You’re Not to Blame!


Children often blame themselves for the bad things that happen to them. As adults, we don’t have to keep blaming yourselves.


In working with trauma survivors for over 12 years, a common theme I have encountered has been that people who are abused as children often take responsibility for what happened to them. They think that if they were lovable, stronger, or better able to figure out what their adult caretakers wanted, the abuse would never have happened. The sad thing is that many perpetrators of abuse say things to encourage their victims to feel responsible for the abuse. Very often these are people whose personal developments are immature and do not allow them to take appropriate responsibility for their actions. Therefore, they project responsibility onto the people they harm. This is true for physical as well as sexual abuse.

Of course, we humans are very good at justifying what we do, and our memory is self-serving in most cases. We’ll remember many events in a way that favors us and makes us look good. However, a healthy, normal adult can also take a step back and look at their behavior, realizing that there are more than one versions of any story. Thus, we can see ourselves as culpable and capable of mistakes in most situations, and hopefully take corrective action accordingly. People who hurt others often find it too uncomfortable and painful to take responsibility, so they have a binary system of responsibility. What this means is that they generally see everyone else as wrong and at fault, and themselves as perfect and poor victims who are acted upon by all those wrong-doers. Other adults can swat away people like this like so many flies, realizing that this way of thinking is unhealthy and dangerous to be around. But children are often stuck in a one-down position in relation to people like this. Imagine being the child of someone who can never admit fault, can never say “I’m sorry” after inflicting physical or emotional pain on you. Or worse yet, who can make you feel as though you deserved to get mistreated. This is one of the horrible side effects of abuse that takes a long time to heal.

If you have come to see your own childhood abuse as your fault, I hope that you can reach a point where you realize that you did not deserve it. It may take a while to realize this, but it is a very important part of healing from trauma. If you feel stuck and believes that don’t work for you, professional help may be essential to your healing. Please consider calling me if you are in the Antelope Valley area; my phone number is 661-233-6771.

Is my grief normal?


People often wonder if the way they respond to grief is “normal” and expected in relation to what other people do and say when they lose someone to death. Unfortunately, the answer is not always so simple. Some factors include the culture of the person, how they were doing psychologically before the loss, what they expect of themselves post-loss, and how they view the loss. For some folks, if their deceased love one was suffering greatly before they died so death may provide some relief, whereas someone who lost their loved one suddenly and unexpectedly may feel a sense of anxiety and bewilderment.

As mentioned in previous posts, there is a difference between what is psychiatrically considered normal, uncomplicated mourning and complex grief. A sense of bewilderment, some brain fog, sad feelings interspersed with other transient emotions, loss of appetite, and temporary anhedonia (not feeling pleasure in activities and things that used to bring enjoyment) are all symptoms of normal grief. Interestingly, other cultures seem to give people longer to grief before they consider a person’s grief pathological or problematic (e.g., Egypt). Our culture seems to think that most of the symptoms of grief should be over after about a year, which depending on the nature of the bond between the survivor and the deceased, could be an awfully short amount of time to sort out one’s feelings about the loss. To give you a sense of what is considered “complicated”, I refer to Pomeroy and Garcia’s book The Grief Assessment and Intervention Workbook for ease:

  1. Are you especially sensitive to other loss and separation experiences?
  2. Do you try especially hard to suppress anxiety with relation to loss and separation?
  3. Are you anxious about death and loss of other loved ones, or yourself?
  4. Do you have an especially strong, unrealistic idealization about the lost loved one or your relationship with them?
  5. Do you have rigid obsessions and compulsions about the dead person and the loss thereof?
  6. Do you avoid socializing with others because you’re afraid of losing new people too?
  7. Do you have a hard time expressing emotions about the loss, and does that difficulty last a long time?
  8. Do you self-sabotage other relationships after the loss?
  9. Do you abuse substances (drugs and alcohol) after the loss?
  10. Do you have PTSD-like symptoms like numbness, alienation, depersonalization, and emotional overwhelm?
  11. Do you have depressive symptoms like anger, irritability and hopelessness that last a while?

If these symptoms are present, you might want to get some help to cope with the loss with professional support. I would be happy to help you, can be reached at 661-233-6771. You can also look for a bereavement support group in your community. Many hospices have them and they are low or no-cost. Whatever you do, try not to judge yourself for what you’re experiencing. You are doing your best in a very hard situation.

 

What is a traumatic event?


In talking to a friend of mine recently, I realized that not everyone who experiences a traumatic event defines it as one. Some people who have had so many terrible things happen to them, think that such events are “just part of life… deal with them and get over it!” Unfortunately, it isn’t usually as easy as that sounds. Over a long period of time, traumatic events tend to accumulate and create self-defeating beliefs about ourselves and the world, as well as behavior patterns that get in the way of getting us what we want.

So just what is a traumatic event? More interestingly, what makes some people think it’s easy to “get over” an event, and what makes other people think the same event is traumatic?

A traumatic event is something that brings an overwhelming sense of terror, pain, or stress to the person experiencing or witnessing it. Some examples are having one’s wife threatened or watching someone be seriously injured or killed, as in war or gang violence. Rape can also be traumatizing, as well as sexual assault or molestation of a child. Loss can also cause trauma, especially if it is stigmatized, sudden and unexpected, or profoundly disorienting. Sometimes sudden change that isn’t life-threatening can also be experienced in a very disturbing way. For example, feeling disempowered by someone else, losing a job for friendship, nasty and ugly divorces, or being taken advantage of in a way that profoundly impacts your life.

 Some of the effects of trauma include emotional numbing, intrusive memories and flashbacks, nightmares, hypersensitivity to sound and other sensory stimuli, a heightened startled reaction, and exaggerated emotional response to things that remind the person of a trauma, and irritability that seems irrational to other people. Many people returning home from combat situations, who has been away from their families for a long time, have difficulty readjusting to civilian life because they are so used to ongoing stress of an unusual nature. Most of us are fortunate to not have to deal with such stressors, but even being in a very dysfunctional family with domestic violence, exploitation, or neglect can cause many of the symptoms. Sometimes people who have suffered from trauma hear other people say that they were traumatized by the situation, and they think “you don’t know what real problems like. You wouldn’t have survived what I went through.” What people don’t realize is that we all have different levels of sensitivity and resiliency to stress, including traumatic stress.

 I will talk about resiliency and another post, but basically you can understand it as a house metaphor. The foundation of healthy mental functioning is secure attachment, I believe. What do I mean by this? Attachments is a phenomenon that occurs between an infant and their caregiver. There are many different ways that adults and infants attach, depending on the mental health of both parties. But the most stable and secure attachments creates the ability to regulate how the infant feels. Over time, this helps the infant’s self-esteem, as well as responding to emotional stress. This is not the only thing that makes humans resilient to stress, but it does play a large part in resiliency. The interaction between the infant and the adult caregiver facilitates very complex and comprehensive brain development, and paves the way for dealing with life much more effectively. People who were unfortunate enough to have insecure attachment, or void attachment, have a harder time understanding and dealing with their emotions. It can be hard to control how they act, think and feel when under stress. Add to this and extremely stressful situation, like being assaulted, robbed, or seriously injured, and it makes it much more challenging to cope with post-traumatic stress.

 If you think that you have been through a traumatic event and need help healing from it, please call 661-233-6771. I’m happy to help you.

 

Loss of innocence


Childhood sexual abuse is hard to cope with, but it’s better dealt with while the child is young than when the experience has a chance to infiltrate the personality.


Sexual abuse, especially in childhood, is one of the hardest experiences I have helped people resolve. It is not always as brutal and acute as physical abuse or an isolated rape incident; in some cases people can be led to believe that what’s happening to them is normal and fine. I’ve heard a lot of people say that what bothers them most is not the sex act itself, although that is often disturbing (especially if it happened to them as children). It is the inappropriateness of the touch or sexual attention that bothers them, haunts them to the core.

I have seen mothers who have been sexually abused themselves as children become hypersensitive to any adult touching their children, even if it is not with sexual intent and is objectively appropriate. I have also seen the opposite extreme. Some parents thing that because what happened seemed “normal” to them, they disbelieve their children when the children tell them about being abused. Or they think the child is doing it to seek attention. I’m sure there are some children who do lie about such a serious matter, but I think that far more often, the child is telling the truth and the abuse goes unreported because they are afraid of getting the perpetrator in trouble. It is especially difficult for some parents to believe when the perpetrator is their own husband, wife, or romantic partner. There are also people who distrust the governmental agencies to whom they would report such incidents. I can understand that, and I don’t pretend that child protective agencies or the police always handle these matters well. However, they are still there to protect children from abuse and neglect, and if the abuse continues unabated it can have lifelong, damaging consequences.

Children need to be able to trust their environments and their caretakers to take appropriate action when they tell their parents they’ve been touched inappropriately. It wouldn’t kill us as a society to take them seriously until the facts have proven that they are not telling the truth. By their very nature, children don’t have the resources and awareness to protect themselves. We need to be in tune with our children to know when something is off with their behavior. We don’t need to necessarily jump to the conclusion that they’ve been sexually assaulted, but we do need to protect their innocence for as long as we can. If you think your child has been touched inappropriately, you can get them help: proper medical attention; psychotherapy; and legal and physical protection against the perpetrators. Don’t let it become their problem later on in the forms of depression; anxiety; PTSD; dissociation; and other psychological and behavioral problems.

Responsibility for Symptom Management


We need to have compassion for our loved ones with mental health and behavioral issues. We (and they) also need to minimize the damage that can come with mental illness symptoms. Taking responsibility includes getting consistent help and observing and managing our own behavior.


Much as some of us struggle to get well from mental illnesses like depression, Bipolar illness, and PTSD, sometimes we have a hard time keeping those troublesome symptoms to ourselves. This can make our lives miserable, and also be difficult for those whom we love. It can be hard for partners of mentally ill people to balance compassion with self-preservation, especially if the symptoms hurt or frighten the loved one.

I often see couples where one person has been traumatized by something that has happened in the past, whether it was done by the partner (as in infidelity or domestic violence), or by someone else in the person’s past. This increases the reactivity of the trauma victim. The trauma survivor can become very sensitive to noise, sound, tones of voice, or cues that remind him or her of the prior trauma. When the person gets triggered, they might yell, become angry, get scared, or act in ways that are hard for the other person to understand.

Often the person who acts differently feels bad about it afterward, once their brain has restored balance and they are no longer in the grips of overwhelming emotion. However, many times their loved one feels hurt and reluctant to trust them again, for fear of recurrence of the emotional instability and erratic behavior.

There is some grace that we allow each other in relationships, whether they are friendships, intimate/romantic relationships, or family ties. On the whole, if we know our loved one has a good heart and kind intentions, we can forgive some of the erratic or hurtful behavior. But the person with the mental issues also has a responsibility to take care of themselves as much as they can so that they can prevent hurting those they love. If a person keeps yelling at someone or treating them poorly, and says, “it’s because I’m triggered by you”, then they are not fully taking responsibility for their part in the interaction. It can be hard to forgive this kind of assertion. Yes, loved ones should educate themselves about their loved one’s mental illness and try to put the strange behavior in context. At the same time, however, the mental illness diagnosis doesn’t give a person carte blanche to act as they wish at that time.

There is nothing wrong with seeking help in coping with mental issues, and in going to groups like National Alliance for the Mentally Ill (NAMI) to get education and support. Both the person with the illness and the partner/friend/family member need to care for themselves and take needed medication, therapy, or whatever will help them cope better, as well as learn to act in a way conducive to healthier relationships.

More about EMDR


I recently found this article to be interesting and informative for people who are contemplating EMDR (Eye Movement Desensitization and Reprocessing) Therapy. I like that it explains the benefits even-handedly, and it’s a good little synopsis of what EMDR could do for someone with complex trauma (multiple traumas that affect the way people relate to themselves and the world). I share the author’s appreciation for how EMDR therapy emphasizes the importance of focusing on the somatic experience of trauma and re-processing. So much of what we experience in our lives is stored in the body, both pleasurable and painful experiences. I have also seen unresolved grief be stored in the body. The impact of these emotional and physical experiences become patterns that can become automatic, ingrained conditioned tendencies (to borrow a term from the great Somatic Coach, Richard Strozzi-Heckler).

What’s So Great About EMDR

While we’re on the topic of how body and mind respond to trauma, I would like to  recommend highly two wonderful books:

Waking the Tiger by Peter Levine, and

The Body Remembers by Babette Rothschild. Both are sensitive, highly experienced clinicians who write beautifully about how we can learn from our bodies to heal from trauma.

If you have more questions about EMDR therapy and how it could be helpful to you, I urge you to call me at 661-233-6771.

Everyday heroes


Lately I have been watching documentaries about luminary, courageous, amazing people like Nelson Mandela, Miriam Makeba, and Mahatma Gandhi. They all possessed strength and amazing grit to stand in the face of injustice and fight on anyway. Equally amazing is that they didn’t let their hardships well, harden them. They were still loving, forgiving people even when they had a chance for vengeance and retaliation. On a smaller scale, I think many people display courage and grit, as well as love and forgiveness, in their challenges. Many are unsung in their valiant efforts to deal with oppression, poverty, and many other social ills. They are heroic nonetheless.

Similarly, I think we can all agree that the people who have served our country and given their lives, limbs, and health for our country are brave and praiseworthy. As we approach Veteran’s Day, I want to give thanks and praise to not only the people who serve our country in the military, but also the people who have courage and strength in the face of everyday challenges that might feel like a battle to them.

For some people with depression, just to get out of bed in the morning is an act of defiance against the disease that insidiously aims to claim their wellness. For people with PTSD and Panic Disorder, leaving the house can take tremendous courage to face the jarring, threatening stimuli outside their cozy sanctuaries. Folks with chronic illnesses like rheumatoid arthritis and fibromyalgia can also have difficulty even moving their bodies, and yet they persist in getting up, doing what needs to be done, and marching on through the pain and fatigue. Even to reveal one’s true self to a loved one and face possible rejection, which might seem small to many, can be terrifying and mystifying to couples in an embattled relationship, or families with a history of dysfunction. All these acts of valor go unsung, and yet we do them because something inside us says, “I must go on. I cannot let this problem conquer me; I deserve a better life and so do my children and their children, etc.” So for all those unsung heroes, please know that someone appreciates the struggles you face, and how brave you are to persist in the face of opposition.

Sleep and PTSD


Recently, there has been interesting research about the role of safety signals in PTSD (Post-Traumatic Stress Disorder). It seems that when people are able to learn about safety and create that in their minds, they are able to get more REM sleep which helps them heal from the traumatic event. This is an article that contains a synopsis of that research:
http://psychcentral.com/news/2014/08/31/new-research-shows-sleep-critical-to-effective-ptsd-treatment/74318.html

One of the ways that I like to create safety for clients is with EMDR. I do what is called “resource” work with “installing” a safe person and a safe place by using bilateral stimulation (eyes going back and forth, alternate tones in the ears, or tapping the hands alternately) while the client thinks about a safe person and/or safe place. What is meant by “safe?” I usually encourage the person to think about a place where nothing bad has ever happened to you, and that makes you feel calm, happy and peaceful while you think about it. Similarly, for the safe person, it should be someone who has not had much conflict with you and who is dependably considerate of your needs and desires, hopefully even helpful to you. I have had many people tell me that this helps them feel calmer and less anxious or stressed when they practice thinking about the safe place or person regularly. Sometimes when we have less stress, it makes sleep that much easier, whether or not we have post-traumatic stress.

Veterans Day


Every November we honor our veterans in this country, many of whom suffer from serious mental health conditions. Many commit suicide, have depression, substance abuse problems, traumatic brain injuries, and anxiety, not to mention physical problems. According to the National Center for PTSD, 5.2 million veterans suffer from Post Traumatic Stress Disorder (Source: http://www.ptsd.va.gov/public/index.asp). I find it very sad how few veterans with mental health problems can get timely help from the VA centers in our country. Our own county, Los Angeles, is one among a few other places where veterans have to wait over two weeks to get treatment for their problems. Given how much these men and women have sacrificed to their country, it seems that quality mental health care should be available on demand. Sadly, however, many veterans that I have talked to cite distrust as one reason they stay away from the VA Centers. This begs the question, what is the solution? It is a complicated problem, I believe, for political and financial reasons, not to mention the very nature of PTSD itself. Many people with PTSD, combat-related or not, have an extremely hard time trusting other people. When they do reach out for help, they need to feel that they can rely on those who provide it to be consistent, caring and professional. I hope that we can improve our service delivery to our veterans, as well as to all US citizens, so that more people can get the help they need when they need it. Perhaps if more people receive treatment early and effectively, the need for interpersonal violence and war will decrease someday.

Traumatic Grief


This is a new way to think about grief, which is a more intense and prolonged form of grief that disrupts people’s lives over a long period of time. There are elements of PTSD or Post-Traumatic Stress Disorder, as well as sharp pangs of longing, searching for the dead loved one, and excessive avoidance of reminders of the dead loved one. A person can have strong sadness and other severe emotions, including fear and anger, and hostility and bitterness about the death. Intrusive thoughts, fantasies and memories about the deceased often plague these sufferers, and they have a hard time functioning. Sometimes people develop severe fears of illness and death in themselves or other family members, and they have a hard time separating their fears from reality. It is as though the death of their loved one acts like a wound, and any subsequent stressor feels like salt on the wound.

Some things that make traumatic grief worse include involvement in a court case, since that keeps the details of the loved one’s death fresh in their minds. Just when a person starts to recover, they have to re-experience the trauma of the loss all over again for a deposition or court date. Another factor is how close the mourner is to the deceased, as well as how their relationship was before death. I often see that when there was conflict between two people who were close, it is harder to let the death go because of intense guilt and/or anger. Lastly, the type of death can make a difference as to whether the grief is traumatic. Sudden or unexpected death of the loved one can trigger traumatic grief because there is no preparation for the loved one’s death. This is often the case with murder, suicide and accidental deaths.

If you or someone you know is having some of these symptoms, it is a good idea for them to get help for it. Grief support groups like the ones offered at hospices and through Compassionate Friends (for parents and siblings of deceased offspring) are one possible source. Another is psychotherapy. Please call me at 661-233-6771 if you would be interested in getting help for Traumatic Grief.