Enlightened Choices Newsletter for Women's Trauma Issues - From WIIT - The Women's Institute for Incorporation Therapy - Offering women's treatment programs for acute symptoms of psychological trauma including depression, bipolar, borderline personality, child abuse, sex abuse, trauma, survivor, dissociative disorder, PTSD, multiple personality, D.I.D., ritual abuse, incest and other trauma issues.

Sexuality issues are, of course, extremely threatening and confusing for many individuals recovering from psychological trauma. In my early years at WIIT, I developed a Sexuality Group that proved to be intense, triggering and confusing—or enlightening—for many participants of WIIT. We looked at the difference between sexuality (internal) and sex (external) and the influences (internal and external) on how we express our sexuality. We looked at the issues when sexual orientation and/or gender (internal) don't match expectations and/or don't match our sexual/gender identity (internal/ external). We looked at sexuality issues within the context of traumatic history.

Now let's take that a step further. We have grown to expect the internal and external to be frequently divergent, but what happens when internal and internal are divergent? What happens when one part of us doesn't match another part of us? (You can insert here the extent of compartmentalization that fits you, whether it's just a feeling, an internal voice, or a well-developed fragment/alter.) "What if I want to express my sexuality with my husband, but flashbacks keep getting in the way?" "What if most of me is straight but one part of me is gay?" "What if most of me is gay but a small part is religiously straight?" "What if I've been acting gay but I wonder if that's because I was sexually or physically abused by someone of the same (or opposite) sex?" "Am I truly bisexual or do I have poor boundaries and my abuse lead me to sexualize everything?" "What about if my body is female/male, and some parts of me feel or believe I (we) are that gender, but the larger part of me feels or believes I am of the opposite gender?"

Although I am doing some research on this topic to see what others have written about it, I am basing this article more on what I have learned from those who have LIVED it. I know many of you would like me to give you definitive answers, but even if I did and it didn't match your own truth, your truth (internal) would still be in conflict and would rebel or override my conclusions. (Besides, if I gave you definitive answers, I wouldn't be Pat.) All I can hope to do, per usual, is to give you information for thought and exploration (internal and external). Also, since you have been doing your positive affirmations and replacing the abuser's values about others' truths being truer than yours, you now know that you have the answers within Self. It's just a matter of sorting them out from all the other information in there.

So, when you're ready, here are some of the questions to ask yourself. Remember, yourself means all parts of self, not just your part.

Is sexuality an issue for me?
How do those concerns or conflicts affect me now?
What are the related abuser's values?
What are the alternative positive affirmations? (Am I saying them?)
What are the influences, e.g. past experience, current peer group…?
How important is each influence to me, e.g. religious beliefs, marital status, parental opinion…?
How strong is my loyalty to each part of Self? To all parts?
How important is congruency, or can I tolerate internal and/or external diversity? To what extent?
What do I risk if I am true to my Self? If I'm not true to my Self? (Decisions, Responsibilities, +/- Consequences)
What am I willing to risk?
How will I grieve the losses? How will I deal with the gains?
What was the purpose of that part of me during the trauma, and is that function still necessary now, or can it be changed to better fit the present? Changed to what new use of strengths and qualities?
What is the balance within Self between conflicting needs? Are these needs or preferences?
What would conflicting part(s) of me need in order to be in harmony, or at least acceptable cooperation, with the Whole?
Am I willing to explore my own issues, feelings and body?
What are my support systems? Do I need to build different ones?
What additional external information would be helpful? Where is that information available?
If I decided to make a different choice than I've made in the past, what would making it happen entail? When? Where?

In my past seven years working with all the intelligent, creative, strong, courageous women (and a few men), I have seen diverse choices about sexuality and gender and the expression of each. I have seen individuals accept their sexuality and/or gender identity, choose to delay dealing with that part of core Self until other areas were stabilized, or continue to be in conflict or exploration. I have worked with individuals who chose to accept their true selves but not to act on the feelings, choosing to honor influences that remained important to them. I have seen individuals choose to remain primarily in one category but find creative, internally acceptable, safe outlets for their alternate interests. I have seen individuals opt to allow a different multifaceted part of themselves to become primary, believing that the previous state had helped them survive but was no longer in their best interest in that role.

Don't ever think you have no choices. We always have choices, although none of our options may be ideal and all are within the context of true Self. We just have to be willing to accept the responsibilities and consequences (+/-) that come with the decisions we make. If, and when, it is time for you to explore your sexuality, honor your sexuality as a true part of core Self, a part so precious that the mind hid it away for preservation through all kinds of adversity. When it is time, if you choose, you may begin to allow your sexuality to come out of hibernation, and even to bloom, within the protective Love of Whole Self.

For decades, the clinical objective in the treatment of survivors of trauma (individual diagnosed with Dissociative Disorders/ Dissociative Identity Disorders) has been integration. Simply put integration symbolically joins the fragmented portions of an individual's personality back together. Today, integration is supported and used in conjunction with conventional treatment of the effects of trauma, acute and chronic, but the level of commitment and relationship needed to execute the process takes years. A technique has been needed to shorten those years of stabilization.

The most extensive research on the effects of psychological trauma (incest, abuse, neglect, or experiencing a catastrophic event) dates back one hundred years.^4,5

Survivors in therapy have reported three distinct problems in the use of the integration process.²

The process is labor intensive for both patient and professional, and it takes many years of focused, intense individual therapy to accomplish.²
The survivors reported having difficulty focusing on the therapeutic objectives in the first two years. This was because of increased mental and emotional instability, emotional reactiveness to repressed memory, and hypersensitivity to both internal and external conflict, crisis and chaos (the result of post-traumatic stress disorder - PTSD).^{1,2,4,8,9,10,11}
Some survivors reported that the process felt like a "silence" or "death" inside.^4,8,9

One major barrier to the process was the reliving of painful emotions (symptom of PTSD) when using memory in the integration process for resolution. The reliving experience resulted in an increase in flashbacks, body memories, dissociative episodes, intrusive thoughts, nightmares, anxiety, fear and panic.^2,11 The reliving of painful memory or "facing one's old buried emotions" resulted in a need for the survivor to "numb out" therefore stopping the therapeutic process.^2,11

Clinical research data revealed a common experience of survivors of trauma. Survivors reported feeling as though a "part of their self" had been "lost" due to their trauma experience, leaving them with a sensation of emptiness and emotional numbness.^2,4,6,11

Patrick Carnes concluded from his research that the emotional and mental "bind is that the child is presented with only two options:

be overwhelmed with terror and not be able to function or
distort reality to survive".¹ Dr. Breuer's research found this "distorting of reality" resulted in a creation of "two distinct states of consciousness" in the mind of survivors of trauma.⁵ Freud also described the same mental reaction as a "splitting of consciousness" in his writings on hysteria.⁴ Freud and Breuer later wrote about their concept of "double consciousness" which they defined as the "mental response to an intense psychological trauma".⁴ Jung's research on trauma in primitive cultures in Africa, described his discovery of the same mental route for survival (split consciousness).⁶ As a result of his research, Dr. Jung reported that the tribesmen described the response to traumatic experiences as a "loss of soul", but that humans were made up of "many souls". Other literature describes a similar "fragmentation process" that occurs to a human personality when exposed to a traumatic event.^2,3,7,8,9

Research concluded that the "fragmentation process" altered the internal structure of a human who experiences a trauma.^{1,2,4,3,7,8,9,10} In the past, survivors were characterized as weak or defective and a negative label was attached to them.^4,3,7

The fragmentation process (Dissociative Disorders/Dissociative Identity Disorders) has also been viewed as a creative protective unfolding process.^1,4,9,10,11 This unfolding process occurs on a symbolic basis and forms a "duality of self" ("splitting of consciousness"; "separation of head from body") in order for the individual to protect life and survive the overwhelming event.^4,6,10,11 This survival process is not an indication of weakness, brokenness or defectiveness, but rather is an indication of power strength and creativity.^10,11

The symbolic fragmentation/unfolding of self happens within the individual on two different levels as a mode of survival. The first level is the symbolic structural separation of the head from the body in order to (a) make reality unreal, and (b) to hide the "core" of self so it cannot be captured.^9,10

The second level is when the symbolic body remains trapped within the traumatic memory and takes on all the physical and emotional pain.^9,10 On a symbolic level, the body feels abandoned and rejected by the head, even though the act was done out of love and preservation. The mind interacts with reality from that point on within an emotionless state (numb) and disconnected from the body. The mind and body exist in conflictual relationship.^1,9,11

Trauma was defined as an "increase in excitation in the nervous system" which the nervous system "has not been able to dispose of by motor reactions".⁵ This excitation becomes stored energy and does not just disappear.³ Freud and Breuer compared trauma reaction to severe fright, shame, or physical pain.⁵ They also described trauma as an event "so personally painful" that the individual instinctively "repressed" the event and emotions.⁵ To escape the pain of reality, the traumatic memory is stored intact with its emotional and physical components.⁹ Clinicians reported from their research, that an individual who experienced a trauma did so in a "state of mental abstraction," characterized by "intensive daydreaming".⁵ This "state of mental abstraction" later became recognized as dissociation (altered state of consciousness).⁴ Herman theorized that survivors were reluctant to give up their symptoms because their symptoms have attained an important meaning in their life. Emotional reactiveness to intrusive symptoms was the only symbolic connection left to the "lost self".^4,9 Survivors felt that if they let go of their pain, all hope for resolution would be gone. Abreaction (reliving and acting out the past trauma) was also used as a symbolic substitute for mourning or an expression of their unresolved guilt.^4,9

Dr. Horowitz reported that "unassimilated traumatic experiences" were stored in a special kind of "active memory". Resolution could only occur when the survivor develops a "new mental schema" for understanding what happened.⁴ Freud felt that hysterical attacks (response to flashbacks) were the mind's attempt to "complete the unresolved reaction to a repressed trauma" 4,5. Research on repetitive abuse demonstrated that the human brain constantly tries to resolve unresolved trauma.^3,4,12 Jung wrote that the natural instinct of the human personality (self) is to seek equilibrium, balance - wholeness.³

Pierre Janet's research found that a "passive method" (revisiting technique) of treatment for traumatized patients was more successful than an "active method" (reliving technique).^5,12 Freud and Jung both felt that "trauma response process" was very symbolic (behavior, thoughts, feelings and/or speech) and that symbolism might be the mode of treatment.^5,6

The integration process was initially a "reliving (abreaction/ desensitization) process" and many survivors experience difficulty participating in it without being re-traumatized.¹¹ Just the reduction of the intensity of the painful emotions through the integration process was not enough to unite the fragmented aspects of the personality.⁵ Facing their painful emotions only made them more aware of their "emptiness".^5,6,8 Comments like having a "hole in my chest", of "not being together inside, broken", that a "piece of the puzzle is missing" or felt as though "parts of my self are lost" were common among survivors.^5,6,8 Herman's ⁴ researches demonstrated that "long after the event, many traumatized people felt like a part of themselves had died."

Even when therapy was successful in reducing painful emotions, survivors still voiced that they felt incomplete and had a strong need to recover what was taken from them during the trauma.^1,2,4,8,9,10 Steinberg & Schnall wrote "Only by getting in touch with hidden parts of yourself that may be thwarting the full realization of your talents or fulfillment in your personal relationships can you prevent or end unnecessary pain".¹¹

A therapeutic problem was that there was not a technique that would help survivors stabilize internally before integration work.¹¹ An intermediate technique needed to be developed. The technique needed to:

be a safe and protective way to access the location of stored "unassimilated traumatic experiences" ("active memory")
be survivor driven (hypnosis is a clinician driven technique that opens the possibility for misdirection and/or decreases the survivor's responsibility for their recovery)
assist the survivor in symbolically recovering what had been lost during a trauma
assist the survivor in constructing a "new mental schema", and
to create a foundation for resolution and growth.^3,4,5,6,11

This paper reports on a clinical technique that I developed seven years ago for the treatment of trauma survivors. This technique offers a new point of view based on the aforementioned research. This stabilization technique, termed Incorporation Therapy Technique, was designed to accomplish the previously listed objectives. Incorporation Therapy is a therapeutic method to stabilize any internal unfolding/ fragmentation and return "self" to a symbolic state of wholeness and balance. The emphasis of the process is on the patient's responsibility for their recovery and their commitment to work towards wholeness.

Incorporation Therapy's architecture builds in the same elements that a survivor would use to live through an overwhelming traumatic experience:

survivor initiated dissociation
symbolism
Self
Soul
Spirit
creativity
strength and
imagination^9,10

Along with these architectural elements, this technique is based on the premise that self (human) is born whole, and that without trauma experience, self would develop toward growth. But if the human experiences any type of trauma, self would move in the opposite direction from wholeness toward unfolding of self for protection. (See Diagram 1) As a result, the human feels out of balance with the world and "less than" everyone else.

Incorporation Therapy Technique theory was based on the premise that if dissociation "runs along a continuum",¹¹ and if trauma is not growth producing, then the survivor would need a way to travel from self-preservation back to wholeness. This travel would need to occur safely and protectively in a revisiting manner in order for the survivor to move therapeutically into growth. (See Diagram 1)

Diagram 1

A study was conducted for seven years at the Women's Institute for Incorporation Therapy (located at Hollywood Pavilion, Hollywood, FL) to assess the clinical benefit of the Incorporation Therapy Technique on a population of trauma survivors. For the purpose of the study, emotional pain was measured by two components: fear and anxiety. A survivor "Self-Reporting Trauma Scale" was created to measure increase or decrease in fear and anxiety response to traumatic memory. The scale consisted of 0 (no fear or anxiety) to 10 (extreme fear or anxiety). The survivors were asked to rate their level of fear and anxiety. This Scale was administered as a pre-test to establish the survivors' fear and anxiety levels prior to participating in the Incorporation Therapy Technique, and then administered as a post-test to rate their fear and anxiety at the conclusion of the Incorporation Therapy Technique.

The resulting data revealed that there was a significant drop in the intensity of both fear and anxiety. This significant drop in the levels of both emotional components increased the patient's ability after participating in the technique traumatic to recall without intense emotions the same traumatic memories that had been terrorizing prior to participating in the technique. (See Diagram 2)

Diagram 2

Results
The clinical data gathered through voluntary Incorporation Therapy sessions with 900 trauma survivors revealed significant reductions in the levels of both fear and anxiety. The level of fear decreased from an average of 7.6 to an average of 1.2. The level of anxiety decreased from an average of 7.2 to an average of 1.1. (See Diagram 2) The significant reduction in fear and anxiety also altered the survivors' "mental schema" toward their traumatic memories. Reactiveness decreased and positive attitude toward recovery increased.

Secondary clinical benefits observed and reported by participants were:

stabilization of internal crises, chaos and intrusive material
decreased fear of self and the past
increased ability to reconnect feelings (emotion system) with thinking (cognitive system)
decreased depression symptoms
reduction of reactiveness to daily stimuli
decreased intensity of pain (emotional, physical, and spiritual) previously associated with repressed memory
increased level of forgiveness and acceptance of self

Conclusion
The clinical data demonstrated: 1) that Incorporation Therapy Technique produces a reduction in fear and anxiety toward previous traumatic material; and 2) that Incorporation Therapy Technique produces a positive shift in the "mental schema" of a survivor of trauma, therefore setting a stable foundation for integration. Follow-up reports from survivors suggested that the benefits from Incorporation Therapy allowed them a "positive mind set" toward their recovery. Participating survivors reported being more focused in their continued outpatient therapy without the previous intense levels of emotional reactiveness and the resulting punishing/abreacting behaviors.

Further research on the Incorporation Therapy Technique is recommended.

Notes

Carnes, Patrick J. (1997) The Betrayal Bond: Breaking Free of Exploitive Relationships. Deerfield Beach, FL: Health Communications Inc.
Friesen, James G. (1991). Uncovering the Mysteries of MPD. San Bernardino, CA: Here's Life Publishers, Inc.
Hall, C.S. and Lindzey, G. (1957). Theories of Personality. (2nd Ed.) New York, NY: John Wiley & Sons, Inc.
Herman, J.H. (1992). Trauma and Recovery. New York, NY: Basic Books, Inc.
Jones, E. (1953). The Life and Works of Sigmund Freud. Vol. 1. New York, NY: Basic Books, Inc.
Jung, C.G. (1964). Man and his Symbols. London: Aldus Books.
Prince, M. (1906). The Dissociation of A Personality. New York: NY, Longmans, Green and Co.
Ross, C.A. (1994) The Osiris Complex; Case Studies in Multiple Personality Disorders. London, University of Toronto Press.
Tollefson, W.B. (1993). "The Forbidden Betrayal: Loyalty within Sexual Trauma". Treatment Centers: Feb. Issue.
Tollefson, W. B. (1997). Separated from the Light: A Path Back From Psychological Trauma. Melbourne Beach, FL: Inner Values, Inc.
Steinberg, M. and Schnall, M. (2001) The Stranger in the Mirror: Dissociation–The Hidden Epidemic. New York, Cliff Street Books–Harper Collins.
Weitzenhoffer, A.M. (1953). Hypnotism: An Objective Study in Suggestibility. New York, NY: John Wiley & Sons, Inc.

I am looking at this life with the eyes of a newborn.
Laughing at this feeling inside as it overwhelms me with joy.
Wanting to feed myself full with the food only you can give.

I am a child of three looking into your eyes to see if all is well
Needing you near for safety's sake.

I am a teen blooming growing feeling strong.
Others tell me lies, that can only be confirmed by you.
Tell me the truth.

I am a woman with a full physic I am here now to tell you all you need to know.
You are loved completely without doubt.
I confirm to you now that you are all and everything you ever wanted to be.
Believe this for I am you, you are we, I am your soul.

In the garden of my soul
God comes to visit me.
He always knows when I need Him
And He knows how to find my special place.

Stone walls shut out the world
But hidden in the ivy on the wall
Is a door known to a trusted few
Which leads to my special garden —
The garden of my soul.

God comes when I am alone
With tangled thoughts
Worry overgrown with Confusion.
When He is there, cool breezes wrap around me.
Showing Him the flowers of my imagination
Laughing and sharing
The happenings of the day —
We delight in each other's Presence.

The light grows dim
My garden takes on a golden hue
Peace settles over the earth with the setting sun
I feel acceptance — trust.
Now my garden is my home
My searching spirit no longer has to wander.
I can finally rest in God's love
In the garden of my soul.

I want to break from the chains of reality
Holding me down to box me into a category
Prison me into a book of rules
Page after page black and white
Small print of society
That commands who I can be
Within my walls of brick solid regulation
A stream of laws without cessation
The steel bars of isolation
And integration into the norm
I must blend in my uniform
To maintain uniformity
Hands tied behind my back
A straight jacket to keep me from going crazy
And flapping free

My fantasy gives me wings
To soar into the infinite sky of my soul
Deep as the ocean
Mirroring the horizon
A reflection of the sky in the water,
Water in the sky,
As the two meet and kiss at sunrise
Opposite energies exchanged
Fire and water, dark as night, light as day
All parts within, different, but not going astray
Coming together as a community
A unity based on eccentricity

My heart is my world
And it is symbolism that
Is my eyes to view you
In colors and shades
Psychedelic and psychic
As I see both the physical and metaphysical
Person and personality
The energy we unleash through our body
Movement that ripples into repercussions
Splashing against me and echoing back to you

My spirituality is my guide to
Creating a shield, my protection, my limit
To foster a freedom that is not frivolous, flimsy or foolish
But rather fluid and flexible in its finite form
Allowing me to separate and connect with you
As a whole to a whole, each our own
Mingling and mixing without fusing and losing ourselves

I redefine my core
As I become so much more
Transcending beyond opinions
Rumors and bullshit galore
And in my new definition
There is no need for redemption
Rejection or objection
Rather it is a place of reflection, inflection, connection

I will not play a role to fit in any longer
Because I am so much stronger in my beliefs
For they are mine and fit me just fine
Your acceptance is no longer of essence
For I accept myself in my confidence
And although I will not join you in a cubicle
To be loyal to a click of classy clichés
I invite you to join me as your true self
To dance in the divinity of the wind of change
And shake off your own chains.

Cristina Andriani is the latest addition to WIIT's therapy staff. She received her Master of Art in Individual, Couples and Family Therapy at Syracuse University, Syracuse, NY and is a Certified Hypnotherapist. She has completed all requirements for Florida licensure as an LMHC except her two years of post-graduate supervised experience and sitting for the final exam. In other words, she is a "Registered Mental Health Counselor Intern."

Cristina has already begun to "incorporate" her intelligence, creativity and talents (including belly dancing and poetry) into WIIT theory and techniques. Her unique style is an excellent complement to our WIIT team.

From the moment you met him there's something familiar about him that makes you feel comfortable. Even though you've just met, it seems like you've known him a long time. Maybe, just maybe, he's the one. He's funny and jokes around. He takes you out, just the two of you, and you find that flattering and very romantic. He has a steady job and even fixes things around your house. He never shows up empty-handed, so you know he's not a mooch, and he must really care because he helps you make decisions about work, family and friends. He's interested in you. In fact, he wants to know everything you do and everywhere you go. He's so different from the last guy who wouldn't have noticed if you'd dyed your hair green right in front of him. He has a little trouble with anger and expressing his feelings, but he's been hurt too, and after all, look at all of the things that he does for you that show you he loves you. He'll open up with you in time. You'll be able to show him that you're not like the others. And once you've proven to him how much you love him, everything will be perfect.

And so you take the leap. You fall head over heels in love with him and dedicate your life to making him happy. He's all you'll ever need and you'll never be alone again. You'll love him so many ways that he'll have to like one of them and eventually he'll trust you and realize how lucky he is to have you. He'll stop being so touchy and grumpy. After all, he works really hard and he can't help being tired and out of sorts when he comes home. You'd want to toss back a few beers and sit down to a good meal too if you worked as hard as he does and for a boss who doesn't appreciate you. So what if he didn't get you a card or even mention your birthday? He washed your car and changed the oil in it didn't he? And he didn't mean to hurt your feeling when you went out the other night. He'd just had a really bad day and drank a little too much. It was your fault anyway. You shouldn't have been talking to your girlfriend at that club when he wanted you to pay attention to him. That's why he made that joke about you to his friends about your being a dog. Anyway, it was only a joke and maybe you didn't look your best that night.

And he promised on his life that he'd never hit you again. You can understand why he gets so crazy jealous. Look at what his last girlfriend did to him. You'll just try harder, that's all. And if he didn't care he wouldn't demand to know every single thing you do every minute of the day. Right? So what if he made you quit your job? He makes enough money that you don't really need to work and beside, that gives you more time to get the house just the way he likes it before he gets home. You'll miss your friends at work, but you can sneak in and e-mail them on his computer before he gets home. And he did help you clean up the mess after he threw his dinner across the room. It'll get better. You'll just have to remember that he doesn't like canned peas, that's all. From now on you'll just have to ask him what he wants to eat every day.

STOP!!!!! Listen to yourself!! Look at what you're doing! You might as well still be at home running around in the no-win circles you spent your childhood in. You are following your abuser's programming perfectly. You've chosen a partner the way most abuse survivors do: by picking someone who possesses the very worst qualities of your father and your mother, sprinkled with just enough positive traits to keep you hanging in there. You've created the classic co-dependent pattern of "him first and I don't count" so you can get more of what you got at home. Did you like it then? Do you like it now? No? THEN CHANGE IT. Take out your list of abuser values and abuser loyalties. Does anything sound familiar here? Of course it does.

In addition to "Mr. Right" turning out to be a carbon copy of your abusers, everything about this relationship is distracting you from your life and your recovery. And you will never break that pattern until you stop looking to another person to fulfill your every need. "But Angie…you don't understaaanndd." Oh yes I do. And what I understand is that you now have the tools to change things. WIIT has taught you how to break the pattern of abuser values and loyalties. It may not be comfortable at first, but it does get easier with practice and you know it does. Stop rationalizing all of your partner's crappy behavior as acceptable when you know it's not. And if there is anything about this scenario that reminds you of your current relationship, then I can guarantee that you're not doing your affirmations or using the other healthy skills you learned at WIIT. How do I know this? Because if you were seriously working on your recovery on a daily basis, you wouldn't be able to stand the treatment you're receiving. Sssoooo. You have a lot of work to do, don't you? But I'm going to help you. Here's a formula that will help you to focus on and identify a bad relationship:

IF

The worst characteristics of dad + the worst characteristics of mom (sprinkled with some positives) + negative events + negative abuser messages = YOUR PRESENT RELATIONSHIP…

…THEN YOU KNOW WHAT TO DO.

You are a beautiful, intelligent, loving woman who deserves to be treasured, cherished and adored. You know what to do, so just do it. No, not everything will be perfect every day. That's what gives life variety. But every handsome prince does not turn into an ugly frog. You can live happily ever after - by your definition, not by stereotypes and abuser values. You deserve happiness! We all believe in you. Go for it! YOU CAN DO IT!!!