Archives for category: Dissociation

Thanks to Athina at Courage Coaching for sharing this video about complex trauma!

Originally posted on A Broken Blue Sky: The following video is one of the best videos I have watched on Complex PTSD. If you suffer from C-PTSD, it will be very emotional to watch. But it will also be very validating of all that you went through and help you to understand your reactions to…

via “Complex Trauma: Understanding and Treatment” — Courage Coaching

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One of the hardest parts about living and interacting with the outside world is being able to regulate my emotions when I dissociate.  Many times, anger triggers dissociation and switching.  Then an alter comes out to deal with the situation.  Once over, that alter retreats, and I or one of the other “in-charge” alters comes back with no clue what just happened.

That’s scary.  It feels out of control.  The memories of what happened don’t always come back right away.  Used to be those alters wouldn’t share what happened for weeks, months, years, even decades.  Now, they share within hours or days.  But the sharing comes as nightmares or daydreams out of context of when/where/how anything happened.  Like living in 2 realities.

The past few days, I’ve been working on an exercise to write down what I am doing, thinking, and feeling whenever I feel even a little anger.  Only problem is that I have not felt any anger this week.  I felt sad, scared, and upset.  I felt guilt and shame too.

Now I have to wonder if maybe one of these emotions is the real trigger.  And then everything else gets expressed as anger.

Maybe someday, this will stop.  And then I will feel more confident interacting and socializing with people.  I will remember what happens when my boundaries get crossed and why people are treating me a certain way.  I will remember why they feel the right to treat me that way and why I feel the need to be wary of them even though being polite is a must.

Finally, maybe this will help with some of the feelings of shame and guilt that come with the periods of not remembering.

Thanks for reading today’s ramble.

Background

In past posts, I’ve talked about boundaries and my view of relationships in general being finite or having an inevitable end.  Growing up, I never had boundaries; did not know they existed.  As an adult in therapy, I learned about boundaries.  I learned how they are created and why they keep me safe.  I also learned that boundaries keep the people around me safe too.  These lessons also taught me that maintaining and respecting boundaries goes both ways.

An individual cannot expect others to respect his or her boundaries if she or he does not respect others’ boundaries.

Not everyone is comfortable with the idea of boundaries or understands how healthy and important having/mainlining boundaries is for a balanced life.  Abusers and perpetrators hate boundaries and do everything they can to ignore them or make them disappear.  Boundaries are invisible protection that keeps abusers and perpetrators from getting or doing what they want to their victims.  Boundaries help build resilience to bullies and other forms of intimidation too.

This is why I did not have boundaries growing up.  And any time I tried to set and enforce boundaries, the abusers in my life punished me; ignored and violated them anyways; pretended to understand and then undermined my efforts; and all around made it clear that I could have them in my life on their terms or keep my boundaries and be rejected by them and everyone else.

Boundaries and Friendships

As a child, adolescent and young adult, I wasn’t allowed to develop and maintain real friendships with anyone.  So my view of any relationship was based on the ones I had with my family (description above).  So I behaved with people I wanted to be friends with the same way I did with family.  That meant a lot of people thought I was nice, malleable, sweet, and easy to manipulate/take advantage of.  When they got to know me and realized I was not really malleable, sweet, or a pushover, I got rejected.  That would trigger me into flashbacks and shame and panic attacks; reinforcing the lessons and negative self image from childhood.

So, on one hand I knew I would always lose friends because there was something wrong with me.  On the other hand, I never knew what I did or what happened to cause the break in friendships and other relationships.  And when I asked, no one told me.  Or people would say I am too pushy, that I don’t respect them, that I am annoying and do care about their feelings.  Which confused me more because on the inside, the secret places no one else at the time got to see, I did care – maybe too much – and truly want to help and understand what was going on.

It wasn’t until I started sessions with my current therapist that I realized part of the problem was switching personalities whenever I got stressed out.  My alters and I have been working together for a long time even if we haven’t always been in direct communication with each other.  One of our greatest strengths is being able to assess a situation and switch personalities so that the one best qualified to handle the stress is in charge.  And the lightning changes in mood and personality can be hard for others to handle especially when the typical dominant personality is unaware that any of this is is happening.

Epiphany and Conclusion

Three weeks ago, a long time friendship got thorny.  He was upset because of something that had me reinforcing my boundaries.  On a personal front, he was having difficulties and under a lot of stress even if he wouldn’t admit to it.  That led some of our discussions to be fraught with anxiety on my part because I never knew if something I said would cause him to blow up at me.  And later, whenever I was happy about something and went to share with him, he would say something negative or in such a way that it sounded complimentary but was actually insulting or shame inducing and had me questioning my choices.

And when he started ignoring me and being rude, I realized that he expected me to come over and apologize for reinforcing my boundaries and being myself.  That irritated me and made me feel angry.  I realized then, that I was not going to apologize for being myself.  And I was okay with him acting childish because I didn’t let him walk all over me.  But then I was worried about why I wasn’t triggered.  But I had other things on my mind.  Like deadlines, troubleshooting other issues with my work, packing and going on vacation, etc.  So I put this away for a while and waited to see what would happen.

This week, back at work, nothing has changed with his attitude.  But something changed inside me.  I realized that our friendship was over.  And that it ended because I protected myself by reinforcing my boundaries in a polite way instead of backing down and letting him have his way.  This felt good because I did not get triggered into shame.  I got triggered into confusion and anxiety because my parts were confused and worried about how this would affect mutual friendships, etc.  It also got us thinking about past relationships and why they ended.

The reason was always the same: I stood up for myself (or an alter stood up for us) and maintained a boundary the other person kept violating.  And that person got mad and walked away.

Because as much as I don’t mind being flexible and accommodating, I will eventually reach a point where I (or an alter) take a stand.  Sometimes I lose my temper and get angry.  Other times, I simply let my actions speak for me.  And I continue to treat the person as always.

So I have to ask myself (and the alters), is this really rejection and loss of friendship?  Or is this removing unsafe people from my life?

Introduction

My kitchen is a scary place.  I go there and remember all of the times I had to deal with family and friends and strangers either with cooking, baking, preparing food, cleaning, or doing something not at all related to food.  Traditional cookware is a trigger.  Bakeware is a trigger.  Knife blocks, cutlery, utensils, tools, silverware, dishes, etc.  All are triggers.

And as I contemplate what to keep and what to get rid of, I realize that brands, types, styles, even materials the cookware, etc. are made of are more triggering than the memories.  I love the idea of having a wok again.  Cooking with a wok means I can make traditional Chinese food I grew up with.  But every time I look at a wok I feel anxiety.  Every time I try to choose one to buy, I feel anger and other negative feelings.  At home, I have a small/medium stainless steel sauce pan with a cover.  Every time I use it, I feel shame.  After I use it, I can’t bring myself to clean it right away.

I used to have a knife set that I got for my first apartment.  If was one of my first purchases for the rental because I wanted a good set of knves to cook with.  And because knives are expensive, I kept it even after I left my family.  Two weeks ago, I realized that looking at the knives made me feel scared and angry.  It was one of the main reasons I had been avoiding my kitchen.  The same thing happened with the set of cooking utensils I bought around the same time.  Getting rid of them was the best decision I ever made.
What Happens Now

Now, when I look for anything kitchen related (whether it’s dish towels or cake pans), I have to ask all of us, is this item something that will trigger us once we bring it home?  Will buying it make us feel good or anxious?  Will we use it or hide it?  Will having this item at home cause anxiety or excitement?  Will a part of us come out during its use and break it because the anxiety and other emotions got so overwhelming the need to destroy the trigger overcame everything else?  Because yeah, that’s happened to us in the past too.  broken cups & plates; tarnished silverware; rusted cast iron, etc.

And buying what I like, what I choose for myself is a trigger in itself.  The fear that someone will come and take what is mine away from me exists in some of my parts.  The urge to destroy what I like as punishment exists in other parts.  And the need to hurt the self because of the rule breaking drives me and some parts to not buy anything out of paralyzing fear.  The triggers start thoughts ruminating; the rumination feeds into obsessions; obsessions trigger compulsions until one or all of us finds relief by giving in to those compulsions or having a panic attack because the coping strategies aren’t working so well.

The Trigger Cycle

Which brings me back to my original feelings of:

Why buy cooking utensils?  Why bother trying to cook?  Is the enjoyment that comes from cooking and baking worth this hassle?  Why not continue to avoid it?  Eating isn’t necessary, and you don’t deserve to be healthy anyways.  It’s not like you’re an important person who does important work.  No one will miss you.  But if you go out and get (insert item here), you will (insert threat here).

This cycle happens whenever I try to do something good for myself.  Examples:

  • Buying clothes that fit
  • Sticking to a budget
  • Deciding to replace my cookware/bakeware/etc
  • Cleaning my apartment
  • Buying garbage bags
  • Wearing accessories and looking stylish
  • Eating food I enjoy

How do you handle your triggers?

The OCD and Rumination Cycle

I’ve been avoiding buying what I need – not exactly the best coping strategy, but it works for now because I am trying to avoid buying too much stuff right now.  Where I live now is great.  All of us enjoy it and are relatively happy.  We feel safe.  But we also know that this place is where we grew up; full of triggers just walking around outside or going to work; and often end up encountering people from the past.

So the decision has been made (by all of us) to move to another state as far away as possible from this one where no one from our family or past that we know of resides.  This will happen around the end of next summer.  And since the price of moving a lot of stuff cross country is ridiculously expensive, why not take the opportunity to sell/get rid of everything unnecessary and use the savings to buy after moving in?

Makes sense right?  But is this another case of avoiding self-care or of being practical?  Am I hurting myself by not nesting where I’ve lived for a year and plan to spend another year?  Or am I being smart by only buying what’s necessary to facilitate self care and then selling it before I move.  I can always re-buy later or give my self a limit of boxes to ship to my new place rather than move everything.

As you can read here, examples of ruminating thoughts, obsessive thoughts, and inability to make choices.

How the Cycle Is Broken

I break the cycle by using CBT and DBT with a judicious dose of meditation most of the time.  When that doesn’t work, self-soothing and sensory grounding usually do the trick.  And when all else fails, a text message or call to someone I trust for some support will help me clear my head.

I hope the quote helps you remember the importance of self-care the way it does for me.

Introduction

Recovery and coping are two paths intertwined with the same end goal.  The path changes as I change, as my parts change, and move closer to healing the damage to mind, body, spirit.

The effectiveness of resources changes too.  What works now, might not work next time.  Or it could work consistently for years until something changes on the inside.  Then that resources is too much or not enough as is and needs to adapt to the current situation.

Each alter has a purpose in our system and has developed strategies for coping with the memories.  Problem is, what worked then does not always work now – not if we want to participate as active members within society.

All of us used to think we had to get rid of this strategies because they were harmful in some way.  That led some alters to feel scared and unwanted.  They reacted with anger and defiance – lashing out at the rest of the alters and themselves with varied and creative punishments.

We know each others’ strengths and weaknesses.  We know which buttons to push to get certain reactions.  And we know how to help, soothe, and support each other.  Compromises benefit everyone; fighting hurts everyone.

Compromise

The language to describe different alters in a system uses words like dominant and submissive.  To clarify, dominant does not mean aggressive or bullying or strong.  Dominant means these alters are protective personalities who happen to be strong enough and willing to take charge and manage the daily tasks necessary for functioning and living.  Submissive does not mean push-over or weak or any similar words.  Some atters work in the foreground while others work in the background.  All are protective, strong, resilient, intelligent.  What matters is how these characteristics are expressed.

Some alters are dominant outside – they are in control most of the time and interact with outside people.  They drive cars, work, buy groceries, manage the budget, etc.

Others are dominant inside – they are in charge of caring for the alters in the family system to ensure that everyone feels safe, works together, communicates and participates in choices, keeps the body healthy, etc.

Then there are the quieter alters, the ones who prefer to work in the background and not interact with outsiders.  They are not more or less dominant than the ones who take charge.  They are as strong and important because they facilitate communication among all alters, help with coping strategies, and work hard to find compromises to keep the system working.

Communication

My system has four dominant alters, 3 females and one male, who grew up together and seamlessly switch from one to another when interacting with the outside world.  Two alters speak, and two do not.  Together, the 4 of us work hard to keep our mind and body grounded in the present and functioning in spite of body memories and anxiety.

But the 4 do not work alone.  Between 15 and 20 alters switch and work together throughout a typical day to ensure everything gets done while also caring for the child alters, teenage alters, and others who prefer not to be classified.  We work outside at our job and inside to manage symptoms and promote self-care / health at the same time.  Parallel tracks and two different lives going on at the same time in the same body.

I am lucky that my alters and I do not hate and blame each other.  The first few years after the official diagnosis and learning about different coping styles for DID were chaotic, painful, and confusing.  A lot of fear and mistrust caused alters to go mute or hide instead of asking for help.  No one wanted to listen, and everyone wanted their own way.  Each of us had coping strategies that worked and were afraid to try something different…to trust themselves, each other, the system as a whole.

Present time

In the last two weeks, our trust in each other and the system as a whole has been tested with symptoms that have not appeared in more than five years.  In trying to remember the coping strategies that worked before, memories were recovered.  Scary, traumatic memories that flooded everyone and everything inside.  The onslaught threatened to spin us inside out and tip the fragile balance of recovery on its side.

One year ago, something like this would have put us on short-term disability and into a partial program.  Six months ago, it would have caused a major relapse in self-harm coping and enough sleepless nights to force the use of a knockout pill.  This time faith, meditation, calls to the hotline, positive affirmations and mantras (I like to think of them as prayers and reminders) to establish safety, DBT, lots of sleep, writing this blog, and sessions with my therapist have kept all of us grounded in the present instead of falling into the past.

Final Word

One psychiatrist told me that recovery is a long, hard road for survivors.  It can take as long as or longer than the expedience(s) that caused the symptoms.  I am lucky to be naturally rebellious – a born fighter – whose parts are the same way.  For those who aren’t natural fighters, please don’t give up.  The symptoms never truly go away, but the future life you want is possible.

Necessary But Not Sufficient

All of us:

Coping strategies and techniques are resources.  The more you learn, the more help you can access.  Therapy, programs, medicine, etc. are resources. Asking for help widens your support system; another way to find potential resources.

Angora:

Meeting basic needs is a resource.  Taking care of physical, emotional, and spiritual health is a resource.  Practicing basic hygiene is a resource.  Discovering and implementing ways to feel safe are resources.

Sunni:

Human characteristics like resilience, courage, intelligence, creativity, persistence, flexibility, acceptance, tolerance, and respect are resources.

All of us:

One is not enough.  How many is enough?  Is there such a thing as too much?

Dawn-to-Dusk & Breezy:

My therapist says that one resource is not a cure-all.  It takes practice and use of many resources to create a solution.  Many times when we reach a wall in therapy, it is because a new aspect of my trauma history has been revealed.  We brainstorm together and separately.  She asks her resources, and I research information.

Sienna:

And when I get frustrated, she reminds me that one resource or many resources, it does not matter.  The more knowledge you have, the better your chances of finding a solution.  What I know, everything I have learned so far is necessary but not sufficient.

Blue, Purple, & Silence:

I like to draw and play in the quiet room.  I like to run and help the adults with protection.  I like to use the catapults and the bubbles.

All of us:

No one individual or resource has all of the answers.  Change is inevitable so we have to adapt to them in order to move on.  Sometimes that is easy.  Most of the time, it sucks.  We tried going it alone for a while.  And we tried having a support network and resources to help when we stumble.  Guess which option worked better?

It has taken a long time for all of us to accept this.  Asking for help is scary.  Accepting help is scarier.  Trusting someone else with inner thoughts and safety is probably scariest.  It took me eleven years to get where I am now.  Some of my parts are in the same place.  Others are not.

And we are nowhere near finished with the recovery journey.

Questions for Readers:

How long will it take you?  Are you willing to persist in spite of the road blocks and relapses?  Will you keep an open mind?  Will you learn to trust yourself one day?

I hope the answers are yes someday, if not now.

When I was a kid I liked watching The Incredible Hulk on TV – not the cartoon, but the sitcom version.  It always amazed me how the mild mannered scientist turned into a monster and a hero when he lost his temper.  And in learning to live with his inner monster, he became a better human.

Fast forward about 20 years, and the Marvel comes out with the first Avengers movie.  In that movie, the scientist explains how he learned to control The Hulk: by always being angry and not shutting out his feelings.

My name is Darkness.  I am one of the few make parts in this system who grew up with the other adults.  Sometimes I forget my age and go back to being a child or teen.  Other times, I feel older than dirt.  And before we started using ISF to communicate, I was like the scientist before he learned the secret to controlling The Hulk.

These days, I am much better about not taking out the anger on innocents.  But sometimes, I forget that I am innocent too.  I turn the anger on myself.  That hurts everyone in the system.  And brings me to my knees with shame.

I used to take over and force us into scary, dangerous situations.  And I used to hurt people, not on purpose, because I did not know my physical strength.  Verbalizing is not something I learned, so I write instead.  Or I share images with the other parts.

It got to the point where the adults who interacted with outsiders avoided contact with everyone because no one knew what would set me off.  And I am extremely protective of my internal family.  But I did not know the difference between “safe” and unsafe” touch or contact then.  So I  attacked everyone on the outside.  Even friends and people who tried to help.

Our female body does not stop me.  The one greatest gift our donors gave us was education in martial arts and self-defense.  I remember every lesson and every technique we learned.  Some memories are fuzzy.  Others are clear.  The other guys and girls who remember workout with me on the inside.  We teach the kids and each other to prepare for attacks.

But we hardly ever use the physical body because that triggers body memories we can’t fight.  Feelings we can’t handle yet.  And anger so intense all I want to do is murder the monsters and blow them up to ash so they can’t regenerate.  As you can imagine, this kind of revenge anger is toxic.  And for a while, the rage took over our life.  It was uncontrollable.

We all thought we were going crazy.  I tried to make it stop by locking myself in a prison.  So did the other parts with uncontrollable rage.  Then I tried to make the memories go away.  It wasn’t until the second therapist and the first program stint that we all learned about anger management and emotion regulation.

That helped with the emotional part, but not the physical part.  The body memories weren’t connected to the cognitive memories then.  And every time a button got pushed, both memories got triggered into flashbacks. And our body instinctively lashed out with physical violence.  Our mouth used verbal and emotional violence.

Our current therapist helped us learn to sit with our feelings and body sensations instead of trying to control them.  The goal is acknowledge, accept, let go, move on.  Like the scientist and The Hulk – stop denying the feelings and learn to live with them.  Most of the time this is true.

But I have trouble controlling my anger when the body memories hit.  I see and hear and feel the others hurting and feel helpless to stop the pain.  My goal now is to figure out how to work with body memories in a safe way.  That means integrating physical activity into our lives.

Because acting like the Hulk after he got his temper and rages under control is a good goal to work on.  Being able to share safe physical contact with friends and connections (maybe a lover for the sexual female alters too) is our ultimate hope.

Coping Techniques Explained

Cognitive Behavioral Therapy (CBT)

The first effective coping technique I learned in therapy was cognitive behavioral therapy (CBT).  The psychologist used this to help with my original diagnosis: clinical depression with anorexia nervosa and generalized anxiety disorder.  Practicing this taught me how to identify emotions and negative thinking patterns so I could change them.  The psychologist also taught me how my emotions and thoughts influenced my behavior.  By changing one, I could change the others.

Self-Help Books, Websites, etc.

The next group of techniques came from a series of books.  Working through lessons in the books taught me how to identify triggers, calm myself down when I felt the anxiety, relax, and refocus on the present.  By using those strategies, I could recognize patterns in my behavior and work to stop self-harm behaviors by using different coping strategies instead.  They helped me find new and creative ways to apply my CBT skills and improve on existing skills like meditation and deep breathing too.  I have a list of my favorite self-help resources here.

Caveats for self-help resources:

  • These resources are guides, not substitutes for qualified professional assistance
  • They can provide factual information, lessons for learning the basic techniques, and useful suggestions
  • They cannot solve your problems and make the issues go away
  • Not all resources are created equal; be wary of anything you read and/or listen to, especially if the resource claims it can solve your your problem
  • If you get frustrated or don’t understand, it’s not your fault.  This may be a good time to reach out and find other supports to assist you on the recovery path.
  • Finally, read, visit, or listen to multiple information sources on the same topic before deciding which techniques to use

Dialectical Behavioral Therapy (DBT)

The third coping technique I learned was dialectical behavioral therapy (DBT).  The creator of this therapy is a survivor and renowned therapist named Marsha Linehan.  Ms. Linehan has Borderline Personality Disorder and created DBT to help her cope with overwhelming emotions and her reactions to them.  I use DBT for feelings of anger, shame, and guilt.  And to help me cope with body memories.  My parts use DBT to help with distress tolerance and emotion regulation that comes from being triggered into flashbacks and nightmares all the time.

If you haven’t noticed already, my internal and external lives are very different with their own perspectives, priorities, and experiences.  Living on the inside and the outside simultaneously requires cooperation and compromise from everyone involved.  It also requires a lot of trust and the development of a system to keep our internal world functional and running smoothly.  That brings me to the final coping technique addressed in this post: Internal Family Systems.

Internal Family Systems (IFS) Model

We are lucky because we are all aware of each other and want to live a full, enjoyable, healthy life together.  That means we work together and help each other instead of working against each other and hurting each other.  We feel safe enough to ask for help, to set individual and group boundaries, and to use open communication to address problems instead of holding it in or casting blame.  Not everyone with DID is that lucky.

I learned about IFS from my current therapist and started using it actively in 2012.  The main point of IFS is that every part has a voice and gets heard.  On the inside, all important decisions are made by committee using 1) majority vote; or 2) unanimous vote.  We have also created a “family hierarchy” of sorts so that everyone shares essential chores and responsibilities equal to their age, developmental stage, and ability.  For example, adults take on adult responsibilities like work, transportation, finances, etc.  Adolescents have chores, responsibilities, and time to explore.  Children get to be children and have chores to complete every day.

We all work together to establish and maintain communication lines.  We all have to compromise and find solutions that work for the system when flashbacks and other symptoms threatens to overwhelm us.  We are all responsible for making good choices, working together, making our internal and external worlds safe, and learning coping strategies to weather the ups and downs of recovery.  Especially when parts get stuck in the past, trapped by traumatic memories (monsters), or lost and get triggered to the point of using automatic defense mechanisms and self-harm to cope.

Without learning and using IFS, none of us would be in the healthy, safe, happy place that allows us to share this information on the blog and the website.

Other Info

Here is a list of some other useful coping techniques.  I do not mention them above because they require assistance from an experienced mental health provider to be most effective.

  • Hypnotherapy
  • EMDR
  • Sensorimotor Psychotherapy
  • Trauma sensitive yoga and other types of moving meditation

Medication

Medication is not a coping technique or strategy I use except under certain conditions:

  • Not sleeping for 36 or more hours
  • Intense physical pain that keeps me awake and unable to move
  • Real physical illness like a cold or the flu

I choose not to use medication because medication makes me physically ill.  I am extremely chemical sensitive and will get the side effects from even the smallest doses (the 1 in 1,000 or 1 in 100 person described in the small print).

This does not mean I am against using medication.  If medication works, please use it.  But don’t expect to see many posts about the benefits of medication as a healthy coping strategy here.  I cannot speak to that topic and work hard not to pass judgement or bias readers for or against any strategies here.

Challenges in not using self-harm as a coping strategy

There are many challenges to stopping self-harm.  The ones listed below are what I have to deal with most often:

Finding Effective Substitutions

Before I started therapy, anorexia, self-harm, dissociation, and switching were the only effective coping techniques in my tool box.  I used them relentlessly to block out the monsters in my mind.  And when that did not work, I isolated myself and developed OCD type rituals.

Therapy, partial programs, and a lot of personal research with books (and then the Internet) taught me a lot of useful coping techniques to help me understand that I did have feelings and how to safely express them in a healthy way.  The four main techniques I use are:

  • Cognitive Behavioral Therapy (CBT)
  • Self-Help Workbooks like: The Anxiety & Phobia Workbook, The PTSD Handbook, and The Anorexia Workbook
  • Dialectical Behavior Therapy
  • Internal Family Systems Therapy

I use “technique” here because each behavior, or group of behaviors, can be learned and used alone or in combination to create effective coping strategies tailored to individual needs.

Breaking Habits

According to scientific research (multiple sources), habits are easy to create and difficult to stop.  A habit can form after a few repetitions.  Breaking a habit can take a at least a month or longer.  Some habits are easy to break.  Others are not.  An addiction is more difficult to break than a habit.

When does a habit or a routine become an addiction?  I honestly don’t know.  But that is less important than understanding the how and why the habit or addiction was formed.  And what purpose it serves in one’s life.

A habit becomes an addiction when the habit starts to take over my life.  When all I can think about is the next opportunity to hurt myself,  Most of the time I used self-harm to help me feel in control of my environment while also distracting me from overwhelming emotions and extreme pain.  The anorexia nervosa was the worst one.  I started that when I was six years old and didn’t start recovery until I was twenty-one.  Twelve years later, I am officially recovered, or in remission.  Like alcoholism, an eating disorder never really goes away.  Relapse is always possible.

These days, my only self-harm habits are food and skin-related: scratching, clumsiness causing bruises, tearing at my nails, eating food that makes me feel  sick afterwards, etc.  And they only come out during a combination of the following situations:

  • feeling unsafe
  • backlash
  • anniversaries
  • bad triggers
  • body memories
  • emotional overload

Any one of these by themselves might cause me to use or feel the urge to use self-harm, but often do not.

I have a variety of strategies to help me when the urges come now.  Most of the time they work.  And when they don’t, I work hard to minimize the backlash that comes with using self-harm.

Relapse Backlash

These broad categories are based on my experiences and discussions with therapists. Please remember that as you read this section.

Anyone who has ever relapsed or failed at something has experienced the negative emotions and thoughts that come with a setback (aka mistake).  Some people and move past these easily because they learned positive, healthy ways to cope from role models.

Others pretend these feelings don’t exist, put them away someplace and forget (or try) their existence; then these people put on a “brave face” and work harder, obsess over mistakes and solutions, to ensure success the next time.  They acknowledge the failure without blaming their sense of self; might or might not hold grudges; and often will try again or decide the task is not worth the time and effort so move on.

Then their are people like me (and maybe you too), survivors who for some reason or other (and to different degrees) have been taught that they do not have feelings; every setback is a failure because they, the human, is a failure and will never succeed; and success is not real success because their is always something wrong with how the task was accomplished; nothing they do is right or good enough, will ever be right or good enough.  And they always get punished for failure.

Backlash is just that: punishment for failure.  Self-inflicted or other-inflicted, it does not matter.  What matters is that some people are compelled to punish themselves for failure of any kind.  Often that punishment is physical; sometimes it is emotional or spiritual or a combination of these.

But punishing oneself for lapsing or relapsing starts a downward spiral back into addictive self-harm behaviors.  I know because I am struggling not to punish myself for relapsing over the last few weeks.

Alters

Many times, my parts and I are co-conscious.  This means we are all aware of what is happening around us – not a complete switch in personalities.  And different parts can/will take control of our body while someone else is in charge of speaking and interacting with outside people.

Many of my alters do not feel like other coping strategies are as effective of as what they already know and turn to like a blankie.  Or they are very young/old and have difficulty remembering the other strategies and techniques under stress.  If they remember the strategies and techniques, they also have to remember how to use them.

Teaching my child parts, adolescent parts, adult parts, and ageless parts these techniques while also working full time, managing day-to-day life, and writing this blog takes a lot of time, patience, and practice.  We practice when we can; try to treat ourselves gently, with compassion and empathy, when there is a set-back or a mistake.

Because it is never failure.  It is always an opportunity to learn.

Finding effective support with therapy

There are a lot of resources available for learning these techniques.  Therapy is not required.  Neither is participation in a program or a group.  But if you are like I was when I first started, working with a professional can help you learn these techniques while providing a safety net to help cope with the backlash, emotions, or memories that can appear as you move through this process.

What is sleep hygiene?

Sleep Hygiene is a term used to define a consistent set of tasks one completes before going to sleep as to help relax and prepare the mind and body for sleeping.  Medical doctors and sleep research specialists recommend changing one’s environment and surrounds to be more sleep-friendly as part of the sleep hygiene routine.  They also have a research-based list of tasks proven to help one sleep.

Mental health providers include the medical doctor and sleep research checkilst, but are more flexible about what is included or not included in the routine.  They believe the routine can be flexible as long as it is consistent and tailored to the individual.  Some examples include, changing from work clothes to home clothes, hanging up clothes, cooking a meal, watching a movie/reading a book, exercising, making a plan for the next day, meditation, and cleaning.

How does it help?

  • A routine can soothe anxiety because the tasks and the process of completing a task from start to finish is ritualized and occurs around the same time every day.
  • Focusing on one task at a time uses mindfulness techniques and engages the senses; that helps keep the mind and body grounded in the present.
  • As each task or ritual is completed, the individual feels a sense of accomplishment and gets immediate gratification/positive feedback that builds confidence and provides a sense of competence.
  • Going through the sleep hygiene routine relaxes the mind and body as the individual moves around the space and remembers that this room is in a safe environment.  Feeling safe helps relax the anxiety so that sleep can come easier.

My Experience

I learned about sleep hygiene from The Anxiety & Phobia Workbook first.  This book was recommended by my second therapist – one who specialized in anxiety and eating disorders.  After she recommended me to the first parital program, I learned more about relaxing rituals, coping strategies, meditation, self-care, and other tasks that can be included in a sleep hygiene routine.

Setting up the routine was easy enough at first.  Sticking to it, though, was difficult.  At the time I first started, I would switch and dissociate without remembering what happened during lost time.  That included my plans for sleep hygiene routines, coping strategies, etc.  Frustrating does not begin to describe the situation.  But I kept trying.  And I learned to be flexible about my routine.  Some tasks had to happen.  Others I could skip if I felt tired, short on time, etc.

These days, I have 3 similar sleep hygiene routines for work days and 2 for weekends/time off.  Each routine has some core tasks and rituals that I always include.  And then, there are about 4 or 5 others I add or skip depending on how my day went.

My Core Routine:
  • Unlock and open my door*
  • Close the door; then turn on the lights*
  • Take off my shoes; put my purse and/or tote down*
  • Hang up my wallet; put coat in closet*
  • Change into comfortable clothes/hang up or lay flat to put away
  • Eat while watching a movie of reading
  • Turn on sleep sounds
  • Get comfortable in bed
  • Listen to the sounds as I fall asleep

For Days when I go to work or go out on weekends

Other Tasks and Rituals
  • Walking or mindfulness meditation
  • Visualization
  • Preparing my outfit for the next day
  • Having a glass of cold water before bed
  • Play time with my alters
  • Cooking a meal from scratch
  • Recite mantras/affirmations with my alters
  • Hot shower or bath
  • Work on my web site
  • Call the hotline
  • Write a blog post
  • Knit

Reader’s Digest

We all know sleep is important.  And sometimes falling asleep and staying asleep feels impossible.  Everyone has reasons for not sleeping.  Sometimes, the problem is medical and can be fixed by a doctor and a pill.  Sometimes, the cause is harder to define.  Nothing seems to work.

I and my parts are sometimes afraid to sleep. The nightmares and body memories wake us up sweating and scared.  Or the flashbacks and hyper-vigilance create tons of anxiety and adrenaline so our body can’t stop.  Not all of us are on the same sleep schedule.

With a lot of experimenting and persistence, we finally discovered a routine that helps us sleep better most of the time.  Because, like any other strategy, it won’t always work.  Or the existing routine won’t work as it is anymore.  That is why one or all of us change up parts when something feels off.  Or when our sleep patterns change.