Thursday, January 11, 2018

Erikson's Pathway Out of Kernberg's Hell

Erik Erikson is one of my absolute faves. Along with Otto Kernberg. In applying Otto's notion of "splitting" as the direct result of abuse and/or stress to each of Erik's stages, one comes to understand pretty much exactly what happens to those who are driven by abuse into borderline personality disorder (about which Kernberg was a leading expert). Many people with CPTSD do not "catch" BPD, but those who have survived severe child abuse without effective treatment for its results are an estimated five to six times as likely to meet the diagnostic criteria as are those who do not have severe abuse histories.

Because in those who have been severely abused (or neglected, ignored, abandoned, discounted, disclaimed, and rejected -- as well as invalidated, confused, betrayed, insulted, criticized, judged, blamed, embarrassed, humiliated, ridiculed, denigrated, derogated, victimized, demonized, persecuted, picked on, dumped on, bullied, scapegoated, and/or otherwise abused -- by others upon whom they depended for survival in early life), ...

1) Trust so often becomes split into too much and too little, or mis-trust and dis-trust, causing such people to be co-dependent here and alternately counter-dependent there; 

2) Autonomy so often becomes split into too much and too little, or hyper-detachment and over-attachment, causing some such abusees to slip into reactive attachment disorder in childhood and deepen their co- and counter-dependence in adulthood;

3) Initiative so often becomes split into too much and too little, or obsessive and compulsive behavior here vs. discouraged depression and lack of initiative there, often confusing the bejesus out of their parents, siblings, playmates and teachers;

4) Competence (which used to be called Industry) so often becomes split into an obsessive drive for -- and achievement of -- capacity and capability here vs. gross incompetence and proneness to making mistakes or even displaying intermittent explosive disorder symptoms when their initiative and drive for competence is frustrated;

5) Identity so often becomes split into fragments of, perhaps -- but not limited to -- "I am extremely capable and competent" here vs. "I am a totally helpless mess" there, or, "I am a sexy goddess everyone wants" here vs. "I am an ugly frump no one wants" there;

6) Intimacy so often becomes split into a dire need for connection driven by fear of being alone vs. an equally dire need to be detached and separate from others driven by an equally powerful fear of being abused;

7) Generativity so often becomes split into a hyper-disciplined obsession with career and achievement on one end of a polarity that includes "who gives a flying f--k about this stupid job" on the other; and...

8) Integrity so often becomes split into something a tortured, hyper-moralistic obsession with being "real" *here* vs. acquisition of dramatic, romantic, delusional, fantasy-steeped "alters" *there*.

Can all this splitting be reversed? In my view (after 30 years of working on the problem personally and with many others), only if Erikson's path of development is rebuilt from the bottom up.

Well. How is that accomplished? Precisely as Briere, Courtois, van der Kolk and Walker (as well as the authors of the books at the end of this reply) have all suggested: On a platform of skills for distress tolerance and emotion regulation like these those learned in Mindfulness-Based Cognitive Therapy (MBCT), Dialectical Behavior Therapy (DBT, the long-time gold standard for severe anxiety symptom management), Acceptance & Commitment Therapy (ACT), Mind-Body Bridging Therapy (MBBT), and/or Mindfulness-Based Stress Reduction (MBSR)... and Eye-Movement Desensitization & Reprocessing (EMDR), Narrative Exposure Therapy (NET), Internal Family Systems Therapy (IFST), Trauma Focused Therapy (TFT), Hakomi Body Centered Psychotherapy (HBCP), Somatic Experiencing Psychotherapy (SEPt), Sensorimotor Processing for Trauma (SP4T), and/or the Neuro-Affective Relational Model (NARM).

John Briere's Therapy for Adults Molested as Children: Beyond Survival;

Christine Courtois's It's Not You: It's What Happened to You: Complex Trauma and Treatment;

Laurence Heller's Healing Developmental Trauma: How Early Trauma Effects Self-Regulation, Self-Image, and the Capacity for Relationship;

Peter Levine's In An Unspoken Voice: How the Body Releases Trauma and Restores Goodness;

Patricia Ogden's Trauma and the Body: A Sensorimotor Approach to Psychotherapy;

Francine Shapiro's EMDR: The Breakthrough "Eye Movement" Therapy for Overcoming Anxiety, Stress, and Trauma;

Pete Walker's Complex PTSD: From Surviving to Thriving; and... 

Bessel Van der Kolk's The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma.

1 comment:

  1. If a person has suffered many of these things and recognizes the effect but has no resources, is there no way to go about attempting to repair such damage on their own? Additionally, with some knowledge of these techniques and the more clinical side of these issues does that have an effect on treatment?