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As some of you know, The Oprah Show did a two-part special on childhood sexual abuse of males. I basically panned the first part in Why I Did Not Appreciate Oprah's "200 Men" Show because I felt it was overly sensationalistic and focused mainly on men telling of their graphic abuse details.

I was only able to watch the second show last week, and it was significantly better than the first. Probably it has done a good service to male survivors and their loved ones as many important themes were touched upon. To the uninitiated, to someone who has not started to heal, to spouses who are lacking closeness, I saw this as progress. So, for that I am thankful for the show. While the first episode is online in its entirety, the second is not. But I will do my best to summarize the show here as well as provide my own commentary, hence this will be a long post.

Because the show spent a significant amount of effort focusing on the impact on spouses and loved ones, my immediate reaction was that if my wife were able to see this show, it could sow the seeds of change for us as a couple. But she does not want to see the show even though it is on our DVR. As I have made significant healing progress these past couple years, I have realized that we are not on the same path. This is difficult for me because it makes me feel like the burden of healing is all on me. Of course, I understand the majority of healing is on me. But I do not think my wife appreciates the toll that all of what we have gone through has affected her and that she may need to do things to care for, and heal, herself. So, I will save the episode and hopefully someday she will be able to see it.

As I watched, I found myself crying. And I realized that I do still have some mourning to do, or maybe a lot. I had always thought I was all done. For expert advice, the show featured Dr. Howard Fradkin, a psychologist out of Ohio who co-chairs the MaleSurvivor Weekends of Recovery, see Male Survivor. Dr. Fradkin made a number of statements that hit home for me. He said many things so perfectly well. While Oprah clearly struggled with the topic of healing, Dr. Fradkin did not. He was the one who brought up the issue by saying: "it's absolutely possible to heal and recover completely and fully. It takes a lot of time and it impacts everyone in your life." I am "technically" in my 20th year of healing, which has changed significantly over the years. I know I have a long way to go, but I appreciate his statement. I found it hopeful.

The show then asked what is different for male survivors versus female survivors. Most of my survivor friends, either online or from the hospital, are female. For me, personally, I have not seen much difference. I see the struggles as the same. But, I have long wondered why I am usually the only male on the trauma/dissociative inpatient unit at McLean Hospital. I have often thought I was different in some way. I have had discussions with therapists about this in the past. Usually I understand it that men typically do not seek help. Or that men are more likely to channel their anger into drugs and alcohol or even land in prison. All of those outcomes make me sad.

But I am also make glad that circumstances for me were such that I broke down right after college in 1990 and sought help. When the 2002 clergy abuse scandal erupted, there was also a sense of coming together for survivors. The public outcry helped to lift the veil of shame. During those early years there were well-attended support groups here in Boston (the epicenter of the scandal) and there was definitely a sense of camaraderie. I suppose what I experienced was what Oprah was aiming for with this show. It was not at all always this way, but now am fairly comfortable identifying myself as a survivor and committing myself to doing the hard work of healing. From the language of some of the guests, I clearly can see that is not the case for many. Again, I consider myself lucky.

Sexual identity confusion was also discussed. This is an area I typically shy away from. Maybe this is not such a problem for me on the whole because the problem is so relegated to parts of me as someone who is dissociative. As grounded me, Paul, I have no problem identifying as a healthy vibrant husband and father. But, that is not the case for many young parts of me. The confusion has always been there. The show addressed a common myth: that male on male sexual abuse can cause homosexuality. The psychologist said, correctly, that sexual orientation is determined around ages 4 or 5, and since most abuse happens later, there can be no effect. But there still is sexual identity confusion. When a boy is abused by a man, the common response is that they do not know what to feel about the connection they felt, sexual pleasure, attention, etc. This confusion remains until it is addressed and healed.

In the next section, there was a discussion about moving from coping to healing. This was right up my alley! Oprah's producer, Ray, said he didn't want to live with the abuse having control over him anymore and that "you get abused by your abuser, and then you get abused again by the aftermath of the abuse." He further said on moving from coping to healing, "We all come up with clever ways in which to live our lives with it lurking in the background. And you're trying to operate and maneuver in the world with it there. I think healing is when you let yourself feel the feelings, when you are honest with yourself about what it's actually has done to you, and mourn that." For me, this was all code for talking about dysfunctional coping. Oprah talked about her promiscuous years. There was some talk about cutting. For me, I have long struggled with self injury and I want to be free of that! I feel over the past couple years I have begun to make the transition from coping to healing. That changes everything!

Oprah repeated her favorite definition of forgiveness, as "giving up the hope that the past could have been any different." She said you have to mourn, but you can't stay there. Then the question was "How to move forward?" She said the first step is to speak up, so that shame can begin to heal. This touched home for me, because I have spoken up in various ways over the years. In the early 90s, just coming forward to get help was a form of speaking up. Then suing the church in the mid 90s, was speaking up further (although that was shrouded in secrecy). As I said, in 2002 the church scandal brought survivors together and there was more speaking up. But, the real watershed moment for me, and I have not ever said this here before, was in 2007 when there was a sex abuse scandal at my daughter's place of gymnastics. While my daughter was not involved in any way, it was the first time that my family life and my abusive past came together. Our town is small, and I spoke up in the local paper. I came forward as a survivor myself. For me this turned out to be a big deal. This speaking up changed things for me. This was when I really started to heal. Therapy made a dramatic shift and this was around the time Mind Parts was created. Lifting the veil of shame has been critical for me.

The low point of the show was when Oprah asked "How men are to find help?" The psychologist talked about therapy, but also about therapists being hard (if not impossible) to find, and so using Internet support groups or bulletin boards were mentioned as alternatives. That, to me, is poor advice. To the best of my knowledge, there are many therapists out there and many opportunities for men to find healing.

Oprah then ended by saying these wonderful words: "The reason why we wanted to do this show is because every man in this room, every one of you, represents the spirit of something dark that has happened to you, but also the spirit of hope and the spirit of survival."

The link to Oprah's shows can be found at: A Two-Day Oprah Show Event: 200 Adult Men Who Were Molested Come Forward.

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Last week, the Oprah show attempted to tackle the problem of male sexual abuse. The premise of the show (see link below) was to bring together 200 male survivors and broadcast to millions in order to "lift the veil of shame."

I do not watch Oprah, nor any other talk show hosts. Of all of them, I probably respect Oprah the most for her willingness to address large societal issues.

But, with this show, I was left severely disappointed as well as seriously triggered.

Many of the statistics were affirmed, like 1 in 6 boys have unwanted sexual experiences or abuse, that more than 9 out of 10 abusers target children they know, that many boys (and indeed girls) are abused by more than one abuser, and that male on male abuse often leads to sexual orientation conflicts in victims.

Oprah had an opportunity to do something really admirable, and the opening image of all the men holding photographs of themselves as boys was extremely compelling and moving. But the show missed the opportunity. The show did not focus on lifting the stigma. I found the show to be unnecessarily sensationalistic. I did not like many of the messages. They were almost uniformly negative. The focus was mainly on dealing with graphic abuse details. The only rationale I could come up with it being done in this way was that it was felt that it was more important for viewership to sensationalize over having frank, perhaps more boring, discussions of the issues.

The guests came off only as victims. That was somewhat predictable. There was no hopeful message from any of the guests. Everyone talked only of the perspective of what was done to them and how hurt they are now. And their lives being taken away. Nothing about moving through and healing. There was no hope. For me, that was the huge disappointment and I found myself getting angry.

There was a segment where two brothers who were abused by priests told their story. That was hard for me to watch and I did not know what to think, probably because a lot of what was said was so similar to my abuse. Perhaps had that segment not been so needlessly graphic, I would have had a slightly different take on the whole show. But, knowing a bit about the clergy abuse scandal reports, I know she chose a rather extreme example. What was the point of choosing an extreme example?

Oprah went on to say she hoped that people watching "will release the guilt and shame they hold." Tyler Perry, one of the guests, talked in a brief comment about men taking back power and healing. And another guest, I think Dr. Fradkin, talked a bit about shame. But those sentiments were clearly not what Oprah wanted the show to focus on. She appeared to be more interested on the shock value of the stories.

While they talked about drug and alcohol addiction and failed relationships, they focused on only the stereotypical male maladies and nothing more. There was no talk about mental health disorders stemming from abuse. There was a passing mention of depression. Nobody mentioned suicide. Nobody mentioned dissociative disorders, other than in the descriptions of abuse which used phrases such as "leaving my body" when abuse occurred. And nobody talked about any kind of path to healing. Nobody.

In what I considered her worst offense, somehow Oprah chose to have a guest, of all the possible guests she could have had, be a man who regularly takes his own children to his mother who still lives with his father who was his abuser. It was as if she did this for a purpose, to call out the man in what I perceived to be a hurtful way. I wondered, as I was watching, how that particular guest was viewed by the 200 men in the audience. Probably he was vilified. I thought it was a poor choice. Surely one of the other 200 men would have made a better choice.

Sadly, nobody asked me!

Of course, I am curious to know what you all think.

Dr. Kathleen Young, a therapist blogger I greatly respect, adressed the show on her blog post: 200 Men: Standing Together to Lift the Veil of Shame.

The link to the full Oprah show can be found at: 200 Adult Men Who Were Molested Come Forward. But beware that the show can be triggering.

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The DSM5 and Dissociation

| By Paul | | Comments (18)

In an editorial to the most recent Journal of Trauma and Dissociation (Vol. 11, pp. 261-5), Dr. David Spiegel writes about how dissociation will likely be addressed in the forthcoming DSM5. For those of you not familiar, the Diagnostic and Statistical Manual of Mental Disorders, commonly referred to as the DSM, is psychiatry's approach to standardizing mental disorders. I understand how many look askew at any psychiatric labels, myself sometimes included. But there is the reality that correct diagnoses are an important component to healing. Having a manual and common language helps to increase recognition, accurate assessment, and align treatments.

There has been some concern that the dissociative disorders, especially dissociative identity disorder, would be subsumed under other diagnoses and thereby essentially be "declassified." Even now, despite their presence in the current DSM, they are not well integrated into the psychiatric community. There are large biases against dissociation, that strangely do not seem to be as apparent in illnesses such as depression or schizophrenia. Probably this is due to the sometimes ephemeral nature of impairment. To the observer, it often appears that dissociatives can just pull themselves together, lending some credence to the belief that no real disorder exists. Yet, to the dissociative, we know there is much more to what we deal with than just being able to pull ourselves together. We know about what it means to lose our identity, to have huge gaps in memory, to have wild swings of consciousness. And, as I have said before, I believe one of the main reasons for the bias is that many clinicians and lay people are uncomfortable with the notion that an adult human being can have a fragmented sense of identity or lose control of their minds and bodies.

In his editorial, Spiegel, a member of the DSM5 Task Force, asserts that the dissociative disorders will be included in the revision which will come out in 2013. He gave a summary of what the task force is proposing. They are proposing that there be a stress and trauma spectrum section which will include PTSD and the dissociative disorders. In so doing, the DSM5 will emphasis the common etiology of these "disorders." This would be a controversial move, since the current version focuses more on description of symptoms. Even though there would still not be a diagnostic requirement of a trauma for a dissociative disorder to exist, placing dissociation squarely into a section with an emphasis on trauma etiology would be a blow to the false memory advocates. It would be a validation and positive step for those of us who appreciate that dissociative disorders do have a strong basis in trauma.

In fact, it appears that this trauma etiology will be pursued even further based on studies by Ruth Lanius and colleagues that there is a substantial subgroup, of nearly one third, of those with post-traumatic stress disorder showing mainly symptoms of dissociation which are far different from the "classic" PTSD symptoms. These clinical findings are supported by functional MRI studies which show that the dissociative subgroup has increased prefrontal cortical activity and reduced limbic activity in response to traumatic stimuli, which is opposite of the typical PTSD response.

One of the proposed changes to the criteria for dissociative identity disorder I believe is a step back. It states that the disruption of identity "may be observed by others, or reported by the patient." Detractors of dissociative identity disorder will say that there is no clinical input. On the other hand, there are clearly disorders where there is primarily patient reporting. Depression comes to mind. The onus would then be on the clinician to determine whether the self-reporting of the patient is consistent with the rest of the criteria for the disorder to warrant the diagnosis.

Complex PTSD, as proposed by Judith Herman in 1992, is not addressed in the current DSM and appears not to be addressed in the DSM5. I think this is for good reason. To do so, would confound matters. The commonly understood symptoms of complex PTSD are basically PTSD symptoms plus overlap with many other areas (such as anxiety, personality, and dissociative disorders). I believe we all, patients and clinicians alike, need to appreciate that the DSM will always have limitations. The manifestations of all of these disorders in practice are almost always more complex than any manual can ever hope to capture. But the goal of the manual should be to make a best effort and provide a guidepost.

To learn more about the recent studies showing the dissociative subgroup of PTSD, see the home page of Dr. Ruth Lanius at the University of Western Ontario. She does not have her most recent journal articles listed. If interested, check out: Emotion Modulation in PTSD: Clinical and Neurobiological Evidence for a Dissociative Subtype (in American Journal of Psychiatry). To read the Spiegel editorial, see Dissociation in the DSM5 (in Journal of Trauma and Dissociation).

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In Part I, we looked at ten iPhone/iPod Touch essential Apps for healing. In this Part II, we look at an additional ten. They are arguably no less important than the ones listed previously. Just different.

11. Boost 3D. In Part 1, I introduced a couple of grounding games, Peggle and Bookworm. I find those to be most helpful when I am very dissociated and need to engage in something that is not at all taxing. A step or two (or more) is the arcade-style Boost 3D, shown in the image above. It is a 3D tunnel obstacle course that is absolutely mind bending. My personal best is 2100, and after you get past 800, you enter into the "zone" and if you are having any other troubles, this game will surely take you away from them for a time. There are a couple of other notable arcade-style games I want to mention. Doodle Jump brings back a "Frogger-like" obstacle course that is downright nerve-wracking. Homerun Battle places you at home plate and your task is to hit the ball out of the park, and allows you to pit your skills against anyone on the Internet. All three of these games use the built-in "accelerometer" capabilities of the iPhone, iPod Touch, and iPad.

12. Labyrinth 2. If your taste is more on the intellectual side, puzzle games may interest you. Labyrinth 2 is a new twist on the old wooden "ball-in-hole" game. The goal is still the same: get the ball in the hole. But the twise is that there are fascinating obstacles added and an endless series of levels. For more puzzle-type games, check out Cross Fingers, a pure puzzle game. Also, Finger Physics challenges you to build interesting structures while obeying the laws of physics.

13. Facebook. No "top list" would be complete without the Facebook App. Now don't misunderstand me, I'm not a huge Facebook fan. But there are times when it's nice to catch up on what your friends are up to. It's a bit of a time waster.

14. Pranayama. If you are aware that your breathing is tied to level of relaxation and you have trouble in that area, then this is a good App. You can select from different breathing patterns, timings, and lengths and follow along with the realistic representation of a person.

15. Yoga in Bed. This is a guided yoga practice that you can do in your bed. I like it because it's geared towards people who do not need to do much physical activity to gain benefit from it. The fact that it's in your bed, makes it very easy to do.

16. Relax with Andrew Johnson. This is a guided relaxation App narrated by Andrew Johnson who has a calming Scottish accent. You can customize the guide by deciding on a sort of long introduction and the length. Another notable relaxation App is Pzizz sleep. This is a little more customizable and variable, but I don't like it as much. It allows you to mix the levels of the music versus the vocals. Both of these I find secondary to Joy of Being which I discussed previously.

17. Inkling. This is a great drawing App. Very simple as it only draws in "ink" color. You simply move your finger slowly for fine lines and the faster you move, the wider the lines. Such a simple concept, but you can do so much with it. And because of its simplicity, it's a good one to turn to if you need to ground yourself. Another notable App is Pollock. It has much more flexibility. Also very simple. But allows you to draw in colors, and randomly places "Pollock" like splotches when you draw.

18. FitnessBuilder. This allows you to create simple and elaborate fitness routines from a huge database. Many don't require any equipment. There are several fitness calculators that help you reach your goals as well as a log. Another App that many love is iFitness, which is quite similar and achieves the same results.

19. Pandora and TuneIn Radio. Internet radio has revolutionized, I think, how we listen to music. Pandora and TuneIn Radio are two of the best, although they approach things slightly differently. Pandora allows you to create your custom stations where you select artists or songs (as many as you wish) and the software will search its "music genome" to play songs for you that match the characteristics of what you've chosen. You can then mix your personalized stations to create basically anything you want. TuneIn Radio is a bit more traditional. You still can select genres of music, but you can also tune into broadcasts from actual radio stations. Both are excellent and will open up the musical world to you.

20. Navigon GPS. If you dissociate like I do, then you may often find yourself in the middle of nowhere and not know how to get home. This is where GPS systems come in really handy. I only have experience with Navigon. I think others are similar, most notably TomTom.

Hope you enjoyed the lists.

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The iPhone is unquestionably the greatest advance in technology I have ever experienced. Yes, I had an Apple in the 80s which defined the personal computer. I worked on mainframe supercomputers with their ability to compute real-time graphics, pretty much all of which you can now do on a capable laptop. I suffered through dialup from home at a time when the pipe dream was that eventually we could stream movies into our bedrooms, which has now happened.

The iPhone (and indeed iPad and to some extent the iPod Touch) are better than all those advances. Maybe that is a little unfair. I mean these new technologies do build on prior technologies. But what you can do with these little "i" devices is just absolutely unparalleled, especially since the technologies are "always on" and "at your fingertips."

I know iPhones, iPod Touches, and iPads are expensive, but they can be invaluable tools for the child abuse survivor. Since I have had my iPhone for the past year and a half, I have turned it into quite the tool for healing. I have downloaded (and paid for) hundreds of Apps. Most of them were horrible. So, I am hoping that my experience can help others in selecting the really good ones.

Here's a list of 10 Apps, plus a few more, that every survivor's iPhone (or iPod Touch) should have on it. Of course, it is nice to have an iPhone because of the constant network access even away from a wireless router. I find this a necessity for me. But it may not be for you. My kids and wife, for example, are plenty happy with their iPod Touches.

1. iPills. Everyone who uses medications on an as needed basis should have a medication logging App. While there are many out there, I have found iPills to be the best for me because it sports the least onerous entry system. I do not use it to log standing medications. As long as you are taking standing medications every day, I find that the time it takes to enter them kind of defeats the purpose of the software. You enter medications in the "My Pills" tab and can change the shape, size and color of the pill. I usually put the strength in the name, like "Klonopin .5mg". And, since I am only tracking PRN usage, I enter "As Needed" for dosing interval and "Any Time" for time of day. What's good about this App, is that it tracks the time taken, but you can still go back and enter data from a previous day if you forgot. Here's how I use this App: At the end of every month, I have the App email me the 30 day history and I log in table format usage of medications. This helps me to keep within usage goals and track trends for things like benzodiazepines and pain medicines.

2. Lifelog. It takes a little while to figure out how to use this App. It is nothing more than a tracking program. It allows you to build custom log "cards" (like diary cards) to track symptoms, feelings, pain, or anything you can rate on a numeric scale. It also does data analysis by showing correlations between variables and displays output numerically or in charts and graphs. I use it in two ways. For one, I use it as a customized "mood and safety monitor." In this card, I use it to track, on a scale of 1-10, acceptance, happiness, anger, fear/anxiety, fatigue, physical pain, dissociation level, and overall safety rating. On another card, I use it as a twice daily check-in with parts, having all the parts listed by name and I go down the list and mindfully check in, selecting all 1s as I go down the list.

3. IM+. I find texting on an iPhone to be absolutely painful. If you have a PC or laptop in front of you, you are much better off choosing one of those. But it is good for quick contact with others, and on the iPad it is actually quite good. IM+ is a do all messaging App that allows access to all the major messaging services like Yahoo! and AOL. This App stands out from some others because it is a universal App (meaning it also works on the iPad). There are other notable messengers. WhatsApp allows messaging between "i" devices only (like iPhone to iPhone or iPod Touch, etc.) through the use of unique identifiers coded to the phone. Also, the built-in iPhone MMS Messaging, which makes use of your cell carrier's messaging services is also a good choice (and probably the most reliable).

4. iPod, Mail, and Safari. Well, let's face it, the iPod revolutionized music delivery when launched in late 2001. It is quite nice to have all your music on your phone. But, I will admit that I prefer a dedicated hardware iPod. Call me old fashioned. Either way, you need music to be accessible. It is one of nature's best medicines. Mail and Safari are also equally dispensable. Technically, while these are all Apps, they are built into the iPhone and iPod Touch. So, I almost did not include it for that reason.

5. WebMD and Epocrates. Do you want to read all the patient information on a particular medication? No problem. WebMD has every possible medication it its database. You can find what the medication is for, what are the possible side effects, and view pill pictures. You can also look up information on diseases and common medication conditions. Equally indispensable is Epocrates (or Medscape). One of them should exist right alongside WebMD. They both contain prescribing information geared towards medical professionals. They also allow you to browse drugs by class, which is particularly helpful.

6. iSSH. I questioned whether to put this on here, because it requires a good deal of technical effort and I may use it in a way that is not common to others. I will probably expand on this as a technical "how to" in a future post. I use iSSH exclusively to enter posts into my private electronic journal. This App is a front end, it allows me to log into one of my computer servers and run a script that does the data entry. The key here is the script. Without the script, the App is pretty much useless. There is one major requirement: you need to have a computer server which you can log into via the ssh protocol. In my follow up post, I will make the case for why you should have your own server and tell you how to do it. Another, similar, App is FTPOnTheGo. It allows me to send images and other data from my iPhone to directories in my private journal. So, for example, I use it to send audio recordings, paintings, etc.

7. Sketchbook Mobile. This is probably the most full-featured drawing App and it is universal. It allows for the creation of up to six layers. It has a huge 1024x682 pixel canvas size. You can save images to the built-in gallery, and export them to your iPhone Photos gallery or email them. I export to the iPhone gallery then use FTPOnTheGo to upload it to my private journal. Then I use another script in iSSH which includes the image in the journal and allows me to enter some descriptive text. Another notable App is Brushes, but I find it a bit more cumbersome to use. In Part II, I will look at additional drawing Apps.

8. Peggle. This is perhaps the most grounding game ever (see image above). When one dissociates wildly, being able to ground is a must. This is where iPhone and iPod Touch games come in very handy. Peggle is the first game I used for this purpose, and is still one of the main ones I goto in a tough situation. The object of the game is simple. You have a ball shooter at the top and the object of the game is to clear all the orange pegs with the 10 balls you have. Simple. Addictive. Grounding. Pop Cap Games, Inc. also has other very worthy games. Perhaps one of the best is Bookworm, which is a scrabble type game. Part II will look at additional games.

9. Ambiance. Do you remember those sound effects records from long ago? Well, Ambiance is a bit of that, but totally awesome! Ambiance connects to a sound repository and allows you to download sound clips and import them into the App. Rain, birds, forests, rushing rivers, you name it, Ambiance has it, and they add more free sounds every week. What makes this App truly wonderful is that you can create your own custom mixes of several sounds and make your very own relaxation sound machine.

10. Joy of Being. This App is "da bomb." There are three beautifully scripted guided meditations, titled River, Forest, and Beach. They are each about 10 minutes long and are focused on positive and healthy grounding which help you to connect with nature and inside. I have talked to the author of this App and I have been told they have scripted additional meditations and are soon going to record them.

I hope you enjoyed this list. I will post Part II by early next week.

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If you have not done so already, please see the video post The Burden.

Feel free to add your own commentary to the comments here. I've closed comments on the original post. And, as always, differing opinions and viewpoints are very much welcomed!

My initial reaction was "Wow! I get it!" and instant identification and extreme sadness.

But my next reaction was wondering what the impact might be on people who have not been abused at all. I wondered if only those of us who were abused and damaged in this way would actually "get it". Then I wondered what the person who has been not severely hurt, but had been abused, would think about this. Would they look at this and say "Hey, you're going way to far with this! I was not affected this way and I was abused!"

The goal, obviously, of the advertising is not to reach people like us who are survivors of abuse, were affected in ways depicted in the piece, and who are healing. But if it speaks only to us, then the advertising would most certainly be deemed a failure. Since I cannot see this from any other perspective but my own, I cannot judge its impact on others. Obviously the problem of child sexual abuse is a societal one and awareness needs to be raised in all areas of society for there to be any drastic changes.

To be honest, I don't really worry too much about any of that. I'm concerned, first and foremost, for myself. Because, for me, this piece hits me to the core. Most of us have seen the short film "INSiDE" which focuses on present day impact of abuse through dissociation, specifically dissociative identity disorder. I have seen many movies where kids were abused or hurting or neglected. I can't remember any having such a direct impact on me personally. And I appreciate the fact that "The Burden" makes its point in approximately one minute. I have a short attention span!

What I think the piece does very well, though, is it portrays the fact that there is an outside reality and an inner reality (or "inner child" if you will). I like also that it shows no abuse images whatsoever. This portrays only the child's reality as a child. There's a part that the outside sees, which can be quite normal. And a part that is the inner world of the child, which likely nobody sees. I understand that the long-term effects aren't part of the piece, but then I fear the power would be lessened because it would try to do too many things. I could imagine, actually, a series of follow-up commercials showing each of the long-term impacts of abuse felt in the present which consist of, perhaps, an adult with the child alongside him/her. The commercials could all keep the same theme, perhaps even the same music, but as a campaign, it could make a significant impact. My reference is the Get a Mac ads.

The challenge for me, as someone who struggles mightily with dissociative identity disorder (DID), is to understand the younger parts inside and help them heal. I don't understand them well. I never have. I don't really experience what they experience. So, I rarely get that upset by their plight. This video is a wake up call to me. Not only did it help me to "get it", but it helps me be more committed to helping them.

I do have trouble with the piece saying a part of the child "dies". On one level I can appreciate that statement. On another level, I have a difficult time acknowledging that in myself. Death is a very tricky subject for DID survivors. We tend to think of it differently from others, for a variety of reasons. The impact of severe abuse, though, is not so much parts of us dying, but parts of us being damaged or forever altered. That's the burden! On the other hand, the very heart of DID is the concept of distinct parts of a personality. From my experience, many of those parts remain hidden, sometimes locked away. I would never say that any are "dead". But in many ways they are so hidden away that an objective observer might say they are very close to being "effectively" dead.

Overall, "The Burden" makes me want to reach out to those children inside myself. It's led to a renewal of my determination to heal all of me. And gives me a new perspective on what "all of me" really means. So, the piece helped at least one person. Maybe that's enough to call it a smashing success.

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This post explores, in a very small way, how film and media help us make sense of our experiences.

Much has been made of the Showtime series "US of Tara" which is about a person with dissociative identity disorder. I only saw the first episode and didn't like it much at all. ISST&D praises Tara and provides running commentaries. I am actually quite offended by the show and feel like it's exploitation. I think, in the end, it only serves to further stigmatize dissociative identities, making very real problems less mainstream and more fringe than they already are. Given that, I think ISST&D's support is not helpful and misplaced. From the first episode, I did not feel as though the way the family accepted Tara's DID was real. The portrayal was too dramatic for me. Sure there are times when the parts are separate and they have conversations with family members and there is drama; but usually it's not like that at all. Most multiples I know with families hide their dissociation to the extreme.

If you want to watch something that's quite good and maybe much more relevant, even to those of us with dissociative disorders and trauma histories, take a look at HBO's "In Treatment". The characters are much more real and the acting is better. If you are interested in how people think and how people interact in the context of therapy, then this is a great show. How can this help you heal? Maybe this is a leap, but I think it's helpful for those of us who deal with more extreme levels of dissociation to realize that there are many problems we deal with that many others deal with also.

In an April 30th interview with Terry Gross on NPR's Fresh Air, Gabriel Byrne who plays Dr. Paul Weston on the show, gave his take on what he thinks about therapy: "I think what a good psychotherapist does, I imagine, is that they help you to write the real narrative of your life and come to terms with it, because I think we have a tendency when we talk about our lives to kind of magnify certain things and give them an importance, idealize certain things and be in denial about other things. And looking at the narrative of your life and how that influences who you are as an adult cannot be but I think a good process." Basically, he's saying that therapy helps you put your life into context. For me, this is what I see as my main task.

Or if you prefer a quote from someone more legitimate, Sigmund Freud (whose birthday was yesterday) said: "The aim of psychoanalysis is to relieve people of their neurotic unhappiness so that they can be normally unhappy."

I kind of like Byrne's quote better. More optimistic. But, who knows, maybe Freud's is more realistic.

In addition to television, I've seen one short film and one song that spoke to me recently, both I've found posted on the blogs I follow.

The first is the short film INSiDE, directed by Trevor Sands. Powerful! This is very real and accurate, at least to me. I talked to my psychiatrist about it who also watched it. He wondered how much it mirrors the experience of people who deal with dissociative identity disorder. I can understand that point of view, and said that of course it is not accurate for most of my life. But there are times when I slide up the dissociative ladder and life is almost exactly like how it was portrayed in this short film. These extreme experiences don't get reported because how do you report them? Usually they are forgotten or misremembered. This is where the real work is for us, though. Despite these extremes, we can learn to stay present and even document these experiences.

The second is the song "100 Years" by Five for Fighting. This song is about a man about to turn 100, reflecting on his life. I couldn't help but see the parallel with my own life. This is all about what being multiple is about. While we all have the ability to look back on our lives and reflect, for a multiple we are constantly looking at life through different lenses. I've rather taken to playing this song on piano and it's been a bit healing for me. Another song I've been playing lately on the piano is "Hallelulah" written by Leonard Cohen. The best recording I've found is a live version by K.D. Lang performed at the 2005 Juno Awards. This piece was played on the closing credits for the 2006 documentary "Deliver us From Evil" about the Catholic clergy abuse crisis. I'll write more about that at some other time.

I'd love to hear what your take is on what I've written about, and feel free to post here media which you find helpful.

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