Trapped Inside: An Underreported Nightmare

 I published this piece on Medium in the hopes of getting a wider audience for information that is not well-known and important for trauma survivors and health professionals. Here is the link.

The Orchid and the Dandelion

 One of the most interesting books I've read in the last couple of years is Thomas Boyce's "The Orchid and the Dandelion."  While I recommend you read the entire book, this interview with Boyce on National Public Radio is a good start. For 30 years, Boyce has been researching why some children, i.e. Orchids, are more vulnerable to both stress and positive things in their environment whereas others, i.e. Dandelions, are able to function despite a high level of adversity. His research studies on children in the 20th century are congruent with genetic research in the last 10 years that shows the a set of genes associated with a person's stress response is correlated both with a range of mental illnesses and with resiliency, depending on the environment. 

This research impacted me because it explains a lot of what I have experienced clinically and in my own life. As a Psychologist, I was struck by the way this concept opens up our understanding of resilience. The field of Psychology as well as the general public tends to think of resilience as the ability to function despite adversity, i.e. they are less sensitive to it. This is not the entire truth of resilience.

Orchids are often told by others that they need to "toughen up" because they are too sensitive, too emotional, dramatic, self-pitying, self-indulgent and "feeling sorry for themselves." Orchid children in abusive environments use their sensitivity to try to read the state of mind of their abusive parents and to predict their parents' behavior. They also sometimes survive an abusive parent by being emotional caregivers for them, anticipating their emotional needs and wishes. Orchid children in less abusive environments can experience things as overwhelming and even traumatic that might not seem objectively traumatic to others. This can cause conflict with Dandelion parents or spouses who may think they are helping their Orchid loved one by explaining to them they are overreacting and encouraging them to calm down. Orchids respond poorly to this and generally become even more emotionally dysregulated. 

An interesting thing is that well-supported Orchids are generally at least as resilient as Dandelions and tend to contribute significantly to society as they are naturally responsive to the needs of other people, animals, and the natural environment. Moreover, their emotional emotional wellbeing can improve significantly when given the right kind of support, perhaps explaining their tendency to make significant progress in psychotherapy when there are ready.

Disorganized Attachment

Many of my clients have a Disorganized attachment style. This is almost a given if you have a Dissociative Disorder and is also true for most clients with Complex PTSD. Having a Disorganized attachment style when you are young is a risk factor for many things, including both physical and mental illnesses. The following describes what it feels like to have a Disorganized attachment style.

I will do almost anything to avoid feelings of vulnerability that might elicit a need for an attachment figure. I may be almost entirely isolated or I may have set up relationships in my life such that attachment vulnerability is avoided. I may be comfortable seeing myself as the person who gives to others or rescues them from bad situations. Alternately, I may be focused on competing with others to prove my value, authority and knowledge and/or submitting to people who seem more powerful than me in order to get their approval. In all relationships, it is important for me to have a sense of control.

If I am forced to feel vulnerable by an external or internal trigger, I become undone emotionally and experience helplessness, panic, numbness, shame, and dissociation. It is also common that vulnerability triggers sudden flashbacks of neglect or abuse.

One reason I cannot find peace when my attachment needs are triggered is that I don’t have only one underlying attachment system. I will likely be pulled between extreme urges toward anxious and avoidant ways of attachment, mixed in with attempts to push away all attachment needs by getting a sense of control through a combination of addictive behaviors (i.e. drugs, alcohol, sex, gambling, overeating, self-injury) and/or relating to others in ways that make me feel in control (i.e. caregiving, rescuing, dominating, or submission.)  I never feel significantly safe alone or with others.  

Insecure-Avoidant Attachment

This attachment style is sometimes labeled Anxious-Avoidant or Dismissive. Many people with this attachment style do not realize they have any issues with attachment. 


The vast majority of the time, I feel self-sufficient and am often comfortable being alone. When personal vulnerability emerges, I have learned to automatically distract myself so that I am hardly aware of it. If the feeling is strong enough so that I’m aware of it, I am unlikely to seek support because I interpret that pain as personal weakness. Instead, I will likely isolate and distract myself more than usual and/or seek additional distraction through addictive behaviors (i.e. drugs, alcohol, sex, gambling, overeating, self-injury) until the negative feeling dissipates. I am vulnerable to being a workaholic or to overinvesting in activities that do not involve my attachment figures so that I can ignore my attachment needs. When others talk about attachment needs, it often makes no sense to me or they seem weak emotionally or morally (i.e. selfish, manipulative)

When there are important people in my life, I relate to them in a way that avoids vulnerability as much as possible. I am usually more comfortable seeing myself as the person who gives to others or rescues them from bad situations. Alternately, I may be focused on competing with others to prove my value, authority and knowledge and/or submitting to people who seem more powerful than me in order to get their approval. 

In my romantic relationships, my partner often complains I am not around enough or are not meeting their needs. I don’t really understand why s/he wants that closeness. As I don’t know how to fix that problem, I am likely to try to ignore it, submit superficially to the requests, or explain to them why they’re being unreasonable/ demanding/ needy.

Note to others: Most of the time, people with Avoidant Attachment do not consciously shut down their emotions and needs, but are skilled in avoiding an awareness of their emotions through distraction, a coping skill they’ve learned under the age of 1.

Insecure-Anxious Attachment

This attachment style is also called Anxious-Resistant and Preoccupied. While this is s stable way of relating to others, it can also be very painful. The following paragraphs describe what it is like to have this attachment style.


I prefer to be in the presence of my attachment figure(s). My need for the physical presence and/or words of connection from my attachment figure is fairly constant.  In the absence of this connection, I worry about whether they are forgetting about me, betraying me, and/or coming to harm from some outside source.

Even when I am physically with my attachment figure and they seem emotionally present and supportive, I cannot fully relax because I’m alert to the possibility I might lose them through death, rejection, or betrayal. If I sense any change in my attachment figure’s mood, it is easy for me to attribute that mood change to how they feel about me. This may lead me to ask (direct or indirect) questions asking questions as to whether they really care, whether they are cheating, whether they are in any risk of harm, etc. I’m also vulnerable to wanting to look at their phone, track them on their phone, talk to exes, and confirm with third parties about their whereabouts and activities.

When I feel abandoned, rejected and betrayed by an attachment figure, I am vulnerable to addictive behaviors (i.e. drugs, alcohol, sex, gambling, overeating, self-injury). Sometimes I perceive abandonments, rejections, or betrayals when my attachment figure has not left the relationship and did not intend to communicate rejection or to betray me.

My need to keep a constant eye on the emotionally accessibility and safety of my attachment figure can inhibit me from enjoying other things in my life and learning about things that interest me outside of what’s impacting my relationships.

Secure Attachment

This is a description of what it feels like to reach out to others when you have  secure attachment to them. Many of my clients cannot imagine what this would feel like.

When I feel vulnerable, it feels natural to turn to my attachment figures(s). When I turn to them, I can fairly quickly find comfort and my distress decreases. When I’m not around the people I’m attached to, I don’t have to worry that they will forget about me, leave me, or get angry at me. This allows me to enjoy other aspects of my life and learning about things that interest me. If my attachment figure does abandon, reject, or betray me, I have the ability to confront them and let them go if they are unhealthy.

I feel okay when I am alone and okay when I am with my attachment figure(s).

What is attachment?

We, along with all mammals, are born with the need to attach to others to survive. The attachment system is activated whenever we feel vulnerable (i.e. scared, sick, overwhelmed) and would ideally benefit from the comfort, support, and encouragement someone we perceive as stronger, wiser, and kind. Attachment behaviors show up at 6-9 months of age.  When we are young, our primary attachment figure is the parent most active in our day to day care and to a lesser extent whoever else is substantially involved in our care (i.e. the other parent, older siblings, grandparents, regular babysitters.)  Children typically rank their caregivers, e.g. choosing mom if she’s present, dad when mom is not around, and grandma when both parents are not there.  


When an attachment figure is able to provide protection and comfort and genuinely delights in the child, children learn healthy ways to cope with their emotions and to relate to other children and adults. When this does not happen, children struggle with more intense and extreme emotions (especially fear and anger) and/or overly constricted emotions. Their relationships with peers and other adults are marked by highly oppositional behavior, overly submissive behavior, and/or caregiving behavior.


When we are teenagers and adults, attachment figures are our closest family members, but also may include older siblings, best friends, romantic partners, and even an admired teacher, boss, pastor, or therapist. Research has shown that healthy attachments with people outside of the family in childhood and young adulthood are especially effective in mitigating the impact of unhealthy attachment patterns at home. Moreover, healthy attachment figures through the lifespan can help someone with difficulties forming a healthy attachment to develop progressively healthier relationships and more effective ways of coping with difficult emotions.


In the next four blog spots, I will write about the 4 attachment styles that develop in response to how we are parented: secure, insecure-anxious, insecure-avoidant, and insecure-disorganized.

How I Became a Warrior

 This poem was written by Jeff Foster. I think it's a fairly accurate and very moving description of what trauma good therapy helps you to do.                            

Once, I ran from fear

so fear controlled me.
Until I learned to hold fear like a newborn.
Listen to it, but not give in.
Honour it, but not worship it.
Fear could not stop me anymore.
I walked with courage into the storm.
I still have fear,
but it does not have me.

Once, I was ashamed of who I was.
I invited shame into my heart.
I let it burn.
It told me, “I am only trying
to protect your vulnerability.”
I thanked shame dearly,
and stepped into life anyway,
unashamed, with shame as a lover.

Once, I had great sadness
buried deep inside.
I invited it to come out and play.
I wept oceans. My tear ducts ran dry.
And I found joy right there.
Right at the core of my sorrow.
It was heartbreak that taught me how to love.

Once, I had anxiety.
A mind that wouldn’t stop.
Thoughts that wouldn’t be silent.
So I stopped trying to silence them.
And I dropped out of the mind
and into the Earth.
Into the mud.
Where I was held strong
like a tree, unshakeable, safe.

Once, anger burned in the depths.
I called anger into the light of myself.
I felt its shocking power.
I let my heart pound and my blood boil.
Listened to it, finally.
And it screamed, “Respect yourself fiercely now!”
“Speak your truth with passion!”
“Say no when you mean no!”
“Walk your path with courage!”
“Let no one speak for you!”
Anger became an honest friend.
A truthful guide.
A beautiful wild child.

Once, loneliness cut deep.
I tried to distract and numb myself.
Ran to people and places and things.
Even pretended I was “happy”.
But soon I could not run anymore.
And I tumbled into the heart of loneliness.
And I died and was reborn
into an exquisite solitude and stillness.
That connected me to all things.
So I was not lonely, but alone with All Life.
My heart One with all other hearts.

Once, I ran from difficult feelings.
Now, they are my advisors, confidants, friends,
and they all have a home in me,
and they all belong and have dignity.
I am sensitive, soft, fragile,
my arms wrapped around all my inner children.
And in my sensitivity, power.
In my fragility, an unshakeable Presence.

In the depths of my wounds,
in what I had named “darkness”,
I found a blazing Light
that guides me now in battle.

I became a warrior
when I turned towards myself.

And started listening.

Podcast Episode: Snap Judgment

I was very touched by this episode of Snap Judgment entitled Borders Between Us. It is the story of a man who has a difficult mother. He told her he wished she was dead shortly before she died. The shame he carries during a complicated grief process that takes years and how he ends up seeking healing are both moving and exemplary of the healing work that trauma recovery involves.

Complex PTSD

Many of my clients have something called Complex PTSD (C-PTSD). Despite the advocacy of trauma therapists and researchers, C-PTSD did not make it to the DSM-V but is hoped for in the ICD-11. In my experience, it is a very real disorder that impacts many areas of your life, including your emotions, the way you view yourself, and the way you experience others. Ongoing difficulties with interpersonal relationships, including avoiding others, choosing abusive people, and even fearing you are or will be abusive to a partner or child are common. For more about C-PTSD, I encourage your to read the following article, "What is C-PTSD?" To give you a sense of the article, here is the opening paragraph explaining why people develop C-PTSD:

"Complex PTSD comes in response to chronic traumatization over the course of months or, more often, years. This can include emotional, physical, and/or sexual abuses, domestic violence, living in a war zone, being held captive, human trafficking and other organized rings of abuse, and more. While there are exceptional circumstances where adults develop C-PTSD, it is most often seen in those whose trauma occurred in childhood. For those who are older, being at the complete control of another person (often unable to meet their most basic needs without them), coupled with no foreseeable end in sight, can break down the psyche, the survivor's sense of self, and affect them on this deeper level. For those who go through this as children, because the brain is still developing and they're just beginning to learn who they are as an individual, understand the world around them, and build their first relationships - severe trauma interrupts the entire course of their psychologic and neurologic development."

If this is you, medication alone will not be enough as it's not solely a genetic, biologically based disorder. While it can be really scary, the best things for you are building relationships with healthy non-abusive people and engaging in therapy over a long period of time with a trauma informed therapist. If you are looking for a therapist, make sure you ask any prospective therapist whether they have experiencing treating Complex PTSD. Also, make sure you choose someone who helps you to feel (relatively) comfortable with them. It commonly takes at least 6-8 sessions to know for sure whether you feel comfortable working with someone, but you may know as soon as the first or second session if you are not comfortable.

Healthy Relationship Triangle

This is a follow up post to my post "Karpmann Drama Triangle."  I created this triangle to help people understand what healthy alternatives were to the Drama Triangle.

In a healthy, mutual relationship between adults, both people will take turns playing all three roles. In a parent-child relationship, the Parent plays the Support and Assertive Role on behalf of his/her child and the Child plays the Vulnerable and Assertive Role on behalf of him/herself.

                                              Support Role


Assertive Role                                                              Vulnerable Role

Support Role

Someone else is hurting and I love them. For this reason, I will offer practical and/or emotional support to them. If I do not have what they need, it does not mean I do not care about them or are putting them in danger. It is not wrong to say no.

Assertive Role

Someone did something that hurt me or someone I care about. For this reason, I will assert myself on behalf of myself or someone I care about. I am not seeking retaliation. I respect the feelings and needs of the person I am talking to as I assert myself.

Vulnerable Role

I have natural needs for affection, attention, support, quality time, and encouragement from a Supportive Person. Vulnerability exists in everyone even if there is no Supportive Person or an inadequate Supportive Person. When I am in this role, I can choose whether or not to seek support, from whom, and how much I want to be vulnerable. I can also choose not to be in a relationship with someone and/or set boundaries with them while staying in relationship.

Karpmann's Drama Triangle

This is an elaboration of the Karpmann Triangle written by Dr. Lora Wiens as it applies to common roles abuse survivers and their therapists fall into.

In an abuse situation, there is an abuser(s), a victim(s), and often a third party who does or does not rescue the victim. For people who experienced abuse as children, these roles feel familiar and are compelling. When we have grown up in a home with abuse, we tend to fall into these roles in our adult relationships. These roles may feel compelling even when there is no actual abuse taking place. In a relationship between two adults who were abused as children, both people in the relationship are vulnerable to playing at least one of these roles, if not two or three. All three roles can also play out in our relationships with our children.

                                 Rescuer/Bystander

Abuser/Perpetrator                                           Victim 

Rescuer/Bystander

Someone is being abused and I must rescue them or I am morally culpable as a Bystander. If I do not rescue them, bad things will happen to them and it will be my fault.

Abuser/Perpetrator

Due to my actions, someone else is experiencing emotional, physical, or sexual abuse. In the moment of my actions, I am either oblivious to the impact of my actions on the person I am abusing and/or I actively want to cause them harm. I may feel in that moment that I am fighting the abusive actions or words of the one I am abusing.

Victim

I am being abused by someone else. I feel helpless to stop it. I feel my only choices are to submit to the abuser, dissociate and/or freeze. My lack of choice may be either because 1) someone else is actively coercing me or because 2) I am emotionally unable due to leave the situation or otherwise protect myself in that moment due to my trauma history.

A Video in Times of COVID19

I created this video for the Samaritan Counseling Center of the NW suburbs in Barrington, IL where I practice. But I thought it might be helpful for some of you as well. Here is the link from the Samaritan Center Facebook page:

Hello again!

My sister challenged me to consider resume working on my blog. This got me thinking about how I might use it in a way that would be helpful for both current clients and others. Most of my earlier entries were originally written by me. While I would like to continue posting things I write, I think it might also be helpful to share things that could be useful to others.

Since starting the blog, my focus as a clinician has become increasing focused on Complex Trauma and Dissociation. While Complex PTSD did not make it to the DSM-5, it will likely be in the ICD-11. Complex PTSD describes the trauma that occurs in response to conditions of repeatedly emotional and relational stress. People with Complex PTSD were usually victims of emotional, physical, and sexual abuse as well as neglect over a period of time as children. Their parents may have been simply overwhelmed with their own trauma, their losses, and/or triggers from their own childhood. They may have had personality disorders. At worst, they may have been sadistic or had psychopathic traits. The worst the abuse, the more likely you are to have not simply Complex PTSD but a Dissociative Disorder.

Given all of this, I want to share things, whether written by me or not, that I believe will be helpful to my clients with Complex PTSD and Dissociative Disorders. I hope that some of you find them helpful. Whether or not I end up being your therapist, please seek help if you need it. The healing path is a difficult one. But it in the only one to freedom, peace, and feeling more alive.