If I hurt you, you do not bleed….

Fonagy talks about individuals reverting to developmentally earlier forms of mentalization or non-mentalization entirely under stress and he also talks about entire systems remaining in non-mentalizing states. He talks about teleological systems, in which only concrete actions can be understood. In this kind of system, individuals become coercive: aggressive means are used to force behaviours which mimic the appearance of care. (I know you care about me, if you do want I want you to do. Hystrionic behaviour can stem from this motivation: if I make you feel uncomfortable enough, then maybe I can make you things I recognize as caring.

Another system he describes is one called psychic equivalence: thoughts are seen as real, and so thoughts must be carefully controlled. Results are equated with intention. There are no accidents.

Finally, he describes pretend systems, and this one strikes a deep chord with me. Only one’s own thoughts and feelings are real. Other people have them, but they are not experienced as “real,” leading to feelings of isolation and emptiness as well as intense selfishness. Lack of sense of reality to feelings “permits interpersonal aggression,” because their emotional impact has no importance.

It also permits acts of self-harm, because psychological existence is seen as being decoupled from physical existence. (I can destroy myself, but only kill off the bad or unwanted part of myself.)

That was also my dad, who could kill animals and people, because their deaths were not felt to be real or to have importance.

They were real to me, and I felt pain and fear when I witnessed his violence towards others. It was decades before I understood this as normal. I grew up seeing only self-interest. I didn’t know I put myself in the place of corpses, because that is actually natural for people to do: not just I could be next, but I tried to understand what it was like to be them, to be dead and to be chopped up into pieces, because actually that is what people do. Imagining the experience of others is natural.

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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.

Lakme

lakmeI have 200 rupee eye liner from India. It’s a nice brand: Lakme. But it’s different from what I’m used to in the US. It is black, for one. You can’t find brown mascara in India and so I bought black eye liner, thinking maybe they should match. The pencil is much, much softer, so that it goes on in a thick line regardless of how thinly I try to apply it. Mainly, I don’t.

I realized last night, putting it on for our farewell dinner with the Minister of Education, that it is made that way because that is how Indian women like their eye liner. When I do wear it, I need to change my paradigm for how eye liner should look. And I can do that.

Meanwhile, I felt like a whore. Specifically, I felt like a seven-year-old child being trafficked for sex. Because they did that: dressed me up in pretty dresses, applied heavy eye-make-up and let the cameras roll.

I felt that way because that happened. Internally, there’s a crush of both belief and disbelief. Because of the extent of my denial about my childhood, these kinds of experiences have felt to me like evidence that I’m over-reacting or histrionic or even crazy. But this is just how memory works.

 

The Long Dark Tunnel

Most of getting better for me has involved sitting with memories and simply being with them, being with myself while I relieve them in very intense and seemingly real ways. This kind of being with them can feel like ascending into the Underworld or entering a long, dark tunnel.

street_tunnel

Sometimes, I come back from these little trips with bits of understanding. Other times I am just exhausted. But going there and coming back into normal life again, with the cat on the bed grooming herself, and the dust on my shelves and the laundry and things really not being so bad seem to be part of the process.

I set aside time for this–less as the years go by. It is a part of my weekend routine most certainly, and it used to be part of my daily routine. Not pleasant, I can tell you, but necessary.

I made one of those little trips down that long-dark tunnel into horror this morning and I came back with this little treasure. I thought perhaps others might be able to relate to it, so I thought I would share. And there is also an irony to it, so I thought I’d share that as well.

To so many people, I was only a body growing up. A hollow vessel, suitable for shoving things inside, capable perhaps of doing things also. I was, after all, enslaved. But for the people who used me, there was no expectation that anything existed inside me–no soul, no will, no feelings of my own. Only a body.

A lot of survivors of various kinds of abuse feel a split from their bodies, a distance. The body is the site of such intense pain, sometimes shame. I suppose I feel that too. But mostly I feel a profound desire to be more than simply a vessel, more than only a body that can do things. I want to be what I really am: a person, with a soul, and desires and feelings.

The irony I mentioned earlier is that the religious cult I grew up impressed upon me the same kind of split, but from the other direction. We were expected only to be soul, to deny our bodies, but also our individual will, desire, feelings, and ego. I’m not really sure what is left after that, or what is really meant by the soul in that context, but the fact is we were spoken about as empty vessels who also denied the importance of bodies. But still vessels.

I know I don’t want to be a vessel. I don’t think we were meant to be vessels. I think we were meant to be people, all filled up inside.

I Can Do This Later

“I’m not going to die tomorrow. I can do this later.”

In addition to relentlessly planning ahead in tiny, tiny increments, I also feel everything needs to be done RIGHT NOW. TODAY. Or at least very, very soon.

That doesn’t mean everything gets done. Sometimes there is so much to do, I can’t figure out where to start or end or how to prioritize and nothing gets done at all. Sometimes I get overwhelmed. Sometimes I refuse to think about anything and start at the beginning of the work and keep plugging until someone calls time. And who knows if what was important got done or not. I did something. And then stopped.

But regardless of what has actually gotten done or not done, the sense of urgency has remained. Until now. When I thought quite suddenly, “I don’t have to do that now. I can do it tomorrow. I’m not going to die and leave it undone.”

I’m not sure how many people can relate to that: not a fear of death, but an expectation of death. All the “t”s must be crossed, the “i”s dotted, because I will most likely die within days of now and I will have left all of these embarrassing loose ends. The sink won’t have been cleaned, and there will be dirty socks on the floor, and dishes in the sink. And no one will be able to make heads or tales of the piles of paper on my desk that I didn’t get a chance to grade.

I don’t have cancer. Just an extreme view of mortality. And I should reassure you it’s not that my death scares me. I have just expected it, daily, for about the last three decades.

Until today. When I thought, “I can do this later. I’m not going to die.”

Unbearable Truths

I’ve just finished reading a really fantastic book. It is called Unspeakable Truths and Happy Endings: Human Cruelty and the New Trauma Therapy. The author, Rebecca Coffey, recounts the stories of a number of people with trauma issues who are trying to get better, including their stories of trauma. Her main point is that the rest of us need to be better listeners. Trauma survivors need to tell others what happened to them in order to again feel part of humanity, but so many people fail to do so because of the distress that listening to these stories causes.

Hearing about traumatic experiences leads those who haven’t been traumatized to question their own understanding of the world as a relatively safe place mostly populated by relatively safe people.

In a word, trauma precipitated by the cruelty of other human beings forces us to confront the capacity for people to be cruel. In order to recover from trauma–and in order to hear the stories of trauma survivors–we need to confront the human capacity for evil.

Throughout her book, Coffey returns to the stories of survivors she introduces early on, probing them, expanding upon them, reconsidering them. Madeline Goodman (not her real name) was gang-raped as a teenager by 27 young men at a party and then left for dead. In trying to heal from her trauma, Madeline must both confront the evil of those 27 young men who perpetrated the rape as well as other victims who were released and failed to go for help.

In other words, she must confront not only evil but the indifference of others to it.

Those have been my struggles as well. I can, in fact, come to grips with the sadism and lack of empathy of my father and my mother’s dangerous emotional dysregulation. I can accept that there are others in the world like them. Just as no two cheetahs have the same pattern of spots, the souls of human beings are not the same either. And some people want to harm others–either because they enjoy it, or because harming others helps them cope with their own pain.

But it is difficult for me, just as it is for Madeline, to confront people who might have helped but didn’t. In some cases, given the limits of the courts and justice system at the time I was abused, people who cared and wished they could help were powerless to do so.

But later, when all I needed to do was to heal from what had happened, people continued to not help. I am thinking here specifically of the years I spent in psychotherapy–more or less just spinning my wheels. There was a marginal benefit of spending an hour a week with a therapist, but it did no more than take the edge off. I did not get substantially better until I gave up on the power of the outside world to help me and began to read.

It took me about 7 years to figure out what I needed to do to get better. After that, I was able to improve substantially quite rapidly. I do see a therapist now, but I no longer expect her to know how to help me. I go in for each session with a purpose and I consider ahead of time whether what I want from that session is something that we both have the tools to give me. Anything we can’t do together is homework. And I have a lot of homework.

There isn’t a lack of knowledge in the field about how to help people with intense and complex traumas, but the individuals I have looked to for help didn’t have it–and haven’t sought it out when it should have been clear that I was not being helped by what they knew.

It bothers me that I don’t trust anyone to be able to help me. It seems an unnecessarily negative and pessimistic view of the world. But people haven’t. I spent a decade waiting around hoping someone could help me. No one did.

What I am left with is wondering why. Because I am thinking here of people who did care–unlike the original perpetrators in my life, they did care. They didn’t want me to suffer. They wanted to help. But they didn’t know how and they didn’t try hard enough to find out that they learned.

I am left thinking they didn’t because it was easier not to. The pain of witnessing my continued suffering was easier to manage than the pain of confronting the gap in their knowledge. And I suspect the largest part of that pain was the pain of accepting the world as it is: a complex place, full of both good and evil, in which we are sometimes powerless.

And although I was in more distress, I had more tools to deal with it than they did. although they were not sufficient, but I lacked their choices. Not confronting my helplessness or the powerlessness of others to help left me in the grip of unbearable memories. Not accepting the human capacity for cruelty left me in a state of unremitting fear. It was easier for me to accept unbearable truths than to wrestle with them.

But for others, who haven’t directly experienced life in that way, there are different choices. And among them is the choice to simply close their eyes and refuse to see.

Insomnia

All of the bad things that might happen to me due to my poor sleeping. Wikipedia.
All of the bad things that might happen to me due to my poor sleeping. Wikipedia.

I can’t sleep. Pretty often. After the shift to daylight savings, my life becomes a slow torture because I can’t adjust. I sleep less than ever these days.

Mostly, I don’t fall asleep. From time to time, when I’ve very stressed, I wake up very early in the morning and can’t sleep again. Or I wake repeatedly in the night. But mainly I can’t fall asleep.

I have decided I don’t know how. I spent so many years trying to stay awake, watching the door, trying to be prepared for what might happen after the lights went out and the house went quiet that I’m good at keeping myself up.

Other people talk about their minds racing. Or turning worries over and over in their minds. I try to give myself interesting problems to work on while I lay in bed, not sleeping. I used to do math in my head, but nowadays math is a little more stressful. Math problems keep me up. They don’t put me to sleep. The thinking is just to give myself something to do while I go on not sleeping. It isn’t keeping me up.

My body is keeping me up, not my mind. I’ve tried relaxing visualizations. It doesn’t really help. I imagine lying in an island paradise, the birds calling, wind rustling, the distant sound of the sea. It’s gorgeous, but my legs still want to move. They want to stand up. My eyes want to open.

Falling asleep is physiological. Your respiration slows, your heart slows. Everything begins to slow. And then you sleep. I am thinking about island paradises while my heart goes thumping away at the usual pace. Nothing is slowing down. My mind might be relaxed, but my body isn’t.

It reminds me of when I used to meditate many years ago. I stopped doing it because all I did was fall asleep. Usually for hours. Meditation made my heart slow down, my respiration slow. Everything began to slow and I fell asleep.

I’m thinking I’ll look into Zen meditation again. Little did I know—those 25 years ago—that it was exactly what I needed. Just for something other than I wanted to use it for.

If you’re anything like me, your mind can slow down. It can come to a complete standstill. No thoughts at all. But getting the body to unclench and let go of the day’s tension is another matter entirely. Sometimes we need to start with the mind to heal, and sometimes we need to start with the body. Trauma (and other difficulties, I suppose) are not just in the mind or just in the body. They are in both.