October 15, 2010
Turning Self-Injury into Self-Soothing
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.
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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.
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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.
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By:
Kathy Broady LCSW
Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation
October 11, 2010
Who’s Looking at You In the Mirror?
The following drawing is a DID survivor’s response to my question: Can you picture dissociative identity disorder?
*** If you are a dissociative trauma survivor, please read the following article with caution. Some of the topics presented in this blog article could create an emotional reaction from your internal system as several difficult but important topics are mentioned. Please be sure to tend carefully to your own safety and stability. ***
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This drawing is helpful to understand dissociation – the very picture itself portrays how it feels to have dissociative identity disorder (DID / MPD). Assuming this drawing represents one actual person, the plural, divided-self experiences are visually obvious.
In addition to the whole of the picture, I’ve picked out a variety of elements that could be significant to the dissociative system being pictured. I will include some of the thoughts and questions that come to mind as I look at the different areas of this drawing. A lot of helpful therapeutic information can surface by asking the following questions to the survivor artist. Many of these questions could be asked to any other dissociative survivor in terms of exploring their own internal systems.
1. The blank face in the mirror
- Why is this a blank slate?
- Is there ever a time when “no one” is there? What is that like?
- Does the face place not belong to anyone in specific?
- How often does this person switch?
- Does anyone claim the face?
- Who does the actual face belong to?
- When you switch, are there visible differences in the face?
- Is there a specific leader to this dissociative system? If so, where is this person pictured?
- How often does this dissociative survivor feel like she is living outside of her body or separated from her body?
2. Notice that there are other inside system parts visible in the overall picture –
- Some parts are in the front
- Some parts are in the back – what is the significance of these different locations?
- Some parts are unknown (blank spots)
- Some parts are pictured standing alone
- Some parts are closely connected to someone else
- Some parts are older, likely adult in age
- Some parts pictured are very young
- Some parts pictured are middle-aged children
- Some parts pictures appear to be teenagers
Additional Questions:
- Can you identify any of these insiders as specific individuals?
- Who talks to who?
- Do the insiders on the back communicate with or know about the insiders located on the artist’s paint palette?
- Since we are seeing only a small portion of the actual body, are there other parts located elsewhere that are not pictured in this drawing?
- If there are other system insiders that are not pictured in this drawing, would you consider drawing another picture that does include them?
- Do the two main figures in this picture represent two distinctly different systems?
- Are you aware of what happens when the insiders “from the back” are out?
- Do you experience more time loss with the parts that are connected to the body but not visible because they are on the back or with the parts that you can see, but are more separate and pictured on the paint palette?
3. The hair and the clothes are different in the mirror — ever so slightly — but still different. Notice the different hairstyles / clothing for the different insiders – a clue for who is out might be related to the actual hairstyle / clothing they are wearing that day.
4. What is the thumb covering? I would need to ask the artist to know what this represents for sure, but several possibilities do come to mind.
- Is this a dark area of the internal system that is trying to hide?
- Is this an area that represents difficult feelings like shame, pain, anger, or any areas of life that may not be comfortable to look at?
- Using the metaphor of the paint palette, the dark spot might indicate a hole in the palette. Does it have any other significance than that? Are there “holes” in your system? To where does that hole lead?
5. Mirrors
As much as one figure appears to be the reflection in the mirror, is the mirror actually the doorway for an entirely different system than the parts outside of the mirror? It is not uncommon for mirrors to be part of the internal world / internal landscape of a dissociative survivor. These mirrors are very significant and will require specific therapeutic attention.
6. Circles
Some dissociative survivors speak about circles in their life, and circles can represent specific relationships, and / or being “in the circle” can have layers of meaning.
- Is there any significance or meaning to the circle designs included in this drawing?
- Do the insiders stay separated in their circle “bubbles” or are they allowed to mingle with each other?
7. Colors
Since the artist of this drawing used the paint palette metaphor to show their system, do colors have an important meaning to their system? Are certain parts associated with certain colors? For example, are there parts from the “green layer” or are there parts associated together as part of the “blue group”, etc. If so, what do the different colors mean, and what are the common characteristics or job roles of the insiders associated with each color?
8. Box Frame
What is the relevance of the square / rectangle mirror frame? Does seeing a main figure inside the box frame have any significance? Are any of your insiders tucked away in boxes? If your system insiders are not in boxes, do you have other issues boxed up?
9. Connection to the Body
One of the strongest themes in this picture relates to the way the different parts of the system appear to be very separate from the body.
- How often is this person in a numb, dissociated, depersonalized, or out-of-body state?
- When the parts from the paint palette are “in the body”, can the artist feel that they are present? Or do these parts continue to have a separated distance?
- Does the body feel the same or different when the mirror-reflection group of insiders is present in the body?
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I have found this drawing to be rich in information that would be useful when discussing the dissociative issues experienced by this trauma survivor. There is much to learn about this survivor-system and asking these questions is just the beginning.
What do you see in this picture?
What else would you wonder about?
———-
By:
Kathy Broady LCSW
Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation
May 24, 2010
Sorting through Transference Issues
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In response to some questions asked about my previous blog article about Mother’s Day, I’ve decided to follow up with an additional post on the topic of transference. Transference isn’t necessarily an exciting topic, but it is fundamentally important to understanding the dissociative therapy treatment process. Hopefully, this article will help to clarify more about the importance of these issues.
What is transference?
How do you recognize it?
How do “mother issues” become a common transference issue for female therapists? (And likewise, how do father issues become common transference issues for male therapists?)
Is transference healthy?
Is it important?
Yes, transference issues are a common part of the healing work done with every trauma therapist / dissociative client. The frequency of transference issues makes them very important topics to talk about and to understand. Transference issues surface all the time in the DID therapy process — in a variety of ways — often in simple and unexpected ways. It would probably be fair to say that some kind of mother transference can potentially show up every week in therapy.
Addressing transference issues appropriately are fundamental to healing, so if it seems I write about them a lot in this blog, it’s because they are important. Transference issues are when feelings about an important person in the past become “transferred” onto another person in the present. It can be as simple as a little reminder, or in the case of some dissociate trauma survivors, it can go as far as the client literally seeing someone else’s face put on to the other person in a flashback type fashion.
Transference happens when something connected to Person A significantly reminds clients of Person B, or to their relationship with Person B, to the point that Person A can be viewed as the same as Person B. Person A is not Person B, but clients deeply tangled in their transference issues may not be able to tell the difference. In essence, it becomes a type of relationship psychodrama where clients address their complicated, complex feelings about Person B by acting them out with Person A. At some point, clients need to recognize Person A is Person A, and that Person A is not Person B. Only Person B is Person B.
In the therapy process with survivors with dissociative identity disorder, the therapeutic goal of working with transference is to allow clients address emotionally painful material with Person A while having that safe distance from Person B (the alleged “bad guy” or traumatic figure). However, therapeutic progress will occur only as clients see that Person A is simply the “reminder” of their feelings and memories regarding Person B. By exploring the issues about Person B with Person A, clients can achieve deep healing on their genuine trauma and simultaneously successfully separate Person A from staying in that “bad guy” place.
If clients do not transfer the feelings back to Person B, but keep them stuck on Person A, they have prevented healing from occurring. Person A is only a temporary “substitute”. The real issues belong with Person B. Staying focused on Person A prevents and distracts the real healing from happening.
Understanding complex details of the actual relationship between clients and their mothers is important to recognizing specific instances of transference, but some common examples of how mother transference issues can be seen in regular DID therapy session situations are:
- The therapist cancels a session (or two or three) and the client fears the therapist will never come back, or that the therapist hates her, or that the therapist is abandoning her. (re: mother abandonment)
- The therapist doesn’t call or email a response quickly enough and the client feels like the therapist is ignoring her, or refusing to speak to her, or hates her, or is mad at her. (re: mother neglect)
- The therapist wears a green shirt that reminds the client of a traumatic situation when the mother was wearing a green shirt, and the client becomes fearful that the therapist will abuse her the same as the mother did. (re: mother trauma)
- The therapist hands a male co-worker a file containing conference information and reference materials but the client becomes convinced that the female therapist (mommy) is telling the male therapist (daddy) all kinds of bad information about her so that the client will end up getting in trouble and abused. (re: mother betrayal)
- The therapist shows genuine kindness, acceptance, and compassion with the client and the child parts. The child parts attach to the therapist and wish with their whole heart that the therapist could be the mommy they never had. The client clings excessively to the therapist and pretends the therapist is her mother. (re: mother fantasies)
Survivors struggle with transference issues all the time, and there are many survivors that find it “safer” to blame a therapist instead of really looking at their family dynamics / actual trauma issues. While it may feel safer or easier to displace the issue onto a therapist, those same survivors can spend a lot of time not actually addressing their real issues because they are obsessing about the wrong person. It can create a lot of wasted therapy, wasted time, wasted resources, ill feelings, etc.
However, it is important realize that some people really will not (or cannot? Or chose not to?) face their real issues, so they transfer and project their issues onto someone else instead for an extended period of time. There can be a number of motivating factors, and addressing why someone wants to (needs to) focus on the wrong target is a critically important part of the healing process too. Why are they stuck at this point? What else is going on for them? What are they avoiding? What secondary needs are they meeting by obsessing on the wrong person? What’s the rest of the story? There has to be more going on somewhere.
Obviously, one of the role of therapists is to help someone build the skills / ability to look at their real issues, and to weed out or steer away from the incorrect focus on distractions / displacements. For a therapist to encourage a client to stay focused on a surrogate target would be a disservice to the client. That would be like medically treating someone for a broken pinky finger when in reality, they had bone cancer. The diagnosis of the problem has to be correct, or it is not proper treatment. This is true in understanding the complexity of transference issues. Accurately recognizing what is being transferred from where to where is critical in resolving the issues.
If someone wants to address their healing, it typically is much more effective for the clients to genuinely address their mother (or father) issues directly instead taking it out on a therapist (or a co-worker, or a neighbor, or a friend, or a spouse, etc etc.). No one will find healing on Situation A if they are obsessed about Situation Q.
It is fair to say that female therapists are frequently put into that “mother role”, far more than the average person would be, especially with traumatized clients. This is even more true for DID survivors with child parts. (Most child parts have bunches of unresolved mother issues, and understandably so.) Yes, working on mother transference issues is a natural part of the therapeutic process, but it is only the starting place, not the ending place.
There is a very fine balance of working with the transference, and not getting caught in them, or stuck in them.
If your therapist is not your mother, but she reminds you of your mother, what can you do to sort out your deep painful feelings?
If your therapist is not your mother, but you wish she were your mother, what can you do to meet those unmet needs?
Do your feelings for your mother effect how you view your therapist?
Have you discussed these feelings openly with your therapist?
The very best remedy to keep from getting caught in a negative transference dilemma involves a lot of detailed, honest communication between you and your therapist. Talk about this. Talk LOTS about this. Sort out who is who and what is what. Don’t be afraid to approach this topic with your therapist, as it is fundamentally one of the most important areas of your healing work.
Good luck – and keep working at this. It’s important!
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By:
Kathy Broady, LCSW
Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation
March 8, 2010
Picturing the Healing Process for Dissociative Identity Disorder
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This set of picture-postcards demonstrates a passage through time for a trauma survivor with dissociative identity disorder (DID / MPD).
These pictures show different phases of the dissociative healing process, and illustrate how healing occurs. Notice that they move from a more shattered, painful, chaotic place to a calmer, structured, organized place. Where there is originally nothing but a fragmented sense of self, there later becomes a clear sense of personal identity.
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Phase One
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The first picture-postcard has a mixture of colored pieces of all different shapes and sizes. Some pieces are more jagged, some are rounded. The mosaic nature of this design would automatically lead to many of the same questions as asked about the DID “Self Portrait” picture. For example, I would ask what the different colors represented, what the different shapes represented, if there was communication (or not) between the different pieces, if the black stitching between the colored blocks had a specific meaning, etc.
For this top picture, there are two specific shapes that I would ask more questions about. There is a definite triangle that points upward and spreads out down towards the bottom of the picture. Triangles can have a variety of meanings, and I would like to hear what this DID artist had in mind. The triangle also has layers to it. Does this have anything to do with the internal system layering?
For example, in the triangle shape that I see, the top two layers are yellow, followed by a green / blue layer, followed by a black layer, followed by a red layer. The placement of these colors could be purely metaphorical or accidental, but I could see this layering as representing important system functions and emotions.
A purely hypothetical system description could include the following ideas. The yellow layers are the happy front parts – the façade layers, the denial parts, the “I’m fine, nothing is wrong here” type of system parts. The blues and the greens could be parts of the system that know a lot of information, do a lot of the everyday work / functioning jobs of the system, etc. These parts know plenty of the historical trauma information but have to keep helping everyone manage life. They can feel some emotions, but work hard to not get overwhelmed or overloaded with emotions. The black layer could be a layer of depression, sadness, grief, anger, or amnesia, dissociated information, deeper internal controls, etc. The red layer could be more intense amounts of pain, anger, fury, trauma information, details about the abuse, etc.
The second shape that could have particular relevance is the large black shape with the blue tip. These pieces have an obvious phallic appearance to them. I would ask the artist if they intended this to be the case (chances are, they hadn’t even noticed that!), and then I would ask them questions pertaining to sexual abuse issues. If this symbol does specifically represent sexual abuse, it is clear how the abuse has been such a huge part of their lives. Just like this black piece is, in some ways, the foundational piece of the whole picture, it might feel like the sexual abuse has been the defining issue in this person’s life.
I see a lot of pain in this picture. The artist does not give the sense of happiness, of calmness peace of mind. The jagged pointy edges remind me of cutting, and I would be asking a lot of questions about self-injury.
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Phase Two
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There has been clear movement from the first picture to the second. Notice how the like colors are starting to get grouped closer together, creating a more cohesive look. There is much more green in this picture, and while the real meaning of that depends on how the artist interprets the colors, to me, it represents a lot of growth. I see a lot of progress being made in this picture. The trauma survivor has clearly been working on their healing issues, and they have been doing a lot of dissociative system work. Things are starting to come together for them.
In phase two, to me, the person is still feeling broken and dissociated, but she is not nearly as overwhelmed with the pain as before. The blue can seen as representing the teamwork efforts being accomplished by the internal system. There are still some missing chunks of time (as seen in the gaps of the blue), but the dissociative person is truly building good internal communication and has built solid connections between the internal parts. This dissociative person is starting to find herself, and she is building a sense of self-esteem, self-worth, and self-identity. As a system, they are definitely doing good work!
There are still several big jagged sharp points, possibly indicating a lot of pain, upset, questions, intense feelings, etc. The phallic shaped pieces in this picture are more obvious, which could be interpreted to mean that the DID artist is clearly addressing their sexual abuse issues. This survivor is aware of the sexual abuse issues, and the healing their sexual abuse trauma is the center of their healing work. While the trauma is still prominent, it is not overwhelming them as much as it used to. They aren’t finished with their healing, but they are making excellent progress. There is less black, and more brown, which feels to me like this person is becoming aware of more and more of the information related to their trauma. They “aren’t in the dark” as much as they used to be and life is feeling much more hopeful.
Even with all the progress, I would still ask this survivor about their suicidal feelings. The sharp points are very painful, and while the survivor may not be using self-injury behaviors as much, they may still have intense moments of suicidal ideation. It appears they are building good coping skills, and not in as high risk of following through with these suicidal thoughts, but the feelings are still there from time to time.
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Phase Three
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This third picture represents the final stages of healing from dissociative identity disorder and sexual abuse. It is hopeful, and shows how everything is coming together for this person. Notice the strength of the center of the picture. All of the colors connect with the other colors and the ability to share information is accomplished easily. Time loss, time distortion, memory gaps are not likely to be a problematic issue anymore.
The C appears to represents the host of the system, or the main “front” person, the leader of the system, or who the person wants to be as a whole. Notice how the front is a whole self, and is clearly and firmly planted in front of any of the others. This C person is now confident as the leader of her system, and presents well out in the external world.
The internal system behind the C is cooperative, quiet, calm, organized, peaceful, etc. The ability to work together, and provide information to the front C self, seems abundantly clear.
I would ask this survivor if the colors still represent the same things as they did in the earlier pictures. The meanings may or may not have changed at this point.
What I see is that the survivor is more aware of all the things she feels. C doesn’t dissociate like she used to anymore. For example, if the red still represents her pain or anger, C is aware of having those feelings, and she can acknowledge their existence, sitting with them, without letting them overtake her, or without having to dissociate them away. C has built the ability to connect with her intense feelings, and this is an incredible accomplishment. C might have times of dark depression or sadness, for example, but again, these moments do not overtake her ability to live her life as she wants it to be.
Notice that there is no obvious phallic shaped symbol in this picture-postcard. The trauma issues are resolved in a much more quiet way, and while C knows about her past, the idea of being a sexual abuse survivor doesn’t have to be the center of her life anymore. She has been able to resolve many of her trauma issues, and lay these to rest, moving on with her life.
The front of the C is facing the yellow and greens, indicating growth, progress, healing, movement, happiness, and enjoying life. C is moving forward into better times! The darkness and pain are more behind her (the black, red and brown are towards the back of the C). While life is probably never going to be perfect for this person, she is hopeful, and she is doing well.
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The Moral of the Story
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Will C create a fourth picture-postcard?
We’ll have to ask her!
The point of these wonderful hand-made picture postcards is obvious. The healing process for dissociative identity disorders works. It helps. Trauma survivors lives can become better. Healing does happen. It takes a lot of work, and a lot of time, but you really can feel better, and have an improved quality of life.
Take the point from C – if she can do it, you can too!
———-
By:
Kathy Broady LCSW
Copyright © 2008-2010 Kathy Broady LCSW and Discussing Dissociation
January 3, 2010
Hopelessness and Despair
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Some days just feel too hard.
Those days feel like you just can’t make it through…
Those are the days when you wish you could curl up in a ball, and sleep or stare all day long…
Or hide away forever…
Ever had a day like that?
Ever felt like your problems were just toooooo big? Or tooooo never-ending? Or tooooo all-encompassing?
Ever felt overwhelmed with hopelessness?
Or despair?
Or sadness?
When the pain is just too much, or the traps are too thick, or the future looks too bleak, or too many abusers snarl in your doorway…
What do you do then?
How do you not give yourself over to those deep dark days?
How do you hold onto hope when the fight seems to be bigger than you can fathom?
How do you find your strength when you feel exhausted to your very core?
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Dissociative trauma survivors know these feelings all too well. Year after year of enduring the pain of trauma and abuse has demanded more from the inner self than can be put into words. DID survivors, overwhelmed by the attacks and betrayals by the people near them, create amnesiac walls and a wide variety of inside parts to get some relief from the overwhelming intensity of such painful experiences. These walls provide a much needed separation from the suffering, space from the heartbreak, a fresh start for a few simpler moments of time.
Separating into different people helps endure the abuse as it is happening.
Leaving the trauma by floating away or hiding within can allow for an escape for at least a few minutes.
The dissociative walls can ensure more separation from the details of what happened.
Box it up, contain it, push it away. That should work, right?
Sometimes it does. In lots of ways it works, but not completely.
Even with layers of separation, it still hurts in there.
Sometimes, trauma survivors use drugs, alcohol, self-injury, shopping, running, or any other form of addiction to help create even more distance from that black hole of pain that just never seems to leave or dissipate.
How does one ever move past such deep emotional pain? The body heals, bruises fade, the bleeding stops. But the heartbreak and sadness and emotional pain remain so long that hopelessness and despair can find a comfortable lodging place right up front on the front row of life.
What do you do, when you feel like you can’t go on anymore?
What do you do when it just seems to be more than you can bear?
Give yourself the permission to feel what you feel. It’s ok to acknowledge that pain, to feel that hopelessness, to sit in your despair. Stay there for awhile, if you need to. These are real feelings, and it really does hurt. You don’t have to pretend that it’s not there. Your heart is heavy, and it feels like there may just be no way out….
But there is a way out.
It will mean doing some new things, but there is a way out of that place of hopeless and despair.
In acknowledging the pain, you might finally give yourself permission to cry. Find a private, safe place, or sit with a trusted friend or therapist, just find a place far away from anyone that will hurt you because you have tears. Find a place where tears are allowed… and let the pain come out naturally… Don’t hold it in. Let your pain have an expression… Let your pain have its own voice.
Wrap yourself in things that are comforting. That might mean surrounding yourself in music that touches your soul, or in warm tight blankets that soothe the skin, or with pets and stuffies that are kind to you.
Self-soothing is important.
And as you can, one by one, tackle those things that have been too huge to touch. Look at the truth of what happened, find ways to separate yourself from those who have hurt you, let yourself have safety and distance from anyone that brings you harm, allow yourself to end the abuse. Your healing will be compromised if you stay involved with people that hurt you. You don’t need that anymore – enough hurt already! Your life will feel much more hopeful when you are safely away from abusers.
So be brave. And be honest. Look at the reality of who has hurt you in your life. Don’t blame people that just happen to be in the way. Look at the real source of your pain. If you blame the wrong target, just because it’s easier, you will still be missing the boat. And no matter how many false targets you take down, you will still hurt inside because you are still not being honest with yourself.
As you reconnect with the pain you once separated from, and as you allow yourself to find true safety and genuine comfort, your heartbreak will lessen. This is not easy, and while there are all kinds of complicated twists and turns in this journey, it is the way out. It’s hard to deal with it all, but little bit by little bit, you can move through it.
Look for something in the future that you might like. What would you like to be able to do that you haven’t been able to do because of all the muddy muck that entangled you? Maybe you’ll have to explore new things to know what else you could enjoy. Maybe you’ll have to be courageous enough to try something completely new. But you can. Have the courage to go there, because if you don’t break out and away from where you’ve been, you’ll only have more of that old stuff.
You don’t have to have the talents of Carrie Underwood or the smarts of Albert Einstein to be successful in your own life. You will have your own abilities. But be willing to try new things to get there. Who knows what talents that you have!
In all honesty, you’ll probably find that you have strengths, talents, and abilities that you never knew you had. You’ll be able to develop interests and skills that you could only dream of before. Your life can be filled with new activities, different priorities, and creative options that you never knew were possible.
You’ll be able to build relationships built on respect, caring, and warmth. Being alone won’t be stifled in pain, but connecting with others won’t be paralyzed with fear. Your insiders can be your very best friends in the world, and effective teamwork can replace isolation. This doesn’t happen overnight, but you can get there.
As you experience true freedom and genuine safety from the chains of abuse, your life will be free to have hope, excitement, fun, and adventure. You can explore the beauty that life offers instead of being tied to the abuse and torment of perpetrators.
You won’t have to stay drowned in hopelessness and despair when you can see something creative and exciting and positive in your very own life that belongs to you.
When you like what is happening in your life, you can feel hope again.
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By:
Kathy Broady LCSW
December 6, 2009
Compulsive Hoarding and Dissociative Disorders
Compulsive Hoarding is a cluttery mess!!
What makes this happen?
Have you seen homes that look like this?
Does your home look like this?
Compulsive hoarding, or disposophobia, is a psychiatric condition that affects millions of people.
Compulsive hoarding is an obsessive need to acquire and keep possessions, even if these items have little value, are unsanitary, or broken, or unusable. Numerous items are kept and not discarded. Instead of using the items already owned, or looking for items that are lost in the piles, new items are acquired repeatedly to the point that the clutter creates significant dysfunction in a variety of areas of the person’s life.
Compulsive hoarding is far more complex than it first appears. It is connected to a variety of disorganized chaotic behavioral patterns and disorganized thinking patterns. It typically occurs in combination with other psychiatric issues, such as depression, anxiety, obsessive-compulsive disorder (OCD), eating disorders, attention deficit disorders, addiction issues, trauma disorders, attachment disorders, etc.
There appears to be a biological base to this behavior as research is beginning to explore a genetic link to compulsive hoarding in generations of families. As children, many hoarders were raised by parents who were hoarders, so not only is it a learned behavior, but it could also be biologically connected. The area of the brain most significantly different for hoarders is the part of the brain that is responsible for focus, attention, and decision-making. According to research done at the University of Iowa, damage done to the to the right medial prefrontal cortex of the brain tends to cause compulsive hoarding.
Hoarders have a great deal of anxiety when pressured to let go of their possessions. They typically require external assistance, including professional assistance, to help with the cleaning and organizing tasks. Feelings of emotional overwhelm, intense anxiety, and panic attacks can be paralyzing for the hoarder. These increased anxiety symptoms create an inability to make decisions, stir up friction and emotional outbursts, lead to fatigue and exhaustion, and repeatedly interrupt the cleaning process. Letting the hoarder have control of the cleaning process and allowing time for the harder to build trust with the cleaning crew is particularly important to successful organizational efforts.
The clean-up process is intense and slow. Forcing a hoarder to clean too quickly will not result in long-term resolution of the problem. The problem is not just “clean up your house” or “throw this away”. The problem lies deeper within the person, and the struggles will manifest again in just a short-time.
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How does compulsive hoarding relate to Dissociative Identity Disorder?
Compulsive hoarding is an issue separate from DID / MPD, but many dissociative survivors struggle with hoarding issues.
DID survivors have a variety of issues that overlap with hoarding behaviors: intense anxiety, deep feelings of hopelessness, fear of being out of control, problems with focus and decision-making, attachment issues, loss and grief, depression, the need for memory reminders, disorganized thought processes, disorganized behaviors, etc.
How many trauma survivors do you know that did not have safe people to attach to? And how many survivors of neglect were left alone, isolated with no one to attach to? When children spend too much time alone, they tend to attach to items, toys, books, stuffies, etc. Attaching to stuff is better than attaching to nothing. It is an adaptive behavior in a painfully difficult environment. However, when this continues over time, the potential for these behaviors to develop into a compulsive hoarding situation increases.
The emotional pain from not having deep personal relationships or the fear of being near people can add to the need to connect with physical possessions or animals instead of people. Building a personal relationship with stuff, and with animals can add to a compulsive hoarding situation. Attaching to stuff can feel much safer than attaching to people.
With all the switching and amnesia that can happen with dissociative identity disorder, DID survivors can experience a lot of chaotic thinking and chaotic behaviors. It can be difficult to complete a task – you can be there, and then suddenly find yourself somewhere else five hours later, having never finished the task you started in the first place. These kinds of disorganized behaviors can leave unattended messes and growing clutter all around your house. Do your child parts pick up the messes they leave behind? Do your teenage parts pick up their clothes? Did anyone remember to finish the dishes? What about the mess those angry parts made? Who wants to clean that up?
The “I didn’t do that, so I’m not cleaning that up” concept can get very difficult for dissociative survivors. You might not know who made the mess in the first place, or the part that did it might not be around anymore, you might not know how to call them back, etc. You might not know who to assign to completing basic household chores. Developing system work and system cooperation can help, but in the meantime, there can be a lot of “that’s not mine” / “I’m not doing that” arguments. Clutter and external disorganization can build while you are sorting out these internal system issues.
How many dissociative survivors have trouble remembering if they have something? Do you own one of those things? Did you buy that, or just think about buying that? Or was that last year? Do you still have that? Or was that way back then? Where did you live when you had that? Or if you know you have it, do you know where it is?
Sometimes it is easier to buy the item again than find it or remember if you have it. While this can be a dissociative symptom, this also contributes to the “Shop and Drop” behaviors found in compulsive hoarding. Shop and Drop refers to a pattern of behavior where the compulsive shopper drops their packages and purchases in some unspecified place. Over time, the packages and purchases get lost in the piles of other clutter, and then when it is time to use the items that were purchased, the location of the dropped items cannot be found. It becomes easier to buy those items again, instead of finding the ones you had.
There is also the complication of accumulation by repetition. Compulsive hoarders will acquire and stash away numerous items that are basically the same. What if you buy everyone in your DID system a stuffie? How many stuffies will that be? What if everyone wants their own books? And of course, many of the different insiders will have their own shirts, their own pants, their own shoes, their own socks, etc. While it is extremely important that the insiders have their own things, the sheer volume of each of the parts keeping their own stuff can add to the size of an ever-growing clutter problem.
The same as with compulsive hoarding, things / possessions / items can represent memories. For DID survivors, memory is a very complicated subject. Having items that trigger memories, or remind you of certain things can be a significant part of a growing clutter issue. Loss and grief are hard emotions to process, and holding on tightly to the items that help you to remember certain people or events can be significant. It is particularly difficult to let go of an item that has emotional significance to you, especially if it feels like you won’t remember someone or something if you don’t have those correlating things.
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Here are a few ideas for addressing compulsive hoarding issues:
- Decide your current life goals, and keep only items that match with those life goals
- Explore the various meanings that possessions have for you
- Consider appropriate medications for anxiety, OCD, depression, etc.
- Work hard in therapy to address your emotional pain and other emotional issues
- For DID survivors, work hard on developing better internal communication and cooperation so clutter issues can be prevented or addressed
- Address your fears of letting go, or letting go of control – what is that about for you?
- Be honest with yourself about what you really need, what you will really use, what actually works, what you can actually fit into, etc. Challenge delusional thinking.
- Get professional help if necessary, especially if clutter is affecting your life
- Consider taking pictures of emotionally important but logically unnecessary items. Photo albums can be less cluttering than keeping all the actual items.
- Donate your excess to those less fortunate than you.
- Consider new rules to live by: If you get something new, get rid of something old.
- Address your deep feelings of shame, embarrassment, humiliation, fear, sadness, etc.
- Work on building deeper and longer-lasting attachments instead of repeatedly discarding and replacing things (but keeping it just over there in case you want it again)
- Work on building meaningful attachments to people, learning to trust, and finding ways to connect
- Find healthy, meaningful ways to fill the voids in your life by doing more, and keeping less
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By:
Kathy Broady LCSW
