Showing posts with label confronting. Show all posts
Showing posts with label confronting. Show all posts

Wednesday, May 28, 2014


Learner therapist (44)…… A first session strategy
Torrey Orton
May 28, 2014

Making contact – aims and methods of the first therapy session

My objectives in Session One: to provide my patients with …

…experience of recognition and acceptance                                                                             

…increased understanding of presenting issue(s)

…hope that change is possible and that some directions towards it exist

…relief of pressure(s) by live exposure and containment of them

…a live model of the therapy experience which will follow

…an appreciation of their existing competences relevant to handling presenting issue(s)

…a sense of personal wholeness

Stages in Session One (and most others) – a collection of conscious processes

Coming into our ‘house ‘– arrival ritual(s)

·         Arriving, paying, waiting, being called up

·         Hello’s, handshakes, seating, name checking?

Opening

·         Blank slate assumption – getting them to start ASAP (prompted by questions like What are you here for? What do you need? What can I do for you? if necessary)

·         Listening for key players, key feeling(s), key theme(s)

·         Initial validations - ‘Noticing’ feelings, themes and players; remarking these as they emerge.

  • Initial feedback – summaries of story chunks for disconfirmation, capturing themes, feelings and players; relevant therapist self-disclosure(s).

Engagement - Joining their story

·         Perspectives – framing their story, similar stories, psych facts conceptualising the ‘problem’

·         Implications – extending their story – how it affects whole life?

·         Objectives – what outcomes wanted; sharpen the focus

·         Work processes – through feelings to truths and new actions, as we are doing here now

·         “Am I crazy?” – a common question to be grasped directly as early as possible.

Closing
·         Summary of overall session tone, topics and tendencies

·         Check fit of my style with their needs

·         Therapeutic prediction – time and labour to ‘recovery’

·         Home works

Leaving our ‘house’ – departure ritual(s)
·         Walk to gate

·         Encouraging word(s)

·         Handshake

·          C u next week…


(Some of) my therapeutic assumptions…

·         Feeling is the pathway to resolutions

·         The pathway to feeling is non-verbal, assisted by feeling language and concrete expression

·         Resolution requires acceptance of the injured self

·         Skills for resolution are mostly present in non-injured self, but inaccessible to the injured at the moment

·         Change emerges from the unconscious and reveals itself in little steps of which a first is starting therapy

·         Many issues arise from misshapen or over-developed life habits based on normal functions and needs.

·         Awareness is the key tool for shifting ineffective habits

·         Getting back own power and defending against others’ power is usually a major covert outcome in depression /anxiety spectrum disorders

·         Our times are net stressors for everyone

·         Sharing secrets w/ significant others reduces internal stressors

·         Families matter cultures matter gender matters age/life-stage matters…

·         Therapeutic progress must occur at thought, feeling and action levels to be resilient and resistant to backsliding.

 

 

Saturday, November 23, 2013


Learning to act right (28)… Cracking nuts - talking to single-issue fanatics

Torrey Orton
Nov. 23, 2013
 “There is a right way of living” he said on the phone from Rome, “and it is our task to try to find it and follow it.”
Cardinal George Pell quoted in TheAGE’s GoodWeekend, June 16, 2012; pg. 10
It should be clear that Pell’s assertion is not remotely true. The Catholic Church’s history can be read as a repeated confrontation with the fact that there are many ways to be human and, so, to live. Pell’s untruth supplies the intellectual and organisational energy for the absolutisms of the Helpers of God’s Little Children’s (HoGPI) personal confidence in their abusing other’s life choices under the pretence of offering “help” they know they cannot materially or socially provide. Of course, similar simplicities underpin the fanatical ends of Islam, Judaism, Buddhism and evangelical protestant Christianity.
The Protestants a few centuries ago arose out of various revulsions at the socio-spiritual voracity of the Church, only then to spawn their own rigidities (sects like the Exclusive Brethren and the cyclical upshots of evangelisms) with which they have struggled ever since. They rest in the near background of our present focus on the Catholic Church at the Fertility Control Clinic. Much about to be said here will apply to them, as to the rabid branches of Judaism (ultra-orthodox) and Islam (Wahhabi / Salafi) and Buddhism. All three monotheisms are fired by periodic ecstatic revisitings of the original texts in search of uncorrupted meanings, pure meanings, the ‘real’ meanings – always a backwards look which fuels backwards steps. The catalysts for the cleansing fires are perceptions of moral decline, often the fruits of socio-economic and scientific / technological growth.
Within these struggles lies the critical one over the question of rendering unto Caesar – that is, the acknowledgment that the religious is neither the only nor the dominant domain of human being and that pretending to be the only domain necessarily leads to astounding corruptions of the religious, and perversions of everything else. The separation of church and state took a lot of killing to achieve, first arriving at a clear closure through Roger Williams in what became Rhode Island in 1636 and that only by self-exile from the rigours of the Puritan Massachusetts Bay Colony.
A shareable assumption, perhaps
Let’s continue with a potentially shareable assumption: the world as we knew it in the 1950’s has fallen apart across a broad spectrum of life domains and has been doing so for a long time before that. The pace of decomposition of basic relationships seems to be increasing, marked by data on reduction of friendships over time and increases of sole occupancy dwellings, especially by women. Marriages are a very un-investable 50/50 commitment these days. The evidence on life satisfaction as a function of increased wealth should be a caution to the hyper-accumulating One Percent club, but it won’t be.  And so on… It’s not hard to think we are in a period of catastrophic decline, surrounded by Decline of Rome type perversion and indulgence.
Some would say the fall started when the Church lost the fight to keep the sun circling the earth 500 years ago; others would say since the discovery of relatively safe sex media starting with reliable condoms and running on into the pills (before and after, in turn), and abortion as a backup for inevitable mistakes/failures of these media; others, again, would say since the acquisition of wealth has become the dominant objective of all leading world economies, and its principal measure, money, the major denominator of virtue (virtue having become just another tradeable commodity); and, others would say since human control of life was put within arm’s reach through the advances of sciences, amongst which the biological is the most prominent.
The Enlightenment scientific project (now a program daily reiterated by announcements of the latest “evidence-based” discoveries) promises to save us from the conditions of being human: from being fallen in the Judaeo-Christian sense, from being frail in the biological sense, from being limited in the ontological sense, and so on. That project is a canonical claim with as much purchase on reality as the biblical but masquerading as possible, not necessary – no faith required, just wondering interest.
Cracking nuts, really?!?
Yes, it is my professional judgment that the HoGPIs are nuts, cracked, crazed and must be addressed as such since an assumption of sanity (e.g. that they not provoke patients in any way!) justifies behaviour which repulses patients, and enrages us, by its inhumanity (to put it moderately). HoGPIs think somewhat the same of the patients (and Friends, too, of course) because we are working against what they see as the natural order of things. The main evidence for the latter thought is that they always present themselves as conflicted by their unrequited love of patients and unrecognised hate for patient’s choices. Their public face and materials (the hoardings worn by men and women to meet the council requirements for no promotional materials on the pathways) are more provocative of patient anger / sadness than they are solicitous of patient concern / interest. Why else keep secret video records of who comes to the FCC without knowing what they are coming for.
HoGPIs may not be cracked throughout their lives, but in Fertility Clinic matters they behave convincingly as if they are nuts. So, how can we talk to them? There are many difficulties having a real conversation in the setting of HoGPIs’ protest. One of us remains admirably committed to the possibility of “real conversation”. I’m a few steps behind him, currently mostly acting as if there is no possible conversation with them these days.
Challenges: major issues which I’d like to turn into development opportunities.
First, ask them their names. Most refuse, saying “I don’t have to tell you.” The refusal can be engaged as an avoidance of personal responsibility for the roles they are playing in “helping”. By staying nameless they do not have to face taking personal responsibility for their beliefs or their expressions of belief to patients. This is a sub-adult behaviour, of course, typical of those with an uncertain grasp of their belief systems. By remaining nameless they can treat us as “murderers” with no humanity. Ask which church they belong to of the two ex-Premier of NSW Christina Keneally a few months ago discussing the challenges of talking to her children about church paedophilia and distinguishing between the “Institutional church” (the putative guilty ones) and some of the church (the real one???).
Help pressed on patients who decline it is harassment.
1)     HoGPIs making the offer of “help” to patients is a legal process, until it becomes harassment. Harassment starts in Melbourne Council ordinances at the moment a potential offer of information or discussion is refused by a member of the public. This refusal may be explicit – ‘no thanks’, etc.- or implicit – a refusing non-verbal of normal sorts like turning away, shaking the head, etc. Nothing may be offered by hand or mouth after that point.
It is also unlawful to pursue patients, or anyone else, from down the street to their notional destination at the Clinic. Daily HoGPIs pursue three ‘innocent’ parties: local inhabitants, local workers and patients with other than termination concerns, often from 50 metres up or down the street from the Clinic gates.
Conflicting rights: the right to offer and the right to refuse; the latter is not acknowledged or accepted in practice by HoGPIs except when Council authorities are present and even then…
“Murder is happening behind these walls”
2) Responding to single issue perspectives packaged as the most important thing right now – e.g. “murder is happening behind these walls” which we (Friends of the FCC) are facilitating in their view, and therefore we are murderers’ too.
Responding to the “murder” charge is necessary because this perception fires HoGPI righteousness!! It is not the legal view of life beginning in Victoria. It is not the scientific view of life beginning in the educated world. It is not the view of all Christians, Jews or Moslems anywhere.
A second response is to deny it is a stand-alone issue…rather, it is part of the whole package of the Church’s birthlivingdeath doctrine, which at any time in history variably validates and supports differing standards for birthing, living and dying; varying principles of decision…specifically the regressive Papal package of no abortion, no contraception, no gay sex or rights, no euthanasia which is the currently received message of the Church on all such matters and undiscussably so, or as Pell would say, “universally”…. though there’s a slight lightening of the atmospherics of the doctrine under the new Pope Francis – less judging but no less condemning.
They are failing miserably…
3) They are failing miserably in their efforts to even get a hearing from patients – 70% will not even accept a handout and most of those who do are Chinese or Indians for whom rejecting a public offer is impolite. Most of those which are accepted are not read, and in some cases couldn’t be because some patients are not native speakers of English.
No real numbers exist on “help” HoGPIs have provided to any patients and they acknowledge they couldn’t provide any large amount of help if they were successful engaging patients. So, they are constantly frustrated. One HoGPI said “It’s about love, not money” when confronted with the impossibility of their “helping” any significant number.
The historical shortcomings of prohibitions
4) Ask them if they know the pre-abortion and pre-contraception history of coat hanger abortion parlours and farming out of children to agencies - Catholic or otherwise – which themselves harboured systemic child abuse practices????
What did the recent Bert Wainer (http://www.abc.net.au/tv/dangerousremedy/video/ ) story tell us?? That no abortion, like no alcohol (have a look at the criminalities spawned by Prohibition in the US 90 years ago for an example of unintended and unimagined consequences of universal virtue imposed for others’ good) and no drugs (the criminalities across the world spawned by the War on Drugs) are practically unsustainable regimes, slowly collapsing under their own weight now and at previous attempts to impose virtue by force… Another case in point: the notorious failure of abstinence-only sex-education in the US!!!
Can you stop people from messing up relationships, committing rape, fumbling pre- and post-marital sexual encounters, having contraception breakdowns (20% condom failure rate?)?? The figures on relationship instability are consistent for 50+ years – around 40-50% formally fail (end in divorce). These figures are insignificantly different for major religious groupings in industrial cultures, except for the cult-like fundamentalist fringe groups across the monotheisms.
Ask HoGPIs what drove people to seek abortions under pre-legalisation conditions, even at great danger to themselves?? This set of forces is most instructive because it tells us something about what will push people into action with high risk potential – a way of predicting likely rates of abortion seeking in spite of a ban.
They are wrong about stress and trauma
5) HoGPIs have incorrect psychology about patient stress, historical traumas, the meaning of tears, leading to embedding untested attributions of patient present states like they are feeling guilt, regret, etc.!!!
 
The last weakness is the most important of all. Attributions cannot be reliably tested under threat like that patients experience out front of the Clinic. The social context there elicits the personal guilt/shame about sexual matters which abounds in our culture. Guilt/shame are known to affect reporting of abuses massively and are recognised widely as a distorting feature of the domain…one which is aggravated by religious upbringings for many people.
The HoGPIs’ abortion regret argument: there is no rigorous support for abortion being especially conducive to “mental health” problems. And, of course, regret and guilt are normally occurring feelings in life situations of many kinds. They are not intrinsically pathological or forecasts of depression.
Tears often have more than one emotional foundation: minimum possible feelings expressed in the simple act of crying are sadness, fear and anger together. Shame/guilt comes second. Stress is cumulative. Acute stress is common throughout life but not dangerous to well-being unless converted into chronic reoccurrences, as in family violence, etc.
If you claim to lead virtue you have to be squeaky virtuous
6) Recognising that different life matters have different moral valences – e.g. those who propose to rule (others) on “the right way to live” are making moral claims much greater than those in everyday life roles and institutions; the closest to the church would be legal and financial ones, w/ medical in the second row; those making great claims about anything and wanting to insist on being followed have to be purer than the rest of us; we can do impurity OK already.
Can you prevent a proportion of the population from being systemically excluded from normal society in ways leading to sub-minimal upbringings over multiple generations? E.g. – the repeatedly poor over generations. And there is “soul murder” – the destruction of quality of life by parents and other responsible adults.
The Church has a noble and long commitment to alleviating poverty, etc…why don’t you put energy into that since those conditions produce the most negative results for children...and doing so is part of your notional spiritual vocations!!
Can you guarantee no child will be assaulted by any religious from any given date forward??
Could you provide for anything like 10% of patients presenting for abortions if they chose your offer??
Sexual abuse and silence
7) Do you know that X % of sexual abuses, and many other intra-familial or communal ones, are never reported formally? Do you know why?
Where does your taking choice away from people stop??  At the church’s “double jeopardy” principle for handling end of life pain mitigation: that medicating to reduce suffering may consciously be used where the process will also produce eventual death (the de facto ‘put ‘em out of their misery’ treatment that has long been allowed in medicine)?
Sexism and power
 
8) Who are you the Church to decide for women and men? Sexism is explicit in the Church’s role structure and ideology.
Liberal democracies judge that everyone has a right to their claims, but not to ones which endanger the dominance of liberal democratic values – i.e. freedom of thought and its assistant, speech. At the gates of the FCC these two values clash quietly for the four groups of participants: patients and families, Friends of the FCC, security guards and HoGPIs. And so, we have the central challenge for Friends and HoGPIs – the challenge of enforcement of regulations which establish and manage the borders of free speech and offence. No one in enforcement wants to be involved with this highly irregular terrain. The last place the police and Council officers want to hear from is the FCC footpath.
Start at home…
9) Why don’t they go after their co-religionists who do not practice the Church’s doctrine on life/ death matters?? Actually the Church has sent an envoy recently to “evangelise” the wayward masses who self-identify as members but are non-practicing…Do they fear the disapproval of their co-religionists? Wouldn’t it make a greater impression if they were known to be putting the resurrection of Catholic morality first in their efforts?? Shouldn’t it be easier to do…or maybe that’s why it’s not a promising venture for the martyr oriented fundamentalists of the FCC front yard.
Matters of faith / belief
10) But in the end, this is a matter of faith, which cannot be adjudicated by facts and we see the issue of life beginning (and ending!) differently, and you have a right to your faith but no right to attempt compelling our faith / belief…though I’m happy to entertain discussion about the rightness of the faiths – e.g. some faith issues have been clearly ruled matters of fact, like varieties of sexualities!!!...just as the role of women as equals in everyday life has been similarly clarified as fact and accepted as such even in the Church except for where further work needs to be done to close the gaps in historical practices  - eg male only priesthood, bishoprics, etc.
A note on faith: there have been three iterations of the Word, of revelation, each of which founds a religion – Judaism, Christianity and Islam - all of which are in the name of the same god. This leads to a wonder at what the god was doing each time, since the revelations overlap in content…did the god realise it had forgotten certain points and needed to have another go? This would make the god a developing or maturing being, not a finished and perfect one.. and therefore having no universal, immutable claims…a fact which is replicated in  the  Church’s Papal infallibility having been repeatedly shown to be fallible, or need adjusting for changing times, etc., by the Church itself, to say nothing of Galileo and company.
 
 
 

Thursday, December 27, 2012

Learner therapist (27)…… Valuing your injured self


Learner therapist (27)……
Valuing your injured self

Torrey Orton
Dec 27, 2012


"…When will I get over this…or, will I ever?"

 
Over the years a recurrent challenge for many of my patients has been handling a sense of wasted life that they carry with their various injuries. The repetition of the question "Will I ever get over this?" emphasizes the difficulty of their recovery challenges. It contains a hope that they could return to some pristine pre-injured state (in themselves) or status (in the eyes of imagined knowing others) struggling with an expectation that they have been inescapably tarnished by their histories.
Part of this sense comes from the victim's perception that he is the author of his own injuries. Another part comes from the injuries being seen to be his fault when it cannot be – childhood violations of numerous kinds are imposed by powerful others (usually close ones). While I may wonder about the value of my life, as many of my acquaintances do about theirs, I'm not confusing this with the wonder of patients whose injuries are deep and long term. The shared part is the human self-evaluation drive. Victims' self-evaluation drives are hyper-vigilant versions of a natural drive, like their threat detection systems which sense danger all the time, correctly but inappropriately.
Valuing the injured part
Certain injuries carry an almost irrepressible shame/guilt – especially those of a sexual nature. As patients' lives unfold in various attempts to create workable ones, they may gather up a trail of partial starts at this or that, or long term stuckness in not ever 'good enough' occupations, relationships and life-styles. How can such a life trajectory be seen to be valuable in more than a pollyanaish way (well, you tried hard, dear) that seems to default to dismissal of the injury? My belief is that most traumas can be valued, at least a lot more often than they may be, and that they must be valued for a final escape from their fate of victims (by embracing them for all to see).
Certainly there are people who have risen above congenital injuries and war injuries which left their bodies deprived of parts and processes. And most of them "carry" their injuries in more or less visible ways. My patients "carry' theirs without others, and sometimes themselves, knowing it. Memory of early psycho-social injuries is notoriously unreliable. Sometimes the injury can only be perceived in the tracks of present relationships and life processes. These early memories are often blocked as well, and the over-developed capacity for blocking distorts the aspects of life where the injury was experienced decades before – again, most notably, blocks to feeling, expression, and imagination in relationships.
If we judged the virtue of being injured from the treatment of those injured on our behalf – for example, our soldiers, sailors, fire-fighters, and police – we'd keep them hidden. And so it is with those of us who carry our injuries to the soul, spirit, and self silently and unobtrusively, and are quickly pushed back in their containers by the deft hand of others' instantaneous disregard whenever we let them slip into their view. On a good day our slips might be deigned to a treatment from another – 'what you should do is…' type stuff. A different push back in the box. Not often a call to 'share'.
Strength from adversity
As a collective matter, the bearing of active systemic disregards of ethnicity, race, gender, religion or class yield peculiar strengths in those who survive by quietly putting up with them. These strengths include insight into the real dynamics of the oppressive system(s). Ask the nuns about the church; ask the women about the men, ask the blacks about the whites….though a 'consultation' about exploitation by the exploiters (openness and transparency and honesty and all that) is likely to be characterised by impenetrable withholding by the oppressed which the oppressors will not seek to penetrate while at the same time discouraging any expression of the perceived oppression. Notice our long social unhearing of the sexually victimised. Any unguarded 'sharing' of perceived oppression (say, of sexist or racist behaviour in any of the footballs) will be put back in the box with defensive disregard – 'it's just a joke', 'it was just a bit of fun'…It's hard to progress bullying, harassment, and hazing in the systemic fog of oppressors' denials.
As a personal matter, the abused/oppressed often find sustenance through success in parallel systems – e.g. the violated child whose gifts translate easily into school success. These successes are all quite normal; the unoppressed do them, too. Personal development, normally, involves a bunch of small steps of increasing complexity and intensity. Progress – that is, a completed development stage – is marked by internal and/or external 'tests' when a normal performance of a life task is required and achieved for the first time in its fullness or wholeness. Some of these developments are required of all humans as foundations of living. Many are possible for all humans, while very high standard performance is possible only for a few and usually only in a few task domains for any individual. The renaissance man/woman is a figment attested by its scarcity.
Acknowledge trying
What recovery from an injured self particularly strengthens are virtuous habits: persistence, focus, assertiveness, etc. As a result a victim made something of herself in unpromising conditions. She tried and tried again as the Quit ad now correctly encourages smokers!! Al Anon has done this for alcoholics for decades. As I've noted elsewhere, success cannot be the measure of a life's quality since the internal and external conditions for high achievement, or any achievement, are not equally available to all. Trying can be expected, and that trying which occurs in the face of a powerful socio-politico-economic headwind is universally well thought of, honoured even.
But, when the headwind is also psychological, the right of the person to honour for their efforts is compromised. We still do not think the injuries of abuse are injuries like a car accident, a road side bomb explosion, a bush fire and so on…all things which have very definite time and place boundaries. They can be seen to be finished and the damages are often visible. The socio-psychologically injured tend to take on themselves this debasing of their emotional currency and so may disable their acknowledgement of their trying.
Another value to be acknowledged is the "functional" parts of themselves which are the basis for what appears to others to be a normal life. The injured often do not even acknowledge these objectively assessable parts. They wince when a compliment is extended for a clearly, undeniably, and externally validated good piece of work. They shift from 'I' to 'you' as subject of their discourse. They cannot put together words of self-approval like 'I did X well', or even 'OK'.
The denial of their uninjured self, or its obscuring in the tailings of the injury, is a collateral damage of the original injury. Learning to accept their own achievements and intentions and valuing by others is competitively as challenging as overcoming their inappropriate guilt for their injury. Resistance to doing so is one of the public signs of hidden injury.
Build self-acknowledgement
How to work on this self-acceptance of injured part(s)? (1) Build self-acknowledgement. I've tried recently to directly confront a self-denigrating thought by amplifying the patient's success achieved in parallel systems (work, school, play). I do this by persistently, sometimes irritatingly, recognising all achievements a patient lets pass unacknowledged, even if mentioned by them (as if they are dead, or recognition would be a kind of dying) and contradicting all implicit disavowals of their own worth (which are an actual piecemeal reinjuring of the self). The disavowals are easier to see as the surface disturbances arising from deeper self-denials. Once started on the pathway to self-acknowledgement, homework of various kinds can target and reinforce self-acknowledgment. A sign it is 'taking' as a normal self is an improved rate of unconflicted positive self-report in session – for example, the steady disappearance of apology as the first step of entering a session and growing into taking charge of session agenda setting.
Understand family history
A different stage in treating injured parts is (2) to pursue understanding how the family (or other systems) became damaging to oneself over time. Knowing that one or both damaging parents were themselves damaged by damaging parents over successive generations gives a perspective which modifies the sense of injustice about one's own trauma. To some extent it no longer has the intensely personal feel it always did. The mining of family history produces appreciation of one's place in it, and usually of one's place in a long history of trauma that is not merely familial. Rather often regional, social, cultural, national or global.
This generation's family trauma is fired by the unexpressed / unacknowledged traumas of the previous ones. Look for the family members who carry undiscussables damages which they sustained for the benefit of future families – the warriors who survived wars for example; the workers who never recovered from depressions...!! Follow the pathways of alcohol and violence within and across generations. Expect to find traumatic peaks in tandem with social, economic and political troughs. Note that there was a 40 year trough between 1910 and 1950 covering two world wars and a global depression. That's enough to affect two generations directly, the latter being the Boomers' parents – the parents of our patients.
Seek acknowledgement from abusers
Next, (3) there's getting acknowledgment of their injuries from those responsible – an experience which redeems life from the pit of self-blame. This can be obtained from others, but often defaults to oneself when the others are even more injured than oneself. The process of seeking, demanding even, acknowledgement of their responsibility from those who perpetrated the traumatic events is a critical step, even if often only a virtual one because the blameworthy are beyond reaching – dead, decrepit, demented….
…this step is critical because through it patients achieve confirmation of their historical experiences, relieving themselves of the paranoid process of retaining the injuries as secrets and creating reliable facts about those experiences. It may be that what is confirmed is their own memory and that has to be accepted without validation by the other(s) concerned. Either way, confirmed or not, self-acceptance as injured is central to recovery. This should lead to apology, completing the guilt erasure process, and may be supported by reparation for damages experienced and guarantees no further ones will occur. These four steps are the basics of a reconciliation cycle.
Create personal power by confronting
To work through this cycle requires development of a further capacity – the capacity to act in the face of explicit and implicit challenge. In other words, patients have to increase their personal power to do any of the above. I work on this by making that objective explicit quite early in the work, saying 'If you want to work through this thoroughly you will need to increase your personal power, and working through steps (like those above) will have that effect'. Many patients are surprised / shocked and then pleased with this idea. The pathway to power is a bit more challenging than accepting or embracing the objective of becoming more powerful. Some of my earlier posts on communication interventions for relationship improvement suggest details of the work.
A major step in confronting abusers is what I call 'self-outing'. It may start with coming to therapy. Finding friends and others who can be trusted to accept the offer of the patient's pain is often an important prior step or early result of therapy. This finishes with confronting victimisers, especially the family system which keeps the family secrets. Some patients go further to join victim advocacy organisations. This is courageous work since each offer of the injured self is a chancy move – even the best friends and colleagues cannot be guaranteed to be good receivers. They, too, may reject the patient's experience. Public advocacy is an invitation to re-experience abuse, since to advocate is to speak into a prevailing breeze of social disregard, if not condemnation, of the matters and people advocated. Another form of whistle blowing.
I am aware that in the background of my working over this post stands the question of what is a technically traumatic life experience. I offer a simple definition for therapists which I use as a guideline for my listening with any patient who appears with serious, endemic anxiety or depression – what they consider persistently life-distorting feelings and behaviours and outcomes. I also offer it to the afflicted as a search guideline for themselves. The definition is:
DIMRS = a quintet of experiences with collective traumatic impact
Death-threatening – the victim feels in danger of death, though not necessarily physical death; spiritual or emotional death will do just fine for a verdict of worthlessness; and
Inescapable – a feeling of hopelessness because he / she is caught in the grip of another on whom they are totally dependent for their survival, both physically and emotionally / spiritually; and
Multi-dimensional – damages occur in many dimensions of well-being: self-care, self-image, aspiration(s), emotional hyper-vigilance; and
Recurrent – the threat is present more or less all the time for years, sometimes up to the present adult time in which they appear in therapy – more or less all of their lives to date; decades in their minds and present living; and
Systemically distorting – the victim's capacity to enter into and sustain relationships of many kinds is restricted by profound distrust expressed in bad choice of potential partners of many kinds (intimate, peer, work, etc.) and inappropriate levels of commitment: too much or too little, sometimes oscillating between the two; the distrust extends to their own perceptions.