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Invisible Scars – Emotional Neglect

When looking at our childhoods we can often miss pivotal clues as to how emotional neglect can contribute to later difficulties in adult life. As a society we often focus on abuse in terms of what was done to us as children and yet what actions our parents may have failed to take can be just as damaging. If parents failed to act to meet our emotional needs, reflected things back to us so that we had a mirror to understand our feelings, emotions and needs and reflect back positive parts of self, then growing up it is likely that we become adults unable to express ourselves or be in tuned with our feelings. This can leave us unable to recognise our needs or emotions, have problems knowing what we need and how to express ourselves. We may have difficulties calming ourselves down and soothing ourselves from painful emotions which can lead us to escape them through compulsive behaviours. We might have difficulties with emotional regulation, expression and ways to articulate our feelings. We may even have difficulties asking for what we need.

Developing a positive sense of self becomes challenging as children. Our sense of identity and self tends to get lost if emotional neglect has taken place in our childhood, and this leads to feelings of emptiness, feeling disconnected, unfulfilled and not being able to know why. As adults, we may then not be able to trust our own emotions. Individuals who have experienced this may therefore have problems taking care of themselves and knowing how to nurture themselves and their wounded inner child. They can remain unaware of the impact of what has happened to them and in the process neglect themselves.

Emotional neglect renders the person invisible, it’s a failure to notice, attend to or respond appropriately to a child’s feelings. It remains invisible as it goes unrecognised and so the child’s experience feels invalidated. It remains an overlooked issue and children themselves remain unaware until symptoms manifest in early adulthood. Even then confusion is to be found due to the fact this is an invisible scar and hidden pain.

There are a few parenting styles that can result in emotional neglect:

  • Absent parents – Reasons could be due to family break ups such as divorce or separation, a parent absent due to illness or addiction or mental health, a parent that may be serving time in jail, a deceased parent or a parent that has left the home and family.

Some situations are not the result of bad parenting, however the impact remains:

  • Authoritarian parents – those who cut off and silence a child and by this silencing their feelings and needs
  • Permissive parents – who leave the child to fend for themselves, so that the child is never shown how to recognise their own feelings by never having them recognised
  • Narcissistic parents – where the child is used to cater the needs of the parent alone, never being able to have their own and theirs met
  • Perfectionist parents – who project their own need for perfection on a child and the child never feels good enough.

All these behaviours ignore a child’s needs and feelings and require the child to sacrifice their own needs and feelings to accommodate others.

Like everything in life, the things that are not visible to us tend to get ignored, yet they are just as damaging and the damage is being done. Let’s take the example of drugs, alcohol, refined sugars and tobacco. These damage our bodies – we cannot see the damage that goes on within our bodies but these toxic substances are doing just that. After much abuse, we see symptoms and start to notice the effects; this is much like the invisibility of emotional neglect and the fact that just because it cannot be seen doesn’t mean the damage hasn’t or isn’t occurring.

Psychologist, Dr. Jonice Webb states: “Childhood emotional neglect is often subtle, invisible and unmemorable”. Emotional neglect can be at the root of emotional disorders and mental illness such as depression and anxiety. Its symptoms include:

  • Sensitivity to feelings of rejection
  • Pervasive feelings of emptiness
  • Sense of not feeling fulfilled
  • Unhappiness
  • Perfectionism
  • Need to people please
  • Feeling like a fraud
  • Disconnection from self
  • Excessive fears and worries
  • Dissatisfaction
  • Difficulty identifying or expressing feelings
  • Being seen as aloof, arrogant or distant.

Children may develop ‘toxic stress response’ and this makes the process of growing up an extremely challenging one. Parents who have experienced emotional neglect themselves may emotionally neglect their own children, not knowing any better as not having experienced any other way of being themselves.

Emotional neglect however is not limited to childhood and is just as damaging in adult life. This can happen within intimate relationships; it feels like rejection and rejection can be painful. In fact feelings of rejection and abandonment are said to send a signal to the part of our brains known as the amygdala, which the triggers intense fear. This is the fear that we are not good enough, unacceptable or unlovable. We then can no longer feel safe and secure.

To heal these wounds as counsellors, we need to not only be aware of what has happened in our clients childhood but what has been missing in it and the gaps created. We need to offer our client’s unconditional positive regard so that they can learn to nurture themselves, through self love and self compassion, and connect to their self so that they become aware of their own needs and feelings and how to nourish these. Clients need to find their own empathy to reconnect to the self, for empathy drives connection and through our empathy to clients this can help drive that connection. Many inner conflicts and addictions or mental health problems, or emotional disorders can be the result of being disconnection from ourselves and life.

As professionals we need to help spread light into the hidden corners that often go unnoticed.

https://www.counselling-directory.org.uk/memberarticles/invisible-scars-emotional-neglect

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The Truth Behind DID (Dissociative Identity Disorder)

All mental illnesses are surrounded by a lack of understanding as to what causes them and a lot of stigma and myths. One form of complex psychological condition which is often incredibly misrepresented and misunderstood yet draws much fascination is DID (Dissociative Identity Disorder), formerly known as and recognised by the term Multiple Personality Disorder.

The misrepresentation of this is often seen with the ignorant and negative and rather insulting portrayal of it by the media who uses it more often than not in horror films. It rarely depicts a true and accurate representation and rarely places individuals who suffer from it in a positive light, but rather a dark light where they tend to be the ones that commit the crimes in horror stories.

This invalidates the pain and experience of survivors and that feeling of being invalidated hurts in a way that cannot be erased. These negative labels and representations are not only inaccurate but painful to see and hurtful to sufferers.

The real truth and real horror lies within what happened to those who suffer from this. It is not a sign of madness, badness or criminality. It is a perfectly normal reaction to abnormal events; it’s a creative way of survival, of surviving horrors done to those who suffer from it. These horrors commence in early childhood when the individual was young, often experiencing repetitive and extreme abuse and unable to cope, too overwhelmed by indescribable and incomprehensible traumas and who developed DID as a means of survival.

The definition of dissociation is the disruption of the normal integrative processes of consciousness, perception, memory, and identity that define selfhood.

This copying mechanism tends to then become reinforced and conditioned and part of a normal way of being in order to keep surviving. It is a highly creative way where the child learns to adapt to the horrors it cannot escape. The child cannot escape the trauma physically so they find a creative way that allows them to “get away” by doing so mentally, emotionally, psychologically (through their heads).

What the child is trying to achieve is an extremely effective defence against severe physical and emotional pain, or the anxious anticipation that follows that pain. This process is thereby created by the child so that the child’s thoughts, feelings, memories and perceptions of the traumatic experiences can be separated off psychologically, allowing them to function as if the trauma had not occurred. Blocking the painful trauma allows survival of unspeakable mistreatment to escape and in doing so also allowing the escape from powerful emotions such as pain and fear/terror.

The result is a split in parts of self and fragmented memories. Each protector created by the splitting process becomes a different identify in itself yet all form part of the same person. In fact we all play different roles in life and act differently in each context. We may act differently with parents than we do alone with friends and act differently at work than at home even if our parts of self (unlike DID sufferers) are integrated.

We all dissociate at some level. In a mild form of dissociation where we may lose touch with conscious awareness of our immediate surroundings; examples include getting lost in a film or book, or when we forget where we placed our keys, or when we may have had a traumatic experience. As we can see dissociating is normal. DID is dissociating at a higher level and is therefore an extreme example and form of dissociating. The person with DID experiences memory loss that is too great to be explained by ordinary forgetfulness.

As we have seen, DID is a consequence of extreme abuse in early childhood. The genesis of DID therefore occurred due to the most typically extreme, repeated forms of neglect, physical, sexual and/or emotional abuse. Children that have been witnesses or subjected to different traumas such as war, torture, accidents, natural disasters, medical trauma, terrorism, sexual exploitation and abuse in other ways, such as but not limited to human trafficking, or sadistic ritual abuse have also developed DID.

90% of cases are believed to be linked with a history of abuse. The child doesn’t have the capacity to deal with such trauma and therefore the mind finds a way to cope and survive this, resulting in DID.

Many people can have more than two protectors – the average can go up to 14-15 and some can have up to 40. Each protector represents an event where abuse took place and each protector is given a job or purpose, such as the protector, the fighter, the child, the parent. Each one has different personality aspects and can be of any gender or age, regardless the gender of the person or their actual age.

The person experiencing DID isn’t always aware of the splitting process. The protector that manifests may be aware of another’s existence, but not vice versa. The protectors may be triggered by stressors. The various protectors may refuse each other, conflict with one another, be hostile to one another or not want to acknowledge the others existence. Depersonalisation can occur, which is defined as a state in which one’s thoughts and feelings seem unreal or not to belong to oneself. It is important to keep in mind that although these alternate personality states may appear to be very different, they are all manifestations of a single person. The condition involves identity fragmentation rather than a creation of separate personalities. Hence why the name Multiple Personality Disorder was changed in 1994, to a more accurate reflection of the condition and now referred to as Dissociative Identity Disorder.

Some individuals with DID may experience amnesia in the form of what is known as “dissociative fugues” which is a case where the person with DID travels and does not remember doing so.

People with dissociative disorders may experience any of the following: depression, sleeping disorders, addictions, panic attacks and anxiety, mood swings, phobias, PTSD, suicidal ideation, self harm, psychotic symptoms and eating disorders, along with physical ailments such as headaches, time loss, amnesia, spacing out and out of body experiences.

Unlike the media portrays, many people that suffer from DID are not evil or criminals – they have been victims of indescribable cruelty. They are good and normal people that deserve our understanding, respect and who are inspirational in their courage and strength.

It is important to highlight the the goal of therapy is not to eliminate a person’s protectors, but to embrace them and incorporate them into the person’s sense of oneness. There are ways that people can do the healing without being re-traumatised, in fact doing so in certain cases can prove damaging and dangerous. We need to go at the clients pace and respect this and respect that trauma can be healed without the need for details of the events. Other therapies that help are creative forms and cognitive treatment.

DID is a creative tool that the mind creates to survive; it is a normal response and reaction to abnormal events. Better understanding and representations are needed to help those with this condition and recognising the normality of this considering the events that led to it, we see how extraordinary the mind is, how it helps us survive and how extraordinary these people are who deserve our love and respect and for their condition to be portrayed accurately, and for this to be seen not as a defect but as the manifestation to trauma. Let us not ask what’s wrong with people who have mental illnesses but rather what happened. Many of these conditions are the result of human pain, not human deficits or madness. Let us give justice to this pain.

https://www.counselling-directory.org.uk/memberarticles/the-truth-behind-did-dissociative-identity-disorder

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Food and Mental Health

Many people don’t pay much attention to their dietary lifestyles or find it hard to accept that diet can make a difference in regards to our psychological well-being.

The truth is that it certainly can. There are foods that contain vitamins and minerals that can help prevent, reduce and manage mental illnesses, they do this by contributing to the maintenance of optimal neurological functions and maintain balance of neuro-chemicals in our brains. Food can help fight off inflammation of the brain.

It is possible that sometimes when we suffer from poor mental health what may be contributing to it can be a deficiency in these minerals and vitamins and so it is important to have an holistic approach to our psychological sessions as counsellors that bares this aspect in mind and to also get clients to consider this information alongside their therapeutic healing.

Doctors, psychologists, psychiatrists and counsellors are not taught about the importance of nutrition and the links that can be made to overall health. So it is important that we are enlightened by this knowledge and share it with our clients to help them further into healing.

A healthy diet in general is part of well being and should be encouraged regardless, this is avoiding sugar (cutting down), eating fresh food and whole foods that remain in their natural state and not processed so avoiding processed foods and junk food. Eating more fruits and vegetables and preferably eating a plant based diet alongside reducing amounts of fizzy drinks, coffee and alcohol. One doesn’t need meat to obtain protein in their diet and meat can also be processed leading to poor health, in addition ethical issues are attached to eating meat. Wholegrain products are also healthier than white alternatives to rice, pasta and bread, so substitute white with brown.

Dairy products also contribute to inflammation especially in terms of skin disorders and even mental health (casein the  protein in milk being the offender) and therefore should be avoided where possible. Many alternatives to milk (oat, almond, rice, coconut, cashew, hazelnut milk) are to be found and much calcium is obtained in vegetables such as: broccoli, potatoes, onions, aubergines.

Scientists have also linked gut health to mental health so a staple of a healthy diet can be beneficial to overall well being. Poor gut health has been linked to memory disorders such as: dementia and Alzhiemer’s disease.

Another food to avoid in relation to poor gut and mental health is gluten. Gluten is not a natural substance and our bodies struggle to digest it. Gluten is found in wheat, barley and spelt. Mental illnesses associated with it include depression, anxiety, schizophrenia, ADHD, autism and eating disorders.

So what vitamins and minerals have studies shown to help mental health?

Let’s look at some of these:

  • Vitamin B’s

A lack of B vitamins not only leads to fatigue but deficiency of these vitamins especially B12 and folic have been linked to depression. Some studies claim that folic acid may reduce depression when taken in conjunction with vitamin B12. Deficiency in folic acid is also believed to lead to anxiety. This is because the role of B vitamins is producing brain chemicals that can affect our mood and brain function. Therefore, it’s important to consider that something such as a deficiency many be causing or contributing to this mental illness and that by regulating the body and brain with the necessary needed vitamins can help reduce depressive symptoms brought on by B vitamin deficiency alongside psychological counselling. Niacin (B3) and Thiamin (B1) can also alleviate symptoms of schizophrenia and alcohol abuse.

  • Magnesium, copper, iron, zinc, managanese

Studies have shown that deficiencies in these minerals can lead to anxiety, depression and other psychiatric disorders. These minerals all aid in the function of neurotransmitters. They can be found in dark, leafy greens such as spinach.

Magnesium has long been known for its calming properties on the nervous system and according to studies can help alleviate panic attacks, anxiety, depression and anger. So if you suffer from panic attacks, depression or anger and anxiety, you may have a magnesium deficiency. Foods that contain magnesium are avocados, vegetables (and green leafy vegetables), bananas, nuts and seeds.

Copper overload can result in emotional meltdowns, frequent anger, anxiety, depression. It is very easy for copper overload to result. Its role is in assisting the immune system, the endocrine system, and the nervous system. Copper deficiency can lead to anger problems, mood disorders and ADHD. Foods that contain cooper are: lentils, sunflower seeds, hazelnuts, chickpeas.

Iron is essential for normal neurological function. Deficiency can present itself as anxiety, depression, irritability, and even poor concentration. In the research article published by BMC Psychiatry, the researchers, concluded that “Iron deficiency increased the risk of psychiatric disorders, including mood disorders, autism spectrum disorder, attention deficit hyperactivity disorder, and developmental disorders.” Foods that contain iron are: artichokes, spinich, broccoli, beans, lentils, dried fruit.

Zinc deficiencies can play a role in depression, it also plays a role in brain functions such as in the functions of neurons and therefore can help with things such as neuroplasticity moods. Foods that contain zinc are: whole grains, beans, nuts.

Managanese aids in brain development and functions, and is essential for human survival. A deficiency can lead to impaired memory, mood changes and mental illness such as anxiety. Like with any minerals too much can also be harmful and lead to side effects, these include symptoms resembling Parkinson’s disease, such as shaking (tremors). Foods that contain managanese are: cabbage, spinach, potatoes, beans, seeds, nuts, vegetables (such as asparagus).

  • Omega 3

Studies in adults suggest that omega-3 fatty acids may be beneficial in the treatment of mild to moderate depression. You don’t need to eat fish to obtain omega 3, it can come from other sources such as walnuts, chia seeds, flaxseed.

As we have seen a good diet and food can make a contribution towards our mental well being so it should never be dismissed or ignored.

Not all people respond to anti-depressents and medication and these can come with side effects. A natural way through diet and psychological counselling therapy are important for overall mental health but a healthy diet is important for general physical health and refers to all of us not just those who suffer from a mental illness, as a healthy diet can help prevent numerous aliments and contribute to a healthier and longer life. For people where medication is necessary, a change in diet can still make a difference.

Important notes to consider is that these deficiencies cannot always be measured by blood or urine samples by doctors, as some such as Zinc deficiency would not show up. Also it is recommended that if you try supplements it is important that you consult a health care provider before starting any kind of supplement regimen. A general overall healthy diet will provide us with the sufficient and necessary vitamin and minerals, however supplements can be needed at times, this is okay as long as one doesn’t rely solely on them and that they compliment rather than substitute a healthy diet.

https://www.counselling-directory.org.uk/memberarticles/food-and-mental-health
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The Truth about Loss and Grief

Grief and loss are universal traumas, affecting most living things to some extent. However, for humans – who think that things need to be fixed, and for whom hope is the last to die – having to accept that there is no hope (that our loved ones won’t return, that grief and loss can’t be fixed but rather need to be felt and heard and the pain allowed) can inevitably be one of the hardest things, and we can feel so overwhelmed by the experience.

There is never a right or wrong way to grieve or to react; some people break down, crying and being inconsolable; some remain composed, and then they may crumble with time or with a trigger of another death reopening wounds and unresolved grief. Some people feel numb and worry, or feel guilty that they should be expressing more ‘pain’ if they cared…however, their reaction isn’t a reflection of how much they loved or cared – it’s an expression of how they are trying to cope. We are all individuals and we all react – we all cope, and we all express ourselves and feel things in different ways. It is normal and okay to be you.

Loss and grief isn’t just about losing a loved one – it’s about loss in general.

This can be grieving the loss of one’s childhood; loss of identity or sense of self; a loss of security and trust in the world or people; loss of self-love or esteem; a loss of a limb; loss of youth, health, divorce and separations…heart breaks and break ups are a form of loss because we may never see that person again. or have them part of our life. Even when a loved one dies, we may be losing what it means to live life differently – the loss of who we might have been with that person, the loss of a shared life if we lose the love of our life. A loss, not just of our baby, but the chance of being a parent to our baby.

Animals are also part of our lives and who we love – they too are equally important and matter just as much. The unconditional love of a pet animal is precious.

If we have lost a loved one through suicide, we are left with a sense of abandonment and rejection, and it can come with feelings of guilt or blame that we should have noticed, done more, could have stopped it. This complicates grieving, just like when sudden death occurs – one can never be truly ready, and bereavement is difficult.

At times, death can be of comfort if we knew that the person was in so much pain and living was painful and unpleasant. If someone who has hurt us dies, we may feel relief and a sense of freedom that this person is no longer alive to hurt us or threaten us.

Psychologist Susan David writes that our cultural dialogue is fundamentally avoidant. This can be seen by the unhelpful comments others might offer: “At least they lived to be old”; time will heal”…people are uncomfortable with pain, and some may distance themselves from the person, suffering leaving them in greater pain and isolation. Our support network is so vital in getting through grief.

Author Megan Davis points out in her book: It’s okay not to be okay. We live in a culture that does not understand grief – take this into consideration. No wonder it can all feel so frightening and overwhelming. She states that unhelpful comments are really telling us to stop feeling so bad, therefore silencing our pain and our grief and not giving us the space and support needed.

She continues to say: “Grief is not a problem to be solved. It isn’t ‘wrong’, and it can’t be ‘fixed’. It isn’t an illness to be cured”.

Do not feel pressured into “healing” or “moving on” – do not pressure yourself. Give yourself the love and compassion that you need. Empathy drives connection; it is important to receive this and not sympathy.

Empathy and sympathy differ.

  • Empathy is walking in another’s shoes, entering their world from their frame of reference; it’s feeling with them, understanding their emotions and thoughts and meaning to things. It drives connection.
  • Sympathy is feeling sorry for the plight of another. It is a feeling of discomfort from the distress of others; it’s disconnection, seeing things from our own frame of reference. It can often feel patronising, and generates pity towards another. While pity makes a victim of the sufferer, empathy empowers them: “I have sense of your world – you are not alone, and we will go through this together”.

Sympathy can also be a feeling of care and concern for someone close, wanting to see them happier or better off, but lacks that real understanding and connection. It’s more to do with that uncomfortable feeling we are getting rather than it being about the other person and able to sit with them in their pain and suffering.

Grief and loss can generate many emotions: anger, sadness, numbness, hurt…and lead to things such as feeling anxious, depressed, difficulty sleeping or sleeping to much, PTSD, nightmares, lack of appetite, low energy, avoidance behaviours that can lead to addictions or isolation. Self-care and kindness to self are so important.

Twitter user Lauren Herschel‏ took to the social media platform back in 2017 to share how her doctor explained grief. This is known as the ‘ball in the box’ analogy.

I will use her drawings to explain it. The ball is grief which is stuck in a box with a pain button.

In the beginning the ball is massive because the grief is all consuming and massive. The ball cannot move without touching that pain button repeatedly. This is why we feel we can’t control grief and why the pain is so intense and just there all the time, It can at times seem unrelenting.

Gradually over time, our outside world which is the box will get bigger and the ball will get smaller in the box. This means it will hit the pain button with less frequency and so things will always hurt but we are not consumed by pain and grief no more. We are able to function in life. On days when we least expect it, the ball will randomly hit the box, because pain based on love, will never go away as love remains, but it get easier to manage.

Another analogy similar to this is the ball in the jar analogy.

This starts with a jar (the size staying the same) and three balls: one large, one medium-sized and lastly one small. If we are to begin to place the larger ball into the jar it would require a lot of strain and difficulty to get it in. This is initially how grief feels, because if grief is the ball and the jar is your world, you can see how the grief fills everything. There is no room (air) to breathe, no space to move around. Every thought, every action reminds us of who has sadly died. If we place the medium ball in the jar, it has room to move about a bit, we may perceive that after some time, our pain will no longer fill every bit of space in our life. If we then continue and repeat the same action, by placing the small ball in the jar, we may believe that like the jar, the grief will get smaller and diminish. At this stage, we are not so consumed by grief and it takes a small part of our lives.

This is a myth. If we are to take two extra jars, one large and the other larger and take the larger ball and squeeze it slowly into the least of the three jars, it would barely fit. If we place it in the next largest jar it has room to move around. That represents the grief more accurately if we see our grief as being represented by the ball. The ball itself doesn’t get bigger or smaller but remains the same. The jar represents our world, our goal is to make the world around us bigger because our grief doesn’t shrink and it’s the love we carry for our loved ones. By our world getting larger, we can work around the grief not eliminate it. In order not to be consumed by grief we need to make that world around us bigger not keep it the same.

There is no specific time for grief or loss – it is always with us. We just get better at managing our pain, and the world around us gets bigger so that we are no longer all-consumed by that sense of loss. People who have physically died live on in our hearts, and it’s when we stop remembering them or push memories away that they die fully.

As Megan Devine states:

“It’s okay not to be okay”.

https://www.counselling-directory.org.uk/memberarticles/why-christmas-may-be-a-dangerous-time-for-victims-of-domestic-violence

Resources: https://www.distractify.com/p/doctors-ball-in-box-analog

https://community.macmillan.org.uk/cancer_experiences/bereaved_spouse/f/bereaved_spouse-forum/64421/ball-in-a-jar—an-article-on-grief

Book: Megan Devine : It’s okay not to be okay.

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Hidden Sexual Pain – Sexual Trauma

When sexual abuse/violence is experienced at any point in a survivors life, not many people are aware of how this may impact on the survivors sexuality, their sexual concept, their attitudes towards sex, their beliefs, the negative mindset left by the abuse, and how this affects the survivors sexual identity. Not much is discussed to highlight this pain and expression of unresolved pain.

Firstly, it is important to make clear that sex abuse/violence is not sex or about sex but about power and control upon another and using sex as the weapon. As someone once quoted: you don’t hit someone with a spade and call it gardening.

Survivors can become very conflicted after the event and can turn two ways; becoming hyper-sexual or suffering from sexual anorexia (avoidance). It is important to realise that survivors can fluctuate from periods of hyper-sexuality and sexual avoidance or vice versa and they can also have elements of both of these normal reactions. These reactions are as normal as bleeding if you are stabbed. There is no right or wrong way to react to trauma. We are all individuals and everyone’s experience will be different.

When a survivor becomes hyper-sexual, many chose to further discredit and victim blame victims by suggesting they couldn’t have been abused or raped, and say hurtful comments like “they would be having trouble if it was really bad and they had been raped”, or they can be negatively labelled as promiscuous with derogatory terms aimed towards them (such as slut shamed)..

Matt Atkinson (2010), in his book ‘Resurrection after rape’, talks about sexualised grieving and that hyper-sexuality after abuse is about grief.

It is important that clients realise that their sexual actions are not the result of faulty morals, their worth as a person or badness. It is important that they don’t label themselves negatively, and that this belief is challenged and the clients are helped into understanding the effects of abuse and the impacts.

Their sexual actions are a result of their inner pain, and it is their inner hurt, not their personal worth, that is driving the cycle. These actions are a sign of despair that cannot be expressed in words and can only be brought to life through certain behaviours. Actions are seen as a way to meet a need and if we take the time to understand the needs we can then uncover the pain and hurts that is buried underneath these behaviours.

For survivors, sex may have lost its value and they may be trying to gain a false sense of control from feeling helpless and afraid. They may believe giving means they will not be hurt again. Many are reconnecting to the meaningless and humiliation of the abuse through meaningless and humiliating sex in an effort to give their grief an opportunity to finally be expressed and emerge. Therefore, Atkinson states that “sexual grieving is an attempt by a rape or sexual abuse survivor to grieve their brokenness through the desperate effort to reconnect their body and emotions”.

Survivors will become hyper-sexual for many reasons. Some of these may include:

Expectations: The belief that everyone wants sex or expects it. Some survivors can come to believe that sex was the reason they were harmed. They may feel that sexual violence is inevitable, also because rapists believe that if people can get away with rape, then most will and this may be communicated to the victim, along with the fact that women (in particular) are from a young age warned about sexual violence and conditioned to fear this happening or expected to have to ‘protect’ themselves from rape with the issue even being seen as ‘women’s issues’. Many have been sexually harassed at one point in their lives. When someone is raped, it may make being raped again more of a possibility than ever before.

Punishment: Survivors often may come to believe and feel that they are bad or that they deserved it or told this and so they may use sex as a punishment, believing they are so bad and deserve to be harmed. Sex is used as a way to self- injure.

Control: Rape or sexual abuse of any kind, takes away someone’s control and choices. Survivors may become hyper-sexual as a way to regain back a sense of lost control, to take their power back. It’s a way to control the process of sex  itself even when meaningless and harmful. It’s to regain control over that sense of powerlessness and helplessness felt during the traumatic event. The survivor is now trying to gain control over the situation, choices and over their bodies and others. Survivors may feel “If I let them do it, it’s okay! (false sense of control).

It can be an attempt to prove they ‘are not a victim’ of their trauma or not affected. A way to prove that if they can go through the act of sex, have it, get through it that they are okay, they can still function, their abilities and sexuality hasn’t been robbed. Some don’t enjoy the sexual encounters or experiences they have even if they pretend or act like they do.

Addiction: Some become addicted and like all addictions it’s trying to fill a void, or numb the pain. They feel compelled towards it and something that is out of their control just like abuse taught them sex was an uncontrollable urge, rather than desired.

Sexual orientation: For men raped or sexually abused by other men, this may lead them to question their sexual orientation and feel conflicted,  so they may become hyper sexual as a way to prove their sexual orientation.

Low self worth: Sex might be for survivors especially those abused as children, all they have known that gives them worth. It can be the only way they have learned to received affection, attention, ‘love’ or have other needs met so sex becomes a way to meet unmet needs.

The brain is trying to understand the trauma, redo it differently or undo it.

The other side of the coin is sexual anorexia termed by Dr. Patrick Carnes to describe the denial or repulsion of sexual appetite. He identifies the following traits in sexual anorexia:

  • A dread of sexual pleasure
  • A morbid and persistent fear of sexual contact
  • Obsession and hyper vigilance around sexual matters
  • Avoidance of anything connected to sex
  • Preoccupation with others being sexual
  • Distortions of body appearance, real or imagined
  • Extreme loathing of bodily functions
  • Obsessive self doubts about sexual adequacy
  • Obsessive worry or concern about the sexual intentions of others
  • Shame and self loathing over sexual experiences
  • Depression about sexual adequacy and functioning
  • Intimacy avoidance because of sexual fear.

Both hyper-sexuality and sexual anorexia are two sides of the same coin. Sexual anorexia is also a surviving tool but it also keeps the client stuck in their pain. It minimises the real role the trauma created in the victims sexual life. It can wrongly persuade individuals to believe that they just don’t want or like sex altogether, or it’s due to timidity, fragility or sense of weakness.

Survivors can also develop sexual dysfunctions as a result of rape; all these are normal reactions just like the result of hearing loss after an explosion that hits us.

It is also important that we realise that sexual trauma isn’t limited to acts of rapes, but any unwanted sexual encounter, coerced sex, sleazy mockery, sexual harassment and deliberate exposure, exposure to pornography as child, or physical trauma to body that makes you feel it’s unattractive. We can even feel traumatised when we have given consent to sexual behaviour and yet felt traumatised without understanding why.

Atkinson talks about women he has counselled who report consensual sexual experiences that have left them feeling ashamed or degraded, including losing their virginity in ways that were seen as distressing or traumatic, these can include being ignored or left after sex after thinking they had a relationship. It is not okay for a partner to sexually abuse another, it doesn’t make it okay because you would have sex with them on another day or you find them attractive or consented in past, or wanting sex but not in way offered or given. You need to feel ready, not pressured or forced and consent means only in the way you have consented with care and respect.

Lundy Bancroft states: “Exploitive, rough, uncaring sex is similar to physical violence in its effects, and can be worse in many ways”.

Atkinson states that these episodes are then programmed into our brains to define sex and an encounter that is seen as shameful and overpowering. This then not only changes and affects our beliefs about sex but our very own brain structures. This means that when we approach a similar situation, our brain fires in similar ways as when we first experienced sex as a trauma.

It is important to realise that boys also do get sexually abused and raped by female and male perpetrators and for most survivors (both male and females) the perpetrator is mostly always someone known and trusted such as a family member, friend, partner, boss, teacher, babysitter…and very rarely is it a stranger.

Recovery and healing is possible, and as counsellors we must be aware of these conflicts and behaviours and have an understanding of the complex ways that sexual abuse/violence can impact on survivors and the struggles they may be experiencing. It is important that we help clients in their healing journey and recognise the many forms in which their pain is expressed, and how that pain may be unresolved and stuck.

For more information on sexual violence/abuse and domestic violence and abuse, check out my eBook

Shattering the myths of abuse: Validating the pain; Changing the culture –https://www.amazon.co.uk/Shattering-Myths-Abuse-Validating-Changing-ebook/dp/B07PSCF9B5

https://www.counselling-directory.org.uk/memberarticles/hidden-sexual-pain-sexual-trauma

References: ‘Resurrection after Rape – A guide to transforming from victim to survivor’, 2nd Edition, Matt Atkinson (2010), RAR Publishing.

‘Sexual anorexia – Overcoming Sexual self hatred’, PhD. Patrick Carnes, 1997

Other useful reading: 

The Courage to Heal by Ellen Bass

The Sexual Healing Journey: A Guide for Survivors of Sexual Abuse by Wendy Malta

Online resources:

Sex after rape or assault – what to expect from your mate:  https://bluegypsy.tripod.com/physical.html

Guilt and Shame Resulting from Sexual Abuse: https://www.angelfire.com/super2/p_bhaskar/guilt.html

Copywrite: Antonella Zottola

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Understanding OCD

When people think about OCD and hear someone mention they have OCD, it is most likely that they see OCD in terms of OCD contamination, the fear of washing as the obsession and the compulsion that accompanies it, that of repeatedly feeling the need to wash.

Obsessions are therefore intrusive, unwelcome, distressing thoughts and mental images, whilst compulsions are the behaviours that those with OCD perform in an attempt to exorcise the fears and anxieties that are being caused by the obsessions.

However, what many people don’t realise is that OCD is varied in its topics. It is not limited to obsessions about dirt and contamination but can consists of many other areas that manifest as intrusive thoughts such as:

  • Violent thoughts
  • Religious or scrupulosity
  • Relationship OCD
  • Inappropriate sexual thoughts
  • Sexual orientation thoughts
  • Obsessions about hoarding or saving
  • Need for order and symmetry
  • Repetitive rituals
  • Nonsensical doubts
  • Superstitious fears
  • Cleaning and washing
  • Hoarding or collecting compulsions
  • Bodily functions (such as blinking) and many others, all of which compromise intrusive thoughts, compulsions and obsessions.

These thoughts are unwanted, distressing, and upsetting. The person who experiences them also experiences panic and anxiety as they question their reality, character and morality. They cannot fathom why they would be having these vile thoughts. These can also follow them into dreams.

It is important to note that although many fear these impulses, nobody with OCD has acted upon their most immoral or disturbing and dark thoughts. Sufferers live in misery with these thoughts and find them repugnant when the thoughts go against their values and morals. OCD attacks the very things that the suffer values, hence what is most important to them and what the mind can think of being the worst possible thing such as new born mothers who have intrusive thoughts of harming their babies. These thoughts are just that – thoughts, meaningless ones.

The reality is that intrusive/unwanted thoughts are normal and common, we all experience them. The difference is how people respond to them. Usually people that don’t suffer from intrusive thoughts are able to dismiss them, forget them and attach no meaning to them. In comparison, those who suffer from intrusive thoughts, attach meaning, feel the discomfort and unease and start to question themselves for having them. They start fearing that they may become a danger and act on these and they become scared, hence the obsession results in thoughts becoming stuck. Attaching meaning therefore gives the thoughts power and makes them stronger, resulting in repeated attacks. In the book, Brain Lock (2016) by Jeffery M. Schwartz, a psychiatrist calls this stuck point exactly that; brain lock. He explains that the brain has become stuck in an inappropriate groove.

These thoughts then become torturous. When the unwanted thoughts become stuck then the content is given false importance. The thoughts get stuck precisely due to the fact that the person doesn’t want them or agrees with them. OCD is a manipulating bully that will go after the things people hold most important and so represent the opposite of what a person may desire. They do not make the person having them a bad person. They are a misfiring in the brain, not a reflection of the sufferer’s character. These thoughts are also upsetting as they will try to disrupt the most beautiful moments in your life.

The key is that these thoughts lose their power when the individual no longer tries to repress, avoid or control them and doesn’t react with fear or give them importance as ascribing meaning to them fuels them. The more we push them back the more they bounce back. This was seen by an experiment where candidates were told not to think about a white bear; the more they tried to push the thought away the more it came alive. Intrusive thoughts are like those malignant pop up ad’s on our computer, they unexpectedly pop up when we least expect them and when we don’t invite them in. There was a time where it was believed that avoidance to triggers and distractions would help, and that those that suffered from this disorder would need long term psychotherapy, this is now acknowledged is not the case and that suppression and avoidance isn’t effective. Mindfulness is used as an approach to accept the thoughts are there, this doesn’t mean agreeing with them or liking them, it means acknowledging that they are there and allowing them to sit so that they eventually get bored of not receiving attention and slowly start to be starved of their power and gradually fade or better control over them is achieved.

Due to the fact that new research and more effective ways are being found and old approaches have been discovered not to be helpful, it’s pivotal that as counsellors we need to keep updated with what approaches are deemed no longer effective and to be open to new ways of helping clients.

The CBT approach has over the years now been proved to be effective in dealing with forms of OCD and intrusive thoughts.

A very useful self-help method for managing and controlling thoughts, using this approach, and of which is pioneered by many organisations who work in this area, is Professor Jeffrey Schwartz’ ‘Four Step Method’.

The four steps are: relabel, reattribute, refocus and revalue.

Let’s look briefly at each step:

1.      Relabel – this is acknowledging that the thought is a false message and relabelling it for what it is – “this is my OCD talking”, “these are obsessions and compulsions, this is not reality and what I feel I need to do is not a need”, “this is my mind playing tricks and trying to fool, bully and manipulate me, “this is a disorder just like any other disorder”.

2.      Reattribute – with reattribute you learn to put the blame straight on the brain. It helps to answer why thoughts persist – “it’s my brain, this isn’t me”. Just like a person that suffers from epilepsy cannot stop the attacks the same with obsessions and compulsions, however with this disorder, the more we train our brains the more we can divert the signals. We can tell ourselves “these are not real thoughts and this is a false alarm”.

3.      Refocus – this helps with compulsions and to change behavioural responses by focusing the attention on something useful and constructive. It’s acknowledging the thought but not responding and reacting to it but telling it that you are going to focus on other things rather than listen to the lies. The idea of this is that when you change your behaviour, you are changing your brain.

4.      Revalue – this is not giving meaning and value to symptoms. It is being able to see them as meaningless thoughts (obsessions) and compulsions. It is being able to see the obsessions and need for compulsions as lies and defining the reality and truth. If we see obsessions as just that and having no meaning then they lose power, we can be able to feel less uncomfortable and anxious knowing it doesn’t define or character and do not belong to the core values we present, that they are the complete opposite. A powerful mind can change the brain by altering responses to the messages the brain sends.

As counsellors we must be aware of the variety of different obsessions and compulsions a client may present with and it is imperative that we do not see this disorder as a true reflection of our client’s thoughts and character but rather for the medical condition that it is which is related to a biochemical imbalance in the brain.

Clients must remember it is not how they feel but what they do that matters and that OCD attacks the very things that are important to them. They are not bad people, they are having bad thoughts and that thoughts do not define us, we all get crazy thoughts now and then, this is normal and doesn’t mean we are dangerous or evil and will act on them. If an individual questions if they have OCD, most likely it is OCD. The very fact they question their thoughts or find certain thoughts repugnant and seek help indicates they are not bad, in fact most people with intrusive thoughts have high morals and hence why it leads them to question these thoughts and attach meaning to them rather than be able to ignore them and pass them off for what they are, meaningless and false messages.

https://www.counselling-directory.org.uk/memberarticles/ocd-intrusive-thoughts

Reference: A Four- Step Self- Treatment Method to Change Your Brain Chemisty. Brain Lock. Free Yourself from Obsessive – Compulsive Behaviour (2016) Jeffrey M. Schwartz, Md with Beverly Beyette: Harper

Please note: I am not a medical practitioner, psychologist or psychiatrist. I am a therapist with OCD knowledge, and some own experience of it.  I have not specialised in this area, but helped others experiencing OCD and done a lot of self-learning from acclaimed academic books and resources written by professionals whose specialism is in this area.