Tag Archives: adverse childhood experience

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abuse, enabler style

I am raised by a family of triangulating enablers and enablees.

The enablers are my mother and two uncles. They are very very smart. Let me qualify that: they are very very smart intellectually. Emotionally, not so much.

The two uncles have PhDs and are professors. They marry wives that are lessor in their view. One tells my mother that he wants a woman who is not as bright as he is. I don’t know if she is less bright, but she is a hella better athlete. I also have the impression that she had a time where she drank too much.

The other uncle marries a woman who tends to be a hypochondriac. He takes her to India, where she gets polio while pregnant. She is then a sick hypochondriac, which is very difficult. The ill can control their families by planning things and then getting sick at the last moment. On the other hand, chronic fatigue and fibromyalgia are very real and we are on the edge of figuring them out. That uncle divorces his wife and I instantly like both of them better. They stop being a weird unit and are suddenly individuals.

My mother tells me, when I am in college, “I wondered if your father was an alcoholic when I married him.” I want to hit her. She won’t leave him, she won’t stop enabling him, they scream at each other at 2 am often. Now I wonder about that and conclude that either screaming at someone was something she needed or she was an alchoholic too.

After my mother dies, I ask my uncle, what about his parents? After all, the three of them learned enabling somewhere and it pretty much has to be at home.

My uncle tells me his parents had a PERFECT marriage and that my grandmother LOVED being the wife of a physician and professor.

Um, so, then, why did she pay my tuition to medical school, uncle?

And I think about my mother’s stories. Once, she says, your Uncle Jim bet his friend Dick that Dick was too chicken to shoot a cigarette out of Jim’s mother’s mouth. Ooooo. With a rubber band shooter. Yes, my grandmother. Bob took the bet and succeeded. My grandmother roared with anger and the two boys ran like hell and hid.

And someone in the family tells me: your grandfather helped your grandmother control her temper.

There it is. The enabler/enablee.

The enablers die first. My grandfather of cancer at 79, my mother of cancer at 62. The cousins are all angry at me because I won’t follow the family rules and triangulate in a satisfactory manner, and I don’t care any more. I am ignoring them. I got my father’s banjo back and I am done. The two cousins I own land with jointly are not the worst triangulators.

I have to remind myself: for them, this is love. For some people, controlling or being controlled is what functions as love and intimacy. Fighting and tears when person A talks to person C about person B and person C then lets person B know, that is how they feel close. It is not only families, but communities. Clay Shirky’s description of a group being it’s own worst enemy describes the same patterns: identify an enemy inside or outside the group and then everyone comes together against the enemy. The enemy says the wrong thing, doesn’t worship the right god/desses, wears different clothes, looks different. And the group feels safer once the scapegoat has been killed, the guy has been burned. It would be nice if we could burn a ritual guy instead of torching each other.

The real anger is in the enabler. They control it by having the enablee express it. Then it is not “theirs”. They can feel superior to the enablee who is out of control. Sadly, the problem is only fixed temporarily and they will need their anger expressed again and again and again.

The cycle can be broken. It is a lot of work.

Blessings.

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love poem to the monsters under my bed

I am trying to wrap my mind around an aspect of Adverse Childhood Experience Scores. Ace scores.

Raised in war or chaos or an addiction household or a crazy household, kids do their best to survive and thrive. I acknowledge that first. “You survived your terrible and terrifying childhood. You are amazing. You have crisis wiring in your brain. You had to wire that way in order to survive.”

And what does that mean? High alert, high adrenaline, high cortisol, reactive. One veteran says that the military loved him being able to go from zero to 60 instantly.

“Yes, and how is that serving you now?” I ask. “Do you want to change it?”

“No.” he says.

“Why not?” I say.

“Because I know I can protect myself.”

He can protect himself, as I can too. But being on the alert for a crisis, being good in a crisis, being able to fire up like a volcano, is that what I want and is that what he wants? If not, how do we change it?

I think of it as being able to see monsters. Other people’s monsters. My crisis childhood wiring is to pay attention to the non-verbal communication: what people do not what people say. The body language, the tone of voice, what the person is not saying in words, when someone is being polite but the body language is a shut down, a rejection, a dismissal, posturing, aggressive, they don’t like me no matter what the words are, belittling. But if I or my high ACE score patients respond to the body language and emotional feeling, we have named the monster. And the person is being “polite” and will not admit to the monstrous feelings. Those feelings are unconscious or at least the person does not want to admit if they are at all conscious.

In clinic I have learned to dance with the monstrous feelings. I don’t always succeed, but I keep leveling up. It’s a matter of delicacy, inviting the person to admit the monstrous. Some do, some don’t, some don’t the first time or second or third, but the fourth time the monsters are brought out. And they aren’t monstrous feelings after all. They are normal. All I do then is listen and say that the feeling sounds normal for what is happening. It’s like letting off a steam valve.

So how do I and my high ACE score folks learn to do this in social settings as well? When someone is talking to me with a monstrous feeling, meanly, I challenge it. Because I am not afraid of that monstrous feeling. But I have then broken a social contract and the person will like me even less then they already did. And maybe that monstrous feeling is not really about me at all. It’s about their own current life events and the feelings that they try not to feel, are ashamed of, are afraid of. It’s not polite of me to challenge that feeling in a social setting, I am not this person’s doctor or therapist and they didn’t ask me. It’s hard because I feel so sorry for the monstrous feeling and for the person feeling it. I am moving to compassion and love for that feeling rather than taking it as directed at me, taking it personally.

That is my intention. We will see how well it goes.

A naturopath told me to have the intention to release old grief. It’s not old grief though. It’s ongoing grief. Grief for all of the monstrous feelings that swirl around daily and the monsters that are not loved. Most people try to ignore them. I don’t. I love them, because someone has to and because they are so lonely and sad. They are crying. Don’t you hear them? That’s what love is, when you can love your own monstrous feelings and other people’s too.

And our own are the hardest.

ACE study: https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/index.html

I took the photograph in the Ape Caves, the lava tube at Mount St. Helen’s.

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Mnemosyne

I am reading The Female Trickster: The mask that reveals, by Ricki Stefamie Tannen.

Regarding Mnemosyne, she writes: “The power of memory was recognized in Ancient Greece by the goddess Mnemosyne who ruled over the Elysian Fields. The nine daughters of Mnemosyne and Zeus are the muses, with Thalia, the muse of comedy imaged with a Trickster’s mask as she playfully composed comedy and ironic poetry. The muses were women unto themselves. According to the myth, upon death a person makes a choice to either drink from the river Lethe or the spring of memory. If you drink from Lethe you forget your pain and all the lessons of your life and are reborn again on earth. Those who choose to drink from the spring of memory go to the Elysian Fields, where there is no strife or pain. The myth tells us that the path to psychological integration comes from a willingness to value and interact with memory. Those that repress memory are doomed to repeat it, over and over again.” (pp72-73)

This seems apropos both to my personal and professional life and also to US culture. Our President speaks like my stage IV substance abuse patients. He says things that are obviously lies, obviously not true, obviously refutable and yet to all appearances he believes his own lies entirely, even when he contradicts himself. He manufactures his own reality and just laughs when someone else disagrees. But my substance abuse patients crash: they eventually find that they are isolated with their own lies when they become so fantastic and bizarre that no one believes them any more. We are watching that play out.

Re my personal life, I think of my maternal aunt’s memorial. I wrote two memories for the memory book. One was about my father saying that she had perfect pitch. I did not know what perfect pitch was when I was little, but I knew from my father’s voice, the respect, that it was special and important. That he was envious. That he admired it. The second was about my aunt and uncle’s divorce, that I had seen them as a unit and liked both of them better when they turned into individuals.

My cousins wanted to use the first memory but not the second. They said that family wouldn’t like it. I thought about their request and finally said no. Use both or neither. They chose neither. And this pretty much illustrates why I have very little contact from a large part of my family. I want to remember the whole person, light and dark, love them all. And that is not what that part of my family wants. An old family friend has not spoken to me about my sister since my sister died 6 years ago. I asked her directly about it a few months ago. She wants to talk to me “only about happy memories of your mother, father and sister.” I respond, “Why don’t you ask me what sort of relationship I want?”

She was and is silent. So I am too.

It’s not a lack of love but it’s a difference in philosophy. I think it is crazy to whitewash the dead: how will our children understand their own dark feelings and impulses and mistakes if they think that their ancestors, grandparents, parents are angels? Why aren’t we honest as a culture? How can we expect our children to be honest with us when we lie to them? The curated lives on Facebook are an abomination, false, lies and look what we have in the White House.

I like the dark as well as the light. If we truly love everything in the universe, how can we not love the dark as well as the light? If each of us owned our dark sides, our dark impulses, the myth says that we will not enact them over and over each generation. Owning the dark, acknowledging our own dark does not mean that we have to act it out in the world and then lie to ourselves and others.

And now I want coal for my stocking: just a small piece, to remind me that I have not always, or will I ever, only be good.

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the virtue of the disconnect

the virtue of the disconnect
learnt early
as a child

they say we are broken
wired wrong
enduring horror

he wakes at night
sleeps lightly

what was your childhood like?
how did you sleep?

it was not safe
we had to get up
leave in the night
gunshots

you survived your childhood

yes, I did

sleeping lightly saved you

yes, it did

you could rewire that
it takes a lot of time
to change the childhood wiring

or you could just
be ok

with sleeping lightly

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Speaking up

For yesterday’s Ragtag Daily Prompt: justice.

I keep hearing “Why didn’t she speak up sooner?”

I spoke up. I was 7. The abuser was a neighbor. Nothing was done. I thought it was my fault, that I was not a virgin, and that at age 7 I was pregnant. I did not understand puberty. I spoke up to my mother, who dismissed it.

So I did the only thing I could: I tried to protect myself and my four year old sister. I told her never ever to go near that neighbor. And I never went near him again.

I was taken for a well child check a month or two later. I didn’t say anything but I thought that surely the doctor would have noticed if I was pregnant, so I must not be.

I grieved on the school bus, thinking that I was the only girl who was not a virgin. I was wrong about the not a virgin, but I also was probably wrong about being the only girl.

I didn’t even realize that hello, I was seven, it was not my fault, I didn’t even understand what was happening. I didn’t understand until I was in college and heard a radio program about how women who are raped feel guilty. Here is a poem about that realization: The bacon burning.

So do you think I spoke up after that? Why would I? No one helped me and I was silenced. I learned this lesson: no one will help and I am on my own. I did speak up in medical school: Make a difference.

Where is justice? And do you really want us ALL to speak up now? About ALL of it?

When I was in my early teens, a friend of my parents french kissed me. He said, “I wanted to be your first french kiss.” Hello, I avoided him after that and did I want a french kiss from an old friend of my parents? He had a PhD but no boundaries, no emotional intelligence and poor ethics.

Shall I go on? In college I worked in two labs: both fruit fly labs. In one the graduate student was professional, courteous and quickly gave me a raise. In the other, I never saw the professor again and I was ignored. I went to resign from the second. The PhD professor said, “What do you plan to do after college?”

“What do you mean?” I asked.

“Do you plan to get married and become some man’s cow?”

Oh, really? Do you Mr. PhD professor refer to all married women as men’s cows? Would you have the same conversation with a male student? I quit. I don’t like you or your lab and that sort of comment reinforces my dislike.

In medical school we had two female physicians on the faculty. One was married but no children. Residents joked about her, that she had the balls in the family, because they were both physicians. The other was not married, an OB-gyn. We asked her to speak to our Women in Medicine group about children and career.

“If you want to be taken seriously as a physician, you should not have children.” she said.

I asked, “What if we have a house husband?”

“No man’s ego could stand up to that,” she replied.

I have children and a career.

I had worked in a clinic for a year and another provider talked to me. “Do you know that they are paying the other physician (male) twice what they are paying you?”

Oh, really? I set up a meeting with the administration.

“Oh, the male physician is the clinic director, that’s why we pay him more.”

This was a lie. I had been in the clinic for a year and there had never been one word that he was clinic director. The next year they standardized paying us by RVUs: his salary went down and mine went up. And so justice was done, right? No, the male physicians are given jobs such as head of hospice or medical director and extra money. Do they work harder? The jobs are not offered to the women physicians.

A male physician at the hospital was made chief of staff. He asks me in the hall, “Do women physicians just quit because they want to stay at home with children?”

“Do you want a serious answer?” I said. He looked surprised. We went to an office and I discussed that almost all the hospital staff were women at that time and that they have a different relationship with female physicians than male physicians. Most of the administrators were male, white males.

So really, do you want all the women in the US to speak up? Maybe we all should. The above is not anywhere near an exhaustive list, it is a start. This is just from thinking about it for two days. I can fill pages…..

 

 

 

 

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admit deny

For mindlovemisery’s prompt: opposing forces. The prompts are admit/deny and presence/absence.

The pairs bring up my current sadness right away. I am struggling with the realization that we have a pervasive legal substance that works at the opiate receptor, is all over the US, and I have to send out urine tests for ALL of my chronic pain and opiate overuse and anyone on any controlled substance. You say, “but it’s legal”. I say, “Overdose and death risk. I can’t ignore it.” Here is the resulting poem.

admit deny

admit to yourself you deny your addiction
the presence of the drug means the absence of the one I love

 

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Container dream

I dream I am at a concert in a park. Or some very big event. With my significant other. It is a beautiful day, the sun is shining, the grass is green, there are rolling hills and trees. People are arriving.

There is a gasp of horror. There is a large box, like the hold of a ship. We hurry to look in: there are three open containers down inside, tops removed. They are full of children. Smuggled? Immigrants? The containers are surrounded by water. My significant other and I drop our things and climb down the long hold ladder into the water, which is cold, filthy, and comes up to my thighs. I’ve kicked off my sandals. We are wading to the containers. An ICE agent in a black uniform, bullet proof vest, belt with tools and guns, and riot helmet, blocks me and says, “You have to be wearing shoes to help.” He is handing out plastic stretchers. He can’t see my feet. Yes, I know it’s dangerous and my feet could get cut, but this is probably sewage and dangerous even with shoes. We should really be in hazmat gear but the kids could be dying. I just look at him, silent, and he hands me a stretcher.

Enough people have come forward, into the water, that all the kids have been placed in one of the containers. None of them are dead. They are being lifted out one by one, to ambulances. Now the hold is surrounded by rubberneckers. I climb out and find my purse and camera and shoes. I am grateful no opportunist has stolen them. The ICE agents are telling people to back off and give them room to work. The news crews are there and a Washington State politician says, “This is Washington State, we will take care of these children, we will not see them separated and incarcerated, I will see that they are returned to their parents.” Good luck, I think, but at least there are tons of witnesses and cameras and news crews.

I need to find somewhere to scrub my legs down with soap and to find my significant other. It’s getting more crowded.

I wake up.

And what I notice is that the water did not stink and was not full of lumps of floating excrement. As I wake I hope that I won’t catch something horrible and die….usually my dreams have full sound, color and smells too. I wonder where the children were from, and why, and whether they had some sort of sanitation….

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young alone

I have a double lot, L shaped, because the 1930s garage extends 5 feet into the second lot.

I don’t mow the second lot. It is in the center of the block and has an apple tree, a plum tree, a maple with a tree house, wild roses and weeds.

The deer leave their young to stay. Intemittently there are young alone in my lot. I went to go in the tree house this weekend, but this small one was alone. I don’t like to scare them into the streets or more exposed yards, so I backed off.

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Mundane Monday #166: parent and child

My theme for Munday Monday #165 is parent and child.

I have this small statue in my clinic. I have a small collection of parent/child and mother/child art that I have collected for years. I was separated from my mother at birth, from my father and his family at 4 months and back to my mother and father at 9 months. I was sure that adults loved me but I did not trust them: they kept abandoning me.

As an adult I understand that it was because my mother had active tuberculosis and that the first separation saved my life. But…. I can love people, but trust must be earned.

A patient said last week that I had a political statement in my waiting room. “I do?” I said. He was talking about this statue.

If this is a political statement, I stand by it.

Attach your parent child picture, political statement or not. And much love and hope for every parent and child and love.

One entry from last week, Mundane Monday #165: sand:

KL Allendorfer: Sand.