Tag Archives: dissociation

The sound of living like a psychological millionaire

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The art of living as a psycholgical millionaire: To use your energy in a way that gives you a result you need.

A person with the possibility of becoming a psychological millionaire does just this. For this to happen, certain principles must be satisfied. Efficient mental energy has four caracteristic features. Its:

– Adaptive

– Goal-oriented

– Successful

and

– Devoid of waste

Examples of non-efficient living:

Certain diagnostic groups can have enough mental energy, but low mental efficiency. This can for example be clients with AD/HD or Borderline personality disorder. They might do a lot of things, like walking around in a room restlessly or having an emotional outburst. Their problem is using the energy in a good way: They can`t regulate it in a way that makes it able to live a good life. Some groups have too low energy to be efficient, like with depressed or fatigued clients.

When working with dissociation, parts have different levels of mental energy and efficiency. EP`s can actually be the most energetic parts in the system, but have very low efficiency, since they repeat behoviors in a dysfunctional way. It is possible to have a dissociative disorder like DID and borderline PF at the same time. In this case most parts will have borderline features, that is: High levels of mental energy but low efficiency.

Energy and efficiency in trauma

“Looking in a cupboard that is empty, will not work no matter how good the torch is”. Nijenhuis, 2013

Trauma can also be understood by using the concept of energy and efficiency. Trauma can be either too much or too little energy or efficiency. For example, an EP can feel stuck, with high levels of energy, but low levels of efficiency. The EP can`t “get out of it”. There is no symbolization of the event, since it “feels like” the trauma is still going on. The part or the EP is “stuck” in what was. To connect the then with the now, it`s necessary to reach the reach the higher level of language, and that is easier when an empathic therapist helps the EP. Empathy is necessary to tune in to the EP`s experience. If the EP is afraid, the voice of the therapist must be soothing and calm. The therapist must tune in so that the EP is seen and validated. When the therapist tries to understand the EP, the ANP of the patient might learn that it`s possible to collaborate and help EP`s.

Example of working with an EP with enough mental energy

Imagine a claustrophobic EP (picture 1). The EP has trouble breathing because her throat feels constricted. The therapist might observe this, and tune in to this with a low, empathic voice “It looks like you have trouble breathing ?” The therapist observes that the EP tries to nod. The therapist continues: “I see you tried to nod, but it looks like its hard to move?”. The therapist explores the EP`s experience, thereby respecting and validating her.

The therapist can also ask the EP to try to broaden her field of consciousness, by asking if they can try to breathe slower or by asking of if the EP could look at something around her that is comforting. He can also try to tell the EP that she is safe, that boundaries will be respected, or say that everything will be okay. Moreover, the therapits can make it clear that the EP decides what happens next, and that everything will be predictable and safe. The therapist watches the EP and helps her, where she is, there and then.


Working with a non-verbal EP

If the EP is young and can`t talk, one has to communicate non-verbally. For example, if the EP is in “freeze-mode”, the therapist can ask questions about the inner experiences of the EP: “Can you find a place in yourself where you have some ability to move?” If the EP moves the ANP`s finger just a tiny bit, the therapist might say: “Is it possible to move your finger a little bit more?” Gradually, the EP is exposed to new experiences that will be healing in time.

If the frozen EP is able to move, either by actually walking around in the room, the EP learns what it couldn`t when abuse happened. When the therapist is able to intone and be there for the EP`s, magic can happen. I`ve experiences this myself, and every time it feels so meaningful. To see a afraid little EP starting to feel stronger, feels like I`ve been able to lift a heavy weight together with them. Therapy is heavy work. The EP must shred the cloak of repression that weigh down on them, and that cost a lot of mental energy. This means that the client must have enough mental energy available.

If he is tired, starved, physicially unfit or doesn`t do anything inspiring that gives joy or energy, it might be best to wait until more energy is available. Trauma-therapy is hard work, and cost both physical and mental energy. Going into trauma-material before the client has filled up her batteries, is not recommended.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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CG Jung and the ‘Leap of Faith’ Into Individuation

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The Red Book has been described as Jung’s creative response to the threat of madness, yet it has also been seen as a deliberate exercise in self-analysis. I believe it’s likely both. When creating The Red Book, Jung knew he was on the verge of madness, and he also knew his analytical skills and expertise as a psychiatrist were his best chance at alleviating suffering, if not creating the conditions for transformation.

In many regards, The Red Book reads like a healing journey — a phrase often used to describe the reclaiming of self after a history of abuse — which is a transformative period that happens for many people committed to overcoming early life trauma. On the way to an authentic self there is first the need to step away from the person one became to survive abuse. Those confronted with this journey often experience a period of ‘going crazy’ on their way to establishing an authentic sense of self.

As The Red Book shows, individuation is a blessed curse. It opens the way to becoming one’s authentic self, and yet also the risk of alienation from the ‘tribe’. Childhood trauma survivors often know this conundrum intimately. Transformation requires a significant reorienting away from the beliefs, feelings, fantasies, and body states that made possible living in traumatizing conditions. Invariably, there is a part of the self that has gone unacknowledged or rejected, and aches to be reclaimed.

In The Red Book Jung found a process for continually rediscovering authenticity. As he often remarked, individuation is an ongoing journey and not an endpoint reached. Jung also intimated the need for what I called in an earlier post leaps of faith: turning away from the larger world’s expectations and towards one’s inner world of wisdom with acceptance and curiosity.

This quote from The Red Book inspires the impulse to creatively go forth into all that you are:

“Woe betide those who live by way of examples! Life is not with them. If you live according to an example, you thus live the life of that example, but who should live your own life if not yourself? So live yourselves.

“The signposts have fallen, unblazed trails lie before us. Do not be greedy to gobble up the fruits of foreign fields. Do you not know that you yourselves are the fertile acre which bears everything that avails you?”

Jung knew such a ‘leap of faith’ is not easy. He also wrote:

“To live oneself means: to be one’s own task. Never say that it is a pleasure to live oneself. It will be no joy but a long suffering since you must become your own creator.”

But he gives helpful advice for the journey, particularly how to live if the world feels contrary to whom you are becoming. Then you must learn to be your own guide:

“To certain things of the world I must say: you should not be thus, but you should be different. Yet first I look carefully at their nature, otherwise I cannot change it. I proceed in the same way with certain thoughts. You change those things of the world that, not being useful in themselves, endanger your welfare. Proceed likewise with your thoughts. Nothing is complete, and much is in dispute. The way of life is transformation, not exclusion. Well-being is a better judge than the law.”

Reprinted in full with permission by the original author Laura K. Kerr, Ph.D, who moderates the blog, Trauma’s Labyrinth: Finding Ways Out Of Trauma. Laura K. Kerr is a mental health scholar, blogger and trauma-focused psychotherapist. [Her] focus is on healing, with special attention to trauma, modernity, and mental health systems of care.

Looking Schizophrenia in the Eye

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Garden of the Mind

272994276_3c83654e97_bMore than a century ago, scientists discovered something usual about how people with schizophrenia move their eyes. The men, psychologist and inventor Raymond Dodge and psychiatrist Allen Diefendorf, were trying out one of Dodge’s inventions: an early incarnation of the modern eye tracker. When they used it on psychiatric patients, they found that most of their subjects with schizophrenia had a funny way of following a moving object with their eyes.

When a healthy person watches a smoothly moving object (say, an airplane crossing the sky), she tracks the plane with a smooth, continuous eye movement to match its displacement. This action is called smooth pursuit. But smooth pursuit isn’t smooth for most patients with schizophrenia. Their eyes often fall behind and they make a series of quick, tiny jerks to catch up or even dart ahead of their target. For the better part of a century, this…

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“The Red Book”: A Primer For Healing Madness In A Mad World

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“Naturally I compensated my inner insecurity by an outward show of security, or — to put it better — the defect compensated itself without the intervention of my will. That is, I found myself being guilty and at the same time wishing to be innocent. Somewhere deep in the background I always knew that I was two persons. One was the son of my parents who went to school and was less intelligent, attentive, hard-working, decent, and clean than many other boys. The other was grown up — old, in fact — skeptical, mistrustful, remote from the world of men, but close to nature, the earth, the sun, the moon, the weather, all living creatures, and above all close to the night, to dreams, and to whatever “God” worked directly in him.” (p. 44, The Red Book by Carl Jung)

“On the contrary, it is played out in every individual. In my life No. 2 has been of prime importance, and I have always tried to make room for anything that wanted to come from within. He is a typical figure, but he is perceived only by the very few. Most people’s conscious understanding is not sufficient to realize that he is also what they are.” (p. 45, The Red Book by Carl Jung)

Laura K. Kerr, Ph.D. wrote an incredible blog post about The Red Book by Carl Jung, read the rest of the article. . . on her blog, Trauma’s Labyrinth.

Stress and Memory From a Neuroscience Perspective

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Stress and Memory From a Neuroscience Perspective

 

 

 

 

 

 

“From a neuroscience perspective, amnesia in the absence of brain damage can be partially explained in biochemical terms. Stress causes a chemical reaction that affects regions of the brain responsible for memory. With repeated overwhelming stress, neurotransmitters and stress hormones are released in the brain in such excess quantity that they can adversely affect portions of the brain responsible for emotional memories as well as other kinds of memory.” p. 33, The Wandering Mind: Understanding Dissociation from Daydreaming to Disorders by John A Biever, M.D. and Maryann Karinch.

i'm not out to convince you or draw upon your mind*Image Credits (all work used with permission through CC license)–
“i’m not out to convince you or draw upon your mind” by Andrea Joseph
“Standing at the Gates of Hell” by Shane Gorski

A Schizophrenic Way Of Saying Things

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A Schizophrenic Way Of Saying Things

 

 

 

 

 

I’d like to go home

but I have to go to the bathroom

and they won’t let me see the stars

cognitive-symptoms-of-schizophrenia-03

I’ll give you a doughnut

because I haven’t got anymore

toilet paper

I want to go to Disneyhome

but Mickey’s dead

God looks at me from the sky

I can see the eyes of

Atlantis

diaptych(right) :: mess-up N/N mess-age

Shut up! she said

I told her somebody stole

my bananas

the walls are missing

where did my feet go

I can smell your armpits, Mister

The hallway’s flooded with blood

because somebody farted

now the toilet smells like

home

Thousand Plateaus Drawing

When I comb my hair pieces

of wood fall out

My brother eats maggots with

his bare feet

My feet went home

Can I go too

I hear dogs calling my name

They don’t know the TV’s on

Oprah’s interviewing Justin Bieber’s

image

diaptych(left) :: mess-up 1/1 mess-age

My mom’s in the audience

with her pet home on a leash

Jim Morrison is singing in my

ear

But I can’t hear the water

running     What?

Was that the doorbell

Someone let the table out

I want to go home

but the silverware left without me

Is it my fault the bed’s on fire

oh, it is

catatonia-schizophrenia-symptoms-01

I don’t sleep in a cloud full

of roses

Want to go outside and play

in the weeds

the roaches won’t care

They’re too busy picking curtains

at the supermarket

Go away but I lost 10 pounds

of home

Help me.

*Image Credits (all work used with permission through CC lisence)–
“cognitive-symptoms-of-schizophrenia-03″ by Life Mental Health
“catatonic-schizophrenia-symptoms-01″ by Life Mental Health
“Thousand Plateaus Drawing” by Magda Wojtyra
“diaptych(left) :: mess-up 1/1 mess-age” by Joel, Evelyn, Francois
“diaptych(right) :: mess-up N/N mess-age” by Joel, Evelyn, Francois

Why Some People Actually Enjoy Having Schizophrenia

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Why Some People Actually Enjoy Having Schizophrenia

by Mhs411 of Mental Health Specialist 411

Schizophrenia , literally meaning:  a psychotic disorder characterized by loss of contact with the environment, by noticeable deterioration in the level of functioning in everyday life, and by disintegration of personality expressed as disorder of feeling, thought (as delusions), perception (as hallucinations), and behavior —called also dementia praecox – m-w.comcan be brought on by many factors.

Schizophrenia has a strong hereditary component. Individuals with a first-degree relative (parent or sibling) who has schizophrenia have a 10 percent chance of developing the disorder, as opposed to the 1 percent chance of the general population.

But schizophrenia is only influenced by genetics, not determined by it. While schizophrenia runs in families, about 60% of schizophrenic patients have no family members with the disorder. Furthermore, individuals who are genetically predisposed to schizophrenia don’t always develop the disease, which shows that biology is not destiny.

Twin and adoption studies suggest that inherited genes make a person vulnerable to schizophrenia and then environmental factors act on this vulnerability to trigger the disorder.

As for the environmental factors involved, more and more research is pointing to stress, either during pregnancy or at a later stage of development. High levels of stress are believed to trigger schizophrenia by increasing the body’s production of the hormone cortisol.

Research points to several stress-inducing environmental factors that may be involved in schizophrenia, including:

  • Prenatal exposure to a viral infection
  • Low oxygen levels during birth (from prolonged labor or premature birth)
  • Exposure to a virus during infancy
  • Early parental loss or separation
  • Physical or sexual abuse in childhood

In many cases of Schizophrenia where voices are heard, the afflicted individual often finds comfort in the company of their voices, they have conversations, debates, and can often become friends on many levels. This is why affected patients often stop taking the medications which they are prescribed because they either severely subdue the voices or negate them altogether. Why would someone take a pill that forbids them from being in contact with their best friend(s), companion(s), etc?

Truth be told, the voices that most Schizophrenics hear do not tell them to hurt themselves, or others, but rather maintain a running commentary on “their” perception of the patients world at large, sometimes even discussing things on a blow-by-blow basis.

So why not enjoy being Schizophrenic? Constant companionship, never bored, never alone. Sounds like a great around the clock party! Right? Well sure, unless you have a type of Schizophrenia with voices that DO tell you to hurt either yourself, others, of both? Then, not such a party.

I remember one treatment center at which I was doing a segment of my practicum. I was assigned a woman mid 50′s who was diagnosed with Schizophrenia Paranoid Type. She was my first Schizophrenic patient, and aside from what the text books had taught me, I had no idea what to expect in a “real world” scenario.

The woman, whom we shall call Linda, was certain, beyond any doubt whatsoever that I was her son, and that we had performed in innumerable stage shows together, and began reminiscing about each show, one by one, covering our 30 year stage career together. Truly, it was fascinating, and even though she was of no harm to herself or to others, because she was so far removed from reality, she was court ordered to spend the rest of her life in a psychiatric facility. Still, she was quite happy and enjoyed spending time with her voices! Therefore, in summation, I suppose it depends on many factors as to whether an individual can enjoy having Schizophrenia, or see it as a never-ending nightmare pushing them towards anger, resentment, and potentially even revenge on a moment to moment basis.

Photo:  http://sciencenewstoyou.blogspot.co.il

Freezing trauma

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Unfortunately, not everyone are born with the same chances to thrive and grow like others. In fact, Norway is one of the lucky countries, and I have discovered time and time again, that being brought up here, is really like winning the lottery. But: Don`t let that fool you; Mental health is a huge problem here, as in many countries. Many live with severe problems and have not had the scaffolding they needed when they grew up.

I will continue this post with sharing more information about a topic I am very concerned about, since I work with it daily. The subject is trauma and dissociation, and I have chosen to reblog a post from a woman who must fight every day, against every type of challenge in the world. Please know that this entry might be triggering for others who have experienced trauma, and keep from reading it if you are at a bad place right now. Thank you for your respect.

Nina, clinical psychologist

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Fight, Flight or Freeze?

Don’t know about you, but we/I are firmly in the freeze camp.

Always have been.

A few years ago, I had some sort of assessment done by a Psychiatrist who drew up a diagram showing the window of tolerance see here for more info.

She said that in her opinion, I was functioning in a state of hypoarousal.
Which means I’m at the bottom end of the chart. When I was officially given the D.I.D diagnosis, H said the same.

Some traumatised people are in a permanent state of hyper-arousal which is where the fight /flight response comes in. An example being that when in a situation that is perceived as threatening, a person may display extreme rage and aggression. However, when a person reacts with hypoarousal, they become quieter, may appear depressed, and withdraw. ( see here for further information.. ).

The freeze response is where I am.
It is a pretty regular thing for me to ‘find myself’ unable to move sitting curled up behind my bathroom door.
shut down when in a situation that feels threatening (note, just because it feelsthreatening doesn’t mean it actually is). ‘Playing dead’ was what I did during traumatic experiences, and what I continue to do. Fighting and fleeing were not options. Theyshould be now though, I think.

While I recognise the reasoning for the freeze response, I also see that it causes huge problems in my day to day life.
I am not alone with this way of responding. It seems that it is the response of most of the rest of me, if not all.

Am beginning to accept that during time loss especially those times where I have evidence of having been out (where?) and being with (abusive?) people, that freeze response may have heightened risk rather than lowered it.

Now, I think (?) we need to learn how to fight and how to flee when in genuinely threatening situations. We also need to learn how to tolerate things that feel threatening but are not. Am not sure if that is possible since it seems from what I’ve read that those responses are learned during very early childhood.

Really hope this makes sense.
Thank you for reading.

sources http://www.kimberlyschmidtbevans.com/1/post/2013/06/the-window-of-tolerance-edges-of-growth.html

http://www.voice-dialogue-inner-self-awareness.com/dtd.html

Clinic for Dissociative studies

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About DID

Dissociative Identity Disorder

The international psychiatric criteria in the DSM IV specify that DID is:

  • The presence of two or more distinct identities or personality states (each with its own relatively enduring pattern of perceiving, relating to, and thinking about the environment and self).
  • At least two of these identity or personality states recurrently take control of the person’s behaviour.
  • Inability to recall important personal information that is too extensive to be explained by ordinary forgetfulness and not due to the direct effects of a substance (e.g. blackouts or chaotic behaviour during alcohol intoxication) or a general medical condition (e.g. complex partial seizures).

Professor Peter Fonagy and others have shown that the most common aetiology for DID is a disorganised attachment followed by abuse at the hands of a care-giver (McQueen, D; Kennedy, R; Itzin, C; Sinason, V; Maxted, F, 2009).

Whilst some people with DID have ‘alters’ that can communicate with each other, others can experience partial or total amnesia between personality states.  Particular events may trigger flashbacks or bring other personalities to the fore.  The results can have a devastating impact on an individual’s ability to maintain relationships and jobs and even to carry out everyday tasks.

ansikt

All those faces

International research has shown that long-term specialist therapy is the most effective treatment option, and that as with work with extreme post-traumatic stress, short-term interventions are unlikely to have a lasting effect if used in isolation.  For some patients, particularly those coming to treatment early, the prognosis can be good.  For others, particularly if they are still being exposed to trauma and abuse, treatment needs to be approached in a similar way to that for long-term conditions, with the aim of minimising further psychological damage, improving quailty of life and reducing risk.

Major research from the Albert Einstein College of Medicine (Foote, Smolin, Neft and Lipschitz, 2008) has shown that adults with dissociative disorders are at high risk of suicide or self-harm, as well as sectioning and other unplanned psychiatric admissions.  As a result of its clinical and theoretical understanding of this subject the risk of suicide or involuntary psychiatric admissions of clinic patients has been substantially reduced.

About trauma. Risk factors

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About trauma and risk factors for PTSD

The Field Glass by Rene Magritte
The Field Glass (1963)
by Rene Magritte

Almost everyone dissociates to some degree, as this illusion illustrates. Dissociation is a fairly normal coping strategy in the face of overwhelming stress, but extreme dissociative tendencies may be pathological. At this extreme, Dissociative Identity Disorder, or DID (formerly called MPD), is a condition requiring specialized treatment. Using Taxometric Analysis, Niels Waller and colleagues identified a separate ‘taxon’ of pathological dissociation useful in screening suspected dissociative disorders. This clinicially-important probability score is calculated from a subset of items in the DES, or Dissociative Experiences Scale. Thankfully, Darryl Perry has translated this algorithm into a downloadable DES Taxon Calculator for (for MS-Excel), described on and available from ISSTD‘s website.

Risk Factors

As you might expect, risk for PTSD increases with exposure to trauma. In other words, chronic or multiple traumatic experiences are likely to be more difficult to overcome than most single instances. PTSD is also more likely if passive defenses, such as freezing or dissociation, are used — rather than active defenses such as fight or flight. Epidemiological estimates suggest that the incidence and lifetime prevalence rates of PTSD in the general population are around 1% and 9%, respectively. But these levels increase markedly for young adults living in inner cities (23%), and for wounded combat veterans (20%). There is also evidence that early traumatic experiences (e.g., during childhood), especially if these are prolonged or repeated, may increase the risk of developing PTSD after traumatic exposure as an adult. This may result from state-dependent learning, where previous responses to a terrifying event are repeated even though more appropriate responses (i.e., active defenses) may now be possible.

Several animal studies have suggested the possibility of permanent physical damage (including shrinkage) in the hippocampus and changes in the amygdala when severe or chronic trauma — and its symptoms — persists (see especially work by Robert Sapolsky and by Joseph LeDoux, respectively). Unfortunately, there is no easy way to compare the relative types or degree of trauma across species. Human data, including Gilbertson et al’s (2002) twin study, suggest that response to trauma may be influenced by pre-existing individual differences in hippocampal volume. Perhaps both processes are involved.

There’s no clear evidence that susceptibility to PTSD varies for members of different ethnic or minority groups (given a traumatic experience). But individual differences clearly play some role. For example, younger children have less ability to predict, avoid, make sense of, or to actively defend against, upsetting events, and more introverted or shy individuals may experience stronger emotional reactions to such experiences.