Silent Type,
I wrote a hideously long post - and I am afraid you will be wishing that I had been the 'silent type' instead. But, I didn't want to leave anything out in case it could be useful.
I first went to therapy for SA about 4 and half years ago. I would later learn that this therapist preferred to use 'behavior therapy' in his practice but that I had issues in the way of his employing behavioral therapy as he would like so alot of our time (2.5 years) would be spent working on perceptions that I had about my life and my past that were wrong. Please don't let the 2.5 years discourage you - I had alot of other problems in addition to SA and I had to work on those too.
We talked extensively about my family growing (a popular theory is that we grow up believing what people around us think of us. So in theory I was ashamed of myself and avoiding other people because, perhaps, my family's attitude toward me wasn't all that positive). In many hours of our weekly therapy - we seemed to be debating what my past was and wasn't like. Changing my view of my past was very hard, took alot of disagreeing and arguing etc. until I could begin to see things more accurately. For example - I said that my parents loved each other very much. Oh my counselor and I argued about that alot (not anger arguing - frustration arguing). Eventually I came to realize that my father really didn't my mother like I thought he did - why else would he make one decision after another that made him happy and broke her heart? FOr years? For their entire married life? He abandoned her when she got cancer etc. but I always believed that they loved each other so much because they taught me to believe that. One element after another - we combed through my life, asking questions like "is THIS how people who love each other, treat one another?" etc. Until I viewed the details of my life through a more balanced lens. This helped in my case because I really had been unhappy in my childhood, so had my parents, but as long as I considered them as happy as a person could possibly be - I was going to avoid people, marriage, family etc. because with my warped view - the very best I could hope for in life was people hurting people, including me.
Once we cleared that hurdle, I had to revisit the two years surrounding my mother's death to understand my role in taking care of her etc. because as long as I believed that I should have taken better care of her (as if that would have made her survive instead of die) then I would tend to avoid people getting close to me. It's as though I had a mental image of myself wearing a sign that said "I did everything I could but I failed the one I love completely" and I didn't want people to get close enough to read the sign. I processed many horrible feelings in therapy as my counselor challenged my thinking (more discussion and arguing). Throughout counseling, it has really helped me to write what I think, and then focus writing about things that make me feel twinges of pain or sadness. When I got close to buried painful topics, I went though 6 months of generalized anxiety disorder, for which I took Lexapro until the GAD went away. I had to uncover painful emotions that I never faced way back when, and now they were warped from my efforts to hide my thoughts from myself. Basically, I had to do alot of crying, grieving etc. I had to finish all the unfinished business.
I left therapy after 2.5 years with this counselor partly because he was beginning to work out of the country and was gone for months at a time, and partly because he was pushing me to 'ask a man out on a date!!!!" or to "attend parties" and that, to me, was absolutely unthinkable. I decided, sort of, that I couldn't be helped anymore, that I was glad I had more peace in my life etc. and that therapy improved my quality of life but that I would never recover. An important thing I gained, for awhile, was the deepest sleep I ever had in my life. I stopped counseling completely for about 6 months before I woke up hyperventillating in a panic attack one night. Back to therapy. I was on Prozac and Xanax for about 8 months until the panic attacks subsided.
THis time I saw a counselor who would describe her approach as CBT. Again in talk therapy, reveiwing my past and what I had learned, I found still more agonizing areas where my feelings (survivor's guilt and othesr) about my mother's death were hiding. I was so disgusted - 2.5 years of counseling and here I was stuck on the same topic?? But - the truth is, that first 2.5 years was neccessary and it made the next phase of counseling possible. After about another 1.5 years of counseling, focusing on my family life, what my feelings were for them, how I was treated, how I treated them, what was reality, - I finally healed in a few more ways. Last Christmas I finally realized (more grieving and crying - but this time - relief) I realized that I really 'did ok' taking care of my mother, and that she tried to tell me that, and that she didn't give up fighting cancer because I disappointed her etec.' The psychological relief was so profound that I started having intense anxiety because I was no longer sure 'who I was'. My thinking was something like "Well, if I didn't let her down, as I now realize this, then I am not who I thought I was all these years. And if I am not she-who-fails, then WHO AM I???" These beliefs I have about my identity are largely tied to my family and how I perceived them, and how they perceived me, and how I THOUGHT they perceived me etc. And when they are finally matched up to reality, then my opinion of myself has to change, to absorb the updated info. Now - a few months after I realized that I was 'ok' in my family, that I wasn't a sign-wearing failure, I started to have suprising experiences with my SA. For example, I accidentally attended an evening gathering at someone's house. It's as though I forgot to be afraid. I was so confused, sitting in a chair in the house, looking around, asking myself "Now WHY was I afraid to come here before???" I wish I could say I was 'cured' but I am not. I CAN say that I really seem, after decades of trying, to be getting better. I have attended 5 gatherings (different types) with greater sucess - without forcing myself to get through the door - gritting my teeth through the whole thing - and then gettting depressed or crying later. These have been among the simpler challenges - I haven't done anything REALLY hard yet but I have, with a confused heart, gone places and socialized with people about 5 times in the past 3 months - and it has gotten, and is geting easier. No way could I ask a man out, or flirt with one! But the strange thing about the 5 little experiences that convince me that I have improved - it's confusing instead of hard.
I joined a 6 month group program (well....I really should count this as a sucess too because I could never attend a group like this before!) for women who were sexually abused in childhood. It is really tough. I am also still in therapy with my counselor. She would like me to work on restoring self esteem through positive exercises, (CBT) hypnosis (Kinda works for me), and learning how to take care of my feeligns and needs as if I matter. Because of my past I tend to ignore how I feel, especially if I feel bad, so I may miss meals, sleep, or hang around people who make me unhappy etc. I faced alot of grief in my life a few months ago by reading a book titled Boundaries (two books of the same name - both were good. I am Christian so I liked both books- those who do not have a spiritual faith may want to skip the one who's male author's last name is Cloud). THe concept of psychological boundaries we can use to protect ourselves in social situations brought up alot of pain because I realized that part of my fear of people is from being around people who were damaging, and not having in my mind boundaries that I could use to protect myself. For example, I let a family member rage at me for hours at a time. The book on Boundaries tries to teach people that you set limits and if people violate them, you leave, refuse to listen etc. This may be obvious to alot of people but it wasn't to me because I had such low self esteem I didn't believe I had the RIGHT to 'make someone feel bad' by walking away or ending a friendship etc. REading the books on Boundaries has been painful (looking at my past) and very encouraging because I began to feel like a party or other social situation would be more bearable if I could protect myself by being hurt by thoughtless or cruel people etc. I feel strange writing this becaus alot of people grew up with good boundaries, and I grew up with none. A follow up book to Boundaries (by the female author) is "Where to Draw the Line". These books have really changed my thinking and encourage me to 'risk' being around people a little more because I'm begining to feel like my feelings count too, and if they want to be hurtful, then they need to take care of their own hurt feelings if I avoid them or ask them not to speak to me that way.
As I told the people in the group for childhood sexual molestation, I begin to see that my family members had problems (as do I) and they did the best they could (as do I ) but that being molested was just one of the ways my self esteem was mangled as I was growing up. That while I was growing up, my family projected alot of painful rejection onto me ( I was stupid, slow witted, inconsiderate etc,) even as they professed to love me, value me etc. I soaked up their negative opinions and loved them so much I never questioned if they were right or wrong. By the time my perverted male babysitter came along, I had no training in making other people 'feel bad' for treating me bad. (Oh YEAH, like how would he like it if I screamed in his face what a pervert he was...hey THAT could hurt his feelings!)
The process of counseling has been setting the record straight about the past, defining what I was and wasn't responsible for, identifying ways that others opinions of me were wrong, identifying ways that my own opinion of myself was also wrong (for example "Random, If your whole family thought you were really that stupid, why did they all give you complete responsiblity for taking care of your dying mother, helping her die, when you were only 16, the youngest person in the family? Seems like an important task that you wouldn't give to an idiot....) The thing that has been hardest is all the grief - crying because I didn't cry back then, crying because I had to face the ways that I was psychologically abused and unloved etc. I am not done yet. But after 4 years of counseling, I can say that for the first time in my life I have experienced improvement. Good, peaceful sleep has returned. And those 5 little social efforts. It encourages me to to keep trying, wondering how much more ground I can claim for myself. I never had to face my family or tell them anything. I was able to do my grieving and anger (oh yes - there's rage that surfaces when you realize what the actual sitatuions were like) on paper and in private. Of course, it's easier for me because most of my family members are dead and so I don't have to 'face' them anyway. But for those who may read this and be thinking "Oh but I love my family and would never hurt them by thinking such horrible things" I want to add that what you think and feel dont' hurt them, you never have to tell them anything. You can heal without them ever knowing it - other than noting that you seem to feel better.
SOmetimes I wrote letters and then read them aloud alone at home, pretending my targets were there in the room listening, raging into the fireplace things I wish I had said back then. And the next mnoring, I felt like a little piece of my heart had returned. The crying, the anger, letting it out has helped. My current counselor just seems to understand me better, have better insight and a wider choice of techniques to employ than my prior one - but my prior counselor did a great job of arguing with me, never giving up on me, so I needed him too. Perhaps it all about seeing a counselor for as long as they personally know how to help you and when they have done all they can, going to another counselor and learning what you can from them.
Saying specifically what they do to help me can be hard - because I don't always know what they are doing. It sometimes seems like normal conversation.
My first counselor, aside from arguing with me, had me write letters to people who had harmed me, and had me read them to him, and then I burned them. He would listen while I read and point out ways I was still excusing others from taking responsiblity for their own actions/decisions or blaming myself etc. THis is something I could not have done for myself.
My second counselor focuses on talk therapy and sometimes uses printed materials based on the situation: For example, a list of statements two pages long that you agree or disagree with by marking an x next to each one. Then she went over them with me, one at a time, identifying which statments reveal ways or situations in which I don't respect or value myself. She would then discuss these with me, asking for my proof of my beliefs, identifying negative feelings that have just become unthinking habit, suggesting ways that what I believe is not accurate, giving me a few more pages to read about self worth. Since I am Christian, she will ask me what I think God thinks about me, and where my proof is. She may give me positive stories or things to read.
She has given me an inventory (a few pages long) of emotions and asked me to record how I feel during the day. ANd then went over it with me, asking me to notice what interactions or thoughts I engage my mind in actually make me unhappy or anxious etc. I am very unaware of what makes me feel good or bad (odd, isn't it) because I used to worry so much about how everyone else felt. She has used hypnosis, given me a positive reinforcemnt CD to listen to, and a small rock with the word 'HOPE' carved in it (she found rocks engraved with positive statements in a store somewhere and bought htem for her clients) because I have a very hard time with feeling hopeful - she wanted me to always 'know you have hope'. I would say the biggest help is setting the record straight (reality check that has taken me a few years) and now the next phase - restoring hope and learning how to make myself happy, take care of myself.
I've scanned the web for various treatment programs - it seems like some people respond very well it seems to a variety of methods, often of much shorter duration than my effort (but then I am dysfunctional in more ways than some people). For example, exposure therapy. I've read that exposure therapy can help people through anxiety in a matter of months - you practice going into situations and surviving it with support from others etc. All those other approaches I read about - seem to work for some and not others. I believe there are treatments out there that can help all of us, counselors out there who can push us a little further toward our goal of healing, we just gotta keep trying. Oh yeah, I say that now but I DID quit counseling in disgust a few times...but I am glad I always went back as soon as I could face it.
