Me Too Therapy
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- Book Review: The Body Keeps the Score, Bessel Van Der Kolk
The Body Keeps the Score is the book I would have needed decades ago.
I would have needed it when I decided to do whatever was necessary to heal. I believe it would have saved me years of confusion.
And even if I feel much better these days, it is still an amazing read.
This book feels validating, compassionate and insightful. It explains perfectly how a traumatized person feels and thinks, and why.
More importantly, it’s full of hope that recovery is possible and points to proven, but not generally talked about, healing modalities.
Validating sexual trauma
I grew up in a place and time that held Sigmund Freud as the one and only oracle in terms of mental health. This view proved to be very detrimental to my well being.
After all, Freud explained all mental health troubles by inner conflicts, one of which being our desire to sleep with our opposite sex parent. He might as well have been carrying a huge sign in front of my eyes saying “there is nothing happening here, it is all in your head”.
For an incest victim, it was particularly unsavory. It still makes me very angry – not that he stated this, it was 150 years ago for God’s sake; it’s more that there are still confused idiots to repeat this nonsense today.
Later, Vietnam veterans fought for the Post Traumatic Stress Disorder (PTSD) to be included in the list of mental health illnesses. They won (after quite a fight).
To my knowledge, it was the first time ever psychiatrists recognized mental health problems might be caused by what happened to their patients, as opposed to them being malfunctioning in some way.
For me though it became even more confusing: trauma seemed to be linked with combat, and not with sexual violence. It involved having nightmares and vivid recollection of horrible war scenes, apparently.
My complex arrays of symptoms did not look like veteran PTSD. I did suffer from emotional flashbacks, depression, attention problems, dissociation, and sky high anxiety alternating with feeling dead inside. But I did not have nightmares or vivid recollection of traumatizing events.
I felt I did not belong to the PTSD crowd.
It felt so validating then, to read a book giving a lot of examples and stories about patients who went through sexual trauma, along with more “classical” examples such as veterans or survivors of road accidents. It is so natural for Bessel Van Der Kolk that he does not even take the trouble to explain that sexual violence is traumatizing.
Of course sexual violence is traumatizing. It can be especially so when it comes from someone we love and trust, as is often the case. We then have to carry the immense confusion between love and abuse, sometimes our whole life. And Dr Van Der Kolk obviously gets this. What a relief.
Hypervigilance and feeling numb are two sides of the same coin
Many traumatized individuals are too hypervigilant to enjoy the ordinary pleasures that life has to offer, while others are too numb to absorb new experiences – or to be alert to signs of real danger.
Bessel Van der Kolk, The Body Keeps the Score.Yeah, this was me. Both hypervigilant and numb.
At times, I have been eaten away by anxiety, or even outright panic. I was detecting signs of danger everywhere. The world seemed hostile. At the same time, I was going through wave after wave of pain, unknowingly reliving emotions from my childhood. Usually, that’s when I felt “in love”. Oh God, what a horrible experience.
At other times, I was so numb that I could not feel a thing, even when confronted with the death of a loved one. As the author aptly writes, when this happens we can feel like monsters.
It also prevents us from detecting very dangerous situations or people. I remember literally standing as a bystander in a gun fight and thinking, well, this is weird, everything is moving in slow motion and I still don’t feel scared.
As I wrote in this article, what Bessel Van Der Kolk drove home is that feeling numb is what happens when we cannot take the pain and fear anymore. We are not monsters. We tune out distress at some stage because it is impossible to function when our inner life becomes unbearable.
We choose functioning. It’s useful for things like, say, earning a living or getting and education. That’s the unconscious choice I made, and it was a good choice. I would do it again.
However, when this happens we are functioning but not really living, numb as we are. Then at some stage it feels too much like dying and we let ourselves feeling again. And the inner chaos is so intense that after a while we shut down again… The first time it happened I was 17, and I went through this cycle a few times afterwards.
Healing is also social, and physical
Usually, we are presented with two types of treatment : talk therapy, and pills.
Bessel Van Der Kolk, despite being a psychiatrist and having prescribed lots of meds in the past, is more severe than me regarding medication. For him, it did overall more harm than good.
His explanation is very convincing. Basically, medication is here because it is easy to prescribe, and generating a lot of money for a lot of people. Not because it is effective.
Because guess what: it is not, and comes with a lot of unsavory side effects. In fact, psychiatric medication have killed more people than heroin. That’s, er, sobering to say the least.
As for talk therapy, he is far more nuanced. I understand he believes it can be of great help, but talking and analyzing cannot on their own heal a person. It is one of the helpful tools that can be used, but ignoring our bodies or our social support is a huge mistake psychiatry and psychotherapy have made.
Bessel Van Der Kolk talks about the efficiency of EMDR. About Yoga. About meditation. About music, theatre, and dancing. And I would add, breathing and exercise. Plus of course, our social circle.
It is so, so important. Our past, our stress, is held by our body and no amount of analyzing will help it one bit. We need to think about what happened to us, of course. But equally important, we have to take care of our social interactions and what our body needs. It’s at least half of the solution.
In other words, if you want to do yourself a huge favor, read this book.
- The power of connection
I used to think I was uniquely defective and alone. At the time, I did not see my beliefs as a consequence of trauma : I thought the reason was who I was. As a result I did not want anyone close. I did not trust myself, and I did not trust others. I had managed to convince myself I did not need others anyway.
But even then, even when completely disconnected from my need to connect (!), I had a strong urge to find out if other people had lived through similar experiences. I wanted to know what happened to them, and how they were experiencing life, others, and themselves after that. And of course, I wanted to know if, and how they had managed to heal.
This urge never left me. During all these years of healing, I continued to look for people like me, survivors of sexual trauma. I looked for them in books, documentaries, and all over the web. I urgently needed to know I was not alone. Recognizing myself in someone else’s story was a huge relief.
The power of therapy
I strongly encourage you to get individual or group therapy if it is possible for you. Good therapy is not enough, but can guide you on the right path and unlock your internal healing powers.
When I started my journey there were not really many options to chose from, but it is far richer in possibilities now. You can find therapists specialized in trauma, or specialized in treating dissociation, which is a consequence of trauma: Internal Family System therapists, or Neuro Affective Relational Model therapists, for example. If you are far away from these practitioners, it is now possible to do online sessions, which is a great help.
Therapists will help you understand that the issue is not what is wrong with you, but what happened to you – and that you are still responsible for your mental health and healing. They will also provide corrective experiences and help you re-write your story in a more compassionate way. Generally speaking, we are far too hard on ourselves.
The limits of therapy
Therapy has its limits though. To start with, some of us do not have access to it, for financial reasons, because therapy is not widely available in some communities, or because there are not enough therapists right now. Some of us are too fragile emotionally to open up to a stranger. Some of us did have terrible experiences and to not want to take the risk again.
Also, as Bessel van der Kolk highlights in this 2013 podcast, traditional therapy ignores two essential aspects of healing: our bodies, as if we could heal stuff staying in our heads (we can’t), and our society, as if we were alone and the problem was only ours to solve (of course not).
Very young, I remember thinking that if someone had held my hand at the time, acknowledged what was happening, and told me it was not my fault, I would have been all right. And it turns out, the great specialist van der Kolk himself is of the same opinion. He points out how survivors of 9/11 did significantly better than others, because the trauma was widely acknowledged and they received a lot of sympathy.
This is not what happened to us, survivors of sexual violence. Because nobody talked about it, we did not have the words to explain what was happening to us. It literally did not exist, socially. When we tried to talk or show what we were going through, we were usually silenced, shamed, or abandoned. And when we started to show mental health consequences of what happened to us, the tendency was to look at what was wrong with us. No wonder we ended up thinking we were the problem. But we are not!
The power of connection
I benefited immensely from therapy, but the Metoo movement was also a great relief. At last, this movement tackled the social, systemic dimension of sexual violence. We feel alone, but we can now access this crucial information : sexual violence against women and children is widespread. It did not happen because we were defective, but because it happens. To the hell of a lot of other people.
It also happened because even when it was common knowledge, nothing was done about it. It was somehow allowed, even if written otherwise in our laws. Why ? Because perpetrators are powerful people, and victims are not. Collectively, we’d rather not confront powerful people and wonder what is wrong with victims.
But we are more powerful together. Veterans put pressure on the medical system to obtain the PTSD diagnosis, together. We need to push for our health mental problems to get the proper diagnosis : as a consequence of sexual violence. And stop pretending we have some genetic vulnerabilities to depression or a faulty belief system, or a dissociative disorder not otherwise specified or whatever else.
How we can start to heal, now
Even if do not have access to therapy, or in addition to it, we can harness the power of connection. Thanks to internet and social networks, it’s easier today to find our tribe. It can help us to come out of isolation, understand ourselves better, and form lasting bonds that will sustain us. That’s what communities are for.
There are big communities in the US, such as the Metoo movement, or Rainn. There are smaller groups on facebook, on healing from sexual violence, or cptsd, depression, dissociation, or any other problems you are struggling with. You have national communities in other geographies. You have blogs and sites like this one.
From there, you will realize that what you thought were your flaws, are actually scars. You can get a glimpse on how to heal, guided by other survivors. You can get hope that healing is possible. And you can also start real conversations with people who will get you.
Don’t stay alone. There is power in connections, they are our chance.
- Feeling dead inside
I was 17 when I realized I was feeling dead inside. I know I had already felt like this as a child. I did not have the words to describe it, but the experience was there already. Unfortunately, it followed me into my young adult years.
If you ever felt dead inside, you know how dark this place can be. It’s the fabric of depression. It prevents us from enjoying whatever is good in our lives; it can destroy our relationships, our successes and our health. It can leave us unable to feel love and caring, unable to mourn a loss – and ending up wondering if indeed we are able to love at all. It can prevent us from reaching our goals, even if we have the necessary energy, intelligence and skills. It can even prevent us from wanting anything at all.
We are going through the motions, disconnected from other people, life, and ourselves, and we are wondering what is wrong with us and if that’s all there is.
What is the not the cause of us feeling dead inside (even if we feel it is)?
Let’s explore first what we sometimes believe the cause of this emotional void, but really isn’t:
- It’s not because we are defective: there is nothing wrong with us, and we definitely shouldn’t feel ashamed of not feeling anything except shame – even if we often do.
- It is not because our life is boring (and everyone else’s life is dazzling). Once the fog is lifted, a normal life can be pleasant and joyful. And as some of us do know, living or achieving great things, or starting a new life somewhere else will not wake us up: wherever we go and whatever we do, here we are (the same).
- By the same token, if we don’t feel love it is not because people who love us are not lovable. Unless they are abusive or taking advantage of us, they are most probably fine (but we know this already, don’t we ? Unless we are narcissistic ourselves of course, but we wouldn’t be reading this blog then.)
What is the real reason for us feeling dead inside ?
I really appreciate the still small but priceless community who follows this blog, and I know you are intelligent, dear reader. You probably know already where I am going with this, but I will write it anyway: the real reason for feeling so empty emotionally is what happened to us. Trauma.
We don’t make the connection initially, because essentially everyone around us avoided the topic. Trauma (especially sexual trauma) does not happen, so of course it cannot be the cause of anything.
According to the CBC, one if five americans experienced sexual violence involving physical contact. But how many of us were asked if we experienced trauma when seeing someone because we were depressed ? According to my experience : none. Sexual violence is written all over my life, my body and my mental state, and I saw a lot of shrinks and doctors over my life but nobody ever asked. So how could we make the connection ?
Even in the medical profession, denial is everywhere. One of my close friend, a GP, still insists there is no proven relationship between what happened to us and our mental health. How is it possible ? Frankly I don’t know; there are now hundreds, if not thousands of studies demonstrating the correlation. Maybe it has to do with the fact that her brother is drowning in alcohol, but she absolutely wants her family of origin to be normal ? We don’t want to see what we don’t want to see.
Speaking of which, we also don’t want to be shaped or damaged by our past : we want our emotional life to be under the control of our great qualities, our will, and our present life. Not the result of what a horrible person lurking in our past did. I fervently did not want my emotional state to have anything to do with my past.
And still, still….
The best explanation of the feeling dead syndrome, ever
I’m currently reading The Body Keeps the Score, from Bessel Van Der Kolk. I now understand why it has been on the New York Times Best Sellers list for 130 weeks: to say it is an excellent book to read for trauma survivors is an understatement. And yes we are many, hence the success of the book.
One of the great things it brought me is the explanation of this feeling dead experience:
“After trauma the world is experienced with a different nervous system. The survivor’s energy now becomes focused on suppressing inner chaos, at the expense of spontaneous involvement with their lives.”
Bessel Van Der Kolk, The body keeps the scoreThis is why I went through periods of absolute emotional chaos (usually centered around difficult relationships activating my past, vulnerable self), followed by periods of feeling dead emotionally when the chaos had become unbearable. This is exactly what happened to me when I went through a major depression at 17. Thank you Bessel, you do truly get it.
Mr Van der Kolk writes how you can see this state of dissociation when looking at someone’s brain activity: it looks like a blank page. Nothing is happening here. Somehow still, our body is flooded with stress hormones.
This is why, counter-intuitively, looking for strong emotions or sensations when feeling dead inside is not a good idea. We all try to do it, but will only make matters worse and push us further into dissociation.
What we need to do rather, like when we feel chaotic, is to calm down and regulate the best we can. Like Dr Perry states: regulate, relate, reason. More on that next week, in the meantime take care of yourself.
- Why do I always fall for the wrong guy ?
“Why do I always fall for the wrong guy?” I must admit it’s a question I asked myself a few times. And when listening to a very interesting podcast with Dr Frank Anderson on Trauma and Internal Family System, the answer came in a reaI “aha” moment.
To be honest, I already knew the answer – or rather, let’s take the grandiosity out of this – my answer. But this very smart psychiatrist and psychotherapist summed it up with a few elegant sentences : “Most adult romantic attractions are really us trying to heal an early attachment wound. Instead of seeking this healing from another person, what we need to do is seek the relationship, get triggered an activated, and then do our work.”
This is brilliant.
Let’s have a look at these few sentences.
Most attractions are us trying to heal an old wound
Of course, while we are in the throws of these attractions, sometimes violently obsessive ones, we do not feel we are seeking salvation or healing. We are convinced we have found a soulmate. Even if this person is not available, highly dysfunctional, or downright dangerous. We believe our love will make everything all right (this time).
But then normal life returns either because the relationship has never started, has failed, or after it has succeeded and we are now in a normal relationship and magical thinking has left. Sometimes we can look back and realize we have dated, or tried to date, the same person all along – with a different name and face, but you know, basically the same. And the relationship, or absence thereof, has basically looked and felt the same as well.
If there is a pattern, we probably are trying to heal an old wound, using different relationships with the same dynamic, over and over again.
In my case, it could be a figure of authority, unavailable, and showing some interest in me (real of fantasized). Or a man who had certain personality traits like narcissism. Best of all: everything at once.
And I have lived my childhood with a narcissistic, married, sexually violent father.
It may seem very obvious stated like this of course, but it took me a very long time to be able to state it that way. Denial is a powerful, far reaching mechanism. It took me years to understand my father was who we was. And years to understand most men are different, so I could be more discriminate.
What we need to do instead is do our work
Nobody can heal us, except ourselves – granted, with the support of others, and if it can be a supportive partner, then it is terrific. But the only person who can really heal us, is us.
I believe we all initially carry this fantasy that someone is coming. We feel terrible, but someone is coming to save us. A prince charming will appear and make us feel all right. It can also be a charming princess of course, depending on our preferences.
It will not work. Nobody’s coming.
I know. I’m really sorry.
If we feel terrible without a relationship, we will feel the same inside a relationship, once the romantic highs fade – and they can fade quickly indeed. It is not the job of a romantic relationship, or any relationship, to heal us. Other people are not here to heal us. Even if they wanted to, they would not be able to, the same way it is impossible to heal someone with broken bones from the outside. The healing happens inside ourselves, mainly because of what we do.
Of course, we don’t necessarily know what to do. This is where books, podcasts, blogs and therapists are useful. They can guide us out of our illusion that some magical person will solve all our problems, and into problem solving. It is the only way.
Now, I have read versions of what I am writing now several times before really getting it. I read them, and believed fervently they did not apply to me. I needed a few iterations of miserably failed relationships to get it.
We all need to have our experiences. But knowing other people frame it differently can help to get it sooner, I think. A guide gives directions we do not necessarily follow, but when we get lost a few times and don’t know what else to do, we backtrack to find the guide and hear him or her out.
Follow the attraction anyway
The wounded part of us is hidden deep down inside ourselves, usually well protected. To put space between this wounded part and our day to day experience, we can use addictions, dissociation (a favorite of mine), intellectualization, compulsive activity, whatever. The result is that our wounded self is not readily accessible. We can actually be very functional, even when carrying a difficult past.
When we get activated by a potential romantic relationship, it touches our wounded self though. This part of us, hoping to be held and healed, comes out. This is what makes us so vulnerable in relationships. This is also why what we feel seems disproportionate sometimes, or not adapted to the situation. We can seem weird from the other side of the relationship. Or we can fit into an unhealthy dance, like the narcissistic – codependent dance, or the avoidant – insecure dance.
If the trauma we went through is significant, the relationship can bring a tremendous amount of pain. We firmly believe we are in the present, but we are in fact feeling and acting from the past. If we are suffering from repeated limerence, or love addiction, we can be sure this is what is happening.
This is our chance. Yes, being limerent or lost in love addiction feels terrible. But it full of hope as well : we are in contact with our wounded self, and can begin real recovery.
After years of doing my work, I still get into limerent episodes although less intense and shorter than before. But each one gets me to a better place. And I hope every one of us will take every attraction, even for the wrong guy, for what it is: a part of us trying to push us into healing.
So the wrong guy may not be the wrong guy after all: he may be a perfect healing opportunity. It all depends on us and if we manage to turn around and look into ourselves .
- Why am I lost in my thoughts ?
Yesterday, my daughter asked me if I was not feeling bored while walking. I told her my truth: no, I am never bored while walking. I have all these thoughts in my head. Even when my brain is not focused on doing something, like working, organizing an evening out, or talking with someone, these thoughts and dreams are still here and keep me busy. I don’t even remember the last time I felt bored.
My daughter’s consciousness is apparently less overly active than mine: when she’s not busy doing something, she does not have all this activity in her mind. So, she explained, while walking she’s bored. I assured her boredom has never killed anybody and it’s a normal part of our experience. I also felt secretly happy: she does not dissociate like I do.
What is dissociation ?
Being lost in one’s thoughts from time to time is normal. Spending lots of time in one’s head, thinking or dreaming about stuff, sometimes to the point of preferring alone time to living, is not. We can call it being very distracted, suffering from maladaptive daydreaming, being lost in our thoughts, and even sometimes being an introvert. What it really is, is life avoidance. It is a form of dissociation.
Dissociation is a big, scary word. It conjures up images of people having multiple personalities, hearing voices or other spectacular symptoms. So we do not feel dissociation can apply to relatively normal folks (whatever normal means). Well I did not, until relatively recently. I since changed my mind: sometimes it is about multiple personalities or hearing voices, sometimes it can be utterly non spectacular, as simple as being often lost in one’s thoughts or daydreaming a lot.
Broadly speaking, it is a way of not being present to our current reality. We are not fully engaged with the world. We are in our minds or imagination. It can be rare , or it can take a huge portion of our time. For me at times it has been the latter.
It took me a surprisingly long time to realize this. Now I see it everywhere in my life. To my credit, nobody talked about it despite several years in therapy, and several years of training as a psychologist. That’s why I think an explanation about dissociation could benefit you, dear reader.
Very “normal” signs we are dissociating:
No memories of chunks of our life
Huge parts of my memories are missing. I don’t remember much from my childhood, only a few scattered memories. As for my adult life, events or moments that were really important to me are here (like cherished moments with people I love), whereas less important stuff has not registered at all. It can seem weird to people around me.
I could be sad about this, but not really. I do know why I don’t remember a lot from my childhood: because most of it was so traumatic, I checked out from reality. A telling sign is how I remember pretty well weeks spent outside of my family, with friends or my beloved grandmother. These weeks were normal. I do remember. For the rest, I’m not keen.
As for my adult life, it is of course more complicated. I spent a lot of time not really participating in my own life, lost in my thoughts or in daydreaming especially as a young adult. But I also was not feeling safe then, even if my reality had changed. Life was unpleasant and scary.
This is what trauma does to us: it changes us, how we perceive the world and ourselves, our reactions, our emotions, our whole experience even when the trauma has stopped. We can heal, but without taking active steps to do so, we remain trapped in our traumatic world. We dissociate a lot, even once safe.
Maladaptive daydreaming
Daydreaming can be a positive thing: it can show us where we want to go with our lives. Visualization can be an important tool to attain a goal.
Maladaptive daydreaming, on the other hand, is when daydreaming takes so much of our time and energy that we are not really living our lives. I did this for months on end: going through the motions the whole day, waiting for my moments of alone time. Turning down opportunities to socialize, do fun stuff and meet new people in order to be absorbed in my own dreams.
I was not engaging with reality because I was scared, from other people mainly. Of course this is not the way I felt at the time, but this is how I see it now.
Limerence
Limerence is a form of obsessive love for someone. It seems it can be the first step towards a long term relationship. For some of us, it can be a sure sign a relationship will not work, or in my case, will not even start. It can become total preoccupation or obsession with someone who is not available to us for whatever reason.
When this happens, we turn to maladaptive daydreaming, with endless variations of one central scenario: how we will be so awesome that the object of our obsession will fall madly in love with us. The whole time, this person is actually living his or her life, not caring at all. It totally sucks.
I spotted this was not what it appeared (falling in love) very early in my life, when I realized I was not interested for long when the guy reciprocated. Deep down, I did not want a relationship: I wanted to obsess about someone and avoid a real relationship. For me limerence is a dissociative tool.
Being lost in TV, social networks, video games, or whatever
Again, playing video games or watching netflix series is normal. Spending several hours a day doing so is preoccupying. And if these activities are the centre of our world, then, we simply use them to keep the world and other people at a safe distance. When we do this, we take the risk of looking back after a few years, and see that we did nothing, lived nothing. A big blank. The activity itself is not the issue. I did it with books, for heaven’s sake. It is culturally more valued, but it was still a way to hide.
What can we do when we dissociate a lot ?
Compassion and self love are key here.
Often our default setting, when realizing we are not so healthy, is self hate and criticism. You know, the “what is wrong with you?” question, followed by shoulds along the lines of “You should stop dissociate”. There is a reason why we react like this of course, but we are being unfair. Even more problematic, this type of reaction is making things worse.
I had a long habit of dissociating when verbally or emotionally abused. It helped me survive my first years, but it has created very problematic situations in my adult life. I sometimes did not perceive I was attacked, or only far too late; I could not protect myself adequately.
Well, I discovered this pattern of dissociation also happens when I am the one verbally attacking myself with harsh and unfair criticism. So reacting with anger towards myself about dissociation will further dissociation. It does definitely not help. Does it ever ?
This does not mean we should not resist gently our tendency to dissociate. We can not change from one day to the next, but what we can do is push a little bit more towards life, each time we have a choice. Over time, small decisions and small changes can lead to a very different life. I’m glad I pushed myself to be a little bit more adventurous and social than what I felt comfortable with initially.
And then of course, let’s understand dissociation is a consequence of trauma. Trying to treat maladaptive daydreaming, repeated limerent episodes, or a video game addiction is like treating a fever. It is sometimes helpful on the short term, but real, lasting improvements will only come with starting a recovery process addressing our traumatic past. Once again, it is not about what is wrong with us, more about what happened to us…
You can find more information on dissociation on this excellent podcast episode: Trauma rewired on Dissociation.
In the meantime, take good care of yourself and have a nice week…
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