When Your Consent is Taken Away

“Our lives begin to end the day we become silent about things that matter.” ~Martin Luther King Jr.

Almost a year and a half ago, Alyssa Milano posted on Twitter: “If you’ve been sexually harassed or assaulted write ‘me too’ as a reply to this tweet.” 24 hours later, there were more than 500,000 responses. 12 months later, the hashtag was estimated to have been tweeted over 18 million times. The #MeToo movement has caught people’s attention worldwide, yet sexual assault continues to be a difficult topic. Although uncomfortable to discuss, it is prevalent and life-altering, and worthy of our attention and dialogue. I write this post in line with April’s Sexual Assault Awareness Month campaign to raise public awareness about sexual violence and to educate communities on how to prevent it.

In my initial research for this blog post, I found some staggering statistics I would like to include:

  • Approximately eight out of 10 sexual assaults are committed by someone known to the victim
  • More than half of female victims of rape reported being raped by an intimate partner and 40.8% by an acquaintance.
  • A forcible rape occurs every 6.2 minutes within the United States.
  • Nearly 1 in 5 women (18.3%) and 1 in 71 men (1.4%) have been raped at some time in their lives
  • Most female victims of completed rape (79.6%) experienced their first rape before the age of 25, and 42.2% before the age of 18.
  • More than 1 in 4 male victims of completed rape (27.8%) experienced their first rape when they were 10 years of age or younger.

Call 800.656.HOPE (4673) to be connected with a trained staff member from a sexual assault service provider in your area.

Let’s discuss the basics of sexual assault. The term “sexual assault” refers to sexual contact or behavior that occurs without explicit consent of the victim. Some examples of sexual assault include attempted rape; fondling or unwanted sexual touching; forcing a victim to perform sexual acts; penetration of the victim’s body; sexual intercourse against a person’s will; forcible sodomy (anal or oral sex against a person’s will); forcible object penetration; marital rape; sexual contact with minors, whether consensual or not; incest; or any unwanted or coerced sexual contact.

Sexual assault can happen to anyone of any age, gender, race, and socioeconomic background. It can happen at any time or place. Assailants may be strangers, acquaintances, friends, or family members, and they may use violence, threats, coercion, manipulation, or other forms of pressure or deception to commit sexual assault.

Not all sexual assault is rape, but rape is one of the more well-known forms of sexual assault,. For its Uniform Crime Reports, the FBI defines rape as “penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim.” This can be done in one of three ways; the first is called a “blitz” sexual assault, which is when a perpetrator quickly and brutally assaults the victim with no prior contact, often at night in public.  The second is called “contact sexual assault”, and is when a perpetrator tries to gain their victim’s trust by flirting, luring the victim to their car, or otherwise trying to coerce the victim into a situation where the sexual assault will occur. The third type of rape is a home invasion sexual assault–when a stranger breaks into the victim’s home to commit the assault.

Call 800.656.HOPE (4673) to be connected with a trained staff member from a sexual assault service provider in your area.

The distinguishing line between sexual assault and consensual sexual activity is just that: CONSENT. Consent is a voluntary, sober, enthusiastic, informed, mutual, honest and verbal agreement. It is an active agreement that cannot be coerced. Consent is a process which must be asked for every step of the way. Consent is never implied and cannot be assumed, even in a relationship; simply dating a person does not give the right to sexual interactions. Legally, an intoxicated person cannot give consent!

Survivors of sexual assault often blame themselves for somehow behaving in a way that encouraged the perpetrator. When your consent is forcefully taken away, it is not your fault. I cannot possibly stress this enough: The victim is never to blame for the actions of the perpetrator! In my experience as a clinician, guilt is a feeling that each victim experiences during his/her healing process. Because of this, it is essential that victims get the appropriate and necessary treatment from a licensed, experienced therapist. I have treated numerous clients who have experienced sexual assault, and am equipped to help you or your loved one along this difficult yet beautiful path to healing. It is possible, and I am here for you. Please contact me today or click here to schedule a session.

Call 800.656.HOPE (4673) to be connected with a trained staff member from a sexual assault service provider in your area.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Making Room for Grief During the Holidays

This topic of grief and/or loneliness always seems to be increasingly relevant for many during the holiday season. In this post I will focus on these feelings, and how to let your grief have a healthy place in your life“Grief is two parts: The first is loss. The second is the remaking of life.” -Anne Roiphe

Last month I wrote about what I referred to as the “trauma of surviving”–or learning to live life after losing someone dear to you. Such loss may be due to divorce, a move, death, or any other change that results in a separation from loved ones. This topic of grief and/or loneliness always seems to be increasingly relevant for many during the holiday season. In this post I will focus on these feelings, and how to let your grief have a healthy place in your life.

A friend of mine recently told me about a movie on Netflix called the Babadook. A widowed mother is plagued by the death of her husband and simultaneously battles with her son’s fear of a monster lurking in the house. Although this is supposed to be a scary movie, the ending is applicable and relatable to the topic at hand. As the mother in the film avoids facing the reality of her husband’s death, the presence of the monster grows, and the complications in her life amount. In the end we see the mother well put-together and clearly in a different, more positive state as she takes food down to the “monster” that has been banished to live in the basement.  She is feeding or acknowledging the monster–or her grief–and by so doing, it is appeased. It stops tormenting her. Its malevolent presence diminishes and she is able to figure out how to live a balanced, happy life even after the loss of her husband. She lets grief have a place in her life.

While I have not personally seen this movie, I love the parallels that can be made between the monster and grief. Avoiding grief and acting like it is not there can wreak havoc on our life. It can and will weaken us and our important relationships. We must first, acknowledge it and second, work through it.

Acknowledge it.

The “monster” in the Babadook terrorizes the mother right up until the end of the film. She struggles sleeping, maintaining friendships, holding a job, and even keeping the basic elements of her life together. In the same way, grief can eat away at you if it is given the chance. A person who is dealing with grief will most likely display some of the following emotional symptoms: Increased irritability, numbness, bitterness, detachment, preoccupation with loss, and inability to show or experience joy. While these emotional symptoms are normal in the days and weeks after a traumatic event, they can be indicators of a more serious disorder if they do not fade over time.

Grief is unavoidable after loss; the only way to overcome it is to give it place in your life–face it. Popular blogger Emily Meyers, a young mother of five, lost her husband to cancer and was left to care for their children on her own. She wrote a beautiful post about grief, and I have found great truth in these words:

“There is no ‘other side’ of grief. It’s never going to pass. You don’t ever ‘move on’ from it. You just learn to live with it. You absorb it. It becomes part of you. You simply adjust and change. You slowly but surely find how to navigate through your new normal with it. It doesn’t get easier, you just get stronger. I’ll say that again: It doesn’t get easier, you just get stronger. You stop waiting for the storm to pass, and instead, learn to dance in the rain.”

I have some clients who, like the mother in Babadook, try to simply ignore their grief and “move on” without facing it. But again, just as the mother in Babadook, this does not and cannot work. As Emily Meyers said, you cannot simply move on. You must learn to live with your grief.  You must acknowledge it. Do not expect to move on from a life-altering loss without allowing yourself to bereave or grieve. Yes, I am telling you to be sad–it is okay!

Work through it.

The loss of anything important to you–a relationship, a job, an opportunity, a loved one– can cause feelings of profound grief. Sadness around the holidays–or any time of year–is okay. It is perfectly understandable and 100% normal to feel like you are not “over” your loss. What is important is what you do with your sadness. Acknowledging it is the first step, and once you have done this, you will need to work through your grief and process your emotions. For some, this may mean crying, writing in a journal, participating in a therapeutic hobby or activity (like exercise), talking with a friend, or counseling with an experienced, licensed therapist. The most important thing is that you take the time to work through your difficult emotions because they do not go away on their own. In my experience, I have seen that simply burying or ignoring grief only exacerbates the problem when it actually does surface. And it is sure to!

If the holidays highlight your loneliness or the absence of a loved one, this time of year can be especially difficult. Many of my clients find themselves in a slump around the Christmas season, and struggle to find something to celebrate. My heart aches for those who are grieving this year. I advise you to take my counsel to heart and acknowledge, then work through your grief. I know that by so doing you will find a place for your grief and will then be able to find a healthy balance of grieving and living life to the fullest. And, as always, if you need help facing or working through your grief, please do not hesitate to contact me today or schedule a session.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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The Trauma of Surviving

The Trauma of Surviving - Cluff Counseling - Denton TherapistDeath is inevitable, yet the loss of a close friend or family member is accompanied with a range of emotions. During this holiday season, and all seasons, it is important to recognize and address the trauma of surviving a loss of a loved one…because YOU are worth it!

Have you ever had a sibling or a roommate move out after living together for an extended period of time? If so, you have experienced what it is like to really notice someone’s absence; suddenly the house is quieter, the bathroom is sadly cleaner, and you feel oddly emptier. This experience, magnified infinitely, is similar to surviving after someone near and dear to you passes on. You become intensely aware of their absence, and it is often accompanied by unavoidable waves of grief and sorrow. This is a type of trauma.

A close friend’s mom passed away when we were freshmen in High School. I remember her putting on her game face, acting grateful her mom was free of cancer, but I knew my friend was a mess inside. I cannot begin to imagine how quiet her house must have felt, or how sad mealtimes must have been, or how many nights she must have cried herself to sleep thinking of all the things her mom would miss–graduations, marriage, babies. Losing her mom to cancer, at age 15, impacted this friend in ways she did not and could not understand at that time.

Everyone deals with death differently. My friend acted like nothing happened and continued living life as normal. Several years down the road, however, she snapped. She got into drugs, alcohol and risky sex, eventually got pregnant, and entered into a marriage she was not ready for or committed to. Years later, she cleaned up her life and is now in a different, stable marriage with additional children. After years of avoiding grieving the loss of her mother, she has started to confront her grief and I am encouraged she will continue to heal from the trauma of surviving the loss of her mother.

My clients, and friend, have taught me many things about the trauma of surviving, and I wish to share some of those with you today! As we enter the holiday season, past and present losses can be felt deeply and I want to give you some tools to help you navigate this season, and all seasons:

  • Talk about it–but only when you are ready. Let others in. Hibernating for a period of time is understandable, but eventually the time will come when you need to let others in. Start slowly by sharing with a few trusted people. Sometimes, this may be safest with a trained, experienced counselor or therapist.
  • Welcome the flood of emotions. Do not feel the need to “be strong” for anyone else. Allow yourself to feel the sorrow, the anger, the devastation, the relief…whatever it may be. Let that emotion have place in your heart and recovery.
  • Recognize you will need to recreate “normal.” Your life will never go back to how it used to be. That is the tragic truth of loss; it changes everything. But YOU and only you have control over the new normal you choose to create in your life. Let that empower you.
  • Do what you love with those you love. Practice self-care and self-love. Travel. Exercise. Pick up or make time for hobbies. Spend time with those you love.
  • Cherish the memories you have. Whether this means displaying pictures, making a photo album, or organizing family videos, celebrate the life and legacy of your loved one. By cherishing the time you did have, those memories can become more poignant, than the memories of the loss.
  • Give yourself time to heal. Recognize that grief is an emotion you need to process, and work through–just like anger, frustration, or resentment. Acknowledge the fact that your grief will be ongoing and that there will be harder days than others. Be okay with that and give yourself whatever time you need to heal.

Living through the death of a loved one is an incredibly traumatic experience, and it merits endless blog posts and conversations. Sometimes my friend will sheepishly admit through tears that she is not “over” losing her mother, and I have to remind her that it is completely okay! Navigating life without those we love most is and will be ongoing. It requires that we talk about it, give place for each emotion that arises, create a new normal, practice self-care, cherish memories, and give ourselves time to heal. I have a deep appreciation for those who live on after the loss of close loved ones; please contact me today and allow me to help you in the healing process. I am here for you!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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I Don’t Have Trauma…or Do I?

I Don’t Have Trauma...or Do I - Cluff Counseling - North TX Couples TherapistMost people associate trauma with terribly difficult and disturbing events like war or a natural disaster. Because of this, you may think you have never experienced something traumatic. However, any distressing event that falls beyond your normal scope of human experience can be considered traumatic! Odds are high that you HAVE experienced trauma. How have you dealt with it?

I was recently talking with a friend who told me she had never been through anything traumatic in her life. Although I knew she was referring to the fact that she had not experienced a death of a loved one, abuse, an accident, or something of like nature, I silently disagreed with her. While those experiences are incredibly traumatic for any individual who faces them, trauma is not limited to life-changing events like those. Trauma can happen every day in the normal course of your day without you realizing what you are up against. In this post, I will focus on the two different types of trauma and how we are all affected by trauma’s expansive reach.

Let’s start by defining trauma. What is it really? At its Greek core, trauma means to wound or to pierce. A search for this word will yield a definition much like this: “A disordered psychic or behavioral state resulting from severe mental or emotional stress or physical injury; an emotional upset, an agent, force or mechanism that causes high distress.” Basically, trauma is intense emotional distress resulting from stressful life experiences. Oftentimes when describing trauma, it is divided into two major categories: Big “T” and little “t” traumas.

Big “T” trauma

Big “T” trauma, or complex traumas, are events that involve physical harm and/or a threat to life or physical safety. Big “T” trauma is trauma in its most severe form, and can often result in Post-Traumatic Stress Disorder (PTSD). Examples of big “T” trauma include being in a combat/war zone, a natural disaster, a terrorist attack, immigration, rape, sexual assault, abuse, death, sickness, moving, financial stress, a car/plane accident, etc. These are extraordinary and significant events that leave us feeling powerless, helpless, and as if we have little or no control in our environment. This element of helplessness is a key difference between of big ‘T’ traumas and little ‘t’ traumas–feelings of helplessness being much greater in big ‘T’ traumas. These events can forever alter a person’s life, and may influence our ability to make/maintain relationships, and function later in life. One big ‘T’ trauma can be enough to cause severe distress and interfere with our daily functioning–which is intensified the longer treatment is avoided.

Little “t” trauma

Little “t” traumas are life events that are more common experiences that, although upsetting to an individual, are less severe or dramatic than big “T” traumas. A few examples of little “t” traumas include being teased in elementary school, always being picked last for a team, divorce, death of a beloved pet, losing a job, or losing friends by moving from school to school during childhood.  It is not necessarily the event that determines whether something is traumatic to someone, but the individual’s experience of the event. If an individual experiences an event as life-altering or upsetting in such a way that it changes the way they think about themselves or others,  it is likely a little “t” trauma.

The term little “t” trauma does not imply, however, that the emotional impact of such an event is insignificant compared to big “T” traumas. The emotional wounds can be as lasting and severe as big “T” trauma wounds!

Trauma’s reach

Everyone has endured some sort of trauma in their lifetime. Both big “T” and little “t” traumas have a strong influence on our view of the world and shape how we cope in life. For example, the little “t” traumas of being teased by peers and being picked last for the team can leave us feeling inadequate or insecure amongst our peers. Big “T” traumas may leave us orphaned, severely dissociated, or less physically capable than we may have previously been. The four core signs of trauma include the following:

      • Hyperarousal: These symptoms can be difficult to manage and can vary from person to person. In general, hyperarousal includes having a difficult time falling or staying asleep, feeling irritable or having outbursts of anger, having difficulty concentrating, hypervigilance (constantly being on guard), and being jumpy or easily startled
      • Dissociation of body and mind: This includes feeling disconnected from oneself, problems handling intense emotions, sudden/unexpected shifts in mood, depression or anxiety problems, derealization (feeling as though the world is distorted or not real), memory problems, concentration problems, and significant memory lapses.
      • Constriction of body and perceptions: Which may include the skewed notion that the individual was responsible for causing the trauma.
      • Feelings of helplessness: The inability to act or think for oneself, or to act effectively.

When symptoms of trauma continue for more than three months, it is considered PTSD or Posttraumatic Stress Disorder. Fortunately, all symptoms are not permanent if addressed properly–which means that healing for both little “t” traumas as well as big “T” traumas are completely treatable. Receiving treatment can truly reshape the way we view both the world and ourselves!

Trauma is treatable

Treatment for trauma consists of specialized counseling techniques and practices that will help you cope and deal with trauma and its effects on your life. I use EMDR (Eye Movement Desensitization and Reprocessing) , as well as Pia Mellody’s inner child framework to treat trauma. Because trauma contributes to negative thinking, negative behaviors, and difficult emotions, counseling for trauma can help you change your thinking and behaviors, which will, in turn, impact your mood. Counseling with me is a safe place where you can explore some very difficult issues that are hindering you from the life you want to live or the person you wish to be. If you think you may struggle with trauma, please reach out to me! Untreated trauma can lead to serious life consequences, the longer it is left untreated.

As always, the take away that I want you to remember (and cling to) is that treatment is available. Healing is possible! No matter where you have been, I can help you get relief from your trauma symptoms. Remember that everyone responds to traumatic situations differently; you may be experiencing only a few of the aforementioned symptoms, or you may be experiencing many. The severity, frequency, and duration of symptoms vary depending on the individual and his/her specific trauma event. What may affect one person may not affect another person in the same way. Counseling can help you explore your trauma and find the healing you may still need. Please feel free to contact me with any questions you may have.  I look forward to working with you!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Healing From Trauma: A Newer Treatment

EMDR - Cluff Counseling - Lewisville TherapistWith over 500 kinds of psychotherapy available today, one relatively new kid on the block has been widely heralded by the media, practitioners and mental health consumers. More than 60,000 trained clinicians believe in the power of EMDR–Eye Movement Desensitization and Reprocessing–including me!

Just a few months ago, in June, I posted on my blog about anxiety. Did you know that an estimated 44 million American adults suffer from anxiety, and only one-third receive treatment? I shared nine signs that often indicate anxiety, and urged my readers to seek help for this treatable ailment. In today’s post, I wish to share one of the newer methods of treatment available today: EMDR.

What is EMDR?

It is more than likely you have never heard of EMDR. That’s okay! It is a relatively new form of treatment, and kind of a funky acronym. EMDR stands for Eye Movement Desensitization and Reprocessing, and it is a breakthrough therapy with a special capacity to overcome the often devastating effects of psychological trauma. It was developed by Dr. Francine Shapiro, an American psychologist, in the late 1980s. Shortly after its discovery, an ever-growing community of therapists saw its power to transform lives, controlled research studies consistently demonstrated its efficacy and effectiveness, and many therapists sought training to become EMDR certified. Often therapists have said that EMDR felt like a gift to themselves and their clients, and they were eager to “pay it forward” by spreading the word to colleagues.

How did EMDR start?

Like many great inventions, EMDR was born out of serendipity. One day in 1987, private California practitioner, Francine Shapiro, went for a walk in the woods. She had been preoccupied with disturbing thoughts. She discovered that her anxiety lifted after moving her eyes back and forth while observing her surroundings. Intrigued, Shapiro tried out variants of this procedure with her clients and found that they also felt better. She concluded that trauma can be resolved naturally when a person recalls parts of disturbing experiences while stimulating the eyes (by moving them laterally). EMDR was born!

Initially, EMDR was utilized and studied as a therapy for PTSD (post-traumatic stress disorder) and other anxiety disorders, such as phobias. Therapists have since extended this treatment to a host of other conditions including depression, sexual dysfunction, schizophrenia, eating disorders, addiction, and even the psychological stress generated by cancer. EMDR therapy is applicable to a wide range of psychological problems that result from overwhelming life experiences. Although I mostly use EMDR for trauma, I have also used it for certain situations where the client faces OCD or is working through fear.

How does EMDR work?

EMDR therapists begin by asking their clients to identify events or situations that provoke anxiety or fear in the present–like the painful memories of a frightening accident. After the history of related anxiety provoking events has been gathered and the assessment phase is complete, the therapist, with the help of a client, identifies a “target” event to start with. By leading the patient in a series of left-to-right, or lateral eye movements, as the patient simultaneously focuses on a disturbing memory, “bilateral stimulation” occurs. Basically the the brain’s two hemispheres synchronize, which allows clarity. A therapist may use her hands, or other EMDR developed devices, to stimulate these bilateral movements.

Dr. Shapiro and her associates developed a number of procedures for coordinating what she termed, “dual awareness,” or the unifying of the two hemispheres of the brain.  The procedures have been refined and validated through controlled research at several centers around the world. Precise and careful use of these procedures can lead to the safe processing of memories, where negative thoughts and emotions can disappear.

This is more than a set of techniques. The EMDR approach provides a model for understanding human potential–including how positive experiences can lead to adaptive living, and how upsetting experiences can lead to psychological problems that interfere with a person’s ability to meet life’s challenges. The EMDR protocol requires clinicians to carefully assess and prepare adequately, particularly for persons with histories of multiple traumas.  

It has long been assumed that it takes a great deal of time to heal from severe emotional pain. However, multitudes of studies have been done on EMDR which repeatedly show that by using EMDR therapy, people can experience the benefits of psychotherapy much quicker. Two particularly notable studies include one where findings indicated that 84%-90% of single-trauma victims no longer had PTSD after only three 90-minute sessions; and another in which a whopping 77% of combat veterans were free of PTSD in just 12 sessions! In fact, there has been so much research on EMDR therapy that it is now recognized by several important institutions (like the American Psychiatric Association, the World Health Organization and the Department of Defense) as an effective form of treatment for trauma, other disturbing experiences, and even the more “everyday” experiences that bring individuals in for therapy (like low self-esteem, anxiety, or feelings of powerlessness).

I became interested in EMDR after witnessing the positive outcomes it had on my clients at an inpatient treatment center. I recognized that many clients, not just those with addictions, come into my office with trauma, and I wanted to find a way to decrease the power that the trauma had on them. This model of treatment works to decrease the intensity of emotions connected to a traumatic memory, and thus lessens the power these events have on them. I have seen EMDR work for countless clients. Two particular clients come to mind when I reflect on the power of EMDR 1) A young female adult, recently involved in a serious car accident, had trouble meeting the demands of her daily life after the accident due to flashbacks. Within 5 EMDR sessions, she was able to function like she had before her accident and the flashbacks had stopped. And 2) A client’s pet passed away which triggered the tragic death of her best friend as a child, which made sleeping impossible and caused her emotionally and physically shut-down. After multiple EMDR sessions, she was able to sleep throughout the night and started reaching out to friends (and even dating) again!

EMDR procedures should only be used by a fully trained EMDR clinician, who holds licensure in the mental health field. I have been fully trained in levels 1 and 2, and use this method on a regular basis. Just today I did three hours of EMDR with my clients! If you or someone you love could benefit from EMDR treatment, contact me today or schedule a session to be evaluated. I would be more than happy to give you an evaluation and offer the relief that can come through the effective administration of EMDR!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area. 

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SPLIT: A Deeper Look into Multiple Personalities

Britney Spears, Nicki Minaj, Marilyn Monroe, Lady Gaga, and Mel Gibson are a few famous individuals who have shared that they face Dissociative Identity Disorder–more commonly known as multiple personality disorder.  The average number of alternate personalities a person with DID has is between eight and 13, but there have been cases reported of more than 100 personalities within one individual. Read on to learn more about the cause and treatments for this mental illness.

Dissociative identity disorder (DID), often called multiple personality disorder (MPD), has fascinated people for over a century. In 2017, this disorder caught a bit of the limelight with the release of M. Night Shyamalan’s hit movie, “Split,” where the murderous villain has 24 personalities manifesting themselves throughout the abduction of three teenage girls. Although this movie was entertaining for some, 1% of the population who truly face this horror, may not have been as amused.

When Truddi Chase was just two years old, she moved out to the country with her mother and stepfather. At this time, she was sexually abused by her stepfather, and the trauma ultimately led to a DID diagnosis. For years, Chase was able to suppress her memories by holding them in alternate personalities that rarely came to the surface. Each of her 92 personalities held different memories, served different roles, and played different parts in protecting her from the past. One personality named Black Catherine held most of her rage. Another personality, Rabbit, held the pain. Chase wrote a book about her life, When Rabbit Howls, and, later, a movie was produced about her entitled, “The Voices Within: The Lives of Truddi Chase.”

The American Psychiatric Association defines Dissociative Identity Disorder as a disconnection between a person’s thoughts, memories, feelings, actions or sense of who he/she is. To some degree, this is a normal process that everyone has experienced. Examples of common dissociation are daydreaming, highway hypnosis or “getting lost” in a book or movie, all of which involve “losing touch” with awareness of one’s immediate surroundings. The difference between those more daily acts of dissociation and Dissociative Identity Disorder, however, is that DID is nearly always caused by a traumatic experience–such as an accident, disaster or crime victimization. Dissociation helps a person tolerate more than what he/she normally could. A person may mentally escape from the fear, pain and horror–which may make it difficult later to remember/recount the details of the experience.

Although there is so much we do not know about DID, we do know some things about DID:

  • Dissociation is present in all races, but is more common in American children.
  • Females experience more childhood abuse than males at a ratio of 10:1 and thus more females suffer from DID.
  • However, more males who have been abused may experience pathological dissociation.
  • Dissociative identity disorder is typically caused by trauma occurring at less than nine years of age.
  • Early age of abuse onset predicts a greater degree of dissociation.

DID is nearly always the aftermath of some form of trauma. Multiple personalities are unconsciously created in order to shield and protect the individual from reliving and remembering the traumatic experience. Sometimes these personalities can lay dormant as life stabilizes, but may manifest themselves during stressful periods of life. There is no medical attention formulated specific to DID; the recommended methods of treatment include the following three steps: 1) stabilization, 2) trauma-work and 3) integration. Dissociative patients who are not appropriately treated or who attempt to treat themselves tend to get worse and DID then becomes one of the most difficult to treat psychiatric conditions. Alternate personalities do not integrate spontaneously; treatment is necessary. Untreated DID tends to leave the sufferer vulnerable to to further trauma.

As with nearly all mental illness, there is a stigma associated with multiple personalities. We need to remember that this is a natural coping mechanism for those who have experienced intense trauma. The way I see it, those people who have DID are courageously fighting to survive and overcome past trauma. This means that functional, high performing, otherwise healthy individuals can experience DID depending on their childhood history. Mary Higgins Clark wrote a book called, All Around the Town where Laurie, the protagonist, is kidnapped at a very young age. She develops DID to face the sexual and emotional abuse she endures. After her release two years later, and the ensuing stabilization of her life, her multiple personalities subside for a time, only to reemerge after being triggered by her parents’ tragic deaths, causing her to confront the horrors of her past in order to heal. This book was incredibly interesting; I likely dissociated into Laurie’s world as I allowed myself to be fascinated by the manifestation of her mental illness!

My hope for those with DID and any other mental illness, is that they can find healing and hope. I never judge my clients facing these difficult challenges. It is important to remember that SPLIT was incredibly dramatized, and that the individuals with DID are just seeking to cope with life. It is likewise important to keep in mind that we all dissociate to some degree as the stresses of life close in on us! As previously stated, the best methods of treatment for Dissociative Identity Disorder is therapy, eye movement desensitization and reprocessing (also known as EMDR–of which I am trained in), and medications to treat depression or related symptoms. As with all mental illnesses, DID is not a life sentence.  Address the trauma that originally led to intense dissociation is the first step.  I am passionate about helping you find hope and healing. Please contact me today or click here to schedule a session.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Strength in Numbers: Support Groups

“Regardless of the road we follow, we all head for the same destination, recovery of the [alcoholic] person. Together, we can do what none of us could accomplish alone. We can serve as a source of personal experience and be an ongoing support system for recovering alcoholics.”            -Alcoholics Anonymous

I posted an article mid-February about disclosing mental illness–when, how, where, to whom, etc. It may seem easier to deal with mental illness alone, but great strength can be found in numbers. The same is true with addiction; more often than not, disclosing addiction to trustworthy individuals can empower and motivate you to overcome your addiction. There is great power found letting other people in so they can can comfort you, support you, and keep you accountable. Your family and friends will have an important role in your recovery and healing, but this post is about the kinship and healing you can find beyond your immediate circle of support and in support groups.

You have likely heard of Alcoholics Anonymous or “A.A.” This is an international fellowship where those looking to overcome alcoholism will be encouraged and supported towards sobriety. People all across the spectrum of alcoholism take part in these A.A. meetings, and participants become friends and a support system.  Alcoholics Anonymous is one of the most well-known examples of a support group, but support groups are certainly not limited to overcoming alcoholism. In short, a support group is a gathering of people who share a common health concern/condition, an interest or a specific situation–such as breast cancer, diabetes, heart disease, addiction, or long-term caregiving.  

The general purpose of support groups is to help identify healthy and effective coping strategies, as well as skills often geared to mitigating feelings of angst, fear, pain, and loss. The groups also provide a great support network—in support groups you can find other members in similar circumstances with similar feelings with whom you can share in an open and unedited fashion. The group allows you to be where you are and validates and normalizes what you are feeling. Imagine the benefits of being surrounded by people who not only support you, but understand what you are feeling and going through!

Support groups are available worldwide. If you are in search of a particular support group, ask your doctor, or mental health provider for recommendations, or search the internet, contact local centers (community centers, libraries, churches, etc.), or ask someone you know in a similar situation for their suggestions. In addition, there are many options online including chat rooms, email lists, newsgroups, FaceBook groups, blogs, or social networking sites. Help is out there!

On the other hand, group therapy is a more formal type of mental health treatment that brings together several people with similar conditions under the guidance of a trained mental health provider. Its focus is more educational, therapeutic, and process-oriented. It provides a forum for change and growth, and there is often a theme presented for the entire group, with specific outcomes anticipated.  Support groups are less structured, with no set curriculum, and the facilitator can be a lay person or anyone who has an interest in the subject (instead, many themes may enter a discussion by a fluid group of members, and the facilitator guiding from the side). The following are a few of the key differences between support groups and group therapy:

  • Openness. Oftentimes, support groups are very open, meaning individuals can come and go as they please. If participants are unable to make it, the group carries on as normal. With a therapy group, participant’s attendance is crucial to the benefit of the whole.
  • Size.  Therapy groups range from four or six to ten individuals. Support groups can be communal, allowing more participants.
  • Facilitator’s role. Therapy groups function because of the therapist at the helm, directly leading and educating the group. In support groups, however, the facilitator, who is typically a selected participant, guides from the side, allowing participants to make comments and build off of one another. In both cases, facilitators objective is to create a safe learning space for all participants.

Each type of group offers a unique dynamic and the key is finding a group that meets your specific needs and association. Not everyone will find it helpful to participate in the more intense, focused, therapy-based experience of group therapy; however, nearly everyone can benefit from a support group. Support groups are readily available and are often free. Benefits from participating in both a support group as well as group therapy include feeling less lonely, isolated or judged; gaining a sense of empowerment and control; improving coping skills; talking openly and honestly about your feelings; reducing distress, depression, anxiety or fatigue; developing a clearer understanding of what to expect with your situation; getting practical advice or information about treatment options; and comparing notes about resources, such as doctors and alternative options.

Support groups and group therapy have an important place in healing and recovery–be it from addiction or from mental illness. Depending on the situation, it may be beneficial to see a therapist one-on-one, in addition to attending groups. In some cases, medication is also necessary. If you would like more information, please contact me today. I am more than happy to schedule a session with you or your loved one and help create a plan for healing. When looking for resources to address addiction or mental health issues, do not forget about the strength of numbers you can find by participating in support groups and/or group therapy!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:

Life After Trauma

A traumatic experience can leave a person feeling broken, angry, hateful, useless, and/or depressed. With time and the appropriate therapy, survivors of trauma can go on to feel strength, forgiveness, empathy, purpose and happiness. Recovery is possible, and lessons learned in the furnace of affliction can go on to be a great strength in a survivor’s life.

Last summer, I wrote a post about being a secondary survivor: those who are the family or loved ones of someone who suffers a traumatic experience. I wrote about how difficult it can be for secondary survivors to watch their loved one struggle and deal with the aftermath of the trauma. I wrote about ways that secondary survivors can help their loved ones as he/she works to overcome their trauma, and offered specific suggestions for things to say to those who have experienced trauma. This post is dedicated to the survivor; although you may feel bruised and broken from the storm you have endured, as you look ahead, you can find your rainbow.

Let’s first define trauma. Trauma is broadly defined as something that produces psychological injury or pain. A traumatic experience can include (but is not limited to) divorce, rape, kidnapping, abuse (physical or emotional), natural disasters, fires, accidents, illness, bereavement, war, etc. Common reactions to trauma include anxiety, trouble sleeping, nightmares, flashbacks, OCD, PTSD (post-traumatic stress disorder), strained relationships, and unpredictable behaviors. In short, the aftermath of a traumatic experience can affect a person’s very being–including his/her daily walk and talk.

Although it may not feel like it immediately after the event, there is life after trauma. In fact, a difficult event can often lead to growth! We see this modeled in nature–majestic rainbows appear after torrential rainfall; butterflies emerge from their cocoon only after the caterpillar disappears as if dead in the cocoon; and even after the coldest of winters, flora and fauna reemerge or blossom for springtime. There are positive outcomes to come out of the wake of trauma; allow me to enumerate a few:

  • Recognizing strength. One of my friends experienced a horrible car accident where not only was she physically injured, but her friend’s life was lost. My friend’s rehabilitation took time, but she summoned the strength to face each day, took the time for both physical and emotional therapy, and is flourishing today. Trauma can teach us about our strength–how much we can endure and withstand giving in. Not only that, but once that strength is found, it is difficult to refrain from applying said strength to other situations. Survivors of traumatic situations tend to use their enhanced resilience to bounce back from opposition better than their pre-trauma selves.
  • Extending forgiveness. It takes incredible courage to be able to forgive the person who rapes you, abuses you, or crashes into you. But holding on to anger, hate, and frustration cankers the soul; when we let go of being wronged, we release bitterness and resentment that is poison to us. It is liberating to forgive, and often the forgiver receives more benefits than the person who is forgiven!
  • Feeling empathy. Experiencing trauma firsthand connects us to so many others who have faced hardship. Until we experience trauma, it can be difficult to really understand what other people are going through, what they are thinking, or what they really need to heal. The connection and compassion a trauma survivor gains provides a further source of strength, as well as, the ability to strengthen, connect with, and comfort others.
  • Finding purpose. Many survivors find that living through a traumatic experience awakens a passion or a deep purpose within them. Elizabeth Smart–who was kidnapped at age 14 and survived nine months in captivity–has used her horrifying experiences to become advocate and published author, traveling around the world bringing awareness to others. Sometimes, the darkest moments of our lives can inspire us to serve others.
  • Enjoying life. One of my clients has survived two deployments to Afghanistan. Although he faces understandable bouts of PTSD, he has found such vigor for living, and gratitude for life. To be alive in a functioning body is an amazing thing. Sometimes traumatic experiences help us enjoy aspects of life we had previously taken for granted.

Trauma is hard, scary, overwhelming. Surviving trauma, however, can teach you things you never knew about yourself, can help you comfort those similarly struggling, can awaken purpose and gratitude for living, and so much more. You may walk away from your trauma a better, changed person. As Viktor Frankl said, “When we are no longer able to change a situation, we are challenged to change ourselves.” Often, those changes can result in positive growth.  If you can wade through the storm your trauma puts you in, you will be able to look around after the storm passes to see how far you’ve come, see the beauty in your struggle, and see all the more clearly where you are going. You may even see that hopeful spectrum of light Issac Newton classified as a rainbow.

It takes time and work–sometimes both physical and emotional–to get to the other side of trauma. I am a qualified and experienced advocate; I can help you work through the effects of trauma. Please contact me today or schedule your first session and let me guide you as you write your story of life after trauma.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:

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Reliving the Horrors: PTSD

Reliving the Horrors - PTSD - Cluff Counseling, Trauma & EMDR TherapyPTSD is powerful and can change how people think, feel, act, interact with others, and see the world. It is estimated 8% or 24.4 million Americans will experience PTSD at a given time…that’s the entire state of Texas!

PTSD stands for post-traumatic stress disorder and can develop in someone who experiences a shocking, scary, or dangerous event. Examples of traumatic events that can lead to PTSD include, but are not limited to, the following: community violence like shootings, terrorist attacks, muggings, burglaries, physical or sexual assault, and bullying; sexual and/or physical abuse, natural disasters;  being in or witnessing a serious car accident; sudden unexpected or violent death of someone close; a serious injury like severe burns or a dog attack; a major surgery or a life-threatening illness; war or political violence.

PTSD manifests in a multiplicity of ways that is unique to the person and specific to his or her trauma. For example, someone attacked by a shark may never want to get in open water again. A person in a car accident may develop a fear of riding or driving in cars. Because the term PTSD often gets thrown around, I have included the list of signs and symptoms that mental health and medical professionals assess to diagnose PTSD.

You may have PTSD if you have the following symptoms for at least one month (as always, I would encourage scheduling an appointment with an experienced, licensed psychologist to get an official diagnosis):

  • At least one re-experiencing symptom:
      • Vivid nightmares
      • Frightening and/or intrusive thoughts
      • Flashbacks–reliving the trauma over and over
  • At least one avoidance symptom:
      • Staying away from places, events, or objects that remind you of the traumatic experience
      • Avoiding thoughts or feelings related to the traumatic event
      • Changing personal routines (like not driving or riding in a car after being in a car accident)
  • At least two arousal and reactivity symptoms:
      • Being easily startled
      • Feeling tense or “on edge”
      • Having difficulty sleeping
      • Having angry outbursts
      • Physical re-activity after exposure to traumatic reminders
  • At least two cognition and mood symptoms:
    • Trouble remembering key features of the traumatic event
    • Negative thoughts about oneself or the world
    • Distorted feelings like guilt or blame
    • Loss of interest in enjoyable activities
    • Feeling isolated
    • Emotional distress after exposure to traumatic reminders

It is natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a month, seriously affect one’s ability to function, and are not due to substance use or medical illness, it is called PTSD. Some people with PTSD may not show any symptoms for weeks or months. PTSD is often accompanied by depression, substance abuse, or an anxiety disorder.

Children, teens, and adults alike can get PTSD–it is a respecter of no one. Children under the age of six may exhibit behaviors like wetting the bed (despite having mastered potty training), forgetting how to or being unable to talk, acting out the scary event during playtime, or being unusually clingy with a parent or other adult. Older children and teens will likely respond more like adults (listed above). It is estimated that 7.8 percent of Americans will experience PTSD at some point in their lives, with women (10.4%) twice as likely as men (5%) to develop PTSD.

It is important to note that not everyone who lives through a dangerous event develops PTSD. In fact, most people will not develop the disorder. Possible resilience factors that can decrease the likelihood of PTSD include seeking support from friends and family, finding a support group after a traumatic event, learning to feel good about one’s own actions in the face of danger, having a positive coping strategy, and being able to act and respond effectively despite feeling fear.

There is hope for those with PTSD. Depending on the severity of the PTSD, the individual may need psychotherapy (also known as talk therapy), medication, or a combination of the two. Treatment plans vary depending on the individual’s circumstances, limitations, and needs. I utilize and have been trained in Eye Movement Desensitization and Reprocessing (EMDR), a type of trauma-focused psychotherapy, which has been shown to be effective in treating PTSD. EMDR involves using bilateral stimulation while the client keeps in mind various parts of the trauma (which helps your brain work through the traumatic memories). Please contact me to discuss which type of treatment might be most effective for you.

Living with anxiety, trouble sleeping, traumatizing dreams, repetitive flashbacks can make it hard to enjoy the simple pleasures of life. Seeking support and guidance through a friend, family member, or a therapist can assist you in the healing process. Call me today to set up your first session and allow me to help you find stability, health, and happiness again.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:

When #metoo Isn’t Enough: A Response

Metoo Campaign - Cluff Counseling - Lewisville Therapist

According to the nation’s largest anti-sexual violence organization, RAINN (Rape, Abuse & Incest National Network), each year 321,500 Americans 12 and older are sexually abused or raped. More than 60% of women are sexually assaulted in college and 88% of them do not report it. The prevalent #metoo movement filling our feeds begs the question–what now? What can be done to stop sexual harassment?

Recently, there has been an outpouring on social media of the hashtag #metoo. You may have wondered what it means, and its purpose. Harvey Weinstein, American film producer and co-founder of Miramax, was recently fired by his company’s board of directors following numerous allegations of sexual harassment, sexual assault and rape. Over the weekend, actress Alyssa Milano tweeted out this hashtag as a call-out to victims “so we might give people a sense of the magnitude of the problem.” The hashtag, #metoo, was created as a bold declarative statement that ‘I’m not ashamed of what I went through” and ‘I’m not alone’ , as well as a way to say–from survivor to survivor–‘I see you, I hear you, I understand you and I’m here for you.'” This hashtag has gone viral; it has been tweeted and re-tweeted, posted and reposted, and received thousands of comments, from both men and women!

If Alyssa Milano’s intent of re-tweeting #metoo was to “give the people a sense of the magnitude of the problem,” it is working! This movement has caught fire across our nation. Many are shocked to see their friend, classmate, neighbor, cousin, or family member post #metoo. The numbers are staggering; sexual abuse and sexual harassment have touched the lives of too many. The sheer quantity of #metoo posts filling our social media newsfeeds is absolutely alarming. According to RAINN, every 98 seconds an American is sexually assaulted, and every eight minutes that victim is a child. This statistic takes my breath away.

To further understand the #metoo movement, I think it is important to understand the definitions of sexual abuse and sexual harassment. Sexual abuse, or molestation, is unsolicited sexual behavior by one person toward another, often done repeatedly.  When the interaction is infrequent, or of short duration, it is called sexual assault. Beth’s story is sadly a common example of this: she and her boyfriend were watching a movie alone in her apartment, when cuddling led to kissing, kissing led to him carrying her back to her bedroom, where he forced himself upon her despite her persistent pleas to stop. Once he finished, he left her alone in the dark, feeling sweaty and dirty, where she justified his behavior by thinking she had not done enough to stop him.

Sexual harassment occurs in a workplace, or other professional or social situation, and involves unwelcomed sexual advances or obscene remarks, often by a person in authority toward a subordinate. Sara’s story exemplifies this: One day, during work at the retail supercenter, her boss approached her from behind and stuck his hand up her miniskirt. When Sara approached him to talk about the inappropriate placement of his hand, he advanced again, forcing her into the corner of his office. She fled the scene and lost her job.

The above abridged stories are only two of the many, many that exist. I share them not to invoke anger or to be triggering; I share them in the hope that it will empower–empower parents to teach their children, and for others to know that they are not alone and that it was not their fault. This movement has definitely served as a strength to so many women (and men) who have dealt with the repercussions of being sexual abused or harassed. But is solidarity enough? Is there more that can be done?

Admitting #metoo takes an incredible amount of courage. Many have never told anyone about their experience, and know that they may re-experience pain by recalling the memory.  By putting #metoo on your social media, you are adding credence to the significance of the problem. And to those of you who keep typing and deleting, #metoo, I see you. I understand where you are coming from. There is nothing wrong with not putting yourself out there and wanting to keep your experiences from the public eye of social media. Sharing your story with close family and friends can be just as powerful and important!

If you are not posting because you feel that what happened to you is not as significant as someone else, I would like to encourage you to reconsider. Your story is yours. What happened to you is no less significant because it is different than what you are reading on social media. My hope would be that by reading all of the #metoo posts, you will feel validated and not alone. I am certainly not saying that it is imperative for all victims of sexual harassment or abuse to share the hashtag, #metoo! What I am saying is that absolutely no amount of unwanted sexual advances or behavior is okay; regardless of “how far it got”, sexual assault or harassment, in any form, is wrong! Please do not invalidate your experience by thinking you are somehow to blame!

So we have said, read, or felt, #metoo. Now what? Yes, this movement has been striking and powerful, but we cannot let the momentum stop there. We need to act. I urge you to get involved in raising awareness so we can decrease the staggering statistics of those affected by sexual abuse. Here are some ideas:

  1. Speak out. On Thursday morning, the Chicago Tribune released an article urging men to speak out against sexual assault and harassment.  Women are not the only ones that are affected here! You have a voice. Within the realm of your comfort, speak out, speak up, and raise awareness.
  2. Share what you have read or experienced (to the degree that it is appropriate) with close friends and family members. Many people are not on social media; tell them what is going on around them and help them understand the implications of movements such as these.
  3. Teach your children about appropriate and inappropriate touch, and create a safe relationship where they feel comfortable asking any questions they may have.
  4. Listen to and support survivors. We all know someone who has been affected by sexual abuse or harassment. If someone comes to you saying they have been sexually mistreated, be there for them. Believe them first and ask questions later. It is astounding how many people around us have experienced some form of sexual abuse. Let us be a safe place for each other.
  5. Respect. Women and men do not like to be groped, receive cat-calls, or have certain body parts be the object of attraction. Operating like this means you are more likely to commit sexual harassment, assault, or rape–even if you think you are not capable of those horrors. Men and women need to stop objectifying each other!
  6. Advocate for better education and prevention. Meaningful, lasting change can happen through a series of  educational and institutional messages about prevention, and comprehensive training for staff and leadership. Holding one assembly at schools/campuses, or bringing in a single speaker isn’t enough to shift attitudes and behavior. Get involved in your community to improve education and prevention.

If you are one of the many people who typed, thought, or relate to the #metoo sentiment, please do not stop there. Now is the time to seek further healing. You do not need to do it alone. As a trained, experienced therapist, who has seen many clients in similar situations, I encourage you to honor yourself by seeking help and support. I urge you to not push this to the backburner. Get the help you need and deserve; schedule your first session with me today.

If you have experienced sexual assault, you can call the free, confidential, National Sexual Assault hotline at 1-800-656-HOPE (4673), or access 24-7 help online by visiting hotline.rainn.org.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Resources:
Allure: “A Note to Survivors Who Aren’t Ready to Share Their Sexual Assaults”
CBS: “‘Me Too’ trend on Twitter raises awareness about sexual assault”
Chicago Tribune: “It’s time for men to join the chorus of voices speaking out against sexual assault”
Cluff Counseling:  “Are You are Secondary Survivor?”
Cluff Counseling: “Choosing the Right Therapist for You”
CNN: “An activist, a little girl and the heartbreaking origin of ‘Me too’”
Huffington Post: How To Respond If Your Partner Has Been Sexually Assaulted Or Harassed”
LiveYourDream.Org: “FEMINIST FILM CLUB: THE HUNTING GROUND”
LiveYourDream.Org: “Understanding Domestic Violence: Facts and Figures”
Mashable: “5 crucial ways men can help end sexual assault”
RAINN Website
Refinery29: “Alyssa Milano Details What Needs To Change In Hollywood After Harvey Weinstein”
TSM: “Literally, Why Can’t I Say #MeToo?”
Wikipedia: “Harvey Weinstein”
Wikipedia: “Harvey Weinstein sexual misconduct allegations”
Wikipedia: “Sexual Abuse”