The “Four F’s” of C-PTSD

This article was originally posted in April, 2016.

I also wrote a review of Pete Walker’s wonderful self help guide for survivors of complex PTSD, which you can read here:

Book Review: Complex PTSD: From Surviving to Thriving by Pete Walker 

Lucky Otters Haven

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I just began reading “Complex PTSD: From Surviving to Thriving” by Pete Walker. I can already tell I won’t be able to put it down (I will write a book review when I’m finished, which shouldn’t take long). I’m also going to bring this book to my next therapy session because I want my therapist to see it.

Walker, who is a therapist and also a survivor of narcissistic abuse and sufferer of C-PTSD, is an engaging writer and definitely knows his subject matter. In one of the first chapters, he discusses the “Four F’s”–which are four different “styles” of coping that people with C-PTSD develop to cope with their abusive caregivers and avoid the abandonment depression. Whatever style one adopts may be based on several factors–natural temperament, the role in the family the child was given (scapegoat, golden child, “lost” or ignored child), birth order, and other factors.

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Available…

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Book Review: Complex PTSD: From Surviving to Thriving (by Pete Walker)

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I finally finished reading a most wonderful book sent to me by my friend and fellow blogger, Linda Lee. It’s called Complex PTSD: From Surviving to Thriving, written by Pete Walker, himself a sufferer of C-PTSD and narcissistic abuse survivor. He is also a therapist who works with others with C-PTSD.

Walker’s book is incredibly readable and tells you everything you need or want to know about C-PTSD, a subcategory of PTSD that isn’t (but should be) included in the Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible of the mental health profession. Complex PTSD is similar to PTSD but there are several important differences. The recognized diagnostic category of PTSD describes a disorder that is caused by one traumatic event, such as a rape or combat in a war. PTSD itself wasn’t recognized until psychologists noticed that many Vietnam war veterans were suffering from a group of similar symptoms including, but not limited to, loss of memory, dissociative episodes, panic attacks, general but severe anxiety or depression, inability to cope with day to day challenges, impaired ability to regulate emotions including anger, impaired ability to relate to others in a healthy way, nightmares, flashbacks, and physical pain with no medical causes. C-PTSD has a similar set of symptoms, but is “complex” because of its cause–instead of being precipitated by a single traumatic event, it’s caused by an ongoing series of traumatic incidents and also usually (though not always) begins during childhood. Very often it’s a result of being “cared for” by narcissistic or sociopathic parents, who are actively abusive or neglect their child. Unlike most self-help books, Walker covers the nature of narcissistic abuse and its soul-murdering effect on a child, and how this can lead to C-PTSD and its various manifestations.

Walker breaks down C-PTSD into four “types,” each one corresponding to a different type of defense mechanism, which he calls “The Four F’s”–Fight (the narcissistic defense); Flight (the obsessive compulsive or “workaholic” defense); Freeze (the dissociative defense); and Fawn (the Codependent defense). Most people will have a combination of these, but usually one will be dominant over the others. I find it intriguing that Walker describes the narcissistic and borderline personalities as manifestations of C-PTSD (BPD is a Fight-Codependent hybrid), because I also think that’s exactly what they are.

Walker doesn’t think that any form of C-PTSD is untreatable or necessarily permanent, although some forms are more difficult to eradicate than others. People with severe C-PTSD may spend most of their time in a “flashback” without even knowing that it’s a flashback. For example, if you are continually depressed and anxious without being able to pinpoint why, you may be in a flashback to a time when you were made to feel shame as a young child. Any sort of invalidation or reminder of the shame, no matter how small, could have set off the flashback.

Also discussed is the importance of nurturing your Inner Child, and Walker shows you how you can begin to do this on your own. He also explains why people with C-PTSD have such a harsh Inner Critic (which is the internalized “voice” of the abusive parent that relentlessly continues to shame the Inner Child) and how how re-training your Inner Critic to be less, well, critical and more supportive of the Inner Child can do wonders for your self esteem and help you begin to heal. One of the most important things that must happen in order to heal from C-PTSD is to be able to grieve the lost or wounded inner child and also to be able to feel and express righteous anger toward the abuser (while being No Contact with the actual guilty party, of course).

While Walker encourages therapy (and states that in severe cases says it may be the only way to heal from C-PTSD), he recognizes that it may not always be appropriate or possible for everyone. For example, some C-PTSD sufferers (usually the Freeze/dissociative type) are so hypervigilant and uncomfortable relating to others that they can’t begin to trust a therapist enough to make any progress that way. Such people may do better on their own, at least to begin with. He points out early on that even if you skip around in the book (because not everything in it may apply to everyone) that you can still be helped. He gives the reader helpful things they can do on their own, such as positive affirmations, self-mothering, self-fathering and the “Time Machine Rescue Operation,” mindfulness skills, thought-stopping the Critic, thought substitution, recognizing signs of being in a flashback, how to grieve, and finding “good enough” relational help, among many other tools.

At the core of C-PTSD is the “abandonment depression,” a feeling of terrible emptiness that the Four F’s have been used to avoid confronting. Walker explains how to cope with the abandonment depression without denying that it exists or using the Four F’s as defense mechanisms against it.

Finally, Walker includes a list of books–which he calls “Bibliotherapy”–that he and his patients and visitors to his website have found useful. He wraps things up with six easily referenced “toolboxes” the C-PTSD sufferer can use as adjuncts to their recovery.

Complex PTSD: From Surviving to Thriving is intelligently and empathetically written, and easy to read without being condescending or dumbed down. Its chapters are organized in an understandable and logical way, and subheaders are used throughout to make it possible to read the book in easy to digest chunks. This book has helped me immensely so far, and takes the complexity out of this “complex” disorder.

You can visit Pete Walker’s website here:
http://pete-walker.com/

Book Review: “The Sociopath Next Door” by Martha Stout

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Dr. Martha Stout’s excellent “The Sociopath Next Door: The Ruthless versus The Rest of Us” is an easy to read, well researched and often entertaining study of the psychology of evil. In some ways similar to M. Scott Peck’s “People of the Lie,” but without the religious overtones, Stout chillingly describes the “ice people”–the sociopaths that walk among us.

As many as 4%–one in 25 Americans–is without a conscience or the capacity to feel empathy for others. Stout doesn’t make a distinction between sociopathy and psychopathy, and in this book she is referring to those people who meet the diagnostic criteria for Antisocial Personality Disorder (ASPD), not Narcissistic Personality Disorder. In fact, narcissism as a disorder is rarely mentioned, although she does acknowledge that all sociopaths are narcissistic.

Stout includes many case studies of how sociopathy can manifest in individuals. Contrary to popular notion, not all people with ASPD (sociopathy) are in prison or even criminals. Antisocial behavior is found as often in boardrooms as in prisons, and sometimes more so. For sociopaths who grew up in well heeled families and were able to get a good education, their antisocial traits are likely to manifest in “socially acceptable” ways. For example, a CEO who needlessly downsizes to increase his own bloated income, ruthlessly firing hundreds of employees without caring about the hardship those fired employees now face, is as conscienceless and unempathic as a cold blooded murderer.

A sociopath can be the gossipy woman next door who tells malicious lies about all the other neighbors, it can be the company president who embezzles and defrauds, or it can be the vicious serial killer who preys after college students.

Stout talks a lot about conscience, that quality that separates the antisocial from everyone else. It’s the lack of this trait that makes people evil. She offers a number of reasons why someone may lack a conscience–they may have suffered horrible abuse or neglect as young children (she discusses the sad plight of Romanian children who were adopted by American parents and many of these kids were found to have an underdeveloped conscience), they may not have been taught prosocial values, or they may be deficient in the parts of the brain where the conscience develops in normal children.

I definitely recommend “The Sociopath Next Door” to anyone who has been a victim of or had to deal with a sociopath, whether at home, work, school, or in a relationship. I’m going to extend the term “sociopath” here to include narcissists and psychopaths because they too lack empathy and a conscience. Really, this book should be read by everyone, because all of us have had to deal with ruthless “ice people” who just don’t care about anyone but themselves.

Sam Vaknin: Narcissist or narcissist wannabe?

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Who in their right mind would want to be a narcissist?

Sam Vaknin evidently does. Vaknin, a self-identified narcissist, is a bit different from the average narcissist. He seems to fit the profile in many ways, but he is surprisingly introspective and in 1997, wrote a self-help book called “Malignant Self-Love: Narcissism Revisited. It can be purchased through Amazon or through his own site, but you can also read free excerpts from the PDF version which is also available through his website.

I have read the PDF full version and while it’s extremely long, verbose, and often repetitive (the published version may have better editing but I am not sure), Vaknin tells you everything you want to know about narcissism (and a few things you may not have known) and offers advice to “normals” on how to deal with narcissistic people like himself. He does not glorify narcissists and in fact is quite critical of them. While it appears he wants to help people handle or even cut themselves off from narcissists, one can’t help but wonder if he wrote the book as a way to promote himself and if he might not actually take pride in having the disorder. After all, narcissism has become Vaknin’s claim to fame and he purports himself as an expert on the disorder (which I can’t argue with, despite his lack of professional credentials). It was Vaknin who coined the term “narcissistic supply,” which is now used by bonafide professionals in the field who specialize in NPD.

Most books about narcissistic personality disorder or malignant narcissism are written by doctors, psychologists, or other professionals who deal with them in their practice, so reading such a book by a self-proclaimed narcissist is an odd experience but gives the reader an entirely different perspective about what really makes narcissists tick–and in a way, perhaps a more accurate one.

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Vaknin with a copy of his book.

Vaknin also differs from the garden variety narcissist because of his brutal honesty. Pathological lying is one of the narcissist’s calling cards, but in 2009 Australian filmmaker Ian Walker made a fascinating and somewhat disturbing but at times extremely funny documentary about Vaknin called I, Psychopath. (I highly recommend watching this film, the extended version of which can be viewed on Youtube (I have linked the first section). In the film Vaknin lies about nothing, and in fact he’s as brutally and cruelly honest as Simon Cowell used to be when judging American Idol contestants (I definitely suspect Mr. Cowell is himself a narcissist, but I digress). That being said, there has been some controversy about Mr. Vaknin’s educational credentials. During one of his interviews with a psychologist, she questions him about his degree–he had written on the questionnaire that he has a Ph.D, but it turned out that doctorate is actually from a diploma mill and its validity is questionable at best. So dishonesty is not unknown to Sam Vaknin (as it isn’t unknown to the rest of us).

In the film, we are treated to interesting and slightly creepy, oddly lit stills of Vaknin superimposed over things like clanking machinery (hinting at how the narcissist is more machine than human), strange landscapes, and time-lapsed highways at night.

Vaknin was born in 1961 to a Turkish mother and an Israeli father. We find out that Vaknin has an extremely high IQ and he is in fact a genius. In his native Israel, he became extremely wealthy at a shockingly early age through clever (and probably dishonest) financial wheelings and dealings, and was a successful dot-com entrepreneur until he was busted for securities fraud in 1999, and lost all his money. He also postulated a scientific theory on chronons and time asymmetry.

At the tender age of 21, Vaknin was living the high life, flying around the world in a private jet, eating in the most expensive restaurants, visiting exotic locales all over the world, and raking in enormous amounts of money. The film describes how the most successful entrepreneurs and corporate bigwigs tend to possess three important traits that make them so successful: good looks, high intelligence, and most importantly, a high level of psychopathy (determined by giving the tycoons Dr. Robert Hare’s Psychopathy Checklist, which is most commonly used to make sentencing decisions for criminals.). Sam Vaknin possesses all three of these traits.

One of the psychologists who tests Vaknin during the film finds that while he does score high in traits that signify NPD, he scores even higher in traits that indicate Schizotypal Personality Disorder, Paranoid Personality Disorder, and bizarrely, scores highest of all in AvPD (Avoidant Personality disorder–a common disorder in narcissists’ victims). This psychologist does not think Mr. Vaknin is actually a psychopath, but that he may be narcissistic. Vaknin, for his part, seems petulant, insulted and almost angry that he is not more of the big, bad psychopath that he believed he was.

Later, his wife, Lidija, is also tested to find out if she is a typical “victim” (highly empathic, sensitive, putting other’s needs ahead of her own) and it is found that she is. And yet, although Sam and Lidija argue frequently, their relationship (at least on film) seems to work for them and Vaknin doesn’t seem excessively abusive, although he insists he has no capacity to feel love the way his wife does. It’s possible he may be more abusive toward Lidija off screen, but this is another thing we are left wondering. One issue that is raised is she wants a baby, but is unsure if her husband would make a good father, due to his narcissism.

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Vaknin with his wife, Lidija.

Vaknin gives his filmmaker, Ian Walker, a difficult time, and while we don’t see an excess of bullying on screen, in Walker’s commentary, he frequently discusses the way Vaknin abuses and calls him terrible names when the camera is off. So to try to capture Vaknin’s alleged abusive behavior on screen, he has Vaknin take over the filming and film Walker. Indeed now we hear Vaknin hurling insults and abuse at him. Walker, for his part, seems hurt, but could this just be the two of them acting out a part for the sake of giving the film more credibility of making it more interesting? There’s no way to tell, but the experiment is entertaining enough.

During the film, well known professionals who specialize in psychopathy and narcissism are interviewed and give their opinions about these character disorders, and their opinions about Vaknin himself. Vaknin, for his part, seems irascible and easily angered (and sometimes acts like a petulant child), but he also is oddly likeable (which could just be his narcissistic charm doing its work) and occasionally is extremely funny. Vaknin’s high intelligence is obvious and he speaks English extremely well too, although it’s not his native tongue.

Vaknin gifts each of the doctors and psychologists who interview him a complimentary copy of his “Malignant Self-Love,” which could be a gesture of courtesy or it could be narcissistic.

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Vaknin is an enigma. During the documentary I sometimes wondered whether he is actually a narcissist at all. He certainly doesn’t seem psychopathic (although I’m not going to say it’s impossible), but if he’s a narcissist, I don’t think he’s a particularly malignant one. My own opinion of Sam Vaknin is that he has Borderline Personality Disorder (BPD), which shares a number of traits with NPD because they are both Cluster B character disorders but differ in important ways. I think Vaknin has strong narcissistic, paranoid, and schizoid traits, but he is no psychopath. Clearly, Vaknin isn’t the easiest person to spend a lot of time with, but that doesn’t make him evil or a psychopath. However, he does say he was diagnosed with NPD twice–in 1986 and 1995.

I do wonder if he wants to be a narcissist more than he actually is one, and if so, why? Whatever the case, Mr. Vaknin has written an excellent and highly readable (if a bit verbose) book about malignant narcissism. I don’t personally care if he doesn’t have the right “credentials,” either as a professional or as a person with the actual disorder, because his book has helped so many people deal with the narcissists in their own lives better.

Update 11/20/14
I added a new post honoring Mr. Vaknin’s requests in the comments section, and also made the requested changes in this article. After viewing the links he posted, I’m much more convinced he’s really the narcissist he says he is.
https://otterlover58.wordpress.com/2014/11/20/sam-vaknin-read-my-post-and-has-a-few-corrections/

Book Review: People of the Lie: The Hope for Healing Human Evil, by M. Scott Peck, MD

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When “People of the Lie” was first published in 1983, the word “evil” wasn’t in the popular lexicon. We were still a nation experimenting with various alternative lifestyles and there was still a lot of philosophical holdover from the “do your own thing” mindset of the 1960s. The religious right, primarily the Moral Majority had been influencing things for several years by this time (hence why Reagan was popular enough to get elected in 1980), but their power was still mainly under the radar and it just wasn’t PC to talk about things like “evil” with its medieval religious connotations. Even today, the word isn’t exactly politically correct, although it’s been bandied about a lot more in recent years, from the religious right to political pundits on both sides of the political spectrum. In addition, comments on social media such as Youtube, Facebook and Twitter often turn into religious arguments and the word “evil” is tossed about like confetti at a parade. Hence the word has lost some of its original power and Dark Ages overtones, but has become more acceptable in public discourse.

At the time of its publication, “People of the Lie” was a groundbreaking work by a respected psychiatrist who was no newcomer to the world of self help books, and it was the first comprehensive book written about what is now recognized by most people as the malignant narcissist, or person with severe narcissistic personality disorder. (People with Antisocial Personality Disorder, while more often criminals than those with NPD, are actually less “evil” due to the fact they actually cannot tell the difference between right and wrong, while a MN can, but doesn’t give a rat’s ass how they hurt others). It’s still a popular book today, and has passed the test of time due to its readability and fascinating case histories of “evil people” (more on this in a minute) and somehow manages to convey a scholarly feel without becoming dry, unreadable, or overly religious.

The book isn’t perfect. The subtitle “the Hope for Healing Human Evil” is a bit misleading, as there’s very little about actually curing the character disorders associated with it, and Dr. Peck frequently mentions how “hopeless” a task it is, given that malignant narcissists really cannot ever change. In one of the central case histories, the story of “Charlene,” Peck continually talks about his frustration in treating her as his patient and his inability to change her, and finally regrets not having “nurtured her like a parent,” actually saying he should have “taken her on his lap and stroked her like an infant,” (wtf?!) This comes off as really creepy and unethical, not to mention possibly illegal. As for Charlene, whether she’s actually evil isn’t too clear, as she never does anything much worse than simply being incredibly annoying. She’s clearly infatuated with Dr. Peck and unable to handle it; she shows stalking behaviors and likes to “play” with him but never does anything worse than just be annoying (indeed, this is how some MN’s who are not criminals break down their “marks” so who knows?) Her reaction to him could be simple transference of a patient to a therapist with nothing really evil about it at all. Peck’s countertransference toward Charlene in some ways seems more pathological than Charlene’s irritating behavior.

Several other cases describe disturbed and unhealthily codependent people (like the weak and dependent Harley dominated by his mean wife Sarah–these two actually seem quite happy in their unholy symbiosis). Sarah may or may not be “evil,” but clearly has narcissistic and sadistic traits and loves to torment poor Harley, who whines to Dr. Peck but seems to do little else to stop it. Peck speculates that a weak or pathologically dependent person like Harley, who can be so easily dominated, may be a bit evil themselves, which is why they “collude” with their abuser in the first place. There may be some validity to this claim, but I certainly don’t believe all abused people are colluding with their abuser or “asking for it.” That’s just blaming the victim, something that’s become increasingly common today.

I think (and others seem to agree on this) the most evil people in the book are the parents who gave their depressed son his older brother’s suicide weapon (THE gun, not just a gun like it) for his birthday. WTF?!? Anyone who would do such a thing to their own child is seriously deranged.

The cases, while all riveting and drawing you in like mini novels (or bad soaps?), don’t really give the reader a clear view of what evil actually is, and certainly not how it should be addressed. Dr. Peck seems at a loss as to what to do, and his last chapter on exorcism is a little over the top although fascinating to read. Peck believes exorcism can be performed effectively by psychiatrists who are well couched in the techniques (basically a classic rite as was seen in the 1973 movie The Exorcist) who also have a strong relationship to God (not necessarily of the born again Christian variety) and a strong enough character to resist the actions and manipulations of evil spirits or demons as they begin to resist the exorcism.

One of the best chapters of the book was the chapter on group evil (describing in the Mai Lai massacres in Vietnam during the ’60s. Peck explains how a group of people, not necessarily at all evil themselves, can be drawn into performing heinous crimes as a group. This is a well known theory–crowds will often behave in ways individuals within that crowd never would, especially if coerced by narcissistic or evil leaders. This is exactly what happened in Germany and Europe under Hitler in WW2 and probably what happened with Mai Lai as well.

I’ve had my copy of POTL for many years, and have read it or parts of it many times over. I still find it useful and was able to identify my mother as an evil person based on what I read. For all its faults, POTL is a must read for anyone interested in malignant narcissism or involved with a person with this character disorder, even if just for its historical perspective on this disorder that has become increasingly prevalent in the pathologically narcissistic and compassion-deficient modern world we are living in today.

Peck is himself a born again Christian, and even though there are definite religious overtones in POTL, he doesn’t bash you over the head with his beliefs, or overwhelm the reader with biblical references. I respect Peck’s religious beliefs, as I respect all religious beliefs, and although I may not agree with all of them and the book comes off at times a bit judgmental, I appreciate the fact he retains primarily the psychiatric and scientific, rather than the religious, perspective in this book. It’s a fascinating way to look at the problem of evil, which I definitely believe exists and is a powerful force, even though I’m not sure it’s driven by an entity called “Satan,” evil spirits, or just a manifestation of the primitive reptilian brain of those who are missing the higher parts of the brain that allow them to develop a conscience and true feelings of love for their fellow humans.

“People of the Lie” is much better than Peck’s later work on the subject of human evil, “Glimpses of the Devil,” his 2005 expansion on the subject, which goes into greater detail on the two exorcisms Peck performed and described briefly in POTL, but has far more blatant Christian overtones and is frankly a creepy and disturbing read and not as comprehensive and scientific as POTL. Still worth a read if you’re into that sort of thing.

Click here to purchase “People of the Lie” from Amazon.