Emotional Abuse Does not show Scars

Emotional abuse – know the signs

violence hurts

Psychological abuse, also referred to as emotional abuse or mentalabuse, is a form of abuse characterized by a person subjecting or exposing another to behavior that may result in psychological trauma, including anxiety, chronic depression, or post-traumatic stress disorder.

Emotional abuse is just one form of abuse that people can experience in a relationship. Though emotional abuse doesn’t leave physical scars, it can have a huge impact on your confidence and self-esteem. There are a couple of different types of emotional abuse and it might not be noticeable at first. However, if you are being emotionally abused there are a number of things you can do to get support.

Emotional abuse is elusive. Unlike physical abuse, the people doing it and receiving it may not even know it’s happening.

It can be more harmful than physical abusebecause it can undermine what we think about ourselves. It can cripple all…

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Ritual Abuse/Mind Control survivors – Internal Keys to Safety by Alison Miller

Trigger warning
A minority of people with Dissociative Identity Disorder or Other Specified Dissociative Disorder (DDNOS) have experienced ritual abuse (also known as trauma-based mind control). The combination of both creates additional struggles in healing because typically alter personalities will have been created to actively disrupt and prevent healing.
Fighting against these alter personalities tends to lead to more problems and prevents healing – but their roles and motives can be understood in a positive way, and survivors can learn to negotiate with and educate these parts/alters in order to heal together. Often these parts/alters will have been lied to and tricked by abusers, and may have been traumatized by them as well. If they discover this they may choose to work towards – rather than against – healing.
Psychotherapist Alison Miller recognizes two areas of problems for survivors of RA/MC:

  • Emotional instability and psychiatric symptoms
  • Inability to keep physically safe from the perpetrator group

She states both are related to programming – which is “the training of child insiders (alter personalities) to do ‘jobs’ assigned by the perpetrators.”

Trigger Warning yellow triangle

Download Internal Keys to Safety by Alison Miller (survivorship.org) to learn more – could be very triggering. 

Survivors may want to review this with your therapist or support person before reading it. This presentation is not meant as therapy or treatment.



Related Links

Books on Ritual Abuse and Mind Control by the Sidran Institute

Becoming Yourself: Overcoming Mind Control and Ritual Abuse by Alison Miller (book cover) 

Dissociative Identity Disorder: Skepticsm decreases with information and education about Dissociative Disorders 

Many studies have shown the majority of both psychiatrists and clinical psychologists view the diagnosis of Dissociative Identity Disorder (Multiple Personality Disorder) as valid. As understanding of Dissociative Disorders increases world-wide, skepticism decreases.

Warwick Middleton: Australian psychiatrist

Transcript

Now when the [trauma and dissociation] unit first started, there were psychiatrists in the hospital that was established who had the sort of reactions that were talked about here this morning, with raised eyebrows and shaking of heads, like borderline hell had just moved in. In fact, it’s sort of interesting that by not attacking, by not being overly defensive, by being warm, inviting, encouraging dialogue, giving appropriate information, research material, articles, books, et cetera, if they were requested, but certainly never attacking anyone for being a disbeliever or having a different paradigm, it’s very interesting over the years just how many of those psychiatrists that were openly incredulous and dismissive, have become stalwart admittants to the unit.  In fact, I can remember one psychiatrist … this is going back more than a decade and a half, who rang me, at that stage he was a senior registrar … it says something about the ambivalence about this area, he rang me saying he doesn’t believe that DID exists, but nevertheless he has a patient with it that he’s like to refer.

Research (Newest articles first)

Leonard, D., Brann, S., & Tiller, J. (2005). Dissociative disorders: pathways to diagnosis, clinician attitudes and their impact. Australian and New Zealand journal of psychiatry, 39(10), 940-946.
Abstract
Results: Of the 250 clinicians, 21% reported experience with more than six cases on average of any one of the dissociative disorders, 38% with less than six, 42% with none; 55% regarded them as valid diagnoses, 35% dubiously valid and 10% invalid. Of the 55 patients, 76% reported delays in diagnosis (57%, <3 years and 25%, <10 years) with adverse consequences in 64%; 80% had experienced sceptical or antagonistic attitudes from clinicians, rated as destructive by 48%. They were disabled (60% rated as <50% impaired) and were heavy consumers of health services (48% hospitalized, 68% <5 times). There was considerable comorbidity including moderate or severe depression (96%), self-harm (68%), suicide attempts (69%), panic disorder (53%), eating disorders (75%), substance abuse (25%), poor physical health (44%), major interpersonal (70%) and sexual problems (90%). Patients rated individual psychotherapy as the most helpful treatment (90%) but medications, such as antidepressants, were also valued (60%). Conclusions: Although over half of the responding Australian clinicians thought that dissociative disorders were valid, the rest were dubious about their validity with 10% believing them to be invalid. Only 21% had considerable experience with the disorders. These findings may relate to some of the difficulties perceived by patients, which included delays in diagnosis, suboptimal treatment and negative experiences with clinicians. http://www.tandfonline.com/doi/abs/10.1080/j.1440-1614.2005.01700.x

Somer, E. (2000). Israeli mental health professionals’ attitudes towards dissociative disorders, reported incidence and alternative diagnoses considered. Journal of trauma & dissociation, 1(1), 21-44.
Results: Years  in clinical  practice  (including postgraduate  and registrar  training)  did not  differ  between psychologists  (mean =  16.1 years, SD  =  9.68)  and psychiatrists  (mean =  18.8 years, SD  =  10.05). Overall, there  was  a  greater  tendency to believe  in the  existence  of  the  condition with 48 (55.8%) respondents  replying “Yes,”  and 32 (37.2%)  replying “No”  to the  reality of  DID. Five  (5.8%) participants  replied “unsure,”  and one  did not  respond to this  item. Excluding the  unsure responses  and one  missing value, a  chi-square  analysis  between psychologists  and psychiatrists for  this  item  showed a  significant  relationship between profession and belief  (chi-square  =  13.00, p  <  .001). Psychologists  showed a  greater  tendency to believe  in the  existence  of  DID  (23 yes, 3 no), while  the  slight  majority of  psychiatrists  did not  believe  in the  clinical  reality of  DID  (25 yes, 29 no).

Abstract Clinical diagnoses of dissociative disorders (DDs), including Dissociative Identity Disorder (DID), are controversial because there are mental health professionals in North America and elsewhere who are skeptical about whether these psychiatric disorders actually exist. This paper explores the attitudes of mental health professionals in Israel toward DDs and DID through a survey of 211 practicing clinicians (return rate of 39.5%). Of the sample, 95.5% scored at or above the point on a 5-point Likert scale measuring belief in the validity of DDs (m = 4.17, SD = 0.78); 84.5% declared at least a moderate belief in the validity of DID (M = 3.5, S.D. = 0.97). The average Israeli clinician surveyed had made 4.8 career-long DD diagnoses (S.D. = 18.06) and carried an average of 1.05 DD patients in his/her caseload (S.D. = 2.86). DID had a career-long diagnosis frequency of 0.14 patients per clinician (S.D. = 0.59) and was currently seen at a frequency of 0.03 cases per clinician (S.D. = 0.20). The five most frequently considered alternative diagnoses to DID in Israel were Borderline Personality Disorder (24%), Psychotic Disorder/Schizophrenia (23%), PTSD/Anxiety Disorder (10%), Malingering (8%) and Depressive Disorder (7%). The findings suggest that attitudes of Israeli clinicians are similar to those of North American clinicians despite the geographical and cultural differences between them. Full paper – https://www.researchgate.net/profile/Eli_Somer/publication/232909347_Israeli_Mental_Health_Professionals’_Attitudes_Towards_Dissociative_Disorders_Reported_Incidence_and_Alternative_Diagnoses_Considered/links/02e7e51cef1213f1df000000.pdf

Cormier, J. F., & Thelen, M. H. (1998). Professional skepticism of multiple personality disorder. Professional Psychology: Research and Practice, 29(2), 163.
Abstract
 If you saw a patient who appeared to have more than one personality, what diagnosis would you make? And how would you vary your clinical approach? Data from 425 respondents indicated that the majority of psychologists believed multiple personality disorder (MPD) to be a valid but rare clinical diagnosis. Respondents cited extreme child abuse as the foremost cause of MPD. Approximately one-half of all respondents believed that they had encountered a client with MPD, whereas less than one-third believed that they had encountered a client who feigned MPD. http://psycnet.apa.org/journals/pro/29/2/163/
Professional attitudes to Dissociative Identity Disorder (MPD) in Britain: More on treating DID where it doesn’t exist.  Paper presented at the 4th conference of the International Society for the Study of Dissociation-UK branch. J Mcintee. 1998. and

Davis, J.D. & Davis, M.L. (1997). The prevalence of dissociative disorders within the mental health services of a British urban district.Paper presented at the Fourth Conference of the International Society for the Study of Dissociation. Chester, UK, April 19-11.

Summarized by Somer, E. (2000) A recent survey conducted in Britain sought to test the prevailing view in the United Kingdom academic press that DID either did not exist or was fashionably over-diagnosed by gullible practitioners, influenced by ill-advised North American colleagues. The survey was designed to examine British psychologists’ and psychiatrists’ attitudes towards the identification and treatment of dissociative disorders (McIntee, 1998). Dissociative disorders had been encountered by 66% of respondents, of whom 14% attributed dissociation to iatrogenesis. The 965 British mental health professionals responding to the survey reported having seen a total of 3225 clients with DDs, 526 clients diagnosed as DID, and 596 clients with Dissociative Disorder–Not Otherwise Specified. The estimated life prevalence rates for a British research sample reported a year earlier were 15.2% for DDs in general and 5.7% for DID specifically, with clinical profiles resembling those described in the North American literature (Davis & Davis, 1997).
Hayes, J. A., & Mitchell, J. C. (1994). Mental health professionals’ skepticism about multiple personality disorder. Professional Psychology: Research and Practice, 25(4), 410.
Abstract
Three studies were conducted to investigate the nature of mental health professionals’ skepticism regarding multiple personality disorder (MPD). An initial pilot study was conducted to develop a psychometrically sound survey instrument. In Study 2, the results of a national survey of 207 mental health professionals supported the hypothesis that skepticism and knowledge about MPD are inversely related, r = –.33, p < .01, although the strength of this relationship varied among professions. Moderate to extreme skepticism was expressed by 24% of the sample. Results from Study 3 supported the hypotheses that MPD is diagnosed with less accuracy than is schizophrenia and that misdiagnosis of MPD is predicted by skepticism about MPD. Findings are related to literature pertaining to mental health professionals’ skepticism about MPD and consequential effects on treatment. http://psycnet.apa.org/journals/pro/25/4/410/

Dunn, G. E., Paolo, A. M., Ryan, J. J., & Van Fleet, J. N. (1994). Belief in the existence of multiple personality disorder among psychologists and psychiatrists. Journal of clinical psychology.
Abstract
Surveyed the attitudes of 664 psychologists and 456 psychiatrists with regard to the existence of dissociative and multiple personality disorders (MPDs). 97.5% of the Ss indicated that they believed in dissociative disorders, while 80% reported a belief in MPD. 12.3% did not believe in MPD, and 7.7% were undecided. Belief in MPD was related significantly to profession, age, and years of experience. Young Ss with less professional experience believed more in MPD than did older Ss. Ss who had worked with patients with MPD would tend to believe in the entity. http://psycnet.apa.org/psycinfo/1995-21368-001

Barton, C. (1994). Backstage in psychiatry: The multiple personality disorder controversy.
Abstract
Arguments about the existence of multiple personality disorder (MPD) are creating a professional dispute. Skepticism is manifested in literary as well as behavioral forms. The most widely cited recent skeptical paper is that of H. Merskey (see record 1992-31500-001). Merskey uses arguments that are sociological in nature but with little attention to empirical evidence. Merskey’s skepticism about MPD differs from skepticism in natural science. Proponents’ research is ignored rather than being subjected to critical examination and disproof through attempted replication. His skepticism appears largely based on challenges to the integrity of MPD patients and questions about the competence of therapists. http://psycnet.apa.org/psycinfo/1995-29438-001 Mersky’s response – and Barton’s response to it

Dell, P. F. (1988). Professional skepticism about multiple personality. The Journal of nervous and mental disease, 176(9), 528-531.
Abstract
Therapists who have treated patients with multiple personality disorder (MPD) were surveyed about professional skepticism regarding the existence of MPD. Of these therapists, 78% reported that they had encountered intense skepticism from fellow professionals. Much of this skepticism appears to be explainable in terms of a) the lengthy decline of psychiatry’s interest in dissociation, b) under appreciation of the prevalence of individuals with dissociative ability, and c) misconceptions about the natural clinical presentation of patients with MPD. These factors, however, could not explain the behavior of those skeptics who deliberately interfered with the clinical care of patients and who engaged in repeated acts of harassment against the patient and/or therapist. Half of the survey respondents reported that they had encountered these latter forms of extreme skepticism. http://journals.lww.com/jonmd/Abstract/1988/09000/Professional_Skepticism_about_Multiple.2.aspx


Life After Abuse: What No-one Tells You

It’s easy to assume that the end of an abusive relationship means the end of the problems caused by abuse. This may happen for a few people, but it’s not true for everyone!

Life After Abuse: What No-one Tells You. "Your old life doesn't just snap back into place immediately. You changed, and others changed along with you. - Thomas Fiffer, The Good Men Project

Your old life doesn’t just snap back into place immediately. You changed, and others changed along with you. – Thomas Fiffer


The lingering effects of abuse, and the extent of the damage that it is caused may only become apparent some time later. You will also find that coping with the abuse has changed your way of interacting with others, lowered your self-esteem and distanced you from those close to you (or, those who were close to you but no longer are.

If this sounds overwhelming and depressing then remember that recovering is both possible, and worthwhile. You can begin to have the good life you deserve. You might find it helpful to read the excellent article below – and to share it with those close to you, to help them understand that possible reactions after the end of the abuse – and what can be done to help.

    The Unspoken Secrets about Life After Abuse by Thomas Fiffer (The Good Men Project)

Related Links

It’s my fault, it’s always my fault: Self-Blame (traumadissociation.wordpress.com)
Posttraumatic Stress Disorder (traumadissociation.com)
Denial: A psychological defense against trauma (traumadissociation.wordpress.com)
If the Abuse is Ongoing (traumadissociation.wordpress.com)
Being male and a survivor (traumadissociation.wordpress.com)
The Misconcepts of Misandry (hatred against men) (rhsroyalreport.wordpress.com)
Signs of being in a pscyhologically abusive relationship (violencehurts.wordpress.com)

7 Things to Avoid Saying to People with PTSD – and What To Say Instead

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1. Get over it
Other variations on this are ‘why aren’t you better yet?’ and ‘But that was years ago.’ This is commonly said to abuse survivors, who often seem to be judged negatively compared to ‘wounded warriors’ who have PTSD as a result of military combat. Nobody chooses to have PTSD and it doesn’t disappear on demand, or when it becomes inconvenient for another person. Some people have PTSD for over 50 years despite working hard to heal, for others PTSD disappears by itself in a matter of months: even a trauma which seems ‘minor’ to another person, or happened decades ago can trigger severe PTSD symptoms. If a person could just ‘get over it’ in an instant, they would have already done so. Healing from PTSD doesn’t have a fixed timeframe, but support from others is known to help.

2. Everything happens for a reason
This view puts pressure on trauma survivors of find a positive reason behind their suffering, and can feel like the horror of the trauma is being minimized and was somehow ‘justified’. Some people do manage to find a positive outcome from the trauma, but it needs to be in their own time, and normally only happens late in the healing process. Healing PTSD involves dealing with loss, including the loss of a person’s former sense of safety, their former way of living (because PTSD symptoms often have a major impact on someone’s lifestyle), possibly losing their job or home, family, partner or friendships, and even sometimes their sense of identity. Would you say ‘everything happens for a reason’ to someone about bereavment? Then don’t suggest this to someone with PTSD.

3. It takes the same amount of effort to behappy as it does it be depressed
The exact opposite is true: lack of energy and lack of motivation are key symptoms of the depression, but a happy overall mood leaves you feeling energized and ready to face the world. Almost as bad is the phrase ‘If you act happy, you will become happy.’ The “persistent inability to experience positive emotions” affects many people with PTSD. Depression (and anxiety) often come as a result of PTSD, so rather than dealing with just one mental health disorder, a person can quickly find they are dealing with two or three. All people with PTSD regularly re-live the trauma, through flashbacks, nightmares or intrusive thoughts: with a mind that won’t stop replaying the worst moments of your life it would be hard to avoid feeling depressed. Severe depression makes it extremely difficult just to get out of bed, and willpower alone is not a known cure for depression. Disturbed sleep caused by PTSD or depression zaps energy levels further. Pressuring someone who is struggling to put on a fake smile or look on the ‘bright side’ in order to make you more comfortable isn’t helpful to them. Thinking or acting positively can help some people, but it can’t be forced. The pressure to ‘be positive’ can increase someone’s sense of isolation and any feelings of failure that depression brings.

4. All you need to do is…
‘You will feel better if you…’ is another version of this. There is no ‘quick fix’ or simple, easy solution to a complex condition like PTSD. It’s natural to want to help someone you care about, but unless you have been asked for advice, or have had a substantial battle with your own PTSD, resist any temptation you may have to offer solutions or well-being/mental health advice. Also be aware that news stories about new PTSD treatments are often misleading and not worth sharing: it is common to find out later they promote unavailable drugs, refer to clinical trials on mice rather than humans, involve a single study only, mention types of therapies which are not widely available, are only effective treatments for a different form of PTSD or PTSD caused by a different type of trauma – and they don’t mention risks (e.g., addiction and paranoia resulting from cannabis use, high drop-out rates, that it’s not advised for certain people, etc).
There is no single treatment or combination of treatments that everyone will respond to. Avoiding seeking professional help does not mean ‘not wanting to recover’ – it can simply be the result of the major PTSD symptom of ‘avoidance’ – which means avoiding anything that reminds the person of the trauma, including trauma professionals. Time does heal a proportion of people with PTSD, so a person’s mind may in fact already be healing by itself.

5. I know how you feel
It’s not possible to know exactly how another person feels, or what their thoughts are, unless you ask them. In PTSD symptoms often go from one extreme to another rapidly: from being emotionally numb to being anxious and ‘on edge’, or depressed and teary, then back again. One moment someone can be unable to stop talking about the trauma, and another time they will avoid conversations about PTSD or trauma and even the slightest reminder of it. Even after asking, you might not be aware of how strong particular feelings are.

6. Why didn’t you… during (or after) the trauma
You may want to keep your belief in a ‘just world’ where bad things don’t happen to good people – or if they do, good things later happen as a result – but trauma can affect anyone, and questioning someone’s actions or blaming them for a trauma is insensitive and judgemental. Unless you were in the same situation, at exactly the same time, and with the same personal history, you don’t know how you would reacted then – or how it would be impacting you now. Trauma responses are instinctive and biologically driven rather than logical decisions, and both ‘freeze’ responses and complying with (rather than resisting) a threatening person are common. Questioning someone’s actions, or rather reactions, during or after trauma is likely to feel like adding blame to someone who may not yet understand their own reactions.

7. It wasn’t that bad
Many people with PTSD will minimize their trauma, or may not mention the extent of what happened at that time (or shortly after the trauma). Some people have amnesia for some or most of the trauma’s details as well. This is the mind’s way of protecting itself from the full horror of the trauma, and the fact it could not be avoided or escaped. Don’t fall into the same trauma-related pattern of thinking and support their belief that ‘nothing really that bad happened’, ‘it was all my fault’ or ‘it was just an auto accident’, etc. The minimization (or even total denial) may later be followed by speaking out the reality of the trauma, which can sound contradictory, confusing and be judged as ‘exaggerating’ or ‘untrue’ because it doesn’t match the previous statements – or just because it sounds too horrible to accept. This pattern of minimizing (or denying) and then re-stating the trauma is not a measure of a person’s honesty, it can simply be the result of PTSD’s symptoms: either “distorted cognitions” about the trauma and/or an “inability to remember” major parts of the trauma (amnesia). A clearer picture of the trauma will emerge in time. If a person has developed PTSD that means the trauma has had a devastating impact and was too much for the mind to handle at the time. PTSD itself is a sign that the trauma was that bad, and even worse is the fact the person is reliving parts of the experience every day.

What To Say Instead
1. I’m here for you
But only say this if you really do mean it, over the longer term.

2. I’m sorry it happened to you
Nobody ‘deserves’ to be traumatized. Nobody makes that choice.

3. How can I help?

4. I can’t fix it, but I can listen.
Remember: listening doesn’t mean offering unsolicited advice.

5. Do you have the details of a helpline you can contact if you need to?
This shouldn’t be said as a way to avoid listening, but as a backup for when nobody is available or things are very hard. Helplines often offer text message or email help, some also offer online chat too.