Surviving holidays with dysfunctional family - 101

     This post is my gift to those, who tend to suffer through the holidays. If you are from a lucky bunch, who enjoys very much spending time with their immediate and extended families during the holiday season, I wish you the most festive celebrations and you can stop reading now. However, if you are a one, who was born into or adopted by a dysfunctional family, keep reading. You may have a laugh or possibly find a useful point or two below.

     Holiday time, especially Christmas time, is a season, when dysfunctional families blossom. They prepare for that time throughout the whole year with passion and enjoy every moment of it with the grimaces of suffering on the family members’ faces. Don’t ask me why. I am not a psychic. Just sharing my observations. So, if you would like to join in with your dysfunctional family and have fun being ridiculed, guilted, put down, and made feel like you are the worst human being that ever walked the face of earth, it is OK. It is a conscious choice, and I do not have any judgment there. You can stop reading now and go do your normal routine. If, however, you are tired of suffering and spending months putting yourself back together after holiday fun with your family, I have some suggestions that I summarized below in the form of steps.

Step 1. Adjust your goals and expectations.

     Somehow many of us have a goal to enjoy holiday time with our families. Crazy, huh? Even though we have never been able to reach this goal in the past, we keep pursuing it and hoping that this year things will turn out differently.  Others come to their homeland with the goal of finally showing them, making them understand, apologize, change, etc. When our goal is not being met, we tend to criticize and blame ourselves for that.  

     Well, maybe it’s a time to consider a different goal? For example, getting through the visit with the family in one piece with minimal emotional wounding with the follow up goal of spending just two weeks instead of four months healing from the experience.  What do you think? Framework is everything J

Step 2.  Give yourself compassion

     After all, you did not choose what kind of family you were born into, adopted by, or married into.  You cannot control other people’s choices or decisions. You are not responsible for the mess they create. But… you are affected by all that shit. It is extremely painful to hear for one hundredth time that unlike you, your brother has impeccable taste in women or is capable of providing for his aging parents. It is difficult to not feel responsible or guilty for your father’s asthma or drug abuse that he acquired working hard to provide for you. So, give yourself a hug and pour some unconditional love on yourself. You are lovable and worthy no matter what your family members say, think, or do. Here is the tape by Kristin Neff that you can download on your favorite digital device and listen to over and over again on your trip, before you go to bed, first thing after waking up in the morning, when you step outside for a breath and so forth: http://www.self-compassion.org/LKM.self-compassion.MP3.  After many repetitions it may brainwash you into believing that you are OK in spite of your mother’s or father’s insistence to the contrary.

Step 3. Predict

     From the previous years of experience with your family, you can predict a lot of what is going to happen. You may foresee that your uncle Henry will get drunk and start inappropriately touching you or make sexual advances towards your girlfriend or wife. You can be pretty confident that your grandma will ask you in front of the rest of the family, why you still have not lost any weight or are not married or don’t have kids or lost your job again. You may even anticipate that your mother will bluntly or subtly let you know that you are not good enough son or daughter, because you don’t visit enough, forgot her cat’s birthday, or obviously didn’t care about her health enough to visit her during the hospital stay you didn’t know anything about or because Shelly’s girl bought her a trip to Europe for Christmas and Pete’s boy got another promotion and is now the CEO of the World’s bank. As long as you step into the time with your family with your eyes open and your memory intact, you can take step 4.    

Step 4. Plan and Modify your responses to the predictable assaults

   

 Your past responses might have been to suffer through it all in silence or defiance or fight the injustice or something else. If you are reading this, it most likely means that whatever you did in the past has stopped working. So, may be it is a time to try something new? With the help from many of my clients and other people I have created a list of different types of responses. It is not an exhaustive list, feel free to create your own options. Just pick/create one or two new strategies to try this season. Write it down on a note card and carry with you as a reminder.

Different kinds of responses to predictable family assaults.

Preventing assaults from happening

·         Shorten your visit

·         Structure the time you spend with the family by playing board games, watching movies, going on hikes, etc.

·         Associate with people, who are supportive of you, and avoid those, who are hurtful

·         Be prepared to leave earlier than planned if things start escalating

Responding to the violation of physical boundaries, AKA unwanted touching

·         Prevent it from happening by maintaining physical distance between you and a family member, who tends to be inappropriate or unwelcome with touching

·         “You might not know this yet, but I have a personal bubble (use your hand to delineate it) and it is not OK for you to go inside it”

·         “I am not in a touchy feely mood”

·         “Stop it. I don’t like being touched”

·         Gently take a person’s hand or other part of the body that is used to violate your space and place or move it back on/towards their body

·         Walk away

·         Say very loudly: “I am sure you meant to touch my shoulder not my breast/ butt/ crotch/thigh. It happens”

·         “I am sure your wife/girlfriend/partner would love a touch like that. But I am your niece/daughter/son/sister, etc.”

Responding to the unwanted questions, jokes, comments AKA emotional fucking

·         INTERRUPT: “I am sorry. I need to go to the bathroom”

·         DISTRACT: “Oh my God, your earrings/necklace/outfit/hair are stunning”

·         DISARM: “I agree. I’m a total fuck-up. After all, the apple doesn’t fall far away from the tree”

·         STOP: “No comments”

·         USE HUMOR: Make a joke

·         IGNORE: pretend you didn’t hear comment or question

Step 6. Plan for crisis

     Depending on how dysfunctional your family is and how volatile and hurtful things have been in the past, you may want to have a safety/escape plan ready before you even leave your house. Make sure that you can exit the gathering place at any moment, give yourself permission to leave, have plan B ready with clear ideas of how to leave, where to go, and how to take care of yourself before you can get back home.

     Be on the lookout for the red flags that signal to you it is time to leave. For example, if you know that every time your uncle gets drunk, the physical fight between him and one or two other family members is coming, then leave when he is on the way to getting drunk and before he is already drunk.

Step 7. Take good care of yourself

     Focusing on yourself during a gathering of a dysfunctional family, is not selfish. It is responsible. What do you need to survive this stressful time with minimal harm to yourself? Answer this question and commit to doing those needed things. I know for myself that during stressful meetings, I need my full 8 hours or more of sleep, meditation, and at least a brief yoga practice. I commit to doing those things for myself. In the past, when I was capable of fitting all three things into my daily routine, I found that jerks I was surrounded by, somehow were more pleasant and easier to deal with.  J

Step 8. Focus on healing when you are back home

·              After you make it back home in one piece, no matter how distraught you are, congratulate yourself. You survived another family holiday gathering, you tried something different, and it is a big accomplishment no matter what the result is.

·         Do something soothing but not destructive. Here are some ideas: wrap yourself in a warm blanket and read your favorite book, have a cup of your favorite tea, take a nap, go for a walk, take a bath with aroma oils, or work out.

·         Process and debrief. Talk to a supportive friend or family member about the gathering, write a funny story about it, make a piece of art, or just journal.

·         Take it easy for a few days. Be gentle with yourself. Recognize that stressful and difficult events need to be followed by restful and restorative ones.

     Please, remember that even though you are not responsible for other family members’ choices and cannot control their actions, you are in full control of yourself. You have the right to protect yourself from being hurt. You have the responsibility to heal yourself after being hurt. If all members of your family did just that, you would not have a dysfunctional family to begin with J

     Have some compassion for your dysfunctional family members. After all, if it was not for you and other targets, they will have to focus on themselves and deal with their own issues. And you know how scary, hard, and plain painful that is. How can you expect someone you love to go through such a torture?

     I hope that this article made you smile at times and gave you some ideas to try. I trust that you were able to distinguish jokes and sarcasm from serious points and suggestions. J

HAPPY HOLIDAYS TO YOU AND YOUR FAMILY!

With much  love and compassion,

Irina

 

Dealing with negative self perception

     Disliking oneself is a very common consequence of the traumatic experiences. This often does not make sense to either trauma survivors or those who live with them. What happened was not their fault, why so much self-hatred? Let’s think about it together. Any violence towards a person carries within it a very powerful message. When violence is directed at me, it says to me “You are worthless and therefore deserving of this kind of treatment” The more intense and/or prolonged violence is, the more energy this message carries.  It often penetrates all kinds of self-defenses and touches the depth of our being. After violence is over, we start repeating this message to ourselves until we completely believe in it. What makes this situation very challenging is the fact that both transmission of the message and its repetition happen on an unconscious level, in the back of our minds.

     Good news is that since self-dislike is a learned response, it can be unlearned and a different positive response may be acquired. If you would like to learn to treat yourself better and have a more positive perspective on yourself, try one or more of the following practices.

1.       Positive affirmations
Those are the brief and precise sentences that describe how you would like to see yourself in a more positive way. The trick is that they are formulated in a present tense. For example, “I am wonderful just the way I am” or “I love and accept myself” or “I am worthy” or “I deserve to be taken care of” and so forth.  Develop three to four sentences. Write them on the notecards, sticky notes, your mirror, your phone. Repeat them as often as possible throughout the day.
At first, you probably would not believe any of those words. It may feel strange, awkward, even fake to say those things to yourself. But the more consistent you are in using those positive affirmations the more you will eventually believe in them.

2.       Loving Kindness Meditation with self- focus
This is a beautiful practice of wishing yourself well and sending to yourself all the healing and support there exists. There are a lot of different versions of it. Multiple tapes are available for you to listen to. I wrote about it in the January 2013 post. Here is an excerpt from it K
1) Choose several phrases that you will be working with (repeating) that start with “May I” and focus on wishing yourself well. Usually, meditation consists of  3-4 phrases repeated over and over again. If you find it difficult to come up with those phrases, here are some suggestions:
- May I be well

- May I love myself no matter what

- May I accept myself just the way I am

- May I be content

2) After you identified and wrote down the phrases you are going to use, find a quiet place, where you will not be disturbed by anyone or anything. Sit in a comfortable position, such as with your legs crossed on a cushion or in the chair or on the sofa. Close your eyes and focus on your breathing for a few moments. Notice how you breathe air in and how you breathe it out. Then visualize yourself surrounded by white or yellow light. Feel the warmth of light on your skin. Enjoy the sensations. Now start saying the phrases that you identified out loud or silently in your mind. Pause after each sentence and connect to the wish it contains. Maintain awareness of your breathing and picture of yourself surrounded by white light. Spend 3-5 minutes repeating the phrases. Repeat this practice daily.
Note that for the first couple of months wishing yourself love and acceptance may feel false or wrong. Some parts of you may think that you don’t deserve all of those things. It’s OK. You don’t have to believe in what you are saying to get positive results. Additionally, the more often you practice this meditation the more you will feel and believe in your worthiness.

3.       Treating self well
     When you take good care of yourself and treat yourself well, you re-wire your mind to believe that you are a good person worthy of love. Even if you don’t feel like it, create a routine of basic care and follow it consistently. For example, every morning when you wake up, take a shower, brush your teeth, put on fresh clothes, and make a breakfast for yourself. Every evening put on fresh pajamas, light candles, and take a few minutes to read something inspiring before you go to bed. This is just an illustration. Listen to yourself and create a routine that feels good for you.
     Take any opportunity to be good to yourself. When you make a mistake and catch yourself in a severe blaming or shaming talk, interrupt it and say something reassuring instead, such as “everyone makes mistakes” or “I can learn from it” or “if God wanted me to be perfect, he would have made me that way”.  When you feel down, bad, lazy, crazy, say something supportive and uplifting, offer self a cup of hot tea or a hug. Treat yourself the way you would treat your dearest friend.
     Remember that learning to treat yourself well is a work in progress. It may be challenging. You may feel like you are failing at it. You may forget and relapse. It is all OK. All of those things are a part of the learning process. You can always try again and you can build on the previous mistakes. That is a beauty of life. Every moment is a new and fresh start J

4.       Abstaining  from self-harm
     Directly related to a previous point, is the idea that self-harm promotes negative self-image and further deepens the belief that you are not good enough. Therefore, to improve your self-perception, it is important to abstain from it. I understand that inflicting pain on self, whether it is cutting, burning, hitting, pinching or something else, is often a way to cope. It helps to suppress more severe emotional pain or on contrary makes you feel something when you are in the state of traumatic numbness. Sometimes it is the quickest way to change a state. Sometimes it is a way to express how much you hate yourself. This behavior is very understandable in those who survived violence, and yet it has to be changed in order for you to start feeling better. Here are a few ideas on how to deal with the urges to self-harm. However, if it is an ongoing issue for you, I recommend that you find a therapist and start working with him/her.
1) when an urge to harm self presents itself, ask yourself a question “who am I angry at other than myself?” Then express your anger towards that person or situation in a non-hurtful way, such as journaling
2) if you cannot identify source of your anger outside of yourself or it feels dangerous, use softer/substitute methods of inflicting pain, such as holding ice-cubes in your hands or immersing your face in ice water for a few seconds; sometimes drawing lines with the red marker at the site where you want to cut or burn, helps to alleviate an urge;         
3) call a trusted friend or a crisis number, such as 1-800-273-TALK to discuss how you are feeling;
4) get out of the current situation: step outside for a few breaths of fresh air, go to the park or to the coffee shop, distract yourself with something positive, such as uplifting book or a movie.

about it, creating a piece of art, going for a run, or screaming/singing in a shower;

     Give yourself time to process the idea that you can change how you feel about yourself. Give yourself time and space to practice the aforementioned techniques. Be patient like you would with a baby, who is just learning how to walk. Remember you will not smack the baby or call it worthless, when it falls down. So, extend the same kind of kindness to yourself. After all, you are just learning or re-discovering how to be good to yourself.

     Some of you may doubt that loving yourself is a goal worthy of pursuit. Isn’t it selfish? Haven’t we all be taught that we need to focus on others before we focus on ourselves? These questions and doubts are very understandable. Here is the way I came to view it based on my years of experience of working with people. Belief that self-love is selfish and therefore bad is a cultural myth. Unfortunately, this myth is wide-spread and has perpetuated a lot of violence and suffering. When a person genuinely loves themselves, they are a joy to be around. They spread positive energy and infect others with love and compassion. They do not have any desire or motive to harm anyone. They value human life. If everyone in this world loved themselves, there would be no war, no hunger, no violence. In my opinion, coming to accept yourself is the best gift you can give this world J

    

Dealing with the messiness of life

     Throughout the years I noticed that many trauma survivors, including myself, have desire to avoid messiness of life at all costs. We lock ourselves in the safety of our houses, relationships, jobs, routines, etc. We dread any change. We want to have full control of our lives, which is very understandable given how out-of-control traumatic experience felt. However, as protective and desirable as it is, this state of avoidance is also unrealistic. We do not have full control of our lives and our circumstances. There are too many forces and factors that play on the stages of our lives. The only control we truly have is of how we respond to what happens.

     Practicing yoga on the beach helped me learn about messiness and control in my life. I have always thought about practicing yoga on the beach as a fun and pleasant activity. I have been craving it for a while. Finally, two weeks ago I arrived at the beach on Hilton Head Island with my yoga towel and a bottle of water and an intent to fully immerse myself in the yoga class offered there. It was 8:30 a.m. in the morning on a sunny day with a fresh breeze coming from the ocean. The sound of waves crushing against each other was very soothing. I placed my towel next to another yogi’s towel and stood at the top of it as instructed by the teacher. As we started engaging in Sun Salutations and other standing poses, I realized that my towel does not hold my weight very well. The sand under it got very bumpy. Moreover, sand got on the towel, on my hands, arms, legs, and feet. It was rubbing against my skin. Wind was blowing sand into my face. My eyes were stinging with sweat pouring from my forehead. People walking on the beach were stopping and staring at our small group, some even took pictures. Seagulls were screaming. Kids were running around sprinkling water all around. “What a mess!” I thought to myself. Suddenly I felt uncomfortable, unpleasant, and disappointed. “This is NOT what yoga on the beach is supposed to be like!”

     Then I realized that there is NOT “supposed to be” for any experience, including yoga on the beach. It is what it is. I have a choice of accepting this experience as it is or fighting it. I decided to slow my mind down and focus on my breathing. Soon I noticed that in addition to all the aforementioned discomforts, I also experienced pleasure from moving and stretching my body, from the breeze caressing my sandy arms and legs, and from being able to identify and intensely listen to the sound of waves. “It’s just like any other part of life,” I heard a voice in my head. “In order to feel joy and pleasure, you need to immerse yourself into an experience fully and be willing to take discomfort that comes with it as well”. 

     When the class hit its midpoint, my experience was quite different. I actually stopped minding sweaty sandy mess that covered my body. My focus shifted towards movement, breath, and ocean waves. I felt as One with all of that. I still noticed all the other stuff, like people walking and staring, seagulls screaming and so forth, but all of them became background for my sense of connection with my body and nature.

     Later on, when I reflected on my experience in the class, I thought of messiness as an integral part of living. Nothing good is ever created without a mess, be it a baby being born or a meal being cooked or a piece of art being created or a tomato being grown. I found the quote by Charles Caleb Colton that I really resonated with: “Life isn't like a book. Life isn't logical or sensible or orderly. Life is a mess most of the time”.

     So, why are we so mess-phobic? Why are we trying to keep mess and disorder out of our lives? Somehow we came to equate mess with danger and evil. We get overwhelmed. We think we will not be able to cope if we get ourselves in a mess. We don’t have skills or resources. So, there are different ways to go about the issue. One would be to avoid mess altogether and accept the consequences of avoiding life and joy and learning and growth. Another way is to learn skills and obtain necessary resources to deal with the mess, so that we can experience our lives fully. The choice is ours. And, we can choose every moment and every day J

Monsters on a healing journey

The following video explains how trauma happens, how it effects our lives, and how we cope and then heal from it. It is told in a form of story involving pictures of monsters and stick people. I believe it helps understand what trauma does to us on a more emotional level. Please, watch and comment.

"Monsters in our lives" video

National PTSD Awareness Month

     June 2013 is a PTSD awareness month. Different events are being held across the nation to improve understanding of experiences and awareness of signs and treatments of PTSD. As I am waiting for the start of the community discussion on PTSD facilitated by Dr. Susan Fuhr (http://www.yourjourneys.net/), I am reflecting on what it means to be diagnosed with PTSD, to live with PTSD. On a daily basis I talk to folks, who survived different kinds of traumas. I hear the stories of survival and struggle. Often there is a lot of hopelessness and despair. Always there is a lot of pain. It is very understandable given what trauma survivors went through. They experience normal reaction to the abnormal situation, even though many of them and their significant others do not think that survivor's response is normal.
     I would like to share some of my thoughts on PTSD. In the past two decades our understanding of this disorder changed a lot due to developing research and clinical practice. We know now that this disorder has neurological underpinnings, and that it changes brain. We know that it affects individuals on all levels: physical, cognitive, emotional, social, and spiritual. We also understand that trauma wounds are not healed by just time and do not go away on their own.
     In spite of all the pain and hardship that PTSD comes with, there is a lot of hope too. In the past decade a number of treatments became available to trauma survivors. Among them are EMDR (http://www.emdria.org/),Internal Family Systems (http://www.selfleadership.org/), Somatic Experiencing (http://www.traumahealing.com/), Sensorimotor therapy (http://www.sensorimotorpsychotherapy.org/), and cognitive processing therapy (http://www.ptsd.va.gov/public/pages/cognitive_processing_therapy.asp). All of these treatment modalities have shown tremendous success in treating the effects of trauma and helping survivors find a way to make sense of what happened to them, assimilate their experiences, and truly move forward with their lives.
     In addition, a number of complimentary approaches were introduced, including yoga (http://www.yogajournal.com/) and mindfulness (http://www.mindful.org/). These practices help survivors re-learn how to be present with their current experiences. They help people stay grounded in the present moment as opposed to the past events. They also have tremendous calming effect on the nervous system and brain.
     If you were to take  away  just one point from this post, let it be the following: PTSD can be treated. Get professional help! The sooner you address it, the better results you will get.
   

Packing for a journey: tools and skills

     Healing from trauma is a long process and a substantial journey. As any big trip it requires preparation and right gear. For some journeys we need clothes and a sleeping bag for others we need tools and skills. This post will help you understand a broader picture of what you may need to support your healing journey. The posts that follow will expand on each category and teach you specific skills.

     Very often when trauma is over, we find ourselves behaving in self-destructive ways, such as abusing alcohol or drugs, cutting self, taking unjustified risks, engaging in unsafe sex and so forth. This happens not because we really want to hurt ourselves but because we are reaching for what is available and quick to relieve our emotional pain. A couple of drinks can really take the edge off in this moment. A one night stand can temporarily relieve loneliness and create a moment of pleasure.  

     The truth is we want to cope. We want to feel better. But we don’t know of lasting and effective ways to bring relief. Nobody teaches us in school or college the skills we might need if we get traumatized. Good news is that we can obtain what we need at any age by understanding common emotional needs of trauma survivors and learning specific ways to address them. So, let’s get to the bottom of it. The table below  summarizes common emotional needs and issues of trauma survivors and suggests different tools and skills that can be helpful in dealing with each one of those. 

Common emotional concerns of survivors	Focus of learning	Skills & Techniques
Mood & affect instability	How to tolerate distress and pain without falling apart; How to improve mood	Distraction Self-soothing Mind-body techniques Containment
Anxiety, hyperarousal, stress and tension	How to tolerate anxiety; How to reduce anxiety	Mind-body techniques Imagery techniques, i.e. Safe Place
Relieving past traumatic experiences: flashbacks, obsessive thoughts, sudden intense emotions	How to be in and return to the present moment	Grounding Mind-body techniques Containment Safe Place Visualization
Difficulty communicating with or relating to others	How to express self effectively; How to listen to others efficiently	Expressing your thoughts and feelings Asking for what you need Effective use of “no”
Non-specific difficulties functioning at the “normal” level	How to take good care of self	Basic  self-care: sleeping, eating, exercising
Negative self-image & shame	How to focus on the core goodness; How to focus on the positive aspects of self	Loving kindness meditation Positive self-talk & affirmations Discovering anger
Persistent feelings of guilt		Loving kindness meditation Forgiveness practice
Intense anger	Validation & safe expression of emotions	Coping affirmations Time out Safe expressions of anger
Suicidal thoughts, impulses to self-harm, homicidal thoughts	Understanding the nature of the thoughts/impulses	Survival kit/box

     In the next several posts I will describe the skills summarized in the table above in detail. Each post will focus on the specific emotional concern (left column of the table) and teach you skills to address or cope with this concern. Some of the skills or concerns have been described in the previous posts. You will find links to those posts in the table.
     As a conclusion, healing from trauma is a long process that takes courage, perseverance, time, and multiple resources. It is a long journey. As any successful journey, it has to be planned and prepared for. Think of learning and practicing coping skills as a very important preparation step.You need those tools in order to cross the "oceans" and "desserts" that you will meet on your way and to reach the oasis of  healed and whole self. So, do not regret time and energy you spend at this step of the process. It will serve you very well once you delve into reprocessing traumatic memories, the most painful part of the .journey.

Tools and skills: Calming and safe place visualization

Many people that I have talked to throughout the years are on the lookout and in search for solutions, prescriptions, and things to do to improve their current mental health situation. I often share this wonderful tool, which proved very helpful to many of my clients. Now, here is a caveat. In order for this tool to be helpful it has to be learned, practiced, and then used. It seems obvious. However, folks often forget this banal truth and expect the tool to work just because they read about it and maybe did it once.

     Calming or safe place visualization is a tool that is helpful in managing anxiety, dealing with stress, re-establishing sense of safety after painful and traumatic experiences, and improving mood.

     This is how it works:

1.     Identify a place that seems calming to you. It may be a natural scene, like an ocean beach or a meadow. It may be a man-made place, like a house or a room or a cave. It may be real, such as a cabin you visited in the past, or completely imaginary, such as a yurt on a faraway star. There are two very important considerations, when you work on identifying the calming place:

a.     Nothing remotely negative has ever happened there. For example, often people choose their former room in the childhood house. This place maybe associated with a lot of positive memories and experiences. However, for most folks something not that pleasant probably happened in that room as well. Maybe they were punished and isolated there at one point or had a fight with their friend or a sibling there. In those kinds of situations, the place can be easily “contaminated” by not so pleasant and relaxing feelings stemming from the past memories.

b.     The image of the place makes you feel good, such as calm, relaxed, joyful, safe and so forth. If this is not the case, choose a different place or a different image.

2.     Give this place a name, so that you can pull it up in your mind easily. I suggest that the name is simple but specific. For example, “Blue condo on the beach” or “Moon cave” or “Eagle Mountain”. It is again important that this name has only positive or neutral associations in your mind.

3.     After you identified a place and gave it a name, you are ready for visualization. Recording posted in this post will lead you through further developing and strengthening this place in your mind. It is 11-12 minutes long. I suggest that you listen to it during the time when you are not likely to be interrupted.

4.     Once you listened to the recording several times in the course of several days or a week, you are ready to start practicing without the recording. I suggest taking few minutes every day to imagine that you are in that calming place, while breathing deeply and relaxing. The best times to practice are the following: just before you fall asleep in the evening and the first thing after you wake up in the morning. Practicing daily for a week will strengthen the image and its association to relaxation response.

5.     After a week of practicing during generally calm times, you can start using this image to cope with stressful situations. Say you are in a stressful meeting at work and feeling so frustrated that you are ready to pull your hair out. Allow yourself to withdraw from discussion for a few moments. Take a mental pause, recall the name of your calming place, and imagine that you are there. Breathe deeply as your mind is relaxing into the image of that place. When you are ready or need to leave the calming place, remind yourself that you can come back anytime. Leave the place in your imagination and bring focus of your attention back to the meeting.

Relaxing place is a wonderful coping tool if used on the regular basis. Take any opportunity to practice the safe place, such as standing in line at the grocery store, stopping your car at the red light, being put on hold during a phone conversation, during a tense conversation and so forth.

Let me know what experiences you had with this tool and whether you have any questions or concerns about it.

Healing is a journey

     As I was looking at the posts from the previous months, I realized that even though they have been covering important healing issues, they felt very random. The main framework, the bigger picture was left out. So, this post looks at the forest not the trees of healing.

     I often hear from my clients that they want to be over their ordeal NOW or even better LAST WEEK, MONTH OR YEAR. My heart goes out to them and all other survivors struggling in this very moment, as I understand this desire very well. Who would like to spend another second suffering from anxiety, depression, panic attacks, feeling suicidal or stuck in the nightmares or horrible memories of what happened? Clearly, no one.

     From my perspective, here is the biggest challenge of a sudden trauma, such as an assault, a military attack, an earthquake, a murder or a sudden death of someone close. It kicks us out of our normal ordinary comfortable life and destroys all the paths back to it. We cannot go back no matter how much we want to or how hard we try. But we continue to carry with us a memory of how it was before. We desperately want to recreate it. We do not understand that it is as if a nuclear bomb was dropped on our house and we need to leave that place behind and move to the new grounds. Now, chronic traumas, such as childhood abuse, domestic violence, living in a criminal environment have somewhat different major challenge. We get so accustomed to living in the war zone, that we either forget or do not know that it is not like this everywhere, that there are safe places and caring people outside of the fence. We do not believe that a better life is possible, if we dare to leave the current situation. Whether we suffered from a sudden or chronic trauma or both, there are several general tendencies that are associated with healing from the aftermath.

     Many people ask me and themselves why it takes such a long time to heal from something that took few seconds, minutes, hours or something that is so far in the past. My understanding is that it is very easy to destroy something and much more difficult to create, grow, and heal. A production of a human being  takes nine months in the mother’s womb, multiple years of caregivers taking care of him/her,  loving and teaching, before a person can be self-sufficient and stand on his/her own. How much does it take to destroy this precious life? Often, just few seconds. Another less horrid example is getting injured while going through some kind of athletic training. Again, takes just a moment. A second ago you were strong capable athlete and now you are lying on the ground screaming from the pain of a broken ankle. It will take months of careful treatment and rehab to heal it and more months to get back in the pre-injury shape.  SO, here is the first important fact of healing. It takes time.

     When we get a small physical injury, like a paper cut, it can heal on its own with minimal effort on our part. When an injury is more serious, such as a bullet wound, it requires much more attention and effort in order to be remedied. We have to clean the wound, medicate it, bandage it and so forth on the regular basis. It is very similar but more complex, when it comes to a psychological wound. We need to tend to it in order for it to heal. But tending to it is painful and the wound is not visible, so the temptation to avoid dealing with it is often very strong. We often pretend that it is not there, while it continues to fester. Alternative of acknowledging it, looking at it, talking about it is so frightening. But the wound will not heal unless paid attention to. The second important fact of healing is: it takes effort.

     Traumatic events stand out of the realm of the ordinary human experiences. Those are things that should not be happening in the normal human life or things that happen once in a lifetime. As a result, we are not equipped to deal with them. We simply do not have knowledge, skills and tools necessary to patch those wounds. No one is prepared. It is not our fault. However, now that we have been injured, it is our responsibility to learn those new skills. We need to figure out how to re-create a sense of safety to continue functioning. We need to learn who and how we can trust. We have to develop an ability to take extra-good care of ourselves. We have got to learn how to cope with anxiety, depression, desire to self-harm, nightmares and other things we might have never experienced before. Many of us also have to put together a new picture of the world, because often the old one was blown up in pieces by the traumatic events. The third important fact of healing: new knowledge and skills have to be obtained.

     There are many tasks in life that we can accomplish self-sufficiently on our own. Healing from trauma is not one of them. We need help and support from others in order to heal. For many people, who have experienced interpersonal traumas of abuse and betrayal by other humans, seeking support is very tough. How do we know that those in helping role will not take advantage of us or betray us? How can we rely on someone, when we survived only because we relied on ourselves and our strengths? How can we overcome shame and embarrassment of telling another human being of what happened and how we coped? How can we trust them to not reject us after they learn what we have been through? Those and others are complicated questions. Many survivors struggle with them for years. Some make decisions to avoid relationships all together.  Others stumble through and get hurt over and over again. If you cannot fathom asking another human being for support, I suggest starting with individual therapy and developing supportive relationship with your therapist. The fourth important fact of healing: we need support of other humans to heal and move forward.     

     The process of healing also has its own rhythm and structure. Years of clinical experience and research suggest that there are certain stages that trauma therapy has to go through. In general, the process is described as having three stages: (1) stabilization stage includes learning new skills, coping with current issues and symptoms effectively, developing a sense of normalcy and safety; (2) reprocessing trauma stage is about reconstructing traumatic experience or processing it, as well as mourning losses associated with it; (3) integration stage includes assimilating new experiences and perspectives, such as new picture of trauma and new perspective on the world; it also includes internal integration of different parts of self that were and were not affected by the events. This framework can be applied to the effective healing process. In addition, timing is an important consideration too. Many of my clients have experienced feeling stuck and frustrated for month only to experience sudden insight one day. Many are also familiar with the experience of taking a step forward only to take two steps back. All of those experiences are normal and a part of healing. Sometimes survivors try to push through and expedite the process of healing. It can be facilitated but only so much. Like a plant has to be a seed and a sprout before it becomes a full-grown plant, so the process of healing has to unravel. It is important to know and respect this gradual growth.  The fifth important fact of healing is that the process has its own rhythm, timing, and structure that have to be respected.

     Finally, we also have to respect our own internal rhythm of coming to terms with what happened. Our psyches are complex and adjusting to the injury takes a number of different steps. Many people go through the following stages: (1) initial shock and feeling numb or overwhelmed; (2) denial that trauma was a big deal or that it had any impact, trying to persuade self and others that they are coping well or are over it; (3) anger often comes next brining in focus realization that they were wronged and that what happened was extremely unfair; folks may also just be angry and irritable at others around them and at the small life stresses without realizing the underlying cause; (4) profound sadness and depression is the stage that is associated with realization of how much was lost; the most difficult realization of all is associated with the loss of parts of self and  ability to enjoy life; (5) finally, acceptance sets in; with it comes a deeper level of understanding about what happened  and that old reality is gone forever; survivors may not like this fact at all but they don’t fight against it anymore. Most folks go through these stages multiple times, back and forth, feeling completely done and accepting, only to find themselves in the throws of anger or denial again. It is a normal process. It feels painful but there is nothing wrong with the process itself. It often helps survivors to understand the dynamics and not blame themselves for the “slow progress” or “relapse”. The sixth important fact of healing: our psyche moves back and forth and gets stuck and unstuck multiple times as we heal.

     I understand that the steps and big picture of healing may seem overwhelming at first. It may take you reading and reflecting on this post a number of times or digesting it in small portions. The idea behind it is to give you hope and understanding that healing is possible and that you have some control over the process. You can take helpful steps, you can stay away from interfering with it too much. You can heal!

     To summarize, the bigger picture of the healing from any trauma includes the following aspects:

1.     Plenty of time

2.     Survivor’s effort

3.     Obtaining new knowledge and skills

4.     Support of other humans

5.     Respect for the rhythm, timing, and structure of the healing process

6.     Acceptance of the cyclical nature of healing and being stuck at times  

I am interested in your comments and questions. The best of luck on your journey!

Dealing with shame

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     Shame is a common consequence of trauma, especially interpersonal injury or stressful events that lasted for a while. When we are treated cruelly, when we are abused by other people, it leaves us feeling like we are bad and not deserving love. Because why else would we be subjected to violence? Trauma survivors may experience shame as ranging from nagging background feeling of not being good enough to the full-blown self-hatred and desire to kill themselves as they are not good.

     Shame maybe defined as a painful emotion caused by a strong sense of embarrassment, unworthiness, or disgrace. Feeling of shame is profound. It affects the way we perceive ourselves. It tells us that we are bad, incompetent, and unlovable. Shame is a toxic emotion, especially when it is experienced on the regular basis. People tend to hide shame, because nobody wants to seem inadequate or bad. As a result, shame is an emotion that is very difficult to express. It loves dark places. It tends to thrive in hiding. Because of the aforementioned qualities, shame is very difficult to deal with.

     I am going to discuss several approaches that compliment each other and can be used together to alleviate painful effects of shame.

     Developing a sense of worthiness and self-acceptance is a potent antidote to shame. There are many ways to work on that. I particularly like two practices described below. When exercised daily over several months to a year period of time, they may lead to dramatic positive change in the level of self-acceptance.

·        Loving kindness meditation is an ancient practice with its roots in Buddhism. The full practice has practitioner wishing wellness, health, love, and so forth to him or herself first, then to a friend, a neutral person, an enemy, and finally all humans. For our purposes, I suggest using only the first part of meditation, which is wishing yourself well.
Here are the instructions: Choose the phrases that you will be working with (repeating) that start with “May I” and focus on wishing yourself well. Usually, meditation consists of  3-4 phrases repeated over and over again. If you find it difficult to come up with those phrases, here is my suggestion:
- May I be well
-May I love myself no matter what
- May I accept myself just the way I am
- May I be content
After you identified and wrote down the phrases you are going to use, find a quiet place, where you will not be disturbed by anyone or anything. Sit in a comfortable position, such as with your legs crossed on a cushion or in the chair or on the sofa. Close your eyes and focus on your breathing for a few moments. Notice how you breathe air in and how you breathe it out. Then visualize yourself surrounded by white or yellow light. Feel the warmth of light on your skin. Enjoy the sensations. Now start saying the phrases that you identified out loud or silently in your mind. Pause after each sentence and connect to the wish it contains. Maintain awareness of your breathing and picture of yourself surrounded by white light. Spend 3-5 minutes repeating the phrases. Repeat this practice daily.
Note that for the first couple of months wishing yourself love and acceptance may feel false or wrong. Some parts of you may think that you don’t deserve all of those things. It’s OK. You don’t have to believe in what you are saying to get positive results. Additionally, the more often you practice this meditation the more you will feel and believe in your worthiness.

·        Affirmations, when used many times a day and especially during the times you feel unworthy or evil, are a great tool for reducing shame. Affirmation is a positive statement about yourself in the present tense. For example, I am wonderful just the way I am. The more specific and relevant  a statement is to the specific thoughts associated with shame the more effective it would be. I suggest working with 1-3 affirmations at a time. To develop helpful affirmation notice what thoughts come up for you when you feel inadequate. Then create a sentence that describes you as a complete opposite of that. So, if you think “I am unlovable”, the appropriate affirmation will be “I am lovable”. If you think “I am a bad person, who does not deserve to live”, a helpful statement will be “I am a good person, and I deserve a good life”. I hope you got the concept. Once you develop one to three affirmations, start using them multiple times a day. I suggest repeating them several times right upon awakening, when you feel ashamed, inadequate or bad, and right before you go to sleep.

      Properly directing and expressing your anger is another powerful technique for combating shame. The theory behind it is that trauma survivors often couldn’t feel anger at their abusers at all or to the full extent, because it was very dangerous at the time and could have prolonged violence. So, substantial part of this anger was directed at self. It was an essential survival tool that helped survivors come out of trauma with minimal possible injuries (even if they were substantial, they would have been worse if a survivor expressed full extent of his or her anger at the perpetrator). If trauma is over at this point, anger can be reconsidered and directed properly.
     So, anytime you feel shame, ask yourself “Who am I angry at right now other than myself?” After you identify a person or situation you are angry at in the moment, find a way to safely express your anger. Some options include journaling about it, aerobic exercise, talking to a safe person about your feelings, singing or yelling in the shower. In some situations it may help to tell the person you are angry at how you are feeling. However, it is not advisable if your anger is too intense or if the person has a potential to become or has been violent in the past.  

          Talking to trusted others about your shame and experiences that caused it is one of the best ways to reduce or eliminate it. Remember that shame loves dark places and hiding. When you shed light on it by talking about it, shame runs away. There are several crucial considerations factoring into decision to open up to someone else. First, it is important to choose a person you trust. Ideally it should be someone, who is able to listen and understand difficult experiences, who is open about their own challenges and difficulties, and who responds with compassion to pain of other people. Second, be aware that initiating and having this conversation, especially for the first time, will not be a comfortable experience for you. And, it’s OK. Just prepare yourself for a challenge. Also, first couple of times you talk to others, shame may increase. Let the person you talk to know about that and ask for what you need from them whether it’s a hug or reassurance that they accept you or something else.

     Working on reducing or eliminating shame is a long-term process. Please, be patient with yourself. However, if the aforementioned techniques don’t make any difference in how you feel within a couple of months, seek professional help from a mental health professional.

     As always, I am interested in your feedback, questions, and comments. Please, share them on the blog page if at all possible.