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“Days and weeks passed by with changes in seasons and the phases of the moon. But the one thing that remained unmoved and constant was something I told myself every single day, "Amira Kashyap, you are fat!”

“My life was now determined by the number on the scale or the digits behind food containers. But I was completely okay with it as long as my 24” waist size never felt even a tad tighter. But if it ever did, hell would freeze over, resulting in 21-day fasts until I felt thin enough.”

“I remembered all those times when the people around me believed that I had spent the last two years of my life faking an eating disorder for the sole purpose of attention. For that reason, every day I would read a thousand articles and watch a hundred videos on real survivors who’d battled anorexia. Then I would question myself. My ribs aren’t popping out of my stomach, so maybe it’s actually just in my mind. Then after a few days of surviving on nothing at all, I would look at myself, see my ribs popping out and ask myself, Am I now?”

“I asked myself this question every single day: Is it possible to break free? To break free from myself? It wasn’t by choice that I became this awfully unhappy. Something, I don’t know what, came upon me and my happiness was snatched away from me in a jiffy. Everything started to feel different. Something didn’t feel right when I woke up every morning and went to bed every night. Something didn’t feel right when I looked at myself in the mirror every 15minutes.Something didn’t feel right when my favourite doughnut became my worst enemy. Something didn’t feel right when all my mind was surrounded by was the pathetic, established standards of bikini bodies and skinny models.”

“It wasn’t like I had started magically eating two entire meals in a day. I would still survive the day with black coffee and apples, but it just seemed like I’d taken one step heavenwards. The mirror felt a little less frightening with each passing day. It was refreshing to talk to someone who was fully convinced that my eating disorder was as real as I thought.”

“Everything was going perfectly well until Dr. Roy paused for a long minute to stare at me with utter shock and revelation. I knew I had messed up. I should have just worn my black, full-sleeved dress instead. But again, I thought that the scars had lightened to an unnoticeable extent. But I guess I was wrong. That was when I realized that scars never went away entirely. “Did you do that to yourself?” he asked.”

“I wanted to be normal again. I wanted to be genuinely happy again and not just pretend. I didn’t want distorted mirror images to destroy and define my life any longer. I wished to breathe in the customary air, instead of the suffocating one people like me had accustomed themselves to breathe. I just wanted to break through these metal rods that I’d been caged behind for the last two years of my life. I wanted to feel plain, simple, genuine contentment again. I wanted to; I needed to.”

“I looked at my reflection in the glass door at the entrance of the house. For the millionth time, I saw something entirely different from what I desperately wished to see. But to be fair, what I wished to see was a replica of the skeletons I had come to worship. I often wondered as to why my eyes couldn't see what the world around me could. Why did my eyes see differently than others?”

“Every day, I saw this new distorted reflection of myself, and everyday, I despised it a little more than the day before. It was uncanny and delusional, my reflection, and I felt this urge to change everything about myself. 'What is happening to me', was a question that remained unanswered for a great amount of time because I was as unaware about it as every other person around me.”

“Whenever I looked at myself in the mirror, I always saw a morbidly obese reflection, while in truth I was achingly underweight. My obsession of looking good corresponded to wanting to look the way skinny models looked in television ads and fashion magazines, the personification of being attractive as described by the world around me.”

“So Amira Kashyap, what’s your story?” he asked as he set the big display stopwatch to a designated period of 59 minutes and 59 seconds. The perfectly tranquil way in which he asked me the question made me slightly nervous, even though I had spent the last few years of my life having imaginary conversations with an imaginary therapist. There were a lot of things I wished to tell him. From wanting to tell him about my first triggers to the very thought of me standing in front of a mirror haunting the living daylights out of me.These were just a couple out of the many thoughts in the archives of my brain. However, my mind went completely blank. I stammered and hesitated and managed to utter a total of seven words.“I don’t know where to start.” “Just say the first thing that crosses your mind,” he said. “I’m scared of food,” I blurted.”

“But although my body constantly reminded me that it was starving, the voices inside my mind never gave me permission to satisfy my hunger. At times, I would get affected when people passed statements like, “Why can’t you just eat?” However, I convinced myself that the only person who could understand anorexia was someone who had been through the eating disorder. I chose to remain quiet.”

“The development of a working alliance is crucial because it addresses a psychic phobia associated with relationships that is common in complex trauma clients. As we discussed, when primary relationships are sources of profound disillusionment, betrayal, and emotional pain, any subsequent relationship with an authority figure who offers an emotional bond or other assistance might be met with a range of emotions, such as fear, suspicion, anger, or hopelessness on the negative end of the continuum and idealization, hope, overdependence, and entitlement on the positive. Therapy offers a compensatory relationship, albeit within a professional framework, that has differences from and restrictions not found in other relationships. On the one hand, the therapist works within professional and ethical boundaries and limitations in a role of higher status and education and is therefore somewhat unattainable for the client. On the other, the therapist's ethical and professional mandate is the welfare of the client, creating a perception of an obligation to meet the client's needs and solve his or her problems. Furthermore, the therapist is expected to both respect the client's privacy and accept emotional and behavioral difficulties without judgment, while simultaneously being entitled to ask the client about his or her most personal and distressing feelings, thoughts and experiences. Developing a sense of trust in the therapist, therefore, is both expected and fraught with inherent difficulties that are amplified by each client's unique history of betrayal trauma, loss, and relational distress.”

“... every therapist must develop enough personal maturity, clinical wisdom, and capacity for good judgment to effectively and safely conduct psychotherapy, an imperative that is especially important in the treatment of this population. The emotion dysregulation and insecure and disorganized attachment of complex trauma clients elicit strong emotional reactions from others, even those in their support network, including therapists. Reactions can range from sympathy, sorrow, fear, and guilt to frustration, impatience, anger/rage, hostility, and disgust or contempt.”

“... the silent client may be experienced as withholding, oppositional, and sulking or as holding the therapist "hostage" in ways that elicit resentment and other negative responses. Because it is not unusual that relational and other forms of traumatization began when the client was preverbal, he or she may not have words. The lack of access to emotions or to words to describe them is known as alexithymia and is a common response to trauma. What the client is likely to have instead is somatosensory, behavioral, dissociative, and relational manifestations that therapists must seek to understand and translate into words, a process that involves hard work and intense focus.”

“Once I had found the courage to tell Rebecca about the children in my head, it wasn't so hard in the coming months to tell Roberta. On the train from Huddersfield one day in May I made a roll call of the usual suspects: Baby Alice; Alice 2, who was two years old and liked to suck sticky lollipops; Billy; Samuel; Shirley; Kato; and the enigmatic Eliza. There was boy I would grow particularly fond of named limbo, who was ten, but like Eliza he was still forming. There were others without names or specific behaviour traits. I didn't want to confuse the issue with this crowd of 'others' and just counted off the major players with their names, ages and personalities, which Roberta scribbled down on a pad. Then she looked slightly embarrassed. 'You know, I've met Billy on a few occasions, and Samuel once too,' she said. 'You're joking.' I felt betrayed. 'Why didn't you tell me?' 'I wanted it to come from you, Alice, when you were ready.' For some reason I pulled up my sleeves and showed he my arms. 'That's Kato,' I said, 'or Shirley.' She looked a bit pale as she studied the scars. I had feeling she didn't know what to say. The problem with counsellors is that they are trained to listen, not to give advice or diagnosis. We sat there with my arms extended over the void between us like evidence in court, then I pushed down my sleeves again. 'I'm so sorry, Alice,' she said finally and I shrugged. 'It's not your fault, is it?' Now she shrugged, and we were quiet once more.”

“It is necessary to make this point in answer to the `iatrogenic' theory that the unveiling of repressed memories in MPD sufferers, paranoids and schizophrenics can be created in analysis; a fabrication of the doctor—patient relationship. According to Dr Ross, this theory, a sort of psychiatric ping-pong 'has never been stated in print in a complete and clearly argued way'. My case endorses Dr Ross's assertions. My memories were coming back to me in fragments and flashbacks long before I began therapy. Indications of that abuse, ritual or otherwise, can be found in my medical records and in notebooks and poems dating back before Adele Armstrong and Jo Lewin entered my life. There have been a number of cases in recent years where the police have charged groups of people with subjecting children to so-called satanic or ritual abuse in paedophile rings. Few cases result in a conviction. But that is not proof that the abuse didn't take place, and the police must have been very certain of the evidence to have brought the cases to court in the first place. The abuse happens. I know it happens. Girls in psychiatric units don't always talk to the shrinks, but they need to talk and they talk to each other. As a child I had been taken to see Dr Bradshaw on countless occasions; it was in his surgery that Billy had first discovered Lego. As I was growing up, I also saw Dr Robinson, the marathon runner. Now that I was living back at home, he was again my GP. When Mother bravely told him I was undergoing treatment for MPD/DID as a result of childhood sexual abuse, he buried his head in hands and wept. (Alice refers to her constant infections as a child, which were never recognised as caused by sexual abuse)”

“Ja, jetzt! Das ist auch einfach. Aber andere Situationen sind nicht so leicht zu entschlüsseln. Das ist ja mein Problem! Ich bekomme Angstanfälle in Momenten, in denen ich überhaupt nicht traurig bin. In denen scheinbar alles in Ordnung ist. Und dann denke und denke und denke ich. Versuche, in meinem Kopf zusammenzufügen, was nicht zusammengehört. Mein Kopf ist wie ein minderwertig produziertes Puzzlespiel, die eizelnen Stücke sind schlecht ausgestanzt und passen einfach nicht zusammen! Es macht mich wahnsinnig immer auf der Suche nach einer Ursache zu sein. Die ganzen Möglichkeiten rennen in meinem Kopf durcheinander wie eine aufmüpfige Kindergartengruppe. Alles schreit und will nicht in einer Reihe stehen!”

“Too often the survivor is seen by [himself or] herself and others as "nuts," "crazy," or "weird." Unless her responses are understood within the context of trauma. A traumatic stress reaction consists of *natural* emotions and behaviors in response to a catastrophe, its immediate aftermath, or memories of it. These reactions can occur anytime after the trauma, even decades later. The coping strategies that victims use can be understood only within the context of the abuse of a child. The importance of context was made very clear many years ago when I was visiting the home of a Holocaust survivor. The woman's home was within the city limits of a large metropolitan area. Every time a police or ambulance siren sounded, she became terrified and ran and hid in a closet or under the bed. To put yourself in a closet at the sound of a far-off siren is strange behavior indeed—outside of the context of possibly being sent to a death camp. Within that context, it makes perfect sense. Unless we as therapists have a good grasp of the context of trauma, we run the risk of misunderstanding the symptoms our clients present and, hence, responding inappropriately or in damaging ways.”

“When I was 15 years old, I came in contact with my first ashram, my first spiritual commune, in the form of Ljusbacken ("The Hill of Light") in Delsbo in beautiful Halsingland in the north of Sweden. Ljusbacken consisted of an international gathering of yogis, meditators, therapists, healers and seekers of truth. It was on Ljusbacken that I for the first time came in contact with my path in life: meditation. It was also on Ljusbacken that I meet people for the first time in my 15 year old life, where I on a deep wordless level felt that I meet people, who were on the same path as me. It was the first time that I meet people, who could put words on and confirm my own inner thirst after something that I could only occasionally sense vaguely, like some sort of inner guiding presence, or like a beacon in the distant far out on the open and misty ocean. For the first time in my life, I meet brothers, sisters and friends on the inner path. It was also on Ljusbacken that I meet the mystery called love for the first time in my 15 year old life. With my 15 year old eyes, I watched with wide eyed fascination and fear filled excitement the incomprehensible mystery, which is called woman. My own thirst after truth, together with my inner guiding light, resulted in an early spiritual awakening when I was 15 years old. It led me back to the inner path, which I have already followed for many lives. It led me back to a life lived with vision, with dedication and meaning, and not only a life governed by the endless desires of the ego, a mere vegetating without substance between life and death. It led me to explore the inner journey again, to discover the inner being, the meditative quality within, and to come in intimate contact with the endless and boundless ocean of consciousness, like the drop surrenders to the sea. At the source, the drop and ocean are one.”

“Although false memory psychologists point to therapy sessions as the setting in which people commonly determine that they forgot, and then remembered, abuse. Elliott (1997) found that the majority of people who had forgotten a traumatic event and then remembered it identified the trigger as some form of media presentation, such as a film or a television show. Psychotherapy was the least common trigger for remembering trauma." KNOWING AND NOT KNOWING ABOUT TRAUMA: IMPLICATIONS FOR THERAPY”

“How do we be with the paradoxes our people bring? We can align with one side of the conundrum and dismiss the other in an effort to relieve the unsettling experience that the logically unresolvable contradiction brings to us and our people. However, if we do this, we are stepping away from our person's experience because he or she is living inside the paradox and can't move away. Staying present asks us to hold the full paradox within our own minds and bodies, to enter the suffering that entails. If we are able to do this and remain in a ventral state, it seems that something happens and we may be able to enter a state in which the paradox begins to reveal its value a little differently than ever before ... As we settled into this broader acceptance together, I believe we made room for the possibility of the arrival of a resolving third thing in its own time.”

“A dysregulated nervous system is the most confining prison that can trap you. But if you can understand the bodily cues of safety and danger, you can learn how to regulate your responses and harness the most effective key to free your mind.”

“Psychoanalysis has suffered the accusation of being “unscientific” from its very beginnings (Schwartz, 1999). In recent years, the Berkeley literary critic Frederick Crews has renewed the assault on the talking cure in verbose, unreadable articles in the New York Review of Books (Crews, 1990), inevitably concluding, because nothing else really persuades, that psychoanalysis fails because it is unscientific. The chorus was joined by philosopher of science, Adolf Grunbaum (1985), who played both ends against the middle: to the philosophers he professed specialist knowledge of psychoanalysis; to the psychoanalysts he professed specialist knowledge of science, particularly physics. Neither was true (Schwartz, 1995a,b, 1996a,b, 2000). The problem that mental health clinicians always face is that we deal with human subjectivity in a culture that is deeply invested in denying the importance of human subjectivity. Freud’s great invention of the analytic hour allows us to explore, with our clients, their inner worlds. Can such a subjective instrument be trusted? Not by very many. It is so dangerously close to women’s intuition. Socalled objectivity is the name of the game in our culture. Nevertheless, 100 years of clinical practice have shown psychoanalysis and psychotherapy not only to be effective, but to yield real understandings of the dynamics of human relationships, particularly the reality of transference–countertransference re-enactments now reformulated by our neuroscientists as right brain to right brain communication (Schore, 1999).”

“How do you think your body and mind would respond if you were surrounded by psychologists, psychiatrists, or drug and alcohol counselors who subscribed to the belief that "once an alcoholic or addict, always an alcoholic or addict" and who believed that your current stay in rehab would be one of many?”

“Working to restore our voice with members of our first family can be a terrific learning experience. We didn't choose these difficult folks, but, as adults, how we talk to them is up to us. Observing and changing our part in family conversations is one royal road to change. In other words, if you can learn to speak clearly and to respond in a new way with your difficult mother or sister, then other relationships will be a piece of cake.”

“In the 1930s, Reich began to measure these energetic shifts in therapy. He noticed that real arousal causes the skin’s electrical charge to rise, especially in the sensitive areas of the body.”

“My parents were delighted that I was getting the help I needed, although I did not fully disclose the details of my living situation with them. While I was growing up, my projected role in the family was to always be the strong one. I was the mediator, or “Miss Perfect” as some family members would say, so I was usually clear on what I told them. With my traumatic brain injury, it was a bit different, so I didn’t share much of the daily happenings with my parents, except for the therapy sessions.”

“Bit by bit, Dr. Driscoll helped me to peel away the layers of protection I had built up over the years. The process was not that unlike the peeling of an onion, which also makes us cry. It has been a painful journey, and I don't now when it will end, when I can say, “OK, it's over.” Maybe never. Maybe sooner than I know. I recently told Dr. Driscoll that I feel the beginnings of feeling OK, that this is the right path.”

“When faced with choosing between attributing their pain to “being crazy” and having had abusive parents, clients will choose “crazy” most of the time. Dora, a 38-year-old, was profoundly abused by multiple family perpetrators and has grappled with cutting and eating disordered behaviors for most of her life. She poignantly echoed this dilemma in her therapy: I hate it when we talk about my family as “dysfunctional” or “abusive.” Think about what you are asking me to accept—that my parents didn't love me, care about me, or protect me. If I have to choose between "being abused" or "being sick and crazy," it's less painful to see myself as nuts than to imagine my parents as evil.”

“When emotions turn and stay sour, when thoughts become cynical and judgmental, good and compassionate treatment is on the line. Helpers who become sour and cynical tend to begrudge their high need clients for their neediness. There is a risk that helpers become too well-practiced at taking a bleak view of those they have avowed to assist. There is a temptation to begin to blame clients for their failure to improve. If treatment ends pre-maturely, with either a client never returning to treatment or a helper 'firing' them out of frustration, there is a tendency for the client to take the fall. Of course what we are talking about here are signs of burnout.”

“I think more people would stay active in church, if they didn't get so offended by the actions of members. Sometimes, you have to view places of worship as free mental health clinics, in order to deal with the piety or hypocrisy. Parishioners are a wounded souls in various stages of healing, who are being treated by angels, with credentials from the University of Hard Knocks. Some take their therapy seriously and try to practice what they learned. Yet, others down the sacrament like a healing dose of Prozac, with no other effort required. When you keep this in mind, you won't feel so annoyed by the personalities you encounter.”

“Only if we are able to widen the lens to take in the bigger picture that includes both the outer challenges and the inner distress do we begin to sense that the protectors are in proportion to what is in need of shelter. It is our system's sense that moving the safeguard aside and allowing the implicit to emerge would be more harmful than whatever the protector is doing in this moment.”

“Schon mit Anfang zwanzig hatte ich mich, nach meiner Niederlage gegen die bösartige Ikea-Hollywoodschaukel, in einer Therapie mit dem Unterschied von Drive und driven auseinandergesetzt. Ich hatte tief hineingeschaut in meine Kindheit und Jugend und wusste seitdem, dass ich zwei Arten von Ehrgeiz in mir trug. Eine helle, lustvolle und eine bedürftige, abhängige. Für diese zwei Arten von Ehrgeiz kennt die deutsche Sprache keine unterscheidenden Worte, und doch sind sie grundverschieden.”