The Role of Helplessness in PTSD Symptoms and Other Disorders

As you may know, many people who experience traumatic events do not subsequently develop post-traumatic stress disorder (PTSD).  One of the determining factors seems to be the feeling of extreme helplessness at the time the trauma occurred:  people who don't feel helpless are able to process the experience in their usual way.  In language I've used elsewhere on this site, they are better able to "contain" their experience.  When someone is overtaken unaware by a traumatic event, however, they can't rely on their usual resources to process or contain the flood of fear, anxiety, pain, etc. aroused by the event.  To protect itself from this overwhelming experience, the mind erects a barrier against the memory, segregating it from other memories and emotions in a process of defense against it.  The defense fails as the memory can't be entirely excluded but continues to exert an extremely powerful effect.  The paradoxical result of this effort to ward off an overwhelming experience is to give it a lasting power to cause pain.

It was Sigmund Freud and Josef Breuer, of course, who first theorized about the power of unintegrated traumatic memories.  In their Studies on Hysteria (1895), the authors presented a theory that women who exhibited conversion (hysterical) symptoms suffered from "reminiscences" or memories -- and in particular, memories of childhood sexual abuse.  They believed that these memories retained a lasting effect because, at the time the trauma occurred, these children were helpless and unable to protect themselves from the assault or react to it in a normal fashion.  As a result, the memory of that traumatic experience becomes walled off, segregated from other experiences and memories; it "acts like a foreign body" in the mind because it hasn't been subjected to normal mental processing like other experiences (p. 6).

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Psychological Obstacles to Grief and the Grieving Process

We tend to talk about grief and the grieving process as if it were a separate category of emotional experience altogether,  different somehow from all the others.  Because it means confronting death, mortality and ultimate loss, the grieving process does have a uniquely large and pervasive impact on our psyches; from another point of view, however, grief is but one of the  emotions and when it becomes unbearable, we will ward it off in our characteristic ways.  In other words, when people go through the grieving process, you will often see them resort to their habitual defenses.  As discussed in my post on the tenacity of defenses, as we grow up, our modes of warding off pain become entrenched; even when we've evolved and developed new ways of coping on a day-to-day basis, when confronted with a feeling as difficult to bear as grief, we may fall into the familiar rut of our oldest defenses.

We had to put our dog Maddy to sleep yesterday.  While it's not quite the same as losing a human member of our family, she has been a beloved part of our lives for the last ten years.  Her death has made me notice how we're all responding to our grief, reflective of our particular defenses, and in not such unusual ways, I believe.  It has also stirred a lot of memories from 20 years ago when, within the space of a few months, my dear friend Tom Grant died of kidney cancer at the age of 45 and my mother-in-law Eva, then in her late 50s, succumbed to metastatic breast cancer.  These untimely deaths -- Tom and his wife had two small children and my mother-in-law was fit, dynamic and vitally alive -- have been among the major losses in my life and on occasions such as Maddy's death, the feelings I had back then are still very much present to me.

Splitting and Projection

For the last year or so, Maddy has had a laryngeal problem common in older Labrador Retrievers; she was scheduled for corrective surgery on Monday.  In the four or five days leading up to the surgery, her condition had deteriorated badly and she basically stopped eating.  We thought it might have to do with her medications, but when we took her to the surgeon Monday morning, he immediately said, "This has nothing to do with her larynx problem."  Her lungs were so full of fluid he couldn't even read her X-ray.  He believed she had some fatal condition and presented euthanasia as an option, although he told us that congestive heart disease, a treatable condition, might also be to blame.

Maddy's loss of appetite had filled me with dread.  Both my friend Tom and my mother-in-law lost their appetites as their conditions worsened; I felt sure Maddy had some form of cancer and I wanted to have her put to sleep that day -- to prevent further needless suffering, I told myself.  The rest of the family felt otherwise and wanted to make sure of her condition first before taking such a step.  I felt very rational and level-headed but kept my opinions to myself.  This was my defense:  in order to evade the pain of loss, I split it off and projected it into the rest my family for them to carry; I became a bit detached and efficient, as I am wont to do at such a moment.  I'm good in crisis situations; my defenses help me put emotion aside and do what needs to be done, though in this case, it stopped me from feeling my own grief.

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The Misuses of Sexual Excitement

In an early post on neediness, I discussed some psychological strategies people use when they can't bear the experience of dependency.  Denial of need, a delusion of self-sufficiency or a fantasized merger with the object of need are some of the ways to avoid feeling separate and dependent.  When it comes to our sex life, an intensified kind of excitement is another.  By relating to sex partners in an almost pornographic way, where a stereotyped excitement replaces particular desire for a specific person, one treats other people as if they were interchangeable and therefore easily replaced.  I'm not dependent on you as my particular object of desire because I can easily find someone else to make me feel exactly the same way.

So-called "sex addicts" use this defense, although I object to the way our culture has adapted the language of addiction to describe virtually everything, including an absurd "addiction to self-esteem," as I described in an earlier post.  This kind of sex may indeed function as a heady drug, sometimes warding off depression, but describing the behavior as an addiction tells us nothing about its defensive function; it shifts our subject to the biological realm of medical syndromes and cures, deleting meaning in the process.  Men and women with serial partners seek the heated thrill of a completely new sexual encounter in order to avoid true intimacy, especially the feelings of need and dependency that go with it.  They may idealize those sex partners for a brief time, but once the excitement begins to wane, the sex addict devalues the other person and moves on, as I discussed in my post on love junkies.

Fetishism can work in a similar but more stable way.  By reducing the sexual relationship to one of body parts (e.g., a foot) instead of whole people, the fetishist depersonalizes the individual.  I don't desire you as a complete person; it's your foot that gets me going ... and other people's feet, as well. Stereotyped fantasies of a fetishistic nature can work in the same way.  There's usually an important unconscious meaning to these fantasies that must be understood, but in addition, they replace personal and intimate desire with an excited fantasy that predates the relationship and will continue after it's over.  I've had
clients, both men and women, who consistently wanted to be degraded in a sexual manner, across their relationships and with no particular reference to their partners. All of these individuals had difficulty sustaining those relationships once they became aware of feeling needy and vulnerable.

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Charlie Sheen’s Rant and the Power of Destructive Narcissism

Charlie Sheen's recent rant on The Alex Jones Show offers a perfect illustration of my earlier post about defenses against shame, as well as many features of narcissistic personality disorder.   Although I wouldn't classify Mr. Sheen as NPD per se, he exhibits a great many features of pathological narcissism.  If you haven't seen or heard the full radio interview, you might want to watch this YouTube video.  It's astonishing, deeply upsetting and sad.

From the beginning of the interview, Mr. Sheen makes clear we're dealing in the territory of shame.  "Dude, I'm 0-for-three with marriage and nary an excuse.  Like in baseball, the scoreboard doesn't lie."  At first, this quote makes it seem as if he's putting himself in the "losers" camp (to use his own terminology); but he rejects any sense of shame in the next sentence while discussing the current women (the "goddesses") in his life:  "What we all have is a marriage of the heart ... of the hearts.  To sully or contaminate or radically disrespect this union with a shameful contract is something I will leave to the losers and the Bible-grippers."

This is what I hear Sheen saying:  "I'm not a shame-ridden loser in marriage because marriage itself is the loser.  People who get married are the losers.  Rather than contaminate myself, I've engaged in a superior polyamorous form of relationship, where we exist on the level of gods and goddesses, peering down with contempt upon you pathetic mortals."  As I've discussed, this kind of contempt is a classic defense against unbearable shame; poor Mr. Sheen must be drowning in it.  Brittle and defensive, he next reports that one of the women in his menage-a-quatre has decamped; he wishes her luck in her new life because "she will need it."  Unable to bear the pain of rejection, he treats his former goddess with the contempt he feels for everyone outside his "family".

In Charlie Sheen's quotes, he continually exhibits a kind of grandiose narcissism, another primary defense against shame. "I'm so tired of pretending that my life isn't perfect and bitchen and winning every second and I'm not perfect and just delivering the goods at every second."  That's a verbatim quote, difficult to decode exactly, but he clearly wants to convince everyone, especially himself, that he has a close-to-perfect existence that's the envy of the contemptible losers around him.  "Look what I'm dealing with, man -- I'm dealing with fools and trolls.  ... I don't have time for these clowns, I don't have time for their judgment and their stupidity.  They lie down with their ugly wives in front of their ugly children and just look at their loser lives and they look at me and they say, 'I can't process it!'  Well no, and you never will.  Stop trying.  Just sit back and enjoy the show."  From Sheen's heavily defended viewpoint, he's a godlike spectacle the world should simply watch and admire.  Beneath that surface, he has to feel confused, out of control and shamed of what he's done with his life.

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How to Tell if You’re Projecting

While many of us can identify the process of projection in somebody else, few of us are able to see it in ourselves.  Think about it -- how many times have you stopped yourself and said, "I'm just projecting; this has nothing to do with John"?

Our own projections are difficult to spot, first of all, because we don't want to identify them as such:  the whole point of projecting is to rid ourselves of something unwanted.  While there are instances where people project their good qualities into others, ridding oneself of painful or unpleasant experiences is much more common.  I've discussed these issues in earlier posts about projection and the toilet function of friendship.  Today I'd like to talk about how we can become more attuned to and aware of our own projections, even when we'd rather not.

Projection is an unconscious fantasy that we are able to rid ourselves of some part of our psyche by splitting it off and putting it outside ourselves, usually into somebody else.  While the initial process occurs outside of awareness, maintaining or insisting upon the reality of that projection often occupies our conscious thoughts.  The process is usually distinguished by its focus and intensity.  I can explain this more clearly with an example, one I alluded to in my first post on projection.  Grouchiness is something most of us have experienced; I suspect my description will resonate for many of you and at the same time, give you the chance to study the process the next time you feel grouchy and see if my explanation makes sense.

So at the end of my work day, I may be feeling irritable because (I believe) members of my family are doing things I find annoying.  In my thoughts, I may begin to zero in on those irritating behaviors -- say, that person's irksome habit of constantly complaining about his or her daily stresses.  These irritations may become preoccupations; I may find myself intensely focused on those behaviors, waiting for them to recur; I may be talking to myself in repetitive ways that have the effect of intensifying my irritation, while at the same time justifying it.  My focus may be exclusively upon the other person with a corresponding lack of attention upon myself and my own body.  The underlying assumption is that the other person is causing me to feel grouchy and if only he or she would stop complaining (as usual!), I'd feel better.

I'm familiar enough with the process by now to recognize it, though without exception, I fight off that recognition every time.  I'll hear myself thinking something like, "Yeah, but this time is different.  That really is irritating."  With effort, I can silence such thoughts.  Silence is key, at least for me; as a fairly verbal person, I find the thought processes that support and justify the projections come in words.  Putting a stop to those words and focusing on my breathing is a crucial first step.  Then I have to shift the focus of my attention away from the other person and into my own body.

I "look" in various places:  my back and shoulders where I carry tension, around my eyes where I register fatigue and sadness, in my belly where I feel hunger and other kinds of longing.  I may notice that my back hurts; I may have the beginnings of a headache.  Often I discover that my body feels tired and a little achy.  I try to hold onto these sensations without "explaining" them in reference to someone else, a difficult and uncomfortable experience.  In the end, I may realize that my own day was stressful, that rather than feeling the depth of my own pain and stress, I'm projecting it outside into someone who complains and whom I mentally criticize.

This is a simple example of owning a projection, and one that many of you will likely be able to replicate.  It's more difficult when we're projecting experiences such as shame or neediness.  In those cases, our entire character structure may be organized around validating the reality of the projection.  The characteristic defenses against shame, for example, have as a common goal projecting damage or unworthiness into other people and then treating them in such a way as to insist upon the validity of the projection -- by blaming or regarding them with contempt.

Finding Your Own Way:

Experiment with grouchiness and let me know what you find.  Does my description of the process hold true for you as well?

Next, think about other areas where an intense focus on or preoccupation with someone else may indicate that a projection is at work.  Do you find yourself dwelling on somebody's else behavior or personality in an intensely critical or angry way?  You may have legitimate reasons, but you may also be projecting something into them.

Some other feelings that may indicate an underlying projection:  contempt (projection of shame), feelings of superiority (projection of neediness ), recrimination (projection of guilt) or envy (projection of an idealized fantasy).  I don't mean to suggest that these are always signs of projections, but when joined to an especially intense preoccupation with the other person, they're a strong indication.

Notice the polarity involved in these projections:  I don't complain about stress and it annoys me that you do.  I feel no shame about my own damage but you're a contemptible loser.  I'm not needy and pathetic like you because I've got it all!  I did nothing wrong and you're entirely to blame.

Now if only I could stop thinking about you.