Learner Therapist (68) … our historical context’s generational demands

Torrey Orton
Dec. 29, 2015

Multi-generational, multi-ethnic, multi-national traumas…

One aspect of what’s in us is our recent human history. It is a conundrum of trauma therapy that trauma at the family level tends to repeat itself over generations. It is an easy assumption, when looking for causes of this pattern, to notice and but not embrace the all-too-human recourse to violence to overcome the residues of the past (or defend them as abidingly necessary truths). We cannot do without our pasts, nor stay anchored mindlessly in them. Pasts are there regardless of the honourable or wondrous purposes and futures which the present may be holding out before us. Here is a literary version of the generational trauma of the first fifty of the last hundred years captured from a novel:

“With 10 million dead, the four years of World War I legitimised contempt for individual life, making possible the purges, pogroms and Holocaust and tens of millions of corpses of the next war, and the pitiful civilians: an old woman with seat covers sewn into a dress, a man in a jacket made from a flag, which gave them an air of desperate grandeur, like guests at an asylum ball.”

Anne Susskind review of Sebastian Faulk’s Where my heart used to beat (2015) in The AGE Spectrum; 26 Dec. 2015

In the novel the story ploughs on for the next 50 years in the lead character’s reflections.

Three generations is a good span…roughly 100 years…which from now takes us back to the early 20^th century when the massed forces of the 19^th century’s scientific, political and social liberations, in the industrial world at least, undermined many deep socio-economic-political structures. It is a good span because chances are we all know three generations of real people - not just socio-political categories like Boomer or Gen X. In that 100 years we have the generations affected in various ways by the 1^st World War (my grandparent’s generation). Then we have that generation re-afflicted by the Depression, as well as the rising generation which fought the 2^nd World War (my parent’s generation). My generation has hosted a serial testing and upgrading of military potentials through Korea, Vietnam with Cold War sparring in the background culminating in the Iraq ventures of ’91 and 2002, Afghanistan and the Iraq overflow keeping military competences tested to this day.

There are variations on the inescapable calamities theme in tandem with the ones above. For instance the fates of being caught in the Balkans as Yugoslavia declined into its component parts and then into smaller parts around religion over the decade from 1995 to 2005; the various Palestinian/Arab/Israeli battles to this day; the various intramural and Islamic spinoffs in Africa worth millions displaced; the oppressions of Central America with the support of the CIA; the struggles in Chile and Argentina between lefts and rights in the 60’s – 70’s and beyond, many sponsored or covertly supported by American cold war enthusiasms.

Trauma effects

These are all events which are characterised by no escape from danger for almost everyone in them, but especially non-combatants, for long periods of time ranging from the lead up to the respective wars and the wind down into non-war, but often with enduring consequential deprivations. This is a rough configuration for chronic trauma on a mass scale, similar in internal structure to the family level experiences which touch ±20% of populations across the industrial world. Developing country levels may be expected to be higher.

We know that those who fight wars are always traumatised to some extent from the reports of survivors of the undiscussability of their wartime experience. We know that undiscussability of traumatic experiences renders them more powerfully corrosive, and we know that this applies to non-combatants as well. We know that the use of legal (alcohol) and illegal drugs are highly associated with traumas, as is violent behaviour learned in the traumas. This kind of trauma – the trauma of protective services like military, firefighting, policing, emergency services, paramedical services – is endemic for those who undertake to protect us from trauma.

Systemic traumas

There is another class of traumatic conditions, emerging in their ultimate form as genocides, usually arising from long-term systematic and systemic discriminations usually on the basis of race, class, ethnicity, gender/sex and religion. Indigenous peoples everywhere, who escaped the local genocides, are caged in actual or virtual agreements that partition off their heritage lands, their original occupancy and, restrained therefrom, their souls. The history of humanity is of growth through dispossession of our predecessors and the irretrievable pollution of their cultures.

Traumatic effects are reasonably consistent across these cultures, taking forms like endemic alcohol (and other drugs) problems which in turn sustain individual and group incapacity to enter modern life, which in turn sustain the drugs and on it rolls. The psychological problems most commonly driven by trauma are conflicts between rage at dispossession (be it deprivation of life, property or affection) and guilt at being the authors in their view of the injustices they are subject to, at helping the oppressors – be they corrupt officials or bent parents, both often themselves products of social system maintenance of the discriminations going back generations. Altogether these forms roil around, re-emerging in family violences and public criminalities.

On the passage through this all too human history we come up against the challenges of responsibility and forgiveness. Forgiveness cannot meaningfully be given except for an acknowledged miscreance, or crime, though certain religious practitioners (see review of Marilynne Robinson’s The Givenness of Things, NYRB Dec. 17, 2015) recommend grace, where forgiveness cannot be obtained or offered. This latter act is perhaps all that’s left for macro explanations of the self-inflicted injuries of humanity’s passage – that we are all fallen, etc. and the grace is that we give more than we can afford and get less than we deserve.

…and how to engage them in the present.

We can ‘test’ moments, patterns or themes of the past emerging in the present whenever a patient’s self-reported automatic response or initiative produces ineffective relationships. Sometimes that ineffectiveness will be clearly visible in the therapeutic relationship itself, expressed as an unnecessary or inappropriate silence, diffidence, deference or provocation (all defences). The ‘test’ can begin with noticing and pointing out the evidence of ineffectiveness in the patient’s engagement at the moment. If carefully gauged to the patient’s current sense of power, that test can be followed with wondering “Is there more?” or, “Are you familiar with this feeling??” which lead in two different directions of cognitive association: one, an unfinished feeling inhibited by the fear of exposing it, and two, an exploration of an existing track of very familiar recurrent feeling.

That’s for starters, only.

 

Learner Therapist (52) … Fear of losing the edge

Torrey Orton

January 22, 2015

 

For the second time in a week I ran into a patient from a traumatised background fearing that if he recovered from his defences against the trauma he might lose his life energy, drive and motivation…that his strength would be diminished or undermined, that he would lose his edge. I remember a very similar feeling myself five decades ago when I was interrupted in my life’s progress by depressive episodes. At the time I argued (to myself of course) against finding some help with the notion that I would lose my quite clear edge in my chosen activities, while in tandem advancing the view that my worries were nothing compared to person X or Y, whose troubles were so obviously more deserving of help than mine. At the time I thought my appreciation of the needs of others was a unique moral insight. I’ve since found an enormous company of helpers and fixers espousing my mantra all on their own. Another edge dulled by normality.

 

This second aspect – unworthiness of help, or much of anything for that matter – is what our hyper-vigilant defences keep from our view. The edge of our defences, their energy, focus and sharpness, is sustained by a largely unconscious apprehension that it is being dulled by the engine of unworthiness.  So, if we deconstruct our defences we will slide back into the sludge of unworthiness and its helpers - hopelessness and helplessness. The actual experience of trying new thoughtfeelingbehaviour is one of re-entering the traumatising world and self – a world of danger which a lifetime’s defences have been designed to prevent. The twister here is the often recognised fact of the abused re-exposing themselves to old and new abusers over the life cycle. Why? Because the defence is more comfortable than the promise of freedom from it, which can only be obtained by daring to behave in new ways!!

 

I think this kind of experience is especially prevalent for the “high performing” among my patients. It might be difficult for them to tell the difference between their injured self and their competent one – all the more so if their high performing self is clearly and unarguably publically acclaimed. It may appear to the therapist as ‘resistance’ to therapy in various forms. An ally of the preference for the edge is disclaiming victimhood, which is encouraged by the pop psych “move on”, “just get over it”, “changing your thinking will change your world” ideology.

 

The third side of the edge is an over-developed competence, which may create an unbalanced self but does not qualify for Medicare funding. A fourth cut of the edge is that it will never wholly disappear, that the wound which it expresses will always be with the wounded to some extent. It is, with respect, called character. The wearing away of our visible person into the wrinkled one of old age is one mark of our learning experiences of all kinds.

 

A sign of therapeutic success for trauma patients is the capacity to hear that they will never get over it in some important senses, one of which is having an edge. Another is seeing our scars as honours. That this is extremely difficult is modelled for us in daily life by the struggle of our defenders – soldiers, police, firies, paramedics… - to handle the traumas of their defence of us and the denial of their experience demonstrated by our social unpreparedness to care for them on return from our wars. Therein lies one of the most obvious sources of intergenerational violences, and around it goes again!

 

Those two patients I mentioned got over it. They were enough into the therapeutic work that they could acknowledge their temptation not to do the work for a tangible reason – that getting better might make them even less well, or so the loss of edge might feel to them. Their edge is among the most reliable of their feelings of being in the world, of existing, and reliable about keeping them in the world in the face of various pressures pushing or pulling them out of it!! But they are successful enough to know that their edge is now constraining their full development, usually in the relationship sides of their lives, either intimate or collegial, or both.

 

Learner therapist (35)…… Spaces for feelings

Torrey Orton

May 2, 2013

Partial out-of-body experiences…

Getting to, creating, or discovering the experiences I describe below is one of the first concrete steps in objectifying the inner dynamics of the chronic trauma which affects patients’ lives. The feeling of these dynamics held at a near distance to themselves is a kind of self-outing, but in the privacy of therapy. This is what a safe therapeutic place supports. For instance…

 

… I’ve recently seen a guy who I first saw 4 years ago whose injured inner world was so close to the surface that he could barely stand being looked at, couldn’t bear to hear his name used or himself to be referred to, even indirectly – in short, he was a raw, exposed wound. He always sat on the edge of his chair, posed for a quick departure. He could also acknowledge that this is how he was – poised for a quick departure in life. Speaking to the presence of his demons was a pathway to keeping him in the room…but the speaking was often somewhat indirect.

 

Another guy could put the black hole of his depression aside just to his right, roughly parallel with his shoulder. It was just on the edge of his peripheral vision, but easily accessible through my pointing, gesturing or even nodding at it … bringing its fullness back into the control of his awareness, without dropping him into its endless decline. So he was having the experience of keeping the threat under control, without denying its existence or blocking it out with palliative self-medication.

Often another patient pulls herself down out of the grip of her demons just there in front of me and I can ask where did they go, are they still in view, can you feel them? And she may say ‘Yes, just here or there’ (gesturing to one side or the other) and usually a bit in mid-air (even a figment is real, after all). While in their grip, she has been contorted in her chair, drawing back and up into a partial ball, while slightly patting/massaging herself on the forearm…with glimpses of scratching or pinching herself…

And then, in all three cases we can discuss the ‘treatment’ of the demon(s). Questions like: Do you want to go there now (pointing at the suspended traumatic contents)? Is there a part you want to look at now? How is it to have it just there? Can you keep it there? And, often, early in the therapeutic engagement, this amount of direct attention riles the demons and the patient begins to fall back into their black hole. The pointing may itself rouse the demons, making their presence more aggressively felt again, more gripping than when observed or sidelined by their relegation to the space. This is something I’ve felt before akin to action at a distance, like gravity, but immediately perceptible to the other like a virtual hug offered across the therapy space without touching but my arms held in an encircling pose…

Holding their demons within reach is also an enactment of the patient’s internal disconnect between their injured and well parts… between their competent and incompetent selves…recovery from which requires slowly increased ability to shift back and forth between the split parts, progressively integrating them. A kind of internalised exposure therapy perhaps?

Learner therapist (20)……Interpersonal politics of coupling, intimate or otherwise!

Learner therapist (20)……Interpersonal politics of coupling, intimate or otherwise!
Torrey Orton
January 27 , 2013

The blame and responsibility challenge – creating truth in shared facts

NB – this is a first go at addressing these issues. I expect it may not be the last because they are so difficult for me.

Michael and I have been having this discussion since we met 20 months ago. It keeps coming up so it must matter, at least to us. I'll call it the truth in relationship discussion. Mike might call it the responsibility in relationship discussion. I start from the question: how can we be jointly responsible for anything? He starts with the belief that we have to be responsible for ourselves first. The struggle between individual and group perspectives is the mental history of modernity, one prefigured in the outstanding lives of ancient individuals in all domains of human endeavour rising above terrain of their socio-historical contexts, without which they, too, could never have risen!! Some say, me among them, that the historical balance is out of whack now. Too much me, too little us.


Both are important perspectives and practices, but neither can stand alone. 'How do we get to be responsible?' is one question on the pathway of upbringing. It emerges from the WEness of family, community, and society in their various overlapping institutional forms. No surprise there.


Along the path of upbringing we may have experiences which compromise our capacity for being and feeling responsible for ourselves. Our social systems are as imperfect as our personal ones. Around this fact roils the search of many wounded individuals to parcel the responsibility (blame!) for 'bad outcomes' which they are subject to, and which they fear reproducing themselves in the next generation. This struggle can only be avoided by self-numbing – a long-term strategy bound for failure.


The compromised self develops distortions (I mean that, not disorders) in its capacities to relate to others and itself. Distortion is a normal occurrence because others' responsibility for us can never be perfect, or even close! As some poet roughly says, parents eff us up. We can only learn responsibility from responsibility; our parents learned theirs from their parents, ad infinitum. As well, the generally accepted contents of adult responsibility have changed measurably in the last century or so, and continue to do so now.


Unintentional offense and responsibility


M and I had been stuck in this discord for months, and amicably so, until one day:

M commented on his distress at my dismissive celebration ("Uh yeah…" w/self-satisfied tone) of him seeing something I clearly thought he should have seen before. (This is an often repeated verbal punctuation in the course of our acquaintance and a behaviour I was aware of; I had not yet gotten to the point of being able to interrupt it, only acknowledge it to myself as it irrupted once again.) I asked what feeling he was having after I said it and with some reflection he came up with "offended" or similar, to which I suggested "disrespected" and he accepted that, too.

 

I agreed he should feel "offended" because it was an inappropriate expression on my part…though I expressed it then, still do at times and not just between us. It is not my intent to hurt and wasn't then. But, I was to blame, he agreed, for his bad feeling about himself at that moment. His feeling included some anger….unsurprisingly. As part of our professional self-development, we have built a relationship of shared responsibility which contained the insult and the complaint about it and so opening another level of discussion between us. This experience lifted us up to the level of our relationship as the subject of conversation in a new way.

This article is a step towards formalising the difference in our understanding of responsibility so as to reduce the distance it provokes between us. Recently, I rediscovered on a back shelf Dr Harriet G. Lerner's book The Dance of Anger (1985) which includes a chapter titled "Who's responsible for what?" It brings together two of my favourite subjects – anger and responsibility in the context of intimate relationships. Here she notes:

It is tempting to view human transactions in simple cause-and-effect terms. If we are angry, someone else caused it. Or, if we are the target of someone else's anger, we must be to blame; or, alternately – if we are convinced of our innocence – we may conclude that the other person has no right to feel angry……

…We begin to use our anger as a vehicle for change when we are able to share our reactions without holding the other person responsible for causing our feelings, and without blaming ourselves for the reactions that other people have in response to our choices and actions. We are responsible for our own behaviour. But we are not responsible for other people's reactions; nor are they responsible for ours ...

I think this is Mike's view, too, though not his exact words… and the view of not a small proportion of my patients who've been exposed to modern no-fault processes which are under-pinned by attitudes / principles like those Lerner proposes above.



Therapy, for those who choose it, is one pathway to undoing distortions of the self. Some undoing takes a few sessions; some takes years. The principal means of effecting recovery is the therapeutic relationship – the most reliable, "evidence-based" characteristic of therapeutic effectiveness, regardless of 'school' of therapy! The relationship stands or falls on the ability of the therapist to be present for patients in ways their histories have not made available to them. In doing so, the therapist is taking responsibility for the patient's recovery…while recognising they cannot be responsible in the end!! This paradox will reappear later in fractured couples' relationships.


Offenses to the self


We had a minor offense to M's self by me. The vignette of its occurrence and our recovery through "shared responsibility" is exemplary of the relationship challenge, while barely noteworthy in the greater picture. A bigger offense might elicit feelings like this:

What is it that is so unacceptable, that I react with such a survival instinct style reflex? What is so horrific about my reaction to these words that has me revert to this primal state? or if not primal, infantile or juvenile, and has me cry ...

"Now look what you made me do!"

I'm particularly interested in childhood experiences which underlie chronic depression and anxiety. Pretty consistently these experiences are major abuses of trust by parental, or broader familial, violations of personal space and self-control – often co-occurring sexual, physical and psycho-social violences. These can be usefully considered offenses to the self, are classified as such in legal systems and labelled traumas in western cultures.


They are chronic for two reasons: one, the offenses are sustained into the present by the social system(s) (families, churches, schools, clubs, workplaces…) in which they were first committed and/or reproduced, and two, optimal recovery often requires some change to those present sustaining systems. Children are not responsible for these behaviours, though almost every adult with an abused childhood attempts to take responsibility for others' abuse of them. Efforts to recover must pass through the blame grinder.


'my pain is your fault'

One couple I have worked with off and on for 2 years found the perspective from which to rise above and hold the pains of their struggles: a place which they shared with equal interest and need. They are a couple both deeply injured in ways which when touched by the other regresses them to catastrophic positions – 'my pain is your fault.' Whichever gets there first on any given occasion, their catastrophic feelings incite the other. They have developed a number of effective workarounds and pre-emptions for many recurring circumstances they share, but not even these can stand up against the most conducive conditions for regression – co-occurring overtiredness, professional stress, excess drink, demanding kids and unbalanced, living parents .

 

The new perspective came into view as they were sinking for the N^th time into the fires of their respective recriminations about each other, dragged down or blown up by the catastrophic certainty of repeated disappointments, each with the other. I interrupted the rising tide of exasperation and suggested they stay with the very specific topic they were on…a matter of how physically close they needed to be when both were highly stressed by various things in their joint and separate lives at that moment. This is, of course, a quite sophisticated exploration already.

One, I don't remember which, verbally stepped back and noted that I had proposed on another occasion that their respective needs for closeness were almost exactly opposed when crisis struck: one withdraws and the other approaches, generating a massive reciprocating tension powered by catastrophic thinking. He/she checked that the other was experiencing it now, which she/he was, and the tension dropped. This was the first time they had created a respite from their struggle without leaving it in a heated rage or quiet despair. That creation remains as a shared platform for their struggle for a workable togetherness at their times of greatest vulnerability. Both acknowledged the achievement.

They had created a shared fact about their relationship which undergirds the potential for getting to new places in it instead of replaying the past, deprived places. This fact expresses and symbolises what the relationship is for, its purpose(s) rather than its product(s). Sometimes it's a revisiting of purposes still in play but lost from view which liberates deep motivation – in fact, the most important things about the relationship: its aspirations.


The blame and responsibility challenge


Now back to Lerner. She says our anger can become a source of useful change,

"…when we are able to share our reactions without holding the other person responsible for causing our feelings, and without blaming ourselves for the reactions that other people have in response to our choices and actions."

The blame and responsibility challenge – people show up for couples work because they are stuck in patterns of repeating failure to meet each other's needs, especially those which make being a couple worth the effort. It is impossible to progress as a couple without transgressing in the view of one or the other, or both, at some times!! There are three domains of likely transgression: (1) style (intellectual, expressive, etc. - preferences of congenital origin), (2) cultural role determined behaviours (responsibilities, tasks, authorities, etc.) and (3) personal needs/wants arising from particular normal developmental transitions. The manner of transgression often includes violences of aggressive (hitting, yelling, betrayal) and passive- aggressive (withdrawal, sniping, silence…) sorts. Often a number of manners and domains are involved together.


Complicating the effort to connect is the fact that injured parties carry loads of self-blame which inclines them to expect they will fail the needs of the other (I'm not good enough, don't care enough….), and they expect the other to blame them for the failure – a self-sealing circle of partner-assisted, covert self-accusation. Someone has to break through that circle to change the relationship disconnect cycle. To do so requires confronting their own sense of failure and their sadness /rage about it and doing so in a way that minimally elicits the partner's version of the same system. This is what the couple above achieved.


It's all a perception…not.
It cannot be achieved from a perspective which says everything in relationships is just a perception, and nobody's perception has a better claim to attention than anyone else's. That perspective is the driver of irreconcilable differences in which the members of a couple stand on their "right" to their perception, and giving any of it up to have a joint perception is not on offer. It only takes one person with such a stance for the relationship to be doomed all the way to the courts and beyond. This is a small part of the broken relationship population, at least judging from the fact that 90+% of broken marriages do NOT end up in court. They create some kind(s) of shared truth out of their "shared facts".


And this is the area of personal development into interdependence – partnership as the playground for skill building in joint ownership, authorship construction and so on. There are no free kicks in couples development, unless the couple are already developed enough to provide them freely?!! There have to be stumbles along the way and some way to do better than build up personal grievance banks loaded with material to prove the justice of ones disappointments with the other, and vice-versa. A combustible collection.


And so couples therapy has one task above others, which is helping the couple to see their existing and near horizon emerging successes in interdependent functioning, a joint ownership where the boundaries of who owns what are dropped, melt, disappear…which is what the romantics dream of in the merger/ melding of self in love, etc. but can't be dreamed, must be achieved…and all the more difficult in our times because the jointness historically was given by roles, which have for some time now been corroded by modernity. They have to blindly take responsibility for each other. An act of faith, repeated.









 

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.