Category Archives: useful techniques or tricks

Phew!

No nightmares about L dying last night.

No nightmares at all last night actually ūüôā

I’m itching to play art again, but I’m at work at the moment. I did bring one of my art journals, but I’m not sure what to draw in it. I couldn’t exactly bring all my paints, and I don’t have a travel paint set put together. I could have brought the gelatos, but I didn’t think of it till after.

It’s all ok though. I’ll have time tomorrow before group to play art. Then tomorrow evening, a friend is giving a talk on paper arts at a local gallery. I was planning on dragging L. It should be fun.

Other than that, progress on the therapy front: I was able to watch what would have been a triggering scene in a TV show without falling into intrusive memories. HUGE, HUGE step for me, even though it was “just” around the domestic violence stuff. I was kinda excited that I was able to be aware of the memories but still remain engaged in the show (it was a scene from Flash about Zoom’s back-story). I kinda laughed when I noticed that I had witnessed a similar scene numerous times (minus the murder part) and marveled that I wasn’t a sociopath…

Anyway, so yeah, little victories and happy-dances all around.

Note to self: engaging in expressive art, and seeking support around the ickiness are both helpful in regaining balance when things are starting to fall apart again.


Art therapy as a processing tool

I’ve long been a proponent of art as therapy, but I had not yet experienced such a drastic shift in symptoms as I did Wednesday evening.

I had been struggling with flashbacks since last Thursday’s doctor’s appointment. It was made worse by the incident that came up Sunday evening. The image and feelings just kept repeating and intensifying unless I was bombarding myself with sensory input.

I told Dr. C as much when I went in for that extra session Wednesday evening. When she asked if I wanted to talk about it, all I could do was nod. She then suggested doing some art around it. I nodded harder to that. I figured it was easier than speaking at the moment.

We moved to the floor and got to work. She had me represent the “memory” as best I could (right side), and had me add the emotions to it also (left side). She then asked me what I wanted to change about the image to help make it feel safer. Did I want to add something between the image of the memory and the emotion? Was there something protective I could incorporate into it to help it feel better?

I admit I was quite stumped.

She started listing off suggestions, then dug through her bag of supplies for more ideas. She pulled out some felt, and offered that up. originally we were thinking of using it as a blanket or towel around the kid, but the color I happened to pick out (red, unusual for me b/c there was also blue there & I normally gravitate to blue) was already cut into a heart shape. As she realized it was a heart, she mentioned that it would be perfect. We re-adjusted the concept of a blanket/towel to using the heart instead. She cut it down to fit on the page, then we set about trying to figure out how to attach it – glue doesn’t work too well on felt. Dr. C happened to have a needle and thread, so she suggested sewing it on.

We ended up with this:

wpid-2015-10-30-11.27.08.jpg.jpg

Yesterday, when describing the piece in group, I said that the heart was covering up the unpleasant image. Dr. C commented that it was an interesting choice of words, since it was meant as a protective measure more than a way to hide it from view… We didn’t delve further into it, but I’m sure there will be a conversation around it during Monday’s session. Either way (hiding from awareness or protecting from it), doing that project helped lessen the flashbacks. They are relatively minor intrusions in my day now, and it’s not nearly as disturbing as it had been all week.

I’ve known expression through art can help change the impact of the trauma for a while. I have even used the technique of changing an expressive piece to help change the experience of whatever it was expressing, but it’s never been such an immediate and noticeable change. It’s always just crept up on me. I would realize the change a few hours or days later. This time, doing it in session with Dr C, it was a huge difference just in the hour and a half we spent on the piece. I went in to her office feeling raw, triggered, and spent, but left feeling lighter and able to smile. It felt a lot like the change in symptoms after an EMDR session. I think part of the relief came from sharing not only the incident, but also the experience of changing it. As I mentioned before, I have tried changing the art to change the thoughts around what it expresses, but it felt more “healing” to be doing it with the help of a safe person.

If you are having a rough time with things, this might be a good technique to try. It’s helpful to have a therapist around to make the overwhelming parts feel a bit less overwhelming, but it can be accomplished solo also. I will try to look up the link to the study¬†I remember reading about this technique. I think I saved the link (or article) somewhere. I just have to find it again. I’ll add it here when I do.

UPDATE: found that article & how to link to it. It’s a free-access article through Taylor & Francis.¬†‚ÄúCheck, Change What You Need To Change and/or Keep What You Want‚ÄĚ: An Art Therapy Neurobiological-Based Trauma Protocol.¬†They actually have a bunch of free-access articles that you can read without having to purchase anything. It’s a great resource.


make rules for yourself (a link)

I saw this about grief, but it can also be true for depression, especially the part about platitudes (and simple things you used to enjoy) being grating…

Also important: the part about remembering to eat. I lose my appetite when really depressed (comes after the stage of eating every comfort food I can get my hands on).

http://www.huffingtonpost.com/megan-devine/grief_b_4509905.html


Trauma-Informed Creative Arts Therapy Articles

This came across my feed and I wanted to share/save it. I really like this page, they have a lot of good info and resources. It’s mostly geared towards professionals, but there’s other resources there also.

Trauma-Informed Creative Arts Therapy Articles

One of the first articles listed is about art journaling as self-help.


untitled art (needs a name) **might be TRIGGERING**

wpid-20150923_164522.jpgNot exactly what I started out picturing, but I think I like it. This is the “finished” piece, though it may just be finished for today… It also needs a title. It was supposed to be a comforting image, but it turned creepy when I couldn’t get the level of detail I wanted with the pastels. It became creepier still when I needed an outlet for these stupid body memories, so they made it into the painting (awesome how memories can be transferred into & contained by art… kinda reminds me of the Vigo painting from GhostBusters II in that respect).

Some cool things I learned about oil pastels while playing with this piece:¬†1. to remove it from a gesso’d background, scrape off as much as you can, then rub over what’s left with paint thinner. I used Turpenoid Natural¬†b/c it is supposed to be non-toxic. It smells like Goo Gone¬†so it may be the same stuff. 2. To make oil pastels behave/look more like oil paints, brush over with a small amount of said paint thinner. To keep the detail of the piece, use a very thin layer applied with a soft brush at a nearly horizontal angle. If you want it to behave like paint, use a bit more paint thinner and brush the pastels as you would if you were painting.

These are some “progress” shots.

 

Loosely inspired by:

wpid-screenshot_2015-09-23-11-14-29.png

 

Other things in the works:

 

 

 


Note to self: it’s ok to need

Met with Dr C today… some things to remember:
-it’s ok to have needs.
-even if that need is simply to check that she is still there (it doesn’t bother her or significantly impact her time away from the office).
-keep trying coping skills, but she is also ok with reaching out. She will respond as she is able. If texting doesn’t work, it’s ok to call her too (or ask her to call).
-it’s ok to change the topic of conversation with a friend if it’s triggering.
-try to notice the dissociation before it’s happening or as it’s happening so the trigger can be dealt with and I don’t have to keep exposing myself to it.
-Dr C will not drop me or refer me out if I’m struggling (same as last time), so it’s ok to say if I am (preferably before a crisis point, and most certainly before I need to show up at my doctor’s office or the ER bleeding out).
-I’m still miles above where I was the last time I was hospitalized, and many more miles above where I was in 2010.
-it’s going to be tough, but it will be ok.


um, so getting back to what I was going to post… black pen test for mixed media art & art journals…

There was a question in an art journal fb group about the preferred black pens to use with mixed media and art journals. I’m a visual person, so I rounded up all the pens I have at home and did some tests to show how they work out. It’s certainly not all the ones available, but all the black pens & markers I could find at home.

I used Strathmore mixed media paper. I tested them on Golden brand gesso (creamier), Golden brand heavy gel, and Liquitex Basics gesso (rougher). The far right column was the pens directly on the paper, then (after heat-dried) washed over with a single pass of a soft brush full of water. I put the gessos and gel on fairly thick to the left side of their respective column, and thinner to the right (but only about 1.5″ wide in each column because I wasn’t thinking). It’s too humid for acrylic stuff to dry well here, so the thicker sides were still tacky when I did this. It effects the pen performance; the thinner sides took the pen better. Oh, and I did a last-minute triple-pass of matte medium over 1/2 the pen in the far left column…

The matte medium and water were used to the right of the lines in the individual examples in each column (except the one dedicated water column)…

The inc R2 & MegaBold pens are both dollar store finds…

Sadly, my favorite pen (Scarlet Lime) is no longer available. If anyone finds one that performs like that, with the same deep black, please point me in the right direction! I tried the FudeBall a while back (what was originally recommended to replace the Scarlet Lime), but it just didn’t hook me. In my opinion, it performed a lot like the dollar store pens for a much higher price. I used a friend’s at the time, so it’s not part of this test page.¬†(I was just told that the Pilot Multiball pen¬†and the Pilot BeGreen Recycled Permaball GellRollerball pen (UK) the same as the Scarlet Lime one… Will have to check both out.)

Does any of that even make sense? Hopefully the pics help…

If you have done something similar (or do it in the future), feel free to show & tell in the comments. If you allow, I will move your test up into the body of this post so it’s all in one place. ūüėČ

 


two “new” resources I’d like to point you to.

The first is the blog WorthIt2BMe – Healing from Complex Trauma & PTSD. It¬†has a really comprehensive overview of trauma theory, it’s effects, and useful links. It also has a great “outside” library of reputable trauma information sources.

The second is the¬†APA’s overview of changes to PTSD diagnostic criteria in the DSM-V. It’s a .pdf, and written in relatively “plain english” to highlight the differences in diagnosing PTSD as of the release of the new DSM. While they have a lot of progress to make around understanding the effects fo trauma, this is a decent start.


new page added!

I created a page for directions on making grounding bracelets. It can be found in the header menu.


jewlery-making as distraction

grounding braceletsI made a handful of grounding bracelets today… I started making one for TM, then made another for her and couldn’t decide which I want to give. Then I just kept going. Made 6 in total, and a necklace. I would have made more, but I am out of toggle clasps. Listed everything on etsy except the two choices for TM.

Now that the distractions are up, all I want to do is cry.

Made some progress on the move front yesterday by reserving a pod (so we don’t have to worry about towing our stuff. in the long run, it ends up costing about the same). We have no place to move to, but hopefully the apartment L applied for will be approved with all 3 dogs. If not, we will keep looking… The hope provided by the apartment possibility is wearing off now. The depression is looming huge and dark. I’m so tired of this.

Add to all that now saying goodbye to TM 2 weeks before we had planned and I’m a puddle. I go through the motions. I function (barely), but I’m not feeling anything but heaviness. I guess tomorrow I will call at least one of the three referrals she gave me yesterday. TL might still work there. If she does, and it would be ok, maybe I could see her again till I leave. It would help going back to someone I know even if it’s a different organization.

There’s so much stuff I know I¬†need to do asap around the house, but I just can’t… The little dog is starting to grow dreads. He desperately needs a bath and haircut. I just don’t have the energy. The reptile room also needs spot-cleaning, but again, no energy.

How do you treat depression symptoms that neither meds nor behavioral therapy can touch anymore? I am still adamantly against ECT, so that will never be an option. What’s left?


Depression sucks donkey balls… or Hot sauce hot enough to take out an army

Seriously. The air is so oppressive sometimes… I wish it would smoother me. I wish something would alleviate the heaviness. I wanted to cry both on the way to journal class and on the way home. Tears escaped my eyes both times.

The only thing that helped once home was a poor hot sauce decision… it wasn’t totally intended that way, though I admit I put more of this really hot sauce on my dinner in hopes of self harming without causing visible damage. It certainly accomplished that. I’ve never had such an intense and painful reaction to hot sauce. I can normally handle really spicy stuff, but apparently this pushed my body to the limit. I had eaten a ghost pepper once on a dare and it barely tingled my tongue. This ghost pepper hot sauce though… I can’t even describe the pain. It was hot enough on my mouth, but that was relatively easily remedied with several spoonfuls of sour cream. A few minutes later though, my stomach felt like it was being dissolved from the inside. I actually got sick from it. I was doubled over on the bathroom floor for several minutes. I could barely crawl to the bedroom for the tums. I took one, but it made no difference. 2 more, still no relief… I think I took 5 total before I finally threw up. :/ I curled back onto the floor willing my stomach to stop the pain. When I could finally stand again, I crawled to the couch and curled up. If I tried to straighten out, the burning and pain intensified. A few seconds later, the tums wore off. I actually then resorted to drinking a glass of milk (I HATE milk. I think it’s gross to drink, and will only use it to wet my cereal, or to cook with). My stomach finally started to slow is death rolls…

I wanted acceptable pain tonight, and boy did I ever get it. 4 hours, 5 tums, a glass of milk, 1/2 cup of sour cream, and a prescription acid reducer later there’s still burning. That might have been some of the worst physical pain I’ve felt yet. I think I’m good.

It also worked to lift the depression a bit. I’m was no longer curled in a ball begging to die because of the emotional pain, I was doing it purely for the physical hurt.

I used to laugh at the concept of eating spicy food to curb self harm urges. I will no longer laugh at that thought. It definitely worked tonight. Holy cow. Prior to this, the worst reaction I had was to “Mayan Death” hot sauce. It felt as if I’d been kicked in the chest by a horse. And that was some decently hot sauce… this ghost pepper stuff though… ouch. It truly kicked my ass.

But again, I’m not crying and willing the universe to kill me already, so… yeah.

I didn’t get a decent pic of my journal background from the class tonight and I have since ruined it by trying a different technique. And now I have to wait at least 72 hours for the new paint to dry (pebeo’s oil based fantasy series)… oh well. Learning experience.

Anyway. Hope the hot sauce experience will continue to work on the depression tomorrow too. I was very close to following through on a call to TM’s agency’s crisis line… I really don’t want to do that, so I’m glad this helped… 


Self-compassion & recognizing limits

An article on self-compassion and understanding your limits was definitely something I needed to read today.

The last few days have me slamming hard into my own limits around processing my trauma. I am working towards acknowledging them to myself, and admitting them to TM (as much as I don’t want to in the moment because it means we will need to tweak our approach). I certainly want to push past my limits, but I need to do so carefully. I really wish I could keep seeing her for longer, and maybe a bit more often to help move past this, but therapy has its own limits and boundaries.

On another note, a friend pointed out something to me last night that was hard to hear, but definitely something that needs addressing. She was suggesting some coping strategies that I have used in the past, but have become huge triggers in the last year (mindfulness around breathing, and progressive muscle relaxation… well, they were always triggers, but not this intense in the past. I could utilize at least breathing techniques in the presence of someone I trusted. I can no longer do that without triggering or intensifying flashbacks). My problem comes from the memories that have surfaced recently. In them, I would pretend to sleep in order to “get it over with” faster. Pretending to sleep involved slowing my breath and relaxing my muscles so the person would believe I was asleep… I didn’t understand why these two techniques were so difficult for me until last year, when the cognitive memories started accompanying the physical and emotional ones. Since then, my reactions to the two techniques are incredibly intense and visceral. In the past, I would panic when I tried them, but I was able to try them without my whole body shaking; not so much any more. I know I need to work on this, but I’m not totally sure how. Time with TM is limited in so many ways, and there is so much to cover. ūüė¶

Anyway, back to the article on self-compassion. It can be found here on GoodTherapy.org. While their articles are often geared towards professionals in the field, they have a wealth of articles for clients, friends, and family. I don’t always agree with what they post, but some are spot on, like the one mentioned.


getting “profeesional” – books on grief (for kids in kid bodies or kids in grown-up bodies)

Funny how when I get overwhelmed with my own stuff, my “profeesional” side kicks in. I take a detached and intellectual jaunt through all of the professional resources I keep around… It’s just much easier than being mired in my own emotional mess.

Anyway, I stumbled across this list of books for kids that deal with grief. I may have to find some of them (especially the pop-up ones, OMG, pop-up books are the best!!!!!… ok, putting my inner child away now).

the list is on brainpickings.org. It’s a site I’ve liked articles from in the past, but never really ventured through. One day it might be worth the wander.

anyway, the list can be¬†found here… One that piqued my personal interest was¬†The Flat Rabbit(public library) by¬†B√°r√įur Oskarsson

 


Grounding/Relaxation tools: Art of Glow

I’ve had the Art of Glow app for several years, but only recently re-discovered it (I would re-install it on every phone, but have not used it much again till this week)… It’s fun to doodle with, but it can also act as a relaxation tool.

If you set it like this:

wpid-screenshot_2015-03-21-23-11-27.png

you can hold your finger on one spot for a few seconds to create a starburst effect that slowly fades. Once it fades, it pauses then repeats the same cycle. It’s similar to watching a snow globe or a glitter ball… I love it. (wish I knew how to take video of this rather than a screenshot, but this is what my settings end up looking like when used… the stars slowly float away from the focal point until there’s nothing left on the screen, then they will replay if you don’t do anything else to it).

wpid-screenshot_2015-03-24-23-10-05.png

It’s available for both Android and Apple devices.

I just wish there was a way to save settings or “artwork” on it. It’s apparently something people have been asking for since the introduction of this app, but the developers have done nothing to accommodate the requests.


site on suicide prevention, support, and treatment resources

someone pointed me to this site. it’s really good. check it out. Speaking of Suicide

it has resources for suicidal people, friends, family, treatment providers… all around good info. (I will also list it under my “resources” page so it’s always relatively easily available).


today’s grounding activity: the beach (more pics added)

wpid-20150223_162516_024.jpgSo, in an effort not to sleep all day today, I dragged myself kicking and screaming to the beach (not really, but damn near close to kicking and screaming, because all I wanted to do was curl up in bed all day)… I plopped in the sand for a while, then decided to take a walk down south to try something different. I walked just over 5 miles total, and it was nice. The beach was mostly empty since those up north got screwed out of February vacation. I plugged my music in, rolled up my jeans (yes, I went to the beach in jeans…), and trucked it up and down the shore. I had wanted to go from pier to pier which would have given me an 8 mile round-trip, but I turned around just after 2.6 miles. My lungs were starting to hurt.

Along the way, I thought I passed De running with a friend. I couldn’t tell for sure, but it might have been her. The woman smiled, waved, and said hello to me. No one else on the beach did that, so I’m assuming she knew me or thought she knew me. It would have been easy for her to recognize me because I have a pretty distinctive and large dragon tattoo on my right leg… I know De is a runner, and at one point we had discussed her penchant for running on the beach at least a few times a week… I’m not sure if I really want to know whether or not it was actually her. On the one hand, it would have been nice to see her, on the other… ugh. transference city. So I stared at the sand as I walked past her a second time. I did turn to look afterwards, but the hair seemed too light in color… :shrugs: I dunno…

Anyway, the beach was fun (let’s ignore that every other step came with the thoughts: I wonder if there are sufficient rip currents today? If I wandered in fully clothed, could I drown myself? If I push myself hard enough on the beach, can I induce an asthma attack or cardiac issue that would mean my death? – coz let’s face it; I don’t think I’ll ever be free of those types of thoughts. As that Hyperbole & a Half panel states: It’s not that I want to necessarily *kill* myself, I just want to become dead somehow). ¬†I then treated myself to ice cream. I had thought about sushi, but the place was more expensive than the $4 ice cream (or at least that is what I am going to tell myself. shhh….)

I watched the sunset while eating my ice cream, and I chatted with L through text. It was a nice change of pace; that “pattern interrupt” that TM was looking for. Thank you S.G. (of Girl in Therapy) for convincing me to go! ‚̧


10 things no one ever told you about life after sexual abuse

saw this on fb tonight and thought I would share.

10 Things no one Ever Told you About Life After Sexual Abuse


Staying Present During Trauma Therapy: Grounding Techniques

grounding in trauma work

Dr. Kathleen Young: Treating Trauma in Tucson

Staying Present During Trauma Therapy: Grounding Techniques

Working through trauma can be scary, painful, and potentially overwhelming. Very often people who have experienced trauma have coped at least in part through some degree of dissociation. While this was necessary for your survival then, continued dissociation (especially forms that are not within your control) is not adaptive once the abuse has stopped. Now the task of therapy is to help you stay present long enough to learn other means of establishing safety in the present. How does someone with automatic survival skills of dissociation learn to do this? Grounding is one skill that can help.

Trauma therapy does not only consist of telling your story or focusing on traumatic memories, though of course that is a crucial part of the work. Bringing trauma memories to mind, talking about them in a trusting relationship, and developing the capacities for managing them while staying present in the moment are all…

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Art idea and Elise’s blog

A friend from college did this activity with her son. I think it can work well for adults too… it’s a good reminder that we are not our poor choices. I would probably use the shredded old script in an art piece that represents strengths. Hmm, there’s an art journal class coming up this week doing a page on 5 of our strengths. If I write out and shred the “old script” before the class, I can use it in the piece. I’m a believer that even the more negative things in our lives can be used as foundation for the positives. The cutting and dissociation got me through a lot. The breakdowns allowed me to look at some ickier stuff from the past that I was not facing. The isolation helped me understand that sometimes people need others to reach out to them, even if they are pulling away…
I guess keep an eye out for Friday’s post. It might be a follow-up to this.


Beach Distractions

I followed through on my plan to head to the beach today. It was nice. I walked almost 3 miles up to the lighthouse which I had not done in years. It was a nice walk. There were tons of shredded moon jellies washed up, a handful of man-o-war, and a mystery blue thing. Looking back at the picture of the blue thing, I should have tried to pick it up and flip it over. I’m thinking it was one of those really pretty, and quite rare blue mollusks that look like glass critters… I should have tossed him back into the water in case he could make it. I didn’t see him on the way back, so I hope someone else did it.

Trying to work on making the day my own. Will have to find another distraction for tomorrow… Maybe I’ll head back to the beach, maybe I’ll pay the alligators a visit. I’m not really sure. There will be a group hike at Everglades National Park on Jan 3rd that I may attend, but I would need to find a carpool person to go with. I’m not in the mood for all that driving by myself (almost 2 hours away, though further for most of the herp society members because they live one county north of me). Anyway, We’ll see…

Mom and I did our christmas thing tonight. We exchanged gifts and enjoyed dinner and dessert. Now I’m hanging out on the phone with L and watching the dogs. It’s nice that I could get a break from the stress of the season… now, to find some chocolate…

I was asking L earlier today if it was weird that I really wanted to talk to TL about today and my ability to follow-through on the distractions she had suggested… I guess it makes sense though, since it was something we were working on in therapy. It also makes sense in terms of the transference, because it feels very much like a little kid wanting to tell her parents that she did well in school. even the way the conversation went in my head, it sounded very little kid-ish – excited and bouncy and proud… wish I could have worked on that a bit more with her. maybe it would have lessened all this.


Tips for managing emotional flashbacks

from this page: http://www.psychotherapy.net/article/complex-ptsd

The article is geared towards treaters, but he included this at the bottom. I wanted to save it for easier access. Definitely not easy to remember to do in the midst of a flashback, but good resource to have.

1. Say to yourself: “I am having a flashback.” Flashbacks take us into a timeless part of the psyche that feels as helpless, hopeless and surrounded by danger as we were in childhood. The feelings and sensations you are experiencing are past memories that cannot hurt you now.
2. Remind yourself: “I feel afraid but I am not in danger! I am safe now, here in the present.” Remember you are now in the safety of the present, far from the danger of the past.
3. Own your right/need to have boundaries. Remind yourself that you do not have to allow anyone to mistreat you; you are free to leave dangerous situations and protest unfair behavior.
4. Speak reassuringly to your Inner Child. The child needs to know that you love her unconditionally‚ÄĒthat she can come to you for comfort and protection when she feels lost and scared.
5. Deconstruct eternity thinking. In childhood, fear and abandonment felt endless‚ÄĒa safer future was unimaginable. Remember the flashback will pass as it has many times before.
6. Remind yourself that you are in an adult body with allies, skills and resources to protect you that you never had as a child. (Feeling small and little is a sure sign of a flashback.)
7. Ease back into your body. Fear launches us into “heady” worrying, or numbing and spacing out.

  • Gently ask your body to relax.¬†Feel each of your major muscle groups and softly encourage them to relax. (Tightened musculature sends unnecessary danger signals to the brain.)
  • Breathe deeply and slowly. (Holding the breath also signals danger.)
  • Slow down. Rushing presses the psyche’s panic button.
  • Find a safe place to unwind and soothe yourself: wrap yourself in a blanket, hold a stuffed animal, lie down in a closet or a bath, take a nap.
  • Feel the fear in your body without reacting to it. Fear is just an energy in your body that cannot hurt you if you do not run from it or react self-destructively to it.

8. Resist the Inner Critic’s catastrophizing.

(a) Use thought-stopping to halt its exaggeration of danger and need to control the uncontrollable. Refuse to shame, hate or abandon yourself. Channel the anger of self-attack into saying no to unfair self-criticism.
(b) Use thought-substitution to replace negative thinking with a memorized list of your qualities and accomplishments.

9. Allow yourself to grieve. Flashbacks are opportunities to release old, unexpressed feelings of fear, hurt, and abandonment, and to validate‚ÄĒand then soothe‚ÄĒthe child’s past experience of helplessness and hopelessness. Healthy grieving can turn our tears into self-compassion and our anger into self-protection.
10. Cultivate safe relationships and seek support. Take time alone when you need it, but don’t let shame isolate you. Feeling shame doesn’t mean you are shameful. Educate those close to you about flashbacks and ask them to help you talk and feel your way through them.
11. Learn to identify the types of triggers that lead to flashbacks. Avoid unsafe people, places, activities and triggering mental processes. Practice preventive maintenance with these steps when triggering situations are unavoidable.
12. Figure out what you are flashing back to. Flashbacks are opportunities to discover, validate and heal our wounds from past abuse and abandonment. They also point to our still-unmet developmental needs and can provide motivation to get them met.
13. Be patient with a slow recovery process. It takes time in the present to become un-adrenalized, and considerable time in the future to gradually decrease the intensity, duration and frequency of flashbacks. Real recovery is a gradual process‚ÄĒoften two steps forward, one step back. Don’t beat yourself up for having a flashback.


asking to slow things down & therapy coupons!

I was able to leave TL a message earlier today asking her if we could slow down a bit. I was able to express that I am really triggered and overwhelmed between sessions, and that it is making me question returning each week… :gulp!:

I am in the process of trying to come up with a new list of things to talk about for this week’s session. Closer to session time, I will leave her another message asking if she could help remind me to address the list (I forgot to ask her in the above message, and I don’t want to go over-board with the message thing just yet. I’m sure I will get there eventually, but for now I am exercising self-control)…

On another note, an online friend and I have agreed to exchange “therapy coupons”. They are aimed at helping make sessions go a bit easier, or at helping us address difficult things. I had sent mine out last week, and this week I got the ones my friend sent. I LOVE them!!!!

wpid-20140915_171445.jpgShe made me: 1) An Ounce of Patience (lol, for when I will be trying TL’s last nerve!), 2) One moment of Inspiration (therapeutic or otherwise), 3) Courage for Two (that 20 seconds of insane courage to start on something difficult to address), 4) A Daring Intervention (accepting an unusual or uncomfortable intervention that TL may suggest, within reason), & 5) One Free Trespass (to help when talking about difficult, shameful, scary, embarrassing, hurtful, or otherwise “inaccessible” topics).

wpid-wp-1410839089008.jpegThese are the ones I made her: 1) A Moment of Inspiration, 2) A Daring Intervention, 3) An Ounce of Patience, 4) Courage for Two.

Most of them are meant to be re-used multiple times (some have restrictions around use, but the user can modify that if they choose… though my friend disagrees on that point. I just don’t want to have to throw the ones I was given out because they are way too cool to be disposable). I’m definitely taking the ones I got in to show TL on Saturday.


things to remember:

Someone on a forum had asked about advice learned in therapy that was useful/imperative/good to know… I had originally listed only the first 4, but felt the others were important to add for myself here. (most are paraphrased, as they have come from various therapists over the years)

  1. consider the source of the advice when considering the advice itself. If you don’t want the life of the person giving it, don’t take the advice…
  2. you matter. people care about you, but they can also be frustrated with you. it doesn’t mean you don’t matter anymore, just means they reached a breaking point within themselves.
  3. eat chocolate if it makes you feel better…
  4. do what you can, when you can.
  5. I am worth arguing with the negative voice.
  6. get off the train.
  7. remember to breathe! (heard this from a few therapists… hmm… trend maybe?)
  8. just because it happened many times in the past does not mean it’s definitely going to happen in the present or the future.

Vertigo and the Epley Maneuver

I was taking to one of my nieces about vertigo, and realized that most doctors either don’t know about, or don’t care to mention to their patients about the Epley Maneuver. It’s simple, quick, effective, and doesn’t require meds. Oh, and did I say it was effective?! It consists of finding out which ear is the one causing the issue, then doing a series of turns in a specific way to move the calcium crystals further out the ear canal. It takes about a minute to do (maybe a minute and a half), and makes the vertigo so much calmer. I went from the room spinning wildly to being able to walk a straight line immediately after we did it.¬† Prior to trying the Epley Maneuver, I was popping motion sickness pills like candy just to get the room to slow. I would lay in bed not moving in hopes of not making those pesky crystals shift.
There are a few considerations with it though, the biggest being able to figure out which ear canal has the crystals (generally, if you lay on your side, the world spins faster when you lay on the side with the floating crystals). When doing the maneuver, make sure you turn to the affected side. The other consideration is doing it with someone who can hold your head steady and keep time (you would be surprised how hard it is to keep your head still when the world is like a merry-go-round on coke). If you don’t hold your head steady, the crystals don’t go to the right place.¬† If you don’t hold the pose for the recommended time, the crystals can’t float on down to where you want them to be.
The best thing about this: it’s free and you can do it as many times as you need to. I only did it once the first time, but twice, a few days apart, the second. It sure beat all the meclizine¬†I would have taken.
Anyway,  I will dig up the video link and post it here, along with some links to other helpful articles on vertigo. Hope no one experiences it, but in case you do, hope this can help.

I couldn’t find the site I had originally visited, but here is the link to the Johns Hopkins info page on it.


today is a new day

I ended up at the beach last night. ¬†It was nice. ¬†I will really miss the beach after the move (it’s a mere 20 minutes from here, but will be about an hour from where we will be living… and there will be no palm trees or wading in the winter months). ¬†I really needed the time away. ¬†I needed to think and drown in my music.

I can’t remember which blog turned me on to Angel Haze, but I am in love. ¬†She’s inspirational, positive, and kicks ass. ¬†I can’t pick a favorite song because I like almost all of them. ¬†Dirty Gold is my current obsession, but there’s also Battle Cry (ft. Sia), Angels and Airwaves, A Tribe Called Red, Same Love (remake)… and ok, just about all of them…

I have been fighting strong self-harm urges since the TSA line back up north. ¬†I guess it’s a good thing they no longer allow sharps in the airport because I would have shredded my arm and leg in the airport bathroom before boarding, they were that intense (and I had that little resolve at the moment). ¬†Music has been my centering tool. ¬†I have not picked my art up again yet, but the iPod is glued to my side, with earbuds wedged into at least one ear. ¬†If I don’t have my iPod on, I am playing music through the computer or my phone. ¬†I am sure I will run through the gamut of coping skills in my repertoire before De returns from vacation. ¬†This weekend is a long weekend and most people already have plans. ¬†M and I will be spending more quality time together. It’s not a bad thing, but we have forgotten how to interact. We don’t have simple casual conversations, it’s only ever stuff that lights one of us on fire (if not both). ¬†I wish I remembered how to talk to her. ¬†I wish I knew how to rekindle that close relationship we had back in the day (or at least I think we had). ¬†We are both lost in our own drama. ¬†When we meet, we tend to collide because the spinning arms of the drama hit before we meet causing sparks to fly and fires to light.

I volunteered for a research project on reporting sexual violence. ¬†I’m not 100% sure what they are looking into, but I believe De had said they are looking into how to improve the reporting experience, and what causes barriers to reporting. ¬†I was supposed to meet the lady tomorrow at De’s office, but they will be closing early for the long weekend. ¬†The lady will be coming here later on this afternoon. ¬†I hope the dogs don’t maul her while trying to get her attention (they LOVE people SO MUCH they are not quite sure how to contain themselves. I also suck at keeping up with their training, and they don’t get out as much down here. They do better when they have seen other humans recently). ¬†The questionnaire should take no longer than 15 minutes she says, so it shouldn’t be too painful. ¬†I don’t think it will be too triggering either, so it should be well worth the money I get from it… I miss research opportunities. ¬†While I was never a fan of writing the papers, I did enjoy coming up with the ideas for the papers. ¬†I love expanding the knowledge base on things that we don’t quite know too much about. ¬†I love education, and helping people understand things. ¬†I wish someone would do more research on the after-effects of sexual violence. ¬†There’s so much anecdotal stuff out there, but so little “official” understanding of a lot of it. ¬†I recently found a blog entry on a topic I have never really seen discussed in print. ¬†I know I have been told that it is not uncommon for assault/abuse survivors, but I had not seen anything even remotely close to educational about it anywhere before. ¬†It is also one of the few places to write about it as a function of coping with the abuse vs a pathology simply deemed psychotic. ¬†I wish medical professionals had access to that information. ¬†I think I may have gotten some more effective treatment earlier on had the doctors seen it as something that makes sense in the context of my trauma. ¬†I’m fighting with the thought of posting a link to it here because I don’t think it’s something I’m ready to admit to anyone outside of a few select people. ¬†I know it would have helped me immensely seeing it before now. It helps ease some of the shame to know (other than just hear one or two professionals tell me it is not uncommon and it makes sense) that others struggle with it. ¬†I was surprised to see the number of comments on that post (well over 200?!) from people all struggling with it in one form or another. I’m just not ready to go public with that aspect of my struggle. I guess I could post a link to the blog itself, and let you wade through the posts to find the one I’m talking about… I just… I can’t say it right now. Not yet. ¬†It’s still something I’m working on with De (and eventually with whomever I see up north)… Anyway, the blog is called Blooming Lotus. She has not written recently, but there’s a ton of good stuff on there (at least stuff that can help you feel less alone). ¬†I hope, if you struggle with anything she speaks about, you will find some peace in knowing that it really is something others struggle with… and that’s coming from people who know it first-hand, not just through trainings or clients…

On a totally random note (random because I’m not 100% sure what train of thought led to this) but how can you hold two completely opposite and contradictory ideas as true at one time? ¬†I know DBT covers some of this, but I am allergic to DBT, so I don’t really remember the concept behind the “dialectics”. ¬†I’m talking about such opposing ideas that they should not be able to be held as true at the same time because they virtually cancel each other out. ¬†If I tweak one idea, it’s a little easier to understand how I can hold them both true and correct at the same time, but they are not tweaked, nor do I wish to tweak them. ¬†One is the concept of ¬†“never, ever give up.” The other is the right to “bow out” as each individual sees fit. ¬†Suicide is seen as giving up, so how can I hold that sentiment with the belief that everyone has a right to give up if they choose to do so? How can I advocate for life at any cost in one breath, and the freedom of choice to end your own life in the next? ¬†I am not currently suicidal, though the freedom to have that “escape route” is calming to me. ¬†I hold at once the obligation to fight any and all demons, and the option to give in to the desire for peace and an ending. ¬†How is that even possible? ¬†Maybe it’s that I understand the pain on both sides. ¬†I have felt the desperate need for relief, and I have felt the devastating black hole born of the death of someone I care for deeply. ¬†I grew up with the women in my family (and possibly even the men, but I don’t remember that as explicitly) lamenting about death being around the corner. ¬†My grandmother said that she would die soon (should die soon, needed to die soon) since before I was born. ¬†My mom would always say she wanted the right to kill herself should she ever be incapacitated (she wanted to make sure we all understood and agreed with her right to choose to end her life if she could no longer live it the way she was used to living, be it physical or mental). ¬†I think I recall my father saying similar things. ¬†No one ever expected to “get old”, yet the only person who did not speak regularly of death died at a young age. ¬†My grandmother was 94. ¬†Both my parents are still alive (despite saying neither of them wished to reach the age they are currently). ¬†Bitch is still alive in her late 70’s (all of us wish she wasn’t). ¬†But K is gone, and has been for 20 years this year. ¬†She was 52 when she died, but she was the only one who wanted to grow old… I was indoctrinated to believe that every human has the right to decide to end their own lives. ¬†But I’ve also felt the loss, and had the training that ingrained in me the instinct to preserve the life of others (and maybe even my own)… so I hold those opposing truths at once. Sometimes it’s a mind-fuck.

pass almost 2 hours: The lady for the research study came and it took me an hour and a half to complete the survey. ¬†Her computer was slow, but I also think I kinda spaced on some of it. ¬†it was only supposed to take 15-30 minutes. ¬†Clearly, I did not fit that time frame. ¬†It was ok. ¬†I thought it would ask more about any history, but most of the questions revolved around the last 12 months. ¬†I remembered an incident I had not thought anything of because of where it happened and the circumstances surrounding it. ¬†It was during a hospitalization last year. It happened on a locked unit, by another patient, and in front of staff. ¬†It wasn’t anything major, he was having a psychotic episode (or so they said) and tried to grope me after another patient mentioned that I was a lesbian. ¬†I pulled away. I was able to re-direct him in no uncertain terms, and staff told him to stay away from me (and really everyone). ¬†Despite the fact that I was in there due to my PTSD reactions over past assaults, I was never spoken to about the incident, no one asked if I was ok. ¬†I simply stayed out of the common areas for a while, and later had some really bad body memories that ended in an uncomfortable verbal incident with another staff member. ¬†The thing is, you lose all rights when you are hospitalized for psych issues. ¬†You lose your personhood. You become a thing without feelings, needs, or any control over anything. ¬†They treat you like prisoners (though I tend to think prisoners may be better off in some respects). ¬†If you don’t do what you are told, you are lectured and called “defiant”. ¬†Things slide that would never slide outside those locked doors. People (other patients as well as staff) can treat you like crap, violate all sorts of boundaries, order you to do things, and you just have to accept it. ¬†You have no rights, you have no decision-making capabilities, and anything you say is clearly an exaggeration due to your mental instability. ¬†I was expected to have no real reaction to this man invading my space and trying to invade my body because he was a patient and so was I. ¬†It’s counter-intuitive that a patient’s reactions and feelings are not taken into account on a psych unit, but it’s true way too often. ¬†The minute you step foot onto that floor, you are no longer a functioning, reasonable human being who is simply having a difficult time, you are a crazy person that needs containment (even if you are there for depression or anxiety). With or without a psychotic diagnosis, you are treated as if you are actively psychotic. ¬†At least, that is how the hospitals in this state are. ¬†Up north, I felt a bit more human, a bit more sane.

Anyway, I digress… the survey took longer than I had expected, but I did get paid, so that’s good.


Paper Crane Invasion

It was suggested that I keep my hands busy when the self-harm urges get stronger, to take care of myself instead of destroy myself. So I made a paper crane,¬† and 100 of his closest friends. Some ended up looking like dragons to me… (and then I rewarded my hard work with ice cream). ¬†I could probably fold these in my sleep now.

 


quick and effective breathing exercise

I found this on a forum last night (or maybe it was this morning? I’m not 100% sure) and liked it a lot.

I learned this in a hospital so it is based on science and has to do with the vagal nerve which has a connection to the sympathetic nervous system, that fight or flight anxiety feeling.

So best to do this standing. Only 3 breaths so take your time. Open your mouth slightly and breathe deeply in through your nose. Pull the breath so the diaphragm goes as far down as possible. Visualize pulling it all the way into the pelvic floor and at the end when you can’t hold it any more, squeeze the pelvic muscles like a keegle.

Then slowly blow the air out through your mouth until you are almost not breathing. Then start a new in breath. Repeat 2 more times. Careful not to get dizzy. I don’t but some do. It is important to focus on the pelvic region and pull the breath down as deeply as possible. The vagal nerve ends at the pelvic floor and the muscles contracting help stop the panicky reaction.

I know breathing exercises are really helpful, but I tend to get frustrated with ones that are too long, or don’t work immediately. ¬†From what others were saying on the forum, this one works really well and really quickly (seeing as you only have to do it 3 times). ¬†I have not yet tried it myself, but I have not needed to as of yet. ¬†I wanted to share it here not only for easy reference for later, but in case anyone else was looking for a quick and effective breathing exercise.


Grounding objects

A long time ago, I realized that certain objects helped me ground or de-stress. ¬†As long as I can remember, I have always had a squishy toy, a small bean bag, a beanie baby (they are good for something other than collecting dust!!), a lavender eye pillow (the sound of the insides swooshing as I rotate it around my hands is incredibly calming, as is the lavender scent), spinning rings, things to meticulously shred, Tangle toys, objects of various different textures (I tend to prefer smooth & soft, but sometimes I go for rougher things), things to peel, etc. ¬†Throughout college, I was known to hoard stress toys in my bag, at work, and in my dorm room. ¬†I still carry at least 1, if not 5, stress objects with me daily. ¬†Heck, even our wedding rings serve as stress objects (they are 3 interconnected rings that I can either take off to play with, or easily roll up and down my finger if I need my other hand for something like driving or writing). ¬†I try to keep most things unobtrusive, as I’m supposed to be an adult now, and carrying around a beanie baby just gets me a whole bunch of weird looks (I rarely carry anything I cannot fit in my pockets, and lately they happen to be “girly jean” pockets, so space is at a premium).

I realized I have a piece of jewelry that I use quite a bit, but had no concept of it until I wound up at The Center (a dedicated Trauma Psych unit in DC). ¬†They did a lot with creative expression and making tools to help ground. ¬†One of the things I made while there was a “grounding bracelet”. ¬†It’s pretty much a single enclosed loop of beads with an additional length of beads – long enough to wrap again around my wrist a second time. ¬†When I have it on, it looks like a double-stand beaded bracelet. ¬†If I need something to fidget with however, I can unwrap the long strand and play with it. ¬†It’s really easy to make, and has come in handy when I need a way to ground or calm myself. ¬†Some of the girls I had worked with in the past really liked the concept (though I never disclosed it’s purpose to them) of having something they could wear that they could also play with. ¬†I remember one night sitting down with a handful of them and everyone making a bracelet.

wpid-PicsArt_1388897605292.jpg

 

To make a grounding bracelet you will need: (see also here)

  • thicker stretchy jewelry string
  • beads of your choice (I used glass beads but you can use any beads you like)
  1. cut a length of jewelry string long enough to wrap around your wrist twice, plus about 3 inches (to allow for knots and a length to tuck under the loop when not in use)
  2. tie a temporary knot at one end and string your beads (can also loop the string back through the bead so it stays in place while you add the others). Make sure you do not string them too tight because it will make the next step difficult. I used a larger bead at the loose end help keep it in place when not in use (doesn’t slide out as easily. ¬†It is also a nice “focal bead” to fiddle with – slightly bumpy in texture for when I want to feel something a little more rough). ¬†I used a variety of shapes and colors, but kept to colors I find soothing. ¬†Some of the beads used to have a sand-blasted texture, but that has since worn off from too much fiddling.
  3. tie one end (without the large “end bead”) back onto the string so that you have the closed loop portion of the bracelet (once around your wrist). Make sure you tie a solid knot at both ends, but especially the loose end. Voila! You have a grounding bracelet!

To wear, simply slide the loop over your wrist, wrap the long portion around a second time, then tuck a length of it underneath the closed-loop portion of the bracelet.  I found mine slips loose if I only tuck it under once, so I loop it back onto itself again and tuck under a second time.  It looks just like any other piece of jewelry, but can double as a therapeutic tool when needed without advertising what it actually is.

wpid-PicsArt_1388899069631.jpgI also made a keychain there with similar intent. ¬†It is a “tassel” of different glass beads attached to a larger bead on a silver ring. ¬†There are about 5 or 6 different strings, each with different colors, textures, and shapes of beads. ¬†I do not use it quite as often as the bracelet (it’s a bit bulky), but I carry it with me when I need extra choices for stress toys. ¬†If I have my backpack with me, my current selection offering of stress relief is: 3 different scented lotions, a squishy ball, a sandalwood scented travel candle, a squeezable ghost, a tangle toy, my stress keychain, my iPod, silly putty, and a glass heart given to me by my first ever therapist. ¬†When¬†I’m feeling particularly vulnerable, Beary, my stuffed bear, will make her way into the bag. ¬†If I only have pocket-space, then I take my heart, the candle, and my iPod. I have taken to wearing the bracelet daily regardless of space for other things to bring. ¬†It has come in very handy while shopping (holiday crowds can be crazy!), in therapy, and any other time I need help reducing anxiety. ¬†I even find myself playing with it randomly when there’s no anxiety or stress present. ¬†I’m really glad I was given the opportunity to make it.

Does anyone else have a “portable stress kit” they use? ¬†What’s in it? Do you find it helpful?


the trouble with borderline personality disorder is…

There’s a whole lot of stigma around bpd, and the people diagnosed with it. ¬†Talk to just about any mh professional about their clients diagnosed with bpd and you get shudders, eye rolls, and a litany of complaints (ok, this is coming from the perspective of someone not only once/sometimes dx bpd, but also as someone who had candid conversations as a peer with other professionals who work with clients diagnosed with bpd without said professionals knowing my own dx). ¬†I think one thing that has been missed in all this is that there is a reason for these traits. ¬†We did not simply wake up one day thinking “how can I be really difficult to those around me?” ¬†Life happened. ¬†Shit happened. ¬†Things that no kid should ever have to endure happened. ¬†So we learned to deal with that as best we could. ¬†We learned that even the best-intentioned people can sometimes (or always) fail us…

While I think it’s slowing some, the trend to diagnose someone as bpd is still more prevalent that looking at the reasons behind their presentation. ¬†And a diagnosis of bpd brings with it a world of hurt (not only from the client, but also the mh system). ¬†If you think credibility is lacking for a person diagnosed as depressed or bipolar, it’s out the window for someone diagnosed as bpd. ¬†The average clinician or psychiatrist that encounters a bpd diagnosis on paper will write that client off as difficult to work with and highly dramatic. ¬†Someone who specializes in trauma however, may look at things differently. ¬†I have yet to meet a person diagnosed with bpd who does not have some significant trauma history. ¬†I think most (if not all) bpd diagnosed clients are simply trying to communicate things they have no idea how to express.

I struggle with the stigma attached to bpd. I think a lot of t’s and pdocs have this image of a bpd client being impossible to work with. While current trending is to try to change that stereotype, it’s true to an extent. A client with bpd symptoms can be incredibly taxing at times, but also someone I would use “kids gloves” with. You didn’t just wake up one day and think to yourself “how can I be difficult to those around me”. Things happened. **** happened that brought on this set of behaviors and beliefs. I think maybe to make therapy work, a focus on what happened (not so much only what is happening now) might be a good place to start. Maybe also finding a t and pdoc whom you can have conversations with around your reactions (if you feel you are in a place to have those conversations at the beginning of therapy). I think the most helpful thing for me was finding a therapist who shrugged off the diagnosis and worked with me as a person. We had conversations about my reactions to things and what I thought fueled those reactions. We had conversations about how she would handle those reactions. We talked about what I thought was helpful, and what she thought may be helpful. When I was stumped about some of it, we went over my last reactions to therapy and attachments. She was incredibly patient but also really helpful. She stayed really level-headed when I’m sure there were times she wanted to strangle me (kinda like Homer does to Bart in every Simpson’s episode) or smack her head into a wall because sometimes taking to me is like taking to a wall.
From what I remember of your other posts, you seem to not be in a place to give up self-harm at this time. Maybe finding a therapist that can help you with the reasons behind the sh without making you give it up completely right now might be a good place to start? I’m not advocating continued sh without regard to damage, but I found it was helpful for me to work with someone who asked me to limit it, but not give it up right off the bat. We focus on the crap motivating the sh, but not necessarily stopping it. We focus on limiting it, and limiting the damage. it’s a bit on the dbt side of things, so maybe a dbt program might be a good place to try?
I can recognize (in my own past) some of the things you were talking about, I just have no real idea how I moved from that space (except making the decision to stay off meds, but I don’t want to recommend that to people because it’s a highly individual decision that is not right for everyone. It was taking a huge risk, but I had a great support system that included a current, trusted therapist, an intensive outpatient program, and major support from friends and family. I was actually inpatient when they weaned me off everything, and that helped a lot. So please don’t take my experience as a suggestion to do it).
I think the biggest motivator for making therapy work for me was fear of the alternatives… if I kept going the way I was, my path would have lead to legally being declared incapable of making my own decisions. Permanently losing that control of my own life scared the crap of of me… What are the pros and cons of therapy for you. What do you fear about it? What do you want to get from it? Can you find a t who is willing to work with that? Are you willing to work with what they ask of you? If something scares you about what they want you to do, can you find some way to talk about it with them instead of just reacting? Can you come up with a plan ahead of time with the new t and pdoc that allows them to see your reactions as a way to communicate (or need to communicate) something rather than just react themselves? It may take time, but finding people (or at least one treatment provider) that can work with you even when you are kicking and screaming may go a long way to finally figuring out how to make therapy work…

 

I think it’s important to look at the roots of behavior as much as it is to work at changing that behavior. ¬†And I think DBT (while good for some) is not the be-all and end-all answer to healing the trauma wounds. ¬†I think we (as treatment providers) and we (as cients) need to take a look at how DBT can be a spring-board for a new and improved treatment model. ¬†The idea of teaching missed lessons is great, but take away the school-like model. ¬†Make it yet more human and accessible. ¬†Add back that availability component. ¬†Add in a kid-glove theory of practice. ¬†Add more individual processing time. ¬†Group can be helpful, but so is that one-on-one connection. ¬† Take away the punitive measures and make it a conversation. ¬†Treat the trauma behind it. ¬†Do it intensively and with caring. ¬†Work on safety while still allowing for personal choice (there’s little scarier to an abuse survivor than the thought of losing control again). ¬†Allow for distractions. ¬†Take things at the client’s pace. ¬†Allow them to have that alternate coping skill (or skills)… Give me space to scream and cry and be triggered. ¬†Help me come out of it safely on the other side (even if I’m a bit more beat up than I was going in). ¬†Promise you will be there when the dust settles, because most people are not… and don’t hate me for it.