Last week when I wrote Vacation, Changes, and Derailment, I had high hopes that I would be able to settle things down internally and find some balance. And, rightly so. Over the past few years, I have made great strides at self-awareness and acceptance. My ability to navigate the murky waters of dissociation is much better now.

However, today, my hopes are quickly waning.

I think I need help. More help than I am getting. I think I am in trouble.

When I write about out of control dissociation, I often talk about contradictions. Good, safe experiences often exist alongside scary, unsafe experiences. So, I can be tending to my gardens and playing piano one moment. And find myself getting horribly hurt in another moment. Since both types of experiences are not separated by much real-life time, I am left utterly confused, shattered, and broken.

Yes, I hurt myself. I know for sure I hurt myself last night and I have some small memory of the day before that and almost no memory of therapy on Tuesday.

I have talked before about how common it is for survivors of child sexual abuse to recreate the abuse in the present. I struggle in my understanding of that. In some way, I see it as an attempt at control. In another way, I see it as confirming perception of self-worth. In still another, I see it simply as not being grounded enough in the present so that old coping is more apt to be called upon. It is difficult to put the pieces together, because all can be true. I do know that last night was very dangerous and not compatible with the life I lead and the ideals I aspire to.

I also know that over the last few days I have been very erratic. I have been losing lots of time. My emotions have been all over the place. I have been picking fights one minute and being incredibly patient and kind the next. I have not seen the red flags, or saw them and simply blew past them and did nothing.

I am well aware that getting hurt does not solve anything in 2010. And my new awareness makes recovery from self-harm difficult. In the past, self-harm events (or self-harm coping) would easily be forgotten because there was not much permeability between parts of myself. Now, this is not the case. Today, I am besieged by flashbacks, pain, panic, and a sense of being totally broken.

Denial adds another layer of difficulty. Even though there has been a lot of lost time, there is a good deal of permeability between dissociated parts of my mind. That leads me to a place of not accepting parts. Of thinking it is all made up. That it is simply a convenient excuse to explain erratic behavior. I say I am a fraud. This leaves me even more confused. Because while I can understand the logic, I know it is some kind of internal ruse.

So, I am left holding the pieces and do not know how to put them back together. I am left knowing that I brought this on myself. How do I accept that? Everything is out of control.

Welcome to Activity No. 4 of the Expressive Arts Carnival. Thank you to all who participate and welcome if you are new!

Submissions are due by September 22, 2010. All submissions must be made by e-mail. Please send me two image files (one for each drawing or painting) with a width for each greater than or equal to 1280 pixels (note the new size requirement is due to the full screen slideshow presentations we now can do). Please also send some explanatory text and indicate which image was before and which was after the breathing. I will figure out how to present them. I may merge the art or show them separately.

You may also wish to send me a link to a page hosted on your own site (or blog), if you have one. It is important to repeat that nobody is required to have a blog in order to participate.

The Carnival will be published on the afternoon of September 23, 2010.

To submit, e-mail to: paul@mindparts.org.

Please use "EXPRESSIVE ARTS" in the subject heading to help me keep track of submissions. Every submission will receive an acknowledgement of receipt. If you don't receive one within a day or so, then please follow up with me.

If you have questions or need clarifications, direct them to me by e-mail or ask in the comments here.

Last week was our family vacation to the beach. I had mixed feelings about going. One of the reasons was that I had been "off the healing track" for months and felt like I was just getting things back on track in the couple weeks leading up to the trip. I did not want to upset that. Another, is that these days I find it almost impossible to sleep away from home without huge difficulties. But, I also saw the trip as an opportunity to have well-deserved together time with my wife and girls away from the daily routine.

The trip was precisely the mixed bag I had anticipated. Every night I had nightmares or very weird dreams (something I had not experienced for a long time). My Healing Guide (therapist) was, for the most part, "out of sight, out of mind." And I flirted with what I guess was denial, wondering what I could possibly have to heal from or why it wasn't over with already? That was not really a bad thing. We all need a vacation from work or from our troubles. During the days, I was quite engaged with the family and had virtually zero difficulties. We played paddleball on the beach, made sand castles, got a tan, played harmonica, and cooked lobster. So, by any measure, it was a success.

When I came home, though, the vacation meant almost nothing. The experience was lost. Even though I have the pictures, they very much have a "newspaper" feel to them.

Then, yesterday, I realized that I was in "robot mode." I was not really connected internally in any meaningful way. I was "off the track," which was something I wanted to avoid. I know that is not good. It puts me at risk. It means that I am more vulnerable to triggers. I am more apt to deal with things in a more fragmented way. My safety becomes jeopardized.

Funny how that happens, huh? Vacations are meant to recharge you so you can resume life with renewed vigor. That like never happens for me! I know this is not the first time dealing with this vacation issue. In June, I wrote Is This a Vacation or Allowing? where I thought I was taking what I thought was a "healthy" internal vacation, but it was not good for me. Last October, after being completely functional while my wife went away on her own vacation, I had a huge collapse that I wrote about in The Boat is Sinking or Is There Even a Boat?

Maybe part of the problem, if you want to call it that, is that we came back from vacation to some big changes. This week is the unofficial start to Fall. And I recently discovered I have an aversion to seasonal changes. The kids started school today. And work officially "ramps up" now for me, as I am on an academic calendar.

I know I have to find my equilibrium. I just get so disoriented so easily it seems. I will try to take it easy on myself. I will try to shift things away from fragmentation. I will try to get on the track again. I know the types of things that I can do to help. They entail checking-in internally, journaling, not throwing myself completely into work.

It is all about balance you know. Of course, those of us who dissociate, know that balance is difficult to achieve. I usually say it is difficult because we are trying to do it while riding a unicycle on a tightrope, backwards, blindfolded, chewing gum, in hundred mile hour winds. But the funny thing is that we can actually do it!

Welcome to the August 2010 edition of the Expressive Arts Carnival. This month's theme, see announcement, was to "choose two (and only two) colors and make a painting that represents where you have been mentally for the past week or so."

For the more traditional view, here are the entries in the order they were received.

Entry 1: Ivory

Ivory titled this piece "Feeling Lost" and wrote: "I am feeling extremely lost and overwhelmed."

Entry 2: Clinically Clueless

Clinically Clueless wrote: "I used my non-dominant hand. This exercise came at a good time as I am working through some of these issues and feelings in therapy now.  During one of the sessions, I said that I feel like coloring.  The colors are a bit washed out.  The colors are a red-orange and purple-blue."

Entry 3: Castorgirl

Castorgirl wrote that this piece is a "representation of how we've felt over the last few weeks as well... scared, frightened, isolated, overwhelmed, hopeless and beyond help."

Entry 4: Inner Family

Inner Family wrote: "There's been more focus lately on the system working as a united whole, even if we never fully integrate. We are our own light, a ball of light, though we have raw wounds, angry red welts of pain and memory. The beliefs we still struggle with, beliefs about our self-worth and the world around us, are a prison. Still, we continue to heal, to let our light shine through."

Entry 5: Jahda

Jahda titled this piece: "2+2≠5".

Entry 6: Shen

Shen wrote: "In another week, this project would have turned out quite differently. Having spent two and half weeks with my family of origin gathered around my house, this piece seems to express how I was feeling by the end of that time. I had only one meltdown during the entire 17 days, which is remarkable and a huge improvement over any time in the past. However, inside it was a barely controlled chaos, most of the time. I was just 'getting through it' by holding myself in the protective custody of my most spiritual self."

Entry 7: Paul

I wrote: "This is the anatomy of a crash. I have been doing so well and felt "on track" for the past week, then all of a sudden, the bottom fell out. The image is a representational timeline of the past week."

Entry 8: Katie

Katie titled this piece "Stinking Thinking" and wrote: "What I discovered lately is that I've been feeling trapped because I've closed myself up into a tiny box of my own narrow expectations, too much pressure I put on myself, and lack of needed expression and connection to those around me."

Entry 9: Kerro

Kerro wrote: "I started with blue and yellow drops of paint, and I worked with them until they merged in a pattern and colour that said something about my week." So, she kept in the guidelines, by using only two colors, and merging them!!

That's all folks! Thanks to all those who contributed. If you think this Carnival is worthwhile, then let others know about it and we can continue to increase the contributors for future months.

I stand by the road
Watching lives go by
Trapped in a world
Without knowing why

Too scared to love
To believe, to soar
Afraid to find out
What's behind the locked door

Alone in the dark
Being called from outside
Hearing the footsteps
There's no place to hide

Living with memories
Of many long years
Longing to breathe
Without drowning in tears

Not all of the demons
Are locked up in hell
I carry some with me
They know me so well

I try to be strong
To outgrow the past
Feeling the pain
How long will it last?

This was written in the early 1990s. I don't have much of a memory of it, but found it saved in some old files. I think it's relevant today because I have walked through much of what is discussed in the poem. There is so much that is still so hard, but I'm not "locked up" anymore, even though it often will feel that way. The question at the end screams out at me: "How long will it last?" I think in many ways it will last forever.

I have been quite an active photographer since the 90s and discussed some of my relationship with photography in Photojournalism as Psychologically Aware Seeing. Around that time, I began wanting to explore abstract photography.

Well, yesterday was my first attempt. Summer has brought many colors to my gardens and I wanted to try a simple technique to see what I could get. The idea I had was to use the camera as a paint brush. When we paint we "load" the brush up and our stroke applies the paint. With the brush, we cover a distance over a period of time.

Generally when we make a photograph, we do not move the camera. The idea is to capture a scene in focus and frozen in time. But we can accomplish a "brushing" effect by leaving the camera shutter open and moving the camera over the course of the exposure.

For my work yesterday, I experimented with different long shutter speeds from 2 to 1/15 seconds. Since you are moving the camera, focus means very little, so I just put the camera on a very small aperture (in this case f/16) and tried different ways to pan the camera (or in art terms, apply a brush stroke).

I did not do any of this which much feeling. It was mainly a technical exercise. But it is interesting what I chose to work with. I focused on two bright colors in my garden. The first set of images I made were with large green hydrangea leaves, which is one of my favorite plants.

My second set was with canna flowers. These have important personal significance for me because they are flowers that my family has cultivated in our gardens for three generations. This was the first year in a long time I was able to introduce them to my summer garden. This is the particular flower I was working with for the abstract image at the top.

Of the 100 images I made, the above image was the one that had the most interest for me. The image was made at 200mm with a half second exposure and a gentle pan of the lens.

I hope you enjoy it. You can click on the images for high resolution versions.

You can see all the photography images I have used on Mind Parts by visiting my Photography Gallery.

Also, a reminder that submissions to the Expressive Arts Carnival No. 3 are due in a week on August 19.

In Trauma and Sexuality, I wrote about sexual healing being a taboo subject in both the literature and in therapy. Nobody wants to talk about it. Yet it is one of the main areas where childhood sex abuse victims were damaged. It is my contention that since the problem is not addressed directly in the literature and in therapy, we discuss the issues tied to sex in an unconsciously masked kind of way. We can talk about being hurt sexually and what was done to us (and think we are talking about sex directly). About being suicidal. Depressed. Triggered. Switchy. And on and on.

But, while all important, these are symptoms of what is a core issue in the present. What is our relationship right now to sex? How is sex in the present dysfunctional? How is sex in the present hurting us? Helping us? Recreating? Overcoming? And how do all these questions about the present relate to the past?

I understand, I think, the essential barriers to talking about sex, even in the "safe" confines of the therapy office. For those of us sexually abused as children, our lives were generally focused on hiding the fact that we were being hurt in that specific a way. It should not be hard to appreciate that this is fertile ground for creating shame and guilt; stains on our soul which stay with us through adulthood and whose purpose seems to be only to deny us from seeking healing (or even thinking we are worthy enough to heal).

Not to mention those of us who were sexually abused were generally taught (we call them "rules") to behave a certain way in dealing with sex, through a number of manipulative means. As with any kind of learning, neuronal circuits are formed. Sex abuse ties in with reward, pleasure and fear circuits in the brain moderated by powerful neurotransmitters like dopamine. Literally, there is an imprint on our brains. These imprints are terribly difficult to heal from. But we can heal from them if we deal with them directly instead of dancing around the perimeter.

I contend that the first step in sexual healing is acknowledging the original sexual injury. The second step is being able to break down some of the guilt and shame barriers to talking about the subject. But there is more.

Obviously, each of us were affected in different ways sexually. Some of us become hyposexual and just run away from sex. Some of us become hypersexual. Neither of these extremes is necessarily bad as long as you are comfortable in them. But many are not comfortable with who they are sexually and simply do not know who they are sexually.

To further complicate matters, some of us use sex to recreate abuses, whether it be through fantasy or in real-life, though I do believe there is a marked difference between the two. In the literature, re-enactment (generally referred to as real-life) is a more commonly discussed sexual outcome. In these situations, we are continuing the cycle of abuse by placing ourselves in harmful psychological or physical situations (and, yes, even if in fantasy).

It can be understood in terms of neuronal imprints and in terms of being a way to manage overwhelming feelings. I believe it is probably likely that the degree of sexual re-enactment is correlated with degree of dissociation. With dissociative identities, parts were created for specific purposes and roles which are harder to move out of. Further, it is easier to realize how sex re-enactment solves certain problems (like being able to tolerate overwhelming feelings of "parts" of us) while isolating other parts of us (who are traumatized by the present-day behavior).

Those are explanations and not excuses. Since, in most cases, the original abuse is not happening anymore, we are responsible for our behavior. In this case, I think it is most aptly labeled as self-abuse behavior.

When one is able to label one's own re-enacting sex as self-abuse, then the third, perhaps the most important, step in beginning to achieve sexual healing is reached. We can achieve this only when we realize that the "positive" effects of recreating sex are dwarfed by the negative effects. And this takes a good deal of self-awareness and brutal internal honesty.

If we keep these three steps in mind—acknowledging original injury, overcoming guilt and shame, and labeling re-enactment as self-abuse—then we are making a great effort to heal. The prognosis, I think, is good.

While sexual healing may seem daunting, the good news is that once you have achieved all three steps, there is no going back. Yes, there are "setbacks", but once you gain awareness, you cannot lose it, you can only temporarily misplace it.

A huge disclaimer here goes without saying: I am not an expert. This post is based on my personal experiences and interactions with other survivors over the past 20 years. It is not meant to be a comprehensive, or even necessarily scalable view on the sexual effects of abuse. I think there is a good chance it may be quite scalable. But I do not pretend to assert that as fact.

For last month's Expressive Arts Carnival, I had a few choices for what I was going to submit. Experiences shift so quickly. One minute I felt whole. Another I felt fragmented.

The above was the image I was going to submit. This is the normal way to represent my internal experience. Through shapes and colors which overlap in layers, sometimes blocking out any clear picture of what's really going on.

The other image I was going to submit was the unedited "Empty Chairs" photograph. The message here was alone and empty and separate. But it also held promise for what was to come (this was taken before a graduation ceremony). There is also strict order in the image.

Right before I submitted this image, I decided it needed to also portray the experience of being fragmented. So, the image was taken into Photoshop, cut up, and arranged in a more or less random pattern.

Here is the "Empty Chairs" photograph as seen by the camera (shot at f/3.2). The focus is on the section of chairs in the background which was where the boys sat separate from the girls.

Welcome to Activity No. 3 of the Expressive Arts Carnival.

Activity: On a white or black background, choose two (and only two) colors and make a painting that represents where you have been mentally for the past week or so. Feel free to use digital (e.g., Photoshop, electronic painting program) or analog techniques (e.g., paint, watercolor, colored pencils, markers).

Submissions are due by August 19, 2010. All submissions must be made by e-mail. You can send me an image file preferably with a width greater than or equal to 550 pixels (with or without explanatory text). Or send me a link to a post hosted on your own site (or blog), if you have one. It is important to repeat that nobody is required to have a blog in order to participate. Submissions may be of current or prior work, but all are encouraged to say some words about your process. The Carnival will be published on the afternoon of August 20, 2010.

To submit, e-mail to: paul@mindparts.org.

Please use "EXPRESSIVE ARTS" in the subject heading to help me keep track of submissions. Every submission will receive an acknowledgement of receipt.

The Expressive Arts Carnival posts monthly activities and encourages submissions which will be published on Mind Parts. For more information, see: Expressive Arts Carnival Home.

If you have questions, direct them to me by e-mail or ask in the comments here.

How society views child abuse has changed dramatically over the years. In the 70s and before, there was nearly complete denial, a virtual "Don't Ask, Don't Tell" policy. In the 80s, reports of abuse shot up in frequency, the pendulum swung in the other direction and survivors were often validated. In the 90s, there was an appreciation that memories are malleable and some cases called into question the whole abuse "movement." Survivors, as well as the mental health community, were put on the defensive. Consequently, it was unpopular to be a survivor in the 90s.

In the past decade, we have reached a sort of middle ground. While a final destination has not been achieved, there is momentum. In which direction are we moving? Are we moving in a direction that tends to help or hurt children? What about survivors? I think these are questions whose answers are outstanding.

The pessimistic view is that while children are technically protected by a slew of laws and safeguards, things may not really be that different now. Only time will tell, of course.

Yes, children are taught about safety in school. There is mandatory reporting. On the whole, those are good. But I do believe that one of the consequences of mandatory reporting is that child protection agencies are overworked and understaffed. As a result, judgment calls need to be made, and who falls through the cracks? Like many well meaning responses, we may not be giving the effort enough of a priority.

Another contributor, which effects survivors negatively, is that I believe collective societal denial is still as strong as ever. In my own hometown in 2007, as an example, there was a public case of child sexual abuse at a gymnastics school. Many young women came forward telling of abuse from a decade or more ago; their stories were consistent. There was also a visual confirmation of physical abuse in the present day. When the case hit the press, the reaction from many (but certainly not all) of the gym parents was: "Not true. They are lying. He's such a nice guy. It's all misinterpreted and taken out of context." What was most distressing was that the ones who were closest to the situation were most in denial!

For me, this was a tipping point in my healing journey. I suddenly broke my silence and spoke up publicly. I came out of the shadows. And learned that to heal you cannot be in the shadows. I learned that to heal, you have to validate your own experiences, else you will be continually seduced by denial.

I was not an activist. I simply wrote a letter in our local paper, stood up for the victims and said that I understood the pain that comes from child abuse. And I was not as shy to bring up the scandal when I talked in public. For this, I got a whole spectrum of responses from hate mail to support.

I learned that there are basically two sets of people when it comes to child abuse. One with their eyes open and one with their eyes closed. For me, this helped me appreciate why we are at a crossroads now in our society.

We can only hope that more and more people are having their eyes opened. That the momentum is in the direction of increasing protection of children. And further, for those who are not protected, that the barriers to healing are not as high.

We can do our part, too. I am not narcissistic enough to think that my speaking up here will change the world. But I do believe that the more of us there are speaking the truth in whatever way we are most comfortable, the more we can help push things in the right direction.

When we keep our eyes open, when we seek healing, when we validate our experiences and the effects of our experiences, then we are unquestionably making a positive difference.

This post was partly written in response to the discussions in a recent post titled Pediatric Symptom Checklist.