11

How Trauma Impacts the Way You View Yourself

(Complex PTSD, Category 4)

As we said earlier, repeated instances of overwhelming trauma can impact all parts of yourself: the way you see yourself (your identity), your body image (and body sensations), your internalized images of others, your values, and your sense of purpose and meaning. Loss of your sense of you, as a person, as a self, may lead you to believe that you are not really a person. Instead, you view yourself as some type of worthless piece of garbage, or as evil. If your traumas began very early and were quite severe, you may have developed a fragmentation of yourself called dissociative identity disorder (previously called MPD or multiple personality disorder). This permanent damage to your sense of self can never be totally overcome. However, it can be modified. We have discussed ways to modify and deal with feelings of guilt and shame in chapter 8. It may help you to refer to that chapter and its exercises as you work through this chapter.

The traumatic experiences you had may have led you to believe that nobody can ever possibly understand what you went through and what happened to you. Not only can others not understand the traumas themselves, but they cannot understand why you react as you do and why you think so poorly about yourself. McKay and Rogers (2000) discuss how triggers that bring back various aspects of the trauma (emotions, thoughts, memories, etc.) can lead to negative perceptions of yourself in relation to others. When you perceive that you have been harmed and victimized deliberately and intentionally, as well as that you were totally helpless and powerless to do anything about what happened to you, you can develop feelings of helplessness.

Exercise: My Feelings of Helplessness

Which of these thoughts do you have? Check those that apply to you:

• _____ People ignore my needs.
• _____ No one understands me.
• _____ When they look at me, people don’t really see me.
• _____ People expect too much from me.
• _____ People take advantage of me and use me.
• _____ People want to control me.
• _____ People are always yelling at me for things I didn’t do.
• _____ People don’t do what I want them to do.
• _____ People manipulate me.
• _____ People bully me and are mean to me.
• _____ People say cruel things to me.
• _____ People have no respect for me.
• _____ People don’t treat me fairly.
• _____ People don’t hear what I say.
• _____ People don’t care about me.
• _____ People don’t help me when I need help.
• _____ People reject me.
• _____ People don’t value me.
• _____ People take me for granted.
• _____ People think I am stupid.
• _____ People see me as unattractive.

How many of these statements did you check? ___________

What do the ones you checked say about you?

___________________________________________

___________________________________________

When the statement you checked says “people,” go back and write down beside the belief the names of those people; for example, who takes you for granted or bullies you?

What did you learn about the persons who hurt, abuse, or disregard you?

___________________________________________

___________________________________________

___________________________________________

Are there few or many such people? _____________

Do other persons see this abuse and disregard for you?

___________________________________________

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Where Beliefs about the Self Come From

In many instances, your beliefs have been gathered from others and are introjects, as we stated earlier in this workbook. You have a choice to accept or deny those beliefs. In this chapter we will give you strategies to challenge them.

Your schemas are your beliefs and expectations about yourself, others, and your world. Schemas guide and organize how you process information and how you understand your life’s experience. Your schemas become your basic rules of life; if they are based on distorted information, they can lead to distorted ways to view yourself, others, and the world. Your strongest schemas are those that have been the most powerfully reinforced. You may develop new schemas to serve old functions; you may also try to apply old schemas to new situations.

Five basic psychological needs motivate behavior, according to McCann and Pearlmann (1990). We have previously discussed the basic need for safety. The other needs are trust, power, esteem, and intimacy. It is your ego resources that allow you to meet your psychological needs. Your ego resources are your intelligence, your sense of humor, your will power, your ability to look inside yourself (introspect), your awareness of and ability to set boundaries, and your ability to make self-protective judgments. Adequate ego resources allow you to keep yourself stable as an individual. They help you tolerate and regulate your emotions (as we discussed in chapter 8), moderate self-hate, and be alone without being lonely.

Trauma disrupts your psychological experience of the world. It distorts your schemas about safety, trust, power, esteem, and intimacy. You develop new schemas that the world is dangerous and that you are powerless. Your beliefs may become negative and disrupt your identity, your emotional life, and your ability to meet your psychological needs. Sometimes these schemas can keep you chronically anxious and hypervigilant. Continuously seeing the world as dangerous and threatening will lead to feelings of fear, anxiety, and panic. If your trauma history prevents you from trusting, you will be suspicious and guarded, and your life will involve feelings of abandonment, disappointment, reluctance to ask for help and support, self-doubt, disappointment, betrayal, and bitterness. You will be led to make bad judgments about others and will put yourself in difficult, risky positions, and you may avoid close relationships.

A basic need of life, according to McCann and Pearlmann (1990) and Rosenbloom and Williams (1999), is to have power and influence over what happens to you and over what happens to others. However, a life of traumatic experiences can lead you to believe that you are helpless to control forces outside yourself. The list of statements you checked in the preceding exercise indicates those beliefs and feelings of weakness, helplessness, and powerlessness. You may believe that you must try to dominate others to avoid being dominated yourself, or give way to others’ demands rather than face the world assertively with personal power.

Journal Exercise: My Beliefs about Power and Control

If you are interested in exploring your own beliefs about power and control, you might ask yourself the following questions, and answer them in your journal or notebook.

1. What does personal power mean to me?
2. In what situations in my life right now do I have to share power with others? Who are those others?
3. In my past, when was I forced to give up my personal power?
4. When do I try to control others?
5. Where is my locus (place) of control—is it inside me or outside of me?
6. Over what aspects of my life do I have control?
7. Do I get into power struggles? With whom? How do they get resolved?
8. How do I react to maladaptive expressions of power in others—threats, manipulations, suicide gestures, etc.?
9. Where does my own sense of power come from? Is it from my job? My size? My gender? My culture? My accomplishments?
10. When my power is threatened, do I try to dominate another person or am I appropriately assertive?
11. What are my fantasies about power?
12. Do I see myself as an independent person? Where? When?
13. Can I rely on myself or must I always rely on others?

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Exercise: Identifying My Core Beliefs

The answers you give to the questions in the preceding exercise are the first step toward identifying your beliefs about power. Now, choose one of your answers and ask yourself the following questions:

1. What does that belief say about me?

   ___________________________________________

2. Now what does that statement say about me?

   ___________________________________________

3. And what does that statement say about me?

   ___________________________________________

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This third question gives you your core belief—the deep belief that underlies the others. If you want to challenge or dispute that belief, you have several options:

1. You may look for evidence or proof that your belief is valid.
2. You may find others and debate your belief with them.
3. You may try to use imagery and visualization to change certain aspects of the belief.
4. You may also ask yourself the following challenging questions about that belief (partially adapted from Resick 1994).

   What is the evidence for and against the belief?

   Is the belief a habit or a fact?

   Is my interpretation of the situation accurate or not part of reality?

   Am I thinking in black and white or all-or-nothing ways?

   Are the words and phrases I am using extreme and exaggerated (such as always, forever, must, should, ought, have to).

   Am I making excuses?

   Is the source of information for my belief reliable?

   Am I thinking in terms of probabilities (shades of gray) or certainties (black and white)?

   Are my judgments based on feelings, not facts? Do I consider a feeling to be a fact?

   Is this belief my own, or does it come from or belong to someone else?

   Does it fit in with my priorities, values, and judgments?

   Does it make me feel bad?

   Is it hurtful to me?

   Is it hurtful to others?

   Is it appropriate in the demands it makes on me?

   Is it appropriate in the demands it makes on others?

   Is it considerate of me?

Exercise: Challenge My Beliefs

Use the technique given in the “Identifying My Core Beliefs” exercise above to identify two or more of your core beliefs. (You may use your journal or notebook to identify the additional core beliefs.) Then answer the questions above for each core belief. Use your journal, as well, if you need more space to answer.

Core belief l ______________________________________________

Answers to the questions:

___________________________________________

___________________________________________

___________________________________________

___________________________________________

___________________________________________

___________________________________________

___________________________________________

Core belief 2 ______________________________________________

Answers to the questions:

___________________________________________

___________________________________________

___________________________________________

___________________________________________

___________________________________________

___________________________________________

___________________________________________

What do the previous three exercises say about your beliefs about power?

___________________________________________

___________________________________________

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Journal Exercise: My Power Shield

One way to develop your personal power is to draw it in the form of a power shield. You may draw a shield in your journal or notebook in any shape that suits you. Divide the shield into six parts and, in each section, draw, write, or attach something that is a symbol of the power you have or of potential sources of your power. You might use words, or pictures to symbolize your skills, abilities, resources, accomplishments, or support systems. If you have problems filling in all six sections using your present reality, think of yourself as you would like to be one year from now, after doing all the work in this workbook, and then draw a shield based on that vision. You may draw both a shield based on your present and one based on your hopes for the future. Some sources of your personal power might be:

• a symbol of your life’s motto (for example, It can be done, Live life to its fullest)
• a symbol of your knowledge
• a symbol of your ability to communicate
• a symbol of those you love or who love you, care for you, and accept you
• a symbol of things for which you have passion and commitment
• a symbol of things over which you have some control
• a symbol of your life
• a symbol of the energy from which you draw strength and find your will to survive
• a symbol of your personal resources
• symbols of those to whom you owe allegiance
• symbols of those who are your mentors
• a symbol of a promise to yourself
• a symbol of a promise to others
• symbols of life experiences that have given you strength
• symbols of beliefs that protect you
• a symbol of your support network
• a symbol of your safe place
• a symbol of your ability to change situations
• symbols of your self-care strategies

You may also revisit your personal bill of rights in chapter 8 and incorporate more statements about power. One example of such a bill of rights follows.

• I have needs and can take steps to meet them or try to meet them.
• I have the right to express my feelings as I feel them.
• I have the right to make mistakes.
• I have the right to change my mind (and what I believe).
• I have the right to change who I am.
• I have the right to ask for help.
• I have the right to set a boundary.
• I have the right to be alone if I want to be.
• I have a right to let go of the past.
• I have the right to seek support from myself.
• I have the right to seek support from others.
• I have the right to set goals and then prioritize them.
• I have the right to give myself a compliment.
• I have the right to forgive myself when I am not perfect.
• I have the right to stop making unrealistic demands on myself.
• I have the right to stop blaming myself for things for which I was not responsible.
• I have the right to believe that I can succeed.
• I have the right to judge myself appropriately.
• I have the right to care for myself before giving to others.

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Journal Exercise: My Story of Personal Power

If you are still unsure about your personal power, you may write a fable about your own journey as a hero. This technique is adapted from Ayalon (1992). This story is a metaphoric work that helps you identify your coping and power resources. You can write it or draw it in your journal or notebook. There are six parts to the story:

1. Imagine yourself as a hero in certain surroundings of your choice.
2. Set yourself a task.
3. Decide who will help you, the hero, get the task done if you need help (you might not—you decide).
4. Look at who or what prevents you from completing your task or trying to.
5. Look at how you cope with the obstacles put in front of you.
6. Decide what happens then and how the story ends.

Through doing this story, you can look at the ways you cope with a stressful situation.

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Self-Esteem

If you are going to overcome at least some of the negative impacts of the traumas that happened to you, it is important for you to learn to nurture yourself and to develop a positive sense of who you are, what you like about yourself, and what you see as your strengths. Trauma can challenge your good feelings and beliefs about yourself and lead to negative thoughts and emotions of unworthiness, badness, contempt, and disillusionment. You may believe that you are flawed, bad, or damaged. You may also think that your presence contaminates others or will doom them to a life of pain just by your presence. A poor sense of self-esteem is associated with feelings of self-loathing, despair, cynicism, and general withdrawal from others.

If you see yourself as having worth as a person, you have good self-esteem. A part of good self-esteem is self-respect. If you see yourself as capable and competent, you will be more able to cope with stress and respond to crisis as a challenge. Doing something well leads to higher self-esteem. A higher sense of self-esteem and a sense of being able to do things leads to accomplishments. In other words, these three things (activity, a sense of being able to do something, and having high self-esteem) are related (Schiraldi 1999).

The major way to build self-esteem is to picture and develop high self-esteem affirmations. You worked on building affirmations in chapter 7. What affirmations did you create then? Do you believe them now? Have you been practicing them over time?

When you develop high self-esteem affirmations, it is important for you to begin the exercise with relaxation (see chapter 2). Once you have relaxed your body, visualize a success that you have had—or other problem, crisis, that you resolved, about which resolution you had good feelings. Experience those good feelings as you remember them.

Exercise: My Self-Esteem Affirmations

Choose four or five affirmations. Relax your body, then state your first self-esteem affirmation out loud or to yourself while visualizing it in detail, as if it were totally true.

Some affirmations you might use include:

• I have worth.
• I like myself for myself, without comparing myself to others.
• I can do good work at my job.
• I do my best.
• I care about others.
• I make a difference in my own life.
• I make a difference in the lives of others.
• I am worthy of love from myself.
• I am worthy of respect from myself.
• I am worthy of love from others.
• I am worthy of respect from others.
• I respect my own and others’ boundaries.
• I am lovable and capable.
• I love myself unconditionally.
• I am capable of changing and growing.
• I am willing to accept love.
• I am proud of my body.
• I am no longer a helpless child.

How does this exercise work for you?

___________________________________________

___________________________________________

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Ways to Raise Your Self-Esteem

There are other ways you can raise your self-esteem. You may want to: improve your communication skills, find a hobby that you can do, or do something for others. You may also want to look at the beliefs you have about self-esteem. (One way to do this is to do the next two exercises.) It is important that the beliefs you hold about yourself are realistic, accurate, and honest (Schiraldi 1999). Self-esteem is built on feelings of unconditional worth and unconditional love for yourself, which is really self-acceptance.

Journal Exercise: My Questions about My Self-Esteem

In your journal or notebook, answer the following questions as fully as you like.

• What do I like or value about myself?
• What do I do to take care of my physical self (my body)?
• How do I take care of myself emotionally?
• What do I do (if anything) to reward myself, and when and how do I do it?
• When and how do I devalue myself or cut myself down?
• What are my hopes and dreams?
• What are my realistic expectations for myself?
• What are my unrealistic expectations for myself?
• In what situations do I have a sense of humor?
• When and how do I show love and affection?
• Where do I find hope?
• Under what circumstances am I open and honest about my feelings?
• Do I help others feel good about themselves even when I feel bad about myself?

*****

Journal Exercise: Identifying My Core Beliefs about Self-Esteem

Turn back a few pages and complete the exercises called “Identifying My Core Beliefs” and “Challenging My Beliefs.” Do them in your journal, using the question about your self-esteem you just answered.

What does completing this exercise teach you about yourself?

___________________________________________

___________________________________________

*****

By recognizing which of your beliefs you want to challenge (and perhaps even change), you begin to improve self-esteem. Other ways to improve your self-esteem include the ability to:

• Be aware of your negative thoughts.
• Stop your negative thoughts by using the thought-stopping technique (chapter 6).
• Practice your affirmations.
• Set realistic goals you can achieve.
• Develop a variety of interests and participate in related activities.
• Maintain a high level of energy while pacing yourself.
• Take appropriate risks.
• Trust in yourself and the decisions you make.
• Stay who you are rather than changing to fit a situation or another person’s ideas of you.
• Live in the present while being aware of your past history, and having realistic future goals.
• Turn any mistakes into lessons.

Exercise: Life Lessons

Write down what you believe are the two main lessons you are to learn in this life.

1. ___________________________________________
2. ___________________________________________

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Coping with and Solving a Problem

You may be faced with situations that need you to make a decision or solve a problem. In the past, if you felt helpless and out of control, you may not have tried to solve problems or make decisions on your own. Instead, you may have just let things happen around you, or continued to keep a victim role. Solving problems by doing something—by taking deliberate action— is a functional way of coping with a situation and eliminating some sources of stress for you. Developing realistic goals for solving a problem can make a crisis more manageable. Tedeschi and Calhoun (1995) describe the functions of coping with a problem as follows:

• a way to work through trauma
• a way to make a crisis manageable
• a way to reverse negative changes
• a way to appraise the degree of threat of a situation
• a way to use spiritual beliefs positively
• a way to learn through the experience of others
• a way to vent emotions
• a way to seek support when you need it
• a way to look at the impact of coping on your schemas

If you are able to cope successfully, you probably have:

• persistence, determination, confidence, flexibility, and tenacity
• the ability to connect emotionally with others
• the ability to accept your limitations when necessary
• an internal locus of control
• the perception you can do what you need to do (self-efficacy)
• optimism
• a problem-focused style
• hardiness (which involves commitments, a belief in your ability to influence life events, and the ability to respond to challenge brought by the normal changes of life)

Exercise: How I Cope

How do you generally cope with a challenging situation, whether or not it involves a crisis? Check which of these apply to you, and give an example of when you use it:

• _____ I deal with my feelings. I name them, accept them, express them. An example of when I cope in this way is:

  ___________________________________________

• _____ I adjust my attitude. An example of how I cope in this way is:

  ___________________________________________

• _____ I make choices using a decision-making plan (like the one described just below). An example of when I cope by problem-solving is:

  ___________________________________________

• _____ I accept my own imperfection and the mistakes I have made (and do make) (Schab 1996). An example of when I cope in this way is:

  ___________________________________________

• _____ I take action. An example of when I cope in this way is:

  ___________________________________________

• _____ I use language to build rapport and then translate the language spoken to an action plan. An example of when I cope in this way is:

  ___________________________________________

• _____ I set realistic limits. An example of when I cope in this way is:

  ___________________________________________

• _____ I remain calm and empathize with others. An example of when I cope in this way is:

  ___________________________________________

• _____ I negotiate and compromise. An example of when I cope in this way is:

  ___________________________________________

• _____ I distance myself from a situation without dissociating. An example of when I cope this way is:

  ___________________________________________

• _____ I seek social support. An example of when I cope this way is:

  ___________________________________________

• _____ I educate myself and get information. An example of when I cope this way is:

  ___________________________________________

• _____ I use another method:

  ___________________________________________

• _____ An example of when I cope this way is:

  ___________________________________________

*****

Facing a Difficult Situation

Suppose you are going to go to your cousin’s wedding and know that your father, who molested you, will be there. You have told your cousin you do not want to sit next to your father at the wedding. In fact, you really don’t even want to go, but you and your cousin are very close emotionally. She does not know about the abuse (yet) and just wouldn’t understand if you didn’t come. You have not spoken to your father in three years—not since you wrote him a letter of confrontation. He wrote a simple letter back that said, “Let’s be a family again.” You need to develop a plan about how you’ll react when you see him. How can you plan how you will react?

First, you might consider which emotions you think you will have and what you will do as they arise. What triggers will hit you upside your head? What can you do to calm yourself ahead of time? Then you could visualize yourself going to the wedding and then to the reception. Imagine that at the reception you have assigned seats and your father is across the table from you. What would you do? In short, imagine what might happen in the difficult situation and decide what resources you will need to cope with what might happen. This strategy is adapted from McKay and Rogers (2000). It is adaptable to any situation that resembles your prior trauma, when you have unexpected or even expected contact with your perpetrator, or if you have to deal with unsupportive others. Another way to prepare yourself in advance for a difficult situation is to refer to the story of the hero that is found just above in the section “Journal Exercise: My Story of Personal Power” and do that exercise using the situation, writing yourself in as the hero.

Exercise: Coping with a Difficult Situation

1. Fill in the blanks using the wedding situation described above.

   The triggers that I will have to deal with are:

   ___________________________________________

   I need cues around me to help me to cope. These might include my list of affirmations, a crystal, a stuffed toy, a small angel, or a miniature of my power shield. My cues are:

   ___________________________________________

   ___________________________________________

   Aspects of timing I need to be able to cope are (e.g., some time alone, a time to go out of the room and throw things):

   ___________________________________________

   The coping strategy (from those listed in the section above, “Coping with and Solving a Problem”) that will help me best is:

   ___________________________________________

   The relaxation strategies I will use to soothe and calm myself are:

   ___________________________________________

   The self-talk that I can use includes:

   ___________________________________________

2. Now, think of a problem that you are having or will have and apply the same strategy to yourself.

   The situation I am facing is:

   The triggers that I will have to deal with are:

   ___________________________________________

   I need cues around me to help me to cope. These might include my list of affirmations, a crystal, a stuffed toy, a small angel, or a miniature of my power shield. My cues are:

   ___________________________________________

   ___________________________________________

   Aspects of timing I need to be able to cope are (e.g., some time alone, a time to go out of the room and throw things):

   ___________________________________________

   The coping strategy (from those in the section above, “Coping with and Solving a Problem”) that will help me best is:

   ___________________________________________

   The relaxation strategies I will use to soothe and calm myself are:

   ___________________________________________

   The self-talk that I can use includes:

   ___________________________________________

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Formulating a Decision-Making Plan

Another strategy for coping with a tough situation is to use the following decision-making plan.

1. Describe the problem:

   What is the problem situation?

   What is wrong?

   Why is it a problem now?

   Who is responsible for the problem?

   What circumstances are responsible for the problem?

   What will happen if the problem is not solved?

   How likely is it that what you believe will happen will happen? Circle the number that best describes it (1 = not likely; 10 = it will happen) 1 2 3 4 5 6 7 8 9 10

   When did the problem start? What happened then? Who caused the problem?

   Might the situation change, and what would it change into? What would happen then?

   What needs to change if the problem is to be resolved?

   What are you thinking right now? How do you perceive the meaning of the problem? (Miller et al. 1989)

   What are you feeling? What spontaneous internal physical responses are you aware of having (from the past as well as the present) that can give you information?

   What are you hearing? What sensory data from the present and triggered from the past are coming in? What intuitive sensations are you having?

   What are you doing? What actions are you taking or are you going to take, and what commitment to action are you willing to make?

   What do you want or intend to do? What are your core values now? What do you want to accomplish? What is motivating you to act?

   How does this problem relate to your earlier traumas? If so, which ones? What was the outcome of those traumas?

2. Understand the problem:

   Have you asked yourself about the problem and why it is a problem?

   Have you asked yourself what needs to happen?

   Have you “sat” with the problem (that is, just spent some time with it without trying to resolve it)?

   Have you considered if you want to avoid the problem? This may or may not be a feasible solution, but it may be an alternative to consider at this time.

3. Make a decision to solve the problem:

   What five reasonable things could you to do resolve the problem for yourself? What are the pros and cons of each?

Pros	Cons
_______________________________	_______________________________
_______________________________	_______________________________
_______________________________	_______________________________
_______________________________	_______________________________
_______________________________	_______________________________

Which of the five possible solutions seems to have the most pros for trying it?

1. It is up to you to decide if you will try your chosen strategy to help solve the problem. If you do, you may want to make a contract that

   formulates a plan of action and sets a reasonable goal

   considers alternatives, their likely costs, and their possible outcomes

2. Once you have tried your chosen strategy, look at its results. Ask yourself:

   What happened?

   What about this strategy needs to change?

   Is there another solution that might also work?

Journal Exercise: My Decision-Making Plan

In your notebook or journal, you may use the description on the pages just above to formulate your own decision-making plan, use it to solve a problem you are having, and describe the results.

Basically, the decision-making plan asks you to:

• State your problem.
• Gather information.
• Brainstorm about possible solutions.
• Evaluate the pros and cons of each.
• Decide which to use.
• Do whatever you have decided to do.

Evaluate the strategy you chose and make any needed changes. Another simple problem-solving model developed by Peterson (1968) is to use the following prompts to describe the problem and its possible solutions:

• My problem is:___________________________________________
• The severity of my problem is:___________________________________________
• The frequency that the problem occurs:___________________________________________
• The problem bothers me because:___________________________________________
• The last time this problem occurred was:___________________________________________
• The changes I need to make are:___________________________________________
• To improve the situation I must:___________________________________________
• I would like ___________________________________________ to happen because ___________________________________________
• I can get help with the problem by:___________________________________________
• If I decide not to make changes to solve the problem, then the impact will be:___________________________________________

  ___________________________________________

*****

Whatever problem-solving model you choose, remember not to try to solve problems without taking the time to look at a number of possibilities and considering the consequences for each. Making impulsive, radical changes can be unhealthy and can throw you into distress. Any plan will also be easier to follow if it is very specific.

Exercise: What I Learned from This Chapter

In this chapter, you have looked at ways to help you improve your personal power and your self-esteem. You have also looked at coping skills and problem-solving strategies. Remember, should you get overwhelmed at any time, you may take a break from doing the work, or refer back to the exercises for relaxation and safety in chapter 2. What has this chapter taught you about yourself? How have you changed or begun to change through the work you have done here?

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