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Getting Through : Dealing

Healing and Help

from Jules - Thursday, December 22, 2005
accessed 2480 times

I have wanted for some time to talk about my own experience with therapy and treatment and to ask for others opinions on this issue. I do agree that we all have our own path to healing and it is a deeply individual and personal road. What I am writing about here is my own experience and what I have learned. I invite those with differing views as well as those who have experienced the same to comment on this topic.

This past year I have faced a number of personal crisis’s and began the difficult process of finding appropriate treatment and support. What I write here is my own opinion, based on my own experiences and research. I am not a medical professional and my views are subjectively just my own.

Counselling vs. Treatment

Personally I strongly dislike the term counselling and I never use it for myself when thinking or talking about my own support. Counselling is a trigger word for starters. It was usurped into the group lexicon and for me recalls memories of intrusive “shepherds” in the group who took it upon themselves to pass judgement on every aspect of my life.

Counselling also implies advice giving, which is not, in my experience, what therapy entails. What therapy is, in my experience, is what a participant previously expressed so well: “[it’s] about you placing things properly, it’s not necessarily about you learning, it’s about you understanding.”

The therapeutic practitioners I have seen who have been appropriate and helpful do not tell me what to do, what my “faults” are or what I should or should not think. What they have done and continue to do is to provide assistance, tools and guidance for my own processing of my experiences and thought processes.

Myths and Lies

One of the most insidious myths the Family perpetuated that has haunted me is that: “if you doubt the Family you will go crazy”. After the publication of “The Last State”, in which Merry Berg was portrayed as insane for believing that David Berg was an abusive alcoholic, one of the primary fear tactics used on teenagers and children raised in the Family was that doubting anything the leaders said would make you crazy. The emotional distress caused from the inability to reconcile what was forced on to us as truth and what our minds, bodies and souls screamed to us was consistently and frequently used as evidence of “instability” and “insanity”.

Of course, looking back from the other side of the wall, I can see the insanity in the position that doubting nonsense like “astronomical fakery” and believing that the stars really were millions of light years away meant you were crazy. Yet, even when I became aware of the manipulation and obvious gaslighting, the residue of the stigma and fear of the C word lingered.

This disdain and simplistic dismissal of psychiatric distress can be seen in the slickly manufactured statements from Family spokespersons and leaders regarding Ricky Rodriquez’s “disturbed mental state”. In it’s more raw essence it can be seen in the condescending and sociopathically callous statements from current young Family members such as Lorie Richards on the Dr. Phil message board: “can’t agree more that these folks appearing on your show obviously need help and need to move on with their lives.”

Perhaps the greatest obstacle to overcome for me in seeking professional support has been learning to understand that being in psychiatric distress does not make one “crazy”. I began to educate myself on the effects of trauma and started to understand why I was in so much pain. I began to understand the principles of cause and effect and how the years and years of abuse had built up residue in my body and mind. I began to understand that the pain I was feeling was not my fault nor was it the result of “hanging on to the past” or a conscious choice to relive the trauma. The shame the Family had taught me to associate with my emotional distress was unwarranted and yet another lie. I started to see past my own fear of being “crazy” and to understand that to attempt to ignore the effects of trauma and to ignore my own need for resolution, balance and healing was to silence my inner self all over again.

When I could finally face up to the fact that many things I was doing to relieve my own anguish were in the long term self-destructive, harmful and dangerous, although admittedly providing a measure of immediate and short term relief, I could then begin to look for resolution and treatment.

Trauma and Recovery

The single most useful thing I have experienced this past year since actively seeking treatment has been reading the book Trauma and Recovery (Judith Herman, 1992). While written for health care providers and therapists, it describes, with uncanny accuracy, everything I have experienced. From the self-destructive behaviour I engaged in without knowing why, to the fears, nightmares and unexplained panic, to attempted revictimization by perpetrators, almost each and every passage in this book was something I could immediately relate to.

Most importantly of all, the second half of the book describes recovery for trauma victims, which meant for me that there is a healing process and there is a way out of the darkness and pain.

PTSD and Complex PTSD

From what I understand, when a person undergoes a traumatic event, five neurotransmitters in the nervous system are altered. These are natural and biochemical responses that put the body and mind into hyper-vigilance so as to react for maximum survival in an emergency response situation. However the body’s chemistry becomes radically altered through this process, the after effects of which can be long lasting and is known as post traumatic stress disorder (PTSD).

With a single traumatic event, the after effects can last for some time, but usually will eventually wear off and can be helped with treatment and medication. However when the trauma persists for an extended period of time and is repeated again and again, the body and brain’s chemistry may not just become altered but will radically change. The long term consequences of such neurological hijacking can be profound and is known as complex post traumatic stress disorder (CPTSD). In particular when children undergo extensive and prolonged trauma, the effects are much more difficult to overcome.

As an example, one of the neurotransmitters released during a traumatic event are endorphins, which inhibit pain and relax us. This can enable victims of physical trauma to mobilise themselves as needed to escape further harm and to overcome fear and react in a crisis. As the endorphins subside, the victim may go into a period of withdrawal, similar to opiate withdrawal and may experience irritability and anger. If one has experienced frequent and repeated trauma over many years, the brain may become accustomed to a higher level of endorphin release. This can result in an addiction to the higher level and as a result one may be driven to seek out danger, pain or trauma re-enactment to maintain the neurological levels they have become accustomed to. This behaviour is subconsciously and neurologically driven, without the person consciously knowing why they engage in such things as abusive relationships, self-inflicted harm or dangerous activities.

Another example is the effect of the neurotransmitter norepinephrine, a by-product of adrenaline. Norepinephrine increases alertness, muscle readiness and efficient problem-solving. It enables us to cope with a crisis and do what we must to survive. However, extended stimulation of adrenaline can result in hyper-vigilance long after the danger is past. One may experience insomnia, exaggerated startle responses, mood irritability, panic attacks, muscle and joint pain and tension headaches.

In particular both endorphins and norepinephrine are crucial in encoding the memory of a traumatic event. When both neurotransmitters are present, the memory of an event is recorded in a different way than a typical memory. Most memories are integrated into the consciousness in a somewhat linear way. While there is no hard evidence on this as yet, researchers speculate that REM sleep and dreams help us accomplish this. Traumatic memories can become detached and may become intrusive, resurfacing at inappropriate times and places. They may be triggered by smells, sounds, places, feelings or words that remind one of the event (which is what is meant by a “trigger”). An intrusive memory that resurfaces with force is known as a flashback. The person experiencing such a memory may think, react and feel as though they are right back experiencing the traumatic event.

In addition, people who have endured repeated trauma may have depleted their bodies supply of certain neurotransmitters. When this occurs a person may retreat into avoidance. They may find little motivation for anything at all and generally retreat from life. Learned helplessness, which is a common effect of repeated trauma, compacted with biochemical withdrawal may result in depression. Depression in victims of extended trauma is bio-chemically different from depression in non-traumatised persons in that there is no cortisol present. From what I understand, no one yet knows exactly why this is, but it is a measurable and quantifiable neurological difference.

Why Seek Treatment?

Not everyone who has experienced trauma suffers from PTSD. I however do, and for me the symptoms had been slowly pushing my life further and further out of control for a number of years. It reached the point where I was no longer able to maintain the level of functioning I needed to and my life became unmanageable. In retrospect, I realise it would have been better for me to seek treatment before I reached this stage of anxiety, but at least I am getting help now.

Symptoms of PSTD have been listed as follows:

"The symptom profile of adults who were abused as children includes posttraumatic and dissociative disorders combined with depression, anxiety syndromes, and addictions. These symptoms include
(1) recurrent depression;
(2) anxiety, panic, and phobias;
(3) anger and rage;
(4) low self-esteem, and feeling damaged and/or worthless;
(5) shame;
(6) somatic pain syndromes
(7) self-destructive thoughts and/or behavior;
(8) substance abuse;
(9) eating disorders: bulimia, anorexia, and compulsive overeating;
(10) relationship and intimacy difficulties;
(11) sexual dysfunction, including addictions and avoidance;
(12) time loss, memory gaps, and a sense of unreality;
(13) flashbacks, intrusive thoughts and images of trauma;
(14) hypervigilance;
(15) sleep disturbances: nightmares, insomnia, and sleepwalking; and
(16) alternative states of consciousness or personalities."
- Joan A. Turkus, M.D.

Additional information on the symptoms of PTSD can be found here: http://www.behavenet.com/capsules/disorders/ptsd.htm

For myself, the most intense and distressing symptom of PTSD was dissociation. When my anxiety and level of stress would peak, I would detach and completely shut down. This resulted in memory gaps and “lost time”. I would “wake up” hours later with no memory of how I got where I was or what had occurred in those hours. This was both extremely frightening and dangerous. While this was the most extreme symptom, other symptoms caused a great deal of emotional distress as well.

Friends and Family

Some participants here have said that the role of a therapeutic practitioner can be filled by friends and family. I disagree with this as it relates to trauma recovery and have disagreed with my own health care providers on the level of support these people can and should provide.

Firstly, I think it is unfair for friends to be expected to be in a supportive role for extended periods of time. My own experience has been that turning to friends for support while in the throes of a crisis can overwhelm them and cause them a great deal of stress and worry. While friends can provide short term and immediate support, I do not believe it is appropriate to expect them to carry out this role for any extended time period. In particular if the friend also struggles with similar PTSD symptoms, emotional venting from those they care about can exasperate their own condition. Over the past few years, one of the reasons for my own symptoms worsening has been from the constant expectation of support that I have believed others required of me. This is not anyone’s fault, but as I learn about healthy boundaries I am able to pull away from demands that are unreasonable or unsafe, some of which I had placed on myself.

I believe that writing or interacting on a web site can be different due to the emotional detachment from most of the other participants (emotional flame wars aside). There is also no direct expectation on most participants for support of another.

Secondly, for many of us, including myself, our families are anything but healthy and/or supportive. My parents are still cult members and anything I tell them is duly reported to cult leaders and used as a way to attack myself and others. When not actively participating in my abuse as a child, my parents took on the role of the non-protecting bystander, a position that still generates a great deal of anger for me. My parents still take on this role and their simplistic world-view does not provide any sort of support or care. To even expect support from them does me harm as they again and again choose their own religious zeal over the well being of their children.

With my siblings, as with my friends, I believe it is unfair to expect them to provide extended support. Many of the view-points we grew up with, taught to us by our parents and reinforced by the group, were unhealthy and damaging. When emotions run hot it is easy to fall back into those roles of blame, anger, jealousy and dishonesty. I have had a great deal of anger towards my siblings through much of this year because they have simply not provided the support for me that I have for them for so many years. However, again as I learn more about appropriate boundaries, I realise that the role I previously allowed myself to be cast in was unfair to me and it is equally as unfair to expect them to provide that to me.

Self-Medication

A common by-product of trauma and one that I have experienced first hand for many years is self medication. The first day that I first started coding the first version of MovingOn I was drinking to do so. From that point on almost every time that I have met, talked to or written a co-survivor of TF, I was drinking. I wanted to do what I could to provide support to others and I wanted to keep my promise to myself that no one should ever have to be as alone as I was. But just being around, talking to, or even working on the code for a web site for other people from my past put me into an immediate panic. I couldn’t breathe, my heart would pound, I would shake from head to toe and I had an irrepressible urge to get up and run. The only thing that would keep me there was a drink or two or three or more.

I have been in treatment for my drinking. I have been learning other ways to cope with my obligations and I have also been learning that some obligations I think I have I can actually walk away from. As a trauma survivor, self-medication, whether drinking in the past few years or other substances in the previous ones, is what I have found as an immediate relief from the panic and the pain. I have tried to hide it most of the time, but it is what is and I am now at the point where I can face it. I have not been entirely successful in overcoming this and still find it very difficult to be around a large number of former survivors without alcohol, but it is getting better.

PTSD and CPTSD is a result of neurochemical imbalances in the brain. Medication can help bring the AWOL neurotransmitters under control and help to restore balance in the body. (If you don’t believe that neurochemistry fundamentally alters us, try seeking comfort from a PMSing woman or getting a truthful answer from a sexually aroused man.)

I find myself now looking to my own advice and something I have told many of my friends and family throughout the years who have also gone down this road: “if you self-medicate, why not see a doctor? At least the drugs you get from them are regulated, not cut with anything and can be specifically tailored by a specialist to treat your specific need. They are not illegal and can actually help your neurochemistry in the long run instead of doing who knows what to it.”

Psychopharmacology

I do think that many doctors tend to gravitate towards medications they have a vested interest in, whether or not they are the most appropriate for their patient. I know for a fact that here in Canada, pharmaceutical companies have relationships with hospitals, clinics and researchers and fund grants and research in exchange for recommendations and prescriptions from medical practitioners to their patients.

That being said, medication can be extremely helpful in the treatment of CPTSD. There are drugs that can alleviate the trauma of nightmares and deal with insomnia. Anti-depressants can treat suicidal ideation, anxiety and depression. Other medications can help with disassociation and flashbacks. Medication alone is not seen an effective treatment for PTSD, but studies have found that a combination of medication and psychotherapy is the most effective form of treatment.

There are a number of medications that are used for PTSD treatment. These include:

Sertraline (Zoloft) – A 2000 study concluded that: “Our data suggest[s] that sertraline is a safe, well-tolerated, and effective treatment for PTSD.” As of May, 2000, the U.S. Food and Drug Administration (FDA) approved this medication for treating PTSD.
Paroxetine (Paxil) – A 2001 study stated that: “Paroxetine treatment resulted in statistically significant improvement on all three PTSD symptom clusters (reexperiencing, avoidance/numbing, and hyperarousal), social and occupational impairment, and comorbid [concurrent] depression.” In 2002 the Therapeutic Products Directorate (TPD) of Health Canada approved Paxil for the treatment of PTSD.
Citalopram (Celexa) - Affects the concentration and activity of the neurotransmitter serotonin, a chemical in the brain thought to be linked to anxiety disorders.
Fluoxetine (Prozac) – A 2002 study found that “Fluoxetine is effective and well tolerated in the prevention of PTSD relapse for up to 6 months”.
Fluvoxamine (Luvox) – A 1992 study of Dutch WWII veterans found that “treatment with fluvoxamine may offer alleviation of chronic PTSD symptoms, in particular insomnia, nightmares, anxiety, intrusive recollections, guilt feelings and tiredness.” .

Medications considered second line treatments for PTSD are:

Venlafaxine (Effexor) – Often used to treat panic and anxiety disorders. A 2005 study found “Patients with posttraumatic stress disorder (PTSD) showed significant improvement when treated with sustained-release venlafaxine”.
Nefazodone (Serzone) – A 1999 study concluded “Nefazodone showed a broad spectrum of action on PTSD symptoms. This profile might make nefazodone a useful drug to treat PTSD.”
Mirtazapine (Remeron) – A 2002 report found that “of more than 300 patients treated, approximately 75% have reported improvement due to reduction of the frequency and intensity of nightmares. A substantial minority of these patients have reported a total absence of dreams related to the traumatic events.”

Other medications may include:

Quetiapine (Seroquel) – This is a mild anti-psychotic. While apparently questionably ineffective in treating psychosis, it is effective in the treatment of insomnia, nightmares and disassociation.

Medications to avoid:

Benzodiazepines – they are addictive and the effects are similar to intoxication. Benzos are sometimes effective in providing immediate and short term relief from intense anxiety. However long term use renders them ineffective and after a couple weeks a physical dependency is likely to occur.

Common benzodiazepines include:
Diazepam (Valium)
Alprazolam (Xanax) – The staff of the in-patient PTSD unit at the American Lake VA in Washington State have published a paper reporting extreme violence by combat vets treated for long periods with Xanax and then taken off of it. This was apparently more frequent and more severe than what they found taking their patients off of other benzos, such as Valium.
Lorazepam (Ativan) – Commonly prescribed as an anti-anxiety medication.

Other medications to avoid are:

Yohimbine (Actibine, Aphrodyne, Yocon, Yohimex) Causes flashbacks and panic attacks. This drug is sometimes used to treat impotence.

Hypnotic sleep-aids such as Immovane are used to treat insomnia and can be useful in overcoming sleeplessness. However, these medications may also affect memory and if something happens between the time you take the drug and the time you fall asleep, you may have no memory of it, which can be frightening.

Medications can interact badly with other drugs and substances. It is important to discuss all other medications you may be on with your doctor and to be honest about your substance use. In addition, herbal remedies (such as St. John’s Wort) can also interact with medications and should be discussed with your doctor. In particular Ma Huang (Ephedra) has been marketed as a natural weight loss supplement and sinus decongestant. This herb contains ephedrine and can react very badly with many medications and can also cause panic, nervousness and heart palpitations all on it's own.

Therapeutic Practitioners

There are different types of therapeutic practitioners, with vastly different levels of expertise and focus among each type.

Psychiatrists
These are medical doctors who can prescribe medication for different conditions. A psychiatrist undergoes basic medical training and then chooses to specialise in psychiatry, for which further training and study is needed. Psychiatrists may also be skilled in different talk therapy approaches, but will very probably prescribe medication as well. PTSD and complex PTSD are psychiatric disorders and are generally classified under anxiety disorders.

Psychologists
A psychologist is not a medical doctor, but is trained more in the psychological and behavioural aspects of mental health and illness. A psychologist has a Ph.D or Psy.D degree and may specialise in clinical or counselling psychology. Psychologists today often focus on cognitive-behavioral therapies (talk), and do not have as intense a training regime in the biological components of mental health disease as psychiatrists.

Licensed Social Worker (L.S.W.)
Licensed social workers are also considered mental health providers because many deal with the issues surrounding life events, substance abuse, family conflicts, disabilities, and violence. However, unlike psychiatrists and psychologists, social workers may also address problems such as inadequate housing, health and work problems.

Licensed Counsellor/Therapist
There are a variety of additional certifications with focuses on different aspects of mental health. These may include: substance abuse, alcoholism, family and children, school therapy, etc. In the US, a therapist may be licensed to practice only in a particular state, and may not be able to provide support to those outside of the geographical area of their own practice.

The Treatment Process

In the book Trauma and Recovery, Judith Herman outlines the process of recovery from CPTSD. This landmark book has become the most common form of trauma treatment and is utilised by many trauma specialists. The three main stages are: Stabilization, Resolution and Reconnection.

Stabilization
Most specialists will not begin treatment if they feel that you are currently in crisis. An initial level of stability is needed in order to begin trauma work and is often a requirement for admission into many trauma programs.

In addition, if substance use is an issue, many specialists will require you to be clean and sober before beginning work. This can be difficult, as substance use is often used by trauma victims to self-soothe and cope with traumatic memories. The notion of attempting trauma work without this coping mechanism can seem overwhelming. However, treatment for substance use can be found through a number of different self-help groups and specialists who can provide support for this particular issue. In recent years practitioners are also starting to understand the need for concurrent treatment and many programs can now offer addictions treatment along with trauma work.

The first step of many trauma recovery programs is to provide a safe place. Without the establishment of trust and feeling of safety, it is impossible for the other stages to progress. A number of techniques for controlling intrusive memories, panic attacks and nightmares may be taught to the client. This enables the progression into more intense trauma work without the process becoming overwhelming and unmanageable.

Resolution
Techniques such as narrative trauma processing allow the patient to tell their own story in their own words. The creation of a detailed coherent narrative with a beginning, middle, and end brings together the fragmented images of the trauma. The therapist may employ techniques such as the development of both an objective account of events and a subjective account of what the trauma felt like and what it meant for them.

This is an intense period of treatment for both patient and therapist and it is essential that the therapist be sufficiently skilled to effectively facilitate this stage. Alice Miller has described the role of a therapist as an “enlightened witness” to a survivor. Clarity, space and compassion are the three qualities of bearing witness. This is an important skill for the therapist while treating a client with shock and trauma.

“the adult who has grown up without helping witnesses in his childhood needs the support of enlightened witnesses, people who have understood and recognized the consequences of child abuse. In an informed society, adolescents can learn to verbalize their truth and to discover themselves in their own story. They will not need to avenge themselves violently for their wounds, or to poison their systems with drugs, if they have the luck to talk to others about their early experiences, and succeed in grasping the naked truth of their own tragedy. To do this, they need assistance from persons aware of the dynamics of child abuse, who can help them address their feelings seriously, understand them and integrate them, as part of their own story, instead of avenging themselves on the innocent.” (Miller, 1997)

“With the help of an enlightened witness, our early emotions will stand revealed, take on meaning for us, and hence be available for us to work on. But without such empathy, without any understanding of the context of a traumatic childhood, our emotions will remain in a chaotic state and will continue to cause us profound, instinctive alarm.” (Miller, 2001)

The goal of this stage of trauma work is to integrate the fractured traumatic memory into a cohesive whole. Techniques such as cognitive reframing, Video-dialogue and somatic interventions may assist with this process.

Reconnection
At this stage of the process, group therapy is often used. Reconnection is described as a time of "I know I have myself". At this stage one can explore the positive changes wrought by the traumas, celebrate the survivor self, and discover intimacy with others in ways that were not possible before.

In the previous two stages, isolation is a common feeling. In the reconnection stage, one can begin to feel a part of the larger society again. Studies show rape survivors and demilitarized soldiers that go on to recount their experience, help others cope, testify, etc. eventually loose PTSD symptoms. Specialists say at this stage is it truly safe for a person to confront perpetrators, to participate in media truth telling or other people's healing.

There are a number of additional and alternative treatment processes for PTSD sufferers. These include:
Autogenic Therapy - http://www.autogenic-therapy.org.uk/
Eye Movement Desensitization and Reprocessing (EMDR) - http://www.emdr.com/
Somatic Experiencing - http://www.traumahealing.com/intro.html
Cognitive Behavioural Therapy – http://www.cognitivetherapy.com/
Group Therapy – http://www.group-psychotherapy.com/
Psychosocial Rehabilitation – http://www.psychosocial.com/
Addictions and Trauma Recovery Integration Model (ATRIUM) - http://www.dustymiller.org/

An in-depth look at a number of different treatments for PTSD can be found in the book Effective Treatments for PTSD: Practice Guidelines from the International Society for Traumatic Stress Studies

Finding Support

In my own quest for treatment and support, there have been some principles I have learned that have greatly helped with finding appropriate care.

Educate Yourself on Your Own Condition
Understanding what you are experiencing is very helpful in both being able to gain control over one’s condition and in expressing and describing your symptoms to a health care professional. Simply understanding that you are not weak, bad or wrong to feel the way that you do is very helpful in maintaining hope, looking for solutions and progressing towards recovery. For me, learning that there is a natural and biological response to trauma relieved much of the guilt and shame I felt in not being able to “just get over it”.

Be as Clear and Accurate as Possible when Initially Speaking With Practitioners
PTSD is very frequently misdiagnosed. The symptoms and effects of trauma can look much like other illnesses and are often wrongly labelled. When you first meet with a health care professional, they will most likely complete an initial assessment of your condition and then make a diagnosis. It is important for this to be accurate as, like most of us, after making a decision practitioners tend to stick to it. The diagnosis may also become part of your permanent health record and it is very important that it is accurate.

Something that can greatly help this process is to, if at all possible, describe rather than act out feelings and emotions. For example, if something makes you angry, rather than reacting in anger, verbalising the feeling can be more useful in helping them understand what you are experiencing and why. “I am feeling very angry right now about X. I understand that my reaction may seem disproportionate, but my anger is due to experience Y, which X is reminding me of.” This is very difficult to do, and health care professionals should be trained to explore reasons for behaviour and reactions, but they do not always do this, nor do they always interpret behaviour successfully. If you can verbalise as much as possible, it can be very useful in reaching an accurate understanding and deciding on an appropriate form of treatment. This level of emotional detachment is only needed in the initial assessment phase. Once the practitioner has accurately diagnosed your condition and you have a mutually agreed on plan of treatment, you can then more safely begin to access and explore your feelings and emotions.

Find a Suitable Practitioner
It is very important to find someone who you can work with appropriately. I have sought treatment in previous years from a number of different therapists and doctors. Some of these were profoundly unhelpful, and I now understand the fault was not usually with them personally, but that they were not trained in the areas of specialty that I needed treatment for. For example, I once went to see an art therapist who specialised in women’s issues. It was very weird and uncomfortable for me and her proposed treatment seemed rather flaky and odd. After that experience I wrote off therapy for a number of years. It was not that the process was wrong, but she was not qualified to treat me. If you know and understand what you need treatment for, it can greatly help in finding a suitable specialist. Some specialists may provide a referral service and will complete an assessment with you and then refer you to an appropriate practitioner.

If possible, I strongly believe it is best to find a practitioner who has access to a team of specialists. Someone who works with a clinic or has hospital privileges will have access to support themselves from colleagues. The treatment of Complex PTSD can in itself create trauma for the practitioner, and while this is not your responsibility, if your provider has access to support from colleagues, this risk can be lessened. In addition you will also have the added benefit of the expertise of the entire team through your own health care provider if needed. A team based environment also provides a level of accountability for the practitioner that may not be available if they are solely in a lone private practice. A health care provider should not take you on if they are not qualified to do so. If they must present your case to the rest of the team before admission into a program, the risk of your investing resources and energy into something that is not suitable for you is considerably lessened.

Most importantly, the relationship between yourself and your health care provider must be based on trust. If you are not comfortable with a particular individual for reasons that go beyond discomfort in talking about traumatic events or worry about the recovery process, then change practitioners.

Keep Copies of All Documentation
What I have found to be useful is to maintain a full record of all practitioners seen, referrals made, diagnosis’s and medical and therapeutic treatment. As an overview, I made a chart with the facility, name and contact information of the specialist, medications dispensed, treatment received, dates seen, and referred by whom, which I update as needed. This has been very useful when seeing someone new or when needing to refer back to a specific time or date. The process of finding treatment can seem overwhelming and confusing and having this organized and at hand has helped me to navigate through the procedure more comfortably.

You also have the right to access your own medical records and only in rare cases where the doctor believes it could cause you or someone else direct harm can they deny you access to these records. It can be stressful to read a diagnosis and comments made about you in a dispassionate manner, but if you wish to do so, you can then ensure the accuracy of these records. Sometimes requesting your records from the treating specialist and having them go through them with you can be helpful. You can then point out and explain anything they may have misunderstood and can also have them explain anything to you that is not clear.

Learn About Insurance Obligations and Payment Options
The world of medical insurance is a nightmare to navigate through when you are in the throes of a crisis or in the process of undergoing trauma treatment. Find out all you can as soon as possible about your options and obligations from your insurance company. A group health policy can be confusing to understand, but in larger companies a member of the human resources or occupational health department is often available to help explain it to you and guide you through the process.

For example, does your insurance cover therapy from a licensed therapist or is it restricted to medical specialists such as psychiatrists? In Canada and other countries with a national health care plan, you cannot see a medical specialist without a referral from your family doctor. What sort of documentation does the insurance company require from your health care provider? Is PTSD considered an existing condition by your insurance provider and will they cover treatment for it?

In addition a number of therapists will provide services on a sliding fee scale. If you can demonstrate financial need, they may be able to offer you support for a reduced rate. Find out if this is available and what documentation they require.

Know Your Rights
Your medical and therapeutic history is strictly confidential. People such as your employer or family may want to know details of what your condition and treatment is. You are under no obligation to disclose any of this information.

Therapeutic practitioners are also bound by a strict code of conduct and medical ethics. Find out from them what these are and what your rights in sessions are.

If you believe that your rights have been violated, you have the right to seek recourse. Find out what the complaint process is for a therapeutic practitioner, insurance company, employer or any other party that has caused you harm. It can be extremely difficult to stand up to an authority figure, especially if you are in a vulnerable state, but regaining a level of control over something that directly affects you can be very helpful in ensuring that you are the primary person who guides your own recovery.

You are under no obligation to blindly accept what you are told if you disagree, and you have the right to mutually respectful care. I have found that a crucial aspect to rebuilding my capacity for trust is to research what I am told for myself. As I find objective outside substantiation, I find I am able to begin to safely open up, knowing that I can also disagree if I need to.

Understand the Responsibilities of Therapeutic Practitioners
There are two situations in which the confidentiality of your treatment may be broken. These are if the practitioner believes that there is a definite risk of harm to yourself or to another person. If a physician believes that there is an immediate risk of harm to yourself or another, they may involuntarily hospitalise you. I can think of few things more traumatic for our demographic than being involuntarily hospitalised and this in itself can compound the effects of trauma that you are seeking treatment for.

To avoid this situation discuss with your provider as soon as possible what feelings of self-harm and anger towards others are actually like for you. If you have lived with daily suicidal ideation for many years, explain this to them and explain the difference for you between thoughts of self-harm and acting on it. If revenge fantasies are common for you, but you have no history of violence or harming others, make sure they are fully aware of this. Explain to your practitioner why hospitalization would be so traumatic for you and make sure they fully understand this. Ask the practitioner up front what specific circumstances would cause them to take action to protect you and/or others from harm. You can then work with them to prevent this from arising.

Additional Information and Resources:

http://ptsd.factsforhealth.org/PTSDGuide.pdf
http://www.ptsdalliance.org/home2.html
http://www.healthyminds.org/multimedia/ptsd.pdf

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from ESJ
Thursday, December 29, 2005 - 19:46

Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5(Agree/Disagree?)
Fantastic, Jules, bloody fantastic! An excellently well-informed and well-presented explantion of what I've seen many ex SG's (and even many ex FG's, especially mothers), experiencing (either privately and secretly, or overtly and dramatically) once they begin to really come out of the fog of denial and internal supression their psyches have been entrained into for a large part of their lives in TF.

To differing degress, those of my children who spent most of their childhood in TF, and even I myself, have personally gone through a lot of this stuff since exiting the cult. (I know of several FG mothers who, like myself, experienced repeated repressed trauma over our being brainwashed and bullied into being 'sex slaves' and 'sex bait' to men we were repulsed by or abused by, and living in an environment of 'constant percieved threat' to ourselves and our children, while being entrained to believe this was all 'wonderful' and for our own and our childrern's 'highest good'. (ie: the 'learned helplessness' equivilant to the 'battered wife syndrome').

All this was/is the ultimate recipe for producing various disocciative disorders (ie: internal fragmentation or 'splitting'), which is why I believe so many FG and ex FG parents, especially mothers, (who have no understanding of what has happened to them) come across as'loopy' or dysfunctional, and are in various states of denial. - (I know of several ex FG mothers, for instance, who have experienced breakdowns and clinical depression and even been hospitalized and diagnosed with a mental illness such as bi-polar).

So if this is the toll it has taken on the FG's who had some semblence of a 'normal' life before joining TF, the effect this environment and enculturation has had on the second generation must be multiplied exponentially. In the FG's the disocciative disorders come from the complete suppression and denial of their former pre-cult personality and critical thinking faculties. In the SG's the disocciative aspect of PTSD actually may not appear so pronounced because many SG's didn't get much of a chance to develop their 'authentic self'in the first place, so the 'disocciativeness' is actually their primary state of mind until such a time as they are ready to question everything they believe and look at the truth about their childhood repressed pain - (which they often don't believe even exists while still stuck in TF's mindset). This is the'complex' aspect of PTSD.

I can relate completely to your need to turn to some substance to 'dull the pain' while having to deal with the issues coming up for other SG's on 'Moving On.' I often feel very heart sick and disturbed reading about the SG's stories, because it is so close to home in regards to my children's and my own experiences. I find that even just looking through copies of TF's literature is incredibly draining and effects me deeply. Now seeing with a freed mind and clearer perspective, TF pubs are so dark and delusional and manipulative and disturbing. It triggers old feelings and memories of what now feels like another life that was a nightmare.

Anyhow, all that to say, thanks heaps for this very relevent contribution. I'm printing copies off for my kids (who are usually too busy and preoccupied with their lives to research the psychological factors so much) and a couple of other SG's I know who need this info. There are other issues along these lines I'd like to discuss, too, but I'm on holiday with my family and minding my young grandson, so it'll have to wait till have some more free.



the required 'cost' of 'living the highest truth'. being under constant 'threat' from for Unfortunately we went the circuitous route of trying many counsellors and professionals, most of whom had no idea whatsoever of for usexperienced

The reason I feel so understanding of my own kids and other ex SG's is because I went through a similar experience
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from SeanSwede
Sunday, December 25, 2005 - 13:09

(Agree/Disagree?)
I am personally corresponding with researchers and doctors along the lines of psychiatry overseas while I am studying to become a worker within psychiatrics.
The project that we are working on and is somewhat something that I sort of came up with and which I presented to these research doctors was a theory about how religion causes mental psychosis. Different types of schizophrenic behaviours and/or symptoms such as phobias and illusions etc. Pulling out of a mental way of thinking or living ones life can result in changes and confusions with can demonstrate themselves in different types of psychosies.
The rarely spoken fact is that religious people are one of the largest risk groups for contracting mental illnesses. The question is, how healthy is it, really, for people to engage in religious activities of all and any types? I know this sounds completley radical but doctors have proven this for years and I`m sure alot of you out there can agree with those facts and are yourself going through mental rehab.
The fact of the matter is that belief in having seen supernatural activies are really just illusions of the mind and the claims of people having seen "visions" etc are symptoms of mental illnessess commonly caused either geneticly or thru stress or negative experiences. In many cases they are first started in childhood. The consious or subconsious missinterpretation of communications such as being submitted to delusions of various sorts which results in pre- induced mental sicknesses along the way or which in later life visually exerts itself in various behavioural disorders.


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From GoldenMic
Monday, December 26, 2005, 10:20

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I hear what you are saying, and I think I see how some of this could help you make sense out of the insanity of a cult past. At the same time, I encourage to continuing looking deeply, because the issue is complex. For instance, while psychiatry labels visions as hallucinations, and assuming they have the mechanism aptly described, why does that make the psychiatric reality any more or less "in the mind" than anyone else's reality? Also, while I completely support your implication that religious oppression and religious abuse is mentally unhealthy, I doubt that you have the historical evidence to prove or disprove a connection between all religion and psychosis, especially in the absence of a significant control group. Even so, these are thoughtful questions and ideas, forcing one's brains into action, and appreciated!(reply to this comment
From
Monday, December 26, 2005, 12:03

(
Agree/Disagree?)
Still stuck on religion, aren't we. Go any mental institution & you will find people saying that they talked to god or saw him, then all you have to do look on TV or in any religious organization and they say the same thing. Who is telling the truth? Who has the right to lock some up & others no? Are you an expert? Do you have the knowledge enough to judge some & leave thousands of others loose? If you look closely at religious experiences they stink of the same thing that you find in mental institutions. Now either they all are telling the truth & in which case we should release the mental patients, or maybe we should put the religious freaks in institutions. All religions started by some grand experience or vision. If we are putting all these people away in institutions maybe we are stopping the next true path to god. Or maybe we are saving the world from millions of deaths in the name of religion. Maybe we could have saved whole cultures & millions if we only had mental institutions around thousands of years ago to put all the "visionaries", "god viewers" & "speakers with god". Are we loosing vital information on god by locking them up or are we sparing the sanity of society. (reply to this comment
From GoldenMic
Monday, December 26, 2005, 13:26

Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5(Agree/Disagree?)

I am not sure how you decided that my comments equate to my being "stuck on religion", but I was actually trying to suggest that it is religious oppression that is objectionable, rather than religion per se. Theoretically, I think its fine for people to join with others in a shared vision or cause just so long as they do not impose it on others or abuse people in the name of that cause, which is what happened to us. As for being stuck on the issue of religion, it is part of my own long process of freeing myself from my years of childhood abuse at the hands of religious zealots, and I feel no shame in continuing to work through that until I have some peace on the matter.

Regarding the issue of people being put away for their visions, I was fascinated by your contrast of losing something vital versus sparing society. That's an an excellent question/observation, though there seems little doubt that the human response to religion has frequently resulted in horrors and oppression, though possibly religious inspiration has resulted in some good, too, from an historical perspective.

As for the question of locking people away, sadly, I am indeed an expert, and I have periodically tried to help schizophrenics and addicts with assisting in time-specific hospitalizations. I think that involuntary hospitalization is tragic, if periodically necessary (i.e. great harm to self or others), but that voluntary participation in intensive residential counseling is sometimes helpful. I may not like it, and I am glad I haven't yet felt the despair needed to utilize it, but I am also glad that some few friends and clients over the years have had this option.(reply to this comment

from tuneman7
Sunday, December 25, 2005 - 10:16

(Agree/Disagree?)

Excellent post Jules,

Merry Christmas!


(reply to this comment)

from GoldenMic
Saturday, December 24, 2005 - 17:00

Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5(Agree/Disagree?)

You have written an excellent commentary and study on the basics of trauma research and treatment, possibly the most broad-based and current examination of the issues I have ever seen, at least in such a concise package.

Meanwhile, you have laid out your personal life and pain openly and without excuse or blame. You have taken a real whack at the illusion where people admire one because they think one is perfect enough or strong enough to bear their burdens. I gave a lot of thought to your comment about the probable unfairness of expecting friends to bear one's pain for too long. I also wonder how many of us you were echoing when you spoke of the chemical assistance needed to even look at the horror of our past. Thanks for saying these things.
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from Wolf
Saturday, December 24, 2005 - 08:22

(Agree/Disagree?)
lots of good sex: cheaper and possibly more effective
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from Benz
Friday, December 23, 2005 - 15:17

(Agree/Disagree?)

I truly feel sorry for people who seem to want to have us believe that emotionally involved or charged discussions are to be written off as irrelevant or based on flawed logic.

I appreciate most of what you've written Jules, however I can't help but feel that for the most part only a maddening primal scream could express the mental torture and anguish that TF childhood was for me.

I'm out of there now! They can't hurt me any more (or can they?). I'm in control of my own destiny from here on in (or am I?).

The "emotionally detached" approach is only a defense mechanism. When someone loses a loved one what is the "appropriate" response. - Oh yes, it must be "emotional detachment" because we all KNOW that that is the "intelligent" way of responding. Detachment, philosophizing, fatalistic tripe, it's all a cop-out.

I am neither in control or out of control.

You talk of "learned helplessness". A psychology student I know lent me some of her textbook which I found particularly interesting:

"Helplessness in dogs ... learned helplessness, an acquired sense that one can no longer control one's environment, with the sad consequence that one gives up trying (Seligmen, 1975).

The classic experiment on learned helplessness used two groups of dogs, A and B, who received strong electric shocks while strapped in a hammock. The dogs in group A were able to exert some control over their situation. They could turn the shock off whenever it began simply by pushing a panel that was placed close to their noses. The dogs in group B had no such power. For them, the shocks were inescapable. But the number and duration of these shocks were exactly the same as for the first group. This was guaranteed by the fact that, for each dog in group A, there was a corresponding animal in group B whose fate was yoked to that of the first dog. Whenever the group A dog was shocked, so was the group B dog. Whenever the group A dog was shocked, so was the group B dog. Whenever the group A dog turned off the shock, the shock was turned off for the group B dog. This ensures that the physical suffering meted out to both groups was precisely the same. What was different was what they could do about it. Group A was able to exercise some control; group B could only endure.

What do the group B dogs learn in this situation? To find out, both groups of dogs were next presented with a standard avoidance learning task in which they had to jump from one compartment to another to avoid a shock. The dogs in group A learned this task easily. During the first few trials, these dogs ran about frantically when the shock began but eventually scrambled over the hurdle into the other compartment. Better still, they soon learned to jump before their grace period was up, thus avoiding shock entirely. Things were different, though, for the dogs in group B, the dogs who had previously experienced the inescapable shock. Initially, these dogs behaved much like any others, running about, barking, and so on. But soon became much more passive, they lay down, whined quietly, and simply took whatever shocks were delivered. They neither avoided nor escaped; they just gave up trying. In the first phase of this experiment, they really had been objectively helpless; there truly was nothing they could do. But in the shuttle box, their helplessness was only subjective, for there was now a way in which they could make their lot bearable. But they never discovered it. They had learned to be helpless (Seligman and Maier, 1967).

Helplessness and depression - Martin Seligman, one of the discoverers of the learned helplessness effect, asserts that a similar mechanism underlies the development of certain kinds of depression in humans. Just like animals who have been rendered helpless, these patients show no initiative, and "just sit there". Both are slow to learn that something they did was successful; both lose weight and have little interest in others. To Seligman and his associates these parallels suggest that the underlying cause is the same in both cases. Like the helpless dog, the depressed patient has come to believe that his acts are of no avail. And Seligman argues that, like the dog, the depressed patient was brought to this morbid state by an initial exposure to a situation in which he really was helpless. While the dog received inescapable shocks in its hammock, the patient found himself powerless in the face of bereavement, some career failure, or serious illness (Seligman, Klein, and Miller, 1976). In both cases, the outcome is the same - a belief that there is no contingency between acts and outcomes and so no point in trying." -Gleitman, Fridlund, Reisberg, Psychology 5th Edition, 1998 New York Norton

To me Jules, at least having emotion shows one isn’t “just sitting there”, accepting ones’ fate. I wonder if there are group A’s and B’s who grew up in TF? – Ones who had more control of their situation for one reason or another and therefore have developed better coping skills (A), and ones (B) who were truly helpless and have never been able to exercise control of their environment and for whom those neurotransmitters have never been sufficiently activated. – If so, could this explain why some people stay in TF? – Have they developed the belief (perhaps only subconsciously) that “there is no contingency between acts and outcomes and so no point in trying ”

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From Otter
Friday, December 23, 2005, 15:35

(Agree/Disagree?)
Your example of the dogs totally shows what I was trying to say in my article "spoiled brat". I was trying to bring out the fact that we had no way of stopping the abuse so we just gave up & learned to live wit it. He on the other hand I think had a bit more say. As in the example I don't think that he did suffer, it's just that we had no choice & learned to be quiet & control our anger more.(reply to this comment
From anovagrrl
Friday, December 23, 2005, 16:07

(Agree/Disagree?)
The research on the resilience to survive adverse childhood experience suggests two important factors: 1) level or inate intelligence and, 2) the presence of a significant adult(s) who gave the child an alternate window on the world. I believe Rick was innately intelligent, but his extreme social isolation hampered his capacity to develop resilient coping strategies. What explains the resilience of "successful" Family survivors, therefore, is that they are both intelligent (however you want to define that), and they experienced some level of exposure to the "real" world while growing up. Begging on the streets for donations meets that requirement. There are different kinds of intelligence--it isn't all about book smarts--but the fundamental characteristic of intelligence is curiosity about life, the world at large, and openness to the diversity of human experience. (reply to this comment
from anovagrrl
Friday, December 23, 2005 - 10:10

Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5(Agree/Disagree?)

Excellent article, Jules. I especially like the fact that you've discussed the neurochemical and physiological changes that occur in the brain as a consequence of trauma. As a behavioral health policy worker, I'll be straight-up honest about the lack of trauma-informed treatment options available to the general public both in Canada & the US. This is very frustrating, because the brain science on childhood and adult trauma is hardly a secret. We also know what sort of treatments work to alleviate symptoms and improve quality of life. Something that keeps me coming to work every day is that I'm currently working on a statewide initiative to disseminate training in trauma-informed assessement and treatment. I suspect that one reason clinicians, particularly doctors, have been so slow to pick up on the pervasiveness of trauma in the lives of their patients is the widespread denial in our culture about the maltreatment of children.

However, the hard nut of denial in the medical establishment is starting to crack a little. An extremely important study funded by the US Centers for Disease Control (CDC) looked at the relationship of physical health issues and a history of adverse childhood experiences and found a strong causal relationship to alcohol & drug abuse, smoking, obesity, and high risk sexual contact. These risk behaviors exponentially increase the likelihood for developing physical health problems like diabetes, hypertension, lung and heart disease, and STDs. The net result is that people with three or more incidents of an adverse childhood experience have a much higher mortality rate than the general population. More information on the study is located at: http://www.acestudy.org/.

We've had a degree of success with getting the physical health establishment in some areas of my state to look at the implications of this study, but the barriers to transforming the system of care are enormous. It makes me heartsick to read comments from people about going to doctors who discounted or dismissed their histories of adverse childhood experiences in the cult. To me, this is just another indicator of the massive denial and misplaced priorities of our society. The real barriers to widespread recognition of the devastation caused by child maltreatment are not medical or social, they're political and economic.
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from A friend
Friday, December 23, 2005 - 09:00

(Agree/Disagree?)

Jules,

When you get a chance pick up "The Stranger in the Mirror: Dissociation - The Hidden Epidemic – By Marlene Steinberg". I'd be very interested in your opinion.
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From anovagrrl
Friday, December 23, 2005, 15:37

(Agree/Disagree?)
I know you asked Jules for an opinion on this book, but perhaps you'll be open to the opinion of a trauma survivor and behavioral health professional who has lived with dissociative processes for the better part of 40 years? If you can understand the phenomenon of dissociation, you will begin to understand many things that pass for religious experience. You will also understand how someone can cut a three-inch long, one-inch deep incision into her abdomen, stitch it up with an upholstery needle and silk thread (all without anesthesia), and only come to the attention of medical practitioners when the wound becomes infected a week later. Dissociation is an extremely powerful survival mechanism. I believe that those of us who can do it make it further in life than those who don't, won't, or can't. At the same time, we have to recognize that dissociative processes are not always the most appropriate coping mechanism when stress bangs us over the head like a sledgehammer.(reply to this comment
from Too many unqualified
Friday, December 23, 2005 - 04:56

Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5(Agree/Disagree?)
I've been to 11 different doctors & they all said the same thing as someone mentioned here. That, I was imagining things, that it didn't happen. And I never talked about any wierd things, just mentioned the countries I lived in & having lived in a cult. I mentioned I spoke different languages, what did they do, told me I was delusional. I told them to bring someone who spoke those languages & I would speak to them in those languages. They just said I was rammbling & needed more medication. Sometimes giving me so much & cocktails of medication, that I was just like a zombie. Then they gave medication that afterwards I was to find out it's side effect was to make you panic. How can so many doctors out there claim to be so smart & yet be so dumb?
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From Jules
Friday, December 23, 2005, 22:24

Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5(Agree/Disagree?)

I experienced the same thing with the very first psychiatrist I went to see when I first left the Family. He also told me I was delusional and in addition had some very derogatory and judgemental comments regarding my self-destructive behaviour. I got up mid-session, walked out of his office and never came back.

That was ten years ago and a great deal has changed since then. Ironically for me, since this web site has contributed to my personal stress over the past few years, MovingOn has been very useful to me in both validating my own story and educating health care professionals on life in the Family for a child. I no longer even bother to try to educate them on the generalities of life in a cult for a child. I direct them to this web site, xfamily.org and to the media interviews archived online and leave it at that. Any therapeutic practitioner who is worth anything will take the time to research things they do not understand for themselves. If they are not willing to do this, I will not invest anything into in working with them.

This year, even with all the self-education I have done and with all the evidence out there, I was misdiagnosed by one of the physicians I saw. I refused to accept their conclusion at face value, but requested my medical records from them, obtained a second opinion and made sure that I fully explained my objections to them. The diagnosis was withdrawn and a more accurate one was made instead.

It is extremely unfair that this seems to be the case, but I have found that you have to know almost exactly what it is you need in order to find appropriate help. In particular crisis and intervention specialists are not skilled in understanding cultural differences for invisible minorities and do not know how to translate language they may not understand (such as Family terminology). If you can communicate with them using their own terms or more generalised descriptions of your distress, it can help speed up their understanding.

One of the other key things I have learned through bitter trial and error this year that I did not include above is the need for an advocate. Health care professionals in particular can sometimes have an attitude towards their patients similar to an IT professional’s thoughts about a “user”. They do not always listen properly and can easily mistake certain symptoms as being evidence of more common disorders than CPTSD, while overlooking the larger picture.

If you can find support when you are not in crisis and can develop a relationship with a health care professional who does get it, understands and supports you, this person can function as an advocate for you while seeking trauma and specialist treatment. A family doctor who has known you for some time can fill this role. For me, my substance abuse therapist has been that person this year. An advocate can explain in language that a specialist understands what the issues are that require treatment and communicate with them as one health care professional to another.

I am personally sceptical about the effectiveness of long-term recovery plans from cult experts for those of us born and raised in these groups. People who specialise in helping adult joiners recover from their cult experience have not as yet developed a long-term recovery model specifically for those born and raised. Personally I have found that I have more in common emotionally and socially with survivors of child sexual exploitation, child survivors of war, torture, incest and slavery than I do with people who joined cults as adults. That being said, one of the ways that specialists who understand cult issues can be of greatest help to us, IMO, is through the ability to translate what we have experienced into terms that other practitioners can understand. They can be very powerful advocates and can help with the initial safety trauma recovery stage and the referral process immensely.

The concept and practice of advocacy from professionals for our demographic is something I have hoped that SPF will be able to develop. A number of specialists have expressed interest in this facilitation.

I have myself experienced this dismissal and disbelief first-hand and I completely understand how upsetting and frustrating it can be. The dire necessity for education, advocacy and awareness is something that has driven me for many years.
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from Thank you
Thursday, December 22, 2005 - 23:40

Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5(Agree/Disagree?)

Excellent article with tons of good information. Thank you for putting all of this together! I know I will be referring to it in the future.

I have been fortunate to have found some excellent professionals. They are quite understanding with my issues of about hospitalization (which you mantioned toward the end), and even in times of crisis I have been able to pursue intensive outpatient treatment instead of inpatient.

Outpatient obviously gives you much more control over your environment, time, movements, choices about eating and sleeping, reading, viewing -- without which I can sometimes feel like I'm back in a "Home," just run by nurses and therapists (still a BIG step up, but I like being the boss of me as much as possible).
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from Bloody-but-UnBowed
Thursday, December 22, 2005 - 21:02

Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5Average visitor agreement is 5 out of 5(Agree/Disagree?)

Thanks for writing this, I tried to get "professional" help once, it didn't go well. The person just misunderstood everything I said, they thought I was delusional and asked how long I had had these "fantasies" about my childhood. WTF? If I were going to have fantasies about my childhood they would have involved pirates or spaceships or something, not the lame-ass Family.

I figure I'll hold out for an "Eternal Sunshine" type mind wipe. One minute you're laying on the OR table, and the next minute OHR's, hitchhiking spirits and the fact that Berg's older brother was named "Hjalmer" are wiped from your mind forever. Ahhh...
(reply to this comment)

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