Coping Strategy: Art and Affirmations

For anyone who survived trauma, abuse, neglect, shame or similar atrocities at any age

this applies to you too.

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An Unexpected Find

I found this piece of artwork on my second or third day in the new city.  The store was closing soon, and all of my parts were tired from a long day walking and jet lag.  But this book store (New Renaissance Bookshop) is dedicated to helping people recover (emotional, physical, and spiritual health) through compassion and spirituality combined with alternative paths to medicine or healing.

As soon as I read the words, I knew it was mine.  But this was the last copy.  And I didn’t want one more item to carry home.  So I asked for it to be held until the next day.  The storekeeper allowed me to put it on hold, and I walked out feeling happy, yet ashamed of myself.  The nasty words and criticisms started up in my head…so quietly at first I didn’t even notice.

Blessings from a Higher Power

The next morning, I headed straight to the store for extra browsing time.  Each part of the store was dedicated to a different topic.  Along with books, the store sold healing crystals, hand crafted dream catchers, singing bowls, jewelry, meditation accessories, music, art, yoga supplies, tea, and more.  One might call it my version of heaven on earth 🙂

As I browsed through the store, something else caught my eye.  It was a book about shame:

It Wasn’t Your Fault: Freeing yourself from the Shame of Childhood Abuse with the Power of Self-Compassion by Beverly Engel

But not the typical book that discusses shame in general terms and explains how to overcome or live without shame.  This book is dedicated to understanding trauma-induced shame and how that kind of shame negatively affects adult survivors (or former victims) of childhood abuse and neglect.

Adults, teens, and any other survivor who struggles with shame will find this book helpful relevant to their recovery as well.  And loved ones, friends, and connections of survivors will definitely benefit from reading this book.  The first part discusses in detail (without being dramatic or overly gory) the connections between childhood abuse/neglect, shame, how layers of shame can be induced by different experiences, the negative affects of shame in one’s life, and how shame is different from guilt.

Normally, I do not like to follow books that offer cures and programs.  They tend to lack flexibility needed to accommodate differences unique to each reader.  But this one is different.  I skimmed Chapter 1 because many of the case studies were similar to case studies in other books.  But I read Chapters 2 and 3 a few times; had to skip over some parts and go back because of triggers.

What Ms. Engel writes about shame answers many of the questions I’ve posed in other posts about shame in such a way that I feel validated for not settling by believing the current misconceptions about compassion, empathy, slow recovery, and bringing the secrets to light by talking about taboo topics.  And yes, I do talk about them in other places too.

I’ve just started Chapter 4 and will share what I learn in other posts.  But I encourage anyone who’s hit a wall in recovery or wonders how to work through the feelings of shame stopping them from moving forward or causing them to act out in ways they regret later (me) or self-harm through neglect, recklessness, injury, etc. (that is/was me too) to explore the book in the link above.  Amazon is great for reading samples and looking at reviews before making a purchase.

Making the connection

The next few days, I struggled with reading, not reading, following through on my plans vs. lying in bed and hiding, and ignoring the louder and louder critical voices in my head that exacerbated my physical pain.  The book came with me to bed.  It got carried down the ladder from my loft to the ground floor and stayed on a box.  It went into the bathroom and came out again.

Finally, I opened the book and started reading.  My head started hurting.  I had to put it down.  Later, I decided to start in another section of the book and go back and forth, re-reading parts as necessary.  And that’s when I made the connection:

The voices started because I felt happy and proud of myself.  For the first time ever, I bought a piece of art and displayed it in my apartment with pride and joy.  I walked around and talked to people on the street.  I took buses to different neighborhoods.  Rude people didn’t trigger panic attacks.  And buying a book about shame didn’t make me feel nauseous or panicky.  I shopped for home; spent money eating at different restaurants; drank beer with pleasure; got a library card; decorated my space; put together furniture; didn’t get triggered into a panic attack when people were rude or stared at me and  then ignored me.

The pain came because I exercised, walked, danced, and played so much that I was too tired to let the anxiety and adrenaline keep me awake in spite of jet lag.  I slept without nightmares, waking only because of time zone differences and the need to use the facilities.  Not until last night/this morning did I wake up in the middle of the night scared and unable to go back to sleep for hours.  A call to the hotline helped.  And making phone calls to follow up on packages, etc. did too.

But what helped the most was listening to the person on the phone as he listened to me, validated my feelings, saw my pain and offered compassion that I couldn’t give myself.  Eventually, I started to relax and believe that.  When the sun started to rise, I felt sleepy again and slept for a few hours.

Today I started Chapter 4 in Part 2 – the beginning of the program and exercises.  Reading these passages helped me realize that I hold myself back, stop myself from doing what I want, neglect personal care and house cleaning out of feelings of shame that stem from my abuse.  Moving helped.  But this will help more.  And maybe I’ll be able to clean house and stay organized like I wish.  Or go to the dentist and be able to take proper care of my mouth/teeth like I want.

Conclusion

Before this book, especially the questionnaires in each chapter, I never really knew how embedded shame is in my life.  It continues to stop me from living and being the best I can be in so many insidious ways.  Self-compassion is such a struggle, yet so beneficial.  Maybe this book will offer resources and strategies that bridge the disconnect between mainstream books and survivors’ or victims’ perspectives.

Thanks for reading

Coping Strategy: Self Care defined

What is Self-Care as a coping strategy?

Self-care is intentionally doing and thinking things that:

  • Help you feel better about yourself and your life
  • Bring you joy, pleasure, comfort and / or humor
  • Promote healthy mind, body, and spirit
  • Reduce stress; calm anxiety; bring one back from flashbacks and panic attacks, etc.

Eventually, the doing and thinking also become believing.  The more I practice self-care (and I am not that great at it), the more I believe I deserve the good things happening in my life.  Self-care allows me to move forward with my plans and goals.  It gives me time to decompress and relax so that I can rest and be ready for the next round of challenges.  Self-care helps me maintain my energy and build reserves in case I need them.

Most important, practicing self-care improves my self-worth by showing me I can successfully take care of myself in spite of all of the internal and external challenges beyond my control.

How is the coping strategy different from regular, daily activities?

This is a question I and my parts constantly struggle with.  Is sleeping at regular intervals self-care?  Is doing laundry self-care? Is reading a book or watching a movie self-care?  Is buying new clothes that fit properly, look nice, and keep me warm when I already have a bunch in my closet self-care?  Is treating myself to an ice cream sundae self-care?

How and why? Aren’t these activities all daily, weekly, monthly or routine chores that need to be done in order to maintain a “normal” life?

The answer to this question came from a conversation with a hotline counselor last Friday.  She told me that self-care as a coping strategy is more about intention than action.  Then she gave me the following example: doing laundry is a regular chore everyone has to do at some point.  But if I tell myself that I am doing laundry to take care of myself and make sure I have clean sheets to sleep on, I am practicing self-care.  The difference is the intention behind the thought and action.

How do I practice self care?

Here is an example from my life: buying shoes is a scary, triggering chore.  Almost every female in my blood family has some kind of shoe obsession or trigger.  Some have hundreds of pairs they collect and never wear; only wearing the same shoes until they fall apart, but never getting rid of any.  Others have only 3 or 4 pairs and look down on those who have more.  Some have hundreds of pairs of shoes and wear them once or twice before “saving” them for a special occasion.  The egg donor is part of the first group.  And she never let me have many pairs of shoes, let alone comfortable ones, because that was competition against her.

Growing up, I avoided buying shoes as much as I could.  Then I only bought ugly shoes she wouldn’t want so that she stopped stealing them from me.  Also to avoid being made fun of by the sperm donor, blood sibling, and various other relatives.  Drawing attention to myself was bad.  The one time I did buy shoes I loved (2 pairs of knee-high, leather, winter boots) I absolutely loved, they were somehow destroyed in one season.  And by destroyed, I mean unusable and had to be thrown out. It was around the time I still made regular trips to visit family and spend holidays with them.  Hindsight tells me that during one or more of my “blackouts”, someone did something to them the same way the egg donor tormented my fish when I wasn’t around.

Fast forward to the present.  I’ve been struggling with having to buy new shoes.  it had been more than 2 years since I bought new shoes, and those had been orthotic-friendly, kind of ugly shoes I needed so that I wouldn’t hurt my feet worse during my commutes.  The first two pairs I got were out of necessity because the previous shoes did not go with dresses or my current outfits.  I did not consider them self-care and got really bad backlash from wearing them instead of returning them.  The most recent 3 pairs I considered self-care and necessity.  Self-care because I recently read a book that talked about how shoes need a rest between wears to dry out, relax, and re-shape themselves for the next wear.  Having multiple pairs of shoes and rotating them during the week helps them last longer too.

As I write this post, I ask myself, does buying 2 pairs of shoes and 1 pair of boots meet my self-care criteria above?  The shoes bring me pleasure and help improve my life because they are stylish and comfortable and not so expensive I broke my budget buying them.  Answer: YES

And what about the intention behind this action?  The intention was to take care of myself by buying comfortable shoes that looked good (to me), went with my personality, felt comfortable, and brought me pleasure whenever I happened to look down and see my feet  Answer: YES

Challenges to practicing self-care

The voices in my head telling me I don’t deserve good things in life or that I am going to be punished for being happy among other things are some of the worst challenges.  The parts of me that still live mostly in the past and are afraid to relax challenge self-care because they are suspicious of it.  Certain thoughts and activities bring back floods of scary memories, so I and my parts avoid them until we are in a better place to cope with the aftermath of participating in those activities.  Fear, uncertainty, lack of confidence, and shame also interfere with self-care.  I am better at self-care than I used to be.  And when I fail, I try to remember to have compassion for myself.  After all, this is new to me and will take practice to get it right.

3 Ways to Start Practicing in spite of triggers and backlash

  • Start small with something already part of the daily routine; make the intention behind the thought or action one of self-care – kind of like CBT where changing the feeling changes the thoughts and behaviors
  • Be mindful when practicing.  The goal is to experience positive feelings not negative ones.  If at any time the action stops feeling good or like self-care, you can stop and try something else without feeling guilt or shame.
  • Be prepared to experience triggers and backlash; they are part of the recovery process and (for trauma survivors in particular) re-learning self-care.  I will tell you from personal experience that the triggers and backlash will lessen the more you practice.  How much and when depends on you.  Same goes for the intensity of triggers and backlash when you start this.  Feeling safe and practicing in a safe environment reduces triggers and backlash significantly.

Recovery Challenge: Self-harm part 3

Coping Techniques Explained

Cognitive Behavioral Therapy (CBT)

The first effective coping technique I learned in therapy was cognitive behavioral therapy (CBT).  The psychologist used this to help with my original diagnosis: clinical depression with anorexia nervosa and generalized anxiety disorder.  Practicing this taught me how to identify emotions and negative thinking patterns so I could change them.  The psychologist also taught me how my emotions and thoughts influenced my behavior.  By changing one, I could change the others.

Self-Help Books, Websites, etc.

The next group of techniques came from a series of books.  Working through lessons in the books taught me how to identify triggers, calm myself down when I felt the anxiety, relax, and refocus on the present.  By using those strategies, I could recognize patterns in my behavior and work to stop self-harm behaviors by using different coping strategies instead.  They helped me find new and creative ways to apply my CBT skills and improve on existing skills like meditation and deep breathing too.  I have a list of my favorite self-help resources here.

Caveats for self-help resources:

  • These resources are guides, not substitutes for qualified professional assistance
  • They can provide factual information, lessons for learning the basic techniques, and useful suggestions
  • They cannot solve your problems and make the issues go away
  • Not all resources are created equal; be wary of anything you read and/or listen to, especially if the resource claims it can solve your your problem
  • If you get frustrated or don’t understand, it’s not your fault.  This may be a good time to reach out and find other supports to assist you on the recovery path.
  • Finally, read, visit, or listen to multiple information sources on the same topic before deciding which techniques to use

Dialectical Behavioral Therapy (DBT)

The third coping technique I learned was dialectical behavioral therapy (DBT).  The creator of this therapy is a survivor and renowned therapist named Marsha Linehan.  Ms. Linehan has Borderline Personality Disorder and created DBT to help her cope with overwhelming emotions and her reactions to them.  I use DBT for feelings of anger, shame, and guilt.  And to help me cope with body memories.  My parts use DBT to help with distress tolerance and emotion regulation that comes from being triggered into flashbacks and nightmares all the time.

If you haven’t noticed already, my internal and external lives are very different with their own perspectives, priorities, and experiences.  Living on the inside and the outside simultaneously requires cooperation and compromise from everyone involved.  It also requires a lot of trust and the development of a system to keep our internal world functional and running smoothly.  That brings me to the final coping technique addressed in this post: Internal Family Systems.

Internal Family Systems (IFS) Model

We are lucky because we are all aware of each other and want to live a full, enjoyable, healthy life together.  That means we work together and help each other instead of working against each other and hurting each other.  We feel safe enough to ask for help, to set individual and group boundaries, and to use open communication to address problems instead of holding it in or casting blame.  Not everyone with DID is that lucky.

I learned about IFS from my current therapist and started using it actively in 2012.  The main point of IFS is that every part has a voice and gets heard.  On the inside, all important decisions are made by committee using 1) majority vote; or 2) unanimous vote.  We have also created a “family hierarchy” of sorts so that everyone shares essential chores and responsibilities equal to their age, developmental stage, and ability.  For example, adults take on adult responsibilities like work, transportation, finances, etc.  Adolescents have chores, responsibilities, and time to explore.  Children get to be children and have chores to complete every day.

We all work together to establish and maintain communication lines.  We all have to compromise and find solutions that work for the system when flashbacks and other symptoms threatens to overwhelm us.  We are all responsible for making good choices, working together, making our internal and external worlds safe, and learning coping strategies to weather the ups and downs of recovery.  Especially when parts get stuck in the past, trapped by traumatic memories (monsters), or lost and get triggered to the point of using automatic defense mechanisms and self-harm to cope.

Without learning and using IFS, none of us would be in the healthy, safe, happy place that allows us to share this information on the blog and the website.

Other Info

Here is a list of some other useful coping techniques.  I do not mention them above because they require assistance from an experienced mental health provider to be most effective.

  • Hypnotherapy
  • EMDR
  • Sensorimotor Psychotherapy
  • Trauma sensitive yoga and other types of moving meditation

Medication

Medication is not a coping technique or strategy I use except under certain conditions:

  • Not sleeping for 36 or more hours
  • Intense physical pain that keeps me awake and unable to move
  • Real physical illness like a cold or the flu

I choose not to use medication because medication makes me physically ill.  I am extremely chemical sensitive and will get the side effects from even the smallest doses (the 1 in 1,000 or 1 in 100 person described in the small print).

This does not mean I am against using medication.  If medication works, please use it.  But don’t expect to see many posts about the benefits of medication as a healthy coping strategy here.  I cannot speak to that topic and work hard not to pass judgement or bias readers for or against any strategies here.

Recovery Challenge: Self-harm Part 2

Challenges in not using self-harm as a coping strategy

There are many challenges to stopping self-harm.  The ones listed below are what I have to deal with most often:

Finding Effective Substitutions

Before I started therapy, anorexia, self-harm, dissociation, and switching were the only effective coping techniques in my tool box.  I used them relentlessly to block out the monsters in my mind.  And when that did not work, I isolated myself and developed OCD type rituals.

Therapy, partial programs, and a lot of personal research with books (and then the Internet) taught me a lot of useful coping techniques to help me understand that I did have feelings and how to safely express them in a healthy way.  The four main techniques I use are:

  • Cognitive Behavioral Therapy (CBT)
  • Self-Help Workbooks like: The Anxiety & Phobia Workbook, The PTSD Handbook, and The Anorexia Workbook
  • Dialectical Behavior Therapy
  • Internal Family Systems Therapy

I use “technique” here because each behavior, or group of behaviors, can be learned and used alone or in combination to create effective coping strategies tailored to individual needs.

Breaking Habits

According to scientific research (multiple sources), habits are easy to create and difficult to stop.  A habit can form after a few repetitions.  Breaking a habit can take a at least a month or longer.  Some habits are easy to break.  Others are not.  An addiction is more difficult to break than a habit.

When does a habit or a routine become an addiction?  I honestly don’t know.  But that is less important than understanding the how and why the habit or addiction was formed.  And what purpose it serves in one’s life.

A habit becomes an addiction when the habit starts to take over my life.  When all I can think about is the next opportunity to hurt myself,  Most of the time I used self-harm to help me feel in control of my environment while also distracting me from overwhelming emotions and extreme pain.  The anorexia nervosa was the worst one.  I started that when I was six years old and didn’t start recovery until I was twenty-one.  Twelve years later, I am officially recovered, or in remission.  Like alcoholism, an eating disorder never really goes away.  Relapse is always possible.

These days, my only self-harm habits are food and skin-related: scratching, clumsiness causing bruises, tearing at my nails, eating food that makes me feel  sick afterwards, etc.  And they only come out during a combination of the following situations:

  • feeling unsafe
  • backlash
  • anniversaries
  • bad triggers
  • body memories
  • emotional overload

Any one of these by themselves might cause me to use or feel the urge to use self-harm, but often do not.

I have a variety of strategies to help me when the urges come now.  Most of the time they work.  And when they don’t, I work hard to minimize the backlash that comes with using self-harm.

Relapse Backlash

These broad categories are based on my experiences and discussions with therapists. Please remember that as you read this section.

Anyone who has ever relapsed or failed at something has experienced the negative emotions and thoughts that come with a setback (aka mistake).  Some people and move past these easily because they learned positive, healthy ways to cope from role models.

Others pretend these feelings don’t exist, put them away someplace and forget (or try) their existence; then these people put on a “brave face” and work harder, obsess over mistakes and solutions, to ensure success the next time.  They acknowledge the failure without blaming their sense of self; might or might not hold grudges; and often will try again or decide the task is not worth the time and effort so move on.

Then their are people like me (and maybe you too), survivors who for some reason or other (and to different degrees) have been taught that they do not have feelings; every setback is a failure because they, the human, is a failure and will never succeed; and success is not real success because their is always something wrong with how the task was accomplished; nothing they do is right or good enough, will ever be right or good enough.  And they always get punished for failure.

Backlash is just that: punishment for failure.  Self-inflicted or other-inflicted, it does not matter.  What matters is that some people are compelled to punish themselves for failure of any kind.  Often that punishment is physical; sometimes it is emotional or spiritual or a combination of these.

But punishing oneself for lapsing or relapsing starts a downward spiral back into addictive self-harm behaviors.  I know because I am struggling not to punish myself for relapsing over the last few weeks.

Alters

Many times, my parts and I are co-conscious.  This means we are all aware of what is happening around us – not a complete switch in personalities.  And different parts can/will take control of our body while someone else is in charge of speaking and interacting with outside people.

Many of my alters do not feel like other coping strategies are as effective of as what they already know and turn to like a blankie.  Or they are very young/old and have difficulty remembering the other strategies and techniques under stress.  If they remember the strategies and techniques, they also have to remember how to use them.

Teaching my child parts, adolescent parts, adult parts, and ageless parts these techniques while also working full time, managing day-to-day life, and writing this blog takes a lot of time, patience, and practice.  We practice when we can; try to treat ourselves gently, with compassion and empathy, when there is a set-back or a mistake.

Because it is never failure.  It is always an opportunity to learn.

Finding effective support with therapy

There are a lot of resources available for learning these techniques.  Therapy is not required.  Neither is participation in a program or a group.  But if you are like I was when I first started, working with a professional can help you learn these techniques while providing a safety net to help cope with the backlash, emotions, or memories that can appear as you move through this process.

Recovery Challenge: Self-harm part 1

What is self-harm or self-injury?

Most people think of self-harm as something physical, like cutting, that leaves visible scars.  Or something drastic like a suicide attempt.  But would you consider overeating, not taking prescribed medication per instructions, or being clumsy self-harm?

Self-harm is a coping strategy to help deal with emotional suffering.  The point is to “express feelings you can’t put into words, distract from your life, or release emotional pain.” (from helpguide.org).  And that the depth and severity of the scars is equal to the internal suffering.  The website http://www.helpguide.org has great articles about self-harm that helped me understand that even though I wasn’t cutting, abusing drugs & alcohol, or putting myself in the hospital, I was still practicing self-harm.

Types of Self-Harm from helpguide.org

  • putting yourself in dangerous situations
  • driving recklessly
  • binge drinking
  • taking too many drugs
  • having unsafe sex

My Definition of Self-Harm

Engaging in any thoughts or behaviors that cause harm and/or injury to the physical, emotional, and spiritual self.

This includes:

  • negative self-talk – verbally abusive or encouraging to hurt self/others
  • putting myself in unsafe situations where I know the person I interact with is going to emotionally hurt me
  • walking alone in dangerous parts of the city late at night
  • scratching and picking at my skin, nose, ears, mouth
  • ripping my nails and hang nails until they bleed
  • having lots of “accidents”
  • maintaining friendships and relationships with people who treat me badly and work hard to make me feel bad about myself
  • Not eating or sleeping on purpose
  • Relapsing into anorexia and losing weight
  • spending money on stuff I don’t want
  • eating food that makes me feel sick afterwards

Why did I practice self-harm?

  1. I practiced for three reasons:
  2. to feel like I had some control over my life (anorexia nervosa)
  3. to express feelings and thoughts I couldn’t say out loud but had to release in some way
  4. to punish myself for having these feelings and thoughts

Why do I continue?

  • Self-harm works in the short term
  • Self-harm is addicting and hard to stop once started
  • Self-harm is so ingrained in my mind and body that I start using it without consciously realizing it

Have I tried to stop?

Yes.  But stopping is difficult.  And “giving in” to the self-harm urge brings up feelings of shame, guilt, self-hatred, etc. afterwards.  That starts a downward spiral of its own.  But most important, teaching myself and my parts to be conscious of triggers takes time and persistence.

Many times I used self-harm when I was dissociated so I didn’t remember all of it.  Other times, the self-harm was so ingrained that I unconsciously used that first.  Would not realize I used self-harm until after I finished.  That still happens now, especially when I am sleeping or tired or switching a lot.

Now that I am not in a dissociative state as much, I try to find substitutions for self-harm coping strategies.  And I use those instead.  But sometimes they don’t work.  Sometimes nothing but self-harm will help in the immediate short term because I desperately need relief and cannot use anything else.

How?

I try to be more aware of my triggers and notice when the self-harm starts so I can stop and use a substitute coping strategy that does not cause harm.  I also talk through episodes with my therapist to brainstorm ideas.  Or I call a hotline for assistance to brainstorm ideas or process the feelings that trigger self-harm.

Reader’s Digest

Self harm is a coping strategy many survivors use for a variety of reasons.  I started using this strategy as a child.  My parts have been using it just as long.  Most of us work hard not to use self-harm anymore.  But sometimes, the substitutions don’t work.  Or I am not aware of the triggering event so do not realize I am using self-harm.  Or that my parts are using self harm.

Helpguide.org has many useful articles and resources to explain this more in depth.  And offer strategies for not using self-harm as a coping strategy anymore.