An abuse survivor's perspective by Terry "GhostWolf" Davidson

Many times, abuse survivors are told by well-meaning, but ill-informed people, "Why dig into the past? It's over, get on with your life."

"Some kinds of abuse are like scratches; a simple cleansing and a bandaid are all that's needed. Other kinds of abuse are like a compound fracture; the damage can be healed only if immediate treatment is afforded. If not, bones, tendons, and muscles do not set properly - and even if the injury looks healed from the outside, the damage is still there, causing discomfort and even crippling pain years later. One does not apply a "bandaid" to that kind of injury; instead, the damaged leg (metaphorically speaking) must be rebroken and reset so that it may heal properly.

In many cases, the mental, emotional, spiritual, and physical injuries resulting from abuse are untreated compound fractures that never healed properly. To illustrate my point, here's an example of an "injury" that I'm still working on healing:

--Guilt. Guilt that did not and could not be resolved until I dug into the past. Yes, it IS good that the child and adult in you talk. Some of the best breakthroughs and recovery I've had are the result of really looking at who I was as a child, of looking at what I really felt then, and how that has shaped my life. The two are inextricably linked.

Could you please explain to me more about how the two, child and adult, are linked? How did you experience this?

This part got my special attention because it's what I am working on right now. I have confusing feelings towards my parents. My biological mom told me not to dig into the past. I believe she feared that what I would discover would cause me to despise and hate her. I wanted to know what happened. But I didn't know why I want to know it. It almost started to become an obsession.

I believe that in many, if not most cases, those who vehemently demand that we not dig into the past, fear what we may find. Like my own genetic mother, their self-esteem is already low due to the shame and guilt they bear for past misdeeds and abuse, and they are not in a place where they can face it again or deal with it.

My mother's hold on reality is shaky at best and it wouldn't take much to push her over the edge. She was very aware of what she had done and feared what I would remember and what I might uncover. I had no desire to push her over that edge and spent much of my time when talking to her reassuring her that I do not hate her, that all I seek is information, answers to gaps in information I have. As time went on, it became easier each time to talk to her about the past. She learned that I wouldn't attack or condemn her and because I listened to her, she found out that sharing her own horrors and feelings with her son - one of her victims - me, was healing for her. She had kept it locked inside herself all these years.

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It took my "digging into the past" to give her the key to unlocking her own experiences - to give her an outlet and some measure of peace, and give me answers to the horrors I experienced as a child. It took that "digging into the past" to give me peace, to decrease the guilt I've carried for so many years over my genetic father's death, a guilt that contributed directly to my becoming a "caretaker".

First, I'll describe what happened to create that guilt and how that guilt was compounded - using the metaphor, how the original compound fracture happened. Following that, I'll describe what "digging in the past" revealed about what happened - metaphorically, this is the resetting of the injury so that it may heal properly.

The Origin of the Guilt

Note: This section is written from the "pre-digging" perspective.

In late 1956, I asked my Dad to show me where he worked. I was six-and-a-half years old at the time. It was a very early Saturday morning when he took me to his workplace in the Mojave desert.

That part of the desert is well-known for very dense fog and we left just as it was starting to get light outside, driving through the fog. Halfway there, my father pulled off the road completely so he could smoke his pipe. He never drove while smoking it.

He was leaning against the left front fender of the car when a drunk driver came out of the fog from the other direction, slowed down a little bit, and then crossed over the line to hit us head on -- with my father sandwiched between the cars.

The drunk then backed up and stopped. I got out and ran to the front of the car - blood was everywhere. My father had been torn open from chest to crotch by the impact but he was still alive. I pulled him into my lap as he touched my face. I saw his heart beat twice. Then he was dead.

All during my childhood and teen years, I blamed myself for his death. After all, if I had not wanted to see where he worked, what he did, we would never have been on that road that morning, right? True, he could have been killed in a different accident, or died some other way, but he was there that morning because I wanted to see where he worked, and I had thrown a fit until he acceded to taking me.

Then in 1971, I got the first clue to what had really happened, but I didn't know it at the time. Art's mother had died and I inherited her journals. Art is my mother's biological father. Both Art and his mother were active - very active - in the cult that abused me and my siblings. In those journals was an account of how the members of the cult cast a "spell" to cause my fathers' death - one week before he died. Yeah, right? Being the skeptic that I am, I brushed that off as so much hocus-pocus and admittedly, one hell of a coincidence.

Then, in 1973, the guilt over my Dad's death was compounded dramatically. Like myself, my sister never forgot what was done to us and like me, she took the (unsuccessful) approach, "It's over, done with, get on with your life."

That approach doesn't stop the nightmares, dissociation, flashbacks or abreactions. It became so bad for her that she tried to drown the pain with alcohol and drugs. One evening in early 1973, she called me, pleading with me to come over to talk with her, be with her as she went through one particularly bad flashback. I brushed her off because I just did not want to take the time. I had no commitments that night, I could have gone, but didn't. She wrote a suicide note, then overdosed on drugs and alcohol.

Our legal guardians found her before she died and got her to the hospital in time to save her life. She was in a coma for several months and emerged from the coma blind, quadriplegic and brain-fried. That was in 1973. She's 43 years old now, still blind, still quadriplegic, with an IQ of less than 60.

More guilt

In 1982, my ex-brother-in-law, who worked at the same company I did, wanted to talk to me about a very tumultuous relationship he was in with a married woman who was separated from her husband. I brushed him off too. Two hours later he was dead, murdered by the woman's estranged husband. More guilt. And this time, there was a flood of feelings and sensations going all the way back to that roadside in 1956. Two deaths, and one that might as well have been a death, all on my hands. Those three incidents (among other things) shaped what became my "caretaking" mode; an intense determination, in all honesty, an obsession, to make sure that no one who asked me for help got turned away.

Sounds noble, but it isn't. Caretaking is a very good way to avoid looking at one's own pains; to avoid dealing with and working through issues. (See Repercussions - Caretaking for more on caretaking.) I was in a closed loop with no way out.

Until I started reading asar...

As I read asar, I related to what others had experienced; the sense of "yeah, I know that feeling" and "yeah, I've been there, done that"; and with those feelings came memories. You know what that's like: you see a freshly-baked lemon-meringue pie, and all of a sudden, there's the memory of Grandma in the kitchen, beaming as she brings her blue-ribbon pie to the table. Things like that.

It took 2 years worth of asar to blow my denial right out of the water, to start healing those untreated injuries. And it started with me digging into the past to find out what really happened.

The Beginning of Healing

I started digging by talking to my genetic mother. I was taken away from her in 1960, and did not see her again until 1995. Even though I had regained voice contact with her in 1986 via the phone, she and I only acknowledged that she had abused me and that she was remorseful.

It wasn't until 1995 when I finally met her again face-to-face - that I started really digging and then asking other family members to confirm or disprove what my mother shared. My mother shared much (and validated much in the process) about my childhood. In particular, she provided information I did not have and did not know.

The cult had indeed performed a "black magic" blood ceremony that was supposed to result in my Dad's death; my mother provided some of my Dad's hair for that ceremony. That ritual was performed for the "benefit" of the cult's rank and file. They did not reveal to the rank and file what actually was done.

The high priestess, "Lilith", and one other cult member came down to the town where my sister, Peggy and I lived with my Dad and stepmother and spent several days tracking my Dad's activities. My mother supplied them with some information on his activities and information on the "town drunk" - which they used along with money and booze - to pay the drunk to "do them a favor."

So it was no accident and as more details were revealed, other things began to make sense to me.

After the drunk backed up, he got out of his car and walked up to us. I was trying to put my Dad back together. I can still feel the warmth and wetness of my Dad's blood and intestines and his heart as I tried so very damned hard to fix him, to save him. I looked up at the drunk, hoping he could help, but he was shaking his head, crying over and over again "I shouldn't have taken the money". I didn't know then what he was talking about and didn't find out until 1995.

The town drunk was the same man who approached me after school earlier that week of the accident, asking me if I liked "show and tell" in class, asking me what I shared. When I told him I had nothing neat to share, he mentioned that my Dad worked with explosives in the oil fields (my Dad was a part-time seismologist among other odd jobs), and wouldn't that be neat if my Dad would take me to show me where he worked and what he did.

The drunk was set up, I was set up, used by my genetic mother, grandfather, and great-grandmother. Lilith was at the funeral. My Dad was murdered. Those bastards used a child, used me to get to my Dad. I no longer feel guilty about my Dad's death. But I lived with that guilt for nearly 40 years. I still struggle with the guilt over my sister's suicide attempt and my ex-brother-in-law's murder. That guilt, however, has been greatly lessened by what I've learned by digging in the past.

So why dig into the past?

To heal. To recover. To uncover the truths that can eliminate the guilt and pain and shame that does not belong to us.

It's obvious now why my mother didn't want me digging into the past. She knew I would discover the truth, that she is to blame for so much of the hell I, and my siblings, had to endure. She knows that I know she is far more responsible for what happened to my sister than I am and she fears what I'll do with that knowledge. How is the "child" of then linked with the "adult" of now.

What the child experienced gave birth to the guilt and pain the adult carries - crippling guilt and pain that resulted in dysfunctional actions as an adult.

Digging into the past resulted in the here-and-now adult comprehending the truth, resulted in the awakening of compassion, belief, and love for the child-then - and for the adult self - now. It allowed me to finally grieve for the child I once was - for the child I was never allowed to be...

next: The Ten Stages of The Recovery Process
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1. Self-Exploration and Self-Discovery
   You will explore your past and present to discover the truth about you.
2. Relationship history / inventory
   You'll examine and perhaps reset your personal boundaries.
3. Addiction control
   You'll get a handle on your addictions and compulsions and take the first steps toward mastering them.
4. Leaving home and saying good-bye
   You'll say the goodbyes appropriate to healing. You may think you did that years ago. Probably you didn't.
5. Grieving your loss
   Grieving is both the bottom of the curve, the very pits of your emotions and feelings, and also the start upward. It's almost like your dentist hanging up his drill. You know he's not done yet, but the worst is over.
6. New self-perceptions
   You will gain fresh perceptions about yourself and make new decisions. What an eye-opener this stage is!
7. New experiences
   You will build a foundation of new experiences to bolster the decisions you've just made.
8. Reparenting
   You will rebuild your past in a sense, and also the present and future, as you become involved in what we call reparenting.
9. Relationship accountability
   You will establish accountability for your new and refreshed personal relationships.
10. Maintenance
    You will embark on a maintenance program that will keep you on track for the remainder of your life.

Write three (3) things of beauty down in your life every day.

Analyzing repressed or unresolved anger

• You need a map or blueprint. Otherwise, how do you know where to go?
• Understanding: core of the human being
  1. to be loved
  2. to be accepted or longing for acceptance

Where love is denied, that's where you're wounded.

All of us are born with the NEED, but we are not born with the skill to meet those NEEDS. We are dependent on our family system. Ask yourself, what were the rules in my family system for ME to get love? --this creates anger, in return this is the emotional trauma that you experienced and must deal with.

If we look back to when you were 4-5 years old, many people who suffered from child abuse have these common beliefs:

• everyone is bad or hurtful
• I possess no power
• low self-esteem
• feel unloveable

How did you cope with that anger as you matured:

• not eating
• became perfectionist
• self-deprecating humor
• displaced anger
• physical symptoms, like migraines, appeared

COPING becomes HABIT
HABIT dictates REALITY
REALITY is OPTIONAL

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If you don't feel it, you can't heal it

1. Intimacy and Anger don't co-exist
2. Anger is emotional response to perceived injustice
3. Anger has many signs, many faces
   1. Inward - Depression
   2. Outward - Hostility
   3. Passive - Obsession to please others

Anger causes consequences. Ask yourself: "What problems does repressed anger cause me?" Especially consider:

• Humiliation
• Shame
• Health consequences

Anger's Common Traits

Rate yourself 1 (that's me) -10 (not me) in the following categories:

• need to control
• caretaker
• people pleaser
• workaholic
• martyr
• perfectionist
• procrastinator
• tap dancer
• hypersensitive
• body shame

Anger to forgiveness, forgiveness is for ME

Things to think about:

• The most painful and difficult thing you can ever deal with is yourself.
• If you don't feel it, you can't heal it.
• Unless I hang on a cross - I will never feel good enough (craziness).
• Life is like a sieve for those who don't want to get help.
• Get over the feeling that you don't deserve to have fun or enjoy life.
• Stop setting yourself up. You can say NO!
• I need to go as deep as the hurt. If I had a splinter, I would need to get all of it out, not just a portion. It would still hurt and eventually might get infected. Later it would be healed.

next: Getting Past The Bitterness
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by Paul McLaughlin
Survivor, Webmaster of Save our Children

How do you get over the hatred?
I can't seem to get on with my life.
I ask God to forgive me, but I just feel helplessness.

So many ask me the same question over and over. How do you forgive those who hurt you? I have no answer to that difficult question. I am sure for those who know, the bible will have an answer.

BUT WAIT A MINUTE.

I forgive those who hurt me just by saying "I forgive you", but I won't forget the pain you put me through. As for me, I guess I have God on my side. I became a believer in 1988, and for some dumb reason, I went home to Pittsburgh and had seen my mother, who I had not seen in 14 years. I went home and gave my mother a hug and told her, "I love you". It did me some good, but it didn't do a thing for her. I just forgave her. I guess this is what God wanted me to do. How can God forgive our sins if we can't forgive the poor soul who has done wrong by abusing us when we were little children?

Many point their finger at God. It's God's fault.

God allows this to happen. I DON'T THINK SO. Did God tell people to hurt you? Did God tell you to hurt other children? Did God tell my mother to sit me on a hot stove at the age of 5? No, God had nothing to do with our sufferings.

The day we die, God will ask us: "Why are you, as an adult, allowing other adults to hurt little children and allowing other adults to hurt other adults?" Do not point your finger at God. We need to point our finger at ourselves.

Many people tell me this: "I never forgave my parents for the little argument we had years ago and we didn't speak to each other for years. Now that my parents are dead, I feel guilty that I didn't fix the problem before they passed away. I wished that I had done something about it while my parents were alive."

As for me, I will not have a guilty mind because I have forgiven my mother for the horrible abuse she put me through.

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If you were very ill and dying, wouldn't you want someone to be by your side? I hope so. No matter what others have done wrong to you, you must not do wrong to others. Give it some time to heal. Stay away from those who hurt you. Only see them from time-to-time. Try to talk to them or hug them. Time heals old wounds. When you are ready, you will in time forgive those who have wronged you. It's in God's time, not your time. You are here for a reason.

Keep in contact with your friends. They are here to give you support and encouragement. I am not an expert, but I am here to encourage you. We are all here to help one another. No matter what some of us had to endure when we were children, we shall overcome. I might not have the proper words to say, but I am sure your friends do.

next: The Feelings Chart
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Evaluate the categories of feelings and then your levels of intensity of feelings to figure out where you're at.-

Intensity

Feelings

Happy

Sad

Angry

Scared

Confused

Strong

Weak

High

Satisfied

Hurt

Superior

Fearful

Bewildered

Potent

Over- whelmed

Elated

Hopeless

Furious

Panicky

Trapped

Super

Impotent

Overjoyed

Sorrowful

Seething

Afraid

Troubled

Powerful

Small

Proud

Depressed

Enraged

Distraught

Torn/Split

Trusting

Useless

Together

Rejected

Victimized

Miserable

Disorganized

Competent

Incapable

Complete

Unwanted

Drained

Frightened

Mixed-up

Energetic

Insecure

Free

Grief

Jealous

Threatened

Foggy

Confident

Inferior

Joyful

Medium

Cheerful

Ashamed

Remorseful

Insecure

Disoriented

Capable

Defensive

Up

Upset

Annoyed

Uneasy

Uncertain

Attracted

Shaky

Good

Distressed

Frustrated

Very strained

Divided

Sure

Unsure

Hopeful

Down

Agitated

Shy

Don't know

Secure

Soft

Peaceful

Defeated

Tense

Timid

Bothered

Durable

Shy

Loving

Beaten

Strained

Unsure

Safe

Low

Glad

Lonely

"Fed Up"

Nervous

Uncomfortable

Content

Sorry

Uptight

Strained

Undecided

Satisfied

Lost

Dismayed

Reluctant

Tired

Positive

Bad

Put Out

Relief (relieved)

Guilty

Nervous

Warm inside

Embarrassed-

Inconvenienced

Feel safe

Disappointed

Tired of

Feel secure

Inferior

Put upon

Accepted

Repulsed

Repulsed

Affectionate

Remorse

Competitive

A sense of belonging

Frightened

Respected

Defensive

Aggressive

Suspicious

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next: Setting Functional Boundaries
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by Pia Mellody, author of Facing Codependence

Why Do We Need to Set Functional Boundaries?

Boundary systems are invisible and symbolic "fences" that have three purposes:

1. to keep people from coming into our space and abusing us
2. to keep us from going into the space of others and abusing them
3. to give each of us a way to embody our sense of "who we are"

Boundary systems have two parts: external and internal. Our external boundary allows us to choose our distance from other people and enables us to give or refuse permission for them to touch us. Our internal boundary protects our thinking, feelings, and behavior and keeps them functional.

What Are Personal Boundaries?

A boundary is a system of setting limits that enhances a person's ability to have a sense of self. Boundaries control the impact of reality on the self and others. The purpose of a boundary is to contain and protect reality.

Reality is composed of four components. These are:

1. the body or what we look like
2. thinking or how we give meaning to incoming data
3. feelings or our emotions
4. behavior or what we do or do not do

There are three components of boundaries. These are an external system, an internal system, and a spiritual system. The External System protects the body and controls distance and touch. The Internal System protects thinking, feelings, and behavior. It acts like a block or filter and functions in conjunction with the External System. The Spiritual System occurs when two people are being intimate with one another and both are using their external and internal systems.

How to Create Personal Boundaries

Boundaries are created by:

• Visualization of External and Internal Systems
• Memorization of statements that create the External Physical Boundary, External Sexual Boundary, and the Internal Boundary.

The statement used to create the External Physical Boundary is:

• I have a right to control distance and non-sexual touch with you, and you have the same right to do so with me.

The statement used to create the External Sexual Boundary is:

• I have a right to determine with whom, when, where, and how I am going to be sexual. You also have the same right to do so with me.

The statement used to create the Internal Boundary is:

• I create what I think and feel and am in control of what I do or do not do. The same is true for you. We need only to note the impact of our reality on the other. If a person acts as a major offender, the person doing the offending is accountable for the impact and owes the other person amends.

Three Guidelines to Boundary Procedures

External Physical Boundary

You create the "self-protective" part of your external boundary when someone is approaching you. You do this by determining how close you allow the person to stand to you and whether or not you are going to allow him/her to touch you.

You create the "other protective" part of your external physical boundary when you are physically approaching another person. You do this by being respectful of an eighteen-inch social distance between you and the other person and by not touching him/her without his/her permission.

External Sexual Boundary

You create the "self-protective" part of your external boundary when someone is sexually approaching you. You do this by deciding for yourself if you want to be sexual with this person by asking yourself if it is in your best long term interest to do so. If you agree to be sexual, you then negotiate the issues regarding when, where, and how with him/her.

You create the "other protective" part of your External Sexual Boundary when you are asking a person to be sexual with you. You do this by directly asking the person if he/she wants to be sexual with you and if the person agrees to be sexual by negotiating the issues of when, where, and how with him/her.

Internal Boundary

You establish the "self-protective" part of your internal boundary when someone is talking. First, set your personal boundary. Then, say to yourself that the other person is responsible for creating what he/she is saying. You only take into yourself what is the truth for you. Block the rest by following this procedure:

1. If it is true, let the information in, embrace it, and allow yourself to have feelings about it.
2. If you determine that the information is not true, allow it to bounce off your boundary.
3. If the data is questionable, gather data regarding the information.

As you observe and analyze the information, you can determine if the information is "true" or "not true". If it is true, filter the information and have feelings about it. If the information is not true, block it and remove it from your boundary.

1. True: Filter/Filter & Feel
2. Not True: Block/Block
3. Questionable: Filter/Block & Gather Data

You establish the "other protective" part of your Internal Boundary when you are verbally sharing yourself. As you share your thoughts and feelings, you say to yourself, "I have created what I am saying and feeling. I am the only one responsible for my thoughts and feelings.

Physical Boundary Violations

• Standing too close to a person without his/her permission.
• Touching a person without his/her permission.
• Getting into a person's personal belongings and living space such as one's purse, wallet, mail, and closet.
• Listening to a person's personal conversations or telephone F. conversations without his/her permission.
• Not allowing a person to have privacy or violating a person's right to privacy.
• Exposing others to physical illness due to your having a contagious disease.

Sexual Boundary Violations:

• Touching a person sexually without his/her permission.
• Not negotiating when, where, and how to engage in sexual activity.
• Demanding unsafe sexual practices.
• Leaving pornography where others who do not wish to or should not see it may see it.
• Exposing oneself to others without their consent.
• Staring or looking at another person lustily (voyeurism) without his/her permission.
• Exposing visually and/or auditorily others to your sexual activities without their consent.

Internal Boundary Violations

• Yelling and screaming
• Name calling
• Ridiculing a person
• Lying
• Breaking a commitment
• Patronizing a person
• Telling a person how he/she should be or what he/she should do (Negative Control)
• Being sarcastic
• Shaming a person

* This material is excerpted with permission from: Facing Codependence: What It Is, Where It Comes From, How It Sabotages Our Lives By Pia Mellody with Andrea Wells Miller and J. Keith Miller

I jotted down some areas that I believe are "Basic Women's Rights". I encourage other women to share their own convictions based on their personal experiences. Hopefully, I can act as a catalyst for a project that will empower other women to find hope and healing.

1. The right to live in peace, without fear of emotional abuse, physical abuse, sexual abuse or psychological abuse.
2. The right to respect on the basis of motherhood.
3. The right to being taken seriously as an intelligent, capable human being with vast capabilities.
4. The right to never have to fear the loss of my offspring to a society that still considers them and myself as men's property.
5. The right to food, shelter, clothing and proper medical care. I will provide it for myself and help others to receive it when I am capable. When I am not, due to childhood, student status, pregnancy, disability or abuse, society will reach out to me in a loving and caring way and assist me to maintain my dignity.
6. The right to free access of knowledge.
7. Quality and affordable day care that enhances my development and that of my children.

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next: Diagnostic Codes for Post-Traumatic Stress Disorder (PTSD)
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American Psychiatric Association

Diagnostic Criteria from DSM-III-R

• 309.89 Post-traumatic Stress Disorder / delayed onset
• 300.02 Generalized Anxiety Disorder
• 300.40 Dysthymia (or Depressive Neurosis)
• 307.10 Anorexia Nervosa

309.89 Post-traumatic Stress Disorder

A. The person has experienced an event that is outside the range of usual human experience and that would be markedly distressing to almost anyone, e.g., serious threat to one's life or physical integrity; serious threat or harm to one's children, spouse, or other close relatives and friends; sudden destruction of one's home or community; or seeing another person who has recently been, or is being, seriously injured or killed as the result of an accident or physical violence.

B. The traumatic event is persistently reexperienced in at least on of the following ways:

1. recurrent and intrusive distressing recollections of the event (in young children, repetitive play in which themes or aspects of the trauma are expressed)
2. recurrent distressing dreams of the event
3. sudden acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative episodes , even those that occur upon awakening or when intoxicated)
4. intense psychological distress at exposure to events that symbolize or resemble an aspect of the traumatic event, including anniversaries of the trauma

C. Persistent avoidance of stimuli associated with the trauma or numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following:

1. efforts to avoid thoughts or feelings associated with the trauma
2. efforts to avoid activities or situations that arouse recollections of the trauma
3. inability to recall an important aspect of the trauma (psychogenic amnesia)
4. markedly diminished interest in significant activities (in young children, loss of recently acquired developmental skills such as toilet training or language skills) feeling of detachment or estrangement from others
5. restricted range of affect, e.g., unable to have loving feelings
6. sense of a foreshortened future, e.g., does not expect to have a career, marriage, or children, or a long life

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D. Persistent symptoms of increased arousal (no present before the trauma), as indicated by at least two of the following:

1. difficulty falling or staying asleep
2. irritability or outbursts of anger
3. difficulty concentrating
4. hypervigilance
5. exaggerated startle response
6. physiologic reactivity upon exposure to events that symbolize or resemble an aspect of the traumatic event (e.g., a woman who was raped in an elevator breaks out in a sweat when entering any elevator)

E. Duration of the disturbance (symptoms in B, C, and D) of at least one month.Specify delayed onset if the onset of symptoms was at least six months after the trauma.

300.02 Generalized Anxiety Disorder

A. Unrealistic or excessive anxiety and worry (apprehensive expectation) about two or more life circumstances, e.g., worry about possible misfortune to one's child (who is in no danger ) and worry about finances (for no good reason), for a period of six months or longer, during which the person has been bothered more days than not be these concerns. In children and adolescents, this may take the form of anxiety and worry about academic, athletic, and social performance.

B. If another Axis I disorder is present, the focus of the anxiety and worry in "A" is unrelated to it, e.g., the anxiety or worry is not about having a panic attack (as in Panic Disorder), being embarrassed in public (as in Social Phobia), being contaminated (as in Obsessive-Compulsive Disorder), or gaining weight (as in Anorexia Nervosa).

C. The disturbance does not occur only during the course of a Mood Disorder or a psychotic disorder.

D. At least six (6) of the following eighteen (18) symptoms are often present when anxious (do not include symptoms present only during panic attacks):

Motor tension

• trembling, twitching, or feeling shaky
• muscle tension, aches, or soreness
• restlessness
• easy fatigability

Autonomic hyperactivity

• shortness of breath or smothering sensations
• palpitations or accelerated heart rate (tachycardia)
• sweating, or cold clammy hands
• dry mouth
• dizziness or lightheadedness
• nausea, diarrhea, or other abdominal distress
• flushes (hot flashes) or chills
• frequent urination
• trouble swallowing or "lump in throat"

Vigilance and scanning

• feeling keyed up or on edge
• exaggerated startle response
• difficulty concentrating or "mind going blank" because of anxiety
• trouble falling or staying asleep
• irritability

E. It cannot be established that an organic factor initiated and maintained the disturbance, e.g., hyperthyroidism, caffeine intoxication.

300.40 Dysthymia (or Depressive Neurosis)

A. Depressed mood (or can be irritable mood in children and adolescents) for most of the day, more days than not, as indicated either by subjective account or observation by others, for at least two years (one year for children and adolescents)

B. Presence, while depressed, of at least two of the following:

1. poor appetite or overeating
2. insomnia or hypersomnia
3. low energy or fatigue
4. low self-esteem
5. poor concentration or difficulty making decisions
6. feelings of hopelessness

C. During a two-year period (one-year for children and adolescents) of the disturbance, never without the symptoms in "A" for more than two months at a time.

D. No evidence of an unequivocal Major Depressive Episode during the first two years (one year for children and adolescents) of the disturbance.

E. Has never had a Manic Episode or an unequivocal hypomanic episode.

F. Not superimposed on a chronic psychotic disorder, such as Schizophrenia or Delusional Disorder.

G. It cannot be established that an organic factor initiated and maintained the disturbance, e.g., prolonged administration of an antihypertensive medication.

307.10 Anorexia Nervosa

A. Refusal to maintain body weight over a minimal normal weight for age and height, e.g., weight loss leading to maintenance of body weight 15% below that expected; or failure to make expected weight gain during period of growth, leading to body weight 15% below that expected.

B. Intense fear of gaining weight or becoming fat, even though underweight.

C. Disturbance in the way in which one's body weight, size, or shape is experienced, e.g., the person claims to "feel fat" even when emaciated, believes that one area of the body is "too fat" even when obviously underweight.

D. In females, absence of at least three consecutive menstrual cycles when otherwise expected to occur (primary or secondary amenorrhea). (A woman is considered to have amenorrhea if her periods occur only following hormone, e.g., estrogen, administration.)

next: How You React To Stress
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The Relaxation and Stress Reduction Workbook

Stress is an everyday fact of life. You can't avoid it.

Stress is any change that you must adjust to. While you usually think of stressful events as being negative, such as injury, illness, or death of a loved one, they can also be positive. For instance, getting a new home or a promotion brings with it the stress of the change of status and new responsibilities. Falling in love can be as stressful for some people as falling out of love. All stress is not bad. Stress is not only desirable but essential to life.

Whether your stress experience is a result of major life changes or the cumulative effects of minor everyday hassles, it is how you react to stressful experiences that can create a stress response.

You experience stress from three basic sources:

1. your environment
2. your body
3. your thoughts

Your environment bombards you with demands to adjust. You must endure weather, noise, crowding, interpersonal demands, time pressures, performance standards, and various threats to your security and self-esteem.

The second source of stress is physiological. The rapid growth of adolescence, menopause in women, again, illness, accidents, lack of exercise, poor nutrition, and sleep disturbances all tax the body. Your reaction to environmental threats and changes also produce body changes which are themselves stressful.

The third source of stress is your thoughts. Your brain interprets and translates complex changes in your environment and determines when to push the panic button. How you interpret, perceive, and label your present experience and what you predict for the future can serve either to relax or stress you. Interpreting a sour look from your boss to mean that you are doing an inadequate job is likely to be very anxiety provoking. Interpreting the same look as tiredness or preoccupation with personal problems will not be as frightening.

Stress researcher, Richard Lazarus, has argued that stress begins with your appraisal of a situation. You first ask yourself what is happening and why (causality). Then, to determine the situation's significance for your well being, you ask how dangerous it is and what resources you have to cope with it. Anxious, stressed people often decide that:

1. an event is dangerous, difficult, or painful; or
2. they don't have the resources to cope.

Working on these issues in a positive way, will give you the confidence that you can cope.

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next: Thoughts That Trigger Anxiety and Anger and Can Ruin Relationships
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Are some of these fallacies creating stress for you in a relationship?

Entitlement fallacy:

The belief is that because I want something very much, I ought to have it...the feeling that there are certain things that I am entitled to. (Fight this fallacy by realizing the other person is free to say no, and that although you have your limits, the other person does also.)

Fallacy of fairness:

The idea that there is some absolute standard of correct and fair behavior in interpersonal relationships...the conviction that relationships must be fair. (Fight this fallacy by recognizing that all needs of all parties are equally important and legitimate, and both parties can negotiate as peers.)

Fallacy of change:

The assumption that you really can have control over and change another person's behavior. (Remember that people will change only when they want to and the only person's behavior you can change is your own.)

The Letting it Out fallacy:

The belief that people who hurt you must be punished. (Keep in mind that punishment or revenge won't get you what you want.)

Conditional Assumptions:

The assumption that behaviors of others have special meaning, such as "if you loved me, you'd have done dishes tonight". (Recall that disappointment doesn't necessarily mean that you or your partner doesn't care.)

Good/Bad Dichotomizing:

The belief that people are good or bad, right or wrong, not seeing "shades of gray" or any less polarized view of another person or their behaviors. (Work on judging less, and allowing others to hold beliefs and ideas that are different from yours. When your needs conflict with others recall that there is not necessarily a right or wrong way of doing things, only that your needs at a given moment conflict with your partner's.)

Assumed Intent:

The tendency to make guesses about how others feel and think without checking it out. Mindreading. (Assume nothing - or check it out!!!)

Magnifying:

Making things worse by focusing and "blowing up" the negative aspects of the situation (and usually minimizing the positive aspects.) (Work on not using words like always, never, and strive towards accuracy rather than exaggeration.)

Global Labelling:

Using words to label others, such as "my boss is an imbecile; my mother is neurotic; my father is stupid; I am a jerk, etc. (Work on not labeling. Instead, be specific about which behavior you observe.)

Adapted from McKay, Matthew, et al, "When Anger Hurts, Quieting the Storm Within," 1989, New Harbinger Publications, California

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next: Coping Statements To Help With Panic Attacks
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