News from Around the Web

What to Know About People With Dissociative Identity Disorder | The Mighty

By Iain C

(Note: This appears to be an interesting site. Link is below.)

Not long ago I was doing pizza and movie night with some friends when that thing I hate happened. A character in the movie, wild-eyed and demented, was revealed to have… dissociative identity disorder! (cue the creepy music)

Some of my friends shuttered, some laughed, others scoffed. They didn’t know someone with dissociative identity disorder, or DID, was sitting right there on the couch, slice of pizza halfway to my mouth. I wanted to tell them DID isn’t like that. I wanted to explain it’s really just another way of being human. It’s our way of managing life and not a joke or a threat to them. In the end, I realized my friends didn’t know enough about DID for me to even begin the conversation.

Here’s a list of what I wish everyone knew so we could really talk.

1. We’re not all ax-murderers like you see on TV. We were overwhelmed by pain and suffering when we were children. It changed us and now our minds work differently than yours. But just like you, we want to have a good life.

2. We have different identities/alters inside one body. They are different ages, have different feelings, ideas, talents and agendas. We work very hard to maintain a functional system that gets us through the day.

3. Switching between identities/alters isn’t very dramatic. Most of the time the switches are internal, seamless and invisible. And, unless you’re our therapist or a really close friend, they’re none of your business. We’re handling things the best we can.

4. When we lose time, it’s really lost. We’re not faking. If anything, we’re pretending we know more about what happened than we really do.

5. If a teenaged identity/alter takes over, they’re not an adult pretending to be a teenager. They’re a real teenager. Demanding they think, act or decide like an adult isn’t going to work. Relate to them based on their age and unique personality.

6. The adult out front isn’t the real us. They are the identity/alter who’s best at getting along in the world. The real us is all of us together.

7. If you’re dealing with us in a crisis and kid identities/alters come out, don’t ignore them and try to force an adult identity/alter out instead. If we could get an adult out front to run things, we would. Help the kids feel safe and our system will stabilize.

8. When the system feels threatened, protector identities/alters can come out. They may be angry, cold or determined to escape. Please don’t take this personally — we’re just overwhelmed. The best way to help is to back off and let us get safe.

9. We already know DID is “controversial.” You don’t need to remind us some people think it doesn’t exist — which sounds a lot like we shouldn’t exist — which sounds a lot like what we heard from our abusers. Not good.

10. There’s nothing wrong with the way I am. We’re different in some ways and like you in lots of others. We share the same world and want the same good things you want. We’re not “crazy” or weird — just a little complicated.

Source: What to Know About People With Dissociative Identity Disorder | The Mighty

New attention for an old therapy to treat PTSD, anxiety, and more – The Boston Globe

Eye Movement Desensitization and Reprocessing is seen as effective treatment for post-traumatic stress disorder

Steve Girard couldn’t shake the memory of recovering a 3-year-old girl during an underwater search and rescue mission, and handing her dead body to her grieving parents.

A 50-year-old Army veteran who served in the Joint Special Operations Task Force in Iraq, Girard kept seeing the little girl’s face in excruciatingly sharp focus. For nearly 16 years, this memory and the suffering he saw later on a humanitarian mission to Guatemala tormented him, interrupting his sleep and pushing him to quit his commission as a police officer in Chesterfield. “I couldn’t adapt to my own family,’’ he said. “I wasn’t the same person who left and came back.’’

Then Girard sought treatment for post-traumatic stress disorder at the Northampton VA Medical Center. Girard hasn’t forgotten the little girl, but he no longer sees her face nor suffers from the memory. He credits the relief to Eye Movement Desensitization and Reprocessing, or EMDR. The therapy typically requires the patient to focus on blinking lights or a practitioner’s finger moving back and forth, usually for a few minutes at a time, while recalling the disturbing memories. In some instances, alternating tones in the ears or electrical pulses in the palms are used instead of visual cues.

Once highly controversial, EMDR has made gains in acceptance. In 2004, both the American Psychiatric Association and the Department of Defense recommended it as an effective treatment for PTSD. In May, the federal Substance Abuse and Mental Health Services Administration, an agency of the Department of Health and Human Services, recognized EMDR as an evidence-based treatment for depression and anxiety as well as for PTSD.

Critics of the treatment still have reservations – even for the treatment of PTSD in combat veterans, the VA ranks EMDR only third as a recommended treatment, behind cognitive behavioral therapy and exposure therapy.

And no one knows exactly how EMDR works. The general theory is that mentally revisiting traumatizing experiences while different parts of the brain are stimulated by the alternating sensations helps the patient overwrite the stored memory with one that has lost its pain and intensity.

Used first in 1987, EMDR has been the subject of dozens of clinical and research studies, including one 1997 randomized clinical trial funded by the managed health care organization Kaiser Permanente, which found that among 67 subjects in an HMO setting, all single-trauma and 77 percent of multiple-trauma patients no longer had PTSD after six 50-minute sessions.

The recognition by the federal mental health agency is important because it will likely make funding available to study EMDR, says Deborah Korn, a Cambridge psychologist who was a co-investigator on a 2007 randomized clinical trial of 77 patients that compared EMDR with Prozac. The study, led by Bessel van der Kolk – past president of the International Society for Traumatic Stress Studies and medical director of the Trauma Center at Justice Resource Institute in Brookline – found that six months after treatment stopped, EMDR patients had fewer symptoms of PTSD and depression than the patients who had been on Prozac.

Korn says that some form of trauma is often at the heart of mental and emotional problems. Sometimes it’s a complex trauma, like child or spousal abuse, but it can also be a single event, such as a car accident, bereavement, or a painful divorce.

EMDR TIMELINE
“You can sometimes see transformation in three sessions, sometimes in 20 minutes,’’ she says. “Other people, it takes months and months. Sometimes it’s a matter of unhooking something that opens up information processing in a way that allows for transformation.’’

Maureen Richardson, a licensed mental heath counselor and registered nurse who uses EMDR in her practice at Interfaith Social Services in Quincy, points to the case of a 63-year-old woman who had suffered from a panic disorder for 10 years.

Although the patient had been prescribed Paxil, she would wake up in the middle of the night with night sweats, unable to breathe. A childhood victim of abuse by family members, she had suffered from anxiety for years.

Richardson suggested EMDR therapy. After four sessions, the patient started feeling better. Her anger dissipated and the night sweats went away.

Richardson says EMDR allowed the patient to reprocess the emotions associated with the memory. “She began to realize it wasn’t her fault and that some one should have attended to it. . . . She wasn’t a bad person, she was just a child.’’

Girard, the Army veteran, says that EMDR changed the visual images in his brain. “It made my memory like picture frames in a movie. The film was still going by, but I had the opportunity to slow it down and change it, in a better way.’’

Harvard sleep researcher Robert Stickgold believes that the constant shifting of focus in the eye movements alters brain chemicals and puts it in a state similar to REM sleep, the natural process where the brain deals with the day’s events.

“If the brain can’t process the trauma and transform it somehow, you are stuck with that raw memory in its original form,’’ he said.

Steven Silver, a Marine and Army National Guard veteran, psychologist, and coauthor of a book on EMDR, “Light in the Heart of Darkness,’’ points to brain imaging data supporting the REM sleep theory.

Silver also notes studies on patients undergoing EMDR have shown physical changes in the brain, including an expansion in the hippocampus – an area that shrinks in people with chronic PTSD.

“We don’t know exactly how psychotherapy works either. But with EMDR, because of all the brain-based studies, we have a better idea. We’re no longer arguing about whether EMDR works, but what causes it to work,’’ he says.

Therapists stress that EMDR therapy is not a cure for everything. Richardson says she is cautious about using it, for fear of bringing up memories patients are not prepared to deal with. Christine Wolff, a psychologist in Waltham, says that she uses EMDR therapy in only about 10 percent of her patients. She considers EMDR a useful tool because so many different mental health problems are trauma-based – “but if you have a long history of problems in your life, it won’t cure you in 10 sessions,’’ she says.

Back at the Northampton VA Medical Center, the administration increased the number of therapists trained in EMDR from one last year to 10 this year. Theodore Olejnik , the therapist who brought EMDR to the center, is the suicide prevention coordinator. As such, he says, he sees only the most dire cases.

During 24 years of active duty with the Air Force, Olejnik recalls treating PTSD victims in the early years strictly with talk therapy and cognitive behavioral therapy, which focus on breaking dysfunctional patterns of thought. “I kept thinking there had to be a better, quicker method.’’

After treatment with EMDR, he says, “so many combat veterans here have said, ‘Ted, you literally brought me out of my ashes, made me whole again.’ ’’

Jan Brogan can be reached at janbroganbooks@gmail.com

Source: New attention for an old therapy to treat PTSD, anxiety, and more – The Boston Globe

News about 2017 Medicare premiums and deductibles

Last week, as the shock and awe over Donald Trump’s election victory continued to consume us, Medicare announced roughly 10 percent increases in 2017 rates for many Part B premiums and the program’s annual deductible. This is a very big deal.

This is a very big deal, because the increases had earlier been forecast at roughly double this size. However, Medicare says it had sufficient financial reserves to absorb half the expected 2017 rise in Part B expenses. It’s good news for consumers who might have expected to pay more.

The agency also announced modest increases for Part A, which covers care in hospitals, nursing homes and some in-home care. Premiums and deductibles next year for Medicare Advantage and Part D prescription drug plans already have been set and are not affected by the Part A and Part B changes.

Part B primarily covers expenses for doctors, other outpatient care and durable medical equipment. Its annual deductible will rise from $166 this year to $183 in 2017.

Monthly Part B premiums are $104.90 a month this year for about 70 percent of Medicare enrollees. These premiums are deducted from monthly Social Security payments. Under a Social Security provision known as the “hold harmless” rule, Social Security payments cannot decline from one year to the next. Higher Part B premiums normally are funded by Social Security’s annual cost of living adjustment, or COLA. (Click link below for remainder of article)

Source: The surprising news about 2017 Medicare premiums and deductibles you may have missed

PTSD from Motor Vehicle-related Accidents

Researchers are looking more closely at motor vehicle accidents (MVAs) as a common cause of traumatic stress. In one large study, accidents were shown to be the traumatic event most frequently experienced by males (25%) and the second most frequent traumatic event experienced by females (13%) in the United States. Over 100 billion dollars are spent every year to take care of the damage caused by auto accidents. Survivors of MVAs often also experience emotional distress as a result of such accidents. Mental health difficulties such as posttraumatic stress, depression, and anxiety are problems survivors of severe MVAs may exhibit. This fact sheet addresses important issues related to MVAs, including how many people experience serious MVAs, how many people develop MVA-related Posttraumatic Stress Disorder (PTSD) and other psychological reactions, what the risk factors are for MVA-related PTSD, and what kind of treatments help MVA-related PTSD.

Below are some articles and resources for survivors of accidents and other forms of trauma.

The Trauma Tool Kit

 

 

 

 

 

Was Part of Your Childhood Deprived by Emotional Incest?

Author: R. Skip Johnson

The term “emotional incest” was coined by Kenneth Adams, Ph.D. to label the state of cross-generational bonding within a family, whereby a child (normally of the opposite sex) becomes a surrogate spouse for their mother or father. “Emotional Enmeshment” is another term often used. And the term “emotional parentification” describes a similar concept – it describes the process of role reversal whereby a child is obliged to act as parent to their own parent.

Patricia Love, Ed.D., past president of the International Association for Marriage and Family Counseling, defines emotional incest as “a style of parenting in which parents turn to their children, not to their partners, for emotional support.”  According to Love, emotionally incestuous parents may appear to be loving and devoted and they may spend a great deal of time with their children and lavish them with praise and material gifts – but, in the final analysis, their love is not a nurturing love, it’s a means to satisfy their own needs.

The term “emotional incest” was coined by Kenneth Adams, Ph.D. to label the state of cross-generational bonding within a family, whereby a child (normally of the opposite sex) becomes a surrogate spouse for their mother or father. “Emotional Enmeshment” is another term often used. And the term “emotional parentification” describes a similar concept – it describes the process of role reversal whereby a child is obliged to act as parent to their own parent.

Many parents and children are close. Closeness is healthy and desirable. The difference between a healthy close relationship and an incestuous one is that in a healthy close relationship a parent takes care of a child’s needs in an age-appropriate way without making the child feel responsible the emotional needs of the parents needs. In an emotionally incestuous relationship, instead of the parent meeting the needs of the child, the child is meeting the needs of the parent.

Emotional incest happens when the natural boundary between parental caregiver, nurturer, and protector is crossed and the child becomes the defacto caregiver, nurturer and protector of the parent. This typically occurs when a the marriage unravels or when there is a broken family dynamic (e.g., substance abuse, infidelity, mental illness and the dependency upon a child increases.  One or both parent may engage the child in talks about adult issues and adult feelings to a child as if they were a peer. The child may be called upon to satisfy adult needs such as intimacy, companionship, romantic stimulation, advice, problem solving, ego fulfillment, and/or emotional release. Sometimes both parents will dump on a child in a way that puts the child in the middle of disagreements between the parents – with each complaining about the other.

What ensues is a role that the child is not capable of fulfilling yet might feel special or privileged in so doing. Clearly in this dynamic the child is covertly, emotionally abandoned by the parent(s) and being robbed of her or his childhood.

Emotionally incestuous parents often slip into an “invasive” role without any intention to harm their children.

It’s important to remember that there are different levels of severity in emotional incest. Sometimes emotional incest is extremely severe and debilitating, and other times it’s more moderate and can almost go unnoticed.

The impact is nonetheless harmful.

 

What are the effects of emotional incest on a child?

According to Dr. Love, “Being a parent’s primary source of support is a heavy burden for young children as they are forced to suppress their own needs to satisfy the needs of the adults“. Because of this role reversal, they are rarely given adequate protection, guidance, or discipline, and they are exposed to experiences well beyond their years.

Emotional incest from either parent is devastating to the child’s ability to be able to set boundaries and take care of getting their own needs met when they become an adult. This type of abuse, when inflicted by the opposite sex parent, can have a devastating effect on the adult/child’s relationship with his/her own sexuality and gender, and their ability to have successful intimate relationships as an adult.

For practical reasons, elder children are generally chosen for the familial “parental” role – very often the first-born children who were put in the anomalous role. However, gender considerations mean that sometimes the eldest boy or eldest girl was selected, even if they are not the oldest child overall, for such reasons as the preference to match the sex of the missing parent.

In adolescence and adulthood, they are likely to be plagued by one or more of the following difficulties:

  1. Guilt about practicing self care especially – an unrealistic sense of obligation to that parent
  1. Difficulties related to sexual identity or gender
  1. Feelings of inadequacy
  1. Love/hate relationship with offending parent
  1. Difficulty in maintaining relationships due to abused individual’s idealization and devaluation of others and an inappropriate expectations placed on partners
  1. Compulsivity that can include sex, substances, alcohol, work, food
  1. Patterns of excessive triangulation (indirect communication) in work, family or romantic relationships
  1. Issues related to sex addiction/avoidance or love addiction/avoidance

What are the effects of emotional incest on the family?

Emotional incest affects all members of a family.   Love identifies five models:

The Invasive Parent is enmeshed with a child in order to meet his/her needs that are not being met in an adult relationship

The Chosen Child is enmeshed with the invasive parent; often treated as “all good” and favored, but their own needs to develop as an individual, to make mistakes and learn, to receive structure and discipline, etc. are actually neglected. Chosen children can also be treated as scapegoats, used not just for emotional support but for the release of anger and tension.

The Left-Out Spouse spouse of invasive parent, is often shut out of exclusive parent-child bond; may turn to workaholism, alcohol, affairs, or other unhealthy coping mechanisms to deal with an unhappy life at home

The Left-Out Child(ren) a non-favored child, may be neglected or receive less of the family’s resources; may bond with the left out spouse

Spouse of the Chosen Child when the chosen child grows up and marries, his/her spouse may find him/herself engaged in a rather disturbing triangle with the chosen child and invasive parent

 

Emotional incest is deeply personal

It is difficult to let go of the wish for perfect parents. We cling to an idealized view of our caretakers because on some level we still view life through the eyes of a child and we still believe we are dependent on our parents for survival. When we see flaws in their characters our very existence can seem threatened. Deep down we may be saying “No one is taking care of me

To cope with this anxiety, we often hold on to the dream that our parents’ faults will magically disappear: this visit, our parents will be sensitive to our needs; this reunion will be smooth and uneventful; this phone call or this letter will repair old wounds and bring us closer together.

Not surprisingly, the character flaws we have the hardest time accepting are the ones that wounded us most during childhood. When our parents act in destructive and familiar ways, our present anguish is magnified by our early pain. Underneath our grown-up dismay is a little child crying out for more love and safety.

 

Recovering from Emotional Incest

An abused individual can attain emancipation and self empowerment with patience, perseverance, and self awareness.

According to Debra L. Kaplan, MA, LPC, an intensive out-patient counselor specializing in emotional incest recovery, the process of recovery is five-fold:

  1. Identify the family of origin and the particular family dynamics involved
  1. Recognize any patterns of emotional incest between caregivers and the abused individual
  1. Learn to set boundaries with that parent. In the case of a deceased caregiver work with a therapist who can help facilitate empty chair work or another experientially based modality for grief and loss
  1. Acknowledge any feelings of abandonment as a result of the emotional incest
  1. Work toward individuation and separation by learning to reparent the self (Inner child work)

Kaplan notes that journeying from wounded child to healthy adult does not occur in isolation. In addition to therapy, individuals should enlist the help of spouses in working through unresolved abuse.  Kaplan also says “much support can be gained by working with the issues as they arise while in relationship. Sharing of one’s experiences can be mutually healing within the context of a support group or among other healthy interactions.

Source: Was Part of Your Childhood Deprived by Emotional Incest? | BPDFamily