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    What to Know About ‘Complex Relational Trauma’

    “There is no growth without real feeling. Children not loved for who they are do not learn how to love themselves. Their growth is an exercise in pleasing others, not in expanding through experience. As adults, they must learn to nurture their own lost child.” — Marion Woodman. Last year,  I wrote an article about child abuse , specifically dispelling the notion that child abuse is “just” physical in nature. I wrote about how child abuse can also look emotional, psychological, verbal and/or neglectful in nature and provided examples of what this can look like. In today’s post, I want to introduce an idea of what can result from the complexity of this child abuse, particularly if the abuse takes place over a period of time and in the context of a relationship with a parent or guardian. This idea is called complex relational trauma and it can be deeply impactful to children and the adults they become. I want to provide a brief overview of what complex relational trauma is, how it happens, what the symptoms and impacts of this may be, and share a curated list of resources you may want to explore further if you identify with complex relational trauma. What is complex relational trauma? “Unlike other forms of psychological disorders, the core issue in trauma is reality.” ― Bessel A. van der Kolk. First, let me be clear that complex relational trauma is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (the DSM, the clinical guidebook of the mental health community). Complex relational trauma and its attendant symptoms do, however, most closely resemble post-traumatic stress disorder (PTSD) which is in the DSM. However, complex relational trauma could and sometimes is also interchanged with terms and descriptions such as complex PTSD, developmental trauma and interpersonal trauma. So, why is complex relational trauma not in the DSM? There are likely many explanations but one I personally and professionally believe is that the DSM — while valuable — sometimes fails to take into account our full spectrum of humanity and complicated relational experiences and, thus, lacks in some ways. So, for the sake of this article, I’ll use the term complex relational trauma, explain it anecdotally (since an official diagnosis is lacking) and provide the symptoms that most closely resemble PTSD as well as what I’ve seen and understood clinically. So again, what is complex relational trauma? Complex relational trauma is likely to happen in our primary relationships with parents, caregivers, guardians or those with authority and great control over us (for example, the head of a boarding school or director of an orphanage) where there is accessibility to the child or teen, and a level of dependency from the victim to the abuser. Complex relational trauma happens more than once and usually over a period of time, making it also, usually, cumulative. For example, complex relational trauma doesn’t have to end in childhood; there can be the same or different perpetrators such as going from having your father be the abuser to having a string of abusive relationships with men. Complex relational trauma is, effectively, anything that undermines, demeans or erodes the dignity, safety and well-being of the individual who goes through it. Examples of events that can lead to complex relational trauma can include the scenarios from  my prior article  and it can also include experiences with caregivers or guardians that are fundamentally chaotic, unstable, unsafe, inconsistent, unpredictable and overwhelming. Exposure to domestic violence, having neglectful, apathetic, or emotionally unavailable caretakers, parents who betray you or fail to advocate for you and your needs, parents with mental illness, being parented by a narcissist or with addictions, etc. All of these are examples of who and what can contribute to the development of complex relational trauma in a child and adult. But what makes these relational experiences traumatic? The bottom line is this: when children experience traumas and stress, it is not necessarily the trauma itself that becomes the problem. If a child has securely attached, attuned, loving, consistent caregivers who can support them in metabolizing the stress, organizing and making sense of it, the child can more or less move through a trauma or stressor functionally. However, if the trauma or stressor is happening within the attachment relationship with the parent or guardian, the child, therefore, cannot usually rely on the adult to help them integrate and process the stress. Or if the trauma or stress happens outside of the attachment relationship but the caregiving adult still fails to support the child in managing, healing or recovering from it, a child will likely develop maladaptive and compensatory responses to organize their experience simply because, as children, they do not have the resources and coping skills to do much else. Maladaptive responses are numerous and varied but essentially, if left unaddressed and untreated, they can lead the child to become an adult who has ineffective beliefs and behaviors about themselves, about others and about the world. So, what specifically can these maladaptive beliefs and behaviors look like? Impacts on the individual who goes through complex relational trauma. “As the ACE study has shown, child abuse and neglect is the single most preventable cause of mental illness, the single most common cause of drug and alcohol abuse, and a significant contributor to leading causes of death such as diabetes , heart disease, cancer , stroke and suicide .” ― Bessel A. van der Kolk . The impacts of complex relational trauma will be wide, varied and unique to the individual who experiences it. There is no one-size-fits-all description. It’s absolutely possible that two children, growing up in the same household where the relational trauma took place, will have wildly different responses due to many factors including but not limited to the child’s temperament and resources, length and intensity of exposure to the trauma, the type of trauma and any if at all support in managing it, etc. So, all of this to say that while there is no one recipe for what the impacts of complex relational trauma may be on an individual, there is, according to the symptoms in the DSM diagnosis of post-traumatic stress disorder (PTSD), and what I have experienced and understood clinically, a list of possible and probable outcomes: 1. Attachment wounds and development of an attachment style that is other than secure (see my forthcoming blog post for more on this); 2. Cognitive distortions (erroneous or non-constructive beliefs about self, others and the world) and/or intrusive thoughts; 3. Avoidance behaviors to minimize contact or recreation of the events or scenarios that caused the distress; 4. Dissociation, an inability to recall the traumas or to stay mentally present when reflecting on and discussing them; 5. Somatic impacts such a hyperaroused nervous system, muscle tightness, trouble sleeping or other uncomfortable body sensations; 6. Interpersonal difficulties in romantic relationships, at work, with friends, with neighbors, with the family of origin, feeling detached and separate from others; 7. Comorbid (meaning co-occurring) disorders such as eating disorders , substance disorders, compulsive behavioral patterns, self-harming behaviors, possible development of a personality disorder or mood disorder; 8. Emotional distress and dysregulation challenges (either too much access or too little access to emotion and difficulties appropriately expressing this emotion); 9. Life task impairments such as holding down a job, creating stable housing, managing money well, achieving relational, academic and professional developmental milestones, etc. And while this list is not exhaustive, you can see that the impacts of complex relational trauma effectively can impair nearly every major life area. Often, this is how life for a complex relational trauma survivor feels: fragmented, broken, splintered and not whole across so many different life areas… Now, as challenging as it can be to begin recovering from a childhood of complex relational trauma, I do personally and professionally think it is possible and that it is one of the most worthwhile journeys anyone could ever make. In essence, it’s a journey to reclaim your life, to take the little fragments and make something beautiful and more whole from them. Healing from complex relational trauma. “As long as you keep secrets and suppress information, you are fundamentally at war with yourself… The critical issue is allowing yourself to know what you know. That takes an enormous amount of courage.” ― Bessel A. van der Kolk. For individuals dealing with complex relational trauma and the clinicians who work with them, it can, quite frankly, sometimes be hard to identify and understand that what you are dealing with is a trauma history. So many of the clustered symptoms of complex relational trauma overlap with mood and personality disorders and may even be missed if a comorbid disorder (like bulimia nervosa or panic disorder ) exists, or if a trauma background is not identified by either party. It’s important if you think that you see yourself in this article or in this concept of complex relational trauma, to talk to your therapist about it. When we shine a light on things as they really are, it gives us a better chance to work with them. That is because in recovering from complex relational trauma, there is plenty of work to be done. Recovery is and will be, for many, multidimensional work as the wounding itself is multidimensional. There’s the relational wounding component and the need for relational healing which, I believe, can happen in the context of a safe, supportive, attuned and reparative experience with a trained professional ( like a therapist ) or with a dear friend or securely attached romantic partner. There is the somatic level of the work, the need to regulate and retrain the nervous system and body that the world is safe and to help it calm down and respond appropriately versus in default. There is the cognitive level of the work which includes recalling, narrating, and making meaning and sense of memories and history as well as forming and internalizing newer, more constructive beliefs about oneself, others, and the world. There is the emotional level of the work, learning or relearning emotional regulation, emotional expression, even being able to identify emotions in the body. And there is, I believe, life skills work that may have been missed or impeded by the complexity of the relational trauma. Work like managing money wisely, seeking out and nurturing a career, practicing self-supporting hygiene and personal care habits, and learning the myriad complex logistical skills that can lead to a whole and fulfilled life. The best way, I truly believe, to begin recovering from complex relational trauma is to seek out professional support, ideally with a clinician who is well-versed in trauma. I also believe that psychoeducation can be a wonderful and helpful tool in the recovery process and so, to that end, I have included some curated resources for you below. Resources on complex relational trauma: “First, the physiological symptoms of post-traumatic stress disorder have been brought within manageable limits. Second, the person is able to bear the feelings associated with traumatic memories. Third, the person has authority over her memories; she can elect both to remember the trauma and to put memory aside. Fourth, the memory of the traumatic event is a coherent narrative, linked with feeling. Fifth, the person’s damaged self-esteem has been restored. Sixth, the person’s important relationships have been reestablished. Seventh and finally, the person has reconstructed a coherent system of meaning and belief that encompasses the story of trauma.” ― Judith Lewis Herman. I want to thank my friend Carol Anna McBride, creator of  The Trauma Project , for her recommendations of resources to further explore the topic of complex relational trauma. I will add, too, that  The Trauma Project  itself is an excellent resource for anyone who has undergone complex relational trauma and is seeking education, support and community around it. Treatment of Complex Trauma: A Sequenced, Relationship-Based Approach by Christine Courtois and Julian Ford. Journey Through Trauma: A Trail Guide to the 5-Phase Cycle of Healing Repeated Trauma by Gretchen Schmelzer, Ph.D. The Complex PTSD Workbook: A Mind-Body Approach to Regaining Emotional Control and Becoming Whole by Arielle Schwartz, Ph.D. The Body Keeps Score: Brain, Mind, And Body In The Healing Of Trauma by Bessel van der Kolk. Other articles of mine that may complement this one in your recovery from complex relational trauma: Dispelling myth of child abuse. How to recover from growing up with a narcissistic parent. The playing field wasn’t level to begin with: on childhood trauma and the fruitless comparison game. The power of being the black sheep in your family. What does it mean to remother yourself and why is it so critical for our growth as women? The five healing tasks of the un- and under-parented. Yes, sweetheart. You do actually get to grieve this. Moving forward. “She could never go back and make some of the details pretty. All she could do was move forward and make the whole beautiful.” — Terri St. Cloud. I include the above quote often in my writing often because, fundamentally, this describes my orientation and belief about therapy and therapeutic work. Our past is not something we “just get over,” nor is it something we can ignore. Our past is something which, when ready and with support, we turn towards and face, and only then can we do the grieving and healing work we need to do in order to move forward and make the whole of our lives more beautiful than our pasts have been. Confronting our personal history takes tremendous courage, but it is so, so worth it. Now I would love to hear from you in the comments below: Have you heard of the term “complex relational trauma” before? Do you see yourself in this? What or who has been a support to you in your healing journey in recovering from complex relational trauma? Leave a message in the comments below so our community of readers can benefit from your wisdom. And until next time, take very good care of yourself. Warmly, Annie.

    How to Heal If You Were Raised by an Abusive, Narcissistic Parent

    Imagine… A father who puts his 11-year-old daughter on the bathroom scale and tells her that no man will ever love her if the line goes above 150 lbs, but then he says he’s “only telling her this for her own good…” Imagine… A mother who seems like the perfect, well-regarded soccer mom, sweet and helpful to other parents and kids out in public, but who rages and screams at her children and husband at home when they displease her… Imagine… A father who plays blatant favorites among his children and who only shows any of them love when they do what he wants or when they act like he wants them to… Imagine… A mother who deliberately makes her kids feel confused by telling them something didn’t happen when it objectively did, invalidating their experience and helping them learn they can’t trust themselves… Do any of these scenarios feel familiar? Do they make you angry or feel uncomfortable? Do they remind you of anyone you know? Each of these sample vignettes could describes an abusive, narcissistic parent, or, rather, are common actions abusive parents may inflict upon their children. And in each of these examples (assuming they’re not just one-off experiences), the impact on the children can be profound. This is a painful, complex and deeply important topic to talk about because the relational collateral damage of having been raised by an abusive father or mother can be vast, hugely impactful and sometimes intergenerational in continuity if left unhealed and unaddressed by the adult child. So in today’s post, I want to talk about what narcissism means, the potential consequences of narcissistic parenting on children and share suggestions and resources for recovery if you identify with having been raised by a narcissist who was abusive. What Defines an Abusive Narcissist? It’s important to clarify that narcissism — excessive interest and pre-occupation in oneself — exists on a spectrum of severity and that all of us as humans are narcissistic to some degree. And while sometimes narcissism is developmentally appropriate (think toddlers who still haven’t figured out the world doesn’t revolve around them), for others who fall on the more severe end of the narcissism spectrum this would not be considered developmentally appropriate — and when those people act abusively towards others, a pattern emerges. People who are abusive and narcissists are defined by an almost exclusive, self-serving focus on themselves and firmly entrenched psychological defenses that guard against almost intolerable feelings of shame stemming from a deeply wounded psyche. Simply put, deep down, people who are abusive and narcissists often feel terrible about themselves, and do whatever they can to make themselves feel better. What Can Make Being Raised by an Abusive Narcissist So Damaging? The psychological effects of childhood neglect and emotional abuse are, fortunately, and unfortunately, well documented. We know that children have core developmental needs that include consistent attachment, mirroring, attunement and positive regard from their primary caregiver(s) in order to help them establish a stable, cohesive and positive sense of self and to help them learn secure relational attachment. We also know that when children don’t consistently receive this, or when they instead receive consistent invalidation, frequent insecure attachment experiences, a lack of empathy or outright hostility from their caregiver(s), this will impact them in myriad ways. Unfortunately, parents who are abusive and narcissistic often possess character traits that are almost antithetical to being able to provide their children what they need to emotionally and mentally develop and thrive. For example: People who are narcissistic and abusive can struggle with being able to focus their attention and orient towards someone else instead of towards themselves (a refocusing parenting begs of us); Children’s normal and natural childhood needs can be a “bother” someone who’s narcissistic and abusive; The moods of people who are narcissistic and abusive may be highly variable and explosive in nature if their fragile emotional regulation skills are challenged (which is inevitable with children); People who are narcissistic and abusive can often seek to put their children down to make themselves feel better and/or play favorites among their children, seeking to stabilize themselves through manipulation of the family dynamics; Seeing the child as an extension of themselves, people who are narcissistic and abusive may attempt to control the appearance, pursuits and trajectory of the child so that they align with the image the parent is personally trying to display to the world; Parents who are narcissistic and abusive may only show love to a child when they perform or act in ways that are pleasing to the parent, disallowing a child’s authentic experiences and individuality to come forth; Instead of displaying and providing consistent support for their children, a narcissist who is also abusive may invert the dynamic and expect validation, support and esteem stabilization from their children, therefore parentifying them; A parent who is narcissistic and abusive, confronted with a child who is particularly strong-willed, defiant or independent, may rage, abuse or even disown the confrontational, scapegoated child. And these examples are just the tip of the iceberg. There are myriad ways in which narcissistic parenting can manifest. However, despite how the individual actions show up, and whether the child was raised by a single parent or in a blended or married family that colluded with the parent who are abusive, it’s safe to assume that any child — whether this child was the favorite or the family scapegoat –doesn’t escape the ill impacts. So what can the ill impacts of being parented by a narcissist who is abusive look like? Again, while the impacts on the child will vary as widely as the ways in which narcissistic parenting may manifest, some of the impacts may include: Absorbing and deeply believing in dysfunctional and destructive emotional templates of what love looks like; They can learn their worthiness is dependent on how they act and what they do, not on who they are or that they are worthy just for existing; They may struggle with setting healthy and appropriate boundaries; They may struggle or fail to recognize healthy romantic partners and even be drawn to dating or marrying people who also show narcissistic traits; Adult children of narcissists may fall into caretaking and rescuing roles, seeking validation and worthiness from taking care of others and people pleasing; They may neglect their needs and wants, or even be “needless and wantless;” They can have a hard time trusting that their feelings and thoughts are valid and that their needs will ever be met; They may deeply struggle with their self-esteem and with maintaining a stable and cohesive sense of self; Adult children of narcissists who are abusive may attempt to cope with their emotional pain from a childhood of neglect and emotional abuse through addictive and self-destructive substances and behaviors; Also, adult children of narcissists who are abusive may possibly grow up to become narcissists themselves. And again, this list is in no way exhaustive of all the psychological impacts being parented through narcissism may have on someone. The impacts will vary and will depend on the context of the child or adult child, how strong their sense of self was, whether they had stabilizing, functional relationships with other adults in their childhood, whether they were the scapegoat or the favorite child, how much or how little contact they had with the abusive parent, etc.. Ultimately though, the adult children of narcissists who are abusive will likely face complex psychological healing tasks as a result of their parenting experiences. So how does one begin healing after being parented by a narcissist who was also abusive? Healing From Narcissistic and Abusive Parenting The healing work required by adult children of abusive narcissists will likely include the following tasks: Educate yourself. Whether this is through books (see my reference list below) or through professional support, you will likely need to begin learning about what narcissism is, how it can show up in parenting and what the possible impacts of it can look like. The first step in any healing process is bringing awareness to what is, and I find that psychoeducation can be deeply illuminating as you begin to make sense of your past. Confront your personal history of trauma and neglect. I strongly recommend working with a therapist or other trained professional as you begin to remember, talk about and make sense of your past. And, side note, don’t necessarily look to your own family of origin for an accurate reflection of your personal history if you have memory gaps or questions. They may not be willing or able to validate your personal history based on their own trauma. Grieve what you did not receive. Inevitably, in the course of educating yourself and confronting your past, you will need to grieve what you did not receive which, essentially, was a chance to truly be a kid. This grieving process may take quite some time, it can, at times, often feel endless, but it’s so valid and necessary to your healing process. Work through the developmental milestones you may not have achieved. Often as children of abusive narcissists we don’t fully get the chance to be children or teens with our own identities, needs, wants and preferences. We may also have missed out on certain development milestones like lifestyle experimentation, dating or even pursuing the education or career we wanted due to the impacts of psychologically unhealthy parenting. It’s, therefore, part of your healing work to begin working through any developmental milestones in conjunction with your personal history confrontation and grieving work. Setting boundaries. Either with the narcissist(s) still in your life or with those you may be over accommodating and catering to. Learning what healthy boundaries are and how to set them with others is critical for those recovering from narcissistic parenting. Seek out healthier, more functional relationships. At first, these may feel hard if not impossible to recognize and you may not trust yourself that you can actually draw these kinds of relationship into your personal life. That’s OK. Start with your relationship with your therapist (a trained professional whose job it is to show up in a healthy, functional way) and allow them to help show you what could be possible in healthier relationships. Over time, this may influence who you attract into your personal life. Focus your healing and recovery work on developing a more cohesive and stable sense of self. For most adult children of abusive narcissists, our core healing work revolves around developing a more cohesive and stable sense of self, learning to love and value ourselves for who we are, not for who we think we “should” be to win approval. A poor sense of self can impact every area of our lives, from our physical and mental health, to our relationships and our career advancement. It can even impact your bank account. So focusing your work with your therapist on cultivating and developing a more cohesive and stable sense of self can be a wonderful way to focus your healing work. Further resources you may want to look into to support your healing journey may include: “Trapped in the Mirror: Adult Children of Narcissists in their Struggle for Self” by Elan Golomb “Disarming the Narcissist: Surviving and Thriving with the Self-Absorbed” by Wendy T. Behary LCSW “Will I Ever Be Good Enough? Healing the Daughters of Narcissistic Mothers” by Karyn McBride “Toxic Parents: Overcoming Their Hurtful Legacy and Reclaiming Your Life” by Susan Forward “Freeing Yourself from the Narcissist in Your Life” by Linda Martinez-Lewi “The Emotionally Absent Mother: A Guide to Self-Healing and Getting the Love You Missed” by Jasmin Lee Cori MS LPC Wrapping This Up This post is not meant to demonize narcissists. At the end of the day, narcissistic parents likely developed this way because of how they were modeled by their own parents. And so it goes through the generations until one person of one generation decides to consciously and intentionally break the cycle. My hope is that if you saw yourself in this article, whether as a child of a narcissist or possibly as a narcissist yourself, that you will make the choice to break the cycle for yourself and whatever family or legacy you create and leave behind. If you would like support in doing this, I encourage you to reach out. Now I’d love to hear from you in the comments below: Do you identify with having been raised with a narcissistic parent? If so, what’s been one big lesson or discovery you’ve made in your healing journey that could help others traveling this path? Leave a message in the blog comments below so our community of readers can benefit from your wisdom. And until next time, take very good care of yourself. Warmly, Annie

    Types of Childhood Abuse That Aren't 'Physical' Abuse

    Often in my work as a therapist I hear questions and statements like: “Well, he never hit me. He would just lock me up in my room when I was misbehaving and then not talk to me for a few days. So that’s not abuse is it? That’s just Dad.” Or: “My mom was never abusive! Yes, she yelled at us a lot and she used to talk about how much I smelled in front of her friends when they came over and yeah, that sucked, but she wasn’t abusive.” Or: “Abuse is what happened to those kids who were beaten by their parents! My parents weren’t perfect and, sure, I don’t remember all of my childhood, but I don’t think I got beaten. So all those other memories couldn’t have been abuse, right?” Unfortunately, collectively, we as a society seem to believe that the “only” kind of abuse that “counts” is physical. And that if something else happened to you as a child beyond being physically harmed, this “couldn’t have been abuse.” But that’s not true. It’s big myth about childhood abuse. And it’s frankly not helpful to believe in the course of your own personal healing work. I really do think it’s important — painful yes, but important — to talk about and to recognize exactly what abuse is because many, particularly those who grew up in dysfunctional or chaotic family homes, may, in fact, have a history of abuse but are unwilling or unable to identify it as such. But when we do, when we can accurately confront and validate our personal history, we allow ourselves opportunities for healing as adults. So today, I want to dispel the myth that there’s “only” one kind of abuse and share information and examples with you about what also counts as child (or adult) abuse. My hope is that you’re able to see and validate yourself and your story more clearly, and use this information to support your own healing process. What exactly is abuse? So what is abuse, anyway? Seems like an obvious one, doesn’t it? But formal definitions of abuse are rather vague. Take, for instance, Merriam Webster’s definition: 1: a corrupt practice or custom; 2: improper or excessive use or treatment: misuse; 3: language that condemns or vilifies usually unjustly, intemperately and angrily; 4: physical maltreatment; 5: a deceitful act: deception. The fact that physical maltreatment gets its own line in the definition might account for why some or many of us automatically link the term abuse to physical abuse. And while we know today that physical abuse is wrong and cause  — at least for mandated reporters like myself — to contact Child Protective Services, the idea that physical abuse of children is wrong is relatively new.* “Spanking,” a euphemism for what’s objectively corporal punishment of children, has long been normalized as “a part of parenting.” (Just watch “Mad Men” and try and get through without cringing at how Betty Draper’s kids are treated.) Even today in the State of California, though I object to it personally and professionally, open-handed “spanks” that don’t leave a mark are permissible. Anything else that leaves a mark is not. So physical abuse, legally and definitively, is relatively “clear cut,” but it’s certainly not the only kind of abuse there is. *Note: throughout this post, I focus the article on child abuse (specifically from parent to child) but I want to strongly emphasize this article applies to adulthood as well, and applies adult to adult. If abuse isn’t just physical, what else can it be? Frankly, I think online dictionary definitions of abuse fall flat and prefer instead to heed what the World Health Organization defines as child abuse or child maltreatment: “Child maltreatment is the abuse and neglect that occurs to children under 18 years of age. It includes all types of physical and/or emotional ill-treatment, sexual abuse, neglect, negligence and commercial or other exploitation, which results in actual or potential harm to the child’s health, survival, development or dignity in the context of a relationship of responsibility, trust or power. Exposure to intimate partner violence is also sometimes included as a form of child maltreatment.” This broad definition feels appropriate to me as a clinician because I firmly believe that childhood (or adult) abuse is not “only” physical, but it can and does include emotional, verbal and psychological abuse and neglect as well. Any kind of treatment that intentionally or unintentionally undermines and puts at risk a child’s health, welfare or dignity is, in my professional opinion, a kind of abuse. *Trigger Warning: The following are examples of non-physical child abuse that may be painful or triggering for you to read if you’ve personally experienced them or something like them. Use your judgment and perhaps skip ahead in the article to the next section if you need/want to.* Examples of non-physical abuse a child might experience includes: Being intentionally abandoned or left in a public or private setting alone so the parent can “make a point.” Being yelled at, screamed at or having derogatory or cruel comments made to or about the child in front of the child. Being locked in a room and having food, water or other basics withheld. Being “gaslit” by a parent, having them deny the child’s reality and experience with the intent of psychologically confusing and undermining the child. Being blamed, accused, insulted and threatened by a parent. Being criticized, mocked, belittled, humiliated and otherwise eroding the child’s self-esteem. Being given little or no affection, having a child’s displays of attention go unreturned or a child being told they’re unwanted or unloved. Being isolated from peers and loved ones and not allowed to play with or socialize with other children or adults. Being denied or not given healthy food and drink, safety and shelter, preventative medical and dental care, weather-appropriate clothing and/or having no one support good hygiene and just generally neglecting and not supervising a child. Being exposed to violence, including domestic violence. Being kept from school or not provided with adequate homeschooling instead, being allowed to have excessive tardiness, being encouraged or supported in truancy, being prevented from receiving needed special education allowances and services. This is just the tip of the iceberg when it comes to examples of what can be considered non-physical child abuse. I’m sure you could generate a half dozen more examples on your own after reading this list. So what’s the point of asking or exploring this? “She could never go back and make some of the details pretty. All she could do was move forward and make the whole beautiful.” ― Terri St. Cloud If you read my last blog post on why therapy is a lot like The Matrix, you will recall that this work — therapy or therapeutic reading — isn’t necessarily comfortable and, truly, I think there are few topics out there such as inviting someone to confront a possible abusive childhood (or current relationship) that can be as discomforting. But it is still so deeply important. The “point” of asking or exploring potential abuse that may have happened in your past is, metaphorically, the same point as Neo taking the Red Pill: to “wake up” to our reality more, to see things more clearly, and in doing so, have more choices about how we want to support ourselves as adults who are no longer powerless children. To use a trite but apt therapy line: we cannot heal what we cannot feel. And we cannot feel what we do not or can not acknowledge in our past. The “point” of asking or exploring whether or not child abuse existed in your own personal history is to help you begin to make sense of your memories and to give you the opportunity to heal from it. When we swallow whole the belief that the “only kind” of child abuse is physical abuse, when we fail to see what may have happened to ourselves clearly, we deny ourselves the opportunity to heal and grow from it. Believe it or not, the point of this article or the inquiries I’m about to provide is not to demonize parents. This is often a bad rap that therapy gets, assuming that the whole point of therapy is to blame parents of the therapy client. But it’s not. The point is to help you, if you did have a history of childhood abuse, be curious and clear about how it may still be impacting you today and then, give you choice about how you decide to get yourself support around this so you can move forward and make a beautiful life for yourself  — no matter what your early beginnings held. Healing tasks for recovering from an abusive childhood. While there is no one linear, prescribed path from recovering from an abusive childhood, some of the key steps along your journey may include: Educate yourself. Whether this is through articles like this one, inquiries (see my list of questions below) or through professional support, you will likely need to begin learning about what child abuse is, how it may have happened to you and what the possible impacts of it can look like. The first step in any healing process is bringing awareness to what is, and I find that psychoeducation about childhood abuse can be deeply illuminating as you begin to make sense of your past. Confront your personal history of childhood abuse. I strongly recommend working with a therapist or other trained professional as you begin to remember, talk about and make sense of your past. Bring the list of inquiries I provide below to your therapy session and begin to work through them, line by line. Grieve what you did not receive. Inevitably, in the course of educating yourself and confronting your past, you will need to grieve what you did not receive which, essentially, was a chance to truly be a kid. This grieving process may take quite some time, it can, at times, often feel endless, but it’s so valid and necessary to your healing process. Work through the developmental milestones you may not have achieved. Often for those who experienced child abuse, you don’t fully get the chance to be a child or teen with your own identity, needs, wants and preferences. You may also have missed out on certain development milestones like lifestyle experimentation, dating or even pursuing the education or career you wanted due to the impacts of psychologically unhealthy and abusive parenting. It’s therefore part of your healing work to begin working through any developmental milestones in conjunction with your personal history confrontation and grieving work. Setting boundaries. Particularly with the abuser(s) still in your life or with those you may be also in present-day dysfunctional or painful relationships with. Learning what healthy boundaries are and how to set them with others is critical for those recovering from abusive parenting. Seek out healthier, more functional relationships. At first, these may feel hard, if not impossible, to recognize. You may not trust yourself to actually draw these kinds of relationship into your personal life. That’s OK. Start with your relationship with your therapist (a trained professional whose job it is to show up in a healthy, functional way) and allow them to help show you what could be possible in healthier relationships. Over time, this may influence who you attract into your personal life. Focus your healing and recovery work on developing a more cohesive and stable sense of self. For most adults who were abused as children, your core healing work revolves around developing a more cohesive and stable sense of self, learning to love and value yourself for who you are, not for who you think you “should” be to win approval. A poor sense of self can impact every area of your life, from your physical and mental health, to your relationships, your career advancement, it can even impact your bank account. So focusing your work with your therapist on cultivating and developing a more cohesive and stable sense of self can be a wonderful way to focus your healing work Inquiries to consider if you suspect you may have had an abusive childhood: Does it feel like the right time for you to begin reflecting on your childhood history and memories? Why or why not? In what ways did you experience abuse as a child? What memory or memories stand out to you in particular? How did you respond to these abusive moments as a child? What helped you cope with this abuse when you were a child? Did any behavior, person or thing help you get through those tough times? How do you feel in your body when you recall these memories even today? How do you imagine that the abuse you went through as a child may still be impacting you today if at all? What do you think would be different about your life if you were able to really truly look back at your personal history, grieve it and heal it? What’s the cost if you don’t? What are the supports you have around you as you begin to face your past? What trained professional, dear trusted friend or resource or program is available to you? Bringing this to a close. It is a myth and a disservice to children and adults to consider the “only” form of child abuse physical abuse. It is a myth I hope I dispelled with some additional psychoeducation in today’s article. And I know that this particular post may not have felt very comfortable to read and I really want to commend you if you made it to the end of this article if you yourself have a history of childhood abuse. It takes courage, bravery and grit to face your personal history. If you would like support in this, please don’t hesitate to reach out. And until next time, take very good care of yourself. Warmly, Annie This post originally appeared on Annie Wright’s blog.

    Veronique Mead

    Living With Chronic Illness and Trauma: What to Know

    When I was a family doctor 20 years ago, I thought the only effects of trauma were psychological, and that the main symptom was post traumatic stress disorder (PTSD). Since I was not a psychiatrist, it didn’t seem relevant to my work. It wasn’t until I left medicine in hopes of better understanding root causes of chronic illness, that I learned what trauma really was. Two experiences made all the difference. First, when I retrained as a somatic trauma therapist and was introduced to research I’d never heard of in my medical training. Second — when I developed a chronic illness myself. At my worst, I became almost entirely bed-ridden for nine months from chronic fatigue syndrome (ME/CFS). There’s nothing like living with a disease to truly understand what it’s like — the vulnerability, the fear that a symptom might be life-threatening, the sense that you might keep worsening until you actually die and no one will be able to help you, the side effects, the frustration and desperation when nothing works, as well as the loss of social connections and work and income and so much more. I’ve learned a lot from being sick. One of the most helpful things has been the realization that having a chronic illness can be traumatizing. This understanding has also been a powerful tool in helping me begin to heal. These are eight lessons I’ve learned from trauma science and research that can help with process life with chronic illness: 1. Trauma is caused by experiences of relative helplessness. Trauma can be defined as any event that triggers relative helplessness — a car accident, a scary medical procedure, the sudden death of a loved one, being given a diagnosis of an incurable disease. Such events trigger the same pathways in the brain as do abuse, rape or war. 2. Anxiety and depression are common effects of trauma. You don’t have to develop PTSD to know you’ve experienced trauma. Two of the most common symptoms of trauma are anxiety and depression. These conditions occur frequently in people living with chronic illness. A lack of trauma awareness means that many health care professionals treat anxiety or depression as their primary approach to our diseases, thinking these are the cause. They believe our illnesses are “all in our heads.” Trauma science, on the other hand, explains how these symptoms can be caused by chronic diseases themselves, and from painful, frightening, unpredictable symptoms for which there are few or no treatments. 3. Past trauma can cause chronic illness, anxiety and depression. Anxiety, depression and chronic illnesses of all kinds can be caused by adverse childhood experiences (ACEs), multigenerational trauma, and institutional trauma such as discrimination due to race, religion, and/or sexual orientation. The research explains how trauma is a risk factor for all of these symptoms. It also explains how the effects of trauma are not because we’re weak, but because adverse life experiences interact with our bodies, brains and physiologies to shape long-term health. 4. The view that chronic illness is “psychological” is false and out-of-date. If you have a chronic illness and your doctor knows you have a history of trauma, they may have told you your symptoms are psychological or all in your head. This may have happened if you have an illness that can’t be diagnosed. This all-too-common perspective is traumatizing as well as inaccurate. It has also been disproven. The science of epigenetics is revealing that life experiences influence the way our genes function and the degree to which they turn on and off. 5. Medical care is often traumatizing. Being disbelieved, judged, shamed or told that a complaint isn’t real is a form of abuse. When the social worker snickers behind the hospital curtain or a nurse whispers outside the office door that our inability to eat or get to the bathroom is due to laziness or “faking it,” this is also a type of trauma. Medical procedures that are scary or pose actual threat to our bodies or our lives are also potential sources of trauma. These are routine experiences for people living with chronic illness. The fact that these events are common, however, does not make them benign. 6. Triggers are indicators of past trauma. The act of scheduling a medical appointment, going to a hospital, or having a procedure often triggers flare-ups or set backs for people with chronic illness. We may develop brain fog, feel shaky or have trouble sleeping before or after such events. Sometimes we avoid doctor visits altogether, despite the possibility our symptoms may get worse. We can also have flares even if we’ve gone to help a family member rather than for ourselves. These kinds of behaviors and bodily responses are evidence of more than simple stress. They are normal indications of unresolved trauma. It’s common to become more sensitive to medical environments over time as our exposures to difficult events accumulate simply because we have a chronic disease. This is an often-overlooked reason why events that seem ordinary and we feel we should be able to easily cope with, can act as trauma triggers. 7. Understanding trauma can empower you. When you begin to understand trauma, you start to recognize that your sweaty palms and increased heart rate during medical appointments may be a trauma response. You start to look for — and gradually identify — events that trigger your flare-ups. As a result, you regain power and control in your life, even if you have a debilitating chronic disease. You realize you often have options. You learn that anything that increases your sense of safety, ease, joy or connection can decrease your threat response. You learn to ask yourself, “Am I in danger?” and that the act of consciously clarifying when you’re safe can decrease or alleviate your symptoms. What you discover is that you can sometimes lessen your flares and maybe even prevent them. 8. Trauma perspectives offer new choices. Once you understand how your body reacts to your own particular stressors and triggers, you gain options. You may find that you are less stressed when you can schedule appointments at the beginning of your doctor’s day so that you spend less time waiting or in the waiting room. Conversely, you may realize you do better with the last appointment of the morning when your doctor seems less rushed. You may retain more information when you bring a friend to appointments or procedures. You may change doctors when they belittle you or don’t hear your concerns about a procedure. Just as each one of us becomes an expert about our own disease, understanding trauma can help us become experts in self-care and in managing our illness. How has trauma affected your life with chronic illness? Let us know in the comments below. Follow this author’s blog on Chronic Illness Trauma Studies

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    Be gentle with your trauma.

    <p>Be gentle with your trauma.</p>
    Shahida Arabi

    5 Devastating Lies We Learn From 'Narcissistic' Parents

    The effects of childhood trauma, including emotional neglect or abuse in childhood, can have alarmingly potent effects on our psyche as we enter adulthood, even to the extent of rewiring the brain. The children of parents who are narcissistic know this all too well, having been raised by someone with a limited capacity for empathy and an excessive sense of grandiosity, false superiority and entitlement. As someone who was raised by a narcissistic parent and has communicated with hundreds of adult children of narcissists for my upcoming book, I want to share the five devastating lies we often internalize as a result of childhood abuse. It’s important to note that having narcissistic personality disorder (NPD) does not mean you are automatically an abuser; however, those with narcissistic tendencies who do abuse others can inflict a great amount of psychological harm when they do so, because they’re operating from a lack of empathy. When parents with full-fledged NPD or narcissistic tendencies emotionally abuse their children, they can affect the early brain development of their children and affect their life-course trajectories. Adult children of people with narcissistic tendensies can struggle with a wide variety of emotional, physical, behavioral and psychological problems as a result of this form of abuse. Adverse childhood experiences can cause us to be more prone to self-harm and suicidal ideation as adults and heighten the risk that we will struggle with addiction and chronic health problems. Children of narcissistic parents are often programmed at an early age to seek validation where there is none, to believe their worthiness is tied to the reputation of their families and to internalize the message that they can only sustain their value by how well they can “serve” the needs of their parents. They have lived an existence where love was rarely ever unconditional, if given at all. This is not to say that childhood survivors of narcissistic abuse cannot rise above their childhood conditioning; in fact, they can be stronger survivors and thrivers as a result of the resilience they are capable of developing and the ways in which they channel their traumas into transformation. It takes real inner work and bravery to unravel the traumas that we’ve had to endure as children, as well as address any retraumatization as adults. Being able to understand our relationship and behavioral patterns, as well as any negative self-talk that has arisen as a result of the abuse, can be revolutionary in challenging the myths and falsehoods we’ve been fed about our worth and capabilities. As children of narcissistic parents, we often learn the following from a very young age: 1. Your worth is always dependent on conditional circumstances. As the child of a narcissistic parent or parents, you might have been taught that you were not inherently worthy, but rather that your worth depended on what you could do for the narcissistic parent and how compliant you were. The emphasis on appearance, status, reputation is at an all-time high in households with a narcissistic parent. Due to the narcissistic parent’s grandiosity, false mask and need to be the best, you were probably part of a family that was “presented” in the best possible light, with abuse taking place behind closed doors. Within the home was a different story than the one presented to the public: you may have witnessed the horrific dynamics of seeing one parent verbally or even physically abuse the other, been subjected to the abuse yourself and/or experienced both parents working together to undercut you and your siblings. If you ever dared to threaten the perfect false image or did anything to speak out about the abuse, you were most likely punished. The emotional and psychological battery children of narcissistic parents endure when going against the expectations and beliefs of the family can be incredibly damaging and have life-long effects on their self-image, their agency and their faith in themselves. They are taught that they are not independent agents, but rather objects that are here to serve the narcissistic parent’s ego and selfish agendas. 2. You need to be perfect and successful, but you should never be rewarded for it or feel “enough.” People with narcissistic tendencies are often masters of moving the goal posts so that nothing others do is ever enough. As childhood abuse survivors, we are no exception to that rule. Our accomplishments are rarely acknowledged unless they meet an arbitrary criteria for “what looks best to society,” or confirms the narcissistic parent’s own grandiose fantasies. Our abusive parent is never genuinely proud of us unless he or she can claim credit for that particular success. Some narcissistic parents can even envy or look down upon the success of their children, especially if that success enables that child to become independent of their parents, outside of their realm of power and control. It is not uncommon for these types of parents to attempt to sabotage the success and happiness of their children if that success interferes at all with their grandiose self-image, their own ideas of what “happiness” should entail (usually whatever makes them look good rather than what makes their children feel good) or their compulsion to micromanage and control every facet of their children’s lives. In the mind of the narcissistic parent, it would be better if their children did not exist, rather than be unable to do their bidding and “perform” the identity that the parent wishes their children to embody or achieve the exact goals they want their children to achieve. Even if they were the perfect daughters or sons, the goal posts would again shift and their level of perfection would still never be good enough in the eyes of the narcissistic parent. 3. There is always someone better, and you must beat them — starting with your own siblings. Children of narcissistic parents are often turned against their siblings in a competition to vie for the affection and love they always craved but never received. Narcissistic parents are well-known for “triangulating” children against one another as an attempt to unnecessarily compare them, demean them and feed their own sense of power and control over their children. Usually there is a golden child and a scapegoat, and sometimes the roles are reversed depending on what the narcissistic parent needs to meet their agenda Scapegoated rebel children are often truth-seekers who desire an authentic connection with their family members, but fail to remain silent about the abuse that occurs when they do not meet the absurd expectations of their parents. The golden child, on the other hand, is usually lauded as the “standard,” but this too can quickly take a turn should the golden child ever exercise his or her agency and do something outside of the parent’s control. We are taught at a very young age that we will never be good enough, that we must always compare ourselves to others, and fail to acknowledge our inherent worthiness and value. As adults, we learn that we do not have to compete with anyone in order to be worthy or valuable, nor do we have to necessarily be the best at everything. Cultivating a sense of unconditional self-love, as well as an appreciation of our unique skills and abilities, can go a long way in combating these harmful internalizations from abuse and replacing them with a healthy level of pride and self-sufficiency. 4. Contempt is a part of love and “normal” in a relationship. Narcissistic parents can subject their children to periods of idealization when they need them, quickly followed by contempt and terrifying narcissistic rage when they “disobey” and threaten their excessive sense of entitlement. The condescension, contempt and hatred with which a narcissistic parent uses to berate their children is not only immensely hurtful, it retrains the mind into accepting abuse as a new normal. This pattern of idealization and devaluation teaches us that love is unstable, frightening, and ultimately unpredictable. It causes us to walk on eggshells, fearful that we may displease others. It can also desensitize us and makes us tone-deaf to verbal abuse later on in adulthood. Although we may learn to identify emotional and verbal abuse, we will be less likely than someone who had a healthy upbringing to recognize how damaging it can be or how unacceptable it truly is, because it unfortunately is “familiar” to us as the only version of love we’ve been shown. We may become “trauma bonded” to our abusive parents and more prone to bonding with abusive partners in adulthood as a result. We may even go to the other end of the spectrum and shut out anyone who resembles our parents in tone or attitude — some of this may be hypervigilance, but much of it is self-protection and intuition about the behaviors that have traumatized us in the past. Children of narcissistic parents can re-sensitize themselves to the fact that abuse is not a normal or healthy part of any relationship by addressing their people-pleasing habits, doing important boundary work and replacing old narratives of unworthiness with empowering ones about the type of love and respect they truly deserve. They can essentially “reparent” themselves in a safe, protective space. 5. Your emotions are not valid. Narcissistic parents, much like narcissistic abusers in relationships, pathologize and invalidate our emotions to the point where we are left voiceless. We are not allowed to feel, so we end up going to extremes: we either become repressed and numb or we become rebel children who “feel” too much, too soon. Our emotions become overwhelming either way, because our grief is not processed in a healthy way, starting from childhood. In adulthood, we gain the opportunity to validate our own emotions and recognize that what we feel, and have felt all along, is entirely valid. We learn how to process our emotions, our trauma, and the grief of being unloved as children and adolescents. We learn that we have opportunities to detach from our abusive parents, whether it be through Low Contact (minimum contact only when necessary) or No Contact at all. We experiment with using our agency to separate ourselves from the identity erosion that has occurred in our childhoods. We learn to separate the narcissistic parent’s harmful beliefs about us and our own burgeoning faith. Most of all, we learn that it is OK to believe in ourselves and to welcome good things into our lives. We learn that we are deserving of all that is good. It is important to remember that as children of narcissistic parents, we carry the legacy of our wounds, but that these wounds can become portals to deeper and richer healing. We do not have to burden the next generation with our wounding, but rather use it as a way to nurture and validate future generations. We have options as to how we can channel this trauma for our own growth, rather than our destruction. These wounds cannot heal if they are not addressed or if we refuse to be awake; at the same time, our timeline for healing will be unique and our journey cannot be compared to that of others. Self-awareness and self-compassion is needed more than ever. As children of narcissistic parents, we have to learn to protect ourselves from further abuse and set up a plan to better engage in self-care. Falsehoods about parents always being loving and having our best interests at heart simply do not cut it when it comes to manipulative, toxic and abusive parents. These parents are incapable of empathy and are likely to “hoover” you back only when they need to use you as a source of narcissistic supply. We must allow ourselves to grieve for the loss of our childhood and embrace the truth that our parents may have never loved us, or wanted the best for us, but that we can “reparent” ourselves the best ways we know how — through empathy, compassion, self-acceptance and self-love. Make no mistake: when you are the child of a narcissistic parent, the idea that you never deserved this love, is perhaps the biggest lie of all. Find more from Shahida on Self-Care Haven.

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