Dissociation and integration

I have an understanding of what dissociation is and how it works that differs somewhat from mainstream psychological ideas. I have mentioned this, but I thought I would explain in more detail.

The standard definition is that dissociation has to do with a separation from an awareness of reality. But what is reality? It’s so many things. There are a thousand bits of sensory input from the external world—some of them important, some of them not. There are sensations in the body, how your skin feels, your heart beating, the sensations in your core that are your enteric nervous system and are part of how you experience of emotions. Then there are your thoughts, the pictures playing out in your mind or the verbal chatter of your mind making sense of things or imagining the future or remembering the past or just commenting on life. That’s all reality. Inside and outside of you is reality. It’s a lot of stuff, and normally we focus our attention on some elements of this reality that seem to be important and away from elements that seem to be unimportant. We cannot possibly maintain our conscious attention on it all, because it is too much to pay attention to at once.

We control our attention. All of us have only so much stimulation we can process and respond to at one time, and we do what we need to do in order to keep it in a range of what is possible and comfortable for us. Dissociation is this control of our own attention.

During traumatic experiences and later, the degree of mental and sensory stimulation is too much, and we shut certain things out of our awareness in the same way we normally do, but to a greater extent. This gets the degree of input down to a manageable level, so that what we are taking in is at a level of intensity we can make sense of and respond to. The more intense the experience, the more constricted we need to make our awareness.

We might shut out stimuli that are very painful so that we aren’t saddled with trying to respond to the pain in addition to doing what the moment demands of us—carry on a conversation, think about maths or whatever—or we might shut out everything but the pain so that we can deal with the pain and not what amounts to trivia. Or we might shut out one kind of pain so that we can attend to a second kind of pain. The stimuli are still being recorded. The knowledge of those stimuli is going somewhere, but we aren’t giving it our conscious attention and it isn’t being processed in the same way as what we are giving our conscious attention to in that moment.

If this goes on very regularly, you end up with a very fractured experience of life. You have a fractured experience of yourself, your past, and the world around you. This fractured experience does not occur separately from your social experience and development. If you are a child, and your personality is developing, your sense of self is going to occur in the same fractured way. So awareness of certain kinds of experiences, certain thoughts or certain feelings, is going to be separated from other kinds of experiences, and they are going to feel like different senses of self.

This creates problems.

It creates flashbacks, for one. As we move through life, we are automatically comparing the present experience to other experiences in the past to see which experiences it might be like so that we can use that information about past experiences to help us be successful in the present in how we respond. At the same time, we are discarding experiences that might at first glance seem similar but aren’t.

But trauma is in bits. The process of mining the past for comparable experiences becomes very difficult, because the memories aren’t rich enough or integrated enough to yield discomfirming details.

I’ll use my bathroom floor as an example. So, as most of you know, my bathroom floor is a kind of pebbly concrete that has been painted red. When I go in the bathroom, I see the floor first. It’s quite bright and noticeable. The most intense memory I have of red, pebbly surfaces involved murder and blood. It’s the first experience that comes to mind for comparison.

When this memory wasn’t processed at all, there was no way for my mind to discard walking into the bathroom as being quite unlike witnessing a murder. The rest of the pieces of that memory of murder weren’t processed. They were either totally unsorted—recorded, but not organized in any way—or stored separately. So every time I walked into the bathroom, the closest bits of that memory arose and presented themselves for sorting and processing and making sense of. Which was, of course, too much. I dissociated them again. And the process continued. It went on for quite a long time this way, until finally the memory was processed and integrated and not stored in a fractured way and so I can automatically discard murder as a memory quite unrelated to walking into the bathroom.

Dissociation of that kind also means you keep experiencing the world in a fractured way. The whole world becomes my bathroom—a possibly related experience that prompts memories of intense, overwhelming trauma—and it continues to be necessary to keep your attention restricted in order to keep life to a manageable level of input. So, it’s self-preserving.

One of the things I have done that has been helpful is to use this deliberate control of my attention to help me process the trauma. I went in the bathroom, and I didn’t pay attention to everything. I continued only paying attention to as much of the stimuli as I could and not more than that. I changed what it was that I paid attention to, but I didn’t try to do more, because biologically I can’t. I focused only on the emotion from the traumatic memory and on my attempt to regulate that emotion. About 1/100 of my attention was on scrubbing the laundry—that is what happens in the bathroom that involves looking at the floor for the longest stretches of time. But everything else was on the emotion and on my attempt to regulate. I shut out the pictures of what happened and the sounds of what happened. I shut out most of my awareness of the laundry. I definitely didn’t let my mind trot on to to worrying about what to fix for breakfast or for how the day was going to go. I kept controlling my attention so that it was focused on the piece that was going to help me.

I felt the emotion in my body and I controlled my breathing. Mostly that is what I did to regulate my emotional state. It’s hard to do a lot else when you are in the bathroom and the floor is wet with laundry water. Sometimes I stood up, because that helps with the emotions too. (Being close to the ground is its own trigger.) But mostly I controlled my breathing, because that helps me stay calm. If I were in a different situation or had had more soothing skills, I might have done something else, but what I had was breath control, so I did that. I did that nearly every day for about six months.

Outside of the bathroom, I went on working with that memory. I shut out my awareness of where I am now, and I only thought of maybe one element of the sensory experience, one thought, one emotion, and I went on doing something to try to keep the emotional intensity down in an artificial way. I controlled my breath, or I wrapped myself up in blankets, or I cuddled a hot water bottle, because those things are calming. I kept using my attentional controls to help me process only the amount of the memory that could be successfully processed until I finally had an integrated, whole memory that my mind now understands is quite different than walking into the bathroom.

And I think that is how you recover from trauma. You do something to lower the intensity of the emotions of the trauma—you do a lot of self-soothing and self-regulating—and you focus your attention very carefully so that it is on what needs to be processed but not more than that. Your attention is on only two things: one piece of the trauma and on the self-soothing. Until the trauma memories get sorted. But I am convinced that this is where it is mostly at, from the standpoint of what one needs to do: self-soothing or self-regulating and attentional controls.

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Touch

I wake up cold. It’s a cold night and I didn’t wear a jacket to bed. I do usually only because in the second before turning in for the night, it doesn’t seem all that necessary to take it off. Then while I am sleeping, I sweat from it. But if I arrange the blankets just right, I feel a little warmer again.

I have woken up before the alarm, and although it is time to get up—the alarm is not that accurate, and it ought to be ringing—I lie there trying to get warm, remembering other kisses.

Remembering Natalya’s casual kiss on the neck, Natalya’s hand on my back or my shoulder

The memories are so vivid, when I get up at last, I am confused.

For many reasons. But perhaps it is mainly because the impulse to try to forget remains in me. The impulse to deny, to say this never happened—because in reality, all of it is so unlikely—is still so strong.

But integration is never about shutting one part up. It is never about saying to myself It did happen and silencing the voice that makes me feel compelled to forget. It is about staying with the sensation of being kissed while also feeling the urge to forget I was. It is about standing the confusion of trying to do this until something magical happens and everything gets put in its proper place.

Which always does happen in the end.

For now, though, I am confused. I am confused at Natalya’s love. I am confused that anyone can love, or that love has a feeling to it. I am confused that it’s possible to feel what I felt—safe, warm, connected, content.

I lived in a cold world. It’s not just that it was violent, but that the coldness—the lack of care or connection—made violence possible. And it’s not that there was no affection in my house. There was. But there was no love in that affection, or if there was, I could not feel it. I was too afraid.

My mother also cuddled me and kissed me, but it was not the same. And not because Natalya was my lover in the memories I am having, or because it is a different kind of love, but because my mother did not love me.

She used me as others used me. Not to the same ends, but still an end. She used me to feel like a good mother, she used me to provide herself with warmth, she used me for purposes I would not have understood as a child.

And so with my mother, it was like being with Yuri. I complied. I tolerated. I endured.

As I remember this, I am struck repeatedly with disbelief. I am struck repeatedly by the truth of how I remember things.

I was loved only outside my family. I could take in love only outside my family. If nothing else, everyone within my family was too dangerous. I did not know where touch might lead, and I had no choices about it. No one was interested in how anything felt to me. No one took that into account. I could only brace myself for the onslaught of terrible feelings that might erupt within me at any moment: I could only try to steel myself against a physical or sexual assault.

When life is like that, touch never feels good. It is never safe. There is no possibility of warmth and you can never relax into anything.

But when life is not like that, there is.

New Year

I am leaving here in eight days. By the time I post this, it will be seven. So, while all of you may have thought of December 31st as the end of an old chapter and January 1st as the beginning of a new one, this is the end of the old chapter for me and the start of a new one will come very soon.

Mostly, our beginnings and endings don’t mean very much. You watch the ball drop or whatever it is you do to mark the exact moment of the ending of the year and find that the new year is more or less like the old one. But this one will not be like that for me. It will be dramatically different—both in ways I know ahead of time and in ways that I don’t.

I have free time right now. After the 19th of this month, I will not. That’s the most obvious of the changes. As it happens, I’ve also been living in a country not my own in a home down the street from my girlfriend. Those will be major changes as well. Nonetheless, what is really on my mind right now is the time I have had and what it has meant to me.

When the school year ended, I thought, “Now is the time to rework that novel that’s been on a back burner for so long.” And, “Perhaps now is the time to research a book on one of the several topics that interests me.” I might have had some other ideas about how to use that time also. Then I realized it wasn’t the time for any of those things. It was time to figure out how to be me for a while longer. I’m grateful I could do that.

However, I’ve been wondering today what that time got me. Did it help?

I suppose it did. It may have helped a lot. That will become more apparent, when I have responsibilities beyond following Uncle #2’s discursive conversations and walking the dog twice a day. On the other hand, I know that in the seven months I took off from employed life, I did not become a healed, whole person without any problems.

To some degree, I am still dissociated. I continue to have trauma symptoms of various kinds. Nothing was magically fixed. I am in something of an in-between state—not where I was, not where I had hoped to be.

So what is this place? It’s a place, I think, where I have wounds but I know what they are and why they are there.

Most of us use a variety of coping strategies to manage our lives. The more difficult your problems are to deal with, the more strategies you need to have. One of mine has been to be action-oriented and solution-focused. Like all strategies, it has a downside. The downside has been that I sometimes saw where I wanted to be more clearly than I saw where I was. (Of course, that is also the upside and the reason for doing it. We all need to motivate ourselves somehow.)

In other words, I sometimes saw my future self more clearly than my present self. My present self is still wounded. My present self is in pain.

My present self remains as evidence of the ways in which I have been harmed. Not seeing that with completely clarity has unfortunately also prevented me from seeing the full extent of that harm. I see it now.

Because of that, I am also seeing the whole matter somewhat differently. I am an ordinary person who was tortured for many years. The symptoms that trouble me now are not defects in my character or flaws in my personality. They are the effects of torture.

Torture wounds the mind more than the body. That is the primary intention of torture—to wound the mind. It also wounds the body, but the effect on the mind is greater. I hurt because wounds hurt; in the same way that a broken bone hurts, my mind hurts. The hurt is not something I “need to let go of” or somehow reach a kind of mastery over. It is not something I need to stop feeling. It is simply there, as a symptom of a problem that may or may not get better from here.

We all want to be the people we might have been had nothing horrific ever happened to us. That is not always what happens. The effects of torture are only sometimes temporary. Other times they are permanent. Irreversible damage to nerves, joints, or reproductive organs is not uncommon. It’s not clear whether the psychological effects are sometimes irreversible as well.

The point isn’t to become that person I might have been. It isn’t to become like I imagine everyone else is—whole and unharmed. The point is to figure out how to live.

That is what next year is for.

An hour, play, and an update

I have an hour. Nothing is planned or needs to be accomplished.

I could…

eat something.

hang the snowflakes I made for Christmas decorations and didn’t get around to doing anything with.

think some things through.

sleep.

An hour is so little time when you are hungry, tired, wanting to hang your belated Christmas decorations and have a lot on your mind to sort out.

Winnicott studied the development of children in WEIRD societies and then presumed these stages to be universal, rather than the effect on children of specific cultural practices. He thought he was a psychoanalyst, but he would have made a better anthropologist.
Winnicott studied the development of children in WEIRD societies and then presumed these stages to be universal, rather than the effect on children of specific cultural practices. He thought he was a psychoanalyst, but he would have made a better anthropologist.

It reminds me of Winnicott, who was convinced that people developed mental illnesses because they did not play enough. (That’s an oversimplification, but bear with me.)

How can you think about playing when there is so much to do? When you are hungry, tired, and just getting through the day takes everything you have?

I realized that after four days of playing. I don’t play—I haven’t played—because I had so many other pressing priorities. I was so deadly serious. I had to be.

And it gives my life a certain perspective. I am not a boring person, nor am I deadly serious by temperament. My life has been deadly serious.

“Work first. Play later,” I tell my students—who always want to play before working. I worked first. First, the work was staying alive. After that, the work was planning a way out for myself, so that the future would not simply be a continuation of the unbearable present. Finally, the work was addressing the remnants of the trauma so that managing my life could become a bit easier.

The work was done—enough work, anyway. I could play. It wasn’t difficult, although my cult upbringing didn’t help. (Something about always being alert, being ready, never frittering away your time, but keeping your mind on higher things. There’s no room for play in that. I had to deal with the anxiety of that, of wasting time. It wasn’t so bad. It was there, but not unbearable.)

I thought I couldn’t play because of some kind of personal deficit, or because I was too afraid to relax enough to play. And that was part of it. But mainly there was just too much to do. How could I think about playing when I had memory gaps? When I had phobias I couldn’t understand? When I seemed to be several different people?

“Work first.” There was too much work–decades of it. The “later” took a very long time to come. But I think it did come. There is still work. But not so much that I can’t also play.

And play is important. Play is when you can try new things, experiment, open the door to the unexpected and see what walks in. It allows you to discover new information—either about yourself or about the world—and it brings you joy. It is also the only way you can ever create anything worth reading or looking at or listening to. If you can’t play, you can’t create.

I have missed out on that for forty years. No longer.

So maybe you want to know how I played. There’s nothing spectacular to tell you. I did not go bungee jumping. I did not paint any masterpieces. (That would have been work in any case.)

I did not do anything on my “bucket list.” That would have turned my play into work: play is not intended to be on a to-do list.

Photo credit: Nevit
Photo credit: Nevit

I walked the dog. I walked Uncle #2. I made snowflakes out of painted newspapers. I spent the day in pyjamas when I wasn’t sick. I played computer games. I played card games with Nandhini. I disrupted my routine. I left off ironing my clothes. I drank kokum soda (which I liked) and ate mysore masala dosa (which I didn’t like).

Nothing much.

Play is a state of mind. It is not a specific activity or even a specific set of activities, and it is distinct from mere recreation. What characterizes play is not the task itself but an approach to the task: an attitude of openness, of “let’s see what will happen.”

If I take the dog for walks, will I be able to leash-train him? (Yes, I did.) Will I like it? (Yes, I do. So does the dog.)

If I teach Nandhini to play Uno, will she like it? (Yes, she did.) Will it be fun? (It was.)

If I order something new at Vaishali, will I like it better? (Yes and no. But I did learn something.)

You need recreation as well. But recreation need not be play. Recreation can be familiar, predictable, routine. It need not involve the unexpected, an experiment, or anything new. You can keep watching the same TV show, making the same splurges, having a coffee at the same place.

The two are different. I didn’t know that either. I learned that only from playing.

Some other thoughts on safety

It would be a quick death, but probably not painless.
It would be a quick death, but probably not painless.

I used to imagine a sense of safety as a permanent condition. You understood you were safe. You felt safe. End of story.

This morning, walking in the damp streets after an unseasonal rain in the night, I realized that wasn’t true. Safety as a sense is something that comes and goes, and also waxes and wanes in degree.

In the dark, in the first few hours after I woke up, the room seemed a bit creepy, grim. I felt uneasy. Not terrified, not that unsafe, but anxious.

And later, walking under a clear sky, a canopy of green leaves overhead, I felt at ease. Later still, sitting with the chai-wallah having my tea, I felt positively secure. I like him. He’s an old man. He smiles a lot. And he’s careful in the way he makes his tea. So I felt safe with him.

Some of this business of safety is really about feeling “safe enough.” Although I felt uneasy in the small hours of the morning, that was acceptable. There wasn’t any real danger, and I didn’t feel overwhelmed with fear–just not relaxed. And later, walking in the lanes of a still-quiet Pune, the feeling I had was better than acceptable. But I was still alert. I still looked carefully crossing streets. It wasn’t like being in bed, tucked up and cozy warm. Having tea wasn’t like sitting in bed either, but it was something close to it.

And I had assumed that all of life should feel like being tucked up in bed with a lollipop, that that was mental health. Not so. What changes is the baseline sense of safety–the feeling you have often enough that you start to think of it as normal. For much of my life, barely restrained terror has been that baseline feeling. That’s no longer the case, but tucked up in bed with a lollipop has not been it either, and perhaps I assumed it should be.

Several studies by Damasio et al have indicated that people with an impaired ability to feel emotions–those with brain lesions in the ventromedial region, a key area for emotional processing–make very poor decisions. Similarly, if I felt safe all the time, I’d never get across the street–let alone navigate other elements of life in a different country. You should be afraid sometimes. You should be anxious. You should be worried.

Sometimes.

Safety as a felt sense is not meant to be left in a permanently on or off position. It is meant to wax and wane, so that we know to be alert to danger and we know to be a bit more careful sometimes.

Another Not-a-Cat Post

It also means you sometimes put up with people taking stupid-looking pictures of you.
It also means you sometimes put up with people taking stupid-looking pictures of you.

I may or may not have mentioned this, but my cat is 17. She’s in remarkably good health, but she’s old. She’s got some of the same problems she’s had since she was a young cat plus some new ones. (As I will have also when I get to that age.)

She had an accident when she was young that involved falling off a roof. I know cats are supposed to survive falling just fine, but it turns out a lot depends on what you land on.

I’ll spare you the details, but the poor thing has had fecal incontinence and mild constipation for the last 11 years at least. (It turns out this is mostly a good combination.) It’s a little like living with a deer.

And now that she’s 17, she’s developing a tiny, tiny hint of bladder incontinence. If I had no sense of smell, I wouldn’t notice this. Unfortunately, I do.

Luckily, she's very small. And there's usually only one of these at a time.
Luckily, she’s very small. And there’s usually only one of these at a time.

Consequently, the bed is swathed in an easy-to-wash polar fleece throw.

There are some other annoying things she’s too creaky and arthritic to do anymore. For example, she has overcome her obsession with water, and I can now for the first time in more than a decade leave a water glass anywhere in the house that I feel like.

The knick-knacks on the upper shelves are safe as well.

My cat, in other words, is really, really cute. And a bit like living with a deer.

I love her to pieces.

She is not, however, anyone’s idea of a trophy cat.

I’m not a trophy person either. Although, so far, I seem to be able to stay away from the top shelves, and restrain myself from knocking over vases just to see where the water will go,

But I do have my issues. Some of them make me hard to live with, even for myself. (Luckily, none of them involve washing the sheets more often.) But they aren’t by any means all charming.

Miss America has her flaws too.
Miss America has her flaws too.

Just like the cat. And like the cat, I don’t really adore everything about myself. If you lined me up next to a bunch of other people, some of them might have fewer issues than me, some of them might be more beautiful or more socially adept. Some of them will probably know how to dance or how to play sports well. Some of them might be doing more to benefit our world. If you had to spend 24 hours a day with someone, it’s possible there might be better choices than myself.

But there’s this thing called unconditional love. If you practice it enough, you might learn how to do it. You might even figure out how to give it to yourself.

Unconditional loves means you might get annoyed sometimes. You might get frustrated. You might even get really, really angry. But day in and day out, you continue to care and to take care. You continue to think that in the larger scheme of things, this whole business might be worth doing. And you keep doing it.

Codependence and Exploitation

codependence
What I see in this diagram are methods of control common in exploitative groups. Punishment, withholding, and bribery (with affection, attention, or kindness) are the only ways to get anything done, because no one does anything except out of self-interest. Fairness doesn’t enter into the question, nor does genuine concern. It’s easy to imagine that fixing whatever problem seems to be at the center of all of this might end the exploitation, but it won’t, because exploitation has become the only way members know how to interact.

Codependency has been in our lexicons for four decades, but I wonder what it means still, and I wonder if we’ve misidentified some of its most important features.

The reason I wonder this is that its most important feature seems to be a lack of appropriate autonomy for individuals in relationships, and yet I’ve spent time in cultures where really no one ever attains the degree of independence that has been normal in mainstream American culture for a long time–and maybe most Western cultures.

Outside of WEIRD societies, people continue to seek their parents’s advice and guidance so long as their parents are alive. The idea of following a career or even entering a marriage your parent doesn’t approve of is unthinkably painful to many people–and although some people might do that anyway, it isn’t common. But these families are quite as happy as any other.

But people in codependent relationships are clearly not happy. And so I wonder if the pain that accompanies codependence has nothing to do with dependence or autonomy at all.

In joint families, individuals have little autonomy and even less privacy. Elders make most important decisions, and with more people living in the house, there is little room for individual preferences to play a role in small decisions.
In joint families, individuals have little autonomy and even less privacy. Elders make most important decisions, and with more people living in the house, there is little room for individual preferences to play a role in small decisions.

If you look back at my post on exploitative groups, what stands out very clearly is that those with the greatest power are able to extract the most value out of other members and are therefore the most harmful to others, but that nearly everyone in the group is engaged in some degree of exploitation with others. Most members are both exploited and exploitative of others.

What seems to arise out of that is a value system organized around exploitation. You might see “good,” as my father did, in being the person who has the most power, is exploiting others the most, and is therefore doing the most harm.

Or, you might see “good” as having the least power, exploiting others the least, and therefore doing the least harm (but being harmed the most).

It seems to me codependence is based on the latter understanding of virtue: Codependent people are usually trying to help others, but they help at their own expense, and they often help more than anyone can reasonably reciprocate. So you don’t see interdependence or reciprocity. You see individuals giving without getting much in return–either giving to someone who only takes, or giving in ways that require a great deal of effort by the giver but don’t actually provide that much benefit to the recipient. In other words, what’s being given is depleting, but the gift doesn’t recharge the recipient to the extent that he or she can return the favor.

Basically, codependence starts out as a leech problem. But the exploitative pattern of relating continues even after you rip off the leech.
Basically, codependence starts out as a leech problem. But the exploitative pattern of relating continues even after you rip off the leech.

Sometimes, what’s being nurtured in these relationships is a grandiose self-image or someone’s desire for constant attention. Other times, it is the tremendous demands of an untreated and possibly undiagnosed disease–like alcoholism or borderline personality disorder. But maybe that isn’t the problem either. The problem is exploitation and that far more is being given to someone or something than anyone is getting back.

Exploitative relationships are exhausting. They don’t meet your basic human needs and they don’t leave you with time or energy to meet your own.

And that is why, in Western societies, we notice the absence of meeting one’s own needs first. That isn’t really the defining feature of these relationships. Their defining feature is the drain on the time and energy. In more interdependent cultures, you would notice the failure of other supportive, nurturing relationships as codependent people lose the time and energy to maintain these relationships in the way they normally would.

I don’t know, but I wonder.