Graham
~ Pesha Gertler ("The Healing Time")Healing From Complex Trauma
"Finally on my way to yes
I bump into
all the places
where I said no
to my life
all the untended wounds
the red and purple scars
those hieroglyphs of pain
carved into my skin, my bones,
those coded messages
that send me down
the wrong street
again and again
where I find them
the old wounds
the old misdirections
and I lift them
one by one
close to my heart
and I say holy
holy."
Areas of Experience
Complex Trauma, PTSD and Dissociative Disorders:
Central to my therapeutic practice is my work with adult survivors suffering from complex developmental trauma who spent their formative years within dysfunctional families of origin. These forms of trauma and dysfunction range from undergoing physical, sexual, emotional abuse and neglect, to growing up within alcoholic and drug addicted families, to enduring the harmful effects of parental mental illness or personality disorders, to experiencing many other, at times subtle and insidious, profoundly damaging childhood events.
Although the majority of my clients are highly functioning adults who oftentimes do not even initially realize the profound impact of their developmental experiences on their present state of being, they tend to manifest a plethora of symptoms and painful personality styles that are often largely attributable to some type of chronic childhood wounding. It can take a great deal of time in therapy to discover, untangle and heal the often deeply buried and elaborate root systems of their current emotional suffering.
The types of symptoms that my adult clients present with in therapy are broad in scope and may include, but are certainly not limited to, some of the classic symptoms of complex post-traumatic stress disorder. Complex PTSD may emerge as chronic anxiety, volatile mood swings, anger/irritability, emotional flooding, frequent experiences of feeling overwhelmed, difficulties with memory and concentration, hypervigilance, panic attacks, phobias, sleep disorders, nightmares, flashbacks, psychophysiologic syndromes (e.g. chronic headaches, irritable bowel, fibromyalgia, etc.), obsessive worries, and compulsive addictive behaviors (e.g. smoking, eating disorders, workaholism, etc.). Other symptoms may include persistent depression, difficulty experiencing pleasure and positive affects; negative beliefs about oneself, others and the world; social isolation, avoidance and distrust of other people; hopelessness and despair; and a felt sense of being trapped, helpless or powerless in one's life.
The clients I see with complex trauma sometimes also suffer from dissociative disorders and symptoms. These often include feelings of depersonalization and derealization: chronic emotional and physical numbing, feeling shut down or empty; experiences of being detached or cut off from one's body, sensations, emotions and thoughts; feeling separated from others as though one is behind a wall or in a fog; an experience of lacking a clearly felt and enlivened self and/or feeling mechanical and a lack of self-agency, and feeling profoundly disconnected in a deep sense from life.
I also have a great deal of experience working with internal structural dissociation in which clients experience a gulf between their conscious adult personas preoccupied with maintaining the responsibilities of every day life and split off or internal traumatized parts of the Self. The latter dissociative self parts carry fragmentary sensory perceptions, painful emotions, psychobiological reactions and defensive patterns accrued during childhood trauma experiences. These exiled aspects of self can include wounded child personality parts of various ages, protective/defensive parts, and perpetrating sub personalities that may heavily criticize, suppress and shame the person. Until these traumatized subparts of the person are healed and integrated consciously into the person's awareness, they can hijack the person's sense of well being through a plethora of persistent subtle or overt painfully chronic symptoms and dysfunctional defensive behaviors.
Adult survivors of complex childhood trauma very frequently suffer from a variety of distortions and deficits in their self-concept that may be experienced with or without ptsd. These self 'holes' often appear as a fundamental and chronic sense of core shame or a shame based identity which may include profound feelings of unworthiness, defectiveness, inferiority, self-disgust, or a vague sense of not being "good enough". Common defensive strategies that attempt to compensate or protect one from experiencing a shame based identity can range from paralyzing perfectionism, to obsessive self-criticism, to social avoidance and phobias.
Survivors tend to experience many challenges in forming and sustaining healthy intimate relationships. A sampling of common relational issues include excessive neediness and demands for attention, insecure attachment patterns, abandonment anxiety and depression, codependency, entrenched caretaking & self-sacrificing behaviors, problems with self-assertion, chronic distrust of self and others, avoidant fearfulness of intimacy, difficulties with commitment and emotional reliability, sexual issues, repetitive perceptions of being victimized or betrayed, frequent experiences of rejection & humiliation, a repetitive pattern of engaging in abusive or unhealthy relationships, and significant challenges in establishing mature communication and empathic interrelatedness.
N Ditz
~ Elizabeth BishopTransforming Shame
"I am too big. Too big by far. Pity me.
My eyes bulge and hurt. They are my one great beauty, even
so. They see too much, above, below...
I feel my colors changing now, my pigments
gradually shudder and shift over...
I have big shoulders, like a boxer. They are not muscle,
however, and their color is dark. They are my sacs of poison,
the almost unused poison that I bear, my burden and my great
responsibility...Beware,
I am an angel in disguise..."
Understanding the historical roots of trauma and uncovering memories is only a very small aspect of the therapeutic journey. The bulk of therapy lies in working with the person's present ways of experiencing and expressing traumatic symptoms, helping the individual change his/ her distorted perceptions and defense styles within the context of current relationships, and overall supporting the person's transformation from feeling emotionally compromised and fragmented to feeling more solid, secure, safe and self-confident.
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