Author:Paul Gilmartin

What is Disorganized Attachment? – A guest blog by Joel Schwartz PsyD

Disorganized Attachment – An Explanation for Non-Clinicians

Many clients who end up in the therapeutic chair or couch are impacted by a disorganized attachment style. Disorganized attachment serves as a diathesis (risk factor) for many difficult psychological syndromes including depression, dissociative disorders, various personality disorders (especially Borderline and Narcissistic Personality Disorders), PTSD, and Complex PTSD. I have found it useful to explain the etiology and manifestation of disorganized attachment to my clients as a way to begin understanding their confusing and dysfunctional coping methods and behaviors. However, my search of the web has yielded little information for the non-clinician. As such, here is my jargon free explanation:

Usually, when infants and young children are frightened or sad they approach their parent or caregiver for safety and comfort.  When the parent or caregiver is able to empathize, soothe, and care for their children, it teaches them how handle their own uncomfortable emotions and be caring and empathic for others. They also learn healthy boundaries and know how to seek out and rely on others for help.  This is the basis of healthy interpersonal relationships and is called “secure attachment.”

However, when parents react to their children’s efforts to receive comfort, empathy, and security in a frightening way, it can really affect their children’s ability to cope with emotions and engage in healthy relationships. Sometimes, parents do not even mean to be frightening. Often, parents can be frightening when they are abusive. However, parents can also be frightening if they have unresolved traumas of their own or are excessively anxious.

When the people who are supposed be a source of safety and security are also the source of danger and insecurity, it results in “fright without solution.”  As a result, two things may happen: 1) Children in these situations tend to disconnect from reality – they dissociate.  They may lose track of time, have out of body experiences, see reality as distorted, feel like events happen to someone else, or have strange and incomplete amnesias. 2) They grow up coping in a confusing way – basically, they are programmed to both approach and avoid caregivers at the same time. As a result, when these children grow up, they experience intimacy as scary.  When people try to be kind to them, they may freak out.  They may really want to get close to someone, but are also scared at the same time and unable to open up or share.

I once had a client who described being frightened at a party.  She ran away and hid in the coat closet.  While there she was wishing so badly that her boyfriend would come and get her.  But at the same time, she was afraid to be found. She wanted to be close to and far away from her boyfriend at the same time.  Another client had a mother with disorganized attachment.  She was not able to be close to her children without being mean and critical. She would hug, and cuddle them, telling them how much she cared and loved them, but at the same time would critical, rejecting, and cruel.  It is because even with her children, she wanted to be close and far away at the same time.

When people who have disorganized attachment experience psychological trauma, they very frequently experience PTSD.  But their PTSD is much more complicated and difficult to treat because when a securely attached person has PTSD, they can quickly trust their therapist and allow themselves to be cared for. When someone with disorganized attachment gets PTSD, it is difficult to treat because the process of learning to trust a therapist is really scary. They want to rely on a therapist and run away from the therapist at the same time. When the therapist tries to care and empathize, or the person feels themselves beginning to trust, that is the moment they start to get scared and want to run away or end treatment. As a result, it often requires the therapist to work intensely on the therapeutic relationship for a long time before directly working with symptoms or other syndromes.

Working with people who have disorganized attachment can be difficult.  Often, informing them about the reasons for their seemingly strange behaviors is an important first step.

More about Dr. Schwartz and his practice can be found at http://www.southbaytreatment.com/joel-schwartz-psy-d

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Applying for Social Security Disability Benefits Due to Mental Illness: A Guest Blog

Applying for Social Security Disability with Mental Illness

 

The symptoms of a mental illness can make it impossible to work. For example, those who suffer from bipolar disorder may have days when it is impossible to get out of bed. Their frequent mood swings may make it impossible to maintain gainful work activity. Fortunately, if you are unable to work due to a mental illness, you may be able to get help in the form of Social Security Disability benefits.

 

There are two types of disability benefits that disabled workers may qualify for. These include Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

 

Qualifying for SSDI

 

In order to qualify for SSDI you must have earned enough work credits through your past work history. As of 2013, for each $1,160 you earn, you get 1 work credit. You can earn up to 4 work credits each year.

 

If you are under age 24, you will need 6 work credits to qualify for SSDI benefits. If you are between the ages of 24 and 30, you will have need to have worked half of the time since turning age 21. For example, if you are 27, you will need to have worked three of the past six years in order to qualify for benefits. If you are age 31 and over, you will need 20 work credits in order to qualify for SSDI benefits.

 

If you are applying for disability benefits and do not have enough work credits to qualify for SSDI benefits, you may be able to qualify for SSI benefits.

 

Qualifying for SSI

 

SSI is a needs-based program. Your household income must not exceed $710 per month as an individual or $1,060 per month as a couple. There are also restrictions on your household assets. You must not have more than $2,000 in assets as an individual or $3,000 in assets as a couple.

 

Medically Qualifying for Benefits with a Mental Illness

 

If you meet the above-mentioned criteria for either SSDI and/or SSI benefits, then you must still prove that you are disabled in order to be eligible to qualify for Social Security Disability benefits. The easiest way to prove that you have a disability that prevents you from working is to provide medical documentation showing that you suffer from a condition that has been listed in the Social Security Administration’s Blue Book. The Blue Book is a list of all of the conditions that could qualify an individual for Social Security Disability benefits.

 

The Blue Book does list specific mental illnesses that could qualify an individual for disability benefits. These include:

 

  • Organic mental disorders
  • Schizophrenic and other psychotic disorders
  • Affective disorders
  • Mental retardation
  • Anxiety-related disorders
  • Somatoform disorders
  • Personality disorders
  • Substance addiction disorders
  • Autistic disorders
  • Pervasive developmental disorders

 

For more information on medically qualifying for benefits, visit: http://www.disability-benefits-help.org/disabling-conditions/mental-disorders

 

Applying for Benefits

 

You can apply for Social Security Disability benefits online (http://www.ssa.gov/applyfordisability/) or in person at a local Social Security Office. When you go to apply, you will be asked to fill out a number of forms. Make sure you fill out each form in its entirety and answer all questions with thorough and detailed answers. The more detailed you are in your answers, the easier it will be for the SSA to understand how you qualify for benefits. Also make sure you provide sufficient medical evidence and clinical documentation to support your claim.

 

 

Article by Ram Meyyappan
Social Security Disability Help

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Dr. David Lisak

Born in Montreal to a WWII widow, the clinical and forensic psychologist talks about the sexual abuse he experienced as a boy, the stigma and confusion adult male survivors grapple with and ultimately how he healed.  Episode is sponsored by www1in6.org which he co-founded.

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Life in Both Chairs: A Therapist’s Struggles – Guest Blog by “Stan F.”

Life in Both Chairs

 

I’ve been listening to this podcast for about a month now, and I’ve been so happy that one of my clients introduced it to me. It’s completely different to hear these incredible stories of pain, loss, and healing outside of my office and to engage with them as a survivor of mental illness, rather than a therapist. I don’t tell my clients about my personal experiences with mental illness (hence the anonymity), even though there are times when I really, really want to. Currently I’m a graduate student in a counseling psychology program, but five years ago I was depressed, suicidal, and hopeless. This is a (very) abridged account of how I went from client to counselor.

It’s actually a little surprising that it took me so long to seek therapy. I made it through two years of physical abuse (between the ages of 5 and 7, when my aunt looked after me) and several panic attacks throughout childhood and adolescence, but eventually it was depression that made me look for outside help. The symptoms of depression started in my last year of high school, and came to a head the summer before my first year of university. I spent the summer away from home, living with a friend in a different city while washing dishes in a restaurant downtown. I started drinking more, and it became a problem almost immediately. I was no stranger to alcohol at this point; I’d experimented with booze and drugs in high school but this was different. I’d never used them to purposefully numb myself before. It turned out that not feeling anything felt pretty good. When I was drunk I didn’t need to feel like a freak for my panic attacks, I didn’t need to worry about university, and I didn’t need to think about my abuse or why my parents didn’t do anything when they found out about it. All of the things I’d been carrying in my head up to that point were just too much. I felt small and alone, I didn’t really know how to trust people, and I was tired of pretending to like the person I’d become. Stopping by the liquor store every day on the way home from work became a habit. I was underage, but I managed to find ways around that. I’d drink with my buddies on their nights off, but if they weren’t free I’d just drink alone. I spent almost every night in a stupor and usually passed out instead of going to bed.

At work I started to fantasize about hurting myself. I worked in the dish pit and occasionally moonlighted in kitchen prep, so there were plenty of opportunities. I remember this machine we used to turn huge slabs of beef into sandwich meat had a massive spinning blade, and how easy it would have been to lose a finger in it, or even a hand if something really went wrong. I reasoned that I’d either go to the hospital, go on workman’s compensation, and not have to work for whiskey money, or I’d die from blood loss. I was sick enough at the time that either seemed like a win for me. Before I could put this plan into action, some friends confronted me about my alcohol use, and I agreed to move back in with my parents to sort things out.

My family still doesn’t make a whole lot of sense to me. My parents are very supportive people, but my relationship with them was strained at that time. I was 6 when I told my parents my aunt had been beating me, but they didn’t believe me until I was 7 and she’d started leaving marks that were harder to explain away. For many years after that I had a hard time trusting them and kept my problems to myself. This time wasn’t much different. I moved back in with my parents for a short while, but I was still drinking (somewhat sneakily), I barely ate, and I spoke very little. I ended up drying out by living with my Mennonite relatives for the rest of the summer, earning money working on the farm.

I went further downhill when I went to university. I moved in with a girl who suffered from an eating disorder, and we turned into just about the worst match you could get. We’d been dating since high school, and we lived in this little studio apartment together.  Maybe it could’ve worked if either of us had been healthy, but we were both too sick to love ourselves, let alone someone else. We blamed each other for our problems and just sat around hating one another in 300 square feet with bad lighting. When we broke up I moved into a small university dorm and hit rock bottom. I went to class in my pajamas or dirty clothes, then I’d go right back to my room to bed. While I’d gotten my drinking under control over the summer, I was still very much depressed. By then my thoughts of self-mutilation had turned to persistent thoughts of suicide. Every subway train or tall campus building was an opportunity. During Christmas break that year I walked into my parents’ garage with car keys and a drainpipe extension late at night. I can’t remember if there was anything that had happened that day that pushed me; I think I was probably just tired of fighting. I had lost almost a quarter of my bodyweight, I looked emaciated, and I was shaving my head to hide the fact that I rarely bathed. I was pretty disgusted with what I was becoming, but I didn’t have the energy to be anything else. I connected the extension to the car exhaust, but I didn’t start the car. I just sat there with my hands on the keys for an hour so, then put the extension away and went to bed.

Shortly afterward, I decided to do what friends and family had been pleading with me to do: go on medication. I’d refused up to that point, because I thought going on meds was admitting defeat. To go on meds was to say that the world was too much for me; that I was weak. Sitting in that car with a drainpipe extension cinched up in the power windows made me change my mind about what defeat really meant. It still scares the shit out of me how it would have been all too easy to turn the keys, sit back, and wait to go to sleep. A week later, I started on citalopram.

Coming back from that point wasn’t easy, but I was very lucky. Medication works for some people, and doesn’t for others. I’m lucky it worked as well as it did for me. I’m lucky I had access to the medical resources I did. I’m lucky I had a family that was willing to support me even though I made it far from easy for them. I’m lucky I’m still here and training for a job where I’ll get to help people through times like I had and worse. I’m really, really fucking lucky I didn’t turn the keys.

The last thing I want is for someone to read this and decide that therapy might not help them, or that it’s a waste of time. I may have needed meds to get my head back on straight, but once that happened therapy was what helped me turn my life around. After almost a year of barely speaking to anyone and only leaving my room for meals and class, therapy provided me with a place to re-learn how interact with the world and the people in my life. It worked incredibly well, especially considering I hadn’t been all that well adjusted to begin with. I made friends with people who were also healing from their own battles, and we helped each other through the hard times that inevitably come with becoming a new person.

I’m a far cry from that garage now. I’m halfway through my graduate program, and this week I’ll clock my 50th clinical hour. I still take my meds, and I still kind of get side effects. I still have good days and bad days. Healing takes time, no matter your diagnosis. I see five to six clients a week now, and I think each of them is so brave for fighting the fight they wake up to every day. I secretly admire them all. I often want to tell them my story, especially during difficult sessions. I don’t want their sympathy or even to enhance my credibility; I just want them to know that mental illness can happen to anyone and that it doesn’t have to define who you become. If you’ve come to this site because of your personal experience with the subject matter then please, please, please don’t give up on yourself. Talk to your medical professional. Tell people you trust that you need help. Find a therapist.  Life can absolutely get better, and at the very least it’s worth a try.

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Erica Rhodes

The actress (Prairie Home Companion, Big Sky) was raised by artistic and intelligent but emotionally reserved parents (her father has MS, her mother is a concert violinist); Erica was emotionally volatile as a child.  Recently diagnosed with Bipolar II, she discusses the suicide attempts, paralyzing depression, mania and people pleasing as well as learning to manage her illness.

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12 Things No One Told Me About Sex After Rape: A Guest Blog by CJ Hale

 (reprinted, originally posted on www.thoughtcatalog.com June 13, 2013)

There is a strange sort of unspoken theory that once a woman has been raped, sex is no longer a viable option for her. Sex has been replaced by trauma, fear, pain, and anxiety. I’m not saying this is never the case. Every survivor’s story and experience is different, but too often the assumption is that if you have been raped, you are sexually broken and forever unfixable. That sort of discourse is not healthy or empowering or even sympathetic. What I want to say is what I wish I had been told: rape is not a form of sex, it is a form of assault. Sex feels good. Assault is traumatizing. It is possible for sex to exist after rape because they are different experiences, just like it’s possible for you to still enjoy going out to eat even if you got food poisoning once. You might never go back to that restaurant again, but it doesn’t mean you will get food poisoning every time you go out.

Admittedly, I don’t know what sex before rape is like. I lost my virginity to rape at 14. People are willing to give a lot of guidance on what a survivor is supposed to do after her rape. Do not change clothes. Do not shower. Have someone you trust take you to the hospital. Report it immediately to law enforcement. Reach out to loved ones, find a therapist, become an advocate for other survivors. But it’s been 10 years and these are the things nobody told me about sex after rape:

1. Nobody tells you that you’ll feel guilty the first time you have a crush on a guy after your rape. Aren’t you supposed to hate men now? I mean, ugh, penises are evil and one ruined your life. You shouldn’t even be thinking about boys. That’s what got you in trouble in the first place. (Oh, hey rape culture, how’d you get here?)

2. Nobody tells you that you’ll be called a tease when you draw the line at making out. Even though you’re pretty proud of yourself for this minor victory on your path to regaining any confidence in expressing your sexuality, some people will think you’re a prude because you won’t take off your pants.

3. Nobody tells you that the first time you do take off your pants in front of a potential partner you’ll cry almost immediately and put them back on, leaving without an explanation. You’ll feel embarrassed and stupid and you’ll wonder if you’re ever going to be capable of intimacy ever again.

4. Nobody tells you that masturbation is a healing practice (OK, maybe your therapist suggested it once or twice) and that realizing you’re capable of sexual satisfaction after rape is an incredible, powerful feeling. Sometimes it takes a while to feel wholly reunited with your body in this way, and you’re allowed to take all the time you need. Sexual exploration is a journey, not a destination.

5. Nobody tells you that your PTSD symptoms will be scoffed at. Your boundaries will be called “arbitrary” and you will be accused of “wielding sex as a weapon” and “putting yourself on a pedestal.” Someone should tell you that people who say these things are the worst type of people to be around. They have no right to make you feel ashamed, but they will. If they have the potential to get angry about the choices you make about what you do with your body, they are not worth your time or energy or thought or love. But nobody tells you that.

6. Nobody tells you that the ‘rape talk’ will be a thing that has to happen before any romantic relationship gets too serious. Nobody lets you know that immature men will freak out and refer to your rape as “baggage” when they cut things off. And unfortunately, nobody mentions that some men will hold your hand and weep with you when you tell them, because they can’t believe anyone would be capable of hurting you.

7. Nobody tells you that there are men who are patient and kind. Some men will listen and support you and they will read and research and seek to understand. They will ask you what you like and what you don’t like, they will be explicit about their concerns, and they will treat you with respect and dignity.

8. Nobody tells you that the first few times you try sex again it might not go well. You might have a panic attack or a flashback, and you might scream or shake or cry or throw up or all of the above. What they should tell you is that the right partner will stroke your back or make you tea or hold your hair back for you. He’ll leave if he’s asked and he’ll keep his phone on him so you can talk if you need to.

9. Nobody tells you that the first time you successfully, enjoyably have sex again is empowering, and freeing, and overwhelming. Even if it only lasts two minutes, it will feel like an enormous victory. You will be happy in a way you weren’t sure you would be happy again.

10. Nobody tells you that it doesn’t work that way every time. PTSD isn’t cured by one blissful experience, and anxiety is a bitch. Sometimes you will burrow down deep in your comforter and wish you could just be NORMAL and have NORMAL sex like a NORMAL person. And it is frustrating. But you will remember that one bad experience does not negate your ability to have future good experiences. And you will drink your tea and feel better.

11. Nobody tells you that people are capable of loving you after you’ve been raped, and that you are capable of loving back. You are allowed to give yourself to someone completely. Likewise, you are allowed to hold back. You are allowed to be fearful but you are also allowed to trust again. Your healing process is your own and regardless of how you get there, know that as long as you are taking care of yourself, nobody has any right to tell you differently.

12. Nobody tells you that just because he’s the first boy you slept with since your rape doesn’t mean you have to fall in love with him. You don’t “owe” anyone else your love or happiness or body. You can be thankful and appreciative and comfortable, but if he’s not “the one,” don’t settle just because he treated you better than your rapist.

You’re going to have good days and bad days. You’re going to have good sex and bad sex. But you’re still alive, and I just thought maybe someone should tell you.

CJ Hale is a high school teacher and proponent of speaking one’s mind. Her work is featured under various pen names in undisclosed locations, but she is thrilled to find her writing on Thought Catalog. Her greatest hope is that others will read her stories and be inspired to share their own. She can be contacted at CJHalesWrites@gmail.com and welcomes your words.

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Scott Thompson Live in Toronto

The comedian/actor/writer (Kids in the Hall, Larry Sanders, Hannibal) opens up about his childhood in Brampton Ontario, coming to terms with his sexuality, especially the bullying that eroded his self-esteem and the lack of support from many in the gay community when he came out in the early nineties.   He also shares about a traumatic and violent even at his middle school that he considers seminal and his past battle with cancer.  This episode was recorded at the Rendezvous With Madness Film Festival.

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Susanna Brisk

Borderline Personality Disorder is often misunderstood.  The blogger, author, performer and mom explains what it’s like to live with, how to manage it and when it’s most challenging.  She also shares about her emotionally volatile childhood with her Russian Jewish relatives who emigrated from Estonia to Australia and being the mother of two boys.  She also shares about living with the idea that her performing dreams may never come true.

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