Dealing with denial

‘But if I accept that this is real, that this stuff really happened to me, then I don’t think I’ll be able to cope.’

The therapist looks at me as I splutter out my confession. I have used denial all my life to cope with my abuse. Now, a couple of years into therapy, I sit perched on the edge of a precipice. Will I free-fall into life without dissociation?

She says nothing. Instead her eyes narrow and she breathes slowly and deeply, looking intently right into the front of my brain. I feel like she is trying to draw more out of me, before daring to respond. The silence is uncomfortable but I refuse to comply.

‘Go on,’ she prods.

I sigh and growl out my frustration with myself.

‘It can’t have happened,’ I say, plaintively, and for a moment everything in me wants her to agree. I desperately, oh so desperately, want her to side with my denial.

But then the kickback: ‘But if it didn’t happen, then I’m just attention-seeking. I’m just a self-obsessed, manipulative, lying, despicable human being. If I’ve made all this up …’ – I wave my hands, trying to convey that I mean the entirety of my existence, not just the memories of abuse – ‘… then … then …’

‘Have you made it all up?’ she asks, gently. She isn’t asking to find out the answer. She is asking so that I confront myself with the answer.

‘No,’ I say, surlily. I glint a frown at her, displeased with her trickery. And then, erupting again, unsure of myself, twisted into confusion: ‘But maybe I have! I don’t know!’

‘Have you consciously made it all up?’ she asks, more precisely. I wonder how much courage it must take for her to persist against my volatility.

‘Definitely not,’ I say, more calmly, and with determination, because I know this isn’t true. ‘But maybe – you know – maybe they are false memories?’

At this point I didn’t really know any of the background of the idea of false memories, the politics of them, the monumental efforts of PR by a group of accused parents to craft a defence. I had just imbibed the vague concepts, from strategic propaganda in tabloid newspapers and lifestyle magazines, that false memories were a thing.

‘And how did you acquire these false memories? Where did they come from?’

She has me stumped here. I have no idea. The accusation from the false memory brigade is largely that therapists implant false memories in their clients, although I was yet to discover this. In my case, it was a moot point as my first memories of abuse had surfaced whilst at University, a good 13 years or so before ever starting therapy. Flashbacks and slivers of these memories then bombarded me during my breakdown in 2005. I came to therapy because of these memories and the impact they were having on my day-to-day functioning, not as a blank slate ready to be inscribed upon by a malevolent therapist fostering dependence.

So if they are ‘false’, where have they come from? I don’t have a good answer for this, and I fall back on defaults.

‘Because I’m bad?’ I suggest, unconvincingly. Even though this feels true, I can at least see that it is poor logic. I haven’t defined what ‘bad’ is, and I haven’t demonstrated how this has led to ‘false’ memories. Or why the only memories that I have that are purportedly false are those of abuse, and not any others. I don’t for one moment doubt family holidays in Spain, or the family blue Ford Cortina, or the tree I sat in after falling in the river. Why are these not ‘false memories’ too?

All I can see, sitting there at this moment, is that my brain spontaneously generates images in my head of unspeakable things: terrible abuses that I don’t know how to imagine, because I don’t know that they can be true. I know, from previous discussions, that neither my therapist nor other ‘normal’ people are assaulted by these kinds of images. Are they psychotic delusions? That always feels like a tempting possibility – to ascribe them to a malfunction of my brain. But then they are accompanied so strongly by gut-wrenching horror, or terror, or shame: I relive the memory, at least partly, every time. And why else am I so messed up? Surely something has happened to me to be like this?

And then, the very next minute, I argue against myself again. No, no, it can’t be true. Because the memories don’t ‘feel’ real. They are different to other types of memory. (It will take me several years more to discover that traumatic memories are indeed a different kind of memory, being mediated principally by the amygdala rather than the hippocampus). Sometimes they are ‘there’ and at other times they aren’t. They seem to dance in the shadows in my brain. Surely this isn’t right, or normal, or sane?

‘What would you gain by creating false memories?’ the therapist asks, disturbing me out of my thought-maze.

What would I gain? It seems a strange question. But then, a lot of her questions seem strange, until I dig a little deeper. Usually they end up with a chink of light suddenly illuminating my brain in a new and surprising way. I both like the way she asks unexpected questions, and I’m also quite intimidated by it: I’m never sure I want to know the answers.

What would I gain? I realise that underlying her question is a theory that our behaviours are often driven by something. Freud and his followers would say that it was libido, the pleasure principle, the avoidance of pain, repressed desires … that our behaviours are basically the result of ‘something’. Evolutionary neurobiologists see it in terms of defence against threat: how would this course of action somehow, in some way, provide a survival advantage? Whatever the theory, the question is an intriguing one. What would I gain?

‘I would get sympathy and attention,’ I say, somewhat laboriously.

‘Hmmm.’

Is this the right answer, or not?

‘And how much sympathy and attention do you in fact get?’ she prods.

I nearly laugh out loud. Of course, I find it eternally confusing, why survivors of abuse are largely blamed, shamed and shunned, rather than sympathised with or plastered with attention. So if sympathy and attention are my goal, I have picked a particularly poor strategy. Surely there are easier ways than pretending that I’ve been abused: perhaps something that doesn’t make people draw back in fear and disgust.

‘Not a lot,’ I admit. I feel a little deflated.

‘And what would you gain instead by believing that they are false memories, if in fact they’re not?’

I feel stuck in some weird kind of Socratic dialogue: maybe at the end of this process I will emerge wise and learned. More likely I will just be appalled by the scale of my self-deception.

‘It would give me some distance from them,’ I proffer. ‘It would make it easier to deal with them. If they’re not real, then they don’t need to hurt.’ And there, right at the end of that sentence, the thought travels 12 inches downhill and stabs me in the heart. Suddenly I get angry, to mask from myself this whorling pain.

‘But I don’t know if they’re real!’ I protest. ‘And I can’t just pretend that I think they’re real when they might not be! What if I’ve made it all up? What if I’m just utterly nuts? What if a messed-up part of my subconscious is just wanting to believe I’m abused so that I have a reason and an excuse not to be good at anything in life? What if I’m putting two and two together and coming up with five? You don’t know that I was abused!’

She nods slowly at me and in a way that is telling me that she hears my pain and is wanting me to take a breath and calm a little.

‘No, I don’t know that you were abused,’ she says eventually. ‘And it’s neither my place nor my role to decide that. I’m not an investigator. I’m a therapist. I’m here to sit with you while you discover your truth.’

I butt in because I’m still too angry with myself to stay quiet. ‘But what if ‘my truth’ is a lie? What if I’m too screwed up to know what’s true from what’s not? You don’t know if I was really abused or not, if I’m just making it all up, and neither do I. So how can I recover from all this stuff’ – I’m waving my arms again – ‘if I don’t even know for sure what’s causing it? Maybe we’re spending all our time focusing on what happened when actually it didn’t? What a waste of time and energy and emotion that would be!’

She’s unruffled by my outburst and that on its own is enough to surprise me into silence. I realise that I’m expecting her to be cross with me for wasting her time with this massive lie, but she’s not. Even as I feel that I’m falling into a cyclone, she’s sitting calmly by, without a breath of wind on her. I feel even more insane. Why isn’t she bothered by my confession?

‘I don’t know whether you were abused or not,’ she says again, calmly. ‘At least, not in a legal, beyond reasonable doubt kind of a way. My job isn’t to declare that something is definitively, historically true. You might be remembering some aspects right, and others wrong. Memory is fallible. It gets distorted in the process of encoding it and then recalling it. We can’t rely on it to be 100% true. But I think it’s reasonable to rely on the overall gist. And the body doesn’t lie …’

I feel annoyed with her for not believing me, when I say I’ve made it all up. I am contrary and paradoxical. I feel unheard that she doesn’t believe my deception, and in five minutes I’ll feel unheard because she doesn’t seem to get the fact that I was abused. I am only vaguely aware of this. It is as if both viewpoints within myself are separated by a wall and I can only see the side on which I’m currently standing.

She carries on, in the same quiet way, with the same steady pace. It is infuriating.

‘We do know that people don’t develop dissociative identity disorder for no reason. We do know that certain experiences in early childhood lead to disorganised attachment. And we do know that trauma is behind both of them. What they don’t tell us is exactly what that trauma was, on what day, how it happened, who perpetrated it. But we can be fairly confident that your responses today, your emotions and your behaviours, your symptoms, the way your brain processes information, your shame and self-loathing, your hyperarousal and dissociation, your lack of affect regulation … it’s not random. It’s trauma.’

I resent the balance in what she’s saying. I feel ashamed of my all-or-nothingness. I wonder how on earth you become the kind of person who can weigh two opposites and hold them at the same time, like this. I feel defective and empty and worthless, even at her measured response to my frantic panic. I am so struck by her way of being that I don’t really take in the words themselves.

‘And we also know,’ she continues, ‘that the natural response to trauma is avoidance. The brain is wired to avoid something aversive. So it makes sense that your brain wants to avoid the reality of your trauma by denying it, by thinking that you’ve made it up. That’s what gives it the sense of ‘other’ – it’s an emotional, distancing technique. Denial and dissociation are two sides of the same coin. You deny that anything bad happened to you and this is the flip side of dissociation, which says at the moment it’s happening that it’s not. It wouldn’t be consistent for you to have a dissociative disorder and not to employ other forms of denial.’

I am at last struck by her logic and I fall silent within myself, feeling both reassured and horrified. Thank goodness I’m normal, I want to say, and also but I wish I wasn’t. Because I wish it were not true.

I know, for certainty, that she’s right when she says I’m traumatised. That’s what all my symptoms add up to: I am classic, gold standard, textbook. There is nothing atypical about me. My brain acts and reacts exactly the way you’d expect a traumatised brain to. Damn.

I scrunch my face up with displeasure. ‘I know, I know …’

‘What do you know?’ I think she’s just pushing me to engage with her, to put into words what is going on in the silence of my brain, so I acquiesce.

‘I know that I was traumatised. That’s the only explanation for my behaviours. I’m not mad, and I’m not bad. I’m just traumatised. I know that makes sense … it’s just … it’s just … I wish there were another explanation.’

A huge sadness seems to have curled around me all of a sudden and I feel small within myself as I look up at her.

‘But if I accept that it’s true – that something bad happened to me, even if I can’t ever be 100% sure what that is – then I’m afraid it’ll overwhelm me. I’m afraid it’ll hurt so bad that I won’t be able to cope. I’m afraid it’ll send me mad.’

She nods sympathetically. ‘I know. And you’ve protected yourself from that all your life through denial and dissociation. It’s a big ask to move beyond that. It’s a different way of coping. No wonder you’re scared. No wonder you don’t know if you’ll cope. Because you’ve never done it before.’

I know where she’s headed, so I jump in. ‘But you’ll say that just because I haven’t done it before, it doesn’t mean that I can’t do it. My default will be to believe that I can’t, because I don’t have any evidence that I can. But you’ll say’ – I’m referencing previous discussions here – ‘that it’s about transferable skills.’’

She nods and smiles a little. I think she’s genuinely surprised that I take in anything at all from our discussions as I spend so much time fighting her. In reality I feast alone in the dark for hours on every word she says.

‘But how do I do it, practically?’ I say, because I’m not content to base my faith on ‘transferable skills’ alone. ‘How do I cope with the painfulness of it all if I don’t use dissociation and denial? What do I do instead?’

‘What do you think?’

She must think I know the answer, to have asked me. Maybe the answer is lurking somewhere on the inside of my skull and I just need to hunt for it. I screw my eyes together to focus on the search. It takes me a while and I only see glimpses of it to start with.

‘Denial and dissociation are based on coping with what is by saying it isn’t,’ I say, to myself, rather than to her. ‘They’re not about facing reality, but distorting it. They’re good strategies if you don’t have the skills to cope.’

It’s her turn to butt in. ‘They were good skills for you up until now. But now you’ve got the opportunity to develop better skills.’

I open my eyes, suddenly puzzled. ‘But why?’ I’ve forgotten the point of it all. ‘Why not just keeping using denial and dissociation if they’re good strategies?’

She cocks her head to one side, as if unsure if I’m being serious. I think she’s genuinely surprised by my denseness sometimes. But she realises that right here, right now, I can’t access that information. So she reminds me.

‘Because they keep you a prisoner. They limit you. You have to put an awful lot of effort into avoiding reality. It’s an exhausting strategy: you have to keep on denying and dissociating, because as soon as reality strikes, you’re helpless to deal with it. It’s much better, surely, to resolve the pain and the trauma so that you don’t have to expend all that energy avoiding it any more?’

I nod but I’m confused. Sometimes my brain is laser-sharp but right now, as often happens in therapy, it’s fuggy and thick.

‘But isn’t it better not to feel overwhelming feelings, than be overwhelmed by them?’ My logic seems, for the moment, at least to me, faultless. After all, it is what my entire life has been based on to this point.

‘Hmmm. But dissociation is a scorched-earth policy. It doesn’t just eradicate negative feelings. It eradicates positive ones too. It stops you feeling alive, knowing that you exist, enjoying yourself.’

Ah yes, that. This is what I always forget, no matter how many times she explains it to me. Because although I understand her words, I don’t understand their meaning. I don’t think I really know what it is like to feel positive feelings, so I don’t crave them. They’re a nice idea, but nothing more.

As if she can read my thoughts, she adds another layer: ‘And you can’t separate your feelings from your body. The feelings are still there, even if they’re dissociated. Instead they come out in physical symptoms.’

Damn.

This I know to be true. This is the best explanation I’ve ever had for years of sickness: chronic fatigue syndrome, medically unexplained pain, a malfunctioning immune system. The best medical science can suggest by way of a cause has always been ‘psychogenic’ or the slightly more stigmatising ‘psychosomatic’. Meaning exactly what the therapist is now saying.

‘So I either feel my feelings as emotions, or I feel them as sickness?’ I ask, miserably.

She pauses as if to acknowledge my pain. It’s filling up the space between us, like an invisible fog. Then she nods. ‘Either way, they are going to be felt,’ she says, almost apologetically, as if she is responsible for this law of the universe.

I feel everything in me sinking down towards the floor. It feels like there is no escape, and I say so. ‘There’s no way forwards without suffering, is there?’ I say, abject and genuinely scared. ‘I either carry on being sick and dissociated, or I have to feel overwhelmingly painful feelings.’

She sighs too. ‘I know. It’s rubbish.’

My eyes plead for hope from her.

‘But it won’t last forever,’ she offers. ‘The thing about feelings is that they don’t persist. You can spend forever avoiding them. But if you actually face them and feel them, then they change. They move on. Remember: emotions have motion. They never stay the same. They only stay the same, painful and overwhelming, while you’re not feeling them.’

It seems a lot to hope for and believe, that you can walk through a fire and you won’t be burned to death in the process.

‘But what if I can’t cope?’ I say, genuinely weighing up what she’s saying. ‘What if I get overwhelmed? What if it sends me mad?’

She leans towards me, earnest and compassionate. It’s everything she is in this moment that is speaking to me, more than her words, because for once I don’t feel alone in the universe. ‘You coped with far worse in the past. You coped with it actually happening. This is nothing compared to that. You’re stronger than you think.’

‘But I coped with that with dissociation. We’re talking here about not dissociating away my feelings any more. Maybe that’s what I’m not capable of ...’

There’s something about the fervid steadiness of her, her belief in me that is permeating the air, that is beginning to settle a strength in me. I know that she won’t convince me with logic. It’s less tangible than that. She believes me. She really, actually, believes in me. I can feel it. The question is: can I believe in myself?

The clock is ticking away, rudely. I catch her sideways glance at it and realise that I have no idea if I’ve been here ten minutes or ten hours. No, time is up. Saved by the bell, I think to myself, wryly. But there’s time for one last thought. Although still fearful of feeling feelings and being overwhelmed by them, there is something tantalising about her belief in me.

‘I suppose I need to at least try …’ I venture. ‘After all, that’s why I’m here, isn’t it? I want fewer symptoms. I want a better life. I don’t want to keep on being affected by trauma. I want to live, and I want to live well …’ I trail off, suddenly anxious that I’m naming my wishes out loud. Who am I to want such things?

‘We can’t go over it …’ she says, in a frequent refrain, inviting me to join in.

‘We can’t go under it …’ I’m tempted to point out that it’s never wise to go with small children on a bear hunt (the origin of the refrain) but I desist.

I get up to get ready to leave.

‘Oh no,’ I say, without much humour, but she’s confident in me for a reason and somehow her right brain is speaking silently to mine, and for this moment I can feel it. ‘We’ve got to go through it …’

Read more from Carolyn's blog at www.carolynspring.com/blog and see her upcoming training, mainly aimed at counsellors and psychotherapists, at www.carolynspring.com/live-training. Online training is also available: www.carolynspring.com/online-training.