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Last year in Looking Back and Ahead, I tried to make sense of my long healing journey as well as identified my gains for the year. I think it is probably good practice for all of us to reflect on the past year and use it as an opportunity to celebrate the gains, validate the tribulations, and set goals for the upcoming year.

For me, this year has been filled with at least as many ups and downs as the last one. Most of what follows is based on a discussion with "My Healing Guide" a couple of days ago. Whenever I talk about short-term gains, she likes to frame them in a larger context, as being built on the accumulated efforts of the entire journey. She says it is like I have already built a foundation, and our task is to add floors and rooms. I do like that metaphor.

I do believe that the Contract of a year ago was the launching point for what I was able to accomplish this past year. The entire Contract is really based on just a few basic principles (summarized by single words): trust, acceptance, and validation. Everything flows from these. While we don't read the Contract much these days, we don't really need to; its creation came from a place of near complete common ground and all inside know its essential elements to our core. Yes, the Contract has stood up well this past year. We have all understood its significance.

While I know our therapy work this past year was a true collaboration, it was important for me to tell "My Healing Guide" that she played a huge role in helping me continue to heal. I absolutely do not take that help for granted. None of my gains would have been possible without her help, without her willingness to be there for me, to walk with me, to listen to me, to promote trust, acceptance, and validation. Likewise, I do not want to underestimate the role that the online community, through this blog as well as reading of others, has played in helping me to think more broadly and regularly about many of the issues I, and others, face.

I also have an appreciation for the fact that healing is really about living. It is not all about therapy. The work we have done has helped me live more of the life I want to live. Yes, there have been some really low lows this year. But there have also been new connections inside, with my children and, to some extent, with my wife.

The 2010 year started out horribly with the Our Family Crisis, which blew up in our faces. This family "friend" was truly distorting my relationship with my wife and driving a huge wedge between us. This situation had been ongoing for years, but I think it came to a head because the "friend" saw an opening partly because I was in the hospital so often. It is astonishing to me that I was able to solve it. I stood up for my family. I took charge. I reestablished boundaries. The result was that my wife and I became much closer and that set us up for what was to come.

In Holy Week, Church Visit, Scandal, and Miracles, I wrote about how "My Healing Guide" went with me to the church where most of my childhood abuse took place. I never imagined that would have been possible, and I still cannot believe we did it! It was initially all completely validating and healing, but it did stir things up inside which caused us to eventually question whether it was the right thing to do after all.

There were gains made, however, which helped us realize it was definitely the right decision. Those gains came at a cost, though, because of internal instability that landed me inpatient quite a bit this past year; five hospitalization for 59 total days. I knew Easter was going to be really tough. In The Word of the Lord?, I wrote about some of the issues I faced during Easter and how I tried to put into perspective the stream of news coming out of Rome.

We then addressed directly a part who was key to the self-abuse. Inside, we were all certain she was the embodiment of evil. We were all afraid of her seemingly unlimited power. In Inside, an art piece done in the hospital, she stepped forward and joined in the healing process. That was a huge leap forward for all of me.

Not all was safe, though. That huge shift led to additional instability in my system. There was a long period of continued self-abuse from other parts who were newly activated. I wrote about this, mainly from an intellectual perspective, in Sex Injury: Past and Present. I used sex to recreate situations that would lead to my own abuse and recreate feelings of worthlessness. I do think, now, that I have come out the other side. I firmly believe that kind of self-abuse is permanently behind me. I am continually being reminded of what it was about (through flashbacks) and know it cannot ever happen again.

There were two occurrences that led to this resolution.

First, was when my wife found out about my self-abuse by my accidentally leaving my electronic journal open to a particularly sensitive entry. That she now knows about what has been my life's deepest secret (though she does not know details) is incredulous to me. Even more surprising is that while she had immense trouble with this new knowledge, I think it has made us stronger as a couple. The cards were put on the table. She finally learned that there are truly dark aspects to what I have to deal with.

Second, was that I physically got hurt from the self-abuse itself. After I wrote Taking Care When Physically Sick, I found out the illness was in fact a direct result of the self-abuse. Getting hurt in this way ushered in a whole new sense of what the consequences really are, a reality that acting out parts had no concept of before. It brought self-abuse parts together with more healthy parts and is causing yet another reordering inside.

I have the sense that this new internal reordering will be what 2011 will be about. I know it will not be painless and I do not know what the months ahead will bring. But I hope the reordering and focus on safety will allow certain aspects of my life to flourish. I expect work and my relationships with my kids and wife will be where new gains will be made.

Already, the new reordering inside is leading me to come face-to-face with how to achieve balance in my life. How can I be successful at work, for example, while practicing good self-care? Or, said more broadly: How can I participate more fully in life and still practice self-care? 2011 will be about finding and maintaining this balance. Whereas 2010 was about acceptance.

Balance partly comes from being in touch with feelings. And this is why I have been proactive lately about getting in touch with feelings as a kid and connecting the past to the present. I have watched movies and television shows and read books which are validating and asked my Mom for old pictures of me as a kid. This is one way I know of to achieve balance. It is more difficult to get lost in a single part of me if I am also reminding myself of feelings. I have to always remember that balance is key now. Yes, I know I am being very proactive. I know I am forcing myself to feel feelings. This is one major aspect of self-care. And this is the one area I know I focused on when I started this new healing path a couple of years ago.

I also know that the sex self-abuse was one way to solve internal problems, even though it was definitely harmful and dysfunctional. I talked with "My Healing Guide" about it not only being about making myself feel worthless. But also about recreating abusive events so that I could come out the other side and prove that I was "not really hurt" and could go on and be functional. I am not sure how much was which. But I do not think it needs to be my job to figure out what the relative weights were. We are all on a new course now.

If part of the self-abuse was to feel worthless, I have to challenge that now and do deeds that heal that way of thinking. If part of it was about control and recreation, I can challenge those by practicing my skills at balancing and validation.

What is important for me to keep in mind is that I know I have skills and a plan in place to help keep my life balanced and safe.

Yes, 2010 was a year of great accomplishment. And I know 2011 will be equally great if not better.

Happy New Year to all of you!

In the last couple of posts, here and here, I wrote about awareness and using specific skills that have helped me (and hopefully you too).

It was interesting that I also paid careful attention in those posts to say that the skills do not always work. Not working probably means many things to each of us at different times. For me, I am very specific. For me, it means that I have not been safe; that I have self-harmed. That is the case today.

I have to tell myself that it does not mean all that work I do means nothing. I have to tell myself that the skills really do help and it is expected that there will be setbacks. I have to tell myself that I will recover from today. I have to tell myself that I need to keep faith in myself that I will keep healing.

I will pick myself up and try again. I will try to be more aware. I will try to do more of what I know helps.

But this is not an easy time period for me. And I know for many others it is difficult too. In the US, Halloween is a major holiday. Well over a month ago, decorations were in the stores. We are surrounded by images and sounds. Images that never "seemed" to bother me in the past, now send me over the edge and reverberate all throughout my system. For the past several years, Halloween has been very hard.

It has always been a time of extreme activation of certain parts of me; the parts who deal with issues of living and dying, good and evil, and other scary things. And, each year, very specific scary memories always rush to the surface. My reactions seem off scale, but comparable to those I experience around Easter.

As I have healed, I have become aware of this unrest inside during this time. I have realized how sensitive I have become. How easily triggered I am. So, navigating through these weeks around Halloween is not ever easy.

I cannot even ride it out in peace because my wife has a huge Halloween party every year for all the neighbors and kids. It does not at all make sense to me. For several years, I have huddled in my bedroom, medicating myself to get through. I do not want to do that this year. I thought I could be involved in the party and have it be okay. I had a sense that things were going to be okay this year.

Until today.

11/2 Update: I just noticed that on Halloween, Dr. Kathleen Young put up an excellent article on the subject as it relates to child abuse survivors. It's worth taking a look at. See: Trauma Survivors and Halloween.

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.

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.

One of the things I like best about Faith's blog Blooming Lotus is that she's not afraid to bring up really important topics. Two interesting discussions there are: Using Pornography that Mirrors Your Child Abuse and Consensual Sex Mirroring Child Abuse. Be aware that the posts may be triggering and contain explicit sexual content.

I wrote around the edges of this topic, from a personal perspective back in July in First Post on Sex and Parental Trust. I'd like to talk about the subject again, from a less personal perspective this time.

Sexual healing is probably the least talked about subject in the clinical literature of childhood trauma. And it's one of the most difficult subjects to bring up in therapy. It's much easier to talk about post-traumatic and dissociative symptoms. And if sex is used as self-injury, it seems easier to talk about practically any other form of self-injury except sex.

But as I said before, the healing journey is messy and is certainly not easy. For those of us who were abused in sexual ways as children, it's important to understand that sexual healing is a quite necessary part of healing. Somehow we need to find ways to overcome the shame and guilt and talk about who we are sexually. This is especially true if we consider who we are sexually to be too deviant or what we believe is not normal.

Human sexuality is one of the core aspects of our being. Of course, for those of us abused sexually as children, sex is probably not going to be so "normal". This is just a simple fact. For us, sexuality was affected in profound ways.

Mark Schwartz and Lori Galperin wrote an excellent article titled "Hyposexuality and Hypersexuality Secondary to Childhood Trauma and Dissociation" (Journal of Trauma and Dissociation, Vol. 3, No. 4, 2002). They wrote of the interplay between sexual acting out and dissociation, and suggested that being able to talk about the details of the experiences in therapy helped to decrease dissociation which then lessened the risk of behaviors. According to them, it all goes back to dissociation. If we can become more present, we gain more control. I tend to agree with their assessment as this has been the case for me.

We have heard this before, but it's worth saying again, that "when sexual abuse occurs, sexual arousal often becomes activated prematurely, but within a context of betrayal, fear, confusion, shame and violence," according to Schwartz and Galperin. What this means is that there is a linking between sexuality and violence that otherwise would not be there. And we have heard before that hypersexuality is "often a reenactment of the original incident repeated over and over." This reenactment is about control and mastery.

But there is no resolution. According to Schwartz and Galperin "it is as if the brain is unable to assimilate the overwhelming, confusing and often contradictory behavior, affect, sensations and knowledge implicit in the sexual abuse and thereby drives the person to repeat in order to finally establish a solution" or to complete the stress response cycle. While I think they are talking about physical sexual acting out behaviors, I think this holds true for continuous sexual fantasies, use of pornography, and masturbation which are all in the context of re-enacting abuse.

So, we were both conditioned and injured.

I don't have many answers to this problem. But I do think that sexual healing is similar to other aspects of trauma healing and that we, as survivors, do need to talk about it. I know it has something to do with acceptance and validation, in the beginning. I have talked many times here about acceptance. Acceptance of where we are at seems to allow us to plot a course for change. And, of course, overcoming the shame is crucial.

I look forward to hearing your thoughts. As always, please be careful in your comments in regards to content that may be triggering to others.

I have a part who helps with sex. I live in a virtual bubble when it comes to sex. Since forever, he has used porn amongst other things, some of which became rather unsafe for me. I eventually classified all that as self-harm, with some activities being more harmful than others. Some are purely psychological harm and others are also physical harm.

I thought for a long while he was just evil. I eventually found out that he wasn't, but rather just doing what he thought he was supposed to in order to protect some of the younger parts. I still don't fully understand how being involved in sex protects younger parts, when in the end it triggers everyone. Well, maybe I do. In some ways it shields them from the abuse, but as we became more aware all over, this kind of coping didn't work as well. Peter is 17.

Peter has been the cause of my getting into some trouble over the years. The acting out started around junior high when he prank phone called girls in my school and the police ended up coming to my house. I don't have the full story on what happened. I suppose I denied it, which was the truth from my perspective. My father confronted me and I think we had a little talk and that was the end of it.

Sex remained an issue and gets dealt with sometimes in ways I'm incredibly uncomfortable, embarrassed, and ashamed about. It's now rarely about serious self-harm and more a nuisance. It's been dealt with insofar as Peter knows the really harmful stuff, all intended to hurt me, is not acceptable because it's hurtful to others inside. I know it will all have to be dealt with eventually, but for now I live with a quirky relationship with sex and accept it.

But tonight, while at my parents, they seemed to be very distrustful of me when I was fixing my Dad's computer. At first I didn't put two and two together. And if this were a year or two ago, I would never have. But, now with my increased awareness, I knew what it was about. They were around for all the "getting caught" stuff, the "lying", the breakdowns and suicide attempts, and the multiple personality diagnosis. So, I cannot help but wonder if my parents were thinking I have multiple personalities and have done things in the past, so I'm not trustworthy because I'm not really in control or I'm not really who I say I am?

If that's the case, then does how far I've come count for nothing? I built a career, bought a house, married, and had kids. I did all that in as whole a way as I could. They know I still have trouble and work at healing, but I thought they knew I was trustworthy and a decent person.

Or do they? That is the question.

Or perhaps a better question is what I say to myself about all this?