October 15, 2010
Self-injury is a problem all too common for trauma survivors with dissociative identity disorder (DID / MPD) or borderline personality disorder (BPD). For that matter, self-injury (SI) is an issue for other populations of people as well. This discussion will focus more on the effects of trauma and abuse and how self-injury can be addressed effectively. However, because self-injury is actually a very complicated topic, this particular blog article will reach only a few of those layers.
In my years of working as a trauma therapist, I have noticed that many DID survivors self-injure when they are in emotional pain. They are hurting, their heart feels broken, they feel betrayed or abandoned, or they feel incredibly sad (but can’t cry). Turning to various forms of self-injury and self-harm sometimes helps to temporarily relieve their emotional pain. (Trauma survivors also self-injure when they believe they need to be punished, or when they are extremely anxious, or when they are feeling strong compulsions or hearing internal instructions, etc.)
One of the reasons self-injury works is because the brain cannot distinguish between a self-caused physical injury and any other type of physical injury and upon recognizing a body injury, the brain releases all the necessarily chemicals and hormones. Dopamine, serotonin, and neural structures are significant in this process. I’ll refer all the complicated medical explanations to others more qualified, but the point being is that the act of self-harm creates a reaction in the brain that allows the hurting person to feel a little more calm and numb.
In other words, when self-injuring, survivors are trying to feel better. They know they are in emotional distress, they recognize the emotional pain, and they know they are hurting. And they want to feel better, or at least to feel differently.
Self-injury can be a quick fix for these intense feelings. In that sense, self-injury is not a lot different from having a few shots of whiskey, or a shot of heroine, or a plateful of doughnuts, or a pound of chocolate. Many addictive behaviors are centered around finding a way to feel better when hurting.
Typically speaking, this has been a life-long issue. From even their youngest days, most dissociative trauma survivors were neglected or ignored when they were hurting. They were not comforted, and their pain was not acknowledged. Even as very young children, they were left alone with their pain and injuries. All too often, they were not properly tended to, they were not cared for, they were not hugged, they were not given medical aid. They were hurt – physically and emotionally – and they were left on their own to manage.
In my opinion, this lack of comfort and the years of neglect are some of the biggest crimes committed against young children. Neglect is as significant in causing harmful life-long effects as any direct trauma.
So, when working with trauma survivors who experienced significant pain and next-to-no comfort, a critical and crucial part of their healing process is to teach how to accept and create healthy and positive comfort.
Children who are injured in healthier environments are very much comforted by their mothers or fathers or other caregivers. Their hurts are recognized and acknowledged appropriately. These children are given hugs and gentle affectionate kisses. They get band-aids — sometimes they get the fancy special band-aids with Snoopy or Spiderman or pretty flowers on them! They are checked on repeatedly, they are allowed to sit close to their caregiver, they are given other little treats (such as stickers, or the chance to watch their favorite cartoon), etc. These injured children learn that positive forms of comfort can help them feel better.
Since traumatized dissociative survivors were typically not taught these ways of receiving comfort, this becomes an important treatment goal in their healing process. They need to know their wounds can be tended, that their hurts matter, that someone hears them, and that they can be treated gently during times of pain.
Tending to the hurts and the wounds often has to be modeled to dissociative trauma survivors. In many situations, this will be completely new experience for them, and the process of having their hurts be important, can be a profound experience.
As trauma survivors start to experience genuine comfort and caring from others (this may start first in the therapeutic office setting), these survivors will eventually learn to copy these same kinds of behaviors and apply them towards themselves and their other insiders.
Emotional pain is no different, and in some ways, addressing and comforting emotional hurts is even more important.
Teaching trauma survivors to sit with their emotions and to increase their ability to endure intense emotions is an essential part of the healing process. In early stages of therapy, most DID survivors can barely touch their feelings. In the later stages of the healing process, DID survivors can sit with their feelings, no matter how intense they feel them, and not turn to anything destructive or harmful.
In order to sit with those feelings, survivors need to learn what to do during those moments. They need to know and understand that they matter and that bringing more harm and pain to their selves and their bodies is not the answer. Learning how to comfort themselves – how to self-soothe, instead of self-injure – is a significant process in their healing.
Self-soothing means that the person is doing something that brings comfort in a helpful, positive way. Feeling better can become about comfort instead of numbing. Survivors can learn that they are worth being comforted, instead of being feeling unvalued and ignored.
Each time trauma survivors are comforted in their pain, instead of ignored or injured more because of their pain, they are experiencing a corrective emotional experience. Correcting the neglect by experiencing proper comfort, including self-soothing comforts, is incredibly significant in the healing process.
Comfort actually works much better than numbing, especially in the long run. Comfort allows for pain to heal. Numbing (or self-injury) means that the pain is just postponed until it comes back again.
Ways to Self-Soothe Include:
Self-soothing is unique to each person, just as any other preference is unique to each person. There are dozens and dozens of healthy options — explore a variety of different options to see what works best for you. Some ideas to try include:
- Listening to music that matches your mood – if you are feeling sad, listen to music that will help you express that sadness.
- Sing to yourself (even if this means making up your own songs, or singing sounds), or play musical instruments as a way of expressing your feelings.
- Wrap yourself up in your favorite comfy clothes or in a warm blanket and snuggle up somewhere safe, quiet, and protected.
- Hold or hug a pet, a stuffie, or a pillow.
- Sit close to someone safe. Lean against their shoulder, or find some way to have physical contact that is in no way sexualized or dangerous.
- Sip on your favorite tea, or any other gentle beverage, and treat yourself to a few simple snacks that are not heavy, but are tasty and nutritious.
- Rock in a rocking chair, or sit in a swing, and let the movement relax and calm you.
- Walk slowly or sit quietly in areas of nature that are beautiful and inspirational.
- Make your room, or your home feel particularly cozy – have nice smelling candles, or soft lighting, or bring out your favorite treasures to look at, sit by a calming fireplace (not for injury purposes! But yes, sitting by a warm fireplace can be very beautiful and calming). If you need to clean up an area first, that is ok, because it is important to be in an area that you can feel calm and quieted.
- Take a warm shower or a warm bath, using very nice smelling soaps and body washes. Dry off with your favorite most soft towels. The more you can make this a “spa-like” experience, the better.
- Bring in fresh flowers, or fresh greenery, or pretty leaves. Looking at something beautiful from nature, even while you are indoors, can be calming and soothing.
- Allow yourself to cry, uninterrupted, when the feelings come. Crying really is allowed, it really is ok, and it is a natural expression for pain. Use soft tissues, and don’t punish yourself for having real human emotions. Give yourself permission to feel, permission to heal, and permission to respond naturally to your pain. The more you can express your emotions in natural ways, the healthier you are.
Trauma survivors — you really can help yourself to feel better without bringing more pain and injury to yourself. The key is to surround yourself with lots of nice, positive moments that help you feel better through the course of the day. Practice self-soothing every single day, especially on painful days. It will get easier, even when if it doesn’t feel easy or natural to you at first. You can learn this, and when you do, it will make a huge difference in your life.
Kathy Broady LCSW
Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation
January 19, 2010
What an interesting phrase.
Externalizing responsibility is when someone fails to accept responsibility for the messes they make or for the problems they cause. It is also failing to accept responsibility for the situations they find themselves in.
Internalizing responsibility is personally taking on the responsibility for what happens (in the past, present, or future). It is accepting the responsibility for personal welfare or for consequences of actions instead of dumping the blame on others.
Do you externalize responsibility?
Do you internalize responsibility?
For dissociative trauma survivors, the issue of when to accept responsibility versus when to deflect responsibility is a very complicated topic.
Most DID survivors have had years of experience internalizing responsibility for the actions of their perpetrators, family members, abusers, etc. Abusive offenders are some of the world’s best at externalizing blame onto someone else, and most trauma survivors internalize that blame, guilt, shame within themselves. Purposeful and direct blaming of the victim, especially child victims, typically ends up with the victim feeling responsible for the abuse.
Having this convoluted, complicated history of who is or isn’t responsible makes “accepting responsibility” a very difficult topic for trauma survivors.
Survivors spend years of time blaming themselves for the abuse (internalizing responsibility). Survivors typically end up feeling like they were bad, or they did something to cause it, or it was because they were too pretty, or too available, or too easy, etc. Survivors were usually told by their abusers that they deserved the abuse, or they liked the abuse, or they wanted the abuse, or some variation of the sort.
Perpetrators know that if they verbally blame the victim, that victim will be more likely to internalize the responsibility for what happened. Perpetrators typically do not accept responsibility for their actions. The more the perpetrators push blame and responsibility onto the victim, the more the victim will internalize that responsibility and blame.
But typically, survivors are not responsible for being abused. At least, they are not responsible for what the abuser does. The abuser is responsible for what the abuser does.
However, it is very difficult for many trauma survivors to put the blame of their abuse back onto their perpetrator. Trauma survivors will argue with their therapists that their abusive loved ones were not at fault – that they cannot be considered a perpetrator – that they are not to be blamed.
How many of you refuse to believe that your father (or mother) sexually abused you even if other parts in your system have said this clearly?
How many of you refuse to blame your perpetrator, and instead will run in circles protecting your family member from being called a perpetrator?
How many of you will argue that you have no right to be angry with your father – perpetrator? How many of you will define criminal actions as “not a problem” in order to not assign responsibility to your loved one?
Children are not responsible for being abused. Adults are responsible anytime they have abused children. Children will internalize the blame, but they are not responsible for being abused.
What about when the trauma survivor is an adult? What if the adult survivor is being abused as an adult? Who’s responsible then?
Adult trauma survivors do get abused. There are thousands of domestic violence situations where adults are being abused on a regular basis. Rapes and date rape situations can happen to adult trauma survivors. Dissociative survivors can still be involved in the sex slave industry or other ongoing abuses even as an adult. Abuse certainly can happen into adult-hood.
Who is responsible in these situations?
Of course, the abusers are still responsible for their own abusive behavior. (The topic of recognizing who abusers are will be discussed in a different blog article.)
However, these issues are not simple once the victim is an adult who has to be responsible for their own selves and any dependents. If you are an adult trauma survivor caught in abuse, it is not your fault you are being abused, but it is your responsibility to get yourself out and away from this abuse.
These adult survivor victims are responsible to get the help they need to get out of their abusive situations. They do not cause the abuser to abuse, but they are responsible to learn how to protect themselves and to protect any children that may be involved in the situation. It is important to build and utilize enough resources for safety and protection that will make the abuse come to an end as quickly as possible.
Finding the Balance
The difficult part is internalizing the correct portion of the responsibility. Even adult trauma survivors well experienced in therapy will internalize responsibility that genuinely belongs to the abuser. Other adult trauma survivors will stay stuck completely in the victim role, refusing to accept responsibility for getting out of the mess they are in. Sometimes survivors will cause-create-instigate-perpetuate emotional conflicts that are of their own making, and yet, claim to be the victim of their circumstances (more on that topic another time…).
So think about it…
Internalizing responsibility vs. externalizing responsibility.
What really does belong to you?
What really does belong to someone else?
Are you taking on too much?
Are you acting like a victim in situations where you are actually responsible?
Kathy Broady LCSW
November 28, 2009
It’s Thanksgiving weekend here in the US, and besides the wonderful traditional family meal and pleasant times with my kids, this time frame reminds me of something else.
Discussing Dissociation has been up and visible for nearly one year now. Yep, in a few days, it will be a year already!
Wow. Where has the time gone??!!!
There is truth to the saying that time flies, or is it because time flies when you’re having fun … or maybe I’m just getting older, lol.
Anyway, I’m being silly, but I do want to say today how much I appreciate all of you that have been readers here at this blog. The number of faithful, returning readers has been utterly amazing to me. If you look back through all the pages, you’ll see well over a thousand excellent comments from a wide variety of the readers. Wow! The input you all have made in this blog has brought it to life and given it a life-filled energy that I certainly couldn’t create on my own.
For the way each and every one of you have contributed to the positive, educational nature of this blog, I sincerely thank you. I truly appreciate your involvement, your thoughts, your comments, your questions. You’ve helped to make this little site a safe, comfortable community for dissociative trauma survivors. I think it’s a job well done, and once again, I do sincerely thank you for your part in this process. Writing a blog wouldn’t be nearly so fun without hearing comments from the readers! You all rock!
Many of you have questioned why I started this blog in the first place. The original reason is not as mysterious or worrisome as some of you may have thought. It’s a widely stated and highly recommended common practice for therapists to use blogs for marketing purposes. Marketing experts recommend to write what you know about, and to respond to the comments you receive. Blogs get quickly listed in search engines, and they are an easy, economical way for your target audience to get to know you, and to see what you do, and to become more familiar with the work that you do. It’s a simple as that. Check the blogosphere for blogs by therapists. You’ll see that most therapists write about their fields of work the same as I do.
I just happen to know about a very specialized topic – dissociative identity disorder. And my readers are a very distinct but wonderful population – dissociative trauma survivors or trauma therapists. (There aren’t very many of us out here — it’s no wonder that we are congregating together!) And yes, practically all of my blog articles have been very specific to DID, not that the topics couldn’t also apply to other populations, but the point of this blog is to “discuss dissociation” so I do tailor my articles to being about dissociative disorders, and the DID population. There’s no mystery there, lol. I think I’ve said that pretty upfront.
But something much bigger has been happening besides my having found a very effective marketing tool.
With all the positive sharing and support that has been created here, this blog has provided a deep sense of hope and healing for so many people. Having that absolute knowing that others are progressing along their healing journey as well, many survivors don’t have to feel so very alone. You might learn things from my articles, but you can also learn from each other, the same as I learn from you as well. It’s a wonderful circle of positive, helpful information, and that in itself is priceless.
Building a sense of safety, knowing you are not alone in your struggles, and learning from others who have been there too provide emotional foundations that so very crucial to healing and can augment your therapeutic process. Please remember, this blog is in no means a substitute for actual therapy, but it does provide a lot of educational support for survivors working on their own healing, or for therapists learning about working DID / MPD.
Again, you all have immensely helped to create that healing, informative atmosphere, and I am grateful for that.
We have to create and protect places of healing.
Even survivor-led blogs such as the truly incredible BTC blog have become targets for destruction by the “hazing / flaming / insaniacs” of the world. Do we really want the haters and gossipers to take over and ruin all the places of healing and support? How sad is this?!!
I know that you know there are predators and perpetrators out there in the world. For some of you, your abuse stopped years ago. For some of you, you are still smack dab in the middle of fighting your abusers. Some of you are being hassled and manipulated by internet predators (whether you know it or not), and some of you are safely away from any direct attack from anyone. No matter where you are in your life, there are abusers and predators out there in the world, (including those wolves in sheep’s clothing hiding within the dissociative population itself), so the importance of having safe retreats amongst all the danger and destruction is more important than you might realize.
Those of you that feel the loss of BTC’s blog can understand what I’m talking about. It’s a real shame that abusive people continue to ruin the good places and run off the good people. I think that is a tragedy. But it happens.
- Are you one that sits back quietly, doing nothing even though you see others destroying places of support?
- Do you believe the lies and negative gossip spread about helpers and healers?
- Are you so angry from your own abuse that you are willing to take that out on people who have helped you?
Surely the survivor population can see through the manipulations of abusers. You are adults now – you can start seeing through the tricks that are being played out there. Please remember to think for yourself the next time you hear some negative hogwash about someone who has dared to be a helper / healer. You can take a stand against that.
Complacency only allows abuse to continue.
Trauma survivors, I encourage you to ban together in protection of your valued and positive healing resources.
So many of you grew up without any safety or comfort or support. You learned to pull deep within yourself or to block out the world entirely. You survived it alone.
But it doesn’t have to be that way anymore.
Most of you are still learning about how important and helpful it is to have places of safe connection, genuine relationship, and gentle bonding. It may be scary to be around people, but building a positive, healing, trustworthy community is a way of overcoming the need to be isolated in order to avoid abuse.
Again, I challenge you to protect your places of healing. Protect those that are your helpers. Stand firm around your leaders that fight against abuse.
Don’t fall into the trap of complacency or destructive participation.
Your healing resources are depending on that.
Kathy Broady LCSW
Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation