Reading Notes – Complex PTSD: From Surviving to Thriving

My Notes

“It is a learned set of responses, and a failure to complete numerous important developmental tasks. This means that it is environmentally, not genetically, caused. In other words, unlike most of the diagnoses it is confused with, it is neither inborn nor characterological. As such, it is learned. It is not inscribed in your DNA. It is a disorder caused by nurture [or rather the lack of it] not nature.” p. 1

Toxic shame: “explored enlightening by John Bradshaw in Healing the Shame that Binds, obliterates a Cptsd survivor’s self-esteem with an overwhelming sense that he is loathsome, ugly, stupid, or fatally flawed. Overwhelmingly self-disdain is typically a flashback to the way he felt when suffering the contempt and visual skewering of his traumatizing parent. Toxic shame can also be created by constant parental neglect and rejection.” p. 4-5

“I once heard renowned traumatologist, John Briere, quip that if Cptsd were ever given its due, the DSM used by all mental professionals would shrink from its dictionary like size to the size of a thin pamphlet. In other words, the role of traumatized childhoods in most adult psychological disorders is enormous.” p. 8

“I have witnessed my clients with Cptsd misdiagnosed with various anxiety and depressive disorders unfairly and inaccurately labeled with bipolar, narcissistic, codependent, autistic spectrum and borderline disorders. [This is not to say that Cptsd does not sometimes co-occur with these disorders.] (cont.)
(cont.)Further confusion also arises in the case of ADHD as well as obsessive/compulsive disorder, both of which are sometimes more accurately described as fixated flight responses to trauma. This is also true of ADD and some depressive and dissociative disorders which similarly can more accurately be described as fixated freeze responses to trauma.(cont.)
(cont.)Furthermore, this is not to say that those so misdiagnosed do not have issues that are similar and correlative with the disorders above. The key point is that these labels are incomplete and unnecessarily shaming descriptions of what the survivor is actually afflicted with.” p. 8-9

YES!!!! “Reducing Cptsd to “panic disorder” is like calling food allergies chronically itchy eyes. Over-focusing treatment on the symptoms of panic in the former case and eye health in the latter does little to get at root causes. Feelings of panic or itchiness in the eyes can be masked with medication, but all the associated problems that cause these symptoms will remain untreated.(cont.)
Moreover, most of the diagnoses mentioned above are typically treated as innate characterological defects rather than as learned maladaptation to stress – adaptations that survivors were forced to learn as traumatized children.” p. 9 

“In this vein, I believe that many substance and process addictions also begin as misguided, maladaptations to parental abuse and abandonment. They are early adaptations that are attempts to soothe and distract from the mental, emotional, and physical pain of Cptsd.” p. 9

“While the origin of Cptsd is most often associated with extended periods of physical and/or sexual abuse in childhood, my observations convince me that ongoing verbal and emotional abuse also causes it.” p. 10

“Many dysfunctional parents react contemptuously to a baby or toddler’s plaintive call for connection and attachment. Contempt is extremely traumatizing to a child, and at best, extremely noxious to an adult.(cont.)
(cont.)Contempt is a toxic cocktail of verbal and emotional abuse, a deadly amalgam of denigration, rage and disgust. Rage creates fear, and disgust creates shame in the child in a way that soon teaches her to refrain from crying out, from ever asking for attention. Before long, the child gives up on seeking any kind of help or connection at all. The child’s bid for bonding and acceptance is thwarted, and she is left to suffer in the frightened despair of abandonment.(cont.)
(cont.)Particularly abusive parents deepen the abandonment trauma by linking corporal punishment with contempt. Slaveholders and prison guards typically use contempt and scorn to destroy their victims’ self-esteem. Slaves, prisoners, and children, who are made to feel worthless and powerless devolve into learned helplessness and can be controlled with far less energy and attention. Cult leaders also use contempt to shrink their followers into absolute submission after luring them in with brief phases of fake unconditional love.” p. 10

“Emotional neglect also typically underlies most truamatizations that are more glaringly evident. Parents who routinely ignore or turn their backs on a child’s calls for attention, connection, or help, abandon their child to unmanageable amounts of fear, and the child eventually gives up and succumbs to depressed, death-like feelings of helplessness and hopelessness.” p. 11

“Carol’s parents started in on her early by disdainfully blaming her for soiling her diaper before she was even one. By the time she was three, she had been so frequently punished for making noise while talking and playfully exploring her house, that her constant state of fear generated an ADHD-like condition in her.” p. 14

Key Developmental Arrests in Cptsd

  • Self-accepting
  • Clear sense of identity
  • Self-compassion
  • Self-protection
  • Capactiy to draw comfort from relationship
  • Abiltiy to relax
  • Capacity for full self-expression
  • Willpower & motivation
  • Peace of mind
  • Self-care
  • Belief that life is a gift
  • Self-esteem
  • Self-confidence

“My efforts to nurture myself in these arrested areas of development were limited and spoiled in early recovery by a feeling of resentment. “Why do I have to do this?” was a common internal refrain. Resentment that should have been directed toward my parents often boomeranged onto me and spoiled or thwarted my efforts at self-nurturance. Thankfully ongoing recovery work helped remedy this resentment. It taught me to practice self-care in a spirit of giving to a child who needed and really deserved to be helped.” p 22-23

“An especially tragic developmental arrest that afflicts many survivors is the loss of their willpower and self-motivation. Many dysfunctional parents react destructively to their child’s budding sense of initiative. If this occurs throughout his childhood, the survivor may feel lost and purposeless in his life. He may drift through his whole life rudderless and without a motor.” p. 23

“The ability to invoke willpower seems to be allied to your ability to healthily express your anger.” p. 24

“Like many other survivors that I have worked with, I developed the imposter’s syndrome. This syndrome contradicted the outside positive feedback that I was receiving. It insisted that if people really knew me, they would see what a loser I was.” p. 24

“The first level of recovery usually involves repairing the damage that Cptsd wreaks on our thoughts and beliefs about ourselves.” p. 24

We need to understand exactly how appalling parenting created the now self-perpetuating trauma that we now live in. We can learn to do this in a way that takes the mountain of unfair self-blame off ourselves. We can redirect this blame to our parents’ dreadful child-rearing practices. And we can also do this in a way that motivates us to reject their influence so that we can freely orchestrate our journey of recovering.” p. 25

Ego: not a dirty word. Another word for self or identity. “The healthy ego is the user friendly manager of the psyche.” “Unfortunately, Cptsd-inducing parents thwart the growth of the ego by undermining the development of the crucial egoic processes of self-compassion and self-protection.” “They do this by shaming or intimidating you whenever you have a natural impulse to have sympathy for yourself, or stand up for yourself. The instinct to care for yourself and to protect yourself against unfairness is then forced to become dormant.” p. 26

Shaming you if you stand up for yourself
“Becoming psychoeducated about Cptsd is the first level of addressing this poisonous indoctrination of your mind against your healthy ego. When you intricately understand how antagonistic your parents were to your healthy sense of self, you become more motivated to engage in the self-help processes of rectifying their damage. The more you identify their damage the more you know what to fix.(cont.)
(cont.)This is essential because without a properly functioning ego, you have no center for making healthy choices and decisions. All too often, your decisions are based on the fear of getting in trouble or getting abandoned, rather than on the principles of having meaningful and equitable interactions with the world.” p. 27

Self-championing stance
“You are free now as an adult to develop peace of mind and a supportive relationship with yourself. A self-championing stance can transform your existence from struggling survival to a fulfilling sense of thriving.” p. 27

In early recovery, psychoeducation typically comes from the wisdom of others who are more educated than you: therapists, writers, friends, teachers. When it reaches its most powerful level it begins to become experienced as mindfulness. p. 28

“Psychologically speaking, mindfulness is taking undistracted time to become fully aware of your thoughts and feelings so that you can have more choice in how you respond to them. Do I really agree with this thought, or have I been pressured into believing it? How do I want to respond to this feeling – distract myself from it, repress it, express it, or just feel it until it changes into something else?” p. 28

Mindfulness is a perspective of benign curiosity about all of your inner experience. Recovery is enhanced immeasurably by developing this helpful process of introspection. As it becomes more developed, mindfulness can be used to recognize and disidentify from beliefs and viewpoints that you acquired from your traumatizing family.” p. 28-29

“I cannot overstate the importance of becoming aware of your inner self-commentary. With enough practice, mindfulness eventually awakens your fighting spirit to resist the abusive refrains from your childhood, and to replace them with thoughts that are self-supportive.” p. 29

“Unfortunately, in this culture only the “positive” polarity of any emotional expreience is approved or allowed. This can cause such an avoidance of the “negative” polarity, that at least two different painful conditions result.(cont.)
(cont.)In the first, the person injures and exhausts himself in compulsive attempts to avoid a disavosed feeling, and actually becomes more stuck in it. This is like the archetyplal clown whose frantic efforts to free himself from a piece of fly paper, leave him more immobilized and entangled.(cont.)
(cont.)In the second, repression of one end of the emotional continuum often leads to a repression of the whole continuum, and the person becomes emotionally deadened. The baby of emotional vitality is thrown out with the bathwater of some unacceptable feeling.” p. 30

A reluctance to participate in such a fundamental realm of the human experience results in much unnecessary loss. For just as without night there is no day, without work there is no play, without hunger there is no satiation, without fear there is no courage, without tears there is no joy, and without anger, there is no real love.” p. 30-31

“Most people, who choose or are coerced into only identifying with “positive” feelings, usually wind up in an emotionally lifeless middle ground – bland, deadened, and dissociated in an unemotional “now-man’s-land.” p. 31

The repression of “negative” emotions causes unnecessary pain as well as many of the “essential aspects of the feeling nature.” “In fact, much of the plethora of loneliness, alienation, and addictive distraction that plagues modern industrial societies is a result of people being taught and forced to reject, pathologize or punish so many of their own and others’ normal feeling states.” p. 31

“Nowhere, not in the deepest recesses of the self, or in the presence of his closest friends, is the average person allowed to have and explore any number of normal emotional states. Anger, depression, envy, sadness, fear, distrust, etc. are all as normal a part of life as bread and flowers and streets. Yet, they have become ubiquitously avoided and shameful human experiences. (cont.)
(cont.)How tragic this is, for all of these emotions have enormously important and healthy functions in a wholly integrated psyche. One dimension where this is most true is in the arena of healthy self-protection. For without access to our uncomfortable or painful feelings, we are deprived of the most fundamental part of our ability to notice when something is unfair, abusive, or neglectful in our environments.” YES!!! This is the reason I am suspicious of the people who claim to only like sunny, “perfect” weather!

“The disease of emotional emaciation is epidemic. Its effects on health are often euphemistically labeled as stress, and like the emotions, stress is often treated like some unwanted waste that must be removed.(cont.)
(cont.)Until all of the emotions are accepted indiscriminately (and acceptance does not imply license to dump emotions irresponsibly or abusively), there can be no wholeness, no real sense of well being, and no solid sense of self esteem. Thus, while it may be fairly easy to like yourself when feelings of love or happiness or serenity are present, deeper psychological health is seen only when you can maintain a posture of self-love and self-respect in the times of emotional hurt that accompany life’s inevitable contingencies of loss, loneliness, confusion, uncontrollable unfairness, and accidental mistake.” p. 32

Emotional intelligence: the degree to which we accept the feelings of ourselves and others. 

“Cptsd-engendering parents often hypocritically attack their children’s emotional expression in a bi-modal way. This occurs when the child is both abused for emoting and is, at the same time, abused by her caretaker’s toxic emotional expression… One archetypal example of this is seen in the parent who hurts his child to the point of tears, and then has the nerve to say:”Stop crying or I’ll five you something to cry about.”” p. 33

“The above is of course a blatant example of the slaughtering of emotional expression. Just as common is the insidious, passive-aggressive assault on emoting which is seen in the parent who shuns her child for expressing his feelings. This is seen in the emotionally abandoning parent who sequesters the child in a timeout for crying or routinely retreats from the crying child into her room.” p. 34

“An especially nasty for of emotional abuse occurs in the traumatizing family when the child is even attacked for displays of pleasant emotion. As I write this I flashback to scenes of my mother sneering at my little sister and snarling: “What are you so happy about!”, and my father’s frequent” “What are you laughing at – wipe that smile off your face!” p. 34


“The rejecting responses of our parents to our emotional expression alienate us from our feelings. Emotional abuse/neglect scsra us out of our own emotions while simultaneously making us terrified of other people’s feelings. (cont.)
(cont.)John Bradshaw describes the devastation of the child’s emotional nature as “soul murder.” He explains this as involving a process where the child’s emotional expression [his first language of self-expression] is so assaulted with disgust that any emotional experience immediately devolves into toxic shame.(cont.)
(cont.)I believe that toxic shame is the affect of the inner critic, and that inner critic thought processes are the conginitions of shame – a terrible yin/yang process emanating from our original abandonment.” p. 35

“Because of the deadly one-two punch of familial and societal attacks on our emotional selves, we need to recover our innate emotional intelligence. This is also deeply important because, as Carl Jung emphasized, our emotions tell us what is really important to us. When our emotional intelligence is restricted, we often do not know what we really want, and can consequently struggle mightily with even the smallest decisions.” p. 35

“Grieving is the key process for reconnecting with our repressed emotional intelligence. Grieving reconnects us with our full complement of feelings. Grieving is necessary to help us release and work through our pain about the terrible losses of our childhoods. These losses are like deaths of parts of our selves, and grieving can often initiate their rebirth.” p. 36

“Grieving restores our crucial, developmentally arrested capacity to verbally ventilate. Verbal ventilation is the penultimate grieving practice. It is speaking from your feelings in a way that releases and resoles your emotional distress.” p. 36

Verbal ventilation is the “key bonding process in intimacy. It is also the key healing process of effective therapy.” p. 37

Example of verbal ventilation: “A client arrives flashbacked and in pain. He verbally ventilates about it. He is the regressed hurt child, feeling bad, and part of him is sad and part of him is mad. He is once again lost in the painful feelings of his original abandonment, and this state is like a death that responds well to grieving.(cont.) 
(cont.)As he lets his feelings come into his voice, he talks, cries and angers out his pain. Through this processing of his pain, he then gradually moves out of his flashback. He is restored to his normal everyday sense that he is no longer trapped in his traumatic childhood. Relief about this returns him to his normal ability to cope. If his grieving is deep enough, he customarily feels more hopeful and lighthearted. Not infrequently, his sense of humor resurfaces, and laughter punctuates his continuing verbal ventilation. This laughter is usually much different than the sarcastic, self-bullying humor of his critic that he might have begun the session with.” p. 37

“The inner critic is sometimes so hostile to grieving that shrinking the critic may need to be your first recovery priority. Until the critic is sufficiently tamed, grieving can actually make flashbacks worse, rather than perform the restorative processes it alone can initiate.(cont.)
(cont.)I have worked with numerous clients who were so traumatized around grieving that we needed to spend many months working on the cognitive level before grieving was released from the spoiling effects of the toxic critic.” p. 37

Finding a sense of belonging: reading spiritual books, meditative practices, nature, music, the arts… p. 38-39 

Spiritual or numinous experiences can provide survivor with first sense of belonging which can lead to meeting author or speaker or fellow traveler which can open door to finding comfort in other humans, realizing that there may be safe enough humans out there to engage with. p. 40

“Good enough parents provide generous amounts of support, protection and comforting. They also guide their children to deal constructively with recurring existential difficulties such as loss, real villains, painful world events and normal disappointments with friends and family.(cont.)
(cont.)Most importantly, they model how disappointments with intimates can be repaired. A key way they do this is to easily forgive their children for normal mistakes and shortcomings.” p. 41

“In the traumatizing family however, there is little or nothing that is good enough and hence little for which to be grateful. The child instead is forced to over-develop a critic that hyper-focuses on what is dangerously imperfect in her as well as others. This sometimes helps her to hide aspects of herself that might be punished. It may further assist her to avoid people who might be punishing.(cont.)
(cont.)Unfortunately, years of this habituates the child into only seeing herself, life and others in a negative light. Consequently, when she grows up and becomes free of her truly harmful family, she cannot see that life offers her many new possibilities. Her ability to see the good in herself and certain safe enough others remains developmentally arrested.” p. 41-42

“Most of the physiological damage of extended trauma occurs because we are forced to spend so much time in hyper-arousal – stuck in fight, flight, freeze or fawn mode.” 

Most common physical reactions to Cptsd-stress:
Shallow and incomplete breathing
Constant adrenalization
Chronic muscle tightness (armoring)
Wear and tear from rushing and armoring
Inability to be fully present, relaxed and grounded in our bodies
Sleep problems from being over-activated
Digestive disorders from a tightened digestive tract
Physiological damage from excessive self-medication which alcohol, food or drugs

“Moreover, in cases of physical and sexual abuse, or capacities to be physically comforted by touch are eliminated or compromised; and, in cases of verbal and emotional abuse, our capacities to be comforted by eye- and voice-contact are undeveloped or seriously diminished.” p. 42-43

“…some somatic repair happens automatically when we reduce our physiological stress by more efficient flashback management. Particularly potent help also comes from the grieving work of reclaiming the ability to cry self-compassionately and to express anger self-protectively. Both processes can release armoring, promote embodiment, improve sleep, decrease hyperarousal and encourage deeper and more rhythmic breathing.” p. 43

About learning to stretch: “The fact that I had to weather many toxic shame attacks because I was always the least flexible person in the group did not help matters. Moreover, when various people commented about how good it felt to stretch, I felt both puzzled and further shamed, because it was anything but pleasant for me.” p. 44

Be wary of somatic processes that claim to work without addressing cognitive and emotional levels. “Some approaches also believe that their techniques eliminate the fundamental necessity of grieving the losses of childhood, and understanding how abusive and negligent parenting is at the root of our problems.” Some practices can ease physiological traumas locked in our bodies however as long as practitioner is not dismissing cognitive/emotional work. “In this vein, it is my opinion that techniques like EMDR and Somatic Experiencing are very powerful tools for stress-reduction. They are especially helpful in resolving simple ptsd. However, they are not complete Cptsd therapies, unless the practitioner is eclectic enough to be incorporating inner critic and grieving-the-losses-of-childhood work.” p. 45

SSRIs can help lower volume of inner critic to make it easier to work with but will come back if you stop unless you do work to shrink the inner critic. At right dosage, don’t seem to blunt affects enough to prevent grieving work. p. 46

John Bradshaw – almost everyone who grows up in a dysfunctional home has an eating disorder. p. 47

Origin of social anxiety: “A child who grows up with no reliable human source of love, support and protection typically falls into a great deal of social unease. He “naturally” becomes reluctant to seek support from anyone, and he is forced to adopt self-sufficiency as a survival strategy.(cont.)
(cont.)Needing anything from others can feel especially dangerous. The survivor’s innate capacity to experience comfort and support in relationship becomes very limited or non-existent. This is despite the fact that many high functioning survivors learn to socially function quite adequately.(cont.)
This is particularly the case in structured situations where expectations are clear and common goals take the focus off conversing and pit it on task accomplishments. Unstructured social situations however, like attending parties or just hanging out can be considerably more triggering. Spontaneous self-expression feels like the same setup for disaster that it was in childhood.(cont.)
Either way, structured or spontaneous, relating often involves hiding a great deal of anxiety and discomfort….” p. 50-51

“A central aspect of the truly helpful relational work was what John Bradshaw called “healing the shame that binds.” I believe toxic shame cannot be healed without some relational help. Several therapists and groups aided me greatly to unbind from the shame that made me hide whenever I could not invoke my perfect persona. Concurrently, I learned that real intimacy correlated with the amount I shared my vulnerabilities. As I increasingly practiced emotional authenticity, the glacier of my lifelong loneliness began to melt.” p. 53

“Therapeutic relations experiences enhanced my self-compassion considerably further than what I was able to accomplish on my own. Moreover, I believe that insufficient self-compassion is the worst developmental arrest of all, and restored self-compassion is the keystone of all effective recovery.” p. 53 

“Many of the successful therapies I have guided come to an end when the client gains an earned secure relationship outside of our therapy. This is typically a partner or best friend with whom the person can truly be themselves.” p. 54

“I have worked with many clients who began therapy with me while they were still over-controlled by their traumatizing parents – both externally, as well as internally…Through in depth exploration of their childhood trauma, many of my still-trapped clients achieved psychological freedom from their parents for the first time in their lives. Once again, this was a freedom that they had not actually achieved even though they had been living on their own for decades… These clients gradually learned to live more successfully on their own without their parents over-controlling spoiling influence. Their ability to build self-nurturing relationships with themselves almost always correlated with a major reduction or complete severing of their relationships with their parents.” p. 55

To recover the ability to be yourself in relationship, must recognize it’s unreasonable to expect others to accept you if you’re being abusively angry or contemptuous. Some trauma survivors flashback into this behavior. See ch 10 to address this. 

Recommended Books: Beyond the Marriage Fantasy, by Dan Beaver 

Reparenting is necessary. Self-mothering provides self-compassion, self-fathering provides self-protection.

“Self-mothering is based on the precept that unconditional love is every child’s birthright. Recovering from the loss of unconditional love is problematic Not getting enough of it as children was the greatest loss we had. Sadly, this loss can never be completely remediated, because unconditional love is only appropriate and developmentally helpful during the first two years or so of life.” p. 58

“The toddler who receives good enough parenting learns relatively easily to survive the very gradually diminishing supply of unconditional love. During the time she learns little by little that other people also have rights and needs. Her absolute entitlement to gratification is coming to an end, and the needs of her parents will not always be forfeited to accommodate her.(cont.)
(cont.)Once again, psychological health is based on having about two years of this no questions asked entitlement to unconditional love. It is the normal healthy narcissism that Freud described as “His Majesty the Baby.”(cont.)
(cont.)Serious problems accrue however when the toddler does not begin to learn that there are limits to his original entitlement. If there are no limits for too long, then the journey toward adult narcissism begins. On the other hand, if there are too many limits too soon, the matrix of trauma beings to form.(cont.)(cont.)Enlightened parents introduce limits slowly but surely. The do it as sucha a rate that by the time the child reaches adolescence he can balance satisfying his needs with helping his intimates to satisfy theirs. He learns to be sharing and reciprocal, a developmental task this is essential to keeping intimacy alive in his life.” p. 58-59

“Some parents can shower love on babies. But as soon as the child begins toddling around and expressing a will of her own, they become severely punishing and rejecting.” p. 59

Necessary to accept that we will never be totally flashback free. p. 68-69

Grieving work culminates in “learning to compassionately support ourselves through our experiences of depression.” p. 69

Many survivors need outside help in deconstructing the many layers of defenses. p. 69

Progress in recovery can be limited by trying to do too much at once or “bite of more than you can chew.” If you find yourself spinning your wheels or not knowing what to focus on or fix, try to simplify and focus on “shrinking the critic,” making that your go to response. p. 70

As the inner critic shrinks, the desire to care for yourself and help yourself will become more spontaneous. “This is especially true when we mindfully do things for ourselves in a spirit of loving-kindness. As such, we can do it for the child we were – the child who was deprived through no fault of her own. And, we can do it because we believe every child, without exception, deserves loving care.” p. 71

“…if the reader is like I was in the past and has no overall perspective on his suffering, he may feel like he is spinning his wheels on one icy patch of road after another. I had decades of trying everything under the sun with what felt like a deepening sense of futility and defectiveness. Gratefully, I eventually reached an invisible critical mass, and realized I had actually come a long way. I had acquired quite a few pieces in this puzzle of recovery, and only needed to organize them into a map to move along further.” p. 71

“In survival mode, even the most trivial and normally easy task can feel excruciatingly difficult. As in childhood, it is all feels just too hard. And if the flashback is especially intense, Thanatos may start knocking down the door.” Thanatos is the death urge. p. 72

“I believe regressions are sometimes a call from our psyche to address important developmental arrests. In this case, it is the need to learn unrelenting self-acceptance during a period of extended difficulty. It is also the need to develop a staunch and unyielding sense of self-protection.” p. 73

“Temptations can be great at such times to revert to the less functional ways of self-soothing that we learned when we were younger. Depending on your 4F type this commonly manifests as increased eating, substance abuse, working, sleeping and/or sexually acting out.(cont.)
(cont.)Sometimes we are triggered into self-medicating in this way because we are desperately trying to keep ourselves on the thriving end of the continuum. Desperately clinging to thriving is a hard impulse to resist, even when we are in reality way past its expiration date.(cont.)
(cont.)Yet as recovery and mindfulness increase we begin to notice that this type of self-medicating indicates that we are in a survival-flashback. We are no longer authentically on the thriving end of the continuum. We have compounded our regression, by regressing further – by self-medicating to unnaturally prolong a preferred experience. At such times, we benefit most by invoking our intention to practice self-acceptance – by recommitting to being there for ourselves no matter where we are on the continuum.” p. 73

It can be hard to accept that recovery is never complete. If we do not accept this falseness of the ‘salvation fantasy,’ we become more susceptible to blaming ourselves when we inevitably regress in the process of recovery. “Moreover, most recoverees often have the unfortunate subjective experience that the temporary regression feels as permanent as concrete. This is especially true because of the interminability feeling of flashbacks. When we flashback, we regress to our child-mind which was incapable of imagining a future any different than the everlasting present of being so abandoned.” p. 76

Pain of being invisible

“Healing from childhood trauma is also a long gradual process because recovering your full self-expression requires a great deal of practice. Being yourself can be intimidating and flashback-inducing. Healthy self-assertion was punished like a capital crime in many dysfunctional families. Expressing yourself in ways that your parents forbade typically triggers intense flashbacks at first. This can cause you to lose sight of how this practice gradually reduces the chronic pain of remaining invisible.” p. 77

“We can further bolster ourselves for such necessary flashbacks by comparing “speaking up” to going to the dentist for a toothache. Unless we accept the acute pain of the dentist’s therapeutic procedure, we will suffer chronic dental discomfit indefinitely. Unless we speak up, the loneliness of our silence will imprison us forever.” p. 77-78

Feeling the fear and doing it anyway
“Recovering from overwhelmingly painful childhoods is also so difficult because we understandably want to avoid any further pain at all. We may even believe that we need to risk a flashback and practice speaking up. But at the moment of facing the triggering that silence can so easily avoid, we cannot somoetimes help giving up and remaining mute.(cont.)
(cont.)However, if we are ever to recover our real voice, we must sometimes invoke the energy of bravery. Bravery is, in my opinion, defined by fear. It is taking right action despite being afraid. It is not brave to do things that are not scary.” Helps to work with anger. p. 78

“With enough practice, therapeutic flashbacks not only diminish, but begin to be replaced by a healthy sense of pride in ourselves for our courageous self-championing. More and more we are rewarded with feelings of safe belonging in the world.” p. 78

It is crucial for deeper level recovery that we learn that feelings of fear, shame and guilt are sometimes signs that we have said or done the right thing. They are emotional flashbacks to how we were traumatized for trying to claim normal human privileges.(cont.)
(cont.)As our recovery progresses, we need to learn to endure these feelings. Reinterpreting the deeper meaning of these feelings is key to accomplishing this. Typically this involves epiphanies like the following. “I feel afraid now, but I am not in danger like I was as a child.” “I feel guilty not because I am guilty, but because I was intimidated into feeling guilty for expressing my opinions, my needs and my preferences.” “I feel shame because my parents rained disgust on me for being me. I say no to these toxic parental curses, and I am proud and right to see how they tried to murder my soul I five them their shame back as disgust – the disgust any healthy adult feels when he sees a parent bullying a child with contempt, or when he sees a parent heartlessly ignoring a suffering child.” p. 78

Optimal stress, necessary for growth
“I believe that optimal stress is frequently attained when we practice the behavious that remedy our developmental arrests. Examples of this include reading self-help books, attending self-improvement workshops, working at deeper self-discovery through journaling, or struggling to be more vulnerable and authentic in a therapy session or an evolving relationship. Moreover, it might be that minor flashbacks sometimes function as optimal stress.” p. 79-80

“We live in an emotionally impoverished culture, and those who stick with a long term recovery process are often rewarded with emotional intelligence far beyond the norm. This is somewhat paradoxical, as survivors of childhood trauma are initially injured more grievously in their emotional natures than those in the general population.” p. 80

“Perhaps the greatest reward of improved emotional intelligence is seen in a greater capacity for deeper intimacy. Emotional intelligence is a foundational ingredient of relational intelligence – a type of intelligence that is also frequently diminished in the general populace.” p. 80

“As stated earlier, intimacy is greatly enhanced when two people dialogue about all aspects of their experience. This is especially true when they transcend taboos against full emotional communication. Feelings of love, appreciation and gratitude are naturally enhanced when we reciprocally show our full selves – confident or afraid, loving or alienated, proud or embarrassed. What an incredible achievement it is when any two of us create such an authentic and supportive relationship! Many of the most intimate relationships that i have seen are between people who have done a great deal of freeing themselves from the negative legacies of their upbringing.” 81

“The survivor who follows the introspective “road less travelled” becomes increasingly free of compulsive and unconscious allegiance to unhelpful familital, religious and societal values that were instilled at an impressionable age.(cont.)
(cont.)The recoveree now gets to choose her own values and reject those that are not in her own best interest. She develops a deeper more grounded self-respect that is not contingent upon going with the herd and shifting center with every new popular trend. In psychological parlance, she becomes free and brave enough to individuate and develop more of her full potential.” 81

“In Joseph Campbell’s worlds, the survivor learns to “follow his own bliss.” He is freer to pursue activities and interests that naturally appeal to him. He evolves into his own sense of style. He may even feel emboldened to coif and dress himself without adherence to the standards of fashion. He may even extend this freedom into his home decor. In this vein, I have seen many survivors discover their own aesthetic, as well as an increased appreciation of beauty in general. How this contrasts with many of the homes of my “normal” sports-buddies, whose homes are often sparsely decorated, as if they are too afraid to put something out or up lest it not be cool enough.” p. 81

“As the survivor recovers the right of free choice, she becomes more open to trying new things – healthy things that mainstream society might consider uncool or even taboo. Here are some examples of this that I believe are conducive to both recovery and healthy everyday living: voluntary simplicity, improved diet, meditation, alternative medicine, broad scale compassion, environmentalism, deeper emotional communication and a broader use of the grieving process.” p. 81-82

“The survivor who pursues long-term development on his journey of recovering generally achieves greater overall evolution than the average citizen. For many untraumatized people, the pursuit of ongoing learning often stops after their last formal learning experience – whether that is high school or college.(cont.)
(cont.)Introspective development also rewards the recoveree with more perspective and wisdom in making important life choices. It also improves his everyday instinctual choices, such as whether to fight, flee, freeze or fawn in times of real danger.” p. 82

Often many layers of minimization. The critic can be so strong it seems to be the entire identity. p. 92

Substance and process disorders can be seen as misguided ways to avoid pain and the desire to reduce these habits can be used as reason to learn other self-soothing tools. Learning to grieve offers many tools for working through emotional pain. After grieving and working through the pain, we require less need to harmfully avoid the pain. p. 95

We evolved to be near our caregivers. For 98% of human history we were in the Hunter-Gatherer era which required being near caregivers for safety. Fear of separation from caregivers is hardwired into the child as a healthy response to the separation. Fear is also linked to the fight response so that an infant separated would automatically cry angrily for attention, help, and cessation of abandonment. However, families that engender Cptsd, loathe angry crying. Many will even find professionals who will support them in routinely leaving young children alone to “cry it out.” 🙁 p. 96

Emotional neglect causes a child to abandon himself and to give up on the formation of a self in order to preserve the illusion of a connection to the parent and protect them from losing whatever connection they have. This requires self-abdication (forfeiture of self-esteem, self-confidence, self-care, self-interest, and self-protection). Recourse becomes to be hypervigilant about things that can go wrong… child’s consciousness becomes overwhelmed with processes of drasticizing and catastrophizing which lead the child to constantly prepare himself for the worst. “This is the process by which Cptsd with its overdeveloped stress and toxic shame programs sets in and becomes triggerable by a plethora of normally innocuous stimuli.” Most notable of stimuli are other people, especially one reminiscent of the parents.This “people-are-dangerous process” can become the social anxiety which is a common symptom of Cptsd. p. 98

“Emotional intelligence and its cohort, relational intelligence, are forced into developmental arrest by abandoning parents. Children never learn that a relationship with a healthy person can be comforting and enriching. The ability to open to and benefit from love and caring from others often lays dormant and undeveloped. (cont.)
(cont.)Moreover, the appropriate management of the normal emotions that recurrently arise in significant relationships is never modeled for them. Emotional intelligence about the healthy and functional aspects of anger, sadness, and fear lies fallow.” p. 99

Emotional abandonment is healed by real intimacy. Real intimacy requires showing up in times of vulnerability, “Deep-level recovering occurs when we successfully connect with a safe enough other during the flashbacked-times of feeling trapped in the fear, shame, and depression of the abandonment melange.” Requires practicing vulnerability (“showing up in pain”). Tend to return to default positions of hiding or camouflaging with substances. “Yet I drew strength from a growing distaste for the social perfectionism of my people-pleasing codependence. I somehow knew my loneliness would never decrease unless I took the risk to see if certain well chosen others would accept me in all aspects of my experience, not just the shiny ones…even after considerable de-minimization of my childhood abuse/neglect picture, I was still convinced that everyone by my therapist would find me abhorrent if I shared about my flashback feelings. Furthermore, my trust of my therapist also wavered quite a bit at first, especially during my deepest flashbacks.” p. 100-101

Life Narrative
There is “growing evidence that recovery from Complex PTSD is reflected in the narrative a person tells about her life. The degree of recovery matches the degree to which a survivor’s story is complete, coherent, and emotionally congruent and told from a self-sympathetic perspective.” “In my experience, deep level recovery is often reflected in a narrative that highlights the role of emotional neglect in describing what one has suffered and what one continues to deal with.” p. 102

Story of Matt searching for mother’s day card and resulting flashback. He had “achieved a great deal of de-minimization since the previous mother’s day when he thought his mother was a good mother because she had never hit him. Now, however, he was heavily triggered by spending an hour in a card shop unable to find a card that he could send to his mother. As we explored this further, we discovered that the sentiments written in every card made him feel like he would be betraying his inner child if he sent it.” Not one of the cards expressed something he was grateful for. “I don’t have one memory of anything nice she ever said or did for me!” He then cried and got angry over “the scornful look and the sarcastic tone of voice that characterized his interactions with her.” After enough healthy grieving, his flashback began to resolve and sense of humor returned. Joked about starting a greeting card business for people like him with cards that said… “Thanks Mom for never knowing what grade I was in” or “Thanks Mom for all the memories of you walking away whenever I was hurting” or “Thanks Mom for teaching me how to only notice what was wrong with me” or “Thanks Mom for teaching me how to frown at myself in self-disgust.” p. 103

“Understanding how profoundly derelict your parents were in their duty to nurture and protect you is a master key to your recovery. You will benefit greatly fro seeing emotional flashbacks as direct messages from your child-self about how much your parents rejected you. When denial is significantly deconstructed, you will typically feel genuine compassion for the child that you were. This self-compassion assuages emotional neglect by providing you with the missed childhood experience of receiving empathy in painful emotional states instead of contempt or abandonment. This, then, helps you to reverse the childhood-survival habit of automatic self-abandonment. In turn, this can further motivate you to identify and address the many ways you were abused and/or neglected.” p. 104

“…it is an empowering accomplishment to really get the profound significance of childhood emotional neglect. IT is often flashback-resolving to realize in the moment that a flashback into bewilderment and hopelessness is an emotional reliving of your childhood trauma. Like nothing else, this can generate a self-protective impulse toward your child-self and your present-time self, kick-starting the process of resolving any given flashback.” p. 104

Charming bully. Combines opposites of narcissism and codependency. Can frequently and dramatically vascillate between fight and fawn. “When a fight-fawn is upset with someone, she can fluctuate over and over between attacking diatribes and fervent declarations of caring in a single interaction. More vitriol and entitlement in vacillations that reverse fawn-fight type. “…his ‘caretaking’ often feels coercive and manipulative. It is frequently aimed at achieving personal agendas which range from blatant to covert. Moreover, the fight-fawn rarely takes any real responsibility for contributing to an interpersonal problem. He typically ends up in the classic fight position of projecting imperfection onto the other.” Tends to have high entitlement and often devoid of real empathy or compassion. p. 124

Origins of codependency (fawn response) – fight doesn’t work
“As a toddler, the codependent (fawn response) learns quickly that protesting abuse leads to even more frightening parental retaliation. Thus she responds by relinquishing her fight response, deleting “no” from her vocabulary and never developing the language skills of healthy assertiveness…moreover, many abusive parents reserve their most harsh punishments for “talking back”, and hence ruthlessly extinguish the ifht response in their children. Unfortunately, this typically happens at such an early age that they later have little or no memory of it.” p. 130-131

And – flight doesn’t work
Future codependent danger is intensified if she tries to run away. An adaptation to the flight response: “Many toddlers, at some point, translate the flight urge into the running around in circles of hyperactivity. This adaptation “works” on some level to help them escape from the uncontainable feelings of the abandonment melange. Many of these unfortunates later symbolically run away from their pain. They deteriorate into the obsessive-compulsive adaptations of workaholism, busyholism, spend-aholism, and sex and love addiction that are common in flight types.” p. 131

And – freeze doesn’t work
The toddler who bypasses the adaptation develops the freeze response by becoming the “lost child.”

Slips into dissociation…”learns to let his parents’ verbal abuse go in one ear and out the other.” Not uncommon for this to become use of numbing substance addictions: pot, alcohol, opiates, etc. p. 131

“The future codependent toddler, however, wisely gives up on the fight, flight, and freeze responses. Instead she learns to fawn her way into the occasional safety of being perceived as helpful. It bears repeating that the fawn type is often one of the gifted children that Alice Miller writes about in The Drama of the Gifted Child. She is the precocious one who discovers that a modicum of safety can be purchased by becoming variously useful to her parent.(cont.)
(cont.)Servitude, ingratiation, and obsequiousness become important survival strategies. She cleverly forfeits all needs that might inconvenience her parents. She stops having preferences and opinions that might anger them. Boundaries of every kind are surrendered to mollify her parents, who repudiate their duty of caring for her. As we saw in the last chapter, she is often parentified and becomes as thoroughly helpful to the parent as she can….(cont.)
(cont.)All this loss of self begins before the child has many words, and certainly no insight. For the budding codependent, all hints of danger soon immediately trigger servile behaviors and abdication of rights and needs.(cont.)
(cont.)These response patterns are so deeply set in the psyche, that as adults, many codependents automatically respond to threat like dogs, symbolically rolling over on their backs, wagging their tails, hoping for a little mercy and an occasional scrap.” p. 132

Extreme emotional abandonment can also cause codependency. A severely neglected child can experience extreme lack of connection as traumatic and may respond by developing the fawn response. If a child experiences that being useful and not requiring anything herself gets her some positive attention codependency can begin to grow. p. 132-133

Trauma-induced codependency is “syndrome of self-abandonment and self-abnegation. Codependency is a fear-based inability to express rights, needs and boundaries in a relationship. It is a disorder of assertiveness, characterized by a dormant fight response and a susceptibility to being exploited, abused, and/or neglected.” p. 133

“In conversations, codependents seek safety and acceptance in relationship through listening and eliciting. They invite the other to talk rather than risk exposing their thoughts, views, and feelings. They ask questions to keep the attention off themselves, because their parents taught them that talking was dangerous and that their words were indictments that would inevitably prove them guilty of being unworthy.” p. 133 

Important to allow others to be imperfect. “We all have minor limitations and foibles that may not be transformable. Loved ones need to be spared from being pressured to fix what is unfixable. My way of approaching this is to always frame my advice as take-it or leave-it. To prove this is so, I refrain from then going on about it repetitively. Additionally, I typically check in first to see if the other person actually wants some feedback.” p. 137

Fawn-fight types can be aggressive in attempts to help others. “Typically they equate helping with changing, and can alienate others by persistently pressuring them to take their advice.” p. 137

“The fawn-fight type is the smother-love caretaker. Her caretaking approach of being over-focused on the other is sometimes a repetition of her childhood servant role. Moreover, her helpfulness is usually less self-serving than the fight-fawn…Nonetheless, the zealousness of her caretaking sometimes makes the recipient believe it when she says, “I love you to death.(cont.)
(cont.)In flashback, the fawn-fight can deteriorate into manipulative or even coercive care-taking. He can smother love the other into conforming to his view of who she should be.(cont.)
(cont.)Fawn-fight types may periodically reach a critical mass of frustration that erupts when the “patient” refuses his advice or balks at his unwanted caretaking. Somethise the fawn-fight feels an entitlement to punish the other “for their own good”, especially in a primary relationship.” Sometimes misdiagnosed as borderline (can be emotionally intense during flashbacks). p. 137

He had the realization: “No wonder I wind up with one narcissist after another. Narcissists love me because I am so enabling of their monologuing. I probably met lots of nice balanced people who did not want another date with me because it seemed like I was hiding and hard to get to know.” He had a friend who joked that “her listening and eliciting defenses were so perfected that she could turn anyone, even a blank-screen therapist, into a monologuing narcissist. “To break free of their codependence, survivors must learn to stay present to the fear that triggers the self-abdication of the fawn response. In the face of their fear, they must try on and practice an expanding repertoire of more functional responses to fear.” p. 139

“As later stage recovery progresses, the survivor increasingly “knows her own mind.” She slowly dissolves the habit of reflexively agreeing with other people’s preferences and opinions. She more easily expresses her own point of view and makes her own choices. And most importantly, she learns to stay inside of herself.” p. 141

“Many fawns survived by constantly focusing their awareness on their parents to figure out what was needed to appease them. Some become almost psychic in their ability to read their parents moods and expectations. This then helped them to figure out the best response to neutralize parental danger. For some, it even occasionally won them some approval.” But now it is needed to work on staying inside their own experience “without constantly projecting their attention outward to please others. Fawn-types who are still habituated to people-pleasing, must work on reducing their ingratiating behaviors. I have noticed over the years that the degree to which a survivor strains to please me reflects the degree to which his parents were dangerous.” p. 141

Emotional individuation work-setting boundaries that let us stay true to our own emotional experience.
Work on being mindful of mirroring and matching behaviors. A “great accomplishment to significantly reduce verbal matching. It is an even more powerful achievement to reduce inauthentic emotional mirroring….dysfunctional emotional matching is seen in behaviors such as acting amused at destructive sarcasm, acting loving when someone is punishing, and acting forgiving when someone is repetitively harmful.” p. 141

One of the most important things he ever learned: how to be okay with disapproval. With good, generally approving friends, some feedback from them is easier to take. And some disapproval can actually be a good thing: lets you know you are moving in the right direction/doing the right thing for you. “Nowhere is this more truer than with the disapproval of the narcissistic parents or partners of clients whom I am working to rescue from their enslavement.” p. 143

Emotional flashbacks
Regressions to overwhelming feeling-states of your childhood abandonment. Dominated by fear, shame and/or depression. Common experiences include: feeling small, fragile, helpless, things are too hard, too scary, being seen feels excruciating and vulnerable, battery feels dead, like “an apocalypse feels like it will imminently be upon you.” Overwhelming and confusing because rarely any visual components. These “occur in the brains of people who have been triggered into a 4F reaction so often, that minor events can now trigger them into a panicky state.” p. 145

Learn to identify things that trigger flashbacks: “unsafe people, places, activities, and triggering mental processes.” Recognizing is crucial in order to avoid. p. 148-9

Triggers can be small. Common triggers include: “someone looking at us,…making a mistake, asking for help, having to speak in front of a group of people.” Sometimes even “feeling tired, sick, lonely, or hungry…any type of physical pain…” p. 149

Learning to fear “the look” is conditioning. “With enough pairings of the look with physical punishment or extreme abandonment, the parent can eventually delete the smack and get the same results with just the look. With enough repetitions in early childhood, this pairing can last a lifetime, so that the parent can control the child forever with the look.” p. 151

There are both internal and external triggers. Internal are more common and often caused by the inner critic. “Typically they are thoughts and visualizations about endangerment or the need for perfection. The survivor may, seemingly without reason, visualize someone being abusive. Moreover he can also, seemingly out of the blue, worry himself into a flashback by simply thinking he is not perfectly executing a task that he is undertaking. He can also frighten himself by enumerating the many ways that he might mess up any upcoming task.” p. 152

“…resolving a flashback requires rebalancing significant biochemical changes in the brain and body that take time to subside. For example, over-adrenalization sometimes dramatically morphs into the hangover of adrenalin exhaustion, before the adrenal function can be rebalanced. Decreasing the intensity of a flashback with quick remedial action decreases the time it takes for our physiology to recover.” p. 153

Signs of being in a flashback (p. 154-155):

feeling small, hopeless or helpless

increase in inner/outer critic (feeling judgemental)

emotional reactions out of proportion

increase in primal soothing: food, distracting activities, mood-altering substances

In flashback we lose access to “post-childhood knowledge.” p. 156

Perspective-substitution: broadens viewpoint to include more than inner critic and “helps us to dethrone the critic from its life-negating point of view…one who dwells so much on what is wrong that he cannot see anything that is right.” p. 185

A practice to counter the inner critic and practice perspective correction: before falling asleep at night, list at least 10 positive experiences that happened that day. Generally will be simple and basic things. Doing this overtime will help balance the negative critic inherited from parents. p. 188

With progress in recovery, there develops the ability to notice the critic before entering full flashback which allows for better protective actions. Flashbacks can also serve as “evidence/proof” of childhood traumatization. “Flashbacks point irrefutably to the fact that your parent’s abandonment forced you to habituate to hypervigilance and negative noticing.” p. 189

Inner and outer critic are usually both silent and internal (except for fight type). “When we regress to the outer critic, we obsess about the unworthiness and treacherousness of others. Unconsciously, we do this to avoid emotional investment in relationships.(cont.)
(cont.)The outer critic developed in reaction to parents who were too dangerous to trust. The outer critic helped us to be hyperaware of the subtlest signal that our parents were deteriorating into their most dangerous behaviors. Over time the outer critic grew to believe that anyone and everyone would inevitably turn out to be as untrustworthy as our parents.” p. 192

Freeze type can judgmentally denounce entire world. 

Flight type can use his “perfectionistic striving to excel so his outer critic can judge everyone else as inferior.

Fawn type uses “self-hate to self-censor and avoid the fear of being authentic and vulnerable in relationship.”

Fight type uses outer critic to control others while paradoxically using prickliness to keep them from getting to close. Can also leave at first sign others can’t be controlled. p. 193

“Children are initially wired to respond angrily to parental abuse or neglect. Outside of the fight types, most traumatized children learn early that protesting parental unfairness is an unpardonable offense. They are generally forced to repress their protests and complaints. This then renders their anger silent and subliminal. This agner however, does not disappear. It percolates as an ever accumulating sea of resentment that can fuel the other critic’s obsession for finding fault and seeing danger in everyone.(cont.)
(cont.)Viewing all relationships through the lens of parental abandonment, the outer critic never lets down its guard. It continuously transfers unexpressed childhood anger onto others, and silently scapegoats them by blowing current disappointments out of proportion. Citing insignificant transgressions as justification, the survivor flashes back into outer critic mode, and silently fumes and grumbles in long judgemental ruminations.” p. 194

Passive aggressive behaviors: (p. 194) 
“distancing yourself in hurt withdrawal” 
“pushing others away with backhanded compliments”
poor listening
hurtful teasing disguised as joking
withholding positive feedback and appreciation
chronic lateness
poor follow through on commitments

Media tends to normalize outer critic. Common behaviors portrayed: (p. 197)

Watching news can serve as trigger. p. 199

Cptsd is from an attachment disorder where child never learns that other people can soothe emotional pain. “She never learns that real intimacy grows out of sharing all of her experience.” “To the degree that our caretakers attack or abandon us for showing vulnerability, to that degree do we later avoid the authentic self-expression that is fundamental to intimacy….subliminal memories of being scorned for seeking our parents’ support then short-circuit our inclinations to share our troubles and ask for help.” “Even worse, retaliation fantasies can plague us for hours and days on the occasions when we do show our vulnerabilities. I once experienced this after being very honest and vulnerable in a job interview with a committee of eight. Over the next three insomnia-plagued nights, my outer critic ran non-stop films featuring my interviewers’ contempt about everything I had said, and disgust about all that I had left out. Even after they subsequently and enthusiastically hired me, the outer critic plagued me with “imposter syndrome” fantasies of eventually being exposed as incompetent in the new job.” p. 200

“Our dysfunctional parents typically kill our protest function before our memory function comes on line. Nonetheless, fear of parental reprisal is often the unconscious dynamic that scares us out of challenging our own toxic thinking.” p. 208

“Our recovery depends on us using mindfulness to decrease out habits of dissociation. Only then can we see the critic programs that we need to deconstruct, shrink and consciously disidentify from. This typically involves learning to tolerate the pain that comes from discovering how pervasive and strong the critic is.” p. 208

“A key characteristic of outer critic-dominated flashbacks is that we displace emotional pain from past relationships onto current ones. Transference is the pipeline from the past that supplies the critic with anger to control, attack or disapprove of present relationships.” p. 210

“The most common transferrential dynamic that I witness occurs when leftover hurt about a parent gets displaced onto someone we perceive as hurting us in the present. When this occurs, we respond to them with a magnified anger or anguish that is out of proportion to what they did.(cont.)
(cont.)Transference can also grossly distort our perceptions, and sometimes we can misperceive a harmless person as being hurtful. Transference can fire up the critic to imaging slights that do not actually occur. Transference typically runs wild when the outer critic is on a rampage.” p. 210

“A person who was “repeatedly pathologized and punished for emoting in childhood may experience grieving as exacerbating their flashbacks rather than relieving them.” p. 220

“Angering can also immediately trigger the survivor into toxic shame. This is often true of instances when there is only an angry thought or fantasy. Dysfunctional parents typically reserve their worst punishments for their child’s anger. This then traps the child’s anger inside.” p. 220

“Critic management is often the primary work of early stage grief work. This work involves recognizing and challenging the ways the critic is blocking or shaming the processes or grieving. As disidentification from the critic increases, grieving can then best be initiated with low intensity verbal ventilation. Over time verbal ventilation can be allowed to gradually increase in sad and angry intonation.” p. 220

“It appears children are hard-wired to release fear through angering and crying.”… “In the dysfunctional family however, the traumatizing parent soon eradicates the child’s capacity to emote. The child becomes afraid and ashamed of her own tears and anger. Tears get shut off and anger gets trapped inside and is eventually turned against the self as self-attack, self-hate, self-disgust, and self-rejection. Self-hate is the most grievous reenactment of parental abandonment.” p. 221

Anger and crying. Need to happen “in concert.” Dysfunctional whining is where either the anger or sadness is repressed but leaks through anyway and in a irritating way. “When a hurt person only knows how to express anger, his repressed sadness unconsciously seeps into his anger in a way that makes him sound like a martyr or someone with delusions of persecution.” Because sadness is not released, there is no relief and can exhaust listener’s empathy. “…when a hurt person is only able to cry, repressed anger tinges her sadness and makes it sound like irritable and interminable bellyaching… ‘anger coming through a very small hole.’”p. 227-228 

Flashbacks are visible in MRI with over-active right-brain (emotional side) and under-active left-brain (thinking). Verbal ventilation can help fix this imbalance by stimulating left-brain. Also thought that this is one reason its so hard to realize you’re in a flashback (because of loss of left-brain function). p. 231

Verbal ventilation is only helpful when freed from control of inner critic. Can easily shift to self-flagellation, especially early in recovery. This will only serve to trigger or intensify flashback(s). p. 232

Verbal ventilation helps us reconnect with and communicate about unmet childhood needs . p. 232

Disassociation is a defense children develop to protect from overwhelming pain. Two types: right-brain and left-brain. Right-brain: classical, common to freeze type, numbing out against intense feeling or strong inner critic. Fantasy, fogginess, tv watching, tiredness, sleep. Left-brain is obsessiveness: catastrophizing, list of worries, trivialization, obsession with sports, celebrities, intellectualization. p. 234-235

“When we share what is emotionally important to us, we learn to connect with others in a meaningful and healing way. This applies to sharing concerns that excite and please us, as well as those that frighten or depress us. Perhaps there was no more detrimental consequence of our childhood abandonment than being forced to habitually hide our authentic selves. Many of us come out of childhood believing that what we have to say is as uninteresting to others as it was to our parents.(cont.)
(cont.)We must repudiate this damaging legacy of the past. Verbal ventilation is the key way that people make friends. It parallels the way tender touch, soothing voice, and welcoming facial expressions help infants and toddlers establish bonding and attachment. When we practice the emotionally based communication of verbal ventilation in a safe environment, we repair the damage of not having had this need met in childhood. This in turn opens up the possibility of finally attaining the verbal-emotional intimacy that is an essential lifelong need for all human beings.(cont.)
(cont.)Committing to this type of practice typically requires courage and perseverance. Authentic sharing can be triggering, and sometimes flashes the survivor back to being punished or rejected for being vulnerable. Therapy, individual or group, can help greatly to overcome and work through these obstacles to vitalizing your self-expression.” p. 236

“Reciprocal verbal ventilation is the highway to intimacy in adult relationships. Sufficient practice with a safe enough other brings genuine experiences of comforting and restorative connection. For me and many of my clients, such experiences are more alleviating of loneliness than we had ever thought possible.(cont.) 
(cont.)Nowhere is this truer than with mutual commiseration. Mutual commiseration is the process in which two intimimats are reciprocally sympathetic to each other’s troubles and difficulties. It is the deepest most intimate channel to intimacy – profounder than sex. Mutual commiseration also typically promotes a spontaneous opening into many levels of light-hearted and spontaneous connecting.” p. 236 

Feeling. Is kinesthetic, not cognitive. Shifting focus of awareness from thoughts to feelings, emotions, energetic states and body sensations. p. 237

“Physical sensations in the body often co-occur with feelings. Moreover, sensations of tightness and tension can develop as a defense against feelings. As unexpressed feelings accumulate, a greater degree of muscular tension is necessary to keep them under wraps.” p. 238

“Holding your breath is a further manifestation of armoring. It is an especially common way of keeping feelings at bay, as breathing naturally brings your awareness down to the level of feeling.” p. 239

“We are typically in advanced recovery when we can both emote out and feel through our anger, sadness, fear, shame and depression. 

An exercise to help feel pain and grieve. Practice it even if it feels silly or inauthentic. Eventually you will feel a genuine experience of compassion. When you do, you’ll know your recovery has reached a deep level. (cont.)
(cont.)Go back in time and visualize yourself as a child. Imagine holding yourself as a child on your lap and comforting her/him and say, “I feel such sorrow that you were so abandoned and that you felt so alone so much of the time. I love you even more when you are stuck in this abandonment pain – especially because you had to endure it for so long with no one to comfort you. That shouldn’t have happened to you. It shouldn’t happen to any child. Let me comfort and hold you. You don’t have to rush to get over it. It is not your fault. You didn’t cause it and you’re not to blame. You don’t have to do anything. Just let me hold you. Take your time. I love you always and care about you no matter what.” p. 240

Staying present to feelings of abandonment depression is deepest level work. “When we are able to do this, our recovering has reached a profound level.” p. 249

“Chronic emotional abandonment devastates a child. It naturally makes her feel and appear deadened and depressed. Functional parents respond to a child’s depression with concern and comfort. Abandoning parents respond to the child with anger, disgust, and/or further abandonment…” p. 249

Depression is taboo in our culture. But often has helpful and important information contained in it. “Healing progresses when we learn to distinguish depressed thinking [which we need to eliminate] from depressed feeling [which we sometimes need to feel].” Occasional feelings of depression are part of the “price of admission to life.” “Depression is sometimes an invaluable herald of the need to slow down for rest and restoration. When depression is most helpful, it gives us access to a unique spring of intuition, such as that which informs us that a once valued job or relationship is no longer healthy for us. In such instances we feel depressed because some irreparable change has rendered some central thing in our lives detrimental to us. This functional depression is signalling us to let it die and move on.” “Overreaction to depression essentially reinforces learned toxic shame. It reinforces the person’s belief that he is unworthy, defective and unlovable when he is depressed.” “Sadly this typically drives him deeper into abandonment-exacerbated isolation.” p. 251

“Deep level recovery from childhood trauma requires a normalization of depression, a renunciation of the habit of reflexively reacting to it. Central to this is the development of a self-compassionate mindfulness.” p. 125

Many sensations are fear: tightening in musculature (jaw, throat, chest, diaphragm, belly, alimentary canal), more intense sensations of fear include nausea, jumpiness, feeling wired shortness of breath, hyperventilation, alimentary distress. Mindfulness involves noticing the tendency to dissociate from these sensations. “Over and over, the survivor will need to rescue himself from dissociation, and gently bring his awareness back into fully feeling the sensations of his fear. Although sensations of fear sometimes feel unbearable at first, persistent focusing with non-reactive attention dissolves and resolves them as if awareness itself is digesting and integrating them.” p. 252

This works through more and more feelings of grief and then can begin to work through depression (feelings include: heaviness, swollenness, exhaustion, emptiness, hunger, longing, soreness, or deadness). Mindfulness digests them and integrates them into consciousness. “One of the biggest challenges of mindfully focusing on depression is to not dissociate into sleep. Sitting up straight in a comfortable chair can help to keep you awake and focused on fully feeling and metabolizing your depression.” p. 253

When critic is very loud and intense, best strategy is to focus on feeling sensations.p. 255

Gabor Mate. Attachment hunger. Confused with real hunger, source of food addictions and food soothing. p. 256

Tiredness can be abandonment depression. p. 256

Example of flashback (generally a mundane, everyday kind of thing): “Cooking…became a central piece of my self-remothering work. It was not until I realized how much I rushed around when I was cooking. Via increased mindfulness, I discovered that the smallest unforeseen obstacle could set off what felt like a small electric shock in my chest. Examples of these obstacles include something spilled, a lid too tight to open, an extra unanticipated task, or the clock showing me that I was behind schedule. In an instant, anyone of these normal hindrances could send me rushing around the kitchen in a low grade panic. Whenever this occurred, I would then inhale my meal as soon as it was ready just to get the ordeal over with….With ongoing recovery work, I realized that anything to do with food could easily flash me back to the family dinner table – the battlefield of my dysfunctional family.(cont.) 
(cont.)Many productive grieving sessions came out of this. They lead me to an epiphany that doing anything intricate with lots of steps to it also flashed me back to feeling picked apart by my parents. I subsequently discovered that angering at my parents, whenever I was triggered by doing something complicated, significantly reduced my fear.” p. 260

“A child, with parents who are unable or unwilling to provide safe enough attachment, has no one to whom she can bring her whole developing self.(cont.)
(cont.)No one is there for reflection, validation and guidance. No one is safe enough to go to for comfort or help in times of trouble. There is no one to cry to, to protest unfairness to, and to seek compassion from for hurts, mistakes, accidents, and betrayals.(cont.)
(cont.)No one is safe enough to shine with, to do “show and tell” with, and to be reflected as a subject of pride. There is no one to even practice the all-important intimacy-building skills of conversation. (cont.)
(cont.)In the paraphrased words of more than one of my clients: “Talking to Mom was like giving ammunition to the enemy. Anything I said could and would be used against me. No wonder, people always tell me that I don’t seem to have much to say for myself.” p. 267

“…the therapist needs to be able to tolerate and work therapeutically with the sudden evaporation of trust that is so characteristic of Cptsd. Trauma survivors do not have a volitional “on” switch for trust, even though their “off” switch is frequently automatically triggered during flashbacks. In therapy, the therapist must be able to work on reassurance and trust restoral over and over again. I have heard too many disappointing client stories about past therapists who got angry at them because they would not simply choose to trust them.” p. 268

“Empathy involves immersing yourself in another’s psychological state by feeling yourself into the other’s experience.” – Kohut p. 269

“When I delve deeply enough into a client’s experience, no matter how initially perplexing or intemperate it may at first seem, I inevitably find psychological sense in it, especially when I recognize its flashback components. In fact, I can honestly say that I have never met a feeling or behavior that did not make sense when viewed through the lenses of transference and traumatology.(cont.)
(cont.)Empathy, of course, deepens via careful listening and full elicitation of the client’s experience, along with the time-honored techniques of mirroring and paraphrasing which show the client the degree to which we get him.” p. 269

“I came to value therapeutic vulnerability the hard way via its absence in my own therapy with a therapist who was of the old, “blank screen” school. She was distant, laconic, and over-withholding in her commitment to the psychoanalytic principle of “optimal frustration.” Therapy with her was actually counter-therapeutic and shame-exacerbating for me as we reenacted a defective child/perfect parent dynamic.” p. 270-271


“My therapist’s modeling that anger, sadness, fear, and depression were emotions that could be healthily expressed helped me to renounce the pain-repressing, emotional perfectionism in which I was mired. With her, I learned to stop burying my feelings in the hope of being loved. I renounced my just-get-over-it philosophy and embraced vulnerability as a way of finally getting close to people.(cont.)
(cont.)I needed this kind of modeling, as so many of my clients have, to begin to emerge from my fear of being attacked, shamed or abandoned for feeling bad and having dysphoric feelings. In order to let go of my Sisyphean salvation fantasy of achieving constant happiness, I needed to experience that all the less than shiny bits of me were acceptable to another human being. Seeing that she was comfortable with and accepting of her own happy feelings eventually convinced me that she really was not disgusted by mine.” p. 271

“I repeatedly express my genuine indignation that the survivor was taught to hate himself. Over time, this often awakens the survivor’s instinct to also feel incensed about this travesty. This then empowers him to begin standing up to the inner critic. This in turn aids him to emotionally invest in the multidimensional work of building healthy self-advocacy.(cont.) 
(cont.)Furthermore, I also repeatedly respond with empathy and compassion to the survivor’s suffering. With time, this typically helps to awaken the recoveree’s capacity for self-empathy. She then gradually learns to comfort herself when she is in a flashback or otherwise painful life situation. Less and less often does she surrender to an inner torture of self-hate, self-dissapointment, and self-abandonment.(cont.)
(cont.)My most consistent feedback from past clients is that responses like these – especially ones that normalize fear and depression – helped them immeasurably to deconstruct their perfectionism, and open up to self-compassion and self-acceptance.” p. 272

“Dialogicality occurs when two conversing people move fluidly and interchangeably between speaking [an aspect of healthy narcissism] and listening [an aspect of healthy codependence]. Such reciprocal interactions prevent either person from polarizing to a dysfunctional narcissistic or codependent type of relating.(cont.) 
(cont.)Dialogicalty energizes both participants in a conversation. Dialogical relating stands in contrast to the monological energy-theft that characterizes interactions whereby a narcissist pathologically exploits a codependent’s listening defense. Numerous people have reverberated with my observation that listening to a narcissist monologue feels as if it is draining them of energy. (cont.)
(cont.)I have become so mindful of this dynamic that, in a new social situation, a sudden sense of tiredness often warns me that I am talking with a narcissist. How different than the elevation I sense in myself and my fellow conversant in a truly reciprocal exchange. Again, I wonder if there are mirror neurons involved in this…(cont.)
(cont.)…In therapy, dialogicality develops out of a teamwork approach – a mutual brainstorming about the client’s issues and concerns. Such an approach cultivates full exploration of ambivalences, conflicts and other life difficulties. (cont.)
(cont.)Dialogicality is enhanced when the therapist offers feedback from a take-it-or-leave-it stance. Dialogicality also implies respectful mutuality. It stands in stark contrast to the blank screen neutrality and abstinence of traditional psychoanalytic therapy, which all too often reenacts the verbal and emotional neglect of childhood.(cont.)
(cont.)I believe abstinence commonly flashes the client back into feelings of abandonment, which triggers them to retreat into “safe” superficial disclosure, ever-growing muteness and/or early flight from therapy.” p. 275

“All this being said, extensive dialogicality is often inappropriate in the early stages of therapy. This is especially true, when the client’s normal narcissistic needs have never been gratified, and remain developmentally arrested.(cont.) 
(cont.)In such cases, clients need to be extensively heard. They need to discover through the agency of spontaneous self-expression the nature of their own feelings, needs, preferences and views.” p. 275

Perhaps rise of coaching has been a response to the problems of traditional therapy. p. 277

“…last phase of therapy is often characterized by increasing dialogicality – a more balanced fluidity of talking and listening. This conversational reciprocity is a key characteristic of healthy intimacy. Moreover, when therapy is successful, progress in mutuality begins to serve the client in creating healthier relationships in the outside world.” p. 278

Collaboritve rapport repair is the process by which relationships grow closer from successful conflict resolution. Misattunements and periods of disaffection are existential to every relationship of substance. We all need to learn a process for restoring intimacy when a disagreement temporarily disrupts our feeling of being safely connected.(cont.)
(cont.)I believe most people, if they think about it, realize that their best friends are those with whom they have had a conflict and found a way to work through it. Once a friendship survives a misattunement, it generally means that it has moved through the fair-weather-friends stage of relationship.” p. 280-281

Rapport repair is probably the most transformative, intimacy-building process that a therapist can model. I guide this process from a perspective that recognizes that there is usually a mutual contribution to any misattunement or conflict. Therefore, a mutually respectful dialogical process is typically needed to repair rapport. Exceptions to this include scapegoating and upsets that are instigated by a bullying narcissist. In those situations, they are solely at fault. I have often been saddened by codependent clients who apologize to their bullying parents as if they made their parents abuse them.” p. 281

How he approaches modeling misattunements: “Firstly, I identify the misattunement [e.g. “I think I might have misunderstood you.”] And secondly, I then model vulnerability by describing what I think might be my contribution to the disconnection.(cont.)
(cont.)Abbreviated examples of this are: “I think I may have just been somewhat preachy…or tired… or inattentive…or impatient… or triggered by my own transference.” Owning your part in a conflict validates the normality of relational disappointment and the art of amiable resolution.(cont.)
(cont.)Taking responsibility for your role in a misunderstanding also helps to deconstruct the client’s outer critic belief that relationships have to be perfect. At the same time, it models a constructive approach to resolving conflicts, and over time leads most clients to become interested in exploring their contribution to the conflict. This becomes an invaluable skill which they can then take into their outside relationships.” p. 282

“…I believe that one of the most common reasons that clients terminate prematurely is the gradual accumulation of dissatisfactions that they do not feel safe enough to bring up or talk about. How sad it is that all kinds of promising relationships wither and die from an individual or couple’s inability to safely work through differences and conflict. (See toolbox 4, chapter 13)

“Earned secure attachment is a newly recognized category of healthy attachment.” p. 285

“I have also witnessed a significant difference in survivors who were helped in childhood to see that it was not their fault that they were being traumatized. When there was one witnessing adult who sufficiently decried what was being done to them, most did not develop such a ferocious, self-annihilating critic. Typically this was the other parent, an enlightened older sibling, a relative, a teacher or a kindly neighbor.” p. 288

Bibliotherapy: describes the very real term of being positively and therapeutically influenced by what you read. Can help with “abject isolation and alienation.” Clients who make the most progress are those who augment therapy with reading homework. p. 303

Realized his therapeutic journey started much before his official therapy with reading and realizing there are trustworthy adults who can teach you better ways. For me- M. Scott Peck and George Feuerstein. p. 304

Read Walt Whitman Song of Myself and Song of the Open Road. p. 304