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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5133
Experience:  Dr. Mark is a PhD in psychology in private practice
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I was sexually and physically abused by my father, as were

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I was sexually and physically abused by my father, as were my brothers and sisters. I have little memory of most of what happened at home, although my sisters and I have talked at length about it. We didn’t talk about it until I was 40-I am the middle child. Up until that point, it was the elephant in the room that no one discussed.
It is still extremely hard to think about this, as my father was a pillar in the community.
My mother was non-existant. She lived in her fantasy world. She didn’t love us and made it clear she didn’t want us. So she did nothing to help us. She was very cold and unloving.
I have episodes that come on very suddenly and I seem to be flooded with what I call a frozen fear. I can’t think very well, I have an overwhelming fear, I feel like everything has been sucked out of me, I won’t say I get suicidal but I certainly think about it, I get a knot in my stomach, can’t eat, can’t sleep, can’t think. This seems to be happening more frequently now. It seems to happen at night when I am alone. I have more free time now than ever before, and things seem to be unraveling. During these times, when I think of my parents, my fear is that I have falsely accused them, I have hurt them tremendously, they are confused. Although I know they did terrible things to all of us, somehow I can’t get out of my head that it really can’t be true. That I have caused the problem. I know this is irrational thinking, especially when I look at how dysfunctional (I hate that word) 4 of the 6 siblings turned out. The three oldest, especially, have serious problems functioning on a daily basis.
But during these episodes, I feel terribly afraid and terribly guilty. As I said, it seems to come on rather suddenly.
Another thing I don’t understand: whenever I try and listen to soothing, calm music, instead of calming myself and relaxing, just the opposite happens. I was recently at a seminar on leadership, and during one segment, the presenter talked us through a way to learn to calm our nerves, by closing our eyes as he talked in a very quiet and soothing manner. For me, instead of helping me to relax, it did just the opposite. I have noticed this before. I recently had a massage, for example, the music being played triggered one of those episodes I described above. So whenever I try and be calm, instead I have the opposite reaction.
Do you have any idea what is happening?
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr. Mark replied 3 years ago.

Hi! You know, to give you the best answer, I think I should ask you a few questions first that will help define the problem and the situation.


Yes, I have a good idea of what is happening. I work with both men and women (more women) who have similar experiences in my private practice very often. You are having classic symptoms of Post Traumatic Stress Disorder (PTSD). We'll discuss this in more depth when I answer. For some women and men with PTSD, closing their eyes in a social situation can lead to intolerable anxiety and panic.

What I'd like to ask is about your therapy: was your therapy for PTSD? Were you using PTSD therapy protocols? If not, what type of therapy was it?

How long was the therapy?

Would you consider going to therapy again that was specifically geared toward treating the traumatic reactions?

Any extra information that will help, feel free to share.


Dr. Mark

Customer: replied 3 years ago.
Yes I was in therapy for PTSD for about 1 year, 2 times a week. I have thought about going again but so far have not made the decision to do so. The episodes I have described are happening sporadically. What do you think is happening?
Expert:  Dr. Mark replied 3 years ago.

Thank you for the added information. It helps a lot. I believe I can now be of help with this issue.


First let me say that I can imagine how confusing and distressing this situation must be for you. You keep trying to just live normally but every so often these experiences just come to overwhelm you with no conscious effort on your part to remember anything traumatic from the past. It is like a pattern that happens to you every so often.

You are right. This is a pattern in your life. And you know the starting point of this pattern. How does this pattern work?

It works in that when there is an unresolved trauma, we subconsciously, in our emotional selves, find ways to reenact that same traumatic situation. And any element can trigger it. For many women, it can be trying to be calm and relaxed. Because their abuser would come at them most often when they were supposed to be resting like normal kids do.

You ask me what is happening. I'm concerned first of all that even what I said above may have opened too much trauma memory (subconscious memory) for you. Safety is so important with PTSD. And safety was so hard to come by when the abuser is the authority figure and you're small.

You've heard of flashbacks, I'm sure. Well flashbacks are not just what you see in the movies, where there's a visual memory that's very realistic of some past event. That's the movies.

Flashbacks for people who really have PTSD are most often emotional trigger reactions. The memories are sometimes so painful that I've had clients who couldn't bring the memories to their conscious minds even though they knew the things happened. But they would have emotional flashbacks.

They would feel the sensations they felt so many years ago again. Something would happen and it would trigger having that emotion state. The anxiety would sometimes be overwhelming. By the way, it's for this part of the emotional flashback state that I'm going to put at the end of the posting a technique you can use to help with PTSD's anxiety you sometime feel. It is something you can do throughout the day for a little relief any time.

So this is what you are experiencing. Instead of a visual/thought memory of the events, you are having the classic emotion/sensation memory of the events. You are feeling that terrible fear and guilt. The confusion becomes overwhelming: you can't tell any more who's right and who's not, who's guilty. This is all the stuff flashbacks are made of.

Psychotherapy that is helpful is some form of Exposure Therapy. I have found EMDR can be very useful especially for one time traumas. It is a type of therapy specifically for PTSD originally. Here is the International Society's website:

http://www.emdria.org/

On the web you will find many opinions on EMDR both for and against. I am trained in it and have found it useful. Exposure therapy is also very helpful. HOWEVER, and this is important: I have found that you need to combine these types of therapy with a more introspective, humanistic approach. If we actually look inside, we can find great relief and meaning. And we can feel whole in ourselves in ways that we haven't for decades. But many EMDR practitioners and therapist working with Exposure Therapy do not take the time to insure the emotional safety of the patient and so that's why you need someone who is more humanistic or psychodynamic in approach. PLEASE take this need for safety and slow work seriously. I see patients who have had bad experiences in PTSD therapy because the therapist has tried to move too fast, to heal the wounds according to his/her needs, not the patient's need. And I can tell you from my experience, YOU need someone who is patient, methodical, and very safety oriented.


If you don't have a good referral source, here is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful (you can see a photo of the therapist!) look at the listing and see if they list working with PTSD and perhaps EMDR and also some form of humanistic or psychodynamic therapy in their orientations.

http://therapists.psychologytoday.com/rms/

You have gone through a lot and you have tried to bring good into the world. It's time to now get to the healthy places within you and to let them lead your actions and guide your future rather than replaying the pattern that was formed by such a tragic event. You did NOT cause the problems. YOU are not responsible. I'm sure you have heard this before. But you need to know that it is true. And you need to reprocess it emotionally.

I wish you both the very best!

Finally, I am going to put here a protocol that is used for anxiety. When I work with people with PTSD, they have great anxiety. So I want you to have this easy technique you can use right away to help you in every stage of your anxiety. Throughout you will have this technique to help you!

Here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. When I teach patients PMR at first they are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. I want you to practice the PMR at least 5-6 times before an attack or feeling acute anxiety. Why? Because when you're in the throes of anxiety even if it just seems like sleeplessness, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum.


I want to stress the importance of breathing as well. Part of the physiology of what is happening to you in anxiety is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety reaction, which strengthens the attack and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help.

So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have anxiety. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?


INSTRUCTIONS:

  1. After finding a quiet place and several free minutes to practice progressive muscle relaxation, sit or lie down and make yourself comfortable.
  2. Begin by tensing all the muscles in your face. Make a tight grimace, close your eyes as tightly as possible, clench your teeth, even move your ears up if you can. Hold this for the count of eight as you inhale.
  3. Now exhale and relax completely. Let your face go completely lax, as though you were sleeping. Feel the tension seep from your facial muscles, and enjoy the feeling.
  4. Next, completely tense your neck and shoulders, again inhaling and counting to eight. Then exhale and relax.
  5. Continue down your body, repeating the procedure with the following muscle groups:
    • chest
    • abdomen
    • entire right arm
    • right forearm and hand (making a fist)
    • right hand
    • entire left arm
    • left forearm and hand (again, making a fist)
    • left hand
    • buttocks
    • entire right leg
    • lower right leg and foot
    • right foot
    • entire left leg
    • lower left leg and foot
    • left foot
  6. for the shortened version, which includes just four main muscle groups:
    • face
    • neck, shoulders and arms
    • abdomen and chest
    • buttocks, legs and feet

Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation’ poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.

What You Need:

  • A comfortable place.
  • Some privacy.
  • A few minutes.

Again:

Customer: replied 3 years ago.
Why do I have images of my parents (who are both now deceased) as them being the victims? I wonder if I have exaggerated in my mind what I think they did to all of us and to myself. Sometimes I think I have destroyed my parents. I know a big part of the problem is that I have no clear memories. And why can I not just relax as normal people do? Classical music, spa music, "new world" peaceful music-all those types of genres seem to churn up the really negative feelings.
Expert:  Dr. Mark replied 3 years ago.
Have you ever seen images on TV of kids being removed by Child Protective Services from their parents? The kids are crying holding on to their parents for dear life. It makes you feel like the CPS people are sadistic.


But then you hear that the parents beat the kids, abused the kids, neglected the kids. Well, if that was the case, why were the kids crying and holding on to their parents with obvious real love?


Because kids don't know what love is other than that they love their parents. They know that something is wrong in what is happening at night when their father does things to them. But they don't know how to say their father doesn't deserve their love. They just know they love him and something is wrong. Why is daddy acting this way? Maybe I'm doing it. Maybe it's me that is bad.


And so kids begin to think that they are the guilty party. Why?


Because if they are the guilty party, then at least the people they love make sense. If I was better, he would not do this, she would not do this. If only I was better. It's my fault.


All of this logic is "child logic". And this is what you are trying to sort through. And you need to do this in therapy.


The same with relaxing music. The more evocative the environmental relaxation, the more triggered you get. Because kids who can't relax because they need to keep their guard up at home, get subconsciously frightened as adults by relaxation, like closing one's eyes in public meditations and demonstrations. It triggers that feeling of having to be on guard, watchful, prepared for the trauma.


Yes, it's a sad inheritance. And you need to bring it out and reprocess it in therapy.


I wish you the very best!


Please remember to click the green accept button because: even though you have made a deposit, I do not get paid for my time unless you press ACCEPT. Feel free to continue the discussion as my goal is to get you the best answer possible. You can continue the discussion even after pressing ACCEPT. Bonuses are always appreciated! If I can be of further help with any issue, just put "for Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5133
Experience: Dr. Mark is a PhD in psychology in private practice
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