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Tuesday, October 26, 2010

PERSONAL SAFETY

Hello everyone, it has been a wee while since I last posted, with one thing and another I just haven't found the right moment to really focus to sit and write in quietness.  But here I am, so sit back, relax and I trust that todays posting will be of some help to you or someone you may know.

THE FIRST PRINCIPLE OF RECOVERY IS THE EMPOWERMENT OF THE SURVIVOR OF ABUSE.  SHE MUST BE THE AUTHOR AND ARBITER OF HER OWN RECOVERY.


Others may offer her advice, support, assistance, affection, and care, but not cure.  The core experiences of psychological trauma are disempowerment and disconnection from others. Recovery, therefore, is based upon the empowerment of the survivor and the creation of new connections and recovery can take place only within the context of relationships; it cannot occur in isolation.
No intervention that takes power away form the survivor can possibly foster her recovery, no matter how much it appears to be in her immediate best interest.

In the words of of an incest survivor, " GOOD THERAPISTS WERE THOSE WHO REALLY VALIDATED MY EXPERIENCE AND HELPED ME TO CONTROL MY BEHAVIOR RATHER THAN TRYING TO CONTROL ME"


RECOVERY UNFOLDS IN THREE STAGES, and the central task of the first stage is the ESTABLISHMENT OF SAFETY.
The central task of the second stage is REMEMBRANCE AND MOURNING.  And the central task of the third stage is RECONNECTION WITH ORDINARY LIFE.


Trauma robs the victim of a sense of power and control; the guiding principle of recovery is to restore power and control to the survivor.  The first task of recovery is to ESTABLISH THE SURVIVOR'S SAFETY.   This takes precedence over all others, for no other therapeutic work can possibly succeed if SAFETY has not been adequately secured.

This initial stage may last days, weeks with acutely traumatized people or months to years with survivors of chronic abuse and the work of the first stage of recovery becomes increasingly complicated in proportion to the severity, duration and early onset of abuse.

For me, I have been working on this first stage for a long time, and I still have to consciously make sure that what ever I do I question whether it is safe for me first.

Survivors feel unsafe in their bodies.  Their emotions and thinking feel out of control.  They also feel unsafe in relation to other people; and safety has to be addressed in all of these domains.

Establishing SAFETY begins by focusing on control of the body, and gradually moves outward toward control of the environment.
Issues of body integrity include attention to basic health needs, regulation of bodily functions such as sleep, eating and exercising.  The management of post- traumatic symptoms and control of self-destructive behaviors.  Environmental issues include the establishment of a safe living situation, financial security, mobility, and a plan for self-protection that encompasses the full range of the survivors daily
life.

Often we are not aware of how we treat our body when we are suffering from Post Traumatic Syndrome.  I for one, never paid attention to my basic health needs, I neglected my body, I became anorexic, and my continual tiredness just seemed to defy sleep.  It also took me a very long time to identify my self-destructive behavior, ways in which I would sabotage myself and the relationships around me.  Financially I needed to spend to feel good about myself, and so my finances were always in a mess, I was constantly in debt.  I also didn't have the courage to move away from an environment that was not safe for me but contributed to more victimization out of paralytic fear.
I allowed myself to become isolated because I couldn't trust people, and as a result I did not have a strong support system behind me to support, nurture or protect me.
A support system such as family, lovers, and friends, the introduction to self-help organizations  and formal institutions such as mental health have all played a huge part in my recovery.

Part of the restoration is control of the body, focusing on the restoration of the biological rhythms of proper eating, getting sufficient sleep and also the reduction of hyper arousal and intrusive symptoms and often medication is prescribed to help with this.  Her informed consent is very important with the outcome regarding the medication prescribed, as if she is simply ordered to take the medication to suppress symptoms, she is once again disempowered, if on the contrary, she is offered medications as a tool to be used according to her best judgement, it can greatly enhance her sense of efficacy and control.


I hated taking medication, I felt that it was a crutch, and that I needed to come through this like a martyred hero without the support of medication.  Until I realized that my condition was not unlike  a diabetic.  I had to first acknowledge that I needed it to help me, that is was a from of support, that it may not be long term, but for now like a diabetic unless I took my insulin/medication, my restoration and healing journey would take longer as I struggled to deal with hyper arousal ,intrusive symptoms, depression and on severe days suicide.


Once she has established control of her body, the focus on SAFETY progresses to control of  the environment.   The acutely traumatized person needs a safe refuge, and this is important in a crisis intervention.    If the perpetrator of the trauma is a family member, home may be them most UNSAFE place she can choose.   Once she has established an initial safe refuge she can then gradually progress toward a widening sphere of engagement in the world.
It may take weeks to feel safe in resuming such ordinary activities as driving, shopping, visiting friends, or even going to work.  I could not face shopping, or even just going out my front door.
Each new environment must be scanned and assessed with regard to it's potential for security or danger.


During my years of abuse and trauma, I could not speak to anyone about what was happening to me,  during the 1970 and early 80's sexual abuse was a thing "whispered" about, never acknowledge as something that actually happened.  The times that I did try, I was not believed.  My environment was very unsafe and I had no place of safety to go to and no one to help me intervene during times of crisis.
Today we are fortunate that there are refuge establishments aimed at providing a place of temporary safety till a more permanent safe arrangement can be established.  There is a vast amount of organizations supporting the abused woman that will provide the support needed.

THE HARDEST PART IS ACKNOWLEDGING THAT YOU ARE IN AN ABUSIVE SITUATION, THAT IT IS UNSAFE, AND GO AND ASK FOR HELP.
FEAR OF WHAT WILL HAPPEN TO US IF THE PERPETRATOR FINDS OUT IS OFTEN WHAT PREVENTS US FROM GETTING THE HELP WE NEED. OR THE FEAR OF NOT BEING ABLE TO PROVIDE SUFFICIENTLY FOR OURSELVES OR OUR CHILDREN IF THEY ARE INVOLVED.  WE HAVE BECOME DEPENDENT ON OUR PERPETRATOR TO THE POINT OF HELPLESSNESS.   BUT THERE IS HELP AND PROTECTION AVAILABLE!

The survivor's relationships with other people tend to oscillate between extremes as she attempts to establish a sense of safety.  She may seek to surround herself with people at all times, or she may isolate herself completely.  In general, she should be encouraged to turn to others for support, but considerable care must be taken to ensure that she chooses people whom she can trust.
Relatives or close friends who take on the task of participating in her safety system must expect to have their lives disrupted for a time.  It will take a real commitment and unconditional love.

Establishing a safe enviroment requires not only the mobilization of caring people but also the development of a plan for future progress.
Remember that she may feel comfused and ambivalent in herself and may find her ambivalence reflected in the contradictory opinions of friends, lovers, or family.  This is an area where the cardinal principle of empowering the survivor is frequently violated as other people attempt to dicate the survivor's choices or take action without her consent.

With survivors of chronic childhood abuse, establishing safety can become an extremely complex and time-consuming task.  Self-care is almost always severely disrupted.  Self-harming behavior may take numerous forms, including chronic suicidally, self-mutilation, eating disorders, substance abuse, impulsive risk-taking and repetitive involvement in exploitative or dangerous relationships.

Often creating a safe environment may require the necessity to make major changes in her life which entail making difficult choices and sacrifices.   I discovered that I could not recover until I took charge of the material circumstances of my life.  Without freedom, there can be no safety and no recovery, but freedom is often achieved at great loss.
In order to gain their freedom, survivors may have to give up almost everything else.  Battered woman may lose their homes, their friends, and their livelihood.  Survivors of childhood abuse may lose their families and rarely are the dimensions of this sacrifice fully recognized.


This probably has been a lot to absorb and may need re- reading a few times.  However, I hope that some of this makes sense and that you are able to apply it either for yourself or help someone who is in an abusive situation.  When we are in an abusive situation, there often are no bars at the windows or barb wire on the fence, or locks in the doors, or a guard outside our bedroom door........but nevertheless we are captive, not free, controlled, and live in fear and sometimes our very life depends on giving in to our abuser, placating him for our own protection.  But it is not true freedom and healing will not come in this way, there is lots of support out there and we have to make the choice no matter how hard to be SAFE.


Love Mel xx

1 comment:

  1. Excellent advice, as always. My PTSD manifested itself in promiscuity, and eating disorders. Even though I now know I am safe, the ghosts return from time to time to haunt me and make me doubt myself and my choices. Recovery is a never ending process.

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