Mental Illness: Emotional Dysregulation

This post is meant to provide a brief overview on symptoms of mental illness and then insight into living with the symptom. It should not be used as a diagnostic tool, but if you relate to what you read, it may be time to have a conversation with a mental health professional. 

Emotional dysregulation is the inability to regulate emotional reactions. There are four main aspects to this issue according to Psychology Today.

• A lack of awareness, understanding, and acceptance of emotions
• A lack of adaptive strategies for regulating emotions (the intensity and/or duration)
• An unwillingness to experience emotional distress whilst pursuing desired goals
• An inability to engage in goal-directed  behaviors when experiencing distress

These are mental and behavioral strategies that ultimately make negative emotions worse.

What does emotional dysregulation look like?

• Experiencing intense emotions
• Crying in response to a variety of feelings, even happiness
• Struggling to take your focus away from your emotions
• Having mood swings and unpredictable emotions
• Having a low tolerance for frustrating situations
• Being unaware of the feelings of other people
• Becoming overly excited

Emotional dysregulation can be aspects of multiple mental illnesses such as depression, anxiety, panic disorders, and borderline personality disorder. They may involve dysregulated behaviors such as self harm, substance abuse, etc. which are unhealth coping mechanisms.

It can also be a side effect of neurodivergence such as ADHD or autism which may result in a meltdown for some if the triggers are strong enough.

Emotional dysregulation can negatively impact multiple areas of your life resulting in workplace difficulties, issues studying or in school, relationship conflicts, worsening mental health struggles, and increasing a tendency for risky behaviors (i.e. substance abuse, dangerous driving, etc.)

What can you do to have healthy emotional regulation?

Practice good mental and physical health as outlined in our sections on self care.

• Exercise
• Deep Breathing
• Yoga
• Acceptance
• Awareness
• Learn your tirggers
• Try the F.O.U.L. Method
• Try the R.A.I.N. Method
• Reframe self talk
• Therapy & Medication may help depending on the reason for dysregulation
• CBT and DBT therapies are often used for emotional regulation

Helpful Links:

Article: Emotional Dysregulation in Children and Adolescents with Psychiatric Disorders (NIH)

Understanding ADHD (by ADDA)

What is Emotional Dysregulation? (Psychology Today)

"Emotional dysregulation is most often something I hear talked about in regards to ADHD these days. I live with three adults with ADHD so its a common conversation in our house. It is interesting to talk about how I have the same symptom as part of my PTSD/PMDD while my bestie has it because of ADHD. The way it works in our heads is different but the end result is the same.

Sometimes the world is just really overwhelming and the ability to regulate or function "normally" is shot. I am pretty good at recognizing when I have reached my limit and shutting myself away until I can regulate again.

I think most often for me it feels like standing still and quiet when the emotions inside me are begging me to just scream and throw things. Its like my emotions are too big for my body and they need to get out somehow, but some rational part of me knows we can't behave that way. It can come from a place of rage or pain or frustration. It takes an enormous amount of self control to just hold my tongue and walk away. I know this is healthy management but it feels like absolute garbage in the moment.

I tried to describe it before so I am going to share my prose "Scream" which I think captures the feeling quite well.

SCREAM

Somedays I just want to scream. I don't want to censor or silence myself. It's beyond longing to simply release the feral beast trapped within. She is not a quiet, passive person. She rages, slamming against the walls of her prison while snarling and clawing any happiness nearby. She need not be provoked for simply being awake is enough to draw forth a mighty anger bore from the darkest reaches of my own soul. Today, I want to scream. I don't want to reason with those I love or hope for their acceptance. Somehow today I want to scream to the overcast skies that there are still unhealed wounds, that I can not bear the saline words ground into them. The silent denial of truths that rock my world, the blissful ignorance of the black abyss monster always poised to drag me under the churning waves. The endless nights laying awake because I can feel the shadows settle as my demons hover over me waiting to lead a legion of nightmares into my slumbering mind. It's the conflict of the primal being as she struggles with her rational form. It's the cramped box of expectation as the air runs out.

- D.M.

Mental Illness: Addiction

This post is meant to provide a brief overview on symptoms of mental illness and then insight into living with the symptom. It should not be used as a diagnostic tool, but if you relate to what you read, it may be time to have a conversation with a mental health professional. 

Need help with addiction?  SAMSA National Helpline Call 1-800-662-HELP

Addiction can be an issue someone struggles with separate from any trauma but it is not uncommon for people who have trauma to struggle with some form or substance abuse or addiction when attempting to self medicate. This disorder is complex and can have multiple factors that contribute to an addiction which includes genetics.

Addiction is considered a chronic condition meaning it is life long. It is a disease. People with addiction issues compulsively seek and take a substance (or perform an activity) despite negative consequences. These can be consequences that impact your health, relationship, work, and/or overall quality of life.

There are two main categories for addictions.

• Substance (alcohol, drugs, medications, etc.)
• Non-substance (behavioral addictions such as sex, porn use or gambling)

Alcoholism is the most common addiction that comes up and as a result there are a variety of resources available to assist. We have included links to resources in the USA, UK, and Canada below. Nicotine and marijuana use are the next most common substance abuse addictions.

What is the signs of an addiction?

• Inability to stop
• Increased tolerance
• Intense focus on the substance or activity
• Lack of control
• Personal problems
• Health issues
• Withdrawal

How is Addiction Treated?

• Therapy
• Support Groups
• Medication
• Rehabilitation
• Hospital Management (especially important for withdrawal from substances that can create serious health concerns.)

Personal Experiences

"I personally do not struggle with addiction issues. A portion of my abuse was by someone who was struggling with abusing medication and as a result I have been very weary of substance use to the point of being extremely reserved in my alcohol consumption and medication use.

A friend of mine who does struggle with alcoholism and addiction as part of their journey has kindly offered to provide some insight. I will be adding them to our collaborators page as they plan to contribute to multiple subjects moving forward." - D.M.

"A Reflection on Addiction

Being an addict colors my thoughts, and actions in many ways. There’s the obvious desire thoughts like I want a drink, a joint, or to get laid. It's deeper than that as well, when I reflect or ruminate it’s from the perspective of an addict.  Anything I do or say serves the purpose of getting relief.  This doesn’t mean I'm ingenuine or only self-serving like addicts are often portrayed.  It means in addition to anything I do there is an underlying need for more. Accepting and not demonizing that fact has been important.

 My mental health is such that I'm riddled with insecurity, self recrimination, and anger. I don’t feel or accept love in the way other people seem to.  I’m constantly overwhelmed with emotion and thought.  I need it to stop if only for a while.  Drugs help the thoughts mellow, sex keeps the insecurities at bay, cutting provides control over my emotions.   It's not about good or bad coping, healthy or unhealthy behavior.  It's about function.  

  Over the years of self work and therapy I’ve learned to accept certain aspects of myself and learned to expand my coping.  I quit drinking, but still smoke weed, and do shrooms. I don't cut as often, but use rubber bands for small doses of pain.  Sex and touch still are the only ways I can process affection and love.  I’m working on it, but it still persists.  Mostly I’m working to unlearn the need to catastrophize or vilify my feelings.  It’s ok to be angry, sad, and insecure. It's the actions we do that matters, a simple enough concept, but it took me a while to really understand it.

  My goal isn’t to beat addiction, any more than it is to beat ADHD, depression, or trauma.  My goal is to live in such a way that I'm not destroyed by anything.  I want to be someone that can be depended on, and manage the requirements of living.  It’s not easy, but most days it seems doable. I have more hope and love for myself than I ever have.  Hopefully my experiences can help others.

Addiction is tough to talk about, because there is a zeitgeist around it being sad, but unsympathetic.  It's hard for people to understand why someone would choose to harm themselves in such a way.  I’d like to reframe how people see addiction.  There is a component to it that is like hunger. A need that can't be easily satisfied. A chemical imbalance, a trauma, or coping mechanism.  The reasons matter when trying to understand. " - R

Resources you may find helpful

National Institute on Alcohol Abuse and Alcoholism - USA

NHS Webpage on Addiction with support links - UK

Addiction resources - Canada

For Loved Ones

What is Substance Abuse Treatment? A booklet for Families (USA)

NHS - Advice for families of people who use drugs (UK)

CAMH - Information for Families (Canada)

Mental Illness : Depression & Anxiety

This post is meant to provide a brief overview on symptoms of mental illness and then insight into living with the symptom. It should not be used as a diagnostic tool, but if you relate to what you read, it may be time to have a conversation with a mental health professional. 

Mental Illness comes with a constellation of symptoms and can vary from person to person even with the same diagnosis. Depression and Anxiety are common symptoms as well as being a diagnosis on their own.

Anxiety is an intense, excessive, and persistent worry and fear about everyday situations. There are many types of anxiety disorders such as Agoraphobia, Generalized Anxiety Disorder, Panic Disorder, Social Anxiety Disorder, etc.

According to the Mayo Clinic common symptoms include:

• Feeling nervous, restless or tense.
• Having a sense of impending danger, panic or doom.
• Having an increased heart rate.
• Breathing rapidly (hyperventilation).
• Sweating.
• Trembling.
• Feeling weak or tired.
• Trouble concentrating or thinking about anything other than the present worry
• .Having trouble sleeping.
• Having an upset stomach or other problems with digestion.
• Having difficulty controlling worry.
• Having the urge to avoid things that trigger anxiety.

Anxiety is more common than depression with a third of adults in the U.S. experiencing it within their life time. It can interfere with daily life and routine activities such as holding down a job, managing schoolwork, and relationships.

Treatment for anxiety typically involves therapy and/or medication. There are many types of medications that may be used to treat anxiety with SSRIs, SNRIs, benzodiazepines, buspirone, and beta-blockers being common choices depending on the type of anxiety.

More Information Here: National Institute of Mental Health

Depression is more than just being sad or having a bad day. It is a persistent feeling of sadness and loss of interest. Depression can be a symptom of many mental illnesses or a diagnosis on its own such as Major Depressive Disorder. It may also be part of a cycle of mood changes for those with Bipolar Disorder.

Hormones can also play a role in depression symptoms as part of Postpartum Depression and Premenstrual Dysphoric Disorder (PMDD).

According to the CDC* symptoms of depression include:

• Feeling sad or anxious often or all the time
• Not wanting to do activities that used to be fun
• Feeling irritable‚ easily frustrated‚ or restless
• Having trouble falling asleep or staying asleep
• Waking up too early or sleeping too much
• Eating more or less than usual or having no appetite
• Experiencing aches, pains, headaches, or stomach problems that do not improve with treatment
• Having trouble concentrating, remembering details, or making decisions
• Feeling tired‚ even after sleeping well
• Feeling guilty, worthless, or helpless
• Thinking about suicide or hurting yourself

Depression is extremely common with 1 out of 6 adults experiencing it sometime in their lifetime. The most common treatments for depression are therapy and medications (typically SSRI or SNRI varieties). Those with Postpartum Depression or Premenstrual Dysphoric Disorder may also be treated to balance hormones.

More Information Here: National Institute of Mental Health

" Depression and Anxiety are the primary symptoms I am being treated for as part of my PTSD. 

The anxiety impacts my daily life the most because I am borderline agoraphobic without medication. I get physical symptoms of anxiety even if I feel calm mentally. Its so frequent that I stopped wearing a smart watch because it was logging my racing heart as workouts when I was just sitting at my desk at work answering emails. I will mix liquid holy basil with tea to sip at work to help maintain that anxiety symptoms at a lower level so that I can work more efficiently.(Note: Holy Basil is a supplement that some people find helps with anxiety but you should absolutely tell your doctor if you are taking it because it can impact blood clotting.)

The anxiety seems to mix heavily with the hypervigilance for me, so being in places with lots of people or without clear lines of sight can push me into panic attack territory. Most of the time I can still function through a panic attack enough to walk out of a place or get somewhere "safe", usually my car. My heart will be racing and its hard to focus and breath but I just make myself practice box breathing and try to stay focused on the next simple task.

Sometimes I am otherwise having a good calm day at home and I can feel the anxiety in my chest, so I will be sitting watching youtube videos with my husband and just be like... man this really sucks and I don't want to feel like something is going to attack me. Usually my husband will just rub my shoulders until my heart rate comes down. It makes it hard to sleep or even stay asleep after waking up.

I have rescue meds I can take for panic attacks. Its a type of antihistamine that can act as a sedative. It works pretty well but also makes me very very sleepy so I don't like having to take it at work.

Interestingly, I don't have social anxiety. I am confident with interpersonal interactions and don't seem to struggle there.

My experience with depression as an adult is mostly that it makes me tired and gives me brain fog. I struggled a lot with it becoming more of an issue when I used hormonal contraceptives, so much that I had to be taken off multiple types because I was getting the severe side effects for it that you are supposed to immediately tell your doctor about. There was also some issue with suicidal ideation increasing with both hormonal birth control and some SNRI medications.

The depression symptoms were definitely more of an issue when I was in my teens, but it is hard for me to gauge how much of that was caused by my hormonal birth control use throughout those years."

-D.M.

* I have included a link to the CDC's website in this post because at the time of writing it is still functional. The current changes happening in the USA may result in this no longer working, at which point we will begin looking for alternate sources to reference.

Personal Growth : Breaking Cycles of Dysfunction

    The next section of is about Personal Growth and taking back control of our own journey. It is the conscious decisions we make to heal ourselves. This entry is specifically about breaking the cycles of dysfunction in your family and your life.

    Dysfunction, like abuse and growth, comes in a myriad of varieties but it will have a pattern and is often generational. There are a set of unspoken rules for how the dysfunction works and continues. Families may unwittingly pass these unspoken rules and dysfunction down through generations, even while attempting to break their own cycles. 

    The first step to breaking a cycle is to acknowledge that one exists in the first place. It is taking a step back to observe patterns of behavior within a family unit and/or within your own actions and to access if this pattern leads to healthy behaviors or dysfunctional behaviors. It may include empathizing and sympathizing with why this pattern has emerged while also recognizing its overall impact to the family and personal health.

" My examples will largely be from the perspective of someone breaking family cycles. The hardest part of seeing the pattern for me was that I was too close to it. I could understand why people were behaving that way and I was giving them a pass. Understanding why someone behaves badly can be helpful in pattern recognition but it should not be a pass on behaving better or holding someone accountable." - D.M.

    The next step is to decide what you are going to do about this cycle of dysfunction that you have recognized. Depending on the type of dysfunction, even making small changes for yourself  can generate a reaction in others around you. It can be hard to decide where to start making changes - Are you going to start therapy? Confront your family with the issue? Get sober? Take an anger management class? Go low or no contact with people? Use Cognitive Behavioral Therapy to modify your own behavior?

    Once you have decided what to do you need to act on that decision.

    Most issues are the sort that you need to start with personal work and changes in your own life before you can incorporate any others in making changes. While therapy can be a great tool for some, it may not be the best fit or even accessible to all. The starting point has to be taking accountability for your own actions and making an effort not to repeat patterns of dysfunction in your own life. 

"I know that saying to make an effort not to repeat a pattern sounds over simplified and in some ways it is but that is the base of what breaking the cycle is. It is taking a long hard look at the life those around you live, noting the behaviors and outcomes and then making a decision for yourself on what you want. For example, I made note of my parents communication styles and how they handled anger. I knew the way their actions made me feel and I decided that I would not be handling my anger the same way they did. It has been an imperfect process of learning what management style works for me but ultimately I have reached my goal of not weaponizing my anger but using it as a conversation piece when moving toward a solution with my own partner and community. I still struggle with feeling like I have rage and anger issues but my feelings do not dictate my behavior. I am not continuing a cycle where my anger is used to create fear in others. " - D.M.

    Ways to break cycles of dysfunction

• Be honest and open to healthy criticism
• Be open to good faith conversations about how your behavior impacts others
• Be willing to sincerely apologize and make an effort to change problematic behaviors
• Disengage from bad faith conversations that continue patterns of dysfunction, this may take practice to learn to recognize
• Make a consistent effort to engage in healthy behaviors
• Accept that you may not know what a healthy behavior is and seek out information and resources to help you learn - its okay not to know what you don't know
• Seek professional help as needed, especially for mental health or addiction issues
• There are some struggles that simply can not be managed alone and it is okay to ask for help when you need it.
• Surround yourself with a community who supports your healthy choices
• Sometimes the family we are born into is not the most supportive, you may need to reach out to your found family or to a support group instead
• Be willing to set firm boundaries with others
• You have to advocate for yourself even if that initially makes you feel guilty or mean
• No is a full sentence
• You can love someone unconditionally without tolerating their behavior unconditionally
• Its okay to put yourself in time out if you need space
• Remember that progress is not linear and that your growth will come with both victories and defeats, but you can always try again tomorrow

   

     Some issues are worth a discussion with your family about why a pattern has emerged and about how it no longer serves to help the family. Whether this is something that is safe or that you have the spoons for is a serious consideration before starting a discussion. A discussion does not mean change on the part of others is guaranteed. 

Some discussions may be heavier one on one conversations with a parent or partner. This can be a place of growth if both parties are receptive to it.

    "Following up on my previous example, once I had addressed my own management of anger and worked through some of my own trauma I had a conversation with my mother. She was receptive to having an adult conversation where she explained to me the personal work she had done and acknowledged the way her anger impacted my upbringing. She then resolved to continue her personal work and the result is we have a much stronger healthier relationship today."- D.M.

    Some discussions will be a series of conversations with multiple people over time that result in an overall change for a wider family unit.

    In my family, the discussions that we have been having focus on mental health and how we talk about it primarily. It is myself and one of my cousins driving these conversations. They are not big sit downs with everyone in the extended family but rather a series of short conversations we have as they come up organically. The overall result is a gradual shift in how most of our family talks about and treats people who are openly struggling with mental illness resulting in more compassion and awareness.

    We do still have family members who are not open to change, but they have identified themselves as not being a safe place to seek help in mental health situations and the rest of the family has been able to adjust their expectations accordingly." - D.M.

    Family or group therapy may be a good fit for some situations but it is important to remember that certain types of abusers can make this an ineffective option. 

    Breaking the cycle of dysfunction is more about a million small choices you make rather than one big one. You may find that you break some cycles and not others. You can always make the decision to try again tomorrow or to try to help someone else in your family or community break a cycle you can not.

    " I talk a lot and I am close to both my grandmothers. It has been an eye opening experience to hear what cycles they broke in their own family before I was born. I think it is important to appreciate that sometimes there is a lot that needs to be fixed and each generation is working within its own paradigm. Again, I am not excusing some behaviors that still came down through the family but understanding why has helped me better evaluate why I make the choices I make.

    One of my grandmothers waited to have children until she could provide a stable home away from her mentally unwell mother in law. The other made a point to be a supportive mother and grandmother in a way she did not have in her own life. They each made their own mistakes but these were big decisions where they were learning as they went and wanted BETTER for their own children. Its imperfect and flawed as all humans are but I still see they act on the motivations for those decisions even today in their attempts to make our family a safe and happy place to be.

    And at the end of the day, both of these women are still willing to have conversations with me about their choices, their successes, and their failures so that my generation can learn from them and do better. This is them breaking a cycle still, because it is a relationship I have with them that neither could have had with their own grandmothers." - D.M.

   

    

Resource: Psychiatric Advance Directives (PAD)

Obligatory I am not a lawyer disclaimer here. 

A Psychiatric Advance Directive (PAD) can be one of the most empowering tools you have at your disposal if you have chronic mental illness that needs crisis intervention. Unfortunately, not all states recognize a PAD although you may be able to alter a advance directive ("Living will") to include mental health provisions in other jurisdictions. You can read more about what US states accept here.

What is a Psychiatric Advance Directive?

A Psychiatric Advance Directive is a legal document in which you describe the types of mental health treatments that you would or would not be filing to receive. It also allows you to designate an authorized decisionmaker for mental health decisions on your behalf.

It is essentially a "living will" for mental health.

How does it work?

You fill out a PAD form with your preferences. The forms are fairly self explanatory where it asks a question and you fill in a blank. A witness or notary may be required to be present when you sign the form to make it legally binding. (FYI: Many banks and post offices have a notary on staff in the US)

This form is then copied and put on file with your therapist, psychiatrist, or doctor for use in medical emergencies. It may also be wise to carry a copy on your person or take a copy with you to the hospital if necessary in a crisis.

You can request this form be removed from your file at any time if you need to update it.

Where do I find the form?

Forms for the US can be found here - https://nrc-pad.org/states/

Form provided by the NHS here

"I am going to be honest, this is not going to be an easy form to fill out for most people. You will need to sit and think about where you are at your worst and be realistic about the treatment you will need as well as what you want to happen. The idea is you let your most stable self make decisions for your most unstable self. 

This also means you are designating someone else to be able to make decisions for you and it will require at least one big conversation with that person to ensure they know what you want and agree to act in that capacity. 

Personally, while my husband knows my mental illness the best and I trust him the most, I did know that he will need emotional support if I am in crisis. I made the decision to make additional notes that he should reach out to two friends we refer to as "The Vulcans" if he was ever unsure of what I wanted because one could emotional support him while being rational and the other is someone I know would make the same choice as me in that spot 98% of the time, so if he was unsure she could provide insight. I know this may not be an option for everyone, especially if you don't have a community that talks about mental illness as openly as mine does. " - D.M.

An important part of being an adult is making sure you have a plan in place for when things go wrong. This includes ensuring you have done some estate planning, even if you are younger, because it ensures your wishes are followed when you do not have control. This can include having a Power of Attorney, Advance Directive (Living Will), and Will drawn up. A Psychiatric Advance Directive may be an excellent addition to these documents. 

" I am a firm believer in my mental illness not being my fault but being my responsibility.

Before I had surgery I needed to get my legal documents in order and I wasn't sure where to begin. My grandma gave me a little list of documents people normally put together so I could google forms. I ultimately decided to sign up for the free trial for Law Depot and use their software to create my forms. They do an excellent job of breaking down this process (here) and I was able to get everything notarized at the post office." - D.M.

Control: Regaining Control as a Survivor

 This next section is about Control which closely relates to the Safety and Security sections.

    Control seems like a very basic concept on the surface. Its simply who has the power to direct behavior or events. Control in practice can be much more nuanced and complex. It can manifest in different ways depending on the people involved or the dynamics at play. Many, if not most, survivors of trauma struggle with feeling like they do not have control or trying to take back a sense of control.

    How to regain control as a survivor can be just as varied as the initial source of trauma. There are healthy types of control such as:

• Taking ownership of the narrative, telling your story out loud
• Establishing boundaries in existing relationships
• Creating distance or going no contact with abusers
• Self actualizing and self work
• Starting over fresh
• Therapy (multiple types)
• Exposure Therapy
• EMDR

There are also unhealthy or maladaptive forms of control that some may attempt to exert such as:

• Authoritative roles in personal relationships
• Codependency
• Toxic feedback loops
• Extreme helicopter parenting
• Self sabotaging
• Lashing out at loved ones
• Destroying personal property
• Rage issues
• Self isolation
• Self harm
• Physical harm such as cutting, burning, etc.
• Putting ones self in dangerous situations
• Addictions and substance abuse
• Disordered eating (a diagnosis on its own that requires specialized treatment)

    It can be very difficult to find a balance between feeling in control and having a healthy level of control. The support available, the information about mental health, and trauma informed care can be major factors and are unfortunately not universally available. Many people stumble on a combination of healthy mechanisms and unhealthy ones as they work through trauma on their own.

    "Its hard to know where to begin because time doesn't always feel linear to me.  Early on, I know that I often felt like I had no control of my own feelings, no control over my life, no say in what happened largely in my home. Some of the first places I felt in control were in self harm. I was in control over how much it hurt, how often it hurt, where it hurt, who saw it, and who knew. 

Later I worked up the courage to tell someone what had happened. I felt so scared and so much guilt. Telling ones story can be incredible in the right setting but it is also a place of vulnerability. It means letting someone in and hoping they don't use it again you.

The first person I explicitly told about my childhood abuse ended up being my next abuser.  It tainted my ability to reach out for help again. I wish I had adults I felt I could trust but I really didn't and unfortunately my religion at the time did not help in that regard. 

For years I would look for control in the moment using the unhealthy mechanisms. It would feel like I was drowning and then for a moment I would lash out and suddenly people saw me and my pain. This contributed to my breakdown in my relationship with J and was ultimately a pattern I did not want to repeat with my now husband.

 It took a dear friend reaching out to be like "You know I am a broken mess but right now you are worse than me. You need help. Please see a therapist." He was right. I made the appointment and started making an effort on learning healthy mechanisms AND putting them in practice consistently.

Healthy coping mechanisms take more work. They are harder because they are something you have to consistently, imperfectly practice until its a habit. It is worth it though because I get to have normal relationships now and I don't feel like I need to hurt myself. I am the closest to consistently happy that I have ever been now."  - D

    Therapy is not the only way to gain healthy coping mechanisms but it can be an enormously helpful tool if it is available to you. There are many self help books, support groups, youtube channels, and blogs dedicated to helping people gain the tools they need.

    "One of the simplest, note simple not easy, things you can do to start this journey is paying attention to your self talk. How do you talk to yourself in your head or when you are alone? Would you let someone speak to a friend or loved one the same way? Probably not.

You have value. You have worth. You deserve to be happy. You are good enough as you are and your best should be measured against where you started not against someone else's successes.

Being kind to yourself sounds so simple but its a hard habit to engrain. However, once you stop being your own worst critic, it becomes easier to accept when others say something kind to you. 

That being said, self actualization is the next step and being honest, but kind, about your own flaws and shortcomings can be even more difficult. I can be this super kind, hardworking, generous person but I can also be a selfish bitch at times. I am both and that is okay because in the future I can make the choice which version of me I am going to act on. It also means owning up to what I did when I was selfish... and its turns out sometimes my selfish was just a boundary others didn't care for." - D

For Loved Ones

How can you help your loved one feel like they have control?

Consistency, Kindness, and Patience. 

Consistently give them space to express emotions, fears, and experiences. Respond with empathy and never use trauma against them or as leverage in a disagreement.

Be kind and patient. It can take months or even years for someone with severe trauma to come to fully trust that you are a safe place. It isn't personal and you are not being "punished" for someone else's behavior, its about survival and over time trauma literally rewires the brain. It takes time to undo that.

If you are not in a place to provide a consistent safe place over an extended period of time then you need to have a talk with your loved one to set expectations and maybe create a system that allows you both to tap out as needed.

"I know that saying to someone "I love you but I don't think I can deal with your mental illness" has to be a scary moment. My husband said this to me early in our time together and while it did sting to hear, I appreciated his honesty because it let me set my expectations. Over the years he put in the effort to learn more about my mental health, what I actually needed from a partner, and to work on his own issues. In the end, he is an excellent partner to me and handles my mental illness well but we both needed time to work on ourselves to reach this place." - D

Safety and Security: Regaining Security

This section on safety and security is intended to discuss the ways in which survivors can regain a sense of security after losing their sense of safety. It can be useful for survivors and their loved ones. Each person will have a unique experience as they seek to regain a sense of security, simply because the loss of security is incredibly personal.

Safety is largely about the physical space one can occupy. It can be difficult to find spaces that are safe simply because removing any trigger and having complete physical control over a space is often limited to one's own home.

Security, on the other hand, is more about the internal feeling of safety. It is how safe someone feels when navigating the world as a whole and their life. A lack of security can manifest in many ways including anxiety, paranoia, insecurities, anger, fear, phobias, etc. Many people will become defensive rather than admit to a feeling of insecurity in a space.

"I touched on my feelings of insecurity in the last post. I have a very hard time feeling safe in public spaces unless I do things like wear pants. For me, regaining security has often been about identifying what generates the most anxiety and fear, then working to minimize that.

I like to feel like I have a fighting chance. I want to be dressed in a manner that lets me run or fight. I want to know how to get in and out of the places I am in. And I like to go places with people I trust to keep me safe in those places.

Home is harder. I am very happy to live in a new apartment that I have no associations with. I have a library even. I do find that when I am very anxious or insecure that I want to curl up in a ball in the bottom of my closet. I am currently working on not doing that. I allow myself to go hide in the library. It has a very comfy seating area with a blanket and some stuffed dinos. I am allowed to curl up in there but not in the closet. The goal is to work to a place where being alone in a room feels as safe to me as physically hiding in a small space does.My therapist and I chat about that sometimes. It is really hard but making myself be willing to walk away, be alone, and come back has helped.

I also find that people I am close to are usually really amazing. I tend to react to someone's disappoint or anger with me by becoming very scared they will scream at me or hit me. I am never entirely certain people wont react this way, even if they have never done so in the past. I understand that is is an irrational feeling coming from internal sources. I have been working really hard to talk to my current partner about these feelings. He is really great about explaining that he isn't going to hurt me, understanding that I can't turn off this thought process, and just helping me work past it. I also have a close friend who makes a point of apologizing and just being really blunt with me. He doesn't get angry with me, because he doesn't allow anything to build to the point of anger. It does come off as abrupt at times but it helps me identify behavior I can work on without getting to the irrational place. It has helped me a lot to simply have people understand that I can not turn off the thought patterns or the fear. I KNOW one thing but I still FEEL another. I hate knowing I can trust a friend or partner entirely and then being so scared of them that it makes my stomach hurt and my hands shake. They don't deserve it and neither do I. But I know that this behavior is what helped me get through some really dark places, so it is very hard to explain." -D.M.

Positive Self-esteem and Self-Worth: The Expanded Version

   Self-esteem and self-worth were covered in a subsection of our Negative Emotions section. That post pertained mostly to loss of self worth and low self esteem. This post is intended to cover positive self esteem, regaining self worth, and how to move forward.

  Below is a brief recap of what self-esteem and self-worth actually are, as well as what makes those things positive.

 Self-esteem is to have "a feeling of having respect for yourself and your abilities" according to the Merriam-Webster dictionary online. This post will discuss having and rebuilding high self esteem, thus a feeling of having moderate to high respect for yourself and your abilities. Self esteem issues, particularly low self esteem, can be caused by a wide number of experiences and some mental health issues. It is not exclusive to abuse survivors and some abuse survivors have good to excellent self esteem. This post will address how best to build self-esteem regardless why one has low self-esteem.

  Self-worth is to have " a feeling that you are a good person who deserves to be treated with respect" according to the Merriam-Webster dictionary online. This post will discuss positive or high self-worth in addition to high self-esteem, thus having  a feeling that you are  a good person and do deserve to be treated with respect. Self-worth, like self-esteem, can be caused by a wide range of experiences and some mental health issues. It is not exclusive to abuse survivors, although it is very common among them. This post will also cover how best to improve self-worth.

  The majority of advice and discussion in this post will be based on personal experiences by our collaborators. We understand that the vast majority of survivors, and people generally, struggle with these issues . The causes of low self-esteem and self-worth can be deeply personal, highly traumatic, and/or completely subjective. Please, take whatever helps and pass over what does not.

  The Mayo Clinic has two lists of steps for how to improve self-esteem that can be found here; one is based on cognitive behavioral therapy while the other is based on acceptance and commitment therapy. The steps based on cognitive behavioral therapy will be more effective for those who use rational reasoning while the acceptance and  commitment therapy steps may be more effective for those who use emotional reasoning. A summary of those steps can be found below.

Cognitive Behavioral Therapy

1. Identify Troubling Condition or Situations
2. Become Aware of Thoughts and Beliefs
3. Challenge Negative or Inaccurate Thinking
4. Adjust Your Thoughts and Beliefs

 This system largely works on redirecting harmful thoughts to create new healthy patterns. It requires some self awareness and introspection.

Acceptance and Commitment Therapy

1. Identify Troubling Conditions or Situations
2. Step Back from Your Thoughts
3. Accept Your Thoughts

  This system works on pushing one to gain perspective using an altered point of view. It focuses on using self awareness and self affirming behaviors to create new healthy thought patterns.

   Improving feelings of self-worth is a process with less concrete steps. Often, when one improves their self-esteem, then self-worth will follow. Setting and maintaining healthy boundaries in relationships, deciding on personal standards, and removing toxic relationships can help create a pattern where self-worth increases on its own. The contrast of a healthy relationship over an unhealthy one can be very motivating, even if maintaining healthy relationships require work. Once firm boundaries and standards are decided upon, using steps very similar to the ones listed above will help in creating healthy thought patterns about self-worth.

   Self-esteem and self-worth issues can be very common; our collaborators at Stars have shared their struggles with negative self-esteem and self-worth in the previous post, now they will share how they have worked to make positive changes in their own lives.

   "I mentioned having a serious streak of bravado. I can be cocky at times. I was very willful and particular as a child; I had things I loved doing no matter how poorly I might do them. I am genetically predisposed to being stubborn like that. I found over time that I had some talents that really made me happy. I was naturally good at science, cooking, painting, and writing. I often indulged in these things for my own happiness. It made it very hard for anyone to take those things away from me or shake how I felt. I could be criticised for them, but some part of me is an asshole enough to say 'Fuck you. I love doing this.' That turned out to be a blessing in many ways. The abusive romantic relationship I was in put me in a situation where I was slowly giving up all these dreams I had, because they didn't feel possible anymore. The one I didn't give up on was culinary school. I knew I was good at cooking and I loved doing it. It was my calm in the storm, so I never ever let anyone convince me I shouldn't do it. It wasn't about good or bad, because it was about my love of doing it rather than the end result.

  My self-worth was not as durable. I still struggle with that a fair amount. I have to remind myself that healthy relationships do not keep a score, and that if you treat others as you wish to be treated, then you set a standard with more than words. I might not feel like I deserve some of the kindness and gentleness I have received, but I do generally expect to be treated as I treat others, so being kind is a very reasonable expectation. External validation helps, but so does the bravado a little bit. It helps to fake the self confidence I don't have until I can sit for a bit to rationalize things. The difference in my life and my happiness now versus about seven years ago is night and day. I would not go back to that for anything, which helps me see that this is better even if I am sometimes insecure. Being a little selfish is a good thing sometimes. I can't say I feel I deserve to be respected all the time, but I don't mind demanding that respect anyways. It creeps into my job a lot. I work hard, but sometimes I have to channel my inner diva a little when I feel anxious or guilty for asking for things." -D.M.

"It Could Be Worse." It is the moment you say those words.

  This post is specifically for listeners and loved ones. It is the flip side of "Are You Okay?"

   There are many times in life that we find ourselves on the receiving end of a difficult disclosure. It could be finding out about someone passing away, a tragic accident, or any number of other situations. It can be very hard to find the right words at those times. We may wish to offer comfort or provide perspective and find ourselves relying on an old cliche. This post is about why those cliches are damaging.

   Let us all begin by acknowledging that each one of us is in a physically, emotionally, financially, or mentally better place than another person on this planet. We are also worse than another person on this planet. We are neither in the best nor worst position. This state of being will be the case from the moment you are born until the moment you die. It is simply a fact of life. Life is not fair and we all must get past that.

   That being said, it is important that we all try to have some sense of perspective. This can be very difficult for many people for a variety of reasons. Sometimes we want to remind someone to count their blessings rather than their sorrows. An understandable sentiment but one which has given us a number of unfortunate phrases.

  These phrases are intended to express that one person believes the other needs some perspective. This might be true but many times the uses of these phrases does not convey that concept. It rather says to the survivor that their experience was not "tragic" enough to warrant the very complex and difficult after effects. These effects range from mild depression to suicidal thoughts. They can include violent impulses, nightmares, disturbing flashbacks, and even be expressed as a number of mental disorders. Everyone has their own tolerance for trauma; thus everyone will get a slightly different mix of effects. These effects can be highly unpleasant.

 The following phrases have each been suggested by a collaborator based on their person experiences. These are things that someone told one or more of us as we attempted to share our stories and experience. We can each attest to how hurtful they were and how they made us feel very alone at times. It is very isolating to experience unpleasant after effects that no one wants to help you weather.

  The phrases are as follows:

• It could be worse.
• At least you're still alive...
• That happened a long time ago, you should be over it.
• Worse things happen to people everyday.
• If it wasn't you, it would have been someone else.
• [Abuser] would never do that.
• It couldn't have been that bad, he/she didn't beat you.
• You must have done something to ask for it.
• Why didn't you just ______ ? 

 These phrases cover a variety of reactions. Some are intended to provide perspective, some are denial, some are misunderstand and some are just attacks. Each of them creates an issue for the survivor who hears them. They can suggest the abuse was less severe than it was, show a complete lack of understanding, come off as callous, basically call the survivor a liar, or just bring up bad memories. It can even feel like a push for more details very quickly, something that more survivors aren't likely to do. It makes a difficult scary situation into a terrifying game of wanting to be believed vs. sharing too quickly.
 
   Many times, survivors do wish that things either hadn't happened or had been the obvious sort of 'bad' that everyone else can recognize. There are many forms of abuse that leave no physical marks and are socially considered to be 'less' damaging. They are not less anything. Furthermore, a survivor may have very conflicted feelings about their abuse. They may be second guessing a lot of their own actions and memories to begin with. On the whole, survivors don't want worse things to happen to other people and they are not trying to take away from the severity of other tragedies. It should be enough that our own trauma has a level of severity that should be taken seriously without acting as if we should be grateful it wasn't worse. Honestly, sometimes worse seems easier, more clear cut to explain and easier to find support for.

  Something to consider for those who read this as a loved one, care taker, or authority figure.

 Finally, if you find yourself thinking of saying something along the lines of " It could be worse." Consider instead saying, " I know this is really difficult for you, but can we take a moment to focus on some of the positive things in your life, like _________." This helps to redirect the survivor to more positive thoughts without belittling their feelings or experience. The other responses show that the listener either doesn't understand the severity of abuse in general or is not the best person to confide in the begin with.


                  **********************************************************
   This last little section is to address the responses that male survivor sometimes get when they reveal that their abuser was female.

• I wish that'd happened to me.
• That's awesome!
• How did you get with an older chick?
• I love [ explicit sexual act ].

  First off, a woman is capable of sexually assaulting or raping a male. Second, arousal is a physical response that many of us have no real control over, consider 'morning wood' or 'workout orgasms'. This automatic physical reaction is not a yes for women, nor for men.

  That being said, our society places a lot of importance on men being macho. It is socially acceptable and even desirable for a man to be with many sexual partners; particularly if they are skilled in some way. A portion of our population thinks that anytime a male is sexual interacting with a female, that it must be pleasurable and wanted by the male. Also, that a man could or would never actually be overpowered or violated by a woman. That is not the case and expressing that as a listener you wish you were in a position to be sexually assaulted or raped- you have shown a complete lack of sensitivity and awareness of serious social issues. Basically, anything that sounds like "I wish it had happened to me," is going to show you have no idea how devastating it is to have no control over your situation or body. It shows you have never even considered that you could be forcibly held down or drugged.

  My only suggestion for this one is, DO NOT SAY IT! I don't care what you are thinking- keep your mouth shut. You are going to do way more harm than good with this one. I suggest some serious research on your part to become better informed. Do not ever tell a survivor that you wish you had experience their abuse. Its beyond not acceptable.


 

How to Communicate: Sharing

  Sharing your story as a survivor can be a most conflicting experience. It feels like an impossible task, being both terrifying and compelling. This choice to share is a deeply personal one, and the way it unfolds can have a huge impact.

 There are a lot of factors to consider when sharing your story. The most important one of all is how you feel about sharing. Sharing will not necessarily be this huge painful event, nor will it necessarily be a huge relief. Rather, it will be somewhere on the spectrum between the two. Your story, when told aloud, will become more real than you have ever imagined in some ways, but it will also lose some of its emotional hold over you.

   The best way to get a read on how you feel about sharing is to pick a quiet place, go there alone, and act it out. Imagine the person you would want to tell is there with you, and actually say the words out loud so you can hear them. Start with something simple such as, "I was abused." The shorter and simpler your opening statement, the easier it will be to just 'jump into' it. Play out the whole conversation in your head and as many reactions as you can imagine. Talk every one of them out. Consider if any of those scenarios helped you to feel better in a way, or if they hurt more than you can tolerate. Sharing may be easiest when you reach a point of "I cant stand the silence/lying anymore," or " I need to tell someone." These feelings will give you more drive to share your story.

  The second most important factor in sharing about your abuse, is deciding who to share your story with. Ideally, the best person to share with is someone who will listen quietly, ask only intelligent and necessary questions, be empathetic, and can keep appropriate confidence. This may not be a family member or close friend.

       Individuals who have done some soul searching and decided that legal action will be necessary (particularly if your abuser has access to other potential victims) will need to pick an authority figure who can be trusted to listen and take appropriate action. This can be any number of persons depending on your situation. It might be a parent, a teacher, a member of clergy, a police officer, a social worker or a doctor. Many of the people in these roles are legally obligated to report suspicion of abuse. Women in particular may find their best opportunity is in their doctor's office, and many medical professionals are given training for such circumstances. I strongly recommend using our link here to familiarize yourself with what will happen after you disclose your abuse, no matter who you choose to disclose it to.

  Some survivors may find themselves in situations where legal action is not their chosen course, or could jeopardize their safety. These individuals may choose to share their story with a friend, a family member, a therapist (some of which may be legally required to report abuse), or other survivors. It is very important to take time to honestly consider the pros and cons of the person you choose to confide in and why. You are looking for someone who can keep confidence, have an open mind, comfortably handle your story and empathize with you. Avoid persons who habitually engage in unhealthy behaviors (such as name calling or shaming you), or who put you in awkward positions. Anyone who is prone to gossip may also be a bad choice. Avoid people who might behave violently toward you. Ultimately, you will make this decision, but think about how you would feel if they tell other people, proceed to shame you, or call you names. These are all very hurtful actions that can negatively impact you and the whole sharing experience.

   Once you have decided if you are ready to share and who you want to share with, you need to decide how you want to share. This will vary greatly depending on whether you are taking legal action or not. Those of you seeking legal action in the U.S.A., please use this link to guide you in how to proceed. Those of you seeking legal action in the U.K. can find more information here.

   There are many ways to share your story with another person. Each has its pros and cons, so choose the one that will work best for you. I advocate face to face conversations if you can handle them. It allows you to connect with another person and then allows them to provide tangible comfort if needed. Writing a letter or email can be a less personal way to share your story, as it will offer a bit of a buffer if you need to work on your confession in bits and pieces. You can even combine the two and write a letter, then read it outloud. Some people may find that creating something artistically helps them present their truth to others, since it begins the conversation in a way. This can be a painting, a sculpture, a song, or a poem, among many other things.

   Once you decide to share your story you will follow many of the steps mentioned in 'How to Communicate; Asking About Abuse'. Pick a safe and somewhat quiet place to talk. Make sure that both you and the person you plan to tell are in a calm emotional state and receptive to what may become an emotionally intense conversation. Try to remain calm throughout, and stop if you need to. Be prepared for the listener to need time to digest what you say. Consider that they may respond in a number of ways, some negative and some positive.

  The conversation of abuse should be started in a simple way, much like you practiced alone. A short statement of fact. Allow your listener to absorb that information and then consider asking them if you may tell them the rest of your story. Keep in mind that others may have a similar past or be unwilling to listen. Give your listener a chance to make that decision on their own. Someone who chooses to engage you in this way is more likely to provide you with positive support.

  The conversation from that point could unfold in a number of different ways. You may find that you can continue very calmly, you may become very emotional being angry or sad, or you may choke up. Try not to rush yourself and move at the pace that is best for you. It is a complicated process and you may find yourself admitting some darker inner feelings such as worthlessness or feeling used. [These feelings will be further discussed in their own posts shortly.]

     Personally, I felt very guilty. I openly admitted to feeling like a bad person, as if I had asked for the abuse. I truly thought I deserved in it in some way. That made it very difficult to express. It wasn't as if I had any feeling of self worth and I didn't feel I deserved worth. These things are not true, and over time I came to have a better understanding of why I felt that way and how to get past those issues, but when I first told someone; It was overwhelming.

   It is perfectly okay to stop sharing because it hurts too much. The conversation may become an ongoing one, where you share as you can. This process is about you and about coming to terms with your own story. It is complicated to say the least but it is very much worth it. Try to remain as calm as possible and don't be overly graphic to begin with. Take deep breaths and stick to the facts as much as you can. Detail what happened and how you felt about it, try not to make assumptions about your abuser's motives.

   Sharing is an incredibly personal process. It is very difficult to give hard and fast rules on how to share. The steps mention in this post are meant as guidelines to help you begin your conversation. In the end, this conversation will be unlike any you have ever had and yet like so many others.


Anyone who has shared is invited to add suggestions in the comments section of this post.

"Are you okay?" : The loaded question

  This post is somewhat related to the communication series we are currently working on. Nonetheless, it is directly related to How to Communicate: Asking about Abuse . The most frequently asked question that people use when asking about someone's emotional state is "Are you okay?"

  "Are You Okay?" is a loaded question despite it seeming like a binary one. Obviously, most people expect a yes or no answer. The problem is that okay has about four definitions, and generically means that one is neither very good, nor very bad.

   A survivor has an emotional range extending between soul crushing agony to I-can't-breath to almost normal to content to happy. Keeping that in mind, does okay mean that I won't burst out crying right now even though I kind of want to die? Does it mean that I can probably keep pretending to smile for the rest of my work shift? Does it mean that I don't feel like self harming or outright suicidal right now? Those can all be middle ground emotions for a survivor, but that probably isn't the 'okay' the one asking is looking for.

  The person asking that question probably wants to know if the person they are talking to has a grip on their emotions, and will be able to say they are happy at some point in the near future. No. And many times, the answer will be "No." if you are a survivor. That is not to say that every survivor is living in a miserable state of depression, but rather that like everyone else, we cycle through a lot of emotions every day. There are times when we reach a trigger - perhaps the anniversary of something traumatic, and our emotional state becomes compromised. [ A section dedicated to triggers will be posted in the future. It is strongly recommended that Loved Ones read it. ]

  The best example that I have of what "okay" means some days, is actually a post from my personal blog, one I share with a select few. Today, I am going to share that with you, my readers. The day I wrote this next paragraph was a day that I went to work and was "okay". I talked to people, did my job, didn't cry, and went home.

 "Somedays I just want to scream. I dont want to censor or silence myself. Its beyond longing to simply release the feral beast trapped within. She is not a quiet, passive person. She rages, slamming against the walls of her prison while snarling and clawing any happiness nearby. She need not be provoked for simply being awake is enough to draw forth a mighty anger bore from the darkest reaches of my own soul. Today, today I want to scream. I dont want to reason with those I love or hope for their acceptance. Somehow today I want to scream to the overcast skies that there are still unhealed wounds, that I can not bear the saline words ground into them. The silent denial of truths that rock my world, the blissful ignorance of the black abyss monster always poised to drag me under the churning waves. The endless nights laying awake because I can feel the shadows settle as my demons hover over me waiting to lead a legion of nightmares into my slumbering mind. Its the conflict of the primal being as she struggles with her rational form. Its the cramped box of expectation as the air runs out.

Today, today I want to scream. I want to roar, leave my throat raw with the rage I hold inside. Today I dont want to smile and lie."  - Feb. 2013 

                                                                                       -D.M.

    Asking "Are You Okay?" welcomes a confession and encourages a lie. The person asking the question is probably not ready for a confession, yet a lie can be incredibly isolating to a survivor. Think about your closest family, your dearest friends, and the person you love. When you ask them if they are okay, you probably want a truth. You want to know their thoughts and feelings at that moment. You are looking for a confession.

   Now, consider your classmates, coworkers, customers, or casual acquaintances.  Imagine asking one of them if they are okay. Perhaps they are a bit too quiet today. Suppose that instead of saying yes or no, that they started to cry and tell you that they woke up from a nightmare of being brutally beaten, nearly to death, even when they begged their attacker to stop. Imagine that that attacker was someone who really existed, perhaps a parent or lover to this person. I doubt that many of us are ready for that type of disclosure. Those of us asking are not ready for that answer, or any like it. It breaks the social convention that someone should share something so intimate on a whim. It was loaded, there was no way we could know what would be said. I have been the one to ask this very question.

  I have been the one shocked by a moment of intimate words that I had no way to relate to or comfort to offer. No apologies or cliches could come to mind. I stood there unwilling to be closer to that person, unable to help or understand. I had basically reached out offering help and found that my lifeline was nothing more than a frayed bit of twine. I wasn't ready for the answer to the question I had asked." Are You Okay?" -D.M.

I have also asked others, survivors that I know and care about, this very question out of genuine concern. Either the response was half-hearted and rang hollow of the truth, or it seemed to inspire a moment of agony before the person burst into tears as their fear of answering and upsetting me or driving me away finally broke the dam of emotions pent within them. Though I know that they knew the question for what it meant, I could tell that they resented me in that moment of genuine concern and good intentions. -J

  And I have been the one to answer.

   I have stood quietly doing my job when I wanted to scream and had a coworker ask me if I was okay. I said no, because I woke up from a nightmare so violent that it made me physically sick. That I was tired of this special hell that comes to me when I sleep. He is a nice man but he was not ready for that answer. It felt good to say it out loud but then to realize that I had upset someone who I rather liked. I could see he had no answer for me, and no comfort. It made me feel sad and alone. I had tried to reach out to another person but they couldn't understand this very personal hell I was in. It was a moment of despair. The question had seemed so like a glimmer of light on such a dark day. But, I had broken that social contract. I had failed to answer him the way he expected. I had to, I couldn't bear to lie even once more about this. I was sick of pretending.

  Alternately, I have stood there and lied. I have said a million times over, day and day out that I was okay. I knew that I wasn't okay. I knew that I was no where close to believing my own lie and that perhaps if one more trigger hit, that I would crave an oblivion from which there was no return. It was isolating, miserable, and the place from which that abyss monster comes. That echoing silence that seems unbearable and infinite. It was killing every worthwhile part of me, but I lied because I didn't know how to handle the discomfort of a broken social contract. I did this for well over a year until I was forced to explain why I needed an escort to my car at night. -D.M.

      One thing I've found useful is to answer with, "Not right now, but it's all right.  I'll be okay later," or some variant thereof.  This both serves to reassure the person I'm speaking to, and, to be honest, it reassures me a little.  It's a reminder to myself that this will pass, and I will feel okay again.   - T.

    I have come to truly feel that asking if someone is okay is one of the biggest loaded questions we could ever ask. Our society has created a social contract where this question has two meanings, one to our intimate circle and one for everyone else. Those in that outer circle should not answer honestly, but with a binary yes or no. We really haven't been taught how to respond when the answer is beyond that. There is no way to win on either side of that question.

  For me, "are you okay?" is at the same time a welcome and dreaded question.  From people I'm close to, I welcome it - the chance to share and get some support.  Sometimes, just knowing that someone cares enough to honestly ask if I'm okay can be a lift. On the other hand, with strangers or acquaintances, all too often I feel like I have to lie, to say I'm okay at times when I'm really not.  Sometimes, if I know it's absolutely visible that I'm not okay, I lie about why I'm not okay, saying that I'm feeling sick or something like that.

  These days, I tend to divide people up into three groups for how I respond - strangers and acquaintances who I lie to; friends who I will tell that I'm not feeling okay, but not go into detail with; and those who I will talk to in detail. In my case, things get complicated by the fact that I still don't feel like I can be completely open with everyone I'm close to about my experiences.  I was abused by my uncle, and bringing that up with my family is just too much of a potential minefield for me right now.

                                                                        - T.

   The best way to move around this loaded question seems to be using more specific questions in it's place. T says it well.

 For loved ones, I'd suggest that asking more specific questions can be helpful - as D.M. writes, 'okay' can cover a broad reach of ground, so it can be easier to answer specific questions, or even if given a bit of framing.  For example, "I've noticed you're staring off into space a lot.  Is there something on your mind you'd like to talk about?", or "I'm worried about how down you've seemed lately.  Are you okay?"  This expresses an interest beyond the simple polite "are you okay?" and can make it easier to open up.

   Also for loved ones, touch can make it easier for someone to open up.  Even something as simple as taking their hand can be a huge help.  If you're unsure, ask.  If they pull away, don't pursue.  Remember, if you're dealing with someone who's been abused, they have many memories of hurtful and hateful touching, and sometimes those memories can be overwhelming, even with someone they love.

  While not common, dissociative disorders are sometimes a complication for those who have been abused, and can make the question of "are you okay?" very difficult to answer for those of us who are also dealing with them.  I think that deserves deeper treatment in relation to dissociative disorders in general, though, so I'll talk about that in a future post. [ A section on dissociative disorders largely written by T. will be included as a later section. If this subject is of interest to you, please comment and we will get you more information.]

  

How to Communicate: Asking about Abuse

  The first four posts of the How to Communicate series give the basics on how to have a conversation, when to have a conversation, how to word things, and how to express discomfort. These basics are intended to create a safe, respectful place for conversations to be had. They are the building blocks for successful communication.

  This post is very specifically for loved ones who are asking someone about their past abuse. Those of you who are reading as an authority figure or concerned friend who possibly needs to report abuse you can find more information specific to that issue here. Please use that resources.

    Asking about abuse is a very delicate process. Ideally, the person you are talking to has already shared a little bit about their past and have shown an openness to sharing. The most important part of asking is compassion. Take some time to consider how scared, upset, angry, frustrated, or hurting your loved on might be feeling. It is unlikely that you completely understand the depth of that feeling without your own experience. You are about to ask them to relive some very painful moments and going into that you need to consider how you would like to be treated if roles were reversed. They may choose not to respond at all or shut down.

   When will you ask if the second consideration. Aim for a time that your loved one is relaxed, fairly calm, and in a decent mood. Pick a time where they have alone time, will have alone time later, and will not be completely without support. Try for a time where they have minimal responsibilities to attend to but not so much free time that you will be leaving them in a dark place for days.If they are nightmare prone, morning is better than evening.

   You have sorted out the proper when and now you need to decide on where. We discuss finding that 'right' place in the How to Communicate: Social Situations blog. This is the same process. Pick somewhere neutral but safe feeling. Home is not the best choice because it can feel too confining and might 'taint' the safe feeling later. I recommend a local park, nearby cafe, or diner personally. These places provided limited distraction, but have a clear escape. Some people like to fiddle with things when they are uncomfortable and these places have such outlets. Be sure the location you have chosen is free of interruptions and will allow you plenty of time for the ensuing conversation.

  How do you ask once you are where you need to be at the right time? You begin with your nonverbal cues. Uncross your arms, look at your loved one, consider holding their hand. Begin by making them feel loved and that this is an open sharing space.

  What do you say though? It depends largely on what you already know and what you plan on doing with that information. Information needed for legal reasons or to report a suspicion will need to be collected in a very specific way. Please use the link here to find out more about that process and what to do.

  Asking out of concern or to reach out is a different more organic process. Supposing you just have suspicions of abuse you might say something like, " I have been noticing that you seem [ sad/angry/down/etc] lately and was wondering why. I hate seeing you like this and want to help." The answer might not be what you expected, particularly if the person is not yet ready to share.

  Supposing you are aware that 'something' bad happened with someone but the details are vague and you are confused. Your dialog might begin with, " You have mentioned that ____ happened with/by ____. I am a little confused about what happened but I really want to help you move past it. Would you mind explaining more or telling me how I can help?" The answer here could be more vague than you want or just a list of things like hugs and friends that they need to feel close to. They may choose not to talk about things now but will mention it again later.

   Now, suppose you know that your loved one was abused. It was in the news or they said as much. You are curious what happened, you want to help, or you think they can help someone else. There is a good chance that this survivor already has a set response to questions. They may be very quiet about it or very open. A good line is, "I heard about _____. I want you to know that I am here for you if you want me to be." Or " I know that you do/dont like to talk about ____. I understand that. I know ____ went through something similar and could use a friend like you sometime." Responses to these lines will vary by how open the person is about their past. They may share and offer to answer any question you have or ask you to mind your own business. Graciously accept whatever response you get.

 Our collaborator T. would like to add that in all of these scenarios it is entirely possible to get a very negative reaction to your questions. His advice is as follows.

  My thought here is that while a negative reaction may not be something you can control, you can communicate about it in a positive way - and that's what this is really about: positive communication.  -T.

   You managed to work out when, where and how to ask. You worked up the nerve to just spit it out and now you are waiting for a response. They could do any number of things or say anything.  Be ready for anger, fear, guilt, relief, or tears. They might joke about their past even. Now, your job is to practice the listening we mentioned in the basics blog. You want to give them all your attention, respond promptly, and do not react emotionally. Do not defend or blame anyone, allow them to simply speak their piece on the matter. You may ask questions when prompted but try to avoid asking for graphic details. Be prepared to ask them to stop if it gets to be too much for you.

   Think about how you'd like someone to communicate with you if the situations were reversed, and try to model your communication after that. Not being accusatory, belittling, and so forth. -T.


   Once you have heard their story, take time to absorb it. Do not treat it as gossip, or use it to start drama. This person has trusted you with something very personal. You may find that the new information you have needs to be told to an adult or authority figure. Keep in mind that the survivor you talked to might truly feel their life is in danger so be sensitive when alerting authorities. They may choose not to be your friend after that.
 
  Asking about abuse is a very delicate process that can go in many directions. It inspires a lot of emotions and thoughts in the survivor. Ultimately, your job as the person asking is to remain emotionally even, be compassionate, and provide a safe place to share. These things help a victim turn into a survivor, by encouraging them to share again in the feature. It gives them another safe place to turn to.