What happens when plans change? Do you sigh with relief, feeling an expanse of unexpected time and space opening up before you? Do you feel yourself tensing, a creeping awareness that you've just lost your projected future? How do you return to the life that existed before your plans? How do you return to what was?
On the brink of change, of conflict, of transition, or of loss? Perhaps you are less on the brink, and more caught up in the irresistable flow of life’s medley of challenges – and you feeling thrust into a future you aren’t quite ready for?
You aren’t ready to let go? You aren’t ready to enter the next bit that’s looming around the corner? That’s okay. You aren’t expected to be anything but what you need for right now. Now matters most. You can’t be equipped for the past, and you aren’t ready yet for the future. But you are here, right now.
Breathe in. Breathe out. Be. Keep being. You are the only you that will ever grace this messy, wonderful world. And we need you. So be. And breathe. Breathe out all the ‘should’s and the ‘try harder’s.
What do you need right now? Who do you need to be right now? Moment by moment our lives play out their journeys, and we wouldn’t want to miss anything.
It is enough to be enough right now. Fill up your life right now with the force of your own presence. Breathe deep and breathe big. You are enough for this moment. And then you’ll be enough for the next moment. And so we will move through our lives… gloriously, bafflingly Enough.
So, it's just occurred to me that I'm going through transition. I know, doh. Due to my impending nuptials, I'm planning on moving house in the next three months. I suppose it snuck up on me. I mean, I've done house moves. I've moved between countries, between cultures, as a student, as a newly wedded wife, as a new mum, as a divorcee. They've been routine, life-changing, hard work, and significant life events. So how did this one sneak up on me?
Isn't that an enticing phrase? A life that is whole, complete, wholesome, meaningful, seen in its entirety? There are many associations we can make with those three little words. The first time they came to my notice, it was as the title of a book being reviewed on BBC's Radio Four.
I grew up amongst some dedicated patchwork quilters. The work was too fiddly to appeal to me; I liked craftwork that gave more instant gratification. The quilters demonstrated seemingly infinite patience, and an ability to match varying patterns and colours in their beautiful creations. Those of us who grew up amongst transition and multiple cultural environments have the ultimate cultural patchwork personalities. Except that instead of the quilters' carefully selected squares of complimentary colours and shapes, each of our cultural worlds contribute their own distinct dimension to that which is 'Us', and these sometimes clash with each other! But, like any creative piece, as unexpected and tension-filled as it might be, its beauty is increased with understanding.
So while I've dipped in and out of the world of Star Trek over the years, I'd never have been described by my nearest and dearest as a 'Trekkie'. And yet I have Trash Jaeger (@spacetimeboss) on Twitter to thank for my special interest in the new series, Star Trek: Discovery. He tweeted: You better BELIEVE I'm hyped about a Star Trek that focuses on a PTSD-suffering Third-Culture Kid and I was hooked!
"I'm so excited; I'm going to the theatre tonight and I've not been in ages!"
"Sounds great - what are you going to see?"
"This thing on trauma. It's billed as both informative and funny."
Trauma. Private pain laid out on the stage? Humorous? A good night out?
We have witnessed many lifestyles, noted many different ways of doing life, parenthood, friendships, relationships. While we might experience not feeling 'enough' in terms of belonging to our passport (or host country) peers, we might also feel 'not enough' as a parent, a businessman/woman, artist, author, friend... the list could (and does) go on. To risk literary pluralism, we feel like "too little butter spread over too much bread" (Thanks, Tolkien).
As a follow up to my previous interview with PTSD practioners (read more here) I was prompted to seek out a therapist who could shed some light on Complex PTSD (or C-PTSD). And Mary-Clare de Echevarria very kindly stepped into the breach. In this post, she outlines the diagnostic and experiential differences between PTSD and C-PTSD and her clients’ treatment experiences.
Though I do not work directly with PTSD, I have gained a growing appreciation for the number of Third Culture Kids who have experiences of trauma featuring strongly throughout their life stories. And I am deeply grateful for therapists such as Mary-Clare who can so expertly support those battling both PTSD and C-PTSD.
Mary-Clare de Echevarria is a UKCP-registered psychotherapist, supervisor and training supervisor with over 20 years’ experience. She is a staff member at The Centre for Counselling and Psychotherapy Education, London, and teaches her own series of workshops on complex trauma, The Missing Piece™. Her website can be found at Primary Light.
What’s the difference between PTSD and Complex PTSD, or C-PTSD?
Trauma is an overwhelming negative experience that’s bigger than our capacity to integrate it. A single experience of ‘loud T trauma’, such as physical, emotional or sexual abuse, witnessing violence, 9/11 or a natural disaster, can lead to PTSD.
C-PTSD comes from ongoing trauma in childhood or adolescence: experiences of quiet t trauma, often coupled with loud T trauma. ‘Quiet t trauma’ refers to less obvious trauma such as not being understood or listened to; not being allowed to have feelings or needs, or not expressing them because your parents/caregivers can’t deal with them; not feeling safe or secure; not having anyone to go to for comfort or protection and feeling utterly alone; or constantly having to break attachments, eg through frequent moves or being sent to boarding school. C-PTSD is also known as complex or developmental trauma.
What draws you to working with clients with C-PTSD?
It’s the realisation that complex trauma underpins everything, and yet this is often not recognised. For so many people, an understanding of C-PTSD and dissociation is the missing piece that allows them to make sense of what they feel and the ways in which their past has shaped them. When you know how to recognise and work with it, the changes that come about can seem magical as they are so real and tangible. My students and clients who have C-PTSD are among the strongest, most creative and inspiring people I’ve met. It’s a privilege to work with them and help them to reconnect with parts of themselves that they had to ‘put away’, or dissociate, in order to survive. They learn to be kinder and gentler towards themselves, and are no longer overshadowed by constant background pain, anxiety or self-doubt. They start to feel powerful, competent and grounded in the present, in touch with themselves and able to stand up for themselves quite naturally and spontaneously. They say things like ‘I feel that I’m really living for the first time’.
What are the common presenting symptoms of C-PTSD that you identify in your clients?
As a therapist you have to learn to look for ‘intrusions into day-to-day functioning’: thoughts, feelings and behaviours that come from the past. They’re very real in the present and affect people’s ability to function in their lives, but they’re memories: emotional and physical memories of what you once felt. They can include critical voices in your head; persistent feelings of helplessness, emptiness, aloneness, or not being good enough; hypervigilance – waiting for something bad to happen; feeling that you have to be the strong one all the time, or that good things are for other people; intense reactions that seem out of proportion to the present situation; anxiety, depression or strange moods that seem to come from nowhere, then they vanish just as suddenly and you may feel ‘what was all that about?’. You may find it hard to have intimate relationships, to trust others or let them come close; you may be drawn to unavailable people, or find that you can’t always parent your children as you would want to.
Are there ‘mental blocks’ that interfere or complicate treatment and recovery from C-PTSD, that are shared by your clients?
Sometimes people are (understandably) afraid that they’ll have to ‘go back into the past’ and feel terrible. That isn’t the case: the aim of trauma therapy now is to help people to process traumatic experiences without becoming overwhelmed. It isn’t about going back into the past, but working with and resolving memories of the past that are coming into the person’s present. It’s essential that clients learn to feel painful feelings just for a moment, long enough to acknowledge them, then immediately bring themselves back to a place of feeling strong, safe, grounded and connected in the present.
What factors seem to be the most helpful in your clients’ recovery?
Psychoeducation – helping clients to understand what happened to them and how to recover, then therapy isn’t a mysterious process that they have to go along with: they know what’s going on and what to do to make themselves feel better. Having a therapist who is a real, attuned person. Above all, having a therapist who knows how to recognise and work with complex trauma and dissociation, is not at all afraid of it and understands that it’s a set of totally natural survival strategies.
Are there specific processes or treatments that you’d recommend in the treatment of C-PTSD, that your clients find especially effective?
A therapy that recognises dissociated states, sometimes known as ‘ego state therapy’. EMDR and interventions from sensorimotor psychotherapy or Somatic Experiencing, woven into an integrative, relational ego-state therapy. It’s essential to work with the body in trauma therapy, and I can’t recommend yoga highly enough as a way of connecting with yourself and your body and learning to feel strong, powerful, centred and relaxed in the present moment. Many of the interventions that I use regularly in my practice are drawn from yoga therapy.
Thank you so much Mary-Clare, for your work and for your insight.
If you have any questions for Mary-Clare, do contact her on the link above.
"So my name is Rachel Cason, and I'm a failure". This was how I felt like introducing myself yesterday. Complete with aggressive self-loathing and topped with misery and embarrassment. I had failed my driving test. Halfway through it I failed to see and respond to the actions of the driver ahead of me, and probably frightened my examiner half to death. I somehow managed to complete the rest of the test competently, but my ultimate failure was made worse by the fact that my examiner was convinced due to my otherwise tolerable driving, that I had seen the danger ahead and simply taken a chance. So I had failed. AND I had been misunderstood. This is such a 'double-whammy'. I am a Third Culture Kid, and have grown up working frantically to try to work out the rules of every new cultural environment I found myself in.