Making the decision to heal from sexual abuse is a life-changing
process. Many choose not to, because its like having to relive the traumas
all over again. Why be victimized twice or even dozens of times? Its easier
to rely on the coping mechanisms youve created over time. For a child,
I believe there are really only four ways to deal with this kind of trauma.
Minimizing- thinking your dad was a little angry last night, when in reality he had beaten you and your mother.
Denying- either you pretend that the abuse never happened, so you dont have to tell anyone or explain how you let it happen to you, or you deny that what happened back then, has any effect on your life now. (Most dont realize the effects until their 30s or 40s.)
Rationalizing- "he was too drunk, to remember rolling me over and climbing on top of me last night"
And Forgetting- Now this is a good one. Its very common for children to TRY to forget the abuse. Some children can even forget the abuse, while its happening to them now. Many survivors report floating above their bodies, during an event, its a way for the childs mind to say, this is not happening to me. Common ways of ESCAPING are Addictions and Dissociation: Examples are Addictions (alcohol, prostitution/sex, drugs, and food addictions/disorders, lying, self-injury, stealing, gambling and religion.) The other main escape is to Dissociate.
Many survivors, especially sexual survivors, first become
aware of a dissociative disorder because they experience PTSD (Post Traumatic
Stress Disorder) symptoms, usually triggered by an important event in their life which has triggered the same coping mechanisms as the original life-threatening
trauma. The following are common dissociative disorders:
Dissociative amnesia, Dissociative fugue, Depersonalization
disorder, Dissociative identity disorder, Dissociative disorder NOS.
To understand the common thoughts by professionals on dissociation,
its helpful to imagine a sliding scale with disorders on it. On the left
side, are more normal responses but on the right side would be disorders used
to handle traumas as children, that were reinforced into coping devices over
time. Beginning on the scale's left with say, daydreaming, then highway hypnosis, then maybe PTSD,
amnesia, dissoc. fugue, DDNOS, DID and finally Poly DID (having over 100 alters)
on the right side of the scale.There is a wide range of experiences in between. Some people with MPD can hold highly responsible jobs, contributing to society in a variety of professions, the arts, and public service. To co-workers, neighbors, and others with whom they interact daily, they apparently function NORMALLY. They often have very high positions or run companies because they are so good at juggling many projects at once. They can be very prolific.(DID) MPD is often referred to as a highly creative survival technique, therefore uncommon as well. Following are a few helpful definitions for
those with loved ones or friends in therapy, these are not strictly clinical
definitions, but should help you a little to understand them.
- Dissociative amnesia--One
or more episodes of inability to recall important personal information, usually
of a traumatic or stressful nature, that is too extensive to be explained
by ordinary forgetfulness. Not occurring exclusively during the course of
another mental disorder, is not due to the effects of a substance, a neurological
and/or other general medical condition. The symptoms cause clinically significant
distress or impairment in functioning. There are several types of memory disturbances
including: localized, selective, generalized, continuous, and systematized.
- Dissociative Disorder Not Otherwise Specified
(DDNOS)-- People who have strong dissociative
symptoms but do not meet the criteria for any of the specific dissociative
disorders. A client who has more than PTSD symptoms or some D.I.D. symptoms but not all the D.I.D.
symptoms required for the DSM-IV diagnosis, like amnesia for important personal information, would be an example
of a person with DDNOS.
- Dissociative Fugue--
Sudden, unexpected travel from home or work, with the inability to recall
some or all of one's past. Confusion about personal identity or assumption
of a new identity. The disturbance does not occur exclusively during the course
of DID and is not due to the effects of a substance or general medical condition.
The symptoms cause clinically significant distress or impairment in functioning.
The onset of dissociative fugue is usually related to traumatic, stressful,
or overwhelming life events.
- Dissociative identity disorder (DID) --
There are four diagnostic criteria: The presence of two or more distinct identities
or personality states. At least two of these identities/emotional states/personality
states recurrently take control of the person's behavior. (These do not have
to be seperate "people" only seperate behavior states!) Inability
to recall important personal information that is too extensive to be explained
by ordinary forgetfulness. The disturbance is not due to the direct physiological
effects of a substance or a general medical condition.
- DID is the present term, for the outdated and misinterpreted
term (MPD) Multiple Personality Disorder. I often describe to friends, thinking
that everyone with MPD is like the "Cybil" in the old movie, is
like thinking of every sailboat, tugboat, cruiseliner, barge, and yacht,
as the "titanic". In my experiences, many survivors diagnosed
with this, have created definite mood swings, and ways of reacting to situations
repetitively and distinctly, rather than actually creating completely separate
alters with different names. DID usually only occurs if life-threatning
trauma occurs before the age of emotional development around nine and is
much more likely in survivors who were abused on a repeated basis over a
long period of time, it is also more common among sexual abuse victims,
than physical, emotional, spiritual abuse survivors. It is known to be highly
correlated with the ability to be strongly dissociated and easily hypnotized.
Sometimes "switching" can be as unnoticeable as changes in voice,
or sudden agitation to a current subject. It often happens quietly, quickly,
and only noticetable to those who are watching for it.
- Eye Movement Desensitization and Reprocessing
(EMDR) A procedure which produces rapid
eye movements in a client while a traumatic memory is recalled and then processed.
This technique seems to lessen the amount of therapeutic time needed to process
and resolve traumatic memories. Developed by Francine Shapiro, this technique
requires training and following of specific protocols for appropriate use.
It is not a cure for overall trauma, but may be useful in a very specific
trauma event. (earthquake, car crash, shark attack).
- Acute stress disorder--
Similar to Post-Traumatic Stress Disorder (PTSD) in that it is evoked by the
same types of stressors that precipitate PTSD. However, in this disorder,
the symptoms occur during or immediately following the trauma. The primary
criteria are the same as those for PTSD, except that the disturbance lasts
for a minimum of two days and a maximum of four weeks and occurs within four
weeks of the traumatic event.
- Anniversary Reaction --The
experience of reacting with feelings or behavior on the "anniversary" of a
previous event. For example, an individual whose house burned down on May
3rd may for years after the event have intense feelings or reactions on or
around May 3rd. In some cases the person may not even consciously
recall why he or she is feeling differently on that date. A common anniversary
reaction is temporary depression or nightmares.
- Body Memory
Often used incorrectly, its actually a misnomer. The body does not have
neurons capable of remembering; but the brain does, and can unconsciously
recreate it. The term refers to body sensations that symbolically or literally
captures some aspect of the trauma. Sensory impulses are recorded in the parietal
lobes of the brain, and these remembrances of bodily sensations can be felt
when similar occurrences or cues restimulate the stored memories. For example,
a person who was raped may later experience pelvic pain similar to that experienced
at the time of the event or A smell of a certain cologne, could bring back
the back pain of a knife wound. This type of body sensation may occur in any
sensory form: Feeling, taste, smell, kinesthetic, or the Eyes. Body memories
may be also be diagnosed as somatic memory.
- Borderline personality disorder (BPD)
--Is best understood as an attachment disorder. The essential feature of Borderline
Personality Disorder is a pervasive pattern of instability of interpersonal
relationships, self-image, and affects, and marked impulsivity that begins
by early adulthood and is present in a variety of contexts as indicated by
five (or more) specific symptoms. Physical and sexual abuse, neglect, hostile
conflict, and early parental loss or separation are more common in the childhood
histories of those with Borderline Personality Disorder.
- Posttraumatic Stress Disorder (PTSD)
An anxiety disorder based on how an individual responds to a traumatic event.
For PTSD, certain criteria must be met: The person has experienced a traumatic
event that involved actual or threatened death or serious injury, or a threat
to the physical integrity of self or others, and the person's response involved
intense fear, helplessness, or horror. The traumatic event is re-experienced
in specific ways such as recurrent and intrusive distressing recollections
or dreams of the event. Persistent avoidance of stimuli associated with the
trauma or numbing of general responsiveness. Persistent symptoms of increased
arousal, such as hypervigilance or irritability. Duration of the disturbance
(symptoms in Criteria B, C, and D) is more than one month. The disturbance
causes clinically significant distress or impairment in functioning. PTSD
may be acute, chronic, or with delayed onset. Many individuals with DID (MPD)
also have PTSD.
Current thinking by leaders in the mental health field indicates that pretending
to be other people, or trying out different roles, is a normal dissociative
phenomenon in young children, which is intensified when trauma occurs, resulting
in the creation of alter personality states.
- Switching-- The
process of changing from one already existing personality state or fragment
to another personality state or fragment. Switching may be set off by outside
stimuli such as an environmental trigger, or by internal stimuli, such as
feelings or memories. Switching may be observable, such as changes in posture
or facial expression, as well as changes in voice tone or speech patterns.
Switching may also be observed by changes in mood, regressed behavior, and
variable cognitive functioning (not remembering a conversation that just occurred,
or a person who sings opera, suddenly mixing up all the words to a familiar
- Pseudoseizures --Sudden
changes in a person's behavior and/or mental state that resemble epileptic
seizures but which are not caused by a physical disorder of the brain. They
may look like any type of epileptic seizure: staring unresponsively, generalized
stiffening and rhythmic jerking, movements of only a few body parts, or alterations
of awareness. During these spells, brain cells are firing normally and the
brain wave tracing does not show the changes which are characteristic of epileptic
seizures. "Several research studies have found that many pseudoseizures are
really dissociative trance episodes, dissociative switching of ego states,
or dissociative states in which unconscious emotional distress is expressed.
Many studies have noted high rates of sexual and physical abuse among pseudoseizure
patients and pointed to abuse as one cause of pseudoseizures. Pseudoseizures
have been reported in dissociative identity disorder patients and may be the
symptom that leads to seeking treatment. However, there are non-dissociative
causes for pseudoseizures, so persons who suffer from them should not be assumed
to have a dissociative disorder.
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