PTSD Therapy Phase Two: FIGHT!
September 26, 2013 at 8:46pm
[To borrow from Paul, Likes = Support, if you would like to offer it.]

I'm about to start the next "phase" of the PTSD therapy I've been doing in earnest since early spring of this year.  What I've learned about this therapy is that the nature of what needs to be addressed in each "phase" is something that will reveal itself at its own time and in its own way.  I usually can't tell what it is until I'm smack in the middle of it, because it tends to catch me by surprise (which makes sense in a PTSD context; it's sneaking in utilizing my old patterns and triggers.)  Over the last two or three weeks, "Phase Two" has made itself known, and as of my first dissociative episode in months last night, we've now reached the point where I need to return to some of the things that I practiced during Phase One in order to properly take care of myself (and to preserve my relationships, which I value tremendously).  

Working on this stuff is largely a solo journey, and I've found that trying to make it more social largely aggravates my problems more than it helps them.  But one thing I continually discovered last time around was that being able to talk honestly about what I was going through, as I was going through it, on FB helped me process a lonely journey while still feeling a tremendous amount of social support.  In particular, it helps me in these ways:

1. It reminds me that people are not judging me and / or rejecting me in the present, which is an incredibly helpful tether to reality when I'm getting fixated on past fears of judgment and rejection.  It helps me separate past and present and put those sort of fears in perspective.
2. It validates that what I experienced in the past and the feelings those events inspired in me, during a time where I felt deeply invalidated.  That makes it easier to dissuade myself from the notion that I'm making this all up or could be handling it differently, and allows me to focus on the actual work that needs to be done.
3. It actively counteracts the cultural behaviors that allowed the trauma to happen in the first place, notably the silence that surrounds abuse and abusive relationships.  By speaking out I am showing both myself and others that there is another way to respond to abuse culture that is more productive than the status quo.
4. Since most of my IRL behavior will not reflect a person who is going through a hard time, it gives my friends and loved ones better information about how to interact with me in person that they won't be able to get from my body language.
5. It reminds me that I am not the only person who wants me to succeed at this; it gives me an amorphous sense of social support that I can connect with as I need it.
6. It communicates who is or wants to be a safe person to discuss these things with, and reveals people I may not have considered before that I can reach out to in emergencies.
7. It reminds me who I should be giving back to and showing gratitude towards as soon as I am in a place where I can do so again.  It helps me spend my limited stores of energy wisely.

… I also realize that being this open about emotional issues on FB can make a lot of people uncomfortable, and I don't expect anybody who feels that way to feel obligated to follow me on these things.  If this isn't for you, that's OK.  But it has been very effective for me and so I plan to continue taking advantage of it.  I've been journalling and self-documenting in some form or another since I was 14 and FB has, for better or for worse, become the natural extension of that for me; it nourishes my self-expression even if it's a flawed tool.

This note is intended to be a bit of a rundown about where I am right now and what I anticipate is coming next, for those who are interested and would like to contribute to the positive social support pattern of the past.  I don't anticipate getting this lengthy again until Phase Three, if and when it happens.

Phase One of trauma therapy seemed to be about addressing the core flawed beliefs that I'd acquired while trying to make sense of a long series of events that, taken together, had a net traumatic impact.  Those few months included a whole lot of time-traveling, where I'd have flashbacks that moved my internal life 10+ years into the past for days on end before some cue from the present would crack the illusion and I'd be able to move on.  I went through this cycle at least 10 times, flashing back to a new collection of memories, images, body sensations, and emotions each time.  Now that the cycle is two months in the past, I've had moments in the last few weeks where I've thought "I used to believe X about myself, on a fundamental bodily level, and now when I check in with that belief it doesn't make sense anymore." Clearly that entire roller coaster of time-traveling nonsense did what it was there to do.  It allowed me to revisit the moments in which I had come to believe these things and make a new choice.  I got a little bit of a break and some restoration after that (largely centering around Burning Man and turning 30), but I knew that there was more work to do and that I probably wouldn't have to work too hard to find it.

Phase Two looks like it will be addressing the secondary beliefs and dysfunctions that came about as a result of the core beliefs being part of my reality for over a decade.  So even though I am no longer holding onto this fear about being X, there are a lot of things I also trained myself to do out of my former belief that I was most definitely X that are still normal behavior patterns for me, and many of those behavior patterns are counterproductive.  A lot of them make absolutely no sense without that core belief to inform them, which makes me think this round of dismantling will be easier - but it's something where I have to trust my body and my instincts over the rational mind(s) that got me into this mess.

I don't know how many phases I'll go through, but I anticipate each one will address this baggage at increasing layers of abstraction.  So Phase Three will probably address the tertiary beliefs - whatever those are.  I don't know how far this cascades out until I feel like I have the resources to address dysfunctional side effects on my own instead of with the help of therapists and a lot of background research, but I suspect I'll figure it out when I get there.  When Phase One wrapped up, it was really obvious that it was over but also obvious that I wasn't done with trauma therapy yet, so I'm just trusting my gut to let me know when the timing is right.

The two core themes of Phase Two appear to be boundaries and physicality / body language.  I wouldn't be able to examine either of these without Phase One out of the way, because those core beliefs were blocking my ability to look at these issues in a way that honors my authentic self.  But I still carry my body like a person who has been traumatized and I still approach my boundaries and the boundaries of others in a very black-and-white way.  There's a middle ground somewhere in there that reflects a healthier approach to all of this; I just need to find it.  There's a way of carrying my body that actually reflects who I am and not what others have projected onto me.

I fell into Phase Two in a predictable way.  I am no longer denying myself certain fundamental human needs, in particular needs around physical touch - with regards to both platonic, nurturing affection and sexual / sensual touch.  I generally told myself it was better for everybody, even if it wasn't good for me, to deny myself these things and learn how to live without them.  It's somewhat normal for people with complex PTSD to have a self-image that poses them as harmful to society, and while I don't feel harmful to society anymore (and that's awesome) I still retain a lot of the behaviors I practiced while nurturing that self-image.  Those behaviors keep me from effectively meeting the needs that I'm now aware of but am still used to responding to with an attitude of "deny harder."  The gap between acknowledging these needs and not being properly equipped to meet them means I have a tremendous amount of work to do around issues with boundaries. When it comes to matters of physical boundaries I still sense a tremendous amount of incoherence and resentment towards the world that I now know is a sign that "there be trauma here" (because treasure-map speak, why not.)

While I'm generally skilled at communicating where I am and what I can / can't handle, there are all sorts of blind spots or fuzzy areas where I'll need to get better at communicating and enforcing my own boundaries.  There is still a lot of fear about negative and suboptimal consequences for enforcing my boundaries in the way I'd like.  And truthfully, I still am getting the hang of learning to check in with my emotional needs (the wants/desires component may actually be a Phase Three thing) with enough skill to be able to identify them and make them known.  So from my end, I need better boundary enforcement.

With others, I've been living in a world that assumes a worst-case scenario following any boundary violation.  This makes my life incredibly constricted and when I do actually violate someone's boundaries (which is inevitable, even if you've spent over a decade trying to get perfect at these things) I find myself completely emotionally unequipped to deal with the fallout.  The following overreaction (which I typically try to hide) does a disservice both to me and to the person whose boundaries I violated, because it blocks authentic communication and connection.  I think I've been aware of the overreaction before, but I clearly need a new approach to proactively respecting others' boundaries that is not based on living in perpetual fear of violating them.  I need to find a more gentle and holistic approach to boundary violation that incorporates the full spectrum of reactions people can have to their boundaries being violated, and an awareness that there are skilled and unskilled responses to boundary violation that can in themselves violate in the opposite direction.  When somebody responds to me unskillfully because I have messed up, I want to be able to own my accountability, while still practicing respect and honor for myself.  I don't want to live in constant fear of hurting people or making them uncomfortable; I need to be able to see the issue of setting, enforcing, and transgressing boundaries in a far healthier way.

This does tie into touch and physicality, in some obvious ways - we usually think about the most egregious boundary violations happening in these domains.  Which means that loosening around these approaches to boundaries will be the hardest part.  But there is an enormous gap between how I express myself physically around a person who feels physically safe to me (as I recently was reminded with FR) and how I express myself around everybody else, including my closest friends.  My body language reinforces a lot of these deeply-held fears and keeps people from tuning into my needs, which means even if my friends want to help me, they can't.  This doesn't even begin to scratch the surface around issues of sexuality either; that might wait for another phase.

I think most people who know me don't think of me as a very touchy-feely person, and I came to see myself as a person who disliked touch for quite awhile.  Lately, I think that's more a reflection of trauma (and my absorption of another person's response to trauma) than it is my reality.  Honestly, I don't actually know what my authentic physical self-expression looks like, because when I finally have a safe person to express it with (like I did with FR) I suspect I'm overcorrecting to make up for lost time - if you ever saw me with him, you know that I was almost always touching him in some respect, even if it was a light touch somewhere inconspicuous - because it was tremendously grounding and nourishing.  Now that FR is out of the picture, I have been dealing with an unending yearning to get these needs met and no longer consider denying that yearning an option - but finding a way to address the need that isn't dependent on a romantic partner is going to require a lot of work and some ingenuity.  And I know that the only way I can heal from this is to prefer physical touch from a romantic partner but not see it as a necessity for getting the need met, and have other healthy options and outlets.  

I have weird things where I briefly dissociate while hugging people or when people I find attractive are affectionate with me, and I project very broken interpretations of others' physical interactions with me that I'm very much looking forward to letting go of.  I've never been able to tolerate massages by anything but machines and I didn't realize that was probably a trauma thing until recently.  There's a lot of little stuff like that which has only recently started to make contextual sense.  It has been a great source of distress to be simultaneously avoidant of physical affection and deeply jealous / resentful of people who can get it with ease.  I'm eager to let that go.

I'm actually really looking forward to this next phase because as it's made itself known, there's been enough pattern-matching with the emergence of the first phase (like dealing with enough emotionally exhausting stuff at once to be pushed past my limit and into dissociative / trauma-informed territory) that I can recognize where things are different or better than before; I can recall the tools I employed and how they worked for me.  I think the main distinction between what I've been doing for the last two months and what I will be doing for this indefinite period of time in the near future is that I'll be prioritizing a set of behaviors that is similar to what I did in May/June/July but a wee bit more integrated with what I know to be my "real" life.  So I think I'll be generally happier this time around, and I'll be a lot less reclusive and isolated - I think there is substantially less to fear in this bout.  But I also know that I'll be significantly more sensitive to certain things than I would be while not in this place, and that will require a certain vigilance that I haven't needed to employ the last two months.  So, here's a brief rundown of the things that I'm prioritizing / focusing on while I'm in this place, and boundaries that I'll be setting - a "tool review" for my sake:

1. Most social endeavors will require building in some self-care options in advance so they stay safe; if I can't do that I'll have to opt out.  I will have to be OK with under-committing.
2. Most social endeavors will need to have a built-in "escape" so that if things get bad I can remove myself from the situation without anybody taking it personally.  I will have to protect my autonomy and self-sufficiency with a vigilance that will make me less flexible as a friend.
3. Isolating myself / finding a safe space where I can be alone will be my default mechanism for responding to dissociation / triggers / emotional activation. It embarrasses me to be in that headspace around other people, because I know I'm not rational or like the person they know me to be, and I don't get any value out of being that way in front of people even though I have many friends who've created space for it.  Isolation also removes all distractions that could keep me from focusing first and foremost on my own needs.
4. That said, I expect to be more social and substantially more in touch with my friends and peers than I was earlier this summer, but I'll be doing so mostly on a 1:1 or small group basis.  Large group stuff will be rare.  I've found that larger group dynamics have been particularly activating over the last few weeks, even when the group is composed of people who I feel totally safe with 1:1.  However, 1:1 over group dynamics doesn't scale well, so I'll be less available.  I'll be very choosy about group situations outside of Ketten - at Ketten I've perfected the art of having my introvert nights at a crowded bar but I haven't had the same practice in other group situations.
5. I will be prioritizing events that help put me in my body and / or put me in nature.
6. I will be prioritizing events that allow me to express myself in a creative or physical way.
7. I will be prioritizing events that allow me to stay at home or in another safe space.
8. I will be prioritizing events that remind me of things I've loved deeply in the past or felt passionate about at some point.
9. I will be taking advantage of Fall being the most grounding season for me, and I'll be keeping a list of Fall-specific self-care mechanisms.
10. I will be significantly less tolerant of people pointing out the ambiguity or flaws in my deeply-held beliefs and perspectives. Being able to trust my own judgment without doubts was a major part of Phase One's healing and I need to keep doing this. I will not tolerate behavior that is insensitive to my history; many of my flashbacks were related to people thinking they knew what was best for me, and being So Very Wrong. None of this actually means that I believe I'm incapable of being wrong.  Rather, I am still moving away from the perspective that everybody is right except for me, and I still have a lot of work to do there.  My intelligence is a part of my toolkit that I haven't been utilizing for most of the last decade, to my detriment, so now I'm going to own it.
11. I will be less willing to play diplomat on abusive or inappropriate behavior.  I'll either take a hard line or disengage with no comment at all.  I have no intention of having a discussion around bad behavior and nobody should feel entitled to one.  I realize I have gifts in this area but using them takes up energy that I don't have available right now.
12. I will shut down, if not outright censor, comments or opinions that police my self-expression or voice without my prior consent.
13. I will proactively show gratitude for those who seek out my consent before engaging in difficult topics and ask questions about where I'm operating from instead of making assumptions.
14. Love and support will be paid back with love and support and everything else will be left to wither on the vine and that will be okay.

… there may be more here, but these are the ones that are coming to mind for now and are the most obvious course-corrections after the last few weeks of getting to this place.

Writing this out has been a really good internal organization exercise, and I'm thankful to the friends who have talked this out with me over the last few days, because those conversations allowed me to see this current situation as an opportunity to grow instead of a major downer.  I am really sensitive right now and holding on to substantially more resentment and bitterness than I'd like, but I still seem to be in touch with my gratitude and larger sense of perspective, and that allows me to make better choices for myself when I do start feeling poorly.  I'm softening around my negative feelings and that's allowing them to carry less weight, but being trauma-informed means that they'll still totally take me by surprise and knock the wind out of my sails once in awhile.

Ways people can help, if they'd like: support by way of "likes" and comments on any reflections about Round Two that I may post.  (Considering starting them out with a [Round Two] header.)  Proactively ask me if I'm doing okay and need anything: most times I will be running great on my own self-sufficiency, but this is a great way to establish trust and will help me not to feel like an undue burden when I do have something I need a hand with.  Avoid making assumptions about where I am or what I need; trust my words over my body language until you hear otherwise.  Ask if you aren't certain.  Call out inappropriate behavior, especially if it's abusive, hurtful, or disrespectful.  If I do something inappropriate or hurtful, or am nursing a massive blind spot, I still want to know, but deliver that news with compassion.  Proactively communicate your boundaries as you feel is appropriate.  Be open to negotiating on areas where our boundaries might conflict; I've done this with a few friends over the last month and it's a really wonderful feeling to be able to meet both people's needs while coming to a better understanding of why the boundary exists in the first place.

Sincere appreciation to anybody who has listened; it means a lot to share this journey with people.

-Addie