Complex PTSD Page 6
“I went to the beach a couple of days ago in the morning and sat watching the sun coming up. I had an incredible moment of the purest clarity. I was watching birds flying low over the water, the moon was still visible and the sun was rising. I realized I was looking at three planets and there was not another person in sight.
“It was a moment of breathtaking beauty and the tears slid down my face at how deep it is possible to feel. I have been numb for so long. I wrapped my arms around myself and felt the presence of the little one so strongly it was almost painful but in a healing way if that makes sense. I realized that all the life experiences I have had to date brought me to that exact moment and gave me the depth to appreciate it at that level. A sense of peace washed through me like a gentle wave and for a few moments I felt a connection to a feeling of everything being part of life. It was breathtakingly beautiful. I felt like I was experiencing this moment with all of my senses and I never knew it was possible to be so much in my body.
“The gratitude feeling is deep and profound when it occurs. It feels like a moment of connection to life itself on the deepest level and all life circumstances and what I deem as problems pale to insignificance in those moments and there is only love in its purest form. It truly feels like a blessing albeit fleeting but gives enough sustenance and hope to continue the journey.”
Whatever the source, spiritual or numinous occurrences sometimes provide the survivor with her first sense of belonging to something bigger and essentially good. Such experiences can lead a survivor to an author or speaker or fellow traveler with similar sensibilities, and sometimes a door opens for finding comfort with a fellow human. Eventually, this may even grow into a sense that there are some humans out there who are good and safe enough to engage with.
Gratitude And Good Enough Parenting
When developing children receive “good enough parenting”, they feel that life is a gift even though it typically comes with difficult and painful experiences.
The term good enough parenting derives from the work of renowned adult and child psychologist, D.W. Winnicott, who coined the term “good enough mothering” to describe his observation that children do not need parents to be perfect. He noticed through his long career that children grew up with their self-esteem and capacity for intimacy intact when their parents were reasonably consistent with their love and support.
Nowadays, many therapists attach the phrase “good enough” to concepts like friend, partner, therapist or person. This is usually done to deconstruct perfectionistic expectations of relationships - expectations that are so unrealistic that they are destructive to essentially worthwhile relationships.
When I apply the concept of “good enough” to people, I generally mean that a person is essentially good hearted, tries to be fair, and meets his or her commitments a large portion of the time.
I also like to apply “good enough” to other concepts such as a good enough job, a good enough try, a good enough outing, a good enough day or a good enough life. I apply this concept liberally to contradict the black-and-white, all-or none thinking of the critic which reflexively judges people and things as defective unless they are perfect.
Good enough parents provide generous amounts of support, protection and comforting. They also guide their children to deal constructively with recurring existential difficulties such as loss, real villains, painful world events and normal disappointments with friends and family.
Most importantly, they model how disappointments with intimates can be repaired. A key way they do this is to easily forgive their children for normal mistakes and shortcomings.
Children who receive good enough parenting easily recognize and protect themselves from bullying and exploitive people because they do not have to become accustomed to being treated unfairly.
Growing up in a safe and loving enough family naturally enhances the child’s capacity to notice and enjoy the many gifts that life also brings. He learns that there is enough good in life to significantly outweigh its necessary losses and travails.
In the traumatizing family however, there is little or nothing that is good enough and hence little for which to be grateful. The child instead is forced to over-develop a critic that hyper-focuses on what is dangerously imperfect in her as well as others. This sometimes helps her to hide aspects of herself that might be punished. It may further assist her to avoid people who might be punishing.
Unfortunately, years of this habituates the child into only seeing herself, life and others in a negative light. Consequently, when she grows up and becomes free of her truly harmful family, she cannot see that life offers her many new possibilities. Her ability to see the good in herself and certain safe enough others remains developmentally arrested.
The cultivation of gratitude requires a balanced perspective. You can learn to see and appreciate the good in life without giving up your ability to discern what is truly negative and unacceptable in the present.
SOMATIC HEALING
Trauma takes its toll on the body in many ways. We need to comprehend the physical damage that Cptsd wreaks on our bodies to motivate us to adopt practices that help us to heal on this level.
Most of the physiological damage of extended trauma occurs because we are forced to spend so much time in hyper-arousal – stuck in fight, flight, freeze or fawn mode.
When we are chronically stressed out [stuck in sympathetic nervous system activation], detrimental somatic changes become ingrained in our bodies. Here are some of the most common examples of body-harming reactions to Cptsd stress:
Hypervigilance
Shallow and Incomplete Breathing
Constant Adrenalization
Armoring, i.e., Chronic muscle tightness
Wear and tear from rushing and armoring
Inability to be fully present, relaxed and grounded in our bodies
Sleep problems from being over-activated
Digestive disorders from a tightened digestive tract
Physiological damage from excessive self-medication with alcohol, food or drugs
Moreover, in cases of physical and sexual abuse, our capacities to be physically comforted by touch are eliminated or compromised; and, in cases of verbal and emotional abuse, our capacities to be comforted by eye- and voice-contact are undeveloped or seriously diminished.
Somatic Self-Help
The good news is that some somatic repair happens automatically when we reduce our physiological stress by more efficient flashback management. Particularly potent help also comes from the grieving work of reclaiming the ability to cry self-compassionately and to express anger self-protectively. Both processes can release armoring, promote embodiment, improve sleep, decrease hyperarousal and encourage deeper and more rhythmic breathing.
Without further expressly somatic work, however, a full relaxed inhabitancy of your body may not be achieved. Fortunately, there are other modes of self-help for healing the physiological wounds of Cptsd. The “Somatic Mindfulness” and “Introspective Somatic Work” sections of chapter 12 describe techniques that can help you to decrease adrenalization, to relax more deeply and to improve your digestion. Moreover, Step 7 of the flashback management steps at the beginning of chapter 8 contains six somatic, self-help techniques for relaxing out of the physiological hyperarousal of a flashback.
Another especially helpful somatic practice is stretching. Regular systematic stretching of the body’s major muscle groups can help you to reduce the armoring that occurs when your 4F response is chronically triggered. This results from the fact that 4F activation tightens and contracts your body in anticipation of the need to fight back, flee, get small to escape notice, or rev up to launch into people-pleasing activity.
Learning to stretch was a major ordeal for me because of my extreme body armoring. As noted above, it was a task of self-nurturing that I resented intensely, and it took me a long time to adopt stretching as a regular practice.
The fact that I had to weather many toxic shame
attacks because I was always the least flexible person in the group did not help matters. Moreover, when various people commented about how good it felt to stretch, I felt both puzzled and further shamed, because it was anything but pleasant for me.
Thankfully however, reading the literature about it convinced me about its great importance, and persistent practice eventually gave me results that I could not discount. I was rewarded by the resolution of decades old back problems. And although I still rarely enjoy the practice, I am absolutely convinced that it explains why I am still able to run, swim and play basketball in my mid sixties. Stretching has become for me a true labor of love and self-nurturance.
Yoga, massage, meditation and relaxation training are formalized disciplines to aid in letting go of unnecessary body tension. Reasonably priced classes in these modalities are usually available in most communities.
Finally, freeze types and freeze subtypes also typically benefit from various types of movement therapy and aerobic exercise regimes. Moreover, assertiveness training and anger release work are especially helpful for survivors who have difficulty accessing their assertiveness or instincts of self-protection.
Cptsd And Somatic Therapy
There are also various somatic therapies that can help our bodies heal. As with my earlier comments about CBT, I encourage you to be wary of somatic approaches that claim to heal Cptsd without working on the cognitive and emotional levels described above. Some approaches, in fact, blanketly dismiss cognitive work in a way that sidesteps the crucial work of shrinking the inner critic. Some approaches also believe that their techniques eliminate the fundamental necessity of grieving the losses of childhood, and understanding how abusive and negligent parenting is at the root of our problems.
Nonetheless, some somatic therapists can ease the physiological traumas that are locked in our bodies, as long as the practitioner is not actively dismissing or impeding the client’s cognitive and emotional work.
In this vein, it is my opinion that techniques like EMDR [Eye Movement Desensitization Reprocessing] and Somatic Experiencing are very powerful tools for stress-reduction. They are especially helpful in resolving simple ptsd. However, they are not complete Cptsd therapies, unless the practitioner is eclectic enough to be incorporating inner critic and grieving-the-losses-of-childhood work.
Other helpful somatic techniques include Rosen Work, Rolfing, Rebirthing and Reichian work. These techniques can also be very helpful in aiding the recovery of the ability to therapeutically emote both tears and anger.
For survivors of physical and/or sexual abuse, I believe Rosen Work is especially helpful. I found that Rosen Work’s emphasis on soft touch helped heal my Cptsd startle response to physical touch. A startle response is the sudden full body-flinching that survivors experience at loud noises or unanticipated physical contact. This is usually a somatic flashback to previous abuses. In my case, the startle response was installed in me by my parents through frequent face-slapping. As a lap-swimmer in public pools, it has taken me ages to significantly reduce being triggered by the hand and arm movements of people who swim alongside me.
I also had to shop around to find a Rosen worker who welcomed my use of the verbal ventilation process. Some practitioners prefer to work in silence, and this limits or eliminates the therapeutic benefit to most survivors.
It is also important to emphasize here that somatic therapies can be especially helpful in healing the anxiety reaction to touch and physical closeness that many survivors of physical or sexual abuse experience. Exceptions to this are the survivors that I have met who have experienced remediation of this symptom through the help of an especially kind and safe partner.
The Role Of Medication
As a psychotherapist, I am not authorized to give pharmaceutical advice, but I have frequently noticed that survivors who need pharmaceutical help seem to benefit most from SSRI anti-depressants. Taken at the right dosage SSRI’s do not usually blunt your affect in a way that makes grieving impossible. Moreover, if your critic does not budge with extended critic-shrinking work, SSRI’s can usually reduce its volume and vitriol enough so that you can effectively shrink it. Once it is diminished enough, you can dispense with medication. One caveat here is that unless you do extensive critic shrinking work, the critic will be as strong as ever when the medications wear off.
Self-Medication
For those who have been repeatedly unsuccessful at stopping or reducing the use of non-therapeutic medications and substances, Gabor Mate’s work on harm reduction may be helpful. Drug and alcohol recovery is beyond the scope of this book, but if you are stuck in habits of self-medication that are not allowing you to progress in your Cptsd recovery, I encourage you to get help from a substance abuse recovery program or from Twelve Step programs like Alcoholics or Narcotics Anonymous.
Working With Food Issues
Let us explore one last arena of physical healing, and that is dietary self-help. I agree with John Bradshaw who says that almost everyone who grows up in a dysfunctional family has an eating disorder. This is a key factor in the digestive track problems that are a common symptom of Cptsd.
Changing your eating habits is extremely difficult. A client left this quote on my waiting room bulletin board: “Alcohol and other drug recovery is like dealing with a tiger in a cage. Recovery from eating disorders is like taking that tiger out of the cage three times a day and then taking it for a walk.”
Deconstructing food addictions, then, is daunting work that needs to be approached gradually and with a sense of compassion. This is because children who are traumatically abandoned naturally turn to food for comfort. Food offers us our first outside source of self-soothing, and when a child is starving for love, he frequently makes food his love object. Over the years he commonly “elevates” it to the status of a drug. Moreover, increasing scientific evidence is showing that processed food products combining high levels of sugar, salt and fat are especially addictive.
Food addictions begin pre-verbally. They are functional and useful at the time and help us to survive the unbearable feelings of the abandonment mélange. Unfortunately, we are typically forced to rely on food-soothing for so long that this over-dependence is extremely difficult to overcome, and I do not recommend that anyone in early recovery make this their primary focus unless they have a life-threatening food issue. Instead, I prefer to recommend Mate’s harm reduction approach. Additionally, Geneen Roth’s book, Breaking Free from Compulsive Eating, also offers a moderate and sensible approach to dietary improvement.
While many survivors can be unconscious of their damaging eating habits, I have met various survivors who take it to the opposite extreme. I was once in the ranks of those who obsessively over-focus on dietary self-help hoping and expecting that all their suffering will be resolved if they can just find the perfect diet. Many also chase after every new highly touted supplement in this pursuit. Some of us also approach exercise in this manner.
These are understandable but simplistic versions of the salvation fantasy, and are typically pursued at the exclusion of working on more core issues of recovering. Nonetheless, almost everyone has some ideas about how they can eat [and exercise] more healthily. My recommendation is to try dietary adjustments when you can on a moderate, doable level.
IMPROVING RELATIONSHIPS
Forewarning:
There are instances of parental betrayal so extreme, that it is not fair or reasonable to expect the survivor to try to trust human beings again. If the recommendation in this chapter to open to the help of others feels too upsetting or overwhelming, please feel free to skip this chapter. There is a great deal of other material in this book that can help alleviate the many symptoms of Cptsd, and since recovery is relative and never complete, you do not need to implement everything in this book. As they say in the Twelve Step Movement: “Take the best and leave the rest.”
Moreover, as I have experienced personally, and as numerous of my clients and website respondents have demonst
rated to me, real relational healing can and does come from non-human sources. This is especially true of mammalian pets whose attachment needs and wiring are similar enough to ours that mutually healing connections can evolve between us. Dogs and cats can be a tremendous source of what Carl Rogers describes as the “unconditional positive regard” that young children must have in order to thrive.
Other therapeutic relational sources include nature, music and the arts. Moreover, for some survivors, authors of helpful books can be kept at safe distances while they contribute to your healing.
Finally, even with the most heinous betrayals, miracles sometime happen in terms of discovering a healing human connection, particularly in the later stages of recovery.
Cptsd As An Attachment Disorder
Many therapists see Cptsd as an attachment disorder. This means that as a child the survivor grew up without a safe adult to healthily bond with. As bears repeating, Cptsd almost always has emotional neglect at its core. A key outcome of this is that the child has no one in his formative years who models the relational skills that are necessary to create intimacy.
When the developmental need to practice healthy relating with a caretaker is unmet, survivors typically struggle to find and maintain healthy supportive relationships in their adult lives.
The Origin Of Social Anxiety
A child who grows up with no reliable human source of love, support and protection typically falls into a great deal of social unease. He “naturally” becomes reluctant to seek support from anyone, and he is forced to adopt self-sufficiency as a survival strategy.