How Does Exposure Therapy Work For Neglect?

[jaccat]

:hug::hug::hug:I'm going to try to reply to this but I'm not sure I can phrase it right. Don't be offended if it doesn't come out right.

I think I need to clarify what I was trying to say in the first post. In order to do that it may be necessary to say a little about myself.

I am the youngest of a fairly large family. I grew up in a household where there was plenty of violence and abuse. I witnessed it on a daily basis but it was never (as far as I recall) aimed directly at me. Instead I recieved nothing from my family, no emotional care, minimal physical care, I was just there.

Perhaps my example of the social situation was a bad one. I could equally have said I fight similar responses when I see something in a shop I like, but can't bring myself to buy it because I don't feel I deserve nice things. That's what neglect has left me with.

Replying to this has been a struggle. Seeing responses from others who know so much more than me has inspired feelings of shame that I dared respond in the first place. This is swiftly followed by anger at how pathetic I am.

Pete Walker sums it up in his book Complex PTSD. I want to quote a bit (if I'm permitted) It's abbreviated a fair bit:

Emotional neglect also typically underlies more traumatisations that are more glaringly evident. Parents...abandon their child to unmanageable amounts of fear, and the child eventually gives up...Over time this fear and shame begets a toxic inner critic that holds the child, and later the adult, totally responsible for his parents' abandonment...

I'm not saying this is the case for you. I wouldn't presume to know, but perhaps consider that that absence is covering something.:hug:

 

[sun seeker]

Yes @jaccat, I get what you are saying and don't worry, I see no reason at all to be offended! I understand where the worry comes from though. I was actually going to add something about that to today's thread on why some people feel they can't post on the forum. One more effect of the neglect is not being sure where the balance is between caring about other people and taking responsibility for their reactions to us. I don't know if that makes sense. Sometimes because I myself am so sensitive to criticism, I worry overmuch that I have offended someone else when most often it turns out that if I ask, they don't even know what I am talking about! But sometimes it's true, and I honestly don't know how to tell the difference because I am so steeped in the assumption that there is always something wrong with me.

I empathize with your brief story of your home life. Mine was similar, though there wasn't a lot of violence but a lot of explosive and unpredictable rage, often directed at me, other times just around me. I am also the youngest, and by the time I was seven I was alone with my parents and used as a pawn in their fighting, and expected to take care of both of them on an emotional level. There were also some more overt traumas I won't write about for now. Like you, what I feel affected me the most was a lack of care, a feeling that I was invisible, not worth caring about, a waste of space. An absence of nurturing, guidance, all those things parents are supposed to do. Like you, the sense of shame and worthlessness is everywhere in my life, in every breath I take.

What I was trying to say about neglect as a non-event was that while there may be specific incidences that classify as traumas, there is this other part of it that is about what didn't happen: all the positive messages I didn't get, the loving touch that didn't happen, the guidance that wasn't present, etc. I was trying to say I didn't know how to work with that because there aren't always discrete incidents (though there are plenty of those, too). But in the process of this thread I have resolved that problem somewhat within myself. For example, even if my sense of shame doesn't come from just one incident, I can work on the painful feelings that come up in social situations as a result of it. Those become the concrete event, turning an absence into a presence. I don't know if that makes sense.

I hear you saying that a way you work on this is to push yourself into uncomfortable situations despite the feelings that come up. Correct me if I've got that wrong. Can I ask how you work on the discomfort? Has it gotten less over time? Is there a line where you decide it's too far to push?

Anyway, thank you for sharing. I'm sorry it was so hard for you. :):hug:

 

[joeylittle]

What @jaccat said - that's me, too. I was left to raise myself. I did not consider this to be a problem until I was in college and saw how other parents "parented". It's only recently that those big holes of "no-feeling" have become really, really ouchy. I think it's normal you are experiencing an absence of feeling with these things, @sun seeker - just from the dentist story alone. But there is stuff underneath that protective layer, and it will come out the more activated you become about these stories, experiences.

And yes - I was actually agreeing with your therapist, and I do even more so when you describe where you are at right now. I do think it would be great for you and her to agree on what your goals are for stabilization, so you don't feel like you are kind of in the dark about where your therapy is at.

 

[sun seeker]

I think it's normal you are experiencing an absence of feeling with these things, [DLMURL="https://www.myptsd.com/c/members/28120/"]@sun seeker[/DLMURL] - just from the dentist story alone.

I think I miscommunicated on that one. I don't have an absence of feeling. Well from time to time I do have periods of numbness, but most of the time I have plenty of feelings. The absence I was trying to describe was more around the things that we don't get as a part of neglect, as opposed to the concrete examples we can point at. So for example, I can point to being left alone at a bus stop at age six with no money to get home and experiencing the terror of abandonment in a very immediate way. That's neglect as an event. But there is also the absence of nurturing in all its forms that is harder to pinpoint because it's something that didn't happen. I went into that some more in the post above.

And yes - I was actually agreeing with your therapist, and I do even more so when you describe where you are at right now. I do think it would be great for you and her to agree on what your goals are for stabilization, so you don't feel like you are kind of in the dark about where your therapy is at.

Yup, got it. Will do.

Edited to add: I forgot to say I totally get what you are saying about not realizing for a long time what a lack of parenting does - or even recognizing it as such. It's interesting that I went rather overboard in the opposite direction with parenting my daughter, even without being able to articulate that I was neglected. But for me it's only recently that I've begun to look at parents and children with new eyes and notice all the things most of them do that I never got. It's easier to recognize what is there than what isn't.

 

[jaccat]

In response to the uncomfortable situations, you've got that about right.

I guess the easiest way to describe it is it's like building up a tolerance over time. Starting small, then repeating that action or one similar, until it becomes less uncomfortable. I won't say normal. I haven't got there yet:wacky:

For instance, the treating myself to nice stuff thing. It started with my therapist challenging me on it. At the time I was living on basic range food and not allowing myself to buy anything I didn't need. By need I mean if it was still holding together it was good enough. Most of my clothes had holes in.

The first challenge was breakfast. My T asked me what I ate, and I gave her the name of a cereal, one of the shop's own brand. I added that it was cheaper. She pointed out that the cost had nothing to do with it and asked me if I liked it. I didn't know the answer to that. She challenged me to try something different. It took three attempts to work up the courage to buy a different cereal. All the time I spent looking at the different products I felt so self-conscious.

One day I saw a duvet cover in a shop that I really liked the look of. I hovered there for ages, thinking it's lovely but I don't need it. Then I got up the nerve and bought it.

Actually what I did was snatch it from the shelf, run to the checkout before I could change my mind and get out of the shop as fast as I could. I couldn't give myself time to think about it, because if I had I wouldn't have bought it. I was embarrassed, ashamed, guilty, it felt like everyone was watching me. It was only a duvet cover! Not even a very expensive one.

The effort it took to buy it was massive. It seems such a small thing too.

The next time I saw something I liked I remembered that I had made it last time, and I had taken pleasure from the thing I bought. That made it just a bit easier to do it again.

Treating myself is still unnatural to me, but the desire to give in is nothing like as strong as it was. Hell, today I worked up the courage to buy a train ticket to spend a day away next month. Last month I couldn't have done that.

Who knows, one day I might be up to going away on holiday, like normal people do?:)

 

[joeylittle]

But there is also the absence of nurturing in all its forms that is harder to pinpoint because it's something that didn't happen.

Ah, understood. Another way to say it might be that you don't know what you are missing? I think we see those things in the negative. Like, I think I am so sure that people don't like me because, basically, my parents didn't express love to me in any way. So I'm just unloveable.

 

[sun seeker]

Another way to say it might be that you don't know what you are missing?

Well... not exactly. Sorry, I seem to be really bad at this! Thank you for persisting.

I know what I am missing, but because I was asking specifically about exposure therapy which seems to be about processing discrete events, I was wondering how to process the aspect of neglect that is a non-event. Does that make any more sense?

I think I've found an answer to that though, as I wrote in the post in answer to @jaccat, or in my dentist example. The event to process becomes the first time I became aware of the effects of the lack. Sorry... I know what I mean, I wish I were better at explaining it!

 

[sun seeker]

Who knows, one day I might be up to going away on holiday, like normal people do?

I'll hold an image in my mind of you happily enjoying your holiday. Where would you like to go?

 

[jaccat]

I have an ambition to see New York with a friend one day, but what I'd really like to do (and this is a whole other level of nerve) is go backpacking round India.

 

[ghotiff]

I was wondering how to process the aspect of neglect that is a non-event. Does that make any more sense?

When I tell my T a tiny bit about my abuse her caring reaction sends me immediately into disassociation. It's a particular version where my vision goes cloudy and I feel faint. I fight it, and when I can, I change the topic.
My T saying caring things to me is my exposure therapy (well...at least I think it is). I managed to tell her last session how I react, but not why...I need to work up to that.

Hope that helps.

 

[joeylittle]

The event to process becomes the first time I became aware of the effects of the lack.

Oh, this makes so much sense to me! OK, I get it. Yes, totally. Bingo! :tup: Thank you for persisting too. :hug:

 

[sun seeker]

Eureka! I love it when that happens.:)