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THE PSYCHODYNAMICS OF SURVIVORS’ SYMPTOMS

19 October, 2015

In a way, what I am about to describe is a testimony to the essential goodness in human beings.  Read on to see why.

While such emotional problems as depression, anxiety and relationship problems are often what bring survivors to therapy and are important, to say the least, they are not the psychological engine that powers the dramatic symptoms of survivors.

The emotional reactions to childhood sexual abuse which power the symptoms of survivors are rage and horror.

RAGE

It should not be surprising that being sexually abused as a child creates a reservoir of anger in survivors — but anger is far too mild a term.  Enormous, cataclysmic rage is more to the point.  It is there, like seething magma always stirring and threatening beneath the cauldron of a volcano.  If allowed to erupt it is a potential threat not only to others but to the psychological integrity of the survivor herself.

The psychological structure of most survivors is not a solid block.  It is, rather, individual bricks held together with a mortar which is vulnerable to any significant shaking.  Loosen the mortar enough and there is the threat of the person collapsing into a rubble of nothingness — of non-being.

In addition, the vast majority of all people, whether or not survivors, would like to think of themselves as good people — would like to be good people.  They find the possibility of harboring destructive rage to be “ego dystonic” — unacceptable to their self images as human beings.

The power of the rage harbored by survivors cannot be overstated.

HORROR

The events of sexual abuse, and the memory thereof, are horrible in every sense of the word.  Many horror movies touch directly or indirectly on the elements of a survivor’s horror.  Consider the classic Dracula, in which a dark clad figure invades the bedroom of a victim and overpowers her.  Consider the various films with body snatcher themes.  Like rage, the level of horror in survivors is cataclysmic in scope.

While enormously uncomfortable to bear, a sense of horror is not the anathema to a sense of self that rage is.  In many ways, it is a testimony to possessing humanity.  Elsewhere, I have stressed the positive reflection of that humanity in the suffering of PTSD by war veterans.  Having PTSD is a testimony to the sufferer’s humanity.  The capacity to be horrified is “ego syntonic”  — more than acceptable to one’s self image as a human being.

Like the power of their rage, the intensity of horror in survivors cannot be overstated.

WHERE RAGE AND HORROR GO IN SYMPTOMS

Given the above, it is not surprising that survivors keep the horror related to their experiences as being a part of themselves.  It is ego syntonic.  It is equally un-surprising that they externalize their ego dystonic rage.  So it is that, in so many symptoms, the horror remains in the survivor while the rage, symbolically, is depicted as being outside of the self.

Here are a few examples from symptoms described throughout this blog:

  • TIDAL WAVES are frequent in the nightmares of survivors. In this nightmare the survivor stands horrified while the rage, symbolized as the tsunami, is outside of herself but threatens to destroy her
  • EVIL PRESENCES sensed in the home reflect the horror harbored by survivors. While they experience themselves as terrified, the malevolent rage is experienced as being outside of the self, personified in the threatening entity
  • BEDQUAKES are common symptoms in which the survivor experiences fear and horror at the perceived threat of an earthquake.  The rage is projected into a destructive force outside of the self which threatens to destroy the survivor

WHAT TO DO ABOUT ALL THIS

First and foremost, the cartharsis — the timely ventilation — of emotions in therapy is the most effective way to reduce both horror and rage and, thus, the energy source of distressing symptoms.  Catharsis cannot be rushed; it cannot be contrived.  It must arise in its time during the therapeutic process.  While catharsis itself is distressing, the payoff is enormous.

Is it safe?  Well handled, it is more than safe.  The mind has its own safety valves.  Survivors do not recall or re-experience more than they are capable of handling at the time.  They need reassurance of that fact as well as encouragement of patience while they steadily grow strong enough for the next cathartic event.  There is a cycle of emergence of memories and related emotions, ventilation of the emotions, relief*, and (in time) the emergence again of memories and emotions.  It can help to point out that, if the client survived the events, she can certainly survive their memory.

For some survivors, it helps to call to their attention this fact:  The part of them that is so enraged is in very great pain, and no less in need of love and acceptance as any other part of themselves.  The monsters that pursue them in their nightmares need a good hug as much or perhaps more than they need vanquishing.  In that particular nightmare, some survivors have turned to confront and even kill the pursuer, symbolically facing and controlling it; rage used to destroy rage.  In rare instances of especially notable progress, a very few survivors have turned to interact sympathetically with the monsters and even hug them.

DO SYMPTOMS COME BACK?

First it should be said it is not necessary for every experience to be recalled and result in catharsis.  Enough relief can be attained that the survivor’s quality of life is improved enormously.  How much is “enough” should largely be up to the survivor.  A few may wish to root out as much as possible.  What’s important is that both the intensity and frequency of symptoms grow steadily less.  A nightmare once every month or so is a great improvement over nightmares nearly every night and a survivor may be satisfied with that outcome.

That being said, symptoms are learned ways of both defending against and expressing conflict.  Having learned those symptoms, even survivors who have made marvelous progress in therapy may have short relapses under significant strain from unrelated sources such as work, a death in the family or the like.  Educating the survivor about that can pro-actively allay concerns, should stressful events lead to a fear that they are having a lasting relapse.


* It is common for survivors to have a period of relief from symptoms following a significant, cathartic experience.  Generally speaking, that dramatic a level of relief does not last, though overall relief increases incrementally.  The therapist should educate the survivor about the cyclical nature of the process, along with the reassurance that each cycle will add incrementally to overall relief.

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