Tag Archives: Trauma


A few days ago, I read an article on complex PTSD symptoms. I don’t have a diagnosis of coplex or regular PTSD and I realize there’s a lot of overlap with borderline personality disorder traits, which I do have a diagnosis of. Of course, I used to have a PTSD diagnosis, but that was removed because I did not have flashbacks that often. At least, that’s what I thought. One symptom after all that I completely relate to in this list, is having emotional flashback.

I never knew emotional flashbacks are a recognized symptom. I just thought they were covered under the umbrella of emotional regulation difficulties, which is a hallmark BPD symptom. As such, I usually saw complex PTSD as BPD when the person was believed to have been seriously traumatized. If a person was believed to just have had a few negative experiences, then they’d be diagnosed BPD. In my experience at least, the BPD diagnosis was used to deny I had been traumatized.

I don’t want to diagnose myself, of course, but the emotional flashback thing really struck a chord with me. Ever since I was a teen, I’ve experienced what I used to call “time shifting”. In a “time shifting” episode I’d have a kind of déjá vu experience. Usually, this was coupled with feelings of floatiness or unreality. The mental health term for this is depersonalization.

An emotional flashback is what it’s called when a person relives the feelings of past trauma. Boy, do I relate to this. Usually, I do have a slight inkling that I am transported back in time emotionally, but not always. I experience an intense feeling of helplessness, fear or sometimes despair.

Another type of flashbacks are visual flashbacks, when you experience the traumatic event as if you’re reliving it. I don’t have these often, although I’d readily trade an emotional flashback for a visual one. At least, with visual flashbacks, I can give words to what I’m re-experiencing and thereby desentisize myself.

Somatic flashbacks, I’m not sure I have. After all, most trauma I endured didn’t leave physical damage. I mean, I do have “weird” physical symptoms, but I’m assuming these are just from mental stress and aren’t direct relivings of a traumatic experience.

Like I said, most of my trauma was emotional or psychological. I usually think this doesn’t “count”, as most people when describing trauma, describe sexual or physical abuse. I didn’t endure much of this and, as far as I know, it didn’t leave me with major post-traumatic symptoms.

I did, however, describe the few incidents of physical and sexual trauma when I was asked about trauma by the psychologist who diagnosed me with PTSD. This is just easier to grasp. When I say a person hit me or threatened to rape me, it’s understandable it was abuse. Then agian, these incidents were few and far apart. For instance, the person threatening to rape me was practically a stranger and it was a single incident that had no connection to the ongoing trauma I endured.

This ongoing trauma left psychological wounds and I endure almost-daily emotional flashbacks of it. That being said, both the flashbacks and the traumatic experience itself are influenced by my interpretation. As such, it might be it wasn’t “real” trauma, but in my BPD mind, I interpret it as such.</P.

Just One Thing

Last week, I started a journal-style blog to explore my inner world. As usual, I didn’t write in it much at all, so I’m resorting back to this blog. The reason I wanted another blog is because of the derogatory comments I’ve gotten here regarding my dissociation. No, I don’t have a diagnosis of dissociative identity disorder anymore and no, I don’t claim to be DID. I do however have insiders, parts, alters or however you’d like to call them. I don’t care what people think of this, or at least, I try not to care. To reclaim myself and my experience, here I’m sharing a post I wrote last week.

Manyofus1980 from Therapy Bits posed an interesting question: if the world could understand just one thing about your mental health diagnosis, what would it be? In the post title, the question is about your “mental illness” rather than your “diagosis”. This is important to my answer, as my short answer is: my diagnosis does not dictate my experience.

I have had countless diagnoses over the years, some of which I agreed with and some of which I disputed. I don’t even know what my current diagnosis is according to my community treatment team. According to the university hospital where I got a second opinion last spring, it’s autism spectrum disorder, recurrent moderate depression and borderline personality disorder traits. Of this, I doubt the depression, because my default mood is low. Then again, I do seem to remember feeling much lower than low in the months that I had my assessment at this hospital. The thing is, I can’t usually connect my feelings from the past to the present if they’re very different.

We didn’t really go into my trauma experience, as my assessment was primarily focused on autism. However, the university hospital psychologist did recommend I get EMDR treatment for the negative experiences I had in the process of moving towards independence. I have not had a trauma-based diagnosis since 2013 and that’s fine by me. I don’t need a diagnosis to justify my experience.

I am who I am. We are who we are. We don’t fit in a diagnostic box, because, well, we’re we.

Sometimes, we feel upset that we don’t get recognition from our treatment team (as far as we know) for our traumatic and post-traumatic experiences. I had a lot of difficulty answering my psychiatrist’s questions about this during my intake interview. I mean, most of the trauma we endured, didn’t leave visible wounds. I know that dissociation can be caused by attachment issues, sometimes even too mild to create PTSD. However, there is still a common belief that only prolonged sexual or ritual abuse can create alter parts. I try not to care. We are we are we, so deal with it.

T – #AtoZChallenge on Mental Health

Welcome to the letter T post in the #AtoZChallenge on mental health. I’m a little late once again to publish this post, because this was a hard letter and I have once again been very tired. Here goes.


Transition or transfer happens when a patient moves from one setting into another. This could be from an acute unit to a rehabilitation, resocialization or long-term care unit. It could also be from a psychiatric unit into supported housing or community care.


Like I said yesterday, many psychiatric patients have endured some form of trauma. Trauma is experienced differently by different people. The diagnostic manual defines trauma for the purpose of diagnosing post-traumatic stress disorder as having endured, been confronted with or witnessed a situation that is life-threatening, threatened or actually caused physical harm, or sexual violation. Starting with DSM-5, it is made explicit that being confronted with such a situation through the media does not count. As such, people who for exampe watched the 9/11 terrorist attacks on TV (ie. virtually the whole world) cannot claim to have been traumatized by it. First responders who witnessed the events themselves, of course, can. So can people who lost loved ones in the terrorist attacks.

Please note that this definition is only used for the purpose of diagnosing PTSD. People can be diagnosed with another stressor-related disorder (eg. adjustment disorder with PTSD features) if their experience does not meet the criteria for trauma but is still distressing.

Treatment Planning

Treatment plans, like I explained when discussing care plans, describe the person’s overall treatment and diagnosis. On long-term psychiatric units, treatment plans are revised every six months or so. A patient has the right to contribute to their treatment plan and to review it, but on my unit, during the actual meeting, patients are not in attendance. I have only been asked to contribute once and am lucky if I know when my treatment plan revision is. Obviously, informal patients (and most patients on a section) must consent to their treatment plan before it can be implemented. In reality though, I’ve not seen my treatment plan in years so I think consent is automatically assumed.

S – #AtoZChallenge on Mental Health

Welcome to day 19 in the #AtoZChallenge on mental health. We’ve arrived at the letter S. Here goes.


Self-injury or self-harm is the deliberate infliction of wounds upon oneself. Some scientists make a distinciton between self-injury and self-harm. Self-injury is then seen as leaving relatively minor, local wounds such as cuts or burns. Many people with depression, anxiety or emotion regulation issues such as in borderline personality disorder self-injure. Self-harm then is the infliction of grave harm onto the self, such as amputation. This is seen more often, according to these scientists, in people with psychotic disorders such as schizophrenia. In reality, of course, only a small portion of even the most severely psychotic patients engage in severe self-mutilation.

In DSM-5, non-suicidal self-injury was introduced as its own mental health diagnosis. Prior to that, many people who self-injure were misdiagnosed, often with borderline personality disorder. The DSM-IV guidelines even said that, if someone self-injured to cope with overwhelming emotions, BPD should be diagnosed, even though BPD has nine criteria, five of which must be met for a diagnosis.


Self-medication refers to the abuse of alcohol or drugs with the goal to cope with mental health problems. It can also refer to the use of prescription medications that haven’t been prescribed to that specific person. Many people “self-medicate” with alcohol, even though alcohol does not have any medical benefits (except in mouthwash). In fact, it can make symptoms worse. Same for drugs. For instance, many people with psychotic symptoms use cannabis because it seems to calm them, even though it is in reality thought to worsen psychotic symptoms.

Of course, some drugs sold on the streets actually do help with certain symptoms. For example, people with undiagnosed ADHD might start using stimulant drugs to counter their symptoms. It is for this reason that self-medication needs to be taken very seriously. In my post on dual diagnosis last October, I addressed the complicated relationship between alcohol or drug use and mental illness


Many people were and still are treated for mental illness against their will. In the antipsychiatry movement, people who come out of (forced) psychiatric care are seen as survivors. Many mentally ill people have indeed endured traumatic experiences at the hands of professionals. Many also have had other traumatic experiences, which may’ve contributed to their mental health condition. As such, they’re also survivors.

Victim to Survivor to Thriver

Last week, one of the Friday Reflections prompts was about being a victim or a survivor. I didn’t have time to write about it then, so I will write about the topic now. I’m pretty fatigued and quite emotional today, so I hope my words make sense.

About ten years ago, I wrote on a mailing list for former preemies asking whether those born prematurely are survivors in the way that abuse survivors are. I mean, literally speaking of course we are survivors, because we survived against all odds. I was at the time still in a very early stage of figuring out my childhood and why I have always felt like a lot of my experiences were traumatic. I was beginning to discover the fact that I dissociate and learning about attachment and its dfficulties. The group owner, herself also a trauma survivor, replied that to survive means to endure hardship, so that in this sense, of course preemies – and most people with disabilities – are survivors.

As a child, I considered myself a victim of many of the experiences I endured. They were still happening, so how could I see myself as a survivor? In the same way, I can now see myself as a victim of mental illness. I don’t, of course, because no-one inflicted my mental illness on me and, besides, I don’t consider my craziness an altogether bad thing. It sucks sometimes, of course – well, most of the time it sucks. My point in saying I could now consider myself a victim of mental illness, is that it’s not over yet – I haven’t survived it as it’s ongoing.

I did survive my childhood trauma and do consider myself a survivor. Being a survivor does not mean having completely healed from your experiences, but it means having come out the other side alive literally and figuratively.

When describing the recovery process for people who endured trauma, we generally use three steps so to speak: victim, survivor and thriver. A victim is still in the midst of an experience. For instance, someone enduring domestic violence who hasn’t left the relationship yet, can be considered a victim. A survivor has escaped the direct effects of the trauma but is stil suffering from post-traumatic symptoms. A thriver has moved beyond their trauma and is living as healthy as possible a life.

The steps are not rigidly divided. For example, if a domestic abuse survivor has left their abuser but has not gone “no contact”, they can be both a victim and a survivor. Thrivership is also a continuum, where some people have no post-traumatic symptoms at all anymore and others can manage in spite of them. I will most likely always have borderline personalty disorder, which is in a way a post-traumatic condition. However, I want to someday have a meaningful life in spite of it.

Mental Health and Art Therapy #Write31Days

31 Days of Mental Health

Welcome to day 15 in the #Write31Days challenge on mental health. I will resume writing about personality disorders soon, but today, I don’t have the energy to do my research. Instead, I will write about art therapy, which is a form of therapy that can be particularly helpful to people with mental health issues.

Art therapy is a creative method whereby art mediums are used in the therapeutic process. It obviously originated at the crossroads of art and psychotherapy. Sometimes art therapy is focused on the creative process itself. For example, today while in art therapy, I made polymer clay beads. Sometimes, art therapy focuses on analyzing the interaction between therapist and client while engaging in creative arts.

Many people use art therpay to express feelings they can’t express in words. For example, trauma survivors, especially children, may use art to express their feelings about their life and the trauma they endured. An example of this was mentioned to my high school class when we got an educational session on giftedness. (My school was a grammar school, where about 30% of pupils were gifted.) A gifted boy, when drawing the human face, always drew an angry face. Another example perhaps comes from myself. In high school, I often drew blue-eyed figures in cages. This was an expression of how I felt trapped by my blindness.

Art can also serve a symbolic step in the healing process. For example, sometime in 2014, I created a baby self out of clay. I put it in a box lined with soft textures to express that she was safe now.

Art therapy can also serve the purpose of having the client explore new creative media. In this way, it can be used to encourage people with anxiety or sensory issues to try out new things. For instance, I sometimes get to try new materials to explore the boundaries of my sensory and emotional tolerance.

The creative process can also be used to have patients step out of their comfort zones. For example, my art therapist and I have used a drawing exercise by which I’d draw a random pattern (I don’t have enough vision to draw anything meaningful anymore). My therapist would first stay at a safe distance with her felt tip, but would try to gradually move into my drawing space.

Lastly, art therapy can simply be a form of leisure or recreational therapy. The polymer clay bead making didn’t have much of a purpose, other than perhaps having me try to handle the feel of polymer clay. Then again, I came up with the idea of doing this. It is more just a way to learn new techniques to use in my free time.

Ten Achievements of the Past Decade

Today in Blog Everyday in May, the prompt is to list ten achievements of the past ten years. Now I already did my 28 Before 28 post in February, so it’s an extra challenge not to repeat myself. I am just going to write, and if I don’t get to ten, well, screw it.

1. Graduated from high school. This happened just shy of a decade ago. I am not particularly proud of myself for graduating, probably because my parents were super over the top proud of me and I still can’t let go of a little parent-defying. I forgot most of what I learned in high school anyway.

2. Learned to clean and cook semi-independently. I went to an independence training home for the disabled in 2006 and 2007, where I learned many skilsl ncessary for independent living. I lost most of these skills again, but the fact that I learned them once, makes me confident that I can relearn them.

3. Overcame a mental crisis. It surprises me that, in the 28 Before 28 list, though I did include my diagnoses, I didn’t include the actual achievement of overcoming the darkest of aspects of mental illness. In all honesty, and I hope this doesn’t get me kicked out of care before I’m ready, I can say I’m much better able to cope than I was back when I was first hospitalized in 2007.

4. Finished two Open University psychology courses with a passing grade. IN 28 Before 28, I did mention that I took five courses in total, but the achievement of passing two of them in 2009 was largely overshadowed by the fact of the three that I didn’t pass.

5. Was able to let go of some of the darker trauma-based emotions and perceptions. As regular readers might know, I’m a childhood trauma survivor, which largely came to the surface when I was at my old rehabilitation unit in 2010. Though I got no evidence-based treatment for PTSD or dissociation, through a lot of talking and some work done on my own, I overcame most of the classic PTSD symptoms. I still have attachment issues, emotion regulation difficulties, etc., but I am confident that I will overcome the debilitating effects of these too.

6. Got married. I don’t usually credit myself for our relationship success, but then again it’s a mutual effort I guess, so I should deserve half the credit. If not, then well, I’m still happy I got married, so this fact still belongs here!

7. Started and restarted yoga. I took yoga classes in 2009 or 2010, but eventually quit because the emotions it brought on were too overwhelming. I recetnly restarted and am becoming quite successful at basic poses and exercises.

8. Was able to participate in group recreational therapy. In my old institution, I used to get individual day activities only. Due to budget cuts, I couldn’t get these for a long while in my current institution so I tried the day activity group. It’s still quite hard, but I can at least usually keep up.

9. Was able to enter the recovery stage with regards to my eating disorder. That is, I comletely stopped purging and recently was able to reduce my binge eating significantly too. I gained lots of weight in the past decade and have only started losing it again little by little over the past couple of months, but at least I’m improving. I also haven’t self-harmed in a few months, but that has not been a conscious effort as much.

10. Am generally much happier than I was ten years ago. This pretty much sums up all of my achievements. I didn’t earn the Ph.D. or get the high-profile job I thought I envisioned for myself ten years ago, but so what? I’m generaly less angry, less hostile and also less anxious than I was in 2005. I’m still not the shiniest example of positivity on the planet, but I’m trying to keep a positive outlook, and that’s what matters!

Found Love. Now What?
The List

Birth Story (Again!)

This week’s spin cycle prompt is “birthdays”. I have probably told what I know about my birth a dozen times, but you can’t raise enough awareness of premature birth. Or pester your readers enough about the emotional pain it inflicts.

I was born on Friday, June 27, 1986 at 12:03 AM at Dijkzigt Hospital in Rotterdam, Netherlands. I had my first ambulance ride right that night when they took me to Sophia Children's Hospital. Both hospitals are now part of Erasmus Medical Center, the university hospital in Rotterdam. Sophia Children's is the largest and oldest children's hospital in the Netherlands, having celebrated its 150th birthday a few years back.

I was estimated to be born at 26 weeks and four days gestation. When I was fifteen, I calculated what should’ve been my due date based on the day I was conceived (which my parents knew precisely because it was my father’s birthday). I then figured my gestational age should’ve been 25 weeks and two days. This weighed heavily on me because my mother had told me that, back then, they didn’t treat babies born under 26 weeks gestation. Now I realize that estimated due dates are just that: estimates. You can’t determine a baby’s gestational age just by looking at it, and the date the baby was conceived ony loosely predicts the date the mother last menstruated. Furthermore, I’ve never been able to find information on guidelines for treating babies in 1986. Now, doctors do have strict guidelines by which they don’t usually treat babies born under 25 weeks gestation. See my reasoning above for why this is nonsensical.

I spent 94 days in the hospital, of which I spent roughly six weeks on the ventilator. I went home on my supposed due date, September 29. While in the hospital, I had all three problems now seen as predictors of poor outcome: a lung infection, retinopathy of prematurity (the eye condition from which I’m now blind) and probably a brain bleed leading to hydrocephalus. The ROP and hydrocephalus were both discovered when I was five months old.

Each year around my birthday, my parents tell stories of how they walked down Gordelweg, where Sophia Children’s was located at the time, from the metro station to the hospital. In Rotterdam, cars are more of a hindrance than a help, so they didn’t have one. I don’t remember ever walking that route because I was discharged from follow-up when I was three. Now, I tell this story more often on my blog than my parents tell it to me.

As I’ve mentioned a couple of times on this blog, my birth story still impacts me. Having become more laid-back about my due date has helped. When I was a teen, I truly thought I’d be retroactively taken off life support for being a poor outcome. I still think so at times. Sometimes, I wonder what it takes to heal the psychological pain that I feel the circumstances surrounding my birth inflicted.

To My Baby Self

I have been thinking a lot about my life in the context of premature birth. It may be because I’m currently reading For the Love of Babies by Sue Hall, a neonatologist writing about her experiences treating preemies and other sick babies.

Today I also came across a writing prompt for PTSD survivors, to write to yourself before any trauma occurred. Since my trauma started right with my NICU experience, and I’m over most PTSD symptoms now, I will instead write to my baby self reassuring her that things’ll be okay in the end.

Little baby, born too soon
You feel so insecure
But let me tell you, you’ll be fine
Of that I am sure

You are too young to realize
That you are here to stay
In this world that may be harsh
You will be okay

Times are hard on you, you feel
So often in pain
If you could tell me, would you say
That your life is in vain?

I will tell you, it is not
Your life is worth the fight
I am your older self and feel
That you and I came out alright

Some people may think of you
That you should not survive
But guess what, you did exactly that
And I am here and thrive

You will have many hardships ahead
But please persist and cope
I will wait here to remind you
Not to give up hope