April 22, 2012
Posted in Compulsive Hoarding, Depression, DID Education, DID/MPD, Dissociative Identity Disorder, emotional pain, Hoarding, mental health tagged Angry, Anxiety, Attachment, Attachment Issues, Boundaries, Breaking boundaries, cleaning house, Compulsive Hoarding, Depression, DID / MPD, DID Survivors, Disaster Survivors, Dissociative Identity Disorder, Don't Touch My Stuff!, Emotional Freedom, emotional pain, Emotional Protection, Estate Sales, Flood Victims, Floods, Garage Sales, Hoarders, Hoarding, Hoarding on A&E, Hoarding: Buried Alive, Invasion of Boundaries, Isolation, Kathy Broady, Lack of privacy, letting go, Liquidation, Losing everything, Memories, Privacy, Professional Organizers, Remembering, selling your things, Stress, Throw out the trash, Tornado Survivors, Trauma Survivors, Violations at 6:16 pm by Kathy Broady
I can’t explain their popularity on this blog, other than the way a rash of television programs have increased the awareness of the complications about hoarding. However, hoarding issues are typically accompanied by extreme anxiety, depression, isolation, family conflict, self-hatred, chaotic thinking, eating disorders and other problems also common with DID / MPD / trauma survivors. Many emotional struggles are certainly not limited to the Dissociative population. Hoarding is probably one of those disorders that the Dissociative community can potentially share with thousands of people more suited to other mental health communities.
It appears that hoarding is a much bigger issue than once officially recognized. As a social worker who has done many home visits over a span of 25 years, I can say that I have seen hoarding issues repeatedly and yes, in my experience, hoarding is a consistent theme within various mental health populations, including dissociative trauma survivors.
How do we address these issues?
Does the professional “helping” community understand the depths of what is involved?
Do the mental health professionals really know what is needed?
On the various Hoarders shows that I’ve watched on television (such as “Hoarders” on A&E, and “Hoarding: Buried Alive” on TLC), most of these processes are expected to be completed within a matter of a few short days. The interventions are quick, intense, and highly dramatic. The hoarders have obvious struggles, and the gains made in their homes and living situations are typically significant and impressive, even if only one or two rooms demonstrate the successful changes.
Over the past few months, I’ve been thinking a lot about the groups of people that experience the anxiety, stress, distress, personal gains, relief, and emotional freedom from having professional organizers empty their houses. There are many groups of people, in addition to the hoarder community, that may require assistance in emptying or reducing the amount of items located within a specific property or home. These issues could surface in extremity, for example, after someone dies (especially when there is no one to inherit the stuff), or during a divorce settlement, or after a bankruptcy, or prior to moving to new home, or downsizing from a large home to a small home, or for any other reason people may decide to liquidate their possessions.
To me, just cleaning out a messy closet is a big job! Emptying, or organizing an entire property is an enormous job! It’s an overwhelmingly huge job.
Recently, I hired some professional sales assistants to help me to downsize / sell many of the items from my home / office in order to prepare for a new phase of my life. My children are grown up, and each has moved into their own homes as adults, giving me all kinds of options for what to do with the physical space that lives around me. I don’t particularly like the “empty nest” phrase, and yet for the first time in dozens of years, I have more freedom to do whatever I want to do, wherever I decide to do it. It’s exciting, and yet very weird feeling all at the same time. That’s all a long story, of course, and it has taken several months (years?!!) of hard work to sort through those kinds of things, including what to do with all the leftover “stuff” that everyone has grown out of.
I took weeks of time to pull out the cherished treasures I wanted to keep, and then left the rest for the organizers to pick through, and to present in the way they created a sale for the masses of people they invited to come dig through my things. As much as I thought I had already selected my most important items, it was never that easy, or that clear.
“Wait! Wait! Maybe I want to keep THAT afterall!”
Or, “Wait! Where did you find that? I didn’t SEE that before. Give me that back!”
Or another rough part was seeing my things just tossed in the trash. Can you believe that my favorite coffee cup ended up in the trash?!! My FAVORITE one! I thought I was going to have a melt down right then and there!
Breathe, Kathy, breathe!
Count to 10.
Ok, count to 100, lol.
The whole process was not anywhere near as fun as I had thought it might be.
In fact, it wasn’t fun at all.
It was really painful and horrible, to say the least.
And I chose to do it. It wasn’t forced upon me. It was MY IDEA. ( yeesh, lol).
This changing, transitional experience has been much more complicated and emotional than I ever expected it to be, giving me all kinds of fodder for blog articles, and a much deeper understanding of the intensity felt by hoarders as they go through their housing changes. Even though I had lots of time to prepare prior to my professional organizers arriving, and I was not forced into making these decisions in any way at all, I found myself having far more struggles, and feeling intense emotional turmoil, and frequently overwhelmed with memories (both good and bad) while sorting through the rooms of stuff. Wow. Yeeesh. Gee Whillakers! Jiminy Crickets!! It was a much more difficult experience than I would have ever imagined it would be.
One thing is for sure. For any television production company to expect to go through and toss away / give away 80 – 90 % of a hoarders belongings over a period of just a few days is just ridiculously cruel. Most people — especially those that tend to be collectors in the first place — are not ready to let go with that much finality that quickly, or that easily. There is no wonder the hoarders on the television shows have so many emotional outbursts – the whole process is set up exactly to create that kind of emotional conflict within them. I suppose that makes for interesting television, but it is not very kind to the hoarder.
My experience of working with professional organizers also reminded me of some of the stories I have heard over and over from many of my clients with Dissociative Identity Disorder (DID / MPD). Let me ask you a few questions. Can you relate to any of these experiences?
As children or teenagers, or even as adults, have you felt violated when your parents or caregivers or family members rifled through your belongings without your permission to do so?
How invasive did it feel to have people touching your things when they were not invited to do so?
How powerless did you feel to see this, and to know you couldn’t stop it from happening?
How did this affect your personal boundaries?
How did it affect your ability to feel like something – anything – belonged to you, and to only you?
How did it affect your privacy, or lack of having any privacy?
When your boundaries were disrespected and exploited, what did you to do cope with the feelings you had?
With whatever trauma and / or neglect you experienced in your life, did you develop a greater attachment and emotional connection to physical items and personal items as a way to bond with something / anything? Or did the repeated violations leave you distanced and unattached to your personal items, able to easily walk off, staying coldly disconnected and apathetic to having anything of your own?
How would you feel if someone took your things from you? Or if someone threw your favorite items in the trash? Or if someone broke an item that you cherished? Would you have an anxiety attack? Would you be angry? Would you withdraw inside, crashing into depression? Would you find yourself switching from insider person to insider person?
Does it feel good and more under your own control to keep the amount of your personal belongings to a minimum? Does that feel safer for you, or does that feel like deprivation? Do you prefer to have bunches of things, feeling safer being surrounded by stuff? Does having layers of stuff feel like layers of protection?
How do victims of floods, fires, tornadoes, and earthquakes, or other natural disasters feel after suddenly losing all of their stuff? Even if they evacuated with a few things, how would it feel to lose so much, so quickly?
It is interesting to explore these questions with yourself. If you aren’t sure what some of the answers would be, try creating the situation, and let yourself experience it first hand. Experience having someone else / something else take your cherished items from you. Chances are, many of you reading this blog have already experienced these situations in your life. But if you haven’t experienced this, don’t judge other people’s reactions and their big feelings about having “house invaders” mess with their things. These experiences are a lot more difficult than you might have ever realized.
It certainly was for me.
Copyright © 2008-2012 Kathy Broady and Discussing Dissociation
August 28, 2009
Posted in Borderline Personality Disorder, DID Education, DID/MPD, Dissociative Identity Disorder, mental health, Self Injury, therapy, trauma therapist tagged Abandonment, Abandonment Issues, AbuseConsultants, AbuseConsultants.com, Anger, Attachment, Attachment Issues, Betrayal, Black and white thinking, Borderline Personality Disorder, BPD, DID/MPD, Dissociative Identity Disorder, Fatal Attraction, Idealization, Intense Relationships, Jealousy, Kathy Broady, Love-Hate, Pedastal, Self Harm, Self Injury, Therapeutic Alliance, Therapeutic Bond, Therapeutic Relationship, Trauma Survivors, trauma therapist, Unstable Relationships at 1:50 am by Kathy Broady
There are distinct differences between Dissociative Identity Disorder (DID) and Borderline Personality Disorder (DID). There are many overlapping symptoms, and some therapists believe that all trauma survivors with DID are also BPD. I, however, do not hold that perspective.
In my opinion, not all trauma survivors with DID are BPD. However, I will guess that the greater portion of DID’ers are also borderline. This makes the discussion of borderline behaviors an important topic for dissociative trauma survivors.
Borderline survivors are frequently characterized with black and white thinking, self-injury, impulsive behaviors, repeated crises, intense abandonment issues, suicidal behaviors, inappropriate anger, mood instability, irritability, paranoid thinking, an unstable self image, etc. There are a wide variety of BPD behaviors that could be discussed over a series of posts. I’ll save those topics for another day.
For this blog post, I want to focus on a particular aspect of BPD: having a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation. (see the DSM IV).
Unstable and intense relationships.
People with borderline personality disorder may idealize potential caregivers or lovers [or therapists] at the first or second meeting, demand to spend a lot of time together, and share the most intimate details early in a relationship. However, they may switch quickly from idealizing other people to devaluing them, feeling that the other person does not care enough, does not give enough, is not “there” enough. These individuals can empathize with and nurture other people, but only with the expectation that the other person will “be there” in return to meet their own needs on demand. These individuals are prone to sudden and dramatic shifts in their view of others, who may alternately be seen as beneficent supports or as cruelly punitive. Such shifts often reflect disillusionment with a caregiver whose nurturing qualities had been idealized or whose rejection or abandonment is expected.
Ok, that’s a lot of psychobabble talk, so what does that mean?
This is when the BPD survivor alternates between thinking someone is wonderful – excellent – the very best, and then thinking that very same person is horrific – awful – horrible. The BPD survivor will show or feel excessive attachment to a new person, and in a sense fall madly in love with this person. They put this new person on a pedestal, believing the person to be more incredibly perfect and wonderful than they could possibly be in real life, and they crave constant attention and special recognition from their new perfect person. (But don’t ask the BPD survivor to admit that. All too many BPD survivors deny their craving for more, more, more.)
But of course, no one can stay “perfect” for long. The perfect person will inevitably do something that just doesn’t measure up. Typically, the “errors” created by the perfect person are that they did not shower the BPD survivor with enough individual, specialized attention. This is nearly always the fatal crime – just not doing enough to keep the attention-starved BPD person happy with unquestionable importance. So, before they know it, the perfect person will suddenly become the hated target, responsible for all evils of the world. And when BPD survivors swing from the feelings of intense positive adoration to the angry hateful place, they are willing to, and actually desirous of, utterly destroying the same person they once loved.
Does anyone remember the movie, Fatal Attraction? That movie portrays a Hollywood version of the love-hate relationship experienced by borderlines. Hollywood was extreme in their portrayal, of course, but the love-hate flip-flop is easily seen.
For trauma survivors with both BPD and DID, the love-hate flip-flop can happen quickly and easily. Remember, as DID survivors, they are very used to switching and to containing opposite life perspectives in opposite extremes. So, when the dissociative BPD feels abandoned by their treasured “good object” and becomes upset with them, the flip into hatred might not be that far away.
The abandonment can be experienced in any number of ways. Being very sensitive to any rejection of intense connection they desire, simple things can be interpreted as huge emotional offences — for example, if the once perfect person sets limits by saying “no” to a specific request, or by not offering extra time, or by going away themselves. Even if the reasons for being away are valid, no reason is good enough – every reason still means they are left behind, and that is not acceptable.
Jealousy is frequently an intense motivator too. When BPD survivors want a cherished relationship with their new perfect person, they have all kinds of jealous pangs if they believe someone else has a more treasured place than they do. Instead of doing the work it takes to keep their own relationships in a positive place, they focus outwardly on relationships that belong to others, drowning in their jealousy and anger, and inevitably destroying the relationships they wanted to cherish.
For dissociative trauma survivors, the therapeutic relationship is an incredibly important relationship. Developing and protecting this relationship is both central and crucial to the entire healing process. DID’ers can spend years of time with their therapist, and cultivating the skills to keep this relationship in a workable, positive place is critical.
For BPD survivors, the therapeutic relationship is equally important. However, these survivors often lack the skills needed to maintain positive long-term relationships, even with therapists. Therapists very frequently become the target of the love-hate flip-flop dynamic. Many therapists refuse to work with clients with BPD precisely because of this dynamic.
This love-hate borderline behavioral pattern should help to explain how any therapist can be the most dearest of therapists, and then a short time later, be the most hated. It’s a behavioral symptom of BPD. It doesn’t mean that the therapist is actually wonderful or horrible. It just means BPD survivor is acting out the black-white, love-hate, attachment-abandonment issue that is central to BPD.
When you know to look for it, you’ll see it happening all over the place in the trauma survivor population.
So when you hear someone attempting to destroy or bad-mouth someone else, consider the bigger clinical context of what this kind of behavior is about.
And please – work very hard to NOT do this to your therapist. Your therapist will not likely become your worst enemy unless you make that happen. Instead of destroying your cherished relationships, it is much better to protect them with all that you have. Don’t believe lies. Don’t tell yourself lies. Remember who your therapist is and do not confuse your therapist with any other person (mother, father, perpetrator, etc). The disordered dynamics related to BPD are a complication, but they do not have to become an insuperable obstacle — you really can choose not to let these dynamics dominate your relationships, with your therapist or anyone else.
Kathy Broady LCSW
December 14, 2008
Posted in mental health, therapy, Therapy and Counseling, Trauma tagged Approach, Assistance, Attachment, Attacking, Block, Boundaries, Challenging, Change, Claim the Issue, Clash, Client, Conflict, Conflict in Therapy, Dissociation, Distract, Emotional, Family, Family Dynamic, Father, Feelings, Gain, Harmful, Healing, Health Professional, Heart Wound, Homework, Infallible, Kathy Broady, Limit, Limitation, Misinterpreting, Mistake, Mother, Need, Painful, Positive Change, Projection, Reasonable, Responsible, Restriction, Rule, Sabotaging, Skill, Style, Talking, Therapeutic Alliance, Therapeutic Attachment, Therapeutic Gain, Therapeutic Mismatch, Therapeutic Process, Therapeutic Relationship, Therapist, therapy, Transference, Trauma, trauma therapist, Trauma-Related Issue, Unmet emotional need, Wound, Your Therapy at 4:36 pm by Kathy Broady
Castorgirl’s comment to the article “Therapy for Trauma Survivors, Part 1″:
An interesting post. It raises many issues that have been a struggle over the last three years of therapy…
The question whenever things don’t seem to be going well in therapy always seems to come back to – “Is this our fault?” Are we sabotaging our own recovery, misinterpreting what has been said or meant.
It always brings forward the issues from the past about the health professionals being infallible and beyond questioning. We’ve just tried to question our therapist, and it hasn’t gone well. Our first foray into challenging a health professional has pretty much come crashing down around our ears…
In a rather rambling way, we’re trying to ask what indicators can you use to see whether it’s a block from us, or a therapeutic mis-match?
Great thought provoking blog…
Thank you, Castorgirl, for asking such a great question. I wish there was an easy answer. This is actually a very big question with lots of layers to it. I could probably make several different posts from this question, each with a different approach.
I have a response for you, but please remember, there are just my thoughts, are cannot be taken as medical advice nor are they to replace or usurp the recommendations of your therapist. (Please see my disclaimer.) For the purposes of this post, I am going to write it from the perspective that the therapist is not making any grave errors. Addressing therapeutic blunders is a big topic, and will reserved for another day.
I want to commend you for talking with your therapist about the issue at hand. You have taken an important step in talking to your therapist about it, and that’s excellent. Even if it didn’t go as well as you wanted it to, you initiated a conversation about it, and I strongly encourage you to keep working on it. But do your homework – meaning… explore your feelings on your own as well, and see if you can move yourself forward through it.
Actually, I don’t think for a second that health professionals are infallible. We all make mistakes and that very fact makes therapists’ human too. However, when we have our “Therapist Hat” on, we make a conscious shift in our heads and our thinking to put our energy and attention on the client. We’ve also been given rules, guidelines, boundaries, and restrictions to follow from our employment agencies, training institutions, educational facilities, and theoretical perspectives that highly influence our thoughts and our behavior. We may very well approach conflict in therapy different “in the office” than we do in our personal lives. Remember that the point of therapy is to be about you, the client, and even in rough patches of the therapeutic process, therapists will tend to keep that mindset in the forefront.
I’m guessing that most therapists examine the interaction between themselves and their clients with the greater focus on their client, what the client is doing (or not doing), saying (or not saying), expressing (or not expressing), etc. Part of keeping the therapeutic process about the client is by keeping our thoughts and interpretations on the client, while keeping our thoughts about ourselves more neutral or in the background. Otherwise, the therapy process becomes about us, and that becomes a boundary issue. Particularly complicated problem points are when the client does something that is actually harmful or damaging to the therapist, or vice versa.
Keep in mind that all relationships have simple misunderstandings and small pockets of confusion. Little mistakes are not the end of the world. If you find yourself blowing normal miscommunication issues up into huge conflicts, then chances are, you are adding other personal issues into the situation.
You would probably be surprised to see how many conflicts with therapists are actually directly connected to projections / transference issues related to the client’s painfully unresolved mother- father-family-trauma issues. As cliché as it sounds, the biggest portion of therapeutic conflict can be seen in the “this is actually about your mother” context. The therapeutic relationship, while it is a current-day professional relationship, becomes the battleground for all the emotional hurts and deep heart wounds of the years past. Because an element of caring and emotional attachment builds between the therapist and client, all too often conflicts arise when the client expects the therapist to fulfill too many of their unmet emotional needs.
Of course, a huge part of therapy is experiencing a correction of formerly wronged emotional experiences. But there is a limit to how far a therapist can go in terms of meeting those unmet needs. There will be a boundary line. It’s understandable that when this line is approached, and the client wants more from the therapist than the therapist can give within their professional or personal limitations, there will be a conflict.
That means many clients get their feelings hurts. The therapist often becomes one of the very most important people in the client’s life, especially for trauma survivors who have poured out their heart and soul in their healing process. Even being as critically important as therapists are, therapists can’t necessarily participate in the important social events for the client, or be emotionally or physically or therapeutically available as their clients want them to be. Many times, therapists can’t even approach the client, or make the first phone call, or offer extra time. While the professional opinions on proper therapeutic behavior vary greatly, the point being, to maintain proper boundaries, therapists have limitations to what they can do. Many client requests will be denied because they go too far outside of the therapeutic box.
One of the very biggest blocks that clients can do that will harm or destroy their therapeutic relationship is to not talk about these conflicts with the focus on their own thoughts, feelings, behaviors. Remember, the goal in your therapy is for you to learn more about yourself and to learn more about how to be personally responsible for your own health and well-being. If you insist on defining the issues as “the therapist’s problems”, then you have missed the boat of what your therapy is about. That doesn’t mean the therapist doesn’t have problems. It means, you are trying to distract from your issues, and your therapist is not to be the focus of your therapy. Keep the focus on yourself. If you want to make gains in your therapy, talk about you. Examine your wants and needs. Examine your behavior. Poke at your beliefs. Keep it all about you, you, you. And protect this time. Treat it as precious for you. Having the time to work on your healing is incredibly important, so don’t share the focus with anyone else.
Because it is your therapy, claim the issue as your own. Attacking or blaming your therapist isn’t going to help you address your own issues, nor will it help your therapeutic alliance. If you are really in therapy to address your own issues, then even in situations where there are potential conflicts with your therapist, first look at how the conflict relates to you.
Talk openly about how the painful conflict at hand affects you. Be courageous enough to look at the painful historical roots for this issue. Be willing to see how this current conflict has shown itself in your life, time and time and time again. Look to old family dynamics and find the parallels. Look at how this new wound is similar to previous wounds. When you find those connections, you will be making progress.
Ask yourself: Why does this bother me? And what’s under that? And then what? And then what? Peel the emotional onion, in terms of getting further down into the root of the issue. Your therapist will be able to help you do this, but you have to be willing to look at it from that perspective.
If you are unsure if there is a therapeutic mismatch, use the same approach in tackling that issue. For example, write out a list of the things that seem mismatched. For each individual issue, ask yourself why that bothers you. Take this first answer, and ask yourself why that bothers you. Take your second answer and ask yourself why that bothers you. Take your third answer, and ask why that bothers you.
Remember, there are many good therapists out there. If your needs truly clash with the style of a particular therapist, then thank them for what they have offered you, and simply move on to someone else. Don’t assume the therapist will or can change to be what you want them to be. It doesn’t mean the therapist is “wrong” or “bad” for not doing what you want them to do. They are who they are, and they have their style of working in place. I use this metaphor:
If you don’t like the food at a particular restaurant, then go to a different restaurant. It would be unreasonable to throw a hissy fit in a Chinese restaurant, demanding Mexican food. If you want Mexican food, just go on down the road till you find the Mexican restaurant, and leave the Chinese restaurant to do what it does best – serving Chinese food.
Too many clients expect the therapist to become what they want or need, typically based out of their own trauma-related issues. Your healing isn’t based on making your therapist change to be what you need. Your healing is based on your addressing your needs, and making positive changes with the assistance of your therapist.
If you want to do more thinking, here are some sample homework questions:
- What is a therapeutic mismatch? How do you define that for yourself?
- Is your therapist challenging you to think / act in ways that are new or uncomfortable? Are these harmful challenges? Or, is your therapist encouraging you to develop new skills?
- List 5 areas you are mismatched, and for each area, list five reasons that feels upsetting to you. What are the common themes, and what have you learned from this?
- What are you doing to encourage or enhance the mismatch issue?
- What do you want your therapist to do that he (she) is not doing? Why is this so important to you? What does it mean if your therapist will never do these things?
- Are these reasonable requests? Do any of your requests take the therapist out of the therapy box?
I hope these ideas give you a starting place.
Thanks for the question.
Kathy Broady, LCSW