INDEX:

About dissociation as a Defence Mechanism

About complex Post Traumatic Stress Disorder (C-PTSD)

About dissociation as a Defence Mechanism

Growing up with self absorb/narcissistic parents

Co-dependency

Enmeshment

What is Attachment based psychotherapy

————————–

About dissociation as a Defence Mechanism

Dissociation is a defence that many people are familiar with, for example when we misplace our keys or when we ‘switch off’ by reading a book when on a crowded train.

When someone has experienced emotional, physical or sexual abuse, dissociation is often experienced to a far greater degree.

This is a painful experience which can leave someone feeling as though they are fragmented and can be very confusing

I have worked with many clients who experience dissociation. I believe long term therapy is very helpful for healing these peoples extremely painful life experiences.

More information:  http://www.isst-d.org/

About complex Post Traumatic Stress Disorder (C-PTSD):

Definition: Complex Post-Traumatic Stress Disorder is a psychological injury that results from prolonged exposure to social or interpersonal trauma, disempowerment, captivity or entrapment, with lack or loss of a viable escape route for the victim.

However, in some cases people experience chronic trauma that continues or repeats for months or years at a time. The current PTSD diagnosis often does not fully capture the severe psychological harm that occurs with prolonged, repeated trauma. People who experience chronic trauma often report additional symptoms alongside formal PTSD symptoms, such as changes in their self-concept and the way they adapt to stressful events.

What types of trauma are associated with Complex PTSD?

During long-term traumas, the victim is generally held in a state of captivity, physically or emotionally, according to Dr. Herman (1). In these situations the victim is under the control of the perpetrator and unable to get away from the danger.

Examples of such traumatic situations include:

• Long-term domestic violence
• Long-term child physical abuse
• Long-term child sexual abuse
• Organized child exploitation rings
• Concentration camps
• Prisoner of War camps
• Prostitution brothels

What additional symptoms are seen in Complex PTSD?

An individual who experienced a prolonged period (months to years) of chronic victimisation and total control by another may also experience the following difficulties:

• Emotional Regulation. May include persistent sadness, suicidal thoughts, explosive anger, or inhibited anger.
• Consciousness. Includes forgetting traumatic events, reliving traumatic events, or having episodes in which one feels detached from one’s mental processes or body (dissociation).
• Self-Perception. May include helplessness, shame, guilt, stigma, and a sense of being completely different from other human beings.
• Distorted Perceptions of the Perpetrator. Examples include attributing total power to the perpetrator, becoming preoccupied with the relationship to the perpetrator, or preoccupied with revenge.
• Relations with Others. Examples include isolation, distrust, or a repeated search for a rescuer.
• One’s System of Meanings. May include a loss of sustaining faith or a sense of hopelessness and despair.

What other difficulties are faced by those who experienced chronic trauma?

Because people who experience chronic trauma often have additional symptoms not included in the PTSD diagnosis, clinicians may misdiagnose PTSD or only diagnose a personality disorder consistent with some symptoms, such as Borderline, Dependent, or Masochistic Personality Disorder.

Care should be taken during assessment to understand whether symptoms are characteristic of PTSD or if the survivor has co-occurring PTSD and personality disorder. Clinicians should assess for PTSD specifically, keeping in mind that chronic trauma survivors may experience any of the following difficulties:

• Survivors may avoid thinking and talking about trauma-related topics because the feelings associated with the trauma are often overwhelming.
• Survivors may use alcohol or other substances as a way to avoid and numb feelings and thoughts related to the trauma.
• Survivors may engage in self-mutilation and other forms of self-harm.
• Survivors who have been abused repeatedly are sometimes mistaken as having a “weak character” or are unjustly blamed for the symptoms they experience as a result of victimization.

more info: http://outofthefog.net/Disorders/CPTSD.html

Growing up with self absorb/narcissistic parents

Parental destructive narcissism can have significant and deep-seated effects on their children and these effects can persist into adulthood.  What is most troubling for many of these adult children of self-absorbed parents is that they feel something is wrong but cannot identify what it is. They may be angry and frustrated with their parents, while at the same time yearning for their parents to be different — to love and appreciate them. Some may avoid their parents or dread interaction of all kinds with the parent. Some may try to behave as an adult only to quickly regress to an earlier parent-child state when in the presence of their parents or display a whole host of other distressing and uncomfortable behaviours and feelings. Worse is that these adults don’t recognize the negative effects of the parental destructive narcissism on their self-esteem, self-concept, interpersonal relationships and life satisfaction. They are affected in masked, hidden and unconscious ways that are not easily identified. These topics along with strategies for helping adult children of destructive narcissists cope with the lasting effects on them and the continuing attitudes and behaviours of their parents are the focus for Children of the Self-absorbed: A Grownup’s Guide to Getting Over Narcissistic Parents (Brown, 2001). This article will explore identification of a parental destructive narcissistic pattern (DNP), describe some effects of the DNP on children and discuss healthy adult narcissism.

They are parents who exhibit a wide range of self-absorbed behaviors that are ultimately damaging their children. Growing up with a narcissistic parent can have many faces.  Some of these traits include:

– Seeing others as an extension of herself

– Feeling his needs should have priority over those of others

– Expects others to read her mind

– Uses put-downs on himself in an effort to get others to disagree

– Reverses parenting, so that the child ends up caring for the adult

– Intolerant of the child’s needs, values, and separateness

The parent can be:

•     unresponsive to others  needs or concerns

•     a strong self-focus and self-absorption

•     indifference to others

•     lack of empathy

•     an inability to grasp one’s core self as there is nothing there

•     shallow emotions

•     an inability to relate to others in a meaningful way

•     strong admiration and attention needs

•     consideration of oneself as unique and special

•     grandiose, arrogant and contemptuous

Responses to be growing up with self absorb/narcissistic parents

There are two major responses children have in been around self absorb/narcissistic parents:

the “compliant” response and the “siege” response.

The compliant response is illustrated when you, as an adult:

•     spend a great deal of your time taking care of others

•     are constantly alert about acting in a way to please others

•     are very conforming

•     feel responsible for the feelings, care and welfare of others

•     tend to be self-depreciating

•     rush to maintain harmony and to soothe others  feelings

•     seldom get your needs met

The compliant response is a continuation of how you acted as a child — when you were expected to take care of your parents. You are continuing to act out these behaviors and attitudes in your relationships, but don’t seem to be able to have a relationship where your needs are met.

The siege response is one of defiance, rebellion, withdrawal and/or insensitivity. You work hard to prevent being manipulated by others, getting engulfed or enmeshed by others  demands and feelings, assuming responsibility for others  welfare and emotional well-being and from feeling diminished when you do not meet others  expectations. In short, even though you are an adult, you are reacting to others as if they were your parents who expected and demanded that you meet their expectations. You decided at some point that you did not want to comply with your parents wishes and demands. You were trying to become separate and independent and had to fight hard to overcome being parentified. You are still fighting that battle with others in your life and this is negatively impacting your other relationships.

For more information –  http://en.wikipedia.org/wiki/Narcissistic_parents

or  – http://www.wmeades.com/id211.htm

Co-dependency:

what is it ? how it affect you? what can you do? 

“Codependency” versus “Recovery”

 ·  Codependency is about focusing on, taking care of, and fixing others. Recovery is about focusing on and taking care of me, and being supportive of others.

I believe that codependency is a set of survival mechanisms and behaviors learned in childhood to protect against abuse from our primary care givers and others. As adults these behaviors and beliefs are self—defeating and do not work for us.

In recovery, we go back, identify that this abuse happened to us, and feel and validate the feelings that we buried for our survival and sanity as children. We also identify and begin to change our offensive, self-defeating and sabotaging behaviors.

·  Codependency is about giving with resentment or with expectations of receiving something in return. Recovery is about giving because I want to.

I believe that our adult child issues, and codependency are behind the addictions (including alcoholism). When I’m in my addictive behavior, they all feel pretty much the same, although I will acknowledge that the chemical addictions tend to have more dramatic results, especially in chaos and suffering. As codependents, we use the addictions to numb our feelings, especially pain and anger.

·  Codependency is about numbing my feelings. Recovery is about learning to celebrate and feel my feelings, even the painful ones.

In one model of Codependency and Recovery, there are five primary symptoms of Codependency:

1.  Low Self-Esteem

2.  Impaired or Non-Existent Boundaries

3.  Problems with Experiencing and Owning Our Reality

4.  Inability to Meet Our Needs and Wants

5.  Difficulty with Experiencing and Sharing Reality Moderately

·  Codependency is about chaos, excitement, obsession, intensity, extremes and feeling overwhelmed. Recovery is about moderation, balance, detachment, peace, and serenity.

When I’m practicing the Serenity Prayer, I’m in my recovery and vice versa.

Here are some jokes from Codependent Recovery Circles:

Balance is something a codependent briefly notices while going from extreme to extreme.

Definition of Insanity:   Practicing the same behaviors and expecting different results.

 ·  Codependency is about desperately trying to control people and situations. Recovery is about acceptance and letting go of the outcome.

In a second model of Codependency and Recovery, the focus is on our codependent tendencies and ways to change them. Some of these are:

Caretaking          Low Self-Esteem     Obsession
Controlling         Denial              Dependency
Reacting            Poor Boundaries     Lack of Trust
Poor Communication  Problems with Anger Sexual Problems

This model deals more with identifying the problem and dealing with it in the present. The first model mentioned is more in-depth and deals more with family of origin issues. Both have had an extreme impact on my recovery.

· Codependency is about reacting to every thing that happens to me.” Recovery is about making choices based on self care and taking action.

We generally think of codependents as being weak, dependent, and victims. This is most likely about 1/2 of the codependent population. The other portion who are also codependent often show signs of anti—dependence, arrogance, grandiosity, being needless and wantless, and lack of containment boundaries. These people often have the greatest difficulty entering recovery as they frequently won’t acknowledge that there is a problem.

· Codependency is about perfectionism and false pride. Recovery is about becoming teachable, learning humility, and accepting and owning my imperfection.

· Codependency is about denial and isolation. Recovery is about owning my truth, going to meetings, sharing, reaching out, working the steps, and working a program.

Some recovery wisdom:   Adults can be left, but only children can be abandoned.

 · Codependency is about having a skewed, self-defeating thought process, belief system, and perception of reality and the world; generally formed by the dysfunctional ways we were raised. Recovery is about choosing to view things in a more accurate, positive and effective way.

· Codependency is about having little or no understanding of where I stop and you start. Some of the behaviors that manifest here include:

1.     Doing something for you that I want you to do for me and

expecting you to magically know this.

2.     Assuming that your reality, needs, desires, and wants are the

sane as mine.

3.     Not being able to respectfully hear “no” from another person.

4.     Inability to take responsibility for my own feelings,

thoughts, attitudes, etc., and at the same time believing that I

caused your reality.

Often the consequences of this are pain, resentment, and damaged relationships. Recovery is about knowing that my feelings, thoughts, etc., are about me and not about you, and vice versa.

· Codependency can be life threatening and debilitating just like the addictions it sometimes causes. The first step of recovery is: We admitted we were powerless over others and that our lives had become unmanageable.

· Codependency is a generational disease. We break the chain of codependency by doing our own work and not passing it on to our children.

· Codependency is about trying to fix others. Recovery is about taking care of me and being supportive of others and their path.

Some Recovery Resources Include:

· Codependents Anonymous Meetings, other 12 Step Meetings, therapists Trained in Codependency Issues, seminars and Workshops, recovery Books and Tapes

The different patters in co-dependency:

These patterns and characteristics are are tools to help you for self-evaluation.

Denial Patterns:

I have difficulty identifying what I am feeling.
I minimize, alter, or deny how I truly feel.
I perceive myself as completely unselfish and dedicated to the well-being of others.
I lack empathy for the feelings and needs of others.
I label others with my negative traits.
I can take care of myself without any help from others.
I mask my pain in various ways such as anger, humor, or isolation.
I express negativity or aggression in indirect and passive ways.
I do not recognize the unavailability of those people to whom I am attracted.

Low Self Esteem Patterns: 

I have difficulty making decisions.
I judge what I think, say, or do harshly, as never good enough.
I am embarrassed to receive recognition, praise, or gifts.
I value others’ approval of my thinking, feelings, and behavior over my own.
I do not perceive myself as a lovable or worthwhile person.
I constantly seek recognition that I think I deserve.
I have difficulty admitting that I made a mistake.
I need to appear to be right in the eyes of others and will even lie to look good.
I am unable to ask others to meet my needs or desires.
I perceive myself as superior to others.
I look to others to provide my sense of safety.
I have difficulty getting started, meeting deadlines, and completing projects.
I have trouble setting healthy priorities.

Compliance Patterns:

I am extremely loyal, remaining in harmful situations too long.
I compromise my own values and integrity to avoid rejection or anger.
I put aside my own interests in order to do what others want.
I am hypervigilant regarding the feelings of others and take on those feelings.
I am afraid to express my beliefs, opinions, and feelings when they differ from those of others.
I accept sexual attention when I want love.
I make decisions without regard to the consequences.
I give up my truth to gain the approval of others or to avoid change.

Control Patterns:

I believe most people are incapable of taking care of themselves.
I attempt to convince others what to think, do, or feel.
I freely offer advice and direction to others without being asked.
I become resentful when others decline my help or reject my advice.
I lavish gifts and favors on those I want to influence.
I use sexual attention to gain approval and acceptance.
I have to be needed in order to have a relationship with others.
I demand that my needs be met by others.
I use charm and charisma to convince others of my capacity to be caring and compassionate.
I use blame and shame to emotionally exploit others.
I refuse to cooperate, compromise, or negotiate.
I adopt an attitude of indifference, helplessness, authority, or rage to manipulate outcomes.
I use terms of recovery in an attempt to control the behavior of others.
I pretend to agree with others to get what I want.

Avoidance Patterns:

I act in ways that invite others to reject, shame, or express anger toward me.
I judge harshly what others think, say, or do.
I avoid emotional, physical, or sexual intimacy as a means of maintaining distance.
I allow my addictions to people, places, and things to distract me from achieving intimacy in relationships.
I use indirect and evasive communication to avoid conflict or confrontation.
I diminish my capacity to have healthy relationships by declining to use all the tools of recovery.
I suppress my feelings or needs to avoid feeling vulnerable.
I pull people toward me, but when they get close, I push them away.
I refuse to give up my self-will to avoid surrendering to a power that is greater than myself.
I believe displays of emotion are a sign of weakness.
I withhold expressions of appreciation.

Enmeshment 

“Enmeshment refers to an extreme form of proximity and intensity in family interactions…In a highly enmeshed, overinvolved family, changes within one family member or in the relationship between two family members reverberate throughout the system… On an individual level, interpersonal differentiation in an enmeshed system is poor…in enmeshed families the individual gets lost in the system. The boundaries that define individual autonomy are so weak that functioning in individually differentiated ways is radically handicapped (Minuchin, et al, 1978, p.30).”

“We’re enmeshed when we use an individual for our identity, sense of value, worth, well-being, safety, purpose, and security. Instead of two people present, we become one identity. More simply, enmeshment is present when our sense of wholeness comes from another person.

We hear enmeshment phrases everyday such as, “I’d die without you,” “You’re my everything,” “Without you, I’m nothing,” “I need you,” or “You make me whole.” Many of us find our identity and self-worth by becoming the mate, parent, or friend of a successful and/or prestigious individual, or we find the need to fix and caretake individuals to give us a sense of purpose.

Enmeshment doesn’t allow for individuality, wholeness, personal empowerment, healthy relationships with ourselves or others, and, most importantly, a relationship with our “Higher Power.”

What is Attachment Based Psychotherapy?

Attachment-based psychotherapy is a branch of relational psychoanalysis exploring interrelated emotional forms of attachment from birth onwards.

The theory behind attachment-based psychotherapy can be traced back to the end of the 19th Century, but it’s really the work of John Bowlby that has had the most influence. Bowlby was a British psychiatrist and psychoanalyst interested in early child development and the forming of early attachments – secure, anxious, avoidant, ambivalent or disorganised. This led to an understanding of how problematic attachment experiences early on in life are subsequently re-enacted later in adult life. He believed that secure and supportive relationships enable us to develop a sense of who we are. Hence, a growing attachment-based relationship with a psychotherapist will allow the client opportunities to mourn past losses, and explore the impact of important relationships on the client’s life in the present and the past.

How does a Attachment Based Psychotherapy works?

Attachment theory and infant research have demonstrated that psychological organization is an adaptation aimed at preserving critical, life-sustaining relationships. Attachment classifications are simply ways of describing and organizing attachment phenomena. These phenomena, and the processes they represent, are the focus of clinical work, not the classifications per se. A basic understanding of attachment theory and research sensitizes the therapist to the nature and functioning of the attachment system and aids in the observation and recognition of attachment phenomena, as revealed in the violent client’s speech and behaviour.

The initial interview provides an ideal opportunity to begin to listen for attachment phenomena, as manifested in the client’s talk about his or her relationships with parents, partners and children. Familiarity with adult attachment research will guide the therapist to listen to the fluency, coherence, affectivity and flexibility in the client’s narrative descriptions of early childhood attachment experiences. This provides the means of identifying his or her particular ways of regulating and defending against attachment-related memories and feelings. Attachment research also alerts the therapist to listen for themes of attachment trauma in the form of loss, neglect, rejection, abandonment and abuse in the client’s narrative. Such narratives can tell the therapist a great deal about the client’s capacities to hold and reflect upon their own and the other’s mental states in making sense of behaviour and relationship patterns, and, by extension, inform us about their early intersubjective experience and developmental trauma. These narratives also offer an opportunity to evaluate the client’s attributions of the other – the nature and affective qualities of her or his internal representations of the other.

Adults who have developed a dismissing attachment style avoid intimacy and exploration of painful thoughts and feelings. By contrast, those who have created a preoccupied attachment style are angrily enmeshed with their past and current attachment figures. These contrasting adult attachment styles are captured in attachment research utilizing the Strange Situation Procedure and the Adult Attachment Interview. Findings show that, while the avoidant infant and dismissing adult develop a state of mind that values emotional self-reliance and separateness, the ambivalent/resistant infant and preoccupied adult develop a state of mind that is angry, frightened and anxious about being separate and autonomous. These states of mind give rise to attachment behaviours and phenomena that are communicated, in part, via the client’s particular discourse style. Being aware of our own predominant adult attachment style may help us, as therapists, to recognize and understand the enactments that we inevitably get drawn into with our clients and inform how best to repair such ruptures to the working alliance.

In clinical practice, then, attachment theory and research is used to conceptualize the developmental antecedents and interpersonal features of the adult client’s problems, particularly his or her strategy for managing closeness and distance, separations and reunions in intimate relationships, and the influence of these phenomena on the formation of the therapeutic alliance. Attachment theory and research provide both a particular way of listening to the client’s story and of understanding the clinical process. An aspect of this process involves identifying similarities in the complex dynamic interplay between the client’s early relational matrix and his or her current intimate relationships, including that with the therapist. This facilitates an understanding of the way in which archaic, non conscious cognitive-affective working models of attachment are being perpetuated in the here and now, actively mediating and distorting the person’s attachment-related thoughts, feelings and behaviour, particularly at times of heightened emotional stress – how the relational past lives on in the interpersonal present.

From an attachment/trauma perspective, the client’s symptoms, destructive and self-destructive behaviours are understood as expressing unprocessed traumatic experience imprinted in implicit-procedural memories, as represented in confused, unstable self-other working models. These non conscious state-dependent memories and patterns of expectancies organize the person’s experience and emerge in the relational system or intersubjective field, being communicated directly to the therapist via the client’s narrative style and expressive behavioural display. This, in turn, activates a matching countertransferential or psycho-physiological response in the therapist, enabling the therapist to participate in the subjective experience of the client in terms of shared attentional, intentional and affectional states of mind.

The developing attachment relationship with the therapist provides a secure-enough base from which the client can explore his or her self-states, as reflected in the mind of the therapist moment-by–moment, thereby unlocking the affective components of their unresolved trauma. Crucial aspects of the therapeutic process consist in the repair of inevitable ruptures to the therapeutic relationship, the interactive regulation of heightened affective moments, the provision of new perspectives, the re-organization of maladaptive patterns of expectancies, the transformation of implicitly encoded representations, and the promotion of reflective functioning or mentalization.

An emotionally meaningful therapeutic relationship facilitates a collaborative co-construction of the client’s dissociated traumatic experience and promotes the recognition of the mental states that motivate human behaviour in various relational contexts. More specifically, the process of interactive regulation of affect facilitates the recognition, labelling and evaluation of emotional and intentional states in the self and in others. This, in turn, engenders a coherent, secure and agentic sense of self as archaic internal working models are revised and updated and new relational models develop. This, together with the client’s growing realization that he or she can contingently influence the therapist and, by extension, others in everyday life, engenders a secure sense of self and recognition of other people as separate, differentiated subjects who can be related to in non coercive, non destructive ways.

The enhancement of the client’s ability gradually to organize and integrate error-correcting information consists, in significant degree, of the moment-to-moment micro-repair of misattunement or misaligned interaction – an intersubjective process operating at the level of procedural or implicit relational knowing. The therapeutic process is informed by the tracking and matching of subtle and dramatic shifts in the client’s mood-state as they narrate their story. This interactive process leads, in turn, to the recognition of the existence of the therapist as a separate person available to be used and related to intersubjectively within a shared subjective reality.

By these means, the therapist’s facilitating behaviours combine with the client’s capacity for attachment. Though operating largely out of conscious awareness, this process of mutual influence or contingent reciprocity engenders a sense of safety and security and thus the development of a working alliance or attachment relationship that facilitates a collaborative exploration and elaboration of painful, unresolved clinical issues and dissociated traumatic self-states underlying the person’s problematic behaviour. Key aspects of this intersubjective and reparative process are the dyadic regulation of dreaded states of mind charged with intense negative affect and the co-construction of a coherent narrative imbued with personal meaning.

Optimally, the therapist becomes a new developmental object, the relationship with whom provides a corrective emotional experience, thereby disconfirming the client’s pathogenic transference expectations. This process enhances the client’s capacities for affect regulation and reflective functioning or mentalization. This, in turn, strengthens the insecure/unresolved client’s ability to activate alternative mental models of interaction, enhances their capacity to empathize with others and so make more moral, reasoned choices, and reduces their tendency to deploy mental defences of perceptual distortion, defensive exclusion and selective inattention in stressful situations that generate a sense of endangerment to the self and a concomitant increase in the risk of destructive and self-destructive behaviour.

From a neurobiological perspective, the process of affect regulation, so central to attachment theory and research, links non verbal and verbal representational domains of the brain. This process facilitates the transfer of implicit-procedural information in the right hemisphere to explicit or declarative systems in the left.

——————————————————————————————-

Conclusion

Psychotherapy as a way of working on oneself:

We need to parent ourselves in the areas where our parents couldn’t:

Books:

– Alice Miller, For Your Own Good.

– E F Howell, Understanding DID.

– Alison Miller, Healing the Unimaginable: Treating Ritual Abuse and Mind Control.

– Judith Herman, Trauma and Recovery: The Aftermath of Violence–from Domestic Abuse to Political Terror.

-John Bowlby, A secure base (lecture 8)

-Nina Brown, Children  of self-absorb : a grown- up’s guide to getting over narcissistic parents.

– Pia Mellody, Facing Codependence: What It Is, Where It Comes from, How It Sabotages Our Lives.

– M Van Derbur, Miss america by day

– John Bradshaw . 3 good  books: On: The Family: A New Way of Creating Solid Self-Esteem; Home coming; Healing – the shame that binds you.

“Since the earliest period of our life was preverbal, everything depended on emotional interaction. Without someone to reflect our emotions, we had no way of knowing who we were.”  John Bradshaw