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what i want most dearly

attachment disorder

attachment disorder (Photo credit: drwhimsy)

When I get to the heart of what I wanted from my therapist, and from men in general because that’s what I’m projecting on to him; what I want is

to be held by him and for him to tell me, ‘I get you,’ and, ‘I’m gonna help you be okay. It’s gonna be okay, and I’m not going to leave you.’

It sounds like such a simple thing, but it’s not, for someone to get me like I think I need to be got. And it doesn’t feel like it’s coming from a helpless ‘maiden in distress’ kind of place either. I just want someone to get me. Really get all of me. And promise not to leave. Like a healthy father figure would get me, and never leave me.

It’s been a day of rest and writing, and fending off a cold, and self care. The neighbour is away and has allowed me to use his space while he is gone, and I’ve appreciated that.No tv in the background, no Mom, wandering in and out, making conversation, just quiet, and space.

I feel like this burning desire in me to tell my therapist … tell him … something, I just can’t quite put it all into words … has somehow caused this cold. I took today to try and get to the bottom of it, get it out onto paper, or some tangible form that is out of my head so it can stop tearing around in me and making me ill.

I’m guessing a little that what I want to tell him is the part of me that doesn’t feel gotten. Doesn’t feel seen. I tell him all of my ‘symptoms’ or the things that bother me — the things I figure I’m there to heal; he reads them earnestly and patiently, but rarely says much to me about them, except for ‘Excellent’ the other day, on my writing about being codependent with women in authority positions. He always asks me if I want the print-outs of my writing, and then reassures me that he will ‘keep them here for me.’ The story in my mind is that he’s just kind of ‘doing the right thing’ by reading them, but nothing really connects for him. The story in my mind is that they make no difference to him. That he thinks I’m just whining or being dramatic. I wonder if he’s trying to emulate my father figure to bring out more of my emotions around this lack of attunement. If he is, it has definitely worked.

It sent me on this journey I have been on for the last 5 days — the painful disappointment, familiar feeling of abandonment that I have known so well in my life. I’m realizing that my tendency to over-attach to people and things is a big part of what creates my ‘symptoms’.

When I went to write earlier today, I ended up instead googling attachment disorder, since it has been so clear to me that what I have been going through is attachment related. I ended up on the website of Attachment Disorder Maryland.

On the page about Attachment Disorder, there is a description of an Attachment Bond:

  • Comfort and safety is sought within the relationship
  • Desire for physical proximity to the attachment figure.
  • Emotional distress in response to enforced separation.
  • The attachment figure is a specific other person and is NOT interchangeable.
  • Emotional significance as safety is established.
  • Persistence across time and situations.
  • Reciprocity and mutuality
  • Develop gradually over time and underlie self and object constancy.  Until constancy is achieved, the length of separations should be monitored so as not to overstretch the developing bond and tear it.

Part of the anxiety I have been feeling seems like it might be this ‘overstretching’ or ‘tearing’ of the developing bond. It feels like there are so many big and intense things happening in me, and there is a sense of panic that he is missing them, and that by the time I get to see him again, I won’t be able to remember them all, and I won’t be really feeling them any more so they are going to get burried again and go unseen. This anxiety is almost agonizing. It’s been distracting me like a heart-break does, giving me the feeling like something is wrong in my world, making me tired and lacking energy or enthusiasm to do things, and yes, today, making me sick. It’s like all these things are stirring around inside me, and they can only be seen by him, so they have nowhere to go. In session, I feel like holding back because I know that he’s going to go away and miss things again.

As I continued to explore the site, what I found has created quite a stir in me, and here I am finally writing, getting it all down, and it feels like things in me are flowing again. Something in me clicked when I read the pages on Developmental Trauma Disorder and Shame and Attachment. I had possibly never felt more deeply relieved to read myself on a page. Words were leaping off the screen that I have used to describe my experiences of isolation, dissociation and sabotage, and the seemingly endless cycle I have been on for most of my life in anything I try to do professionally. For me, these writings seem to encompass just about everything I have touched on and wondered about. I’ve been reading and highlighting them all day, and it has felt like shedding light on whatever it is in me that wanted to be worked out. Maybe it’s just the ‘being seen’ feeling I get from these writings. That there is someone who gets me, and people who feel the same way.

I’m still digesting all this, but I do feel a little bit better having finally written a post about it. Thanks for reading. Time to sleep.


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Developmental Trauma Disorder

I have been pointed towards the effects of trauma before, by my old counselor a year or so ago, who pointed out that the symptoms of trauma are very similar to Borderline Personality Disorder. My recent experience of attachment with my therapist caused me to research Attachment Disorder today, and found me at the website of Attachment Disorder Maryland.

My jaw dropped and I nearly gasped several times reading their page on Developmental Trauma Disorder (DTD). It’s been a while since I’ve had the experience of immense relief to read about parts of myself that hadn’t yet been reflected to me externally. I am feeling immense relief and hope that this has been written about.

Most-striking excerpts from the website of Attachment Disorder Maryland — their page on Developmental Trauma Disorder (DTD):

Definition Developmental Trauma Disorder is a diagnostic proposal for DSM-5, authored by Bessel van der Kolk and colleagues.  The concept of DTD is based on a wide array of research data that comprises tens of thousands of children across multiple research studies.  DTD results from growing up in an interpersonal context of ongoing danger, maltreatment, unpredictability, and/or neglect.  80% of all child maltreatment is at the hands of children’s own parents.  Maltreatment embeds “hidden traumas” in infant – caregiver interactions that are neglectful, intrusive, unpredictable, threatening, aggressive, rejecting, or exploitive.   These interactions convey that the world is a dangerous, unreliable, and/or indifferent place that offers little or no safety. Given the highly limited capacities of infants / young children to assess risk, this lack of physical and/or emotional safety quickly rises to the level of a subjective survival threat (annihilation anxiety) even though the objective nature of the event may not actually be at that level.  For this reason, such events do not warrant a diagnosis of PTSD because the events are not “imminently life threatening”, a criteria for PTSD.  However, it is subjective perception, and not objective lethality, that determines trauma.  Using PTSD criteria, the element of trauma gets missed, and the erroneous diagnostic process has begun.

Major diagnostic criteria for DTD
There are seven major diagnostic criteria for DTD.

  1. Witnessing or experiencing multiple adverse interpersonal events involving caretaker(s) for at least one year.
  2. Affective and physiological dysregulation.
  3. Attentional and behavioral dysregulation.
  4. Self and relational dysregulation.
  5. Chronically altered perception and expectations.
  6. At least two post-traumatic symptoms.
  7. Functional impairment- at least two of the following areas: academic, family, peers, legal, health.
  8. Duration of disorder is at least 6 months.

(#7 of Developmental impacts:)

Fragmentation / disorganization:  We know from object relations theory that whatever is communicated as being off limits to an infant’s caretaker is also off limits to the Self.  Infants quickly pick up implicitly, what their caretakers do not want to see, will reject, are afraid of, will retaliate against…  These elements become “off limits” which lays the groundwork for fragmenting the child’s Self construct.  This fragmentation of the Self produces a pervasive state of internal disorganization that causes further fragmentation as time moves forward, and so the disorganization is both effect and then cause.  This internal disorganization impairs integrative processing such that the integration of sensory, cognitive, emotional, and behavioral experience into a congruent picture does not occur and so children with DTD can appear very different across time and situations.  This, in turn causes significant confusion for the adults interacting with these children on an ongoing basis.  Given their confusion, the adults are prone to respond inconsistently to the child, thereby validating the child’s view of the world as unpredictable. Now the original traumatic context is being replicated in the present in a dizzying escalating spiral that carries profound implications for attachment….

DTD vs. Post Traumatic Stress Disorder (PTSD):  PTSD stems from discrete, traumatic incidents rather than an ongoing pattern of embedded trauma.  It manifests as specific responses to stimuli that are reminders of the traumatic incident.  In the absence of traumatic triggers, PTSD symptoms may be minimal to wholly absent.  PTSD lacks the pervasive developmental sequelae of DTD.  Since PTSD can’t account for all the symptoms of DTD, other diagnoses are often added to PTSD to cover the additional symptoms.  This produces fragmented diagnostic thinking and the partial diagnosis phenomenon.  Once again, it’s the Blind Men and the Elephant story.  The part is mistaken for the whole, leading to a lack of understanding about the whole (systemic dysregulation resulting from developmental trauma) and a partially effective, clinical response at best.On the other hand, the “hidden traumas” of  DTD do not meet the DSM-4 definition of a “traumatic event” as they are not imminently life threatening.  Evidence based treatments for PTSD do not adequately address the pervasive developmental impairments and attachment difficulties that come with DTD.

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attachment pain

I’ve continued to feel distraught and perturbed from my last session. Although I have maintained what has been a very active social life in the last 3 days, I have felt internally as if I have just broken up with someone, ended a relationship. That horrible feeling like part of my world has crumbled, and nothing except seeing him again will make it go away. The amount of angst I am feeling around my therapist is humbling to me, and I keep wanting to fix it. I guess I’m not sure how to move it. If I should be speaking up to him that I am / have been affected this way or just endure until our next session, which is not for another week and a half.

Aside from the whole wanting to be special / heart-broken thing, another part of my perturbment is that I want him to confirm that he sees the split in me; he sees why I am there in his office, that he doesn’t think I’m being a drama queen. Yes, there is that term again – drama queen. What is real. Yada yada … yada yada … I keep comparing myself to the patients he sees in the psych ward who are unable to have a normal conversation and who, if left to their own devices would off themselves immediately.

If I’m not that, I don’t deserve therapy. I should get my act together and get on with it. I keep feeling as if something in me that I am not particularly in control of is driven obsessively to prove to him that I am bad enough to need therapy.

On the other hand, another part of me knows without a doubt that I do, and I am benefiting from seeing him.

And this very debate going on in my mind IS why I am there. It permeates every part of my life. The feeling of having secret personalities, secret lives; the obsessive flip-flop anxiety and catastrophic self-doubt I feel when I put myself out there, with resumes, career paths, training, etc.

And, the fact that I feel heart-broken at the ending of a session because he did not say how wonderful and special I am, take me into his arms and tell me everything’s going to be alright. The familiar heart-break / abandonment / rejection pain that throbs through my chest, down my arms and out my fingertips, leaving my body feeling “dead”, completely empty, without will, defeated. Dead.

My attachment with him is becoming more painful, and the intensity of it scares me a little. Maybe because he’s a therapist, he’s not going to abandon ship without telling me, and I will actually be able to work through this.

iStock attachment finger

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mending attunement, standing fully in my place

elephants in a row

elephants in a row

Another shoe drops this evening, watching the TV Series Parenthood – a family drama / comedy along similar tastes as Six Feet Under, but a little less dark and twisted.

The show follows several families within a family – dynamics, transitions, realizations of all the diverse family members. In this episode, a 20-something engages in a romance with her boss, in an assistant position created for her by her Aunt, who catches her in her neglege in the hotel room. One is left to presume that the Aunt heard her niece was going on this business trip alone with this older man, had a hunch that something was up, and flew out to rescue her. In the same episode, a teenage boy is uncontrollably upset when he finds out that his mom is planning to have a baby with his step-father. His Mom talks about it with the step-father, and he decides to take the boy out for a burger; later on, the Mom talks to the boy’s father about it, because the boy is unable to articulate his feelings very well with his Mom.

psychotherapy image

psychotherapy image

The thing that struck me was a sadness in me for the fact that I did not grow up in a family like that. I never felt like other family members understood what I was feeling and took loving, supportive action. What it comes down to is that I always felt alone in dealing with what I was feeling – no one knew, and the few times they did, they didn’t respond in a way that spoke understanding, compassion or support to me.

What then struck me is that I have just finally had this experience this weekend, while liquidating my storage unit, back in the place I lived for 8 years before my melt down in the Spring. It was a new experience for me to reach out in the way that I did and ask for what I needed. No, in advance of my speaking up, no one really had the where-with-all to realize the anxiety I felt about going. I had extreme anxiety in the form of raised heart beat and panic attacks in the middle of the night for several weeks leading up to my trip, and in retrospect, the root of that anxiety was the notion that I was going to have to face all my old stuff up there alone, and that my tired brain was simply unable to handle all the details. That I was going to have to cover up the panic inside again, pretend like everything was fine and somehow get it all done without letting the stress show.

That’s what I did for most of my life. I was an ice burg, in quiet, frozen desperation, so well automatically hidden, I cannot blame myself for seeing no hope. It took a natural disaster from the universe to melt.

My friends this weekend showed me the kind of love in this episode of Parenthood – the kind of love I always wanted, and thought that I just didn’t deserve. I thought that I didn’t deserve it because what I was feeling was grotesque and unacceptable, that there was something horribly wrong with me. If I was normal, I wouldn’t have to hide so much, and people wouldn’t leave me alone so much.

The kind of damage I sustained in my childhood is not overtly even close to so many other stories of abuse. The sources of dysfunction in myself are far more subtle, every single one of them. I illustrate the reason that not everyone who is diagnosed with Borderline Personality Disorder was abused , in the typical sense of the word, in their childhoods. I have lived with chronic confusion about how I really am in the world, because I have been so confused about where I have come from – did I come from abuse, or am I being a drama queen? Do I have feelings and reactions that are not normal, or am I only choosing to see it that way? This was the endless loop of confusion I lived in. The definition of cause for BPD by Tami Green opened the door to a lot of clarity for me: A sensitive child who does not receive the extra attention and validation he or she needs in order to develop secure attachment. I am back to my previous post about how abuse is a completely subjective experience.

I’m appreciating the perspective and understanding in myself about the pressure I felt to be a sensation, without the social and emotional supports so many take for granted. Add perfectionism, sensory and emotional intensity to that, and you have a pretty good recipe for the disaster that was my life.

Another wave of grieving, compassion, mending, loving. A particle of light in some deep reserve in me.

Source Image: Tribe Jewelry by Gayle Mahoney

Source Image: Tribe Jewelry by Gayle Mahoney