pulling sensation. In general, I simply did not have full success, and I would be discouraged by only having partial success on the first try. One of the lessons in learning meditation also helped me a great deal with this. “It is OK to not succeed. It gives me another chance to practice. Just refocus and try again.” I also learned that a partial success added to 3 other partial successes could get me fairly well grounded.

And then I discovered that if I allowed myself to really sit there and fully feel myself sitting there, heavy from the gravity, I also felt like some part of me was sinking into the earth. And I could feel the solidity and realness of the earth. It was an excellent way for me to counteract the spacey, not fully in the room feeling that I was frequently getting at the time.

So, I learned all of these wonderful, useful tools and they have helped me a great deal, but there still are times when they just don’t seem to work or they barely worked. And I had a feeling that I was doing something “wrong” but that didn’t make sense, what could I possibly be doing wrong with grounding?!? It’s so straightforward and that’s part of its beauty, because I need something uncomplicated that I can do when I can hardly think straight.

Well, tonight I accidentally stumbled across what I have been doing wrong. Often, when I try to ground, I am strongly engaged in a child state. It may or may not be obvious from the outside, but my internal experience is more through that lens than through my “normal” self. And very often, when this is the case, I start to do the grounding work from inside that child state. By doing that, I am paying attention to the way that part experiences something and in some ways drawing myself more into that child part. So I might lose the trauma memory that was plaguing me, but I would still be in a dissociated state.

I was missing the essential first step. At the very beginning of the grounding exercise, I need to find at least a corner of me and make sure that I am doing the exercise from me, not a child part.

I discovered this effect this evening completely by accident and while I wasn’t trying to do a grounding exercise per say. I was fighting another migraine and there is something about migraines that seems to erode the safeguards that I normally have up to keep me from slipping into a dissociative state. So I was somewhat feeling the presence of a child part, but I wasn’t in a distressed state, other than generally not feeling great. I went to get some nuts to eat, hoping that the protein might help with the migraine and I started to really pay attention to what I was eating. And I realized that I was experiencing the tastes and textures of the nuts through the child part and it was strengthening my connection to that child part. I stopped, because that was not what I wanted to do, felt for myself and then paid attention to eating the nuts. As I did this, I felt more grounded and concrete in the room. Out of curiosity, I tried eating more through the child part again, and once again it started to strengthen that connection. When I went back to making sure that I was experiencing eating the nuts through myself and stayed that way until I was done, I was able to help myself feel more concrete and solid than I had felt for the previous hour or two. It really was illuminating for me to feel the contrast between strengthening the two different states and how I was able to influence that process.

I am hoping that this might help me to be more fully successful when I work on grounding. And in retrospect it seems so obvious to me: of course I need to be working from the me that I am trying to ground into, not a dissociated part! How could I have missed that for the last year or so? I don’t know, but I’m glad that I ate those nuts tonight and that I was in a place where I could observe what I was experiencing.

Does anyone have any unusual grounding techniques that they have figured out? Or have you figured out ways to make grounding an easier process?

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Human beings are hard wired to need touch.  In fact, the need is so basic that infants will “fail to thrive” if they are not touched and held in a caring way, even if otherwise they have all of their needs met.

Over the last seven years, I have watched my daughter soak up all of the physical contact that her father and I have given to her and I see just how core touch continues to be to her well being and connection to us, her primary caregivers.  I never had any idea just how many different messages a hug can convey, without needing to say a single word.  Of course, “I love you” and “You are the most wonderful daughter in the world” are givens, as is “You got hurt and I want to comfort you.”  But a high five is a physical way of saying, “Good job!”  Brushing her hair in the morning because she prefers that I do it says, “I value our contact so much that I am willing to stop by bustling about, in order to play with your beautiful hair.”  Holding her while she cries bitter tears of frustration after fighting with a friend says, “I’m here for you” as well as helping her to learn emotional self regulation.  Holding her hand while we cross the street says, “Your safety is very important to me.”  I could go on and on, but the point is that touch can and should be used to help a child develop, create connections, and flourish.  I believe that touch is essential to forming a healthy attachment with caregivers, which then provides a solid foundation to build all later relationships upon.

When a child is sexually abused, especially by someone who should instead be providing the safe, nurturing type of touch, it turns everything around.  Touch becomes dangerous, even terrifying, a source of shame, and all too often painful.

I cannot state strongly enough how angry it makes me that something that is so central to our human nature, something that can be such a powerful source of good for a child, is perverted and turned against children instead.  Because we so need touch and we are programmed to use it to help us learn our value, it seems that we are almost defenseless when it is used against us while we are young and so we learn the opposite of what we were meant to learn.  “I cannot trust anyone.”  “I will be harmed by those who are supposed to love and protect me.”  “I am worthless.”  “I am bad.”  “I was made to be used.”  “I will never be safe.”

And those messages are then carried with us into adulthood and instead of a solid foundation, we are trying to build our relationships on quicksand.

Touch does not diminish in importance as we grow into adults; we still use it to cement our relationships.  We share hugs or handshakes with friends.  We are intimate with our partners in ways that we are with no one else, because it is a special type of relationship.  We go on to use it to help to raise our children.  Or at least that is the way that it is supposed to work, but when the meaning of touch has been perverted, it can no longer function in the manner that it was designed to.

I know that for me, there were many years when I “knew” that touch was supposed to be all of those good things, but the young parts inside of me would instantly be triggered into re-experiencing the terror of being abused when I was touched.  I wanted to be able to connect via a hug or snuggle or even touch on the arm and not have it turn into something terrible.  But part of the problem was that with every time that I was triggered, I strengthened the connection between touch and terror, until it built to a point where I didn’t want to be touched at all, even by the most trustworthy people in my life.  I would have been so grateful if I had been told that I would never have to touch anyone again, at the worst point.  And so it becomes a catch 22 situation: I try to touch, I get triggered, and it makes it more likely that I will be triggered again next time.  But if I never try to touch, then I can’t learn that anything good will come of touch and I will continue to be triggered.  Believe me, this is one of those things that you can talk about in therapy until you are blue in the face, and it won’t change much of anything, except that you now have a better understanding of why you are so messed up about touch.

So how does a person escape this trap?  Very, very carefully and all too often heartbreakingly slowly.  Some people use EMDR.  I tried the technique and had mixed results, although thinking back, I believe that my experience of touch began to transition around the time I gave EMDR a try.  Maybe it was the EMDR, maybe it was just stepping back and taking as much pressure off of myself in regards to touch as was possible, but something allowed me to start to engage in touch in the smallest ways.  And from there, it was a matter of making sure that I didn’t start to push myself too fast and trigger myself into terror states, but bit by bit I added elements of touch that were just a small step more challenging than the last.

I had to ask for an immense amount of patience from my husband and will always be grateful that he was both willing and able to stick with me through all of this.  And then as I experienced more and more success and connection via touch with the people I loved, I developed more confidence to take on more challenging types of touch.

It took me many, many years to get here, but I am happy to say that I went from being a very frightened young woman who was triggered into flashbacks when her husband simply touched her arm, to someone who revels in touch.  Yes, on rare occasions touch will still be triggering for me, after all I can never undo the fact that I was abused.  Despite this, I believe that I have finally been able to heal this part of me to the point where I actually am essentially who I was meant to be, if the abuse had never happened.  Because touch is so meaningful for me, I am not someone to touch others or allow myself to be touched casually, but that is due to my choice, it is not a restriction based on fear.  And with the people I most care for, it is now a source of comfort, nurturing, and even joy.  With my husband and daughter, I almost can’t get enough of it.  These days, I would feel profoundly deprived if the ability to touch was somehow taken from me.

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One of the things that I have struggled with over the years is experiencing myself as having solidity.  Not just being emotionally and psychologically solid, but actually physically having solid form.  At its worst, it is like I experience myself as a phantom.

A lot of that has been due to low level, habitual dissociation which created a disconnect between myself and my physical sensations.  With a lot of work, I have broken the habit of existing in the world on an everyday basis that way.  How is that done?  Basically by going around day after day saying to myself, “This is my skin, which surrounds my whole body.  I can feel my shirt touching the skin on my arm.  I can feel my weight in the chair.  I can feel the breeze on my face and it is cool.  My daughter’s cheek feels soft and smooth.”  By being mindful of what I was actually experiencing, I slowly demonstrated to myself that most of my physical sensations were either neutral or even pleasant.  And I thought that the problem was solved.

But it isn’t so simple, because while I learned to connect with the physical sensations related to my interfacing with the outer world, I forgot that about the internal sensations that we all feel.  What internal sensations?  Think of butterflies in the stomach, or suddenly feeling cold, or realizing that your jaw is clenched.  One of the things that can be done in trauma therapy involves tying together internal sensations and the emotions and thoughts that go along with them.  So, over the last several months, Mama Bear has been asking me, “What are you physically feeling in your body right now?”  At first when she asked me that question, it terrified me, because somatic flashbacks were always right under the surface, so she stopped asking the question until we got the hyperstimulation under control.

However, after she went to a week long work shop on Complex-PTSD, she started asking the question again.  I kept on drawing a blank, side stepping the question, and talking about something else, without even really noticing what I was doing.  (The mind is tricky that way!)  Finally, yesterday, when she asked me that question 4 or 5 times in the same session and I could only answer it once, it finally dawned on me that most of the time I am completely unable to recognize what is going on inside my body.  I could vaguely tell that I was feeling something, but I had no idea what the sensation was or even where it was located in my body.

The one time that I was able to identify the sensation was quite useful, because I realized that I felt like my throat was closing up on me, at a time when I was struggling to express feelings of anger at and betrayal by my mother.

I also realized that it is no wonder that I often feel like my body is an empty shell these days, if I can’t feel what is going on inside of it.  This is something that I need to pay attention to, because I have found that the more solid I feel, the more confidence I have while interacting with the world.  When you feel solid, you know that the world can bump you a bit, but you can still remain whole.

So on my drive home yesterday, I started to try to pay attention to my internal sensations.  Notice the word “try.”  I thought that it would surely be easier when I was in a neutral situation and not under any stress.  I suppose that it was marginally easier, but I was only able to identify the internal sensations in the vaguest way.  And to my surprise, I was only able to do it for a minute or two at a time, before I started to feel overwhelmed.  I can see that I am now in for a lot of practice at slowly learning to both identify and tolerate feeling what is going on inside.

So, now I am really curious…  What is it like for you when you try to pay attention to your internal sensations?  Are you aware of them most of the time?  Does it take a lot of concentration?  Are you basically blind to them, the way that I am?

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