Breakthroughs

After a long wait, I started cognitive analytical therapy this spring.  I have had a lot of different kinds of therapists over the last few years. Six, in fact. But don’t be put off by the number: the best indicator of success in therapy is the relationship between the therapist and you. Simply put: at any given time, you will always be you. Therefore, the therapist really, really matters. It may take a few to find the right one.

In this case, I feel like I have hit the jackpot. There is nothing special about this particular therapist. Or about this particular therapy. But I have lucked out, because it is the perfect therapy at the perfect time for me.

The structure of cognitive analytical therapy reduces my anxieties about the therapeutic process. This makes it easier for the therapist to challenge me during our sessions. I already feel like we have made significant progress.

Our goal is to develop strategies to improve my social skills. The method is to identify patterns in my thoughts, beliefs, feelings and behaviours, much like cognitive behavioural therapy. But cognitive analytical therapy goes a step deeper and also looks at our past experiences to understand why these patterns exist.

I was referred for this therapy because, well, I was kinda already doing it with myself.

Self-development is a huge priority for me. I come from inauspicious beginnings, but I don’t balk at a challenge. Even this last major wall (infertility) left me wondering, in my grief, just what I needed to scale it.

In this case, I needed more therapy. A new job. And friends.

The new job was easy to get. And now that I am settled, I love it. I work from home. I make my own hours. I make more money. I have more responsibility. It ticks so many boxes for me. I have even made some friends. I feel part of something. I feel like I am doing something essential for the community.

Yes!

Making friends has never been a problem either. I can charm the pants off people when I want to. That’s what you do, when you are used to moving around so much. You become good at first impressions: good at making first impressions and good at judging others.

Building friendships, on the other hand, is a baffling empire. The British, especially, do it with gusto. People seem to find friends and link arms for life. Infiltrating these networks (much less navigating them) has been a nightmare. Sometimes it feels like if you weren’t there at the beginning, you aren’t there at all.

Enter from stage left: Therapy.

The best thing about cognitive analytical therapy is that most of the work is up to me. The therapist facilitates the method, and his judgment is an essential ingredient, but the impact? The change? It is all up to me.

For a traumatised child, sometimes retaining that little bit of control can make a world of difference. I can already tell I am changing. I look forward to the person I will be later this year, when I begin preparation group training.

If we meet our goals, I will have less anxiety, more self-esteem, less perfectionist compulsions, and better social skills. Again, therapy will facilitate that, but the real work will be done in the field: making friends, building relationships, and being more of me.

…Breaking through the walls I have built myself, in order to build stairs instead.

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Dissociation and regression

I learned about dissociation years ago, from a friend who had been experiencing dissociative identity disorder. To cope with stressful situations, she often dissociated and regressed. Due to her life experiences, she was not given the same opportunities to develop into a healthy adult. Her identity is fragmented, and so is mine. Identities naturally have different parts, because we are rarely raised in isolation. As children, we take in bits and pieces from everyone we meet. We try out these pieces in the world. And eventually, enough of us is reinforced in practice that we become adults with integrated and functioning identities.

For many people, childhood was not so straightforward. These children experienced overwhelming and chaotic emotions and sensations. It was hard to make sense of the world and hard to know which pieces to keep.

Some children find dissociation is a successful way to navigate the very different demands people place on them. They develop personas which are often very different. And, as they grow into adults, these parts do not always grow together.

For me, the dissociation is simple. Once I learned that it was a primary coping strategy of mine, I could accept how my brain was organised and make better choices. It was easier for me than for my friend, because I used many other strategies to cope: intellectualising, distraction, sublimation. My core trauma happened at a much older age and I was genetically gifted with an extraordinary ability to learn, which meant that it was easier for me to navigate the adult world and give myself space and time to develop.

Infertility was a trauma that hit me where I was most vulnerable: my identity. When I went to the GP, unable to speak, tears running down my face, I had little idea that the road to mental well-being would be through such dark pastures. This was because I had dissociated a good part of my trauma. My brain, to cope, split the cognitive memories from the emotional memories. Infertility opened the door to these emotional memories and without the connection to their cognitive counterparts, I was overwhelmed and re-traumatized.

In therapy, I regressed to the age of my original trauma. Over time, I learned words for my un-met needs. I learned how to get those needs met.  Through meditation training, I learned to accept and sit with my emotions. I still regress. But I’m integrated enough to recognise it when I do and care for myself in a safe way. I see other “healthy” and “normal” people regressing all the time. I see that we are all still children, made up of many parts. That helps me feel connected. I no longer feel so scared about or by dissociation and regression.

Now, I am reaping the rewards of my years of hard work. My job requires a high level of emotional literacy and also the confidence to establish healthy boundaries. I judge people, I raise concerns, I give constructive criticism… I help people see things that they weren’t seeing before. They expect me to point out their weaknesses (that’s why I’m there) but in reality, I more often need to point out people’s strengths. Our greatest weakness is when we do not realise our strengths: when we underestimate ourselves and our ability to do better. To do more.

It is ironic that I am paid to re-enact healthy parenting with “healthy” adults, when I myself have experienced complex trauma and neglect. People become vulnerable in front of me, and I watch as they choose their preferred coping strategies. I empathise. I anticipate. I mirror. I do what I can to maintain their sense of safety. I receive, contain and make sense of their emotions. I reassure. I do all of this while reinforcing the boundaries and making clear my expectations.

I would never have been able to do this as a teenager, muchless in my twenties. And if someone dared to tell me that I would never be able to do this ever, because of my traumatic childhood, I would have laughed in their face (and then cried when alone). I know now that is impossible to judge where a traumatised child will be in twenty years. I never gave up on myself. Imagine where I would be right now if I also had that support from my parents?

I learned about healthy parenting, step by step, by putting myself in situations where I needed to be a parent. I challenged myself so that I could build a sense of identity that could process the trauma I had so neatly dissociated. As soon as I was able to process it, my body let me. I have been making sense of my childhood experiences at a rapid pace ever since.

I still need some support from the mental health services. This takes the form of specialized therapy and now also medication. Did therapy and medication make me into the person I am today?

No.

The reason I cope so well today is because of the strengths and skills I had as a child. I was lucky enough to see and use my strengths in a way that enabled me to identify opportunities for development and kept me safe (enough) to grow. I did not meet my milestones. I could not be a normal teenager. I may always be “behind” my peers in social skills. At thirty years old, though, I am no longer measured that way.

I look forward to being a parent. I know that there are never guarantees. I understand that my five year old boy may never make sense of his early experiences. But I hope at least to help him value himself and realise he does have the power and independence to make choices about himself and his life. I expect him to regress, even as a forty year old. And even as his 70 year old mum, I will still look for opportunities to help my boy grow.