Complex PTSD

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Complex PTSD Page 13

by Pete Walker


  Right-Brain Dissociation

  It is often the scapegoat or the most profoundly abandoned child, “the lost child”, who is forced to habituate to the freeze response. Not allowed to successfully employ fight, flight or fawn responses, the freeze type’s defenses develop around classical or right-brain dissociation. Dissociation allows the freeze type to disconnect from experiencing his abandonment pain, and protects him from risky social interactions - any of which might trigger feelings of being retraumatized.

  If you are a freeze type, you may seek refuge and comfort by dissociating in prolonged bouts of sleep, daydreaming, wishing and right-brain-dominant activities like TV, online browsing and video games.

  Freeze types sometimes have or appear to have Attention Deficit Disorder [ADD]. They often master the art of changing the internal channel whenever inner experience becomes uncomfortable. When they are especially traumatized or triggered, they may exhibit a schizoid-like detachment from ordinary reality. And in worst case scenarios, they can decompensate into a schizophrenic experience like the main character in the book, I Never Promised You a Rose Garden.

  Recovering From A Polarized Freeze Response

  Recovery for freeze types involves three key challenges.

  First, their positive relational experiences are few if any. They are therefore extremely reluctant to enter into the type of intimate relationship that can be transformative. They are even less likely to seek the aid of therapy. Moreover, those who manage to overcome this reluctance often spook easily and quickly terminate.

  Second, freeze types have two commonalities with fight types. They are less motivated to try to understand the effects of their childhood traumatization. Many are unaware that they have a troublesome inner critic or that they are in emotional pain. Furthermore, they tend to project the perfectionistic demands of the critic onto others rather than onto themselves. This survival mechanism helped them as children to use the imperfections of others as justification for isolation. In the past, isolation was smart, safety-seeking behavior.

  Third, even more than workaholic flight types, freeze types are in denial about the life narrowing consequences of their singular adaptation. Some freeze types that I have worked with seem to have significant periods of contentment with their isolation. I think they may be able to self-medicate by releasing the internal opioids that the animal brain is programmed to release when danger is so great that death seems imminent.

  Internal opioid release is more accessible to freeze types because the freeze response has its own continuum that culminates with the collapse response. The collapse response is an extreme abandonment of consciousness. It appears to be an out-of-body experience that is the ultimate dissociation. It can sometimes be seen in prey animals that are about to be killed. I have seen nature films of small animals in the jaws of a predator that show it letting go so thoroughly that its death appears to be painless.

  However, the opioid production that some freeze types have access to, only takes the survivor so far before its analgesic properties no longer function. Numbed out contentment then morphs into serious depression. This in turn can lead to addictive self-medicating with substances like alcohol, marijuana and narcotics. Alternatively, the freeze type can gravitate toward ever escalating regimens of anti-depressants and anxiolytics. I also suspect that some schizophrenics are extremely traumatized freeze types who dissociate so thoroughly that they cannot find their way back to reality.

  Several of my freeze type respondents highly recommend a self-help book by Suzette Boon, entitled Coping with Trauma-related Dissociation. This book is filled with very helpful work sheets that are powerful tools for recovering.

  More than any other type, the freeze type usually requires a therapeutic relationship, because their isolation prevents them from discovering relational healing through a friendship. That said, I know of some instances where good enough relational healing has come through pets and the safer distant type of human healing that can be found in books and online internet groups.

  Phyllis, a self-proclaimed couch potato, began therapy with me with a great deal of ambivalence. Her third brand of anti-depressants no longer worked and her daily pot use was making her increasingly paranoid. Fantasies of dying were becoming more frequent and morbid. She told me: “I know therapy won’t help, but I’m afraid my husband is going to leave me. He says I’m starting to scare him.”

  Phyllis managed being married because her husband paid the bills and left her alone with her TV shows, science fiction books and online browsing. Additionally he was a workaholic, rarely around and gone in the computer when he was home.

  In our therapy, trust building was a long gradual back and forth process. This is not un common with many survivors, regardless of their 4F type.

  Phyllis’s dark sense of humor was a saving grace, and helped her weather my psychoeducation. She frequently met my attempts to link her current suffering and her awful childhood with sarcastic rebuttal. Fortunately, growing up in New York gave me some resilience to sarcasm. I was willing to weather her sardonic sense of humor because there was no mean spiritedness in it.

  Eventually I was able to help her direct the angry part of her sarcasm at her bullying family. With that, my psychoeducation finally began to seep in with a ring of truth. She gradually began to angrily vent about her father’s sexual abuse, her mother’s silent collusion, and all of the family using her for target practice. This in time morphed into crying which rewarded her with her first ever experience of self-compassion.

  It was not until we reached this stage, some years into the therapy, that Phyllis got a glimpse of the vicious inner critic that persecuted her. Prior to this she rebuffed my “critic ravings” as absurd. When we progressed sufficiently with the inner critic, the same process occurred with my hypotheses that she had a great deal of underlying fear and anxiety that was keeping her housebound. She laughed with a great deal of ironic amusement: “Look at me, Pete! Nothing scares me. I am so relaxed that I can hardly hold my body up in this chair. Jeez! You know I’m always nodding out. My husband calls me ‘Mellow Yellow.’”[Phyllis is blonde].

  A breakthrough eventually happened here when she passed a man on the sidewalk outside my office that was a doppelganger for her father. She came into the session on the verge of hyperventilating. As I helped her slow and deepen her breathing, she had a therapeutic flashback in the office. She had a horrifying memory of her father sneaking into her bedroom at night. Much grieving then resolved this particular flashback to her sexual abuse.

  Phyllis’s denial shrunk significantly in this session. She really “got” that social anxiety was imprisoning her on her couch. Deep level recovery work then ensued from this point in time, and culminated with Phyllis feeling emboldened enough to go back to school. She went on to become a medical assistant. This in turn opened the door to her finding a meaningful place in the outside world. A key part of the meaningfulness was the healthy friendship that she developed with a fellow worker who was also in recovery.

  The progression of recovery for a freeze type is often as follows. Gradual trust building allows the recoveree to open to psychoeducation about the role of dreadful parenting in his suffering. This then paves the way for the work of shrinking his critic, which in turn promotes the work of grieving the losses of childhood. The anger work of grieving is especially therapeutic for freeze types as is an aerobic exercise regime. Both help resuscitate the survivor’s dormant will and drive.

  THE FAWN TYPE AND THE CODEPENDENT DEFENSE

  Fawn types seek safety by merging with the wishes, needs and demands of others. They act as if they believe that the price of admission to any relationship is the forfeiture of all their needs, rights, preferences and boundaries.

  The disenfranchisement of the fawn type begins in childhood. She learns early that a modicum of safety and attachment can be gained by becoming the helpful and compliant servant of her exploitive parents.

  A fawn type/codependent is usually
the child of at least one narcissistic parent. The narcissist reverses the parent-child relationship. The child is parentified and takes care of the needs of the parent, who acts like a needy and sometimes tantruming child.

  When this occurs, the child may be turned into the parent’s confidant, substitute spouse, coach, or housekeeper. Or, she may be pressed into service to mother the younger siblings. In worst case scenarios, she may be exploited sexually.

  Some codependent children adapt by becoming entertaining. Accordingly, the child learns to be the court jester and is unofficially put in charge of keeping his parent happy.

  Pressing a child into codependent service usually involves scaring and shaming him out of developing a sense of self. Of all the 4F types, fawn types are the most developmentally arrested in their healthy sense of self.

  Recovering From A Polarized Fawn Response

  Fawn types typically respond to psychoeducation about the 4F’s with great relief. This eventually helps them to recognize the repetition compulsion that draws them to narcissistic types who exploit them.

  The codependent needs to understand how she gives herself away by over-listening to others. Recovery involves shrinking her characteristic listening defense, as well as practicing and broadening her verbal and emotional self-expression.

  I have seen numerous inveterate codependents become motivated to work on their assertiveness when they realize that even the thought of saying “no” triggers them into an emotional flashback. After a great deal of work, one client was shocked by how intensely he dissociated when he contemplated confronting his boss’s awful behavior. This shock then morphed into an epiphany of outrage about how dangerous it had been to protest anything in his family. This in turn aided him greatly in overcoming his resistance to role-playing assertiveness in our future work together.

  With considerable practice, this client learned to overcome the critic voices that immediately short-circuited him from ever asserting himself. In the process, he remembered how he was repeatedly forced to stifle his individuality in childhood. Grieving these losses then helped him to work at reclaiming his developmentally arrested self-expression. Recovering from the fawn position will be explored more extensively in the next chapter.

  TRAUMA HYBRIDS

  There are, of course, few pure types. Moreover each type is on a continuum that runs from mild to extreme. Most trauma survivors are also hybrids of the 4F’s. Most of us have a backup response that we go to when our primary one is not effective enough. When neither of these work, we generally then have a third or fourth “go to” position. Here are some common hybrid types.

  The Fight-Fawn Hybrid

  The Fight-Fawn type corresponds with the charming bully described earlier. This type combines two opposite polarities of relational style – narcissism and codependence. Narcissistic entitlement, however, is typically at the core of the fight-fawn type. This type, in the extreme, can also be Borderline Personality Disorder [BPD]. She can frequently and dramatically vacillate [split] between a fight and fawn defense. When a fight-fawn type is upset with someone, she can fluctuate over and over between attacking diatribes and fervent declarations of caring in a single interaction.

  The fight-fawn is more deeply understood by contrasting him with the fawn-fight, described in the next chapter. This fawn-fight type is also subject to vacillating during an emotional flashback, but typically does so with less vitriol and entitlement.

  The fight-fawn also differs from the fawn-fight in that his “care-taking” often feels coercive or 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. This essentially narcissistic type is also different than the fawn-fight in that entitlement is typically much more ascendant in the fight-fawn. His fawn behavior is typically devoid of real empathy or compassion.

  I have worked with several clients who were unfairly labeled borderline by themselves or others. I could however tell by the quality of their hearts, that they were not. This was evidenced by their essential kindness and goodwill to others, which they always return to when the flashback resolves. They also exhibit this in their ability to feel and show true remorse when they hurt another, as we are all destined to do from time to time. Unlike the true borderline who has a narcissistic core, they can sincerely apologize and make amends when appropriate.

  Another variant of the fight/fawn is seen in the person who acts like a fight type in one relationship while fawning in another. An example of this is the archetypal henpecked husband who is a tyrant at work, and who also stays at work to all hours because he so prefers the fight stance. This type also occurs in reverse: monster at home and lovely lady at the office.

  The Flight-Freeze Hybrid

  The Flight-Freeze type is the least relational and most schizoid hybrid. He prefers the safety of do-it-yourself isolationism. Sometimes this type may also be misdiagnosed as Asperger’s Syndrome.

  The flight-freeze type avoids potential relationship-retraumati-zation with an obsessive-compulsive/dissociative “two-step.” Step one is working to complete exhaustion. Step two is collapsing into extreme “veging out”, and waiting until his energy reaccumulates enough to relaunch into step one. The price for this type of no-longer-necessary safety is a severely narrowed existence.

  The flight-freeze cul-de-sac is more common among men, especially those traumatized for being vulnerable in childhood. This then drives them to seek safety in isolation or “intimacy-lite” relationships.

  Some non-alpha type male survivors combine their flight and freeze defenses to become stereotypical technology nerds. Telecommuting is, of course, their preferred mode. Flight-freeze types are the computer addicts who focus on work for long periods of time and then drift off dissociatively into computer games, substance abuse or sleep-bingeing.

  Flight-freeze types are prone to becoming porn addicts. When in flight mode, they obsessively surf the net for phantom partners and engage in compulsive masturbation. When in freeze mode, they drift off into a right-brain sexual fantasy world if pornography is unavailable. Moreover, if they are in intimacy-lite relationship, they typically engage more with their idealized fantasy partners than with their actual partner during real time sexual interactions.

  The Fight-Freeze Hybrid

  These types rarely seek recovery on their own initiative. A colleague of mine told me about a fight-freeze type who was dragged into therapy by his wife. She complained that she was lucky to get ten words out of him in a week. She was at the end of her rope and if therapy did not fix him, she was filing for divorce.

  The husband was a computer engineer who telecommuted and only left his home office for bathroom breaks and meals which were eaten separately from his wife. He bullied his wife into providing these meals according to a written schedule that he e-mailed to her.

  My colleague’s initial “Hello” to the husband was met with a scowl and a grunt. Intuitively, she kept the focus off him as much as possible, but each delicate attempt to make connection with him was rebuffed with sarcastic scorn. “You expect me to fall for that phony smile?”; “You’re not gonna shrink me with your psychobabble!”

  My colleague, who is the most compassionate, non-intrusive person I know, was not able to crack the prickly fight shell that guarded this poor man’s extreme social withdrawal. No miracle was performed, and my colleague said she was amazed in retrospect that he even lasted twenty minutes before he left in a wake of hostility and resentment.

  I have met with fight-freeze types a few times in similar circumstances, i.e., they were dragged into therapy under the threat of divorce. Each was like the character in the famous poem: “The Autocrat at the Breakfast Table.”

  The fight-freeze is a yin or passive narcissist. He demands that things go his way, but he is not much interested in having any h
uman interaction. No one gets to talk at the table, not even him – unless of course someone needs to be put in their place.

  The fight-freeze type is a John Wayne couch potato, dominating family life with foul moods and monosyllabic grunts and curses. He is typically as untreatable as the extreme fight types mentioned earlier.

  SELF-ASSESSMENT

  I recommend that you self-assess your own hierarchical use of the 4F responses. Try to determine your dominant type and hybrid, and think about what percentage of your time is spent in each of the 4F responses.

  You can also assess where you lie on the relevant continuums that stretch between the two extremes in each line of the chart below.

  Continuums of Positive and Negative 4F Responses

  Fight: Assertiveness Bullying

  Flight: Efficiency Driven-ness

  Freeze: Peacefulness Catatonia

  Fawn: Helpfulness Servitude

  Recovery And Self-Assessment

  As stated earlier, a key goal of recovery is to have easy and appropriate access to all of the 4F’s. There are also two more continuums that can be used to assess this. The degree to which we are balanced along each of them reflects the degree of our healing.

  The Fight Fawn Continuum of Healthy Relating to Others

  Healthy relating occurs when two people move easily and reciprocally between assertiveness and receptivity. Common and important examples of this are an easy back and forth [1] between talking and listening, [2] between helping and being helped, and [3] between leading and following.

  Normal healthy narcissism and codependence happen at the midpoint of the continuum. To the degree that I polarize to the narcissistic/fight end of the continuum, I monologue and dominate the conversation. To the degree that I polarize to the codependent/fawn end, I get stuck in a listening defense, hiding from the vulnerability of showing what I think and feel.

 

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