I grew up in the mental health system when Prozac was the new craze. Prozac was the second drug I took and within three years there was the new field of psychopharmacology. By that time, getting the right combo became quite the rave. What that meant there was little to no exploration of the role of trauma in my life. Instead of learning about elements of trauma that were related to the eating disorder that threatened my life, I was diagnosed with a personality disorder and told not to research it because it would only make it worse.

My therapist would repeat to me that the only way to deal with a personality disorder was in the context of a psychodynamic relationship. She didn’t let on that she didn’t think I was college material even though my GPA was a 3.9. She told my parents. They concealed this from me.

I stuck with this psychologist for seven years. It was true I didn’t want to look back at my life growing up with privilege. I also didn’t get the feeling that it was mature to blame my parents for the shameful eating disorder that left me dwelling in the inner-city and without a sense of support. My suffering was nurtured in psychotherapy by a rolling of the eyes and waiting for the impact of the next drug combination.

A History of Class Conflict:

I first started to notice not enjoying being around other people in fourth grade. It started by being bullied and teased by my peers for not wearing the latest fashions that my parents refused to buy. For some reason I dealt with this by fighting back and getting nerdier. My parents sought therapy for me. Perhaps, they were embarrassed by hearing about my social problems from their other friends on the private school faculty.

Back then, I could not understand why I stood out so much. My parents and shrink would tell me that my superego was too dominant. The shrink would get my Mom to let me buy more fashionable clothing.

Meanwhile, in the summers I found that I, in fact, did fit in with the welfare family who rented the downstairs of the Lodge, our vacation home in a rugged boon town in the Adirondacks. My family once owned a lumber company and my father inherited many old buildings which we used to vacation and rent out. With the welfare family living downstairs for three summers, I felt totally accepted. I was too innocent to realize that their lives depended on keeping me happy. We didn’t need to bathe and could be wild and have fun.

My welfare brothers would talk about hunting frogs with bb guns. The frogs wouldn’t die. Bbs would lodge themselves under the frog’s thick skin. They could shoot them all day. They loved to hunt frogs all day. One had so many bbs in it, it just floated in the water with a stunned look on its face.

One morning I woke up screaming from terrors. Pigs were being slaughtered in my dreams. My welfare brothers would laugh at me. They would tell me I was screaming, “Don’t you do that . . . Don’t you do that . . . Ah . . . AAAhhhh!” Then, we would go to work for my father who always told me that my welfare brothers were better workers than me.

I guess I lived and worked with that family enough to see the world from their perspective. And, boy, when I did that my family didn’t look too good. In many ways it only reinforced self-hatred.

Misfit:

Of course, even though I dressed better, things would still only get worse for me at the private Quaker school I attended in a Philadelphia suburb. I would break into my French-Canadian northern drawl to confront my peers about their teasing.

I think my social awkwardness really stood out during summer outings away from the Adirondacks. First, it was a two-week backpacking trip with middle-class Albany, NY kids at the adjacent YMCA camp. Next, it was not fitting in with rebellious rich kids who were getting straightened out at a North Carolina Outward Bound Course. And, finally, I attended a work camp in Belize where all the boarding school kids only wanted to drink and be ugly American Tourists. Meanwhile, I stuck to my stated goal, to live and work as though I lived in Belize. I was told it was the wrong reason for making the trip, but I didn’t care.

Starving:

The year before my parent’s divorced I didn’t sleep more than three hours a night for nine months. Then, when my parents got divorced things got tough as I had to keep up with sports, work, extra curriculars, travel between both houses, and the sharp increase in school work. My mom started staying out at all hours of the night and forgetting to check on me while I was up working through learning disabilities at two in the morning. My dad still expected me to do his house chores no matter how many papers I had to write or how hard I worked at my fast food job.

I was a hundred and three pounds when I got admitted to the hospital. My parents packed my bags to drop me off at the hospital and the therapist said, “Wow, these bags are really heavy!” Then, he ordered my family to attend daily family sessions with me.

When I graphically failed to gain weight in that setting, my family had to pay out of pocket for two months of inpatient treatment, so I could gain twenty pounds. My father cried signing over the check and I felt much shame. I presumed the expense depleted my college fund. Because my room was converted to a study and I moved in with a friend upon discharge, I chose the least expensive commuter school.

College:

Okay, my choice of College was not quite that simple. In the all-female inpatient unit where I’d be forced to revisit for an additional three months (this time insurance paid for it,) even a repressed fellow such as myself managed to learn to how to kiss. I started a sexual relationship with a twenty-five-year-old newspaper photographer who was schooling at the affordable commuter campus. After I graduated and worked at a summer camp, I moved in with her. Because she wouldn’t allow me to have friends, the relationship only lasted two years.

The latter two years, I hid the fact I was binging and purging by keeping to myself. I never learned to hang out and fit in. I didn’t make it to as much as a single college party. Instead, I worked with the neighbourhood kids at a local Korean gangster’s deli. Community relationships and the associated sociological learning was the thing that kept me going.

I’d do a little better with my socialization in grad school when I was medicated and under psychodynamic treatment. However, when I tried to breakaway and make a comeback on the west coast, it wouldn’t end well. I found myself compelled to uncover murder and mayhem in a local section 8 housing facility. I’d end up in a state hospital and believing I was under surveillance for two years.

One-to-One Hundred:

 It’s true with complex trauma, I am sensitive and overwhelmed by the regular issues that come up between people and in families. My emotions are based on a social justice narrative and I go from one to a hundred when I am getting teased, causing me to be further targeted. I may not get the joke right away, roll with it and have a good comeback. The insult may cut at my core when I think about it later.

During my twenty-something years, when people drank (or drugged,) I generally responded the same way I do when I get teased. I’d get a numb look on my face, withdraw, look at my watch and long to be somewhere else. Then, I notice when people talk to each other as if I’m not there and I don’t know what to do about it.

Disassociation:

Of course, despite all the years of treatment I received, nobody noticed or asked about my experiences with disassociation. It wasn’t until I wrote a memoir about surviving the schizophrenia diagnosis that I recaptured a memory of molestation the summer of my third-grade year. In fact, I don’t disassociate regularly, but it can happen in times of excessive stress.

Of course, my response to the molestation incident was so extreme, I wonder if that was my only experience. I have many traipsed memories that feel like dreams and mystery. Are they also disassociated memories? Are they Dreams? I have always had them, and I have always wondered. Additionally, having many hypervigilant memories means, I have lost trust for people without understanding why.

Post-Partum Depression:

I never really understood how devastating the experience of post-partum depression can be for a mother. Then I heard a severely-traumatized patient I work with say that her post-par-tum depression was the lowest point of her life. Think of a traumatized person. Think of years and years of homelessness, rape, physical abuse, family suicide, substance abuse. And think that all this does not compare to the pain endured during a post-par-tum depression when a woman just can’t connect with her child. This really made me think . . .

Up until recently, my mother made yearly visits to visit family in the area during which she would spend a day at my house. One year I drove out a couple of hours away to meet her at a park local to her other relatives to see her an extra day. Out walking in a flat, marshy California park amid Spring flocks of birds, my mother finally gave me a feel for what she went through after my birth. Her mother refused to support her in her most difficult hours. I knew she had been depressed when her mother died, but I hadn’t known this. I knew she only told me this because she wanted me to stop processing depressing stuff and I listened to her.

In my family two-generations back, lobotomies and institutionalization were the cure for family mental problems. There was no support available to my mother when it came to having depression. She had to buck it up. She still expects me to do the same.

Still the Pariah:

I find no comfortable around people. I avoid social engagements because I feel stigmatized, patronized or outclassed by the comments of others.

For example, while it’s true I do not know exactly what all my relatives really think about me, I think that in observing a slew of collective behaviour, most would conclude that something is going on that is not positive.

It is true I bear the stigma of having schizophrenia because I choose to live out of the closet. Additionally, my memoir was honest and not always flattering toward the family support I received going through the experience.

My grandmother with dementia could not remember who I was, but when she found out I was the author of the book, she declared, “It made the family look bad!”

My mother has said, “I could have written a book about all we did to try to help you and about how difficult you were!”

My uncle, a career professor at Princeton University, demurred in his response for a while and then said only, “the last chapter was positive.”

Even though it won awards in four contests, my aunt gave my book four stars on Amazon and wrote, “it is a difficult book, as the author, a trained mental health professional, dumps the reader into his own experience with precarious mental health . . .”

Many relatives refuse to look at me and only speak to my wife or each other when I am around.

When I had to miss a reunion because of a severe back injury that had me out of work for several months, I was told by my mother and cousin that my relatives said: “well, why couldn’t Barbara (my wife) have come!” It seems it was a joke that was tossed around so much at the reunion, some felt I should get to enjoy it as well. I still don’t know what to make of it. Do you?

It is true not all the responses of family members are necessarily negative. For example, the judicious comment of my uncle may not have been as negative as it had seemed. He later told me he liked my book when he saw I was upset. But it is much easier to withdraw and avoid my family. If my uncle really supported me, would he tolerate the jokes about me that are at my expense? I often wonder.

I perceive similar acts of hostility from other groups of people and choose to withdraw and write when I am not working.

Recovering from Psychiatric Treatment:

Being a psychiatric survivor means that I along with other marginalized groups in America like many veterans, homeless, felons, inner-city children and other abuse victims can relate to the symptoms of complex trauma. While it’s true there is the potential history of emotional neglect, the disassociation, the molestation, the hypervigilance, the psychic numbing, the emotional dysregulation, the avoidance of related things, the shame, the people-pleasing, there’s also a history of privilege.

It’s true, I didn’t have it that bad until I entered the twisted system of care that is based on a schizophrenia diagnosis.

While it’s true I continue to be dependent on medication, I do so because it helps me manage the oppression that surrounds me working in an inner-city outpatient psychiatric unit. I have learned with the help of the medications to have a public relationship with consensus reality that enables me to have meaning and purpose. I am liked and helpful to people on the unit where I work.

I suppose when I was coming up no one could get it right because a complex trauma disorder didn’t exist back then. Instead there was disorder after disorder after disorder. Nurses on the eating disorder unit suggested I was an adult child of an alcoholic. Now there’s another disorder or two to add of the epigenetic sort. What can I say, I am an easy person for whom to ring up a bill!

When I was in state hospital they couldn’t shut me up about how much trauma I was enduring locked up for being a whistle-blower. I circled the day room I was confined to for two weeks and got on the phone and yelled to my family and friends that the mafia was following me.

Meanwhile, I negotiated unwanted relationships with a red-state-Mexican-mafia-female and resisted the offers to run away with her. Then, I resisted the opportunity to join an outlaw gang for protection against her.

Also, there was a short, illiterate thief with severe scoliosis who said he was there to recruit me into the Navy Seals. He said I had what it took to be a great assassin.  He said I passed all his tests. However, for my last test, he said I had to say that Ronald Reagan was a great president. I failed that one! As a result, I was sentenced to stay in the hospital against my will for three months.

Six months later, after two moves, the only job I could find and maintain was a job at an upscale Italian Deli. So, all gaslighting, taunting and teasing aside, maybe I had a point!

Believe me, still taking medication for complex trauma is not the worst thing that can happen to those of us who are coming from an era of misinformation! But if I had been treated for trauma and experienced more compassion, I wonder if I would continue to need the medication?

The post Growing Up with Complex Trauma in an Era of Misinformation: appeared first on Redefining "Psychosis".

In these happier days, I am extremely thankful to have my wife and my dog with me. This Thanksgiving we have escaped the urban psychiatric backward upon which I work for a few days in Lake Tahoe. Still complex trauma must be managed. I am bound to have unpleasant holiday as memories bubble up, no matter what I do.

I may remember the first year I got diagnosed with a personality disorder. I was twenty and just out of the hospital. It was the first year I honored cultural traditions on my own. I remember sitting all alone on Thanksgiving in the roach infested inner-city apartment in Camden New Jersey writing a villanelle praying for a phone call because there was no one to reach out to. Indeed, neither my parents, who were traveling, or the female I’d just asked out were going to call.

I may recall awakening depressed the very next black Friday morning to two six-hour seasonal shifts. I might remember the ceaseless Christmas music, the selfish stress of the customers, the vat of Barney Dolls sitting right in front of the cash register I was operating. I might remember the one customer threated to throw-up on me because I was so slow. Others were free to pick the Barney dolls up squeeze them. The “I Love You,” song would play from beginning to end. “I love you, you love me, we are a happy family . . .” All day long! Three or four different dolls singing at a time!

Or I may remember losing one of those jobs because I handed out three twenty-dollar bills to three random customers. One customer even brought one back to prove I had done it. Perplexed, I’d quit the job and blamed myself. I didn’t want to risk getting fired. I’d not noticed the signs that I was likely the victim of a holiday flim-flam scheme. Poor cashiers need to have Christmas too. Forty-dollars does make a difference. They were right to target me. My family did come from money.

Or my mind might flash to the Thanksgiving I was just out of the state hospital and homeless. I might remember how I took the day off looking for work to bike ride away from the city of Fresno CA until I caught a flat. I may remember returning to town in the dark and sinking so low as to ask a worker at the cheap motel I was staying at out on a date. No longer did I care if I got any calls. I believed my relatives were mafia and had used their private fortune to facilitate my three-month hospitalization. They did not have access to my whereabouts. Though I hadn’t run out of medication yet, for the subsequent year and a half I would feel followed and threatened daily! I would be alone at Christmas with my credit cards frozen. At least that Thanksgiving, the pretty motel worker was polite about her boundaries and the fact that I was a drifter. I still remember the bitter taste of the Oscar Meyer cold cuts in my lonely room.

Of course, there are hosts of other bad holiday memories that may come up: Christmas, the years I was working seven days a week and the unstable girlfriend was giving me the silent treatment; the “festive” phone call from a cousin in which I heard her in-laws insult me; the Easter holiday I worked alone at the delicatessen because everyone else conspired to take the day off.

Not only will parts of these holiday experiences flash in my mind, they will mix with current stressors. For example, this year we had a well-loved co-worker suddenly die of sepsis during a routine operation. I work on an urban outpatient psychiatric unit. Supporting the clients through this stunning news meant processing violent deaths in the city of East Oakland. Imagine intimate details about a dear sibling getting gunned down in the Felix Mitchell eighties. Then, others would bring up a twenty-two-year-old cousin or two who’d faced similar demise. Imagine living in a board and care home with nothing but these memories and stories to process over the holiday. Or being wrongly incarcerated in Juvenile Hall during that grief and dropping out of school as a result.

Indeed, in Tahoe I feel guilty for being able to escape these realities and the fact that I survived what I did. When it comes to celebrating Thanksgiving, my mind skips from bad memory to current vicarious trauma, to the people who have hurt me during work politics, and then back to bad memory again.

Simple Formulas for Dealing with Complex Trauma:

I have created some simple formulas that help me endure the weekends and holidays when my head gets flooded like this. I have always enjoyed nature and hiking through my pain. One summer I was facing a lot of pain and I took off hiking for forty-six days and successfully covered six hundred miles of the Appalachian Trail. I learned that surviving natures elements is a great distraction.

I have learned that when I am suffering, I need to get out into he woods on a hike. There, I let the troubling thoughts and experiences bubble up. When I process and honor them I can accept them and move forward. It beats internalizing the choir of negative thoughts I have heard about myself over the years. Moreover, my breathing from the exercise grounds me and seeds of resilience kick in.

Another thing that has helped me endure is to acknowledge that I have disassociated through some traumatic incidents leaving me constantly mistrusting and hypervigilant. As I have recaptured a few of these early memories it helps me remember that I am not entirely a genetic mishap who must be behaviorally controlled in a board and care home. For two years I fought against everyone else who insisted this was my reality. Now I know that this is not true about me or anyone else. Sure, I was the child who never smiled, but I wasn’t smiling for a reason.

Also, it helps me to trace my relationship with the community back through my development. Ever since my earliest memories, relations with people who don’t have complex trauma are at the heart of my suffering. What saves me is knowing that my brain is different and truly hated by the chronically normal folk. I’ve got two or three neurodevelopmental conditions to prove it! Therefore, all those years I was bullied and excluded from the circle, it was because elements of trauma showed in my interpersonal relationships. At the time, I never understood why the world was so cruel. Now, when I recognize why and accept it, I can accept the choices I make and appreciate the love that I have found. I can get the chronically normal negative thoughts out of my head. I have had cohorts call me evil for my social awkwardness! I don’t have to agree. I can just say, different!

And finally, it helps to have found love. My wife gives me the space to go through my trauma on our hikes. She has nurtured other family members with complex trauma. In fact, with a history of learning disabilities and OCD, she may smile, but she doesn’t feel much better a lot of the time. She resists the invitation to gang up on me with the rest of my family during family get-togethers. I am so grateful for such a loyal companera.

However, without the support of my wife, without my writing habit, without grounding myself in nature, the judgements and true gossip of the chronically normal folk come into my head like a plague and rule the day. Judged thoughts are so much harder to let float by like a cloud in the sky. I can really see myself being depressed and frozen in a board and care home without these areas of privilege and resilience.

When Politics Bubble Up . . .

I can see that others gossip about complex trauma and poor social skills. I know it happens because I sit in team meetings listening to colleagues discuss the behavior of our patients with complex trauma. They may experience behavior that bubbles up from those painful memories. Cohorts may not understand. They may judge the person based on their pain when they are not grounded. Then, they talk about behavior out of context.

It is easy, for example, for me to hear a person who frequently assassinates the characters of others, and then I see how everyone around me is full of negative perspectives about me and my work and connect-the-dots. When this happens, it makes sense to imagine that there is a real likeliness that my complex trauma is being exploited. Indeed, treatment teams, behavioral health administrators or other forms of secret societies exist and meet!

In families, secret emails get sent, venting gets whispered-down-the-lane, and suddenly the person with complex trauma is barraged by a world of people reacting to what they’ve heard. It is a lot like being treated on a hospital unit. Indeed, the process is replicated in mental health organizations and even in some peer organizations led by those who vie to direct and manage the unit.

Sometimes in team meeting staff members can learn something helpful about complex trauma in their lengthily venting sessions. Sometimes I take the opportunity to speak up and challenge chronically normal reactions. Sometimes other workers speak up too. There are ways to endure and help heal. But we all must pick and choose our battles, or we too will be targeted.

A Simpler Formula for the Surrounding Community:

I suppose this essay isn’t only about surviving another year for me. As a marriage and family therapist I like to think I can share my story to help the chronically-normal-folk understand how not to make things worse.

Let’s not forget that some chronically normal minds might want to be in relationship with us! They may connect with us in ways that don’t stab us and make things worse. Indeed, these chronically normal folk may be our mothers, fathers, brothers, sisters, co-workers, therapists, case workers, hospital workers. People who are forced to deal with the grief we endure at this time.

Just as I have laid out a simple formula for my survival. My suggestions to the chronically normal brains of the earth is not very complicated. It involves only two things that can be avoided that would make a sufferers’ life much easier.

First, when someone is going through it, don’t tell them they are just being selfish, inappropriate, or shameful. Instead be curious about the stories behind the behavior.

Second, don’t spread an out-of-context freeze-frame of the pain we share, and play whisper down the lane with the community that surrounds. Especially don’t use the struggles against the person to rise to power. Instead try to honor the trauma and suffering the person endured.

If you want a relationship with the person you can tolerate their suffering without personally attacking them. If you don’t, that’s okay, just don’t do the whisper-down-the-lane. There are other ways to be successful.

Initially, I was not brave enough to share the worst memories I have. They involve reflecting on the people who have succeeded by throwing me under the bus in this manner. They often hold high positions in the mental health or other type of social hierarchy. On the other hand, if I were to point them out I would be breaking my second rule.

Remembering the Intention of the Holiday:

In surviving the holidays, I have no need for revenge. I am grateful to be where I am at. The best revenge up here in Lake Tahoe is to celebrate what I do have and take care of myself so I can continue to reach and teach others who are likewise suffering. The point of the holiday is to remember to be thankful. Right before one of the world’s largest genocides, the perpetrators recognized and remembered to be thankful for the kindness of their victim. For god’s sake, let’s hold on to the intention.

Sometimes when I make a biannual escape to Tahoe, I do hate myself for being so lucky! On top of other things, I have survivor’s guilt. But many people I work with on the outpatient psychiatric unit find their own ways to celebrate the holidays despite their trauma. They have ways of being resilient and the least I can do is respect them. No one wants to be pitied. Instead, I can appreciate what they teach me, accept that we all have our ways of coping, and try to be stronger for it. I celebrate with them on the unit and do not feign from mentally bringing them with me on my vacation. And those who are lost and truly suffering as I have been, may they one day find their way to some form of recovery as well!

The post Simple Formulas for Surviving Complex Trauma Over the Holidays appeared first on Redefining "Psychosis".

We all know that ending a secreted abuse and getting public support is an important element of healing. Indeed, it is nice when society comes to the rescue as they did to victims when the world trade towers fell. When victims sense they are supported there is more opportunity for resilience, heroism, and healing.

But alas, many of the people I work with on an Outpatient Psychiatric Unit do not enjoy such support. Many lead lives of poverty and neglect due to what is presumed to be the medical illness of the mind. Many have done stints standing on the corner with a cardboard sign and are used to be seen in a negative light. Imagine the constant digs or exclusionary put-downs they may receive from their community of origin. Many choose to withdraw from the world. It is as if society has managed their crisis by tying them down to their beds like African-American, male Katrina-victims. Progress toward healing is slow.

As a worker in the system, I have come to feel that many of our clients get dehumanized when we focus on behavioural control rather than freedom from abuse. Focusing on behaviour can point out what is wrong with the person and make it unsafe to talk about the ways they have been hurt. I feel weeding through hurts helps a person gain acceptance and healing.

Perhaps this focus on behaviour happens because of the way our institutions define human suffering as being part of a medical mental illness. Thinking you have an illness may feel good at first but often make problems worse down the line. Some who suffer may feel, they have been born with a diseased mind all along. They may feel this way, for example, with a label of schizophrenia because many people with a disease model mentality may treat them that way.

I believe that when trauma is hard to detect or complex, the mental health system assigns blame inside the scientific sanctity of the individual. This can result in things like multiple diagnostic labels, use of forced medication as a punishment, restraints, solitary confinement, psychiatric incarceration, and, eventually, permanent warehousing.

As a psychotherapist, I have found that understanding these problems as signs of micro abuse that accelerate with stigma and exclusion to be vital to being able to connect with participants in our program.

Understanding the Role of Sexual Trauma in my own Life:

Like many psychotherapists, my first client has been myself. I admittedly have lived experience with a long list of psychiatric labels including recurrent depression, anorexia, bulimia, ADD, dyslexia, schizophrenia, and now that I have recovered, schizoaffective disorder.

I have spent decades in therapy and received care that emphasized the illness narrative. I have taken pharmacies of detrimental pills even though I have come to a place where I believe I get some help from small doses. I have even been referred to as permanent warehousing in a state hospital in Montana.

I am writing to demystify the role that complex trauma has beneath the surface for so many of our most defamed, dehumanized, and marginalized people.

How Controlling Behavior May Lead to Re-traumatization Instead of Help:

It is true I have had an ongoing suspicion that I was sexually abused. Particularly when locked up for extended periods of time for an eating disorder, and most recently for schizophrenia, my suspicion that my suffering had sexual abuse behind it escalated. I went through a phase of clothing myself while bathing post-latency that was always hard to understand. My sense of shame associated with my body was suggestive to me.

Yet, I once had a female therapist confront me about secreted accusations I had made against my mother on an inpatient unit. At the time I was confronted, I could not remember the real incidents of sexual abuse that I experienced. I just stopped confiding in the therapist in any meaningful way. This really added to my sense of shame. It’s true I recovered, but I lead a limited life of work and torment.

Without knowing that I once was abused, it becomes that much harder to discern triggered re-traumatization, from abuse. People who don’t realize that their suffering is due to trauma are often unable to do this. They may repeatedly feel abused a gazillion times and it becomes hard to see how the community might come to the rescue. Instead, we get cast as not taking responsibility for our own problems that are generated by our defective genes.

The Importance of Vigilantly Assessing for Disassociation:

I have always been aware that I disassociate. I think it is a good idea for therapists and mental health workers to assess for disassociation. It is a simple question but may need to be teased out a bit to accurately assess for it.

Though I had been in therapy my whole life, I only had one therapist take note and get suspicious about the disassociation I described. What I have come to realize by listening to others is that if a person has experiences of disassociation, there is the possibility of incidents of distressing events that they may have forgotten.

An example of a disassociation I experienced was when I was alone scouting a trail. I stepped within six inches of a rattlesnake, a childhood obsession of mine. The rattle made me run even though I knew better. Then I became aware that I lost track of time. Finally, one of my peers on the Outward-Bound course came and found me staring off into space and I grounded myself.

Another time, my best high school friend made a pass at me after communicating in metaphoric manners that were suggestive that he might have been tripping on acid. I came to at several points to find myself hiding in the house. At one point I heard him talking to my mother when she returned to the house. He was talking about gay marriage and, somehow, I had gotten down into the basement again.

And, finally, after being teargassed at the WTO Protest in 1999, and pepper-sprayed directly in the eye, I took a walk and lost track of where I was and what I was doing. Suddenly, I realized I walked past my destination and had been out.

I am now at the point of arguing that these seemingly inconsequential incidents are faint traces that there is a need to explore more. I emphasize that I advocate doing this to help understand oneself instead of vilifying others. For example, my best friend does not deserve to be vilified, and yet the disassociation was real. Though disassociation experience may not seem significant to the daily suffering that gets experienced, I think it is an important indicator of trauma that may accelerate over time if it goes unaddressed.

How I Broke through the Wall:

I took it upon myself to write about starting to disassociate in front of my nephew when he was a bathing cherub in a tub in front of me. I did not fully disassociate and I considered the experience a flashback. I was going outside my body but didn’t leave all the way. This had been happening to me on a few occasions when I was working seven days a week trying to get back on my feet financially after my post-state-hospital period of homelessness.

As I was editing the scene suddenly I got a vague flash of being molested in a bathtub. The girl, my best friend’s sister, was only one year older. I would later remember that she ordered me to take my clothes of and get in the tub with her while our parents were out walking on the railroad grade.

I still don’t remember my response. There is a story that I ate a mothball thinking it was a marshmallow necessitating poison control to be contacted. I was a little old to make such a silly mistake. It’s true I could be wrong, but I connect that action to my response to the tub incident. I do believe that that was the summer I started bathing in my trunks.

When I took this story to my mother, I got an additional answer. “No, you are thinking of the time we caught the babysitter touching you,” she said.

While I continue to have no memory of this incident I remember several occasions when I was around this babysitter later in life. Before I hadn’t been able to understand my piercing feelings, behaviour and memory of those occasions.

“Thank you for telling me,” I stated to my Mom.

“I probably shouldn’t have told you,” she said, “Now you are going to think you have been abused a gazillion times!”

When Hypervigilance and Numbing Seem Like They Are Normal:

Just like the bath with my step-sister might not have been distressing to many untraumatized young boys, there is the possibility that memories of intense hypervigilance may not always be indications of sex abuse. Not all intense memories I have led to recovered memories.

Before I broke through the wall disassociation I could never understand why I got such strong intuition and suspicions. I didn’t realize that I was doing this for a good reason. I often presumed there was something wrong with me. I had to learn to numb out to prevent embarrassing myself worse socially.

I also have a hard time defending myself when I get attacked. When I do defend hypervigilance, I come off too strong and the results never go well. Then, when I am called on to defend myself during a test, I often fail to act because I think it may be hypervigilance.

People who prey on others can see these signs and chose people they can hurt without getting in trouble. This can open a body up to bullying that can become institutional when labels get attached. Powerful mental health administrators have done this to me and I remain marginalized in the county in which I work.

More Meaningful Memories:

When I found out that her brother had sexually abused a childhood friend, I suddenly had a flash and an image. I saw him rape her, became paralyzed with fear and fled. Had I really behaved like that? It seemed like more of an intuitive dream, that a solid reality.

Typical, I thought, for a schizophrenic to hear about sex abuse and think it is all about him. Perhaps some of the readers may think so as well.

However, I do remember visiting the two of them alone in a vacation cabin along the Chatooga River in the Adirondacks. They were skinny-dipping, she with just a shirt on, he in the nude, and me, very attached to my bathing suit. My last memory of the evening involves him standing behind her wrestling her around.

The distinctive flash of a rape and an overwhelming feeling of cowardice and helplessness that overtook me when I should have protected the victim is unconnected to any other part of the evening.

The brother has only admitted to inappropriate touching. So, I acknowledge that even saying the word rape may be inappropriate and unfair. If I considered these flashes reality, there are several other incidents in my life to talk about with other adult men.

Years later I had rescue fantasies and psyched myself up to respond to rape scenes. This happened at a time when I took a job in a lawless section eight housing project; and used community activists and the press to fight the management company, the police and the black market dealers against all odds. This is an action that caused the police and my parents to attempt to institutionalize me in a state hospital.

Is it possible that my objectionable behaviour of using the press to out real murder and mayhem was simply an unconscious expression of ongoing existential guilt from unrealized events? Is it possible that some of my schizophrenia was exacerbated by real government monitoring? For a year the only job I could maintain was an arranged job at an Italian Deli through which I thought I was being persecuted by the Italian Mafia. When I stopped acting persecuted and started being thankful for a nine-dollar an hour job, I was able to return to professional job opportunities.

“The first question that gets asked shouldn’t be what is wrong with you, it should be what happened to you?”—Jackie Dillion

I think therapists have a responsibility to assess for incidents of abuse. This is not about potentially wrongly vilifying people like the brother above, it is about healing and changing behaviour. For healing, even heinous acts need to be emotionally accepted, yet never forgot. It involves constant intuitive listening and questioning and remembrance of patterns on the part of a psychotherapist. What is far more common in psychiatry these days is the focus only on symptoms and behaviours associated with mental illnesses. It becomes easy to become part of the problem for many when blame is assigned within the genetic codes and neurotransmitter cocktails of the individuals.

Overemphasizing these concepts without acknowledging the role of trauma promotes stigmas and generalizations. This not only orients us towards not considering traumatic occurrences, it makes it highly likely that we will re-traumatize sufferers and further marginalize them.

I believe that when therapy is governed with an illness narrative mentality, money gets made, and many of the recipients lose support and wind up deprived, impoverished and defeated. The mental health system becomes much more a system of control and ongoing abuse when things are as such.

I would advise someone who is suffering and receiving psychiatric care not to underestimate the role that trauma may have in their suffering. Learning about this and honouring it yourself can help you make meaning of your suffering. Unfortunately, if our communities don’t understand or teach us about trauma, we need to do this for ourselves. I believe this is when psychotherapy can be helpful. However, when psychotherapists maintain the psychiatric illness mentality, therapy can go on for years without understanding underlying complex trauma.

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I fervently believe that having survivor-led group therapy that redefines “psychosis” is missing in the system.

Over the last nine years, I’ve been leading what I call special message groups in multicultural settings. I have found that such groups can be run safely and have the power to transform lives. However, I do admit that when it comes to kicking people out of group to maintain group equilibrium and safety that I believe there are a few things to consider first.

Firstly, I believe that a group leader needs to be prepared for the fact that mad people show up in very different ways. Group facilitators need to be familiar with and recognize a wide variety of presentations or manifestations. Perhaps group members may feel like they are being mocked by others in the group via illusionary ideas of reference or even controlled by them. They may code up their language for protection. They may treat the facilitator as if the facilitator can hear the same voices they hear. They may not believe, in spite of stories shared, that the facilitator has experienced what they have.

I have prepared myself for these challenges by attempting to better define “psychosis.” I have reconstructed a definition that can sync up a wide variety of what have historically been defined as conditions. I believe if the leader is not prepared to accept all presentations, people will not feel safe talking about their experiences. Intolerance for people who show up in a different or what is perceived as a difficult manner can be extremely hurtful.

Secondly, I believe the facilitator can take measures to help train the group to be brave and tolerant of each other. I frame coming together with the specific purpose of sharing untold stories to be an oft neglected privilege that has unfortunately been denied because the “they” experts say it is not safe.

Spirit of Risk Taking

I am always willing to start out with my own story. I advocate for a spirit of risk taking by acknowledging that people in the group may be so used to dangerous or distressing experiences that guaranteeing safety would be a disservice. I also point out that despite what “they” say, this practice has been an effective movement in different countries and I’ve done it for a long time.

These kinds of comments are treating the “set of symptoms” as a neglected culture that is subjugated. In the earlier stages of group development, keeping the group focused on the things they have in common can help. Also, strongly supporting alienated individuals helps train the group to be more tolerant and can help avoid many problems that come up later in a group. It discourages them from expecting a trouble maker will be kicked out.

Thirdly, because there is a high degree of diversity in the mad community, I believe the facilitator needs to be extremely sensitive to all forms of culture, particularly pertaining to relevant issues of subjugation. Discerning the social factors that are affecting the person shows up in a difficult manner is key. Race, class, gender, sexual orientation, age, religion, education, legal justice history, substance abuse history, immigration, gang affiliation, disability, employment history are all social factors that can show up

It is wrong, I believe, to exclude someone because they are testing or trying to teach you about these kinds of issues. Some people may try to dominate the groups. A group facilitator needs to be prepared to accept, learn and support everyone. Again, a person who is not accepted on the basis of something that the facilitator is ignorant about or is not curious to explore, may do harm.

Fourthly, it may be necessary to meet with individuals outside of group to learn more about why they are hurting the group. If a group member is dominating to the point he or she is doing intentional harm, that individual may, in fact, be expressing a need to connect with you.

Perhaps, he is experiencing messages that are extremely misunderstood or there is a cultural issue with you that needs to be talked about.

But when the group is truly becoming unsafe for participants, which is rare, out-of-group meetings are necessary and the facilitator needs to work to better understand the problems that come up in group and clear up any cultural issues.

A meeting could involve two individuals. Making the time for this encounter outside the group is an important resource.

Behavior Contract

Finally, if taking the time for a meeting or two doesn’t improve the behavior, the leader can propose a specific behavior contract to protect the group. This approach is best utilized in real emergency circumstances and needs to be devoid of the leader’s cultural biases to the best of his/her ability. This approach is also something that requires the participant’s input so that the problem can be identified and an agreed upon solution can be proposed.

At the very least, the contract needs to be something the participant can buy into. When the participant takes the power to get involved, consequences can involve sitting some groups out or being referred to an individual therapist or perhaps a different group.

I’d suggest that if the participants take steps outside the group to improve themselves, the leader can be in communication with them, pining for their return.

It is true that many people who suffer from “psychosis” or message crisis also have complex histories, trauma and other co-morbid problems like substance abuse and nuero-diversity. I have seen these kinds of complex issues, that may challenge safety, get addressed within a group process as described, even by survivors who visit programs rather than work in them.

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