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Defense Mechanisms Help Or Harm Us?

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I've had some "success," but the grounding has not been a gentle hang-glide to earth. More like dropping from the top of the Empire State Building at 200 miles per hour to a hard thud on the concrete.
What do you mean by grounding in this example? Have you done any work around pacing and containment?

I really get from what you write that you feel like being you, the real you, living your real life, is intolerable? That's heartbreaking. I'm so sorry things are really hard right now.

You have described this to be a choice between
coming back to reality after living in denial is like crashing from a drug. Having to go through the crash on a rapid cycle is a lot to take.
and
Do I need to falsify my story and my identity somewhat -- as unhealthy as those things sound?
Basically, as a choice between crashing and burning or pretending you are someone else.

That doesn't seem like to me as an issue of how much to use the defense mechanism of denial, but that you are right now using the one of black and white/all or nothing thinking. (Almost everyone does this to some degree.) I'll try to explain... but I might mangle it. Take my words with a lot of salt.

There are not just those two choices. There is a third and a fourth, and a fifth choice.... They may seem too hard right now, or too painful, or completely impossible. It might be worthwhile to begin to brainstorm what they could be, even if they are impossible right now.
I remember one therapist telling me that your mind doesn't do things for no reason -- if you developed some defense mechanism, it is because you needed it.
Yes, this is true. People use any number of defense mechanisms to push away pain. If someone needs to use a defense mechanism, it's usually because they are trying to escape pain. Not because it's good to keep the mechanism, and it's usually not the only option to cope with the pain. Sometimes it's just the best one in the moment. Sometimes it's helpful, and sometimes it's no longer helpful.
I've had some "success," but the grounding has not been a gentle hang-glide to earth. More like dropping from the top of the Empire State Building at 200 miles per hour to a hard thud on the concrete.
Grounding without skills to contain and pace the work of grounding is basically inviting someone to crash and burn. Healing from trauma is not like ripping off an band-aid and diving in. That usually leaves people more shaken up than when they started. If that is what the process has been like for you, I can see why you want to pretend to be someone else!

Every well studied mainstream form of treating trauma paces the work. Therapists are taught to not dive in deep and rip off all the denial because it will cause people to crash and burn. I spent two years just working on pacing myself and learning a bazillion ways to contain the work long before facing reality. I had to do that work first. Not to just be grounded and face what happened, but to be able to put it aside without having to fall back into old habits, old ways of thinking, old defense mechanisms.

Even when doing something as confronting of reality like exposure therapy, pacing is a crucial part of the work. It's not separate from it. If someone goes too fast, they just end up shaken and re-traumatized and likely more compelled to use unhealthy ways to cope with the pain. But if the process is slowed down, which I think is the HARDEST thing, then it becomes very helpful and healing to the nervous system. It's not a jump off a building to smack into the pavement, but a process that is like slowly walking down the stairs, with lots of rests breaks, and becoming stronger by the time one reaches the ground.
 
@Justmehere, thank you for a great, intelligent reply.

Have you done any work around pacing and containment?
The word "containment" brings to mind a therapist telling me to mentally take the trauma and put it in a container. To me, that sounded like a joke, basically. Like, oh really, it's that easy? As for pacing, I don't think I've ever had a therapist who authentically wanted to treat the trauma, but in a healthily paced manner. The pacing thing has just been a line that lazy or avoidant therapists have used to give themselves easy sessions and get out of hearing uncomfortable stuff. So I don't really know what you mean by this, unfortunately. If you have any practical tips to offer, that would be nice.

you feel like being you, the real you, living your real life, is intolerable?
Yep. Exactly this.

There are not just those two choices. There is a third and a fourth, and a fifth choice
Hmmm. I don't know what they are. For the last day I have been just trying to distract myself -- reading, etc.

Therapists are taught to not dive in deep and rip off all the denial because it will cause people to crash and burn.
The therapist I have now is pretty crappy. She is not a trauma specialist, she's pretty young, she has literally like, three years of practice under her belt. I am totally driving therapy myself -- she doesn't seem to have a plan. (Please don't tell me to find another one. I'm really out of other options.)

But if the process is slowed down, which I think is the HARDEST thing, then it becomes very helpful and healing to the nervous system.
Slowing the process down is the hardest thing? I kind of feel like my mind automatically wants to go back and stay in defenses instead of facing things. Anyway, any practical tips for finding the right pace?
 
For exercise, consider that polar thinking, the Good/Bad reflex, is a faulty mechanism. Polar thinking is very useful: it allows us to make sense of a terrifying world very quickly, and formulate rapid responses - but easy and rapid are not necessarily accurate and useful.
The problem is that even when this defense mechanism mitigates bad feelings in the short term, indulging in it further ingrains the pattern in my brain and keeps me dependent. It's like drug addiction. Taking another hit will make you feel better in the short term, but it's still a net negative over all.

Basically, the fantasy is that I get his approval, but it never lasts. For some reason the rejection always re-enters the picture, along with desperation and panic. But when I cut off the fantasies, I get this feeling like I can't live without his approval. I need some way to get through these feelings without relapsing to the defense mechanism (constant obsessive fantasies). How do you get to the other side and what is actually there?
 
Basically, the fantasy is that I get his approval, but it never lasts. For some reason the rejection always re-enters the picture, along with desperation and panic. But when I cut off the fantasies, I get this feeling like I can't live without his approval. I need some way to get through these feelings without relapsing to the defense mechanism (constant obsessive fantasies). How do you get to the other side and what is actually there?

Remove him from the equation?

It's a fantasy, so you're already granting yourself approval, just by proxy. (And then rescinding it, also by proxy). Remove the proxy. Learn to approve of yourself.
 
Slowing the process down is the hardest thing? I kind of feel like my mind automatically wants to go back and stay in defenses instead of facing things. Anyway, any practical tips for finding the right pace?
I'm terrible at it myself. I'm recovering from surgery, and even with that recovery I keep trying to charge ahead and get it done too fast. I easily forget that test and pacing is a part of physical healing as much as it is mental healing. I'm setting myself back on a regular basis - or I was, until my physical therapist stopped me in my tracks. She gave me a list of what I could and couldn't do, and holds me accountable for it.

Having a therapist help keep someone accountable for pacing in treatment and in between sessions can be super helpful as well. I know your therapist isn't stellar, but if you ask for help pacing, learning to slow down, and for accountability to do this, she should be able to do that.

Skills to actually do it? Awareness is the first step. Catching yourself and being able to admit the struggle is there is huge, and you are doing that.

Other skills to pace and contain are ones that frankly seem stupid and possibly cheesy, but over time, some of them may work. I don't know what will work for you, but I'd suggest approaching this like it's an experiment and to keep a log about how different skills work or don't work.

CBT uses logs for compulsive behaviors a lot because it really helps skills stick and have greater impact. The log process trains your brain to notice something working, even if only slightly, and that makes the brain more likely to gain more improvement form it next time. (The book "The Brain That Changes Itself" talks about this very phenomena.)

So I'd suggest try keeping a log, and note how you are feeling and doing throughout the day, and then try different skills and note how you feel afterwards and how the rest of the day goes. I'd give each skill a try at least 10 times. (Yes, that's what it takes with compulsive stuff like this - it's annoying and hard. I've been there so many times.)

Look into the CBT skill urge surfing - it involves feeling the urge to think about this fantasy more deeply and resisting it.

Thenmindfulness skills around imagining thoughts on boats floating down and imaginary river might help too. There is the process too of putting things in an imaginary box in therapy - and while these things seems silly, they are tricks that help the brain let go. Olympic athletes will often practice imagining a race and imagining it going well over and over, just imagining it, because studies have shown that mental training actually helps them physically perform faster and better. It's the same kind of idea with some of the skills to pace out the work.

Some of the work is things you know to do - like distraction and etc. but it might be new variations on them, and going back at me forth between the fantasy and doing something else. For me, I will at times set a timer to allow myself to think about a certain matter I'm stuck on. I will even jot it down, in a brief few words. When the timer is up, I put that list away. I make it a physical act to help remind my brain that this is away. Then I use what is called the 5 second rule and I count down - 5, 4, 3, 2, 1 - and do something else. The countdown oddly sometimes works for me.

A lot of it is sort of getting our brains to switch gears, through silly things like that. It takes time and lots of practice to build the skill.

It usually seems like to me I should just be able to just choose what I think, but it's not always so much the case and I have to use all these other tools to get my brain to go there. The more repetition the easier it gets because the neural connection is strong every time it's done.

Expect it to feel a lot worse at first. If pacing was comfortable, you would be doing it already. It will get easier and help a ton to even put this process. Give yourself some time to get there. That permission is part of the pacing work itself.

How do you get to the other side and what is actually there?
The process involves finding other healthy ways to get the need for acceptance and approval met, and grieving what been lost. Internal family systems therapituc techniques may help in this regard, a long with self re-parenting and what @Friday wrote about: giving yourself some of the approval you have been missing.

The other side is a good place. It is a place of freedom and relief and connection and deeper relationships with others. The trauma repetition compulsions that I have worked through have led to relief I didn't think was even possible. I can't describe it well, but it's been so worth it.
 
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I think it's true that our brains don't do things for no reason. The way my T puts it is that all this stuff was, at one time, adaptive.

But, I also think that part of the PTSD deal is, our brains tend to get stuck "over there, back then". For example, it may have been true, at one time, that my mom was a threat to my survival. But that was not true when she was a frail, little old lady at the end of her life, and i was an independent adult. It wasn't easy to recognize that and behave accordingly, though. I didn't always manage it perfectly.

Things change. Coping mechanisms can become out dated. There may be better options available. We need to look for them.
 
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