Admitting to something being wrong is the first step. Doing something about it is the second step. Both are essential. That's where PTSD therapy is essential. It's all very obvious and clear-cut. Admit the problem, get treatment. As neat and orderly as running unarmed into a war zone and getting gunned down. Nothing about it is clear-cut. It's just another phase in a war that seemingly won't ever end.
Though I have had psychotherapy for my PTSD at my current therapist for over a year now, it's only recently that my therapist deemed my current situation stable enough that we could start with the actual PTSD treatment, in the form of trauma (memory) integration therapy. This essentially involves digging out memories to create an ever more coherent timeline of memories, to ultimately approach and explore the traumatic memories.
I have forgotten so much. No, not forgotten, but tossed to the side, not thought about them, because they weren't important. Memories of being a child, of growing up, of looking at the future ahead of me. Of the person who I was, and who and what I thought I would become. This PTSD-induced narrative that my mind evolved over the years is however pervasive.
It's hard to put it into words. Probably mostly because the trauma-induced narrative that one's brain produces isn't rational. That's why one often feels so frustrated and angry with oneself, because what should be easy and clear just isn't working, or takes much longer than it should. Things that are easy for others seem complicated and take up a lot of energy. Thus one feels angry with oneself. Blames oneself.
Others will perceive this frustration and anger as being targeted at them, or interpret your internal struggles as you being slow or inattentive. The resulting external struggles in addition to one's internal struggles leads one to feel as though one is trapped inside a maze with the exit visible behind many doors, only to see them slammed close before they can get to them. Because they're too slow. Because they don't measure up. Because there's no reason for you to keep trying any more. Because it's better to give up.
This week's first trauma integration session already loosened up a lot of memories that I had thought gone or buried. Many impressions and sensations I haven't experienced in years. The flood of emotions that comes with this is overwhelming. And this is just the beginning.
I thought I knew who I was. The child back then thought it knew who it was. Now it's time to pull on all those loose threads and see what happens.
Maya
Saturday, 31 August 2019
Friday, 9 August 2019
The brain of a childhood abuse victim
The realisation that we are our brain rarely feels more relevant than when considering the impact of childhood on an individual's development and the adult which they'll ultimately become. With half of the neuronal connections within the brain getting pruned between the age of 3 and adulthood, massive structural changes occurs occur within the brain during this period.
Little wonder, then, that essentially anything that a child experiences will impact which connections will get pruned or rewired and what the child's adult brain will end up look like. This is most apparent when it comes to victims of childhood abuse and neglect [1]. By exposing the young brain to a high-threat environment, it has been observed that this makes the amygdala (part of the emotional regulatory system and fight or flight mechanism) less responsive.
Along with the hippocampus (responsible for short-term memory handling), both regions thus become optimised for a high-threat, high-stress environment. While great for surviving such an environment, this adaptation makes it hard to impossible for those such affected to thrive in an environment where no such threats exist. Especially dealing with diverse, non-threatening emotions becomes exceedingly hard, with in the most extreme cases children being unable to distinguish between emotions such as sadness and anger.
Along with the hyper-vigilence and inability to regulate their emotional state, this can pose severe difficulties in the interaction with others. Since the child's brain is tuned for a high-threat environment, warnings by adults or certain actions by peers can be interpreted as a prelude to imminent danger, causing the child to display overly aggressive or aversive behaviour. In turn, this leads the former to issue sterner warnings and proceed with more aggressive forms of punishment and the like, continuing the cycle.
This combines with symptoms from Box 2 in the previous link, which includes an aversion to physical contact, even with caretakers and close family, as well as low self-esteem and the feeling that one deserves anything bad that happens and any form of punishment, since obviously one is a bad person.
Other common issues include homelessness, substance abuse including alcohol and drugs, criminal and violent behaviour, as well as mental health issues. The latter includes depression, post-traumatic stress disorder and a range of related disorders. Finally, another major impact of childhood abuse appears to be medical, in that the affected individual will suffer more medical issues over time, likely caused both by the effects of the initial high-stress environment on the child's development immune system and the results of the later high-risk behaviour and unhealthy life style choices.
A few years ago this led to the resurfacing of a recollection of being physically or sexually abused. Likely the latter as I remember lying on this surface, with two or more adults present, touching my undressed child's body. I think I must have hurt one of them as I struggled to get away. Next I remember is me running and ending up in this dark room with no way out. Then this adult male standing in the doorway and yelling at me that it's 'all my fault' before slamming the door close. Leaving the child alone in that dark room.
If it was just that apparent recollection I might have dismissed it as just a dream or fantasy, but long before this my mother would tell me that around the age of 5 I suddenly went from this open, energetic and super-friendly child to a withdrawn child, who didn't even allow their own mother to touch them, instead flinching away from any form of physical contact. Over the following years one can then track a pattern of similar symptoms that are typical of abuse as discussed earlier.
I still do not know who might have abused me, how many times or for how long it happened. I do know that a cousin of mine committed suicide after growing into a young adult because she could not live with the memories and lack of support in the family where an uncle and grandfather sexually abused her along with a number of other young girls. Especially after a legal error set the two criminals free again. Things like that are too close for comfort, and it makes one wonder about other dark secrets. Maybe even ones involving one's 5-year old self.
I'm beginning to realise that what I'm struggling with for years now are essentially the results of childhood abuse, combined with years of social rejection and bullying at school, followed by years of rejection and ridicule by doctors and psychologists regarding my intersex condition. Oh, and getting raped, sexually and psychologically abused on multiple occasions because I too fell for the lure of high-risk, abusive environments like so many of child abuse victims.
In a sense it's comforting, I guess, that I appear to be such a textbook-style case of child abuse. By realising that what's 'wrong' with me is that my brain is simply tuned for an environment which hasn't really existed since I was a child. That the way to hopefully fix this is to correct for this behaviour by being more aware of it, hopefully forcing my brain to stop living life as though there's a child rapist and murderer behind every corner. In the midst of a war zone and zombie apocalypse.
The many years of doctors and kin mistreating me the way they did has done me no service, and they will likely never relent, but there are things which I can control and fix. Together with my therapist I can dive back into what really happened, finally release that child from the dark room and show it that there can be a life after such an event. To evaluate life and other people not as a potential source of threats, but as a potential source of interesting and fun interactions and experiences.
It sounds terribly easy when I write it like that. And that's sadly the thing with cases like mine. One can cover up the literal emotional damage to one's brain with intelligence and reasoning, but in the end one is still one's brain, and just like a broken leg one cannot just wish the physical damage away. It will take time and good care to make things heal and go back to the way things were. Just like a broken leg it will however never be quite the same again.
Here's to the long road to recovery.
Maya
[1] https://pediatrics.aappublications.org/content/122/3/667
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743691/
[3] https://www.psychologytoday.com/intl/blog/somatic-psychology/201104/the-lingering-trauma-child-abuse
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117717/
[5] https://www.nap.edu/read/2117/chapter/8
[6] https://aifs.gov.au/cfca/publications/effects-child-abuse-and-neglect-adult-survivors
Little wonder, then, that essentially anything that a child experiences will impact which connections will get pruned or rewired and what the child's adult brain will end up look like. This is most apparent when it comes to victims of childhood abuse and neglect [1]. By exposing the young brain to a high-threat environment, it has been observed that this makes the amygdala (part of the emotional regulatory system and fight or flight mechanism) less responsive.
Along with the hippocampus (responsible for short-term memory handling), both regions thus become optimised for a high-threat, high-stress environment. While great for surviving such an environment, this adaptation makes it hard to impossible for those such affected to thrive in an environment where no such threats exist. Especially dealing with diverse, non-threatening emotions becomes exceedingly hard, with in the most extreme cases children being unable to distinguish between emotions such as sadness and anger.
Along with the hyper-vigilence and inability to regulate their emotional state, this can pose severe difficulties in the interaction with others. Since the child's brain is tuned for a high-threat environment, warnings by adults or certain actions by peers can be interpreted as a prelude to imminent danger, causing the child to display overly aggressive or aversive behaviour. In turn, this leads the former to issue sterner warnings and proceed with more aggressive forms of punishment and the like, continuing the cycle.
Abuse and symptoms
Not all types of childhood abuse are the same, obviously, and each will have a different set of common symptoms in the affected children [2]. In the case of sexual abuse victims: "Disclosure is the most obvious indication of sexual abuse. Age-inappropriate sexual behaviour or excessively sexualized behaviour might be an indicator of abuse. Indirect signs can include any of the following:"- acting out (with aggression or anger);
- withdrawal;
- regression;
- fears, phobias, and anxiety;
- sleep disturbance or nightmares;
- changes in eating habits;
- altered school performance;
- mood disturbances;
- enuresis or encopresis;
- running away;
- self-destructive behaviour; or
- antisocial behaviour (eg, lying, stealing, cruelty to animals, fire-setting)
This combines with symptoms from Box 2 in the previous link, which includes an aversion to physical contact, even with caretakers and close family, as well as low self-esteem and the feeling that one deserves anything bad that happens and any form of punishment, since obviously one is a bad person.
Adulthood
For most victims of childhood abuse and neglect the consequences persist into adulthood, where their struggle with emotions and stress responses causes many issues [3][4][5][6]. Their views of the world and other people will be more negative than average, and the difficulty in recognising positive emotions causes significant friction in the interaction with others. Many will end up in abusive relationships that imitate the original environment in which they grew up, others will exhibit risky and/or extreme sexual or otherwise self-destructive behaviour as they find themselves struggling with a low-threat environment. A number will attempt suicide.Other common issues include homelessness, substance abuse including alcohol and drugs, criminal and violent behaviour, as well as mental health issues. The latter includes depression, post-traumatic stress disorder and a range of related disorders. Finally, another major impact of childhood abuse appears to be medical, in that the affected individual will suffer more medical issues over time, likely caused both by the effects of the initial high-stress environment on the child's development immune system and the results of the later high-risk behaviour and unhealthy life style choices.
A personal note
Repressing memories of the traumatic events is apparently also quite common, even as the neurological effects do not change. This is how I was able to believe for many years that I had had a normal childhood and youth, with a caring family and a safe environment. Even as I was exhibiting many of the symptoms of child abuse during this time and well into adulthood. By being ever more confronted with my own behaviour and the reasoning behind it, it has forced me to quite literally dig into my oldest memories to put things together.A few years ago this led to the resurfacing of a recollection of being physically or sexually abused. Likely the latter as I remember lying on this surface, with two or more adults present, touching my undressed child's body. I think I must have hurt one of them as I struggled to get away. Next I remember is me running and ending up in this dark room with no way out. Then this adult male standing in the doorway and yelling at me that it's 'all my fault' before slamming the door close. Leaving the child alone in that dark room.
If it was just that apparent recollection I might have dismissed it as just a dream or fantasy, but long before this my mother would tell me that around the age of 5 I suddenly went from this open, energetic and super-friendly child to a withdrawn child, who didn't even allow their own mother to touch them, instead flinching away from any form of physical contact. Over the following years one can then track a pattern of similar symptoms that are typical of abuse as discussed earlier.
I still do not know who might have abused me, how many times or for how long it happened. I do know that a cousin of mine committed suicide after growing into a young adult because she could not live with the memories and lack of support in the family where an uncle and grandfather sexually abused her along with a number of other young girls. Especially after a legal error set the two criminals free again. Things like that are too close for comfort, and it makes one wonder about other dark secrets. Maybe even ones involving one's 5-year old self.
I'm beginning to realise that what I'm struggling with for years now are essentially the results of childhood abuse, combined with years of social rejection and bullying at school, followed by years of rejection and ridicule by doctors and psychologists regarding my intersex condition. Oh, and getting raped, sexually and psychologically abused on multiple occasions because I too fell for the lure of high-risk, abusive environments like so many of child abuse victims.
In a sense it's comforting, I guess, that I appear to be such a textbook-style case of child abuse. By realising that what's 'wrong' with me is that my brain is simply tuned for an environment which hasn't really existed since I was a child. That the way to hopefully fix this is to correct for this behaviour by being more aware of it, hopefully forcing my brain to stop living life as though there's a child rapist and murderer behind every corner. In the midst of a war zone and zombie apocalypse.
The many years of doctors and kin mistreating me the way they did has done me no service, and they will likely never relent, but there are things which I can control and fix. Together with my therapist I can dive back into what really happened, finally release that child from the dark room and show it that there can be a life after such an event. To evaluate life and other people not as a potential source of threats, but as a potential source of interesting and fun interactions and experiences.
It sounds terribly easy when I write it like that. And that's sadly the thing with cases like mine. One can cover up the literal emotional damage to one's brain with intelligence and reasoning, but in the end one is still one's brain, and just like a broken leg one cannot just wish the physical damage away. It will take time and good care to make things heal and go back to the way things were. Just like a broken leg it will however never be quite the same again.
Here's to the long road to recovery.
Maya
[1] https://pediatrics.aappublications.org/content/122/3/667
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3743691/
[3] https://www.psychologytoday.com/intl/blog/somatic-psychology/201104/the-lingering-trauma-child-abuse
[4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4117717/
[5] https://www.nap.edu/read/2117/chapter/8
[6] https://aifs.gov.au/cfca/publications/effects-child-abuse-and-neglect-adult-survivors
Tuesday, 6 August 2019
I'm completely alone as a hermaphrodite
Now that the immediate urgency of being homeless, various legal matters and health issues have subsided or vanished with me having moved into a new apartment, it seems only fair that other matters would suddenly push into the foreground. Such as this little matter of me being intersex. And not just a weird little genetic gotcha like (C)AIS or XXY, but in the form of a full-blown chimeric condition called a true hermaphrodite in medical terms.
Which is to say that in Western society I do not exist. Theoretically there should be more people like me around in the West, and thousands around the world. Yet I have never met anyone else like me. Among the dozens of doctors and other medical specialists none of them had ever encountered one either, or they had merely opted to ignore the details and just 'normalised' the babies or infants born with both male and female genitals.
I guess I am an oddity in that I managed to reach adulthood without getting tossed into the hellscape of 'intersex treatments' [1] first. Yet as an escapee I still will not learn answers to the many questions I have about my body. About this second puberty that I'm still in the midst of. In how far the abdominal pains that I suffer are normal for someone with a mostly female phenotype. Why old scars are suddenly vanishing and I seem to be getting younger in appearance over the past few years since this second puberty started.
With no answers forthcoming, I'm left to try and live my life. Even ignoring the childhood and other assorted traumas that I got handed, it's so incredibly lonely and frustrating to feel that one is the only person of one's kind in this world. Though I managed to at least improve the dissonance by having my official sex changed from male to female, it's not a fix. It's still not who and what I am.
Because of the many negative experiences I have had over the past decade, I feel both cursed and stuck with this body of mine. True, one is still a human being, but by not having my intersex and hermaphroditic nature acknowledged, it feels as though I'm only allowed to partially exist. As long as I pretend that I'm just a regular woman who has had a regular youth and regular female puberty, I can get along fine. Since I'm physically primarily female, suffer through the same joys of monthly periods and everything as every other woman, I can share in everything minus the part where I have to admit that I was born infertile, let alone that I bleed internally because my labia have merged.
It's as though I am two people: the part that society accepts, and the part which will not ever be acknowledged.
The same thing is true in any relationship. There's always the feeling that there's this cultural divide, with either side growing up in a different world. People will often tell me that they 'get it' what my life must be like as a hermaphroditic intersex person, but do they really? The many years of confusion and fear as one's body does things which do not make sense as puberty kicks in, along with an increasing dissonance as the image society tries to project on your body becomes more and more mismatched.
Naturally, the only way that I could have grown up as a 'girl', officially, would have been if it was discovered when I was born that I am a hermaphrodite and they had opted to chop off the penis and not rip out the vagina and other female bits, which would be roughly a 50/50 bet. That my current situation forces me to consider myself to be 'lucky' is possibly the saddest part of all. I made it without suffering genital mutilation.
There's the knowledge of what still has been done to me, as well as the questions which I will likely never have answered, not to mention the cold certainty of always feeling like a one of a kind, sort of freak of nature. All of this makes me seriously consider whether life has much to offer to me. Whether I'll ever be truly happy, or whether it'll always be this intense feeling of loneliness and sadness that fills my heart. It often hurts so much just to live through another day, let alone for me to consider my future.
Maybe if humanity decided that we could let go of this 'male' and 'female' distinction, and just treated everyone as a human being, without having to conform to unrealistic labels. As things stand, however, all I can do at this point is play along with society's game even as my heart yearns to finally be allowed to be myself, along with all others who are like me.
Maya
[1] http://mayaposch.com/intersex-controversy.php
Which is to say that in Western society I do not exist. Theoretically there should be more people like me around in the West, and thousands around the world. Yet I have never met anyone else like me. Among the dozens of doctors and other medical specialists none of them had ever encountered one either, or they had merely opted to ignore the details and just 'normalised' the babies or infants born with both male and female genitals.
I guess I am an oddity in that I managed to reach adulthood without getting tossed into the hellscape of 'intersex treatments' [1] first. Yet as an escapee I still will not learn answers to the many questions I have about my body. About this second puberty that I'm still in the midst of. In how far the abdominal pains that I suffer are normal for someone with a mostly female phenotype. Why old scars are suddenly vanishing and I seem to be getting younger in appearance over the past few years since this second puberty started.
With no answers forthcoming, I'm left to try and live my life. Even ignoring the childhood and other assorted traumas that I got handed, it's so incredibly lonely and frustrating to feel that one is the only person of one's kind in this world. Though I managed to at least improve the dissonance by having my official sex changed from male to female, it's not a fix. It's still not who and what I am.
Because of the many negative experiences I have had over the past decade, I feel both cursed and stuck with this body of mine. True, one is still a human being, but by not having my intersex and hermaphroditic nature acknowledged, it feels as though I'm only allowed to partially exist. As long as I pretend that I'm just a regular woman who has had a regular youth and regular female puberty, I can get along fine. Since I'm physically primarily female, suffer through the same joys of monthly periods and everything as every other woman, I can share in everything minus the part where I have to admit that I was born infertile, let alone that I bleed internally because my labia have merged.
It's as though I am two people: the part that society accepts, and the part which will not ever be acknowledged.
The same thing is true in any relationship. There's always the feeling that there's this cultural divide, with either side growing up in a different world. People will often tell me that they 'get it' what my life must be like as a hermaphroditic intersex person, but do they really? The many years of confusion and fear as one's body does things which do not make sense as puberty kicks in, along with an increasing dissonance as the image society tries to project on your body becomes more and more mismatched.
Naturally, the only way that I could have grown up as a 'girl', officially, would have been if it was discovered when I was born that I am a hermaphrodite and they had opted to chop off the penis and not rip out the vagina and other female bits, which would be roughly a 50/50 bet. That my current situation forces me to consider myself to be 'lucky' is possibly the saddest part of all. I made it without suffering genital mutilation.
There's the knowledge of what still has been done to me, as well as the questions which I will likely never have answered, not to mention the cold certainty of always feeling like a one of a kind, sort of freak of nature. All of this makes me seriously consider whether life has much to offer to me. Whether I'll ever be truly happy, or whether it'll always be this intense feeling of loneliness and sadness that fills my heart. It often hurts so much just to live through another day, let alone for me to consider my future.
Maybe if humanity decided that we could let go of this 'male' and 'female' distinction, and just treated everyone as a human being, without having to conform to unrealistic labels. As things stand, however, all I can do at this point is play along with society's game even as my heart yearns to finally be allowed to be myself, along with all others who are like me.
Maya
[1] http://mayaposch.com/intersex-controversy.php
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