Complex PTSD Read online

  Needing anything from others can feel especially dangerous. The survivor’s innate capacity to experience comfort and support in relationship becomes very limited or non-existent. This is despite the fact that many high functioning survivors learn to socially function quite adequately.

  This is particularly the case in structured situations where expectations are clear and common goals take the focus off conversing and put it on task accomplishments. Unstructured social situations however, like attending parties or just hanging out can be considerably more triggering. Spontaneous self-expression feels like the same setup for disaster that it was in childhood.

  Either way, structured or spontaneous, relating often involves hiding a great deal of anxiety and discomfort. One very successful businessman client of mine told me: “I’m so cool, calm and collected in meetings. A veritable wordsmith with the composure of Michael Caine. I’m a king on the outside, but on the inside I’m a drama queen anguishing in doubt and shame about everything I say or do.”

  In worst case scenarios, social anxiety can devolve into social phobia, especially during prolonged flashbacks. Extensive childhood abuse installs a powerful people-are-dangerous program.

  When I was at my least recovered, I couldn’t take out the garbage when I was in flashback. I feared that my neighbor – my sweet, always affirming neighbor – would look out the window and see how wretched and pitiful I was. Even worse, I dreaded the prospect that she might come out and want to interact with me.

  Nonetheless, I socialized for decades when necessary, and seemed to be doing it with a considerable amount of success, no matter how dreadful the reviews were from my critic. I even eventually came to see, when not in flashback, that a lot of people really liked me.

  Unfortunately, however, I rarely derived any satisfaction or comfort from this perception, because underneath my smooth persona, I was writhing in discomfort, and typically measuring the time until I could least obtrusively make my escape.

  A Journey Of Relational Healing

  The incident I am about to describe marked a huge step in my long, gradual journey of opening to real intimacy. I was sitting on my porch with my dog George, the only being I could truly relax with, when he broke his lead and sprinted across the street in pursuit of a cat. Before he could get to the cat, he was run over by a car – both axels-run over. It was the worst thing that ever happened in my adult life, and when the shock [dissociation] wore off, I was drowning in the abandonment mélange.

  Beyond devastated, I felt panicky and catatonic at the same time. As I had to in childhood when feeling overwhelmed, I hid in my room for thirty-six hours - dreading contact with my fair weather friend-roommates. I was 28 and still thoroughly phobic about showing any vulnerability. All my relationships had been developed under the guise of my people-pleasing, funny guy persona, and in my current state there was not a joke anywhere to be found. There was no way I would let myself be seen in what felt like a repulsive condition.

  I could not sleep, and as sleep deprivation deteriorated into a fear that I was truly going crazy, out of nowhere came this amazing grace. Grace disguised in a form I usually abhorred. It was the grace of a deep surrender into weeping - a long sobbing release more soothing than anything I had ever experienced before.

  It was the release I describe in chapter 11 and extensively throughout my first book. When the tears were cried out I knew I would be okay and I knew I was not going to go crazy. I could face my roommates with the realest, perhaps the first sense of self-esteem I had ever known. And from that point on, I knew I wanted more of these incredibly healing tears.

  Healing The Shame That Binds Us In Loneliness

  I soon discovered however, that my tears were as stuck as they had ever been, or at least since I was six – the last time I could remember crying. Further reading and researching then lead me to seek help, and so ensued my baptism into therapy, blessed by the great fortune of finding a good enough therapist on the first try.

  This was a milestone achievement for me, and it evolved into a long meandering journey of finding more relational help with an array of healers, therapists, therapeutic groups and deeper friendships. These experiences ranged from extremely helpful to counter-therapeutic, but as time went on they became increasingly helpful.

  A central aspect of the truly helpful relational work was what John Bradshaw called “healing the shame that binds.” I believe toxic shame cannot be healed without some relational help. Several therapists and groups aided me greatly to unbind from the shame that made me hide whenever I could not invoke my perfect persona. Concurrently, I learned that real intimacy correlated with the amount I shared my vulnerabilities. As I increasingly practiced emotional authenticity, the glacier of my lifelong loneliness began to melt.

  It is important to note here that groups can be even more powerful for the healing of shame than individual work. This is because there is typically more mutual vulnerability in a group than in individual work. Moreover, feeling compassion for someone who has suffered similarly to us sometimes naturally expands into feeling the same for ourselves.

  Therapeutic relational experiences enhanced my self-compassion considerably further than what I was able to accomplish on my own. Moreover, I believe that insufficient self-compassion is the worst developmental arrest of all, and restored self-compassion is the keystone of all effective recovery.

  In retrospect I can clearly see that as my self-compassion increased, my toxic shame decreased. Modern advances in neuroscience [see: A General Theory of Love] suggest that we are intrinsically limited in our ability to emotionally regulate and soothe ourselves. More and more research suggests that our ability to metabolize painful emotional states is enhanced by communicating with a safe enough other person.

  Finding Good Enough Relational Help

  In chapter 13, I provide guidance about how to shop for a good enough therapist. I also explore more deeply the principles of therapeutic relational healing to help you know what is reasonable to expect from your therapist.

  I have also met a number of survivors who have been lucky enough to get this kind of relational healing from a partner or a friend, typically one who had good enough parents or who “has a lot of recovery”.

  Finally, attachment theorists have developed the concept of earned secure attachment to describe the recovered enough state where the attachment disorder of Cptsd becomes sufficiently healed. This is typically evidenced by the survivor forming at least one supportive and reliable enough relationship.

  Many of the successful therapies I have guided come to an end when the client gains an earned secure relationship outside of our therapy. This is typically a partner or best friend with whom the person can truly be themselves.

  Another potential source of relational healing is the co-counseling relationship. Guidelines for creating a co-counseling relationship are also contained in chapter 13.

  Many respondents to my website have reported glowingly about the help they get from others through online recovery groups and forums. These groups can be particularly helpful for those who still find it difficult to be vulnerable in person. Sometimes the distance and relative anonymity of these forums can decrease the fear of self-disclosure, and this in turn can enhance therapeutic relating. An increasing number of therapists also seem to be offering telephone sessions for this same reason.

  The section “Finding an online group” in chapter 13, lists recommended online groups.

  Parentdectomy And Relational Healing

  I have worked with many clients who began therapy with me while they were still over-controlled by their traumatizing parents – both externally, as well as internally. Sometimes the control was enforced by as little as one phone call a week.

  Not infrequently, these clients were also being overpowered and /or abandoned in relationships as abusive and neglectful as the ones they had with their parents. This is repetition compulsion at its most destructive, and it strands survivors in experiencing the wors
t of both worlds.

  Through in depth exploration of their childhood trauma, many of my still-trapped clients achieved psychological freedom from their parents for the first time in their lives. Once again, this was a freedom that they had not actually achieved even though they had been living on their own for decades.

  These clients gradually learned to live more successfully on their own without their parents over-controlling spoiling influence. Their ability to build self-nurturing relationships with themselves almost always correlated with a major reduction or complete severing of their relationships with their parents.

  My client, Joe, who was variously misdiagnosed as Schizoid, Asperger’s, and Paranoid, was living alone when he began therapy with me. He was extremely shut down and self-contained but recognized himself as a freeze type from reading articles on my website.

  Getting him to talk at first was like pulling teeth, but over time I discovered that he was engaged in daily phone contact with his narcissistic, emasculating mother. Through our work and tremendous courage on his part, he gradually reduced the phone contact with his mother: at first to once a week, then once a month, then only major holidays, and after a few years to almost never.

  When a parent is unrelentingly toxic, hearing even a few words from them can trigger the survivor into an intense emotional flashback. I have worked with numerous clients who made very little progress in their recovery while they maintained contact with the toxic parent[s]. For this reason, such clients usually require a parentdectomy to progress. There is a classic book by Bob Hoffman on this topic entitled Getting Divorced from Mother & Dad.

  As external freedom from “smother-mothering” continued, Joe gradually achieved more and more internal freedom from her. During this time he began to experience the first meaningful relating of his life in an ACA group that for many years provided him with a great deal of positive companionship and relational healing. Joe finally concluded therapy with me when a healthy primary relationship that he formed with a group member reached the two year mark.

  Learning To Handle Conflict In Relationship

  One caveat for recovering the ability to authentically be yourself is that it is unreasonable and unfair to expect anyone to accept you if you are being abusively angry or contemptuous. Some trauma survivors flashback into this type of behavior by acting out from their Outer Critic. If this is an issue for you, chapter 10 provides guidance for deconstructing this intimacy-destroying habit.

  In this vein, it is important to note that intimacy does not mean unconditional love. As John Gottman’s scholarly research shows, a certain amount of disagreement, disaffection and disappointment is normal in relationship. The hallmark of successful couples is their ability to handle feelings of anger and hurt in a constructive and civil way. Gottman’s studies have identified this as a key characteristic of couples who still really like each other after ten years.

  “Tools for Lovingly Resolving Conflict” [Toolbox 4 in chapter 16] is a pragmatic list of techniques and perspectives to help couples resolve disruptions in their mutual attunement. Moreover, books by the Gottmans and Sue Johnson provide a great deal of practical help. I also find that Beyond The Marriage Fantasy, by Dan Beaver is especially helpful for men.

  Reparenting

  Reparenting is a key aspect of relational healing. It is primarily a process of addressing the many developmentally arrested needs of the traumatized child that we were. In this book we repeatedly address the two most fundamental of these needs: love and protection.

  “Suggested Intentions for Recovery” [Toolbox 1 in chapter 16] renders yet another picture of the diverse developmental arrests that may as yet be unaddressed in the Cptsd survivor. The toolbox presents these needs as tangible goals that we can use to direct our recovery efforts.

  Self-Mothering And Self-Fathering

  An important, yin/yang dynamic of reparenting involves balancing self-mothering and self-fathering. When a child’s mothering needs are adequately met, self-compassion is installed at the core of her being. When the same is true of her fathering needs, self-protection also becomes deeply imbedded.

  Self-compassion is the domicile of recovery, and self-protection is its foundation. When self-compassion is sufficiently established as a “home base” to return to in difficult times, an urge to be self-protective naturally arises from it. Living in the world without access to these primal instincts of survival is truly terrifying.

  We advance our recovery process immeasurably when we commit to re-mothering and re-fathering ourselves. I encourage you now to commit to becoming an unshakeable source of compassion and protection for yourself.

  Self-Mothering Grows Self-Compassion

  The most essential task of self-mothering is building a deeply felt sense that we are lovable and deserve to be loved. Self-mothering is the practice of loving and accepting the inner child in all phases of his mental, emotional, and physical experience. [If “inner child” is a problematic concept for any reason, you can imagine nurturing the developmentally arrested part of yourself.]

  Self-mothering is based on the precept that unconditional love is every child’s birthright. Recovering from the loss of unconditional love is problematic. Not getting enough of it as children was the greatest loss we had. Sadly, this loss can never be completely remediated, because unconditional love is only appropriate and developmentally helpful during the first two years or so of life.

  After this time, the toddler has to begin to learn that human love comes with some conditions. Although love still needs to be copious at this time, the child must be gently shown that behaviors like hitting, biting and breaking things are not acceptable. The period of conditional love has begun and is successfully guided via a very gradual increase in learning about necessary and healthy limits and rules.

  The toddler who receives good enough parenting learns relatively easily to survive the very gradually diminishing supply of unconditional love. During this time she learns little by little that other people also have rights and needs. Her absolute entitlement to gratification is coming to an end, and the needs of her parents will not always be forfeited to accommodate her.

  Once again, psychological health is based on having about two years of this no questions asked entitlement to unconditional love. It is the normal healthy narcissism that Freud described as “His Majesty the Baby”.

  Serious problems accrue however when the toddler does not begin to learn that there are limits to his original entitlement. If there are no limits for too long, then the journey toward adult narcissism begins. On the other hand, if there are too many limits too soon, the matrix of trauma begins to form.

  Enlightened parents introduce limits slowly but surely. They do it at such a rate that by the time the child reaches adolescence he can balance satisfying his needs with helping his intimates to satisfy theirs. He learns to be sharing and reciprocal, a developmental task that is essential to keeping intimacy alive in his life.

  Cptsd is a syndrome of the dearth of unconditional love, or what the great therapist, Carl Rogers, called “unconditional positive regard”. Cptsd can also occur when unconditional love is shut off in an all-or-nothing way in early childhood.

  Some parents can shower love on babies. But as soon as the child begins toddling around and expressing a will of her own, they become severely punishing and rejecting.

  The Limits Of Unconditional Love

  The terrible absence of love - or its abrupt premature termination - is extremely painful and its loss is very difficult to address. We cannot help desperately wanting the unconditional love we were so unfairly deprived of, but we cannot, as adults, expect others to supply our unmet early entitlement needs.

  The one exception to this is therapy, but that of course is usually only one or two hours a week. Miraculously, I have seen the unconditional positive regard of the therapist be enough on numerous occasions to significantly repair the damage of not being parentally loved. And when it is enough, the therapist’s co
nsistent caring facilitates the awakening of the developmentally arrested need to hold yourself with enough unconditional love.

  We survivors often struggle with managing our understandable but unrealistic yearnings to receive permanent unconditional love from a friend or partner. Like the toddler, we eventually have to accept the limits of adult love. This is especially true in romance where the intoxication of unconditional love rarely lasts for more than year. Around this time, partners inevitably begin to feel some frustration with each other because of differences in their individual needs.

  Nonetheless, romantic love can be a significant source of therapeutic unconditional-like love, especially when it survives the inevitability of some disappointment. Susan Campbell’s A Couples’ Journey is a pragmatic, research-based book on how to reap more intimacy out of normal relationship disappointments

  Inner Child Work

  Let us return to the concept of self-mothering. As mother to ourselves, we commit to increasing our self-compassion and unconditional positive regard. Self-mothering is a resolute refusal to indulge in self-hatred and self-abandonment. It proceeds from the realization that self-punishment is counterproductive. It is enhanced by the understanding that patience and self-encouragement are more effective than self-judgment and self-rejection in achieving recovery.

  You can enhance your self-mothering skills by imaginatively creating a safe place in your heart where your inner child and your present time self are always welcome. Consistent tenderness towards yourself welcomes the child into the adult body you now inhabit, and shows him that it is now a nurturing place protected by a warm and powerful adult.