Depression

Depression is when you feel sadder than your circumstances dictate, for longer than your circumstances last, but still can't seem to break out of it. 

It's almost inevitable if you have lived in an abusive environment for any appreciable length of time that you will experience some kind of depression or negative effect. You may have emotions that confuse you or frighten you. You may not be "yourself". For abuse sufferers, this is normal. It's not to be expected that a person suffer abuse and feel nothing afterwards or have no scars.

Knowing we are depressed is one thing but doing something about it is another. It can be possible to know all the facts, the diagnosis, the prognosis and the technical details and yet be powerless to fix it. We can even know we are depressed but we can't just "snap out of it". If someone tells us to just "snap out of it" or "get over it" we may feel ashamed, humiliated, embarrassed or angry at them. Such advice, however well-intentioned can be as poorly timed as a comedy routine at a funeral. 

Symptoms of Depression

Here is a list (from Mayoclinic.com) of common symptoms of depression:

• Loss of interest in normal daily activities
• Feeling sad or down
• Feeling hopeless
• Crying spells for no apparent reason
• Problems sleeping
• Trouble focusing or concentrating
• Difficulty making decisions
• Unintentional weight gain or loss
• Irritability
• Restlessness
• Being easily annoyed
• Feeling fatigued or weak
• Feeling worthless
• Loss of interest in sex
• Thoughts of suicide or suicidal behavior
• Unexplained physical problems, such as back pain or headaches

Source: Mayoclinic.com

Depression symptoms can vary because different people experience depression in different ways. For example, a 25-year-old man with depression may not have the same symptoms as a 70-year-old woman. For some people, depression symptoms are so severe that it's obvious something isn't right. Others may feel generally miserable or unhappy without really knowing why. 

Depression While in a Relationship

If you are in a relationship and experiencing some of the symptoms of depression it is important to know that what you are experiencing is not uncommon. It is quite normal to struggle emotionally when faced with challenges which chronically and significantly affect our quality of life. It would be abnormal not to suffer from some kind of depression from such an experience.

Depression while in a relationship with a person who has a personality disorder can develop for a number of reasons:

Loss of "the dream" - Everyone dreams of having an idyllic life and we all experience disappointment and frustration when we discover that our own lives have not turned out the way we had hoped or like the heroes and heroines of popular fiction. It can be hard to accept the reality that our life is going to be different. 

Disregarded Priorities - When we are in a crisis-fighting mode, it is common to relegate our other "non-essential" priorities. This is OK so long as the crisis is short-lived. The problems come when the crisis never goes away. You may find yourself neglecting important goals in your life - such as family, career, friendships, dreams and aspirations which all take a back seat while you deal with the issues that come up from your relationship with a personality disordered individual. The frustration you suppress under the surface has a way of "coming out sideways" and depression is a natural consequence.

Reaping the Fruit of Poor Decisions - It is common to make choices which we later come to regret when in a relationship with a person who suffers from a personality disorder. Sometimes these less-than-perfect decisions are made in a frantic effort to "keep the peace" to pacify a raging partner or family member. You may do things like sacrifice friendships, career opportunities, you may decide to avoid family, you may spend money on fruitless projects to try to fill the seemingly bottomless pit of need of your loved one. You may give up things which are important to you. The trouble is that these sacrifices have long-term effects which you have to live with for months, years - even a lifetime. Living with the consequences of those decisions can make you feel very depressed. 

If Only ... - Those most tragic words: "If Only...". If you have lived with a person with a personality disorder then you have probably had such thoughts. It's almost impossible not to think about what might have been, what could have been, what should have been - if only things were different - as they should have been. Why me? Where did I go wrong? What did I do to deserve this? Many people will tell you that you shouldn't think that way. The reality is - it's difficult not to. 

Lingering Depression After a Relationship 

What is not so obvious - and harder to understand - is how depression affects us even after a relationship is over and the apparent source of all the trouble is gone. This happens to people who become separated or divorced, or who break off contact with a family member who suffers from a personality disorder, or who experience the death of a loved-one with a personality disorder. 

What causes depression after the dust has settled isn't so clear. Perhaps it is because we have a quieter more tranquil place and time to dwell on our own feelings rather than on the feelings of the people we have cared for. Perhaps it is because we allow ourselves to stop suppressing our own feelings. Perhaps it is like letting go of a tightly wound spring. Perhaps it is because we look ahead to the future with uncertainty, fearing that things will not get better or regretting the wasted years and the lost treasures of time and kindness and love. The reasons are uncertain but somehow our brains seem to be wired in such a way that we cannot instantly forget or move on from the traumas in our past. 

So it is that people who exit a relationship with someone who suffers from a personality disorder often feel worse immediately following the separation - not better. This can be hard to understand and sometimes can lead a person to doubt the wisdom of their decision to leave or get out of the relationship. 

There can be some obvious explanations for that depression - post departure. 

Drop in adrenaline - There can be a surge of energy or "buzz" that people feel when embroiled in a crisis. When this is taken away we have to fall back on our more "natural" energy sources. You may miss the thrill of the fight or the immediate gratification of the short term fire-fighting lifestyle. It may take some time to adjust. 

Ongoing consequences - While removing yourself from someone who suffers from a personality disorder takes away one source of trouble, it doesn't immediately remove all the trouble. You may have debts, children, fatigue, bad life choices, any number of long term consequences of the relationship which don't just evaporate when the relationship is over. 

The loss of someone to blame - After removing yourself from someone who suffers from a personality disorder, you can no longer point the finger at that person for your situation. But the instinct to fight can take some time to subside. Faced with sudden quietness that aggression can sometimes be turned outward towards people who we come into contact with or inward towards ourselves. 

Loneliness - Leaving a person who abuses you can be an extremely lonely experience. You may be relieved at the sudden removal of the trouble and fear but you may find yourself feeling very alone - facing an uncertain future, scared and longing for companionship again.

Fear that history will repeat itself - As you look to the future, you may find yourself with a pessimistic outlook. You may begin to wonder if perhaps you contributed to the troubles you have experienced - or that you don't make good decisions in relationships or in life. You may feel unlucky, cursed, unlovely or unattractive. You may find yourself believing that somehow you don't deserve a better life or that you are not smart enough or good enough to improve your situation. You may begin to believe that history will repeat itself. And when you feel powerless over your own destiny, or hopeless about your own future, you are experiencing depression. 

You can find some ideas about combating depression in our Working on Ourselves page. Also, visit our Support Forum and talk to others who have been there.

Non-PD Anger

Anger is what you feel when you don't get what you think you deserve. Non-PD's often feel a sense of anger over past abuses, an uncertain future outlook, unequal burden-sharing and persistent denial of their personal needs.

Anger is a feeling - and as such it is something which is neither good nor bad - it just is. You can't control your feelings any more than you can control the wind. Feelings are a natural response to circumstances and expectations. You simply feel things - and anger is something you are going to feel if you are subjected to injustice, abuse or intimidation.

According to Karla McLaren, anger is the body's signal that a boundary has been broken.

Sometimes feeling anger is foreign to a nonPD in an Unchosen Relationship. Often growing up in a PD environment provides powerful motivation (survival instinct) to suppress all anger in its entirety. In a toxic PD household having anger is not possible for the nonPD, it needs to be suppressed in order to survive. The nonPD role is often the happy and compliant fixer, to take abuse not to stand up to it. So learning to feel anger even at low levels and reset boundaries is unfamiliar, feeling anger and balancing anger needs to be learned.

Anger and other emotions are passing, they are felt and if we address the message and intent of the emotion it passes. It doesn't serve a purpose to hold on to anger for any great length of time. Once the boundary has been restored anger should pass. So that said if every time something happens your boundary is reinforced and you stand up for yourself there is no reason to hold on to anger, angers purpose is served, the boundary has been restored. (Based on Karla McLaren Language of Emotion that emotions ebb and flow, come and go, to serve a particular purpose.)

You can control what you do about your anger - your own behavior - but you can't make it go away. It's very common for people to represent anger as a bad thing and to encourage you not to be angry. They might as well tell you not to feel pain when you get hit over the head with a baseball bat.

If you have been exposed to abusive behavior to a prolonged period of time and you are a normal human being you are going to feel anger. Period.

You are likely to feel anger at times when you expect it and at times when you don't. It's hard to control the times or circumstances that your anger will rise up and demand your attention.

You may find yourself dealing with your anger in appropriate or inappropriate ways. For example, you may resist the temptation to deal violently with the next person who cuts in front of you as you wait in line - or you may find yourself inappropriately picking on someone who you perceive to be weaker than you.

You may feel ashamed of your anger or you may deny it is even there.

Physiologists tell us that anger comes from our primitive "fight or flight" instinct - when we feel angry we have a surge of adrenaline, our heart rate increases and our senses are heightened - we are ready for battle and we may have strength or energy beyond what is normal for us. Our blood is diverted towards the parts of our bodies that are needed for a fight or flight - our muscles, our brain, our senses. We may feel less pain, less guilt, less sensitive. Our digestive system shuts down. Appetite is suppressed, our digestive system expels waste and anything which is not essential to the immediate crisis. We become less analytical and more reactive. We become less stressed and become more pragmatic. We become less depressed and become more decisive. Anger can be good for us - in a crisis.

When anger can become destructive is when it is misdirected towards situations or people that aren't responsible for the pain we feel or when we are in situations that don't require a fight or flight response.

One such situation is when you are dealing with a person who has a personality disorder.

• The problem - your loved one has a mental illness and is abusing you.

• Your reaction - You get angry at them and hit back.

• The result - You don't escape the abuse, they don't understand your anger - because they have a mental illness and can't see past their own feelings.

• The conclusion - Nothing is fixed and the cycle repeats itself.

Here's another one:

• The problem - your loved one has a mental illness and is abusing you.

• Your reaction - get angry at yourself for getting into this situation.

• The result - you don't escape the abuse, they don't understand your guilt - because they have a mental illness and can't see past their own feelings.

• The conclusion - nothing is fixed and the cycle repeats itself.

One more:

• The problem - your loved one has a mental illness and is abusing you.

• Your reaction - You take it out on an unpopular person at work who won't retaliate.

• The result - you don't escape the abuse, you become less popular and trusted at work.

• The conclusion - nothing is fixed and the cycle repeats itself.

So what can you do? Well first - admit your anger and embrace it - don't be ashamed of it - it's a natural gift to protect you in a crisis. But understand that it can't save you from all problems and isn't appropriate to act out of anger in every situation. If you are dealing with a person who has a personality disorder, it is far more effective to find out everything you can about the mental illness you are dealing with and learn what works and what doesn't work. You can begin to protect yourself in a way that works and instead of feeling angry you can begin to feel a little more empowered about your situation.

---

cPTSD and Anger

Here at Out of the FOG we often welcome members dealing with a lifetime of injury in the case of PD Parent or Child or else extended years of trauma in the case of Chosen relationships. Often times a rush of feelings surrounds the 'lightbulb moment' where one finally reaches a breaking point, searches for answers and lands here on the OOTF website and forum. 

This rush of emotions sometimes includes anger that has been suppressed for a lifetime and comes rushing in all at once. Other times someone has been the lifelong scapegoat fighting back in anger all their life, demanding a voice, to be heard, angrily demanding the love one so deserves, hurt and angry not to receive it. Whatever the source, what do we do with all this anger? Here is some Information to help you heal and bring a sense of balance as you restore your boundaries: 

Those years of trauma and toxic relationships take a toll on ones emotional and mental health. Often without realizing ones might suffer from cPTSD, a form of PTSD. They are slightly different - cPTSD is from ongoing and continuing abuse rather than an isolated experience as is the case of PTSD.

Anger is healthy, it is an emotion that helps us set our boundaries. It signals us that a boundary has been violated and that boundary must be reset. Felt at the lowest level anger is so simple: violated boundary, few calm words, boundary is reset. No drama, no chaos, no outbursts necessary. Not so in a toxic relationship where control is used to subjugate victims through various means by creating Fear, Obligation, Guilt. Once we see the FOG we start to take back control ourselves. 

So many members have not been able to feel the anger for so long. It often wasn't allowed by the PD persons controlling our world, was repressed in fear for for survival sake, pushed aside out of a sense of Obligation, ignored out of Guilt. Once someone has reached that breaking point sometimes what happens is a huge rush of anger, the last straw, suddenly it all becomes clear. 

Out of the FOG has guidelines around healthy ways to express anger. One reason is because anger has been used to control and create FOG for many members, so we need reminders to tread lightly especially when triggered into anger so we don't wind up triggering someone else. 

Here's some healthy ways to feel and express anger:

• Information on verbal ventilation and angering page 3 - http://pete-walker.com/pdf/GrievingAndComplexPTSD.pdf 
  
  Verbal Ventilation is a process, generally guided by a trained professional, to aid healing. (See Out of the FOG Disclaimer)
  
  Caution: Verbally ventilating here on Out of the FOG means the recipients of the verbal ventilation are fellow members healing and grieving and in pain. One persons angering can easily feel like the toxic spew and raging so many of us were subject to all our lives. Unsent Letters board might be a safe place to practice Verbal Ventilation. 
  
  Sometimes coming out of the FOG results in a member becoming hyper aware of others emotions, some raised without boundaries have a difficult time recognizing boundaries and recognizing my stuff vs your stuff. Newer members may be unable to separate themselves or prevent themselves from absorbing the churning emotions of other members. One persons venting can be internalized by another and can thereby damage the reader. Some have had said they've had to step away for a few days, unable to handle other members pain, other members have said they read and then sit crying over the pain of fellow members. 
  
  Page 7 describes how when a person is in flashback the emotional right brain is overactive while the thinking left brain is under active with actual loss of access to the left brain cognitive functions shown by MRI study. That's why we're not equipped to handle members in flashback and why sometimes things just hit the fan.

Pete Walker outlines various ways cPTSD is manifest:
http://pete-walker.com/fourFs_TraumaTypologyComplexPTSD.htm

Lightbulb Moment

Definition

Lightbulb Moment - A Lightbulb Moment is the description many non-personality-disordered individuals use when they first discover the existence of personality disorders. For the first time, they have discovered a plausible explanation for the strange and frightening behaviors of a loved-one or family member who suffers from a personality disorder and learn that their situation is not uncommon. It is as if a light were just turned on.

Description

Many friends and family of personality-disordered individuals struggle for years trying to cope with their loved-one's destructive and often chaotic behavior with no help. Knowledge about personality disorders is growing but there is still a significant gap between what has been learned and how much of that information has been provided to the people who need it most - the people who are caring for a person who suffers from a personality-disordered individual on a regular basis.

These people often feel isolated - having no family or friends who they can talk to openly about the situation or having nobody who really understands the confusion and frustration they feel.

Even among mental health professionals they may come into contact with, there may exist a professional avoidance that prevents that person from helping them effectively:

Professional Avoidance - Professional Avoidance of Individuals who suffer from Personality Disorders describes a common reluctance among mental health providers to diagnose or treat individuals whom they suspect may suffer from a personality disorder.

When these people finally learn about the existence of personality disorders as a diagnosis and see many of the characteristics of their situation described and explained, there is often a great sense of relief. This is often referred to as the "light bulb effect" or "light bulb moment".

While the Light Bulb Moment provides a welcome and much needed sense of relief to a non-personality-disordered individual, some Non-PD's make the mistake of thinking that all their problems will be easily solved now that they are armed with a diagnosis.

There are a large number of lightbulb moments described in our Introductions forum here: The Welcome Mat

Adult Children

Definition:

Adult Children - An adult child is a term commonly used to describe any grown adult who was exposed to emotional, physical or sexual abuse as a child.

Description:

The term "Adult Children" was first coined by self-help groups supporting the grown children of alcoholic parents. However, over the years, the term has become generalized to include all grown children who grew up in abusive homes or dysfunctional families. Therefore, the terms "adult child" or "adult children" can refer to those who grew up in a home with a personality-disordered parent.

At "Out of the FOG" we often refer to adult children asUnchosen's. Unchosen's are people who are in a family relationship with a person who suffers from a personality disorder. They are called "unchosen" because they had no choice in entering into that relationship. Unchosen's include children, parents, siblings or relatives of a person who suffers from a personality disorder.

Characteristics of Adult Children

The following 13 characteristics of adult children was created by Dr. Janet G. Woititz.in her 1983 book "Adult Children of Alcoholics".

Adult Children: -

• guess at what normal is.
• have difficulty in following a project through from beginning to end.
• lie when it would be just as easy to tell the truth.
• judge themselves without mercy.
• have difficulty having fun.
• take themselves very seriously.
• have difficulty with intimate relationships.
• overreact to changes over which they have no control.
• constantly seek approval and affirmation.
• feel that they are different from other people.
• are either super responsible or super irresponsible.
• are extremely loyal, even in the face of evidence that loyalty is undeserved.
• tend to lock themselves into a course of action without giving serious consideration to alternative behaviors or possible consequences. This impulsivity leads to confusion, self-loathing, and loss of control of their environment. As a result, they spend tremendous amounts of time cleaning up the mess.

Complex Post Traumatic Stress Disorder (C-PTSD)

Complex Post Traumatic Stress Disorder (C-PTSD) is a condition that results from chronic or long-term exposure to emotional trauma over which a victim has little or no control and from which there is little or no hope of escape, such as in cases of:

• domestic emotional, physical or sexual abuse

• childhood emotional, physical or sexual abuse

• entrapment or kidnapping.

• slavery or enforced labor.

• long term imprisonment and torture

• repeated violations of personal boundaries.

• long-term objectification.

• exposure to gaslighting & false accusations

• long-term exposure to inconsistent, push-pull, splitting or alternating raging & hoovering behaviors.

• long-term taking care of mentally ill or chronically sick family members.

• long term exposure to crisis conditions.

When people have been trapped in a situation over which they had little or no control at the beginning, middle or end, they can carry an intense sense of dread even after that situation is removed. This is because they know how bad things can possibly be. And they know that it could possibly happen again. And they know that if it ever does happen again, it might be worse than before.

The degree of C-PTSD trauma cannot be defined purely in terms of the trauma that a person has experienced. It is important to understand that each person is different and has a different tolerance level to trauma. Therefore, what one person may be able to shake off, another person may not. Therefore more or less exposure to trauma does not necessarily make the C-PTSD any more or less severe.

C-PTSD sufferers may "stuff" or suppress their emotional reaction to traumatic events without resolution either because they believe each event by itself doesn't seem like such a big deal or because they see no satisfactory resolution opportunity available to them. This suppression of "emotional baggage" can continue for a long time either until a "last straw" event occurs, or a safer emotional environment emerges and the damn begins to break.

The "Complex" in Complex Post Traumatic Disorder describes how one layer after another of trauma can interact with one another. Sometimes, it is mistakenly assumed that the most recent traumatic event in a person's life is the one that brought them to their knees. However, just addressing that single most-recent event may possibly be an invalidating experience for the C-PTSD sufferer. Therefore, it is important to recognize that those who suffer from C-PTSD may be experiencing feelings from all their traumatic exposure, even as they try to address the most recent traumatic event.

This is what differentiates C-PTSD from the classic PTSD diagnosis - which typically describes an emotional response to a single or to a discrete number of traumatic events.

Difference between C-PTSD & PTSD

Although similar, Complex Post Traumatic Stress Disorder (C-PTSD) differs slightly from the more commonly understood & diagnosed condition Post Traumatic Stress Disorder (PTSD) in causes and symptoms.

C-PTSD results more from chronic repetitive stress from which there is little chance of escape. PTSD can result from single events, or short term exposure to extreme stress or trauma.

Therefore a soldier returning from intense battle may be likely to show PTSD symptoms, but a kidnapped prisoner of war who was held for several years may show additional symptoms of C-PTSD.

Similarly, a child who witnesses a friend's death in an accident may exhibit some symptoms of PTSD but a child who grows up in an abusive home may exhibit the additional C-PTSD characteristics shown below:

C-PTSD - What it Feels Like:

People who suffer from C-PTSD may feel un-centered and shaky, as if they are likely to have an embarrassing emotional breakdown or burst into tears at any moment. They may feel unloved - or that nothing they can accomplish is ever going to be "good enough" for others.

People who suffer from C-PTSD may feel compelled to get away from others and be by themselves, so that no-one will witness what may come next. They may feel afraid to form close friendships to prevent possible loss should another catastrophe strike.

People who suffer from C-PTSD may feel that everything is just about to go "out the window" and that they will not be able to handle even the simplest task. They may be too distracted by what is going on at home to focus on being successful at school or in the workplace.

C-PTSD Characteristics

How it can manifest in the victim(s) over time:

Rage turned inward: Eating disorders. Depression. Substance Abuse / Alcoholism. Truancy. Dropping out. Promiscuity. Co-dependence. Doormat syndrome (choosing poor partners, trying to please someone who can never be pleased, trying to resolve the primal relationship)

Rage turned outward: Theft. Destruction of property. Violence. Becoming a control freak.

Other: Learned hyper vigilance. Clouded perception or blinders about others (especially romantic partners) Seeks positions of power and / or control: choosing occupations or recreational outlets which may put oneself in physical danger. Or choosing to become a "fixer" - Therapist, Mediator, etc.

Avoidance - The practice of withdrawing from relationships with other people as a defensive measure to reduce the risk of rejection, accountability, criticism or exposure.

Blaming - The practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.

Catastrophizing - The habit of automatically assuming a "worst case scenario" and inappropriately characterizing minor or moderate problems or issues as catastrophic events.

"Control-Me" Syndrome - This describes a tendency which some people have to foster relationships with people who have a controlling narcissistic, antisocial or "acting-out" nature.

Denial - Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.

Dependency - An inappropriate and chronic reliance by an adult individual on another individual for their health, subsistence, decision making or personal and emotional well-being.

Depression (Non-PD) -Depression is when you feel sadder than your circumstances dictate, for longer than your circumstances last, but still can't seem to break out of it.

Escape To Fantasy - Taking an imaginary excursion to a happier, more hopeful place.

Fear of Abandonment - An irrational belief that one is imminent danger of being personally rejected, discarded or replaced.

Relationship Hyper Vigilance - Maintaining an unhealthy level of interest in the behaviors, comments, thoughts and interests of others.

Identity Disturbance - A psychological term used to describe a distorted or inconsistent self-view

Learned Helplessness- Learned helplessness is when a person begins to believe that they have no control over a situation, even when they do.

Low Self-Esteem - A common name for a negatively-distorted self-view which is inconsistent with reality.

Panic Attacks - Short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as hyperventilating, shaking, sweating and chills.

Perfectionism - The maladaptive practice of holding oneself or others to an unrealistic, unattainable or unsustainable standard of organization, order, or accomplishment in one particular area of living, while sometimes neglecting common standards of organization, order or accomplishment in other areas of living.

Selective Memory and Selective Amnesia - The use of memory, or a lack of memory, which is selective to the point of reinforcing a bias, belief or desired outcome.

Self-Loathing - An extreme hatred of one's own self, actions or one's ethnic or demographic background.

Tunnel Vision - The habit or tendency to only see or focus on a single priority while neglecting or ignoring other important priorities.

C-PTSD Causes

C-PTSD is caused by a prolonged or sustained exposure to emotional trauma or abuse from which no short-term means of escape is available or apparent to the victim.

The precise neurological damage that exists in C-PTSD victims is not well understood.

C-PTSD Treatment

Little has been done in clinical studies of treatment of C-PTSD. However, in general the following is recommended:

• Removal of and protection from the source of the trauma and/or abuse.

• Acknowledgement of the trauma as real, important and undeserved.

• Acknowledge that the trauma came from something that was stronger than the victim and therefore could not be avoided.

• Acknowledgement of the "complex" nature of C-PTSD - that responses to earlier traumas may have led to decisions that brought on additional, undeserved trauma.

• Acknowledgement that recovery from the trauma is not trivial and will require significant time and effort.

• Separation of residual problems into those that the victim can resolve (such as personal improvement goals) and those that the victim cannot resolve (such as the behavior of a disordered family member)

• Mourning for what has been lost and cannot be recovered.

• Identification of what has been lost and can be recovered.

• Program of recovery with focus on what can be improved in an individual's life that is under their own control.

• Placement in a supportive environment where the victim can discover they are not alone and can receive validation for their successes and support through their struggles.

• As necessary, personal therapy to promote self-discovery.

• As required, prescription of antidepressant medications.

What to do about C-PTSD if you've got it:

Remove yourself from the primary or situation or secondary situations stemming from the primary abuse. Seek therapy. Talk about it. Write about it. Meditation. Medication if needed. Physical Exercise. Rewrite the script of your life.

What not to do about it:

• Stay. Hold it in. Bottle it up. Act out. Isolate. Self-abuse. Perpetuate the cycle.

• What to do about it if you know somebody else who has C-PTSD:

• Offer sympathy, support, a shoulder to cry on, lend an ear. Speak from experience. Assist with practical resolution when appropriate (guidance towards escape, therapy, etc.) Be patient.

• What not to do about it if you know somebody else who has it:

• Do not push your own agenda: proselytize, moralize, speak in absolutes, tell them to "get over it", or try to force reconciliation with the perpetrator or offer "sure fire" cures.

C-PTSD Support Groups & Links:

• Out of the Storm - Support Group for people who suffer from C-PTSD.

• Out of the FOG Support Forum - The Support Forum here at Out of the FOG.

• PTSD Forum Contains a Wiki page and Active Support Forum.

• Psych Forums PTSD Forum.

• http://healmyptsd.com/ - Resources & info about recovery from PTSD & C-PTSD

• C-PTSD Page - by Author Sarah Tate

• Trauma: Complex PTSD MentalHelp.net C-PTSD Article by Dr. Allan Schwartz

The 5 Stages of Grief

The 5 Stages of Grief - Denial, Bargaining, Anger, Depression and Acceptance - were first introduced by Elisabeth Kübler-Ross to describe a process which many people go through when dealing with a significant tragedy or loss.

The 5 Stages of Grief are:

1. Denial
2. Bargaining
3. Anger
4. Depression
5. Acceptance

Most Non-Personality-Disordered Individuals go through our own version of the 5 stages of grief as we come to terms with the reality that we are dealing with someone in our home who suffers from a significant mental illness and whose personality disorder brings long term struggles and difficult choices that we have to face. In a way, we face a death - death of the dream of coming from a "normal" home and the expectation of being loved the way we deserve by those closest to us.

Examples of Denial Statements:

• It's not that bad. Most of the time we're really happy.
• She's rough on me but she really cares about the kids
• I feel like I have a connection with her like no other.
• She's had a hard life.
• She's been working hard on our marriage lately

Examples of Anger Statements:

• You psycho bitch! 
• You only care about yourself!
• You'll be sorry someday.

Examples of Bargaining Statements:

• If you don't keep to our agreement I'm going to divorce you.
• I came home early from work every day last week. How can you say I don't care?
• I forgave you when you hit me!
• I love you (thinking - please don't hurt me)

Examples of Depression Statements:

• Maybe she's right
• I could never leave, my life would be ruined
• I have to stay for the sake of the kids.
• At least I have a good job.

Examples of Acceptance Statements:

• I still love you. I'm leaving because I don't want these fights to continue.
• I know I've made mistakes too. I'm sorry for that.
• I wish her well and hope the best for her.
• There were some things I still like about him, there were some things that scared me.
• I'm not happy I'm divorced, but I'm glad I went through with it.

Learning to Cope with Grief:

Grief is a consequence of loss and much as we want to we often find that we can't go over it, can't go under it, can't go around it and have to go through it.

Mourning

It's OK to mourn. Think about the way it should have been, could have been, might have been. Imagine your life if the abuser in your life had had a healthy mind, a sense of responsibility, a conscientious kind heart. Write it down. What dreams did you sacrifice? What pain did you swallow? Mourning is the time to cry. And when you are done, if you want to, cry again.

Rant about it. Talk to a safe group of friends about it. Tell somebody what happened. Get it off your chest. Why was it wrong? What happened? How in the world did you put up with that for so long? Take a load off! Tell someone your story.

There are lots of people here at Out of the FOG who have been there, who are still there - who are trying to find the courage to say: "I hurt!", "That was wrong!", "It didn't have to be that way!", "I deserve better!" Somehow we feel stronger when we hear from others who have faced or are facing the same struggles as ourselves.

Anger

Read more on processing anger here. 

What NOT to do:

• Don't be ashamed of your grief. It is something that makes us all very human.
• Don't be ashamed to admit your grief to others or to seek assistance.
• Don't believe that you will always feel this way. The only thing that stays constant is change.
• Don't isolate yourself or cut yourself off from people who really care about you.
• Don't pressure yourself to snap out of it. Celebrate who you really are.

What TO do:

• Remember that the person you are today is no less valuable than the person you were on your greatest day.
• Remember that grief is a process which takes time.
• Be good to yourself - give yourself something every day that you will look forward to.
• Get help and support from people who understand what you are going through and who care about you.

FOG - Fear, Obligation & Guilt

Definition:

FOG - Fear, Obligation & Guilt - The acronym FOG, for Fear, Obligation and Guilt, was first coined by Susan Forward & Donna Frazier in Emotional Blackmail and describes feelings that a person often has when in a relationship with someone who suffers from a personality disorder. Our website, Out of the FOG, is named after this acronym.

Description:

Fear is a mental process that that triggers a physical response in humans when confronted by a threat. Fear produces adrenaline that prepares us for the classic "fight or flight" response to threatening situations. When we fear, we anticipate the possibility that something bad might happen soon. Our bodies shut down all long or non-critical functions as we prepare for immediate physical action. Our digestive systems shut down and expel unnecessary waste. Our immune systems and growth systems are put on a lower priority as we prepare to deal with sudden, immediate threats. Our heart beat and breathing quickens to provide increased oxygen to our muscles. Our senses heighten and our peripheral long range thoughts are relegated. Fear is a survival instinct that preserved some of our ancestors in moments of extreme danger. So fear can be a good thing. However, prolonged fear - also known as stress or anxiety, is not so good for us and can lead to increased risk of long term health problems.

Obligation comes from an innate sense of community responsibility. We are born with an instinctive sense of obligation to those around us. Historically, humans who isolated themselves from a community were in much greater danger of perishing. Only those who contributed to the community were accepted by the community. As a result, our communities have evolved in such a way that those who have a strong sense of community responsibility are more likely to be accepted by others and ultimately to produce children. Obligation has served our ancestors well in forming communities. However, when a ruthless person takes advantage of our instinctive sense of obligation, they can manipulate our gut reactions to do things which do not always help us thrive and prosper.

Guilt comes from the same root as obligation. Most of us feel guilt when we do something that we think hurts others or disappoints of others. Our societies have evolved in such a way that it is not socially acceptable to deliberately hurt another person and those who do are often incarcerated, ostracized and condemned by others. However, our instinctive gut reactions of guilt can also be activated when we refuse to help another person. This is where most Non-PD's experience guilt because often in the process of setting boundaries, Non-PD's will have to make a choice of whether or not to give another person, who suffers from a personality disorder, something which they want, which comes at a great personal cost to the Non-PD if they say "no".

Examples of FOG - Fear, Obligation & Guilt

• A man tells his wife - "I will kill myself if you ever leave me"
• A mother tells her adult children "You can't possibly care about me if you won't come to Christmas Dinner"
• A teenager tells his parents "I hate you - you've ruined my life!" when they refuse to grant a request.
• A young girl overdoses on pain killers after her boyfriend ends the relationship
• An office employee falsely states "everyone in the office agrees with me" after a disagreement with a co-worker.

What it Feels Like

FOG can produce a sense of dread and hopelessness and make you do and say things that you are uncomfortable with. People have stayed in abusive homes and marriages, lived in squalid conditions, suffered physical pain without medical care, sacrificed their entire wealth and some have sacrificed their lives because of FOG.

If you have been living for a long time with a person who suffers from a personality disorder, chances are you have been living with FOG and her 3 dreadful companions - hopelessness, helplessness and powerlessness. Like a defeated animal backed into a corner it is quite common to have the instinct to just lie down and take it. This can lead to a form of Learned Helplessness.

What NOT to do

If you are living in FOG - Fear, Obligation & Guilt:

• Don't forget that it's harder to see everything clearly in fog - so everything you see isn't everything that is there.
• Don't rely purely on your gut instincts or your feelings to guide you, because your feelings are mostly negative.
• Don't allow yourself to be isolated and for the person with the personality disorder to be the only person you talk to on a regular basis on the subject.
• Don't stop doing things that are good for you, healthy behaviors, friends, work, recreation etc.
• Don't sustain any situation or relationship where you do not have the option to say "no" where it is reasonable to do so. Nobody who is a true friend will demand "yes" 100% of the time. Healthy relationships are two-way streets - not one-way streets and anyone who is a true friend or who truly loves you will give as much as they receive.
• Don't sacrifice taking care of yourself in order to help another person. That just makes both people poor.

What TO do

• Learn all you can about personality disorders.
• Get yourself a support network where you can discuss things that concern you without feeling judged.
• Work on setting Boundaries that will help you escape the feelings of helplessness, hopelessness and powerlessness.
• Try to add logical rational thought to every emotional thought of Fear, Obligation & Guilt.
• Try to substitute "what really works" for "what feels right" when you are making decisions.
• Promptly remove yourself and any innocent children from any emotionally abusive situations.

Feeling Trapped

Definition:

Feeling Trapped - Most people who have a relationship with someone who suffers from a personality disorder would like to bring an end to the relationship but are unable to or afraid to end it because they feel trapped in some way.

Description:

It's common for people who have never experienced verbal, physical or sexual abuse to wonder why the victims of abuse don't do more to protect themselves.

People who live in abusive relationships often stay in them because they feel trapped. They may feel like to stay in the relationship is bad but to leave would only make things worse - and that staying is like choosing the lesser of two evils.

Examples of Feeling Trapped

• A teenage girl lives with her verbally and physically abusive mother but feels trapped because she depends on her for food and shelter.
• A religious man wishes he could separate from his verbally abusive wife but feels obligated to stay because of his wedding vows.
• A woman in an abusive marriage is afraid to leave in case he finds her again and is even more violent.
• A father would like to divorce his verbally abusive wife but fears that the courts will grant custody of the children to her and he will be unable to protect them.
• A woman would like to take the children and leave her narcissistic husband but fears that she will be unable to provide adequately for the children if she leaves.
• A parent of a violent teenage daughter feels obligated to do everything for her and cannot just walk away from her.
• A sexually harassed employee is afraid to complain about the way she is being treated in case she loses her job or loses her chance at promotion.
• A man wants to cut off all contact from his abusive parents but feels obligated to look after them in their old age.
• A woman would like to leave her boyfriend who abuses drugs but feels like she is the only one who can help him.

Many people who are trapped in abusive relationship do so because of unrealistic expectations placed on them by themselves or others such as:

stigma of divorce
scandal of abandoning a sick or elderly relative
absolute religious condemnation for breaking the marriage vows.
social stigma of admitting a child to a mental health care facility.

What NOT to do

If you are feeling trapped in a relationship with someone who suffers from a personality disorder:

• Don't isolate yourself or cut off contacts with supportive and trustworthy friends or family.
• Don't narrow yourself down to 2 choices. Life usually offers an abundance of possible futures.
• Don't focus on trying to change the person who suffers from the personality disorder. You can't change another person. They can only change themselves.
• Don't become dysfunctional yourself - this is known as "Getting fleas"
• Don't rely purely on your gut instincts or your feelings to guide you, because your feelings are mostly negative.
• Don't allow yourself to be isolated and for the person with the personality disorder to be the only person you talk to on a regular basis on the subject.
• Don't stop doing things that are good for you, healthy behaviors, friends, work, recreation etc.
• Don't sustain any situation or relationship where you do not have the option to say "no" where it is reasonable to do so. Nobody who is a true friend will demand "yes" 100% of the time. Healthy relationships are two-way streets - not one-way streets and anyone who is a true friend or who truly loves you will give as much as they receive.
• Don't sacrifice taking care of yourself in order to help another person. That just makes both people poor.

What TO do

• Learn all you can about personality disorders.
• Get yourself a support network where you can discuss things that concern you without feeling judged.
• Work on setting Boundaries that will help you escape the feelings of helplessness, hopelessness and powerlessness.
• Try to add logical rational thought to every emotional thought of Fear, Obligation & Guilt.
• Try to substitute "what really works" for "what feels right" when you are making decisions.
• Promptly remove yourself and any innocent children from any abusive actions, conversations or events.

Feeling Isolated

Definition:

Feeling Isolated - It's common for people who have a relationship with someone who suffers from a personality disorder to systematically isolate themselves from other external relationships.

Description:

When someone finds themselves in a situation where they are subjected to abuse or unfair treatment, it is an instinctive reaction to reach out to others for help. If this help arrives on time and in an effective way, the abuse victim will feel encouraged to repeat the action the next time abuse occurs. However, if the response to a cry for help is misguided or untimely, the abuse victim may feel humiliated or confused and be discouraged from seeking help in the future.

Because people who suffer from personality disorders do not always fit the mold of typical human behavior or thinking, the kind of "common sense" advice which is often given out can be counter-productive or dangerous.

Some examples of hopeful counter-productive advice:

• She'll probably just grow out of it - they all do.
• He seems to have really turned things around lately. I know you guys are going to make it.
• He's feeling a lot of stress at work. When things calm down I think it will get better.
• I've found that prayer really helps in this situation.
• Maybe she just needs some space.
• If you treat her like a queen she will treat you like a king.
• If you listen to his needs and learn to communicate better - that is the key.

The trouble with this kind of advice is that it is applicable to people who fall in the middle of the human behavior spectrum. People who suffer from personality disorders fall on the extremes of the human behavior spectrum - and thus do not conform to typical human response and behaviors.

Treating a person who suffers from a personality disorder as though they have normal or average behavior is a bit like trying to extinguish a forest fire with a bucket of water - you are using the wrong tools for the job.

When a person who is in a relationship with someone who suffers from a personality disorder reaches out to others for help, they commonly get this kind of misguided advice. When the advice doesn't work, they often feel hopeless and begin to isolate themselves from the advice-giver. They may feel condemnation because they have not successfully implemented their advice or adhered to their model of the world.

In this way, abuse victims often find that non-abuse victims are of little help or support. They just don't seem to understand. Over time they may begin to feel that nobody understands.

Likewise, those who offer help and support often fail to understand why the abuse victim just "doesn't seem to get it". They may become judgmental or impatient with the abuse victim, they may fail to understand that personality disorders fall outside the scope of normal human behavior.

This is why support groups can be so important. When and abuse victim talks to other abuse victims they often find relief in discovering other people who know that the "standard" advice doesn't always work.

If you are feeling isolated, we encourage you to join a support group of other abuse victims.