Containment 101, A How-To

Oh the joys of containment! I am not sure how many are familiar with this symptom management technique, so I decided to put it out there for those that are not. Containment summed up is a way to teach your brain a more helpful way of storing traumatic material, a less intrusive way and one that grants the sufferer more control over these intrusive thoughts, feelings and behaviors.

DISCLAIMER: I ask you to forgive me now, I am not a PhD, and some of my terms may not be exactly the best clinical way of describing them. I hope that my layman speak will actually be easier to understand. For all intent and purpose, this description is best applied to those that have a trauma history and not the general population.

Ok, the below chart is a description of how people with trauma typically store information related to their abuse in a way that can lead to flashbacks, body memories, feelings that don't match to the present day and acting out behaviors not directly related to a current stressful event.
The conscious is where we keep all current information like date and time, or where we are. We are aware of this knowledge but it is not something we necessarily acknowledge. But it's always available.
The preconscious is where we store information like our birthdate, our address, phone number or things like our first car, our first job. This information is something we can recall when we put some effort into it and doesn't really have any trauma attached to it.
The unconscious is a deep dark place that you really cannot access, even with considerable effort. Trauma survivors store all their blocked out memories and feelings in this place, hoping for it to never come back again.

We break our memories up into behaviors, affect, sensations and knowledge...or BASK. The chart also demonstrates what happens with that stored information. Sometimes a trigger occurs, other times for no reason at all, one of those pieces of information shoots up in the conscious and reeks havoc on your conscious. Flashbacks and body memories abounding. Then, we tend to shove it right back down into the unconscious where it looms until the cycle begins all over again. It can be torturous and definitely effect your ability to function in your daily life!

So really, what is a person supposed to do? How can you end the cycle? How can you start a process that allows YOU control over this?

This is where containment comes into play. Containment is a set of strategies that re-train your brain to take those BASK pieces and store them appropriately in your preconscious where YOU have the control to access them or not to. This is not to be confused with stuffing, or keeping quiet. This won't stop the information from invading, it won't stop the flashbacks all together, however the more you use this...the less there is to store in your unconscious and the less there will be to come out invasively.

So how do you do this you ask?

Well, first you need to figure out how you learn best. Are you a concrete thinking that requires something tangible, something more hands on? Or do you better with imagery and closing your eyes and just thinking something through? (and eventually you can do both)

For the concrete thinkers out there, the best practice for this is finding yourself a small box, preferably one you can lock or by using your journal. When you experience the intrusive symptoms quickly write down on a piece of paper or in your journal three or four simple describing words that will help you to recall the information you experienced. Try to be gentle with the memory trigger words, not too graphic. Seal this information up in the box and lock it or in your journal. Spend the next 15 minutes or so using pleasant imagery, go to your safe place in your head and take care of yourself. Remember, you store that information for later...you don't need to deal with it right now. Once you've successfully done that, congratulate yourself. You just did containment. Sometimes you have to go through this process SEVERAL times before you get relief. It's a learned skill and it takes practice.

Now, with this 'stored' information you can take it to your therapist and add it to the list of things to process. You have the memory triggers there and you can recall it in a safe environment with support.

For people that prefer a more imagery based approach (which is a little more difficult in my opinion) the possibilities are endless for your containment devices. Some people can just make a box in your head, and others I listened to have constructed some VERY intense ways to store it. Some examples include:

-A Hot air balloon
-a treasure chest with multiple locks at the bottom of a lake
-a remote control car with a box locked to it
-a treetrunk with a revolving keypad entry door

One of the most important things to remember about imagery and containment is that with whatever you decide to use, the object must be attached to something that you can imagine yourself using to pull the object back. For example, with the hot air balloon you could have a tether tied to the ground. Or with the treasure chest, and rope attached to a dock or boat. Now that you have your object of storage you can place all the intrusive symptoms in that object and send it to where it is supposed to go and then pull it back while you are in therapy.

Like I said before, the imagery way of doing it can be very complicated and I recommend trying the tangible way first.

Some pointers?
-Test your ability to use this skill with begnin information. Something I used was a commercial I saw on TV. I saw it, wrote a few words on a piece of paper and locked it up. I wrote a note on my computer reminding myself to recall that information later in the day. I tried to remember the commercial without my box, but no such luck. When I opened the piece of paper it was easily recalled. I've also done it with trying to remember important meetings and dates nd it worked. Get comfortable with that before trying to tackle th big stuff.
-DON'T GIVE UP. Sometimes it works, other times your brain just might not be ready and it's something you HAVE to practice.
-Be creative, find something that works for you and ONLY you.
-If you have DID you may need multiple forms of containment, and some parts might want to contruct their own object for their information. It's a wonderful tool.
-Remember, this is a tool to give you control...not silence you.

If you have any questions I'd be more than happy to help you out. e-mail me at crackersandjuice at gmail dot com.

-Allie

The BASK Model using containment

Tunes & Treatment

One of my reasons for starting this blog is to perhaps help those out there struggling in their recovery from childhood abuse by providing helpful techniques that have worked in my personal therapy. So this is the first attempt at this.

Music has played a very important role in my treatment, attachment to my therapist and general ability to self-soothe. I highly recommend it. I have always had a strong attachment to music and often used songs to try to relate to people, but no one really go it until I shared this experience with my current therapist. Her original intention (I believe) was to connect with her patients (me being one of them) by showing them that she could understand their struggles and used music as a foundation for that understanding. If I recall correctly, the first song we discussed was by Lifehouse and it was "Sick Cycle Carousel".

I often struggle with words to describe feelings and sensations, and it is very easy for me to pick out songs that reflect these feelings. When I am feeling extremely inarticulate I can think about a song and how it made me feel and interpret the feelings into words that the song has verbalized for me. Very helpful.

Also, music has provided tangible attachment to my therapist. In general, therapists cannot give you something like a pillow or blanket to keep around when you are feeling extremely detached and alone. Music has given me my security blanket and it's something that is tangible and truly a gift. It's portable and not weird to have it around you. Perfect to lower the scale of weirdness! On some very rare occasions my therapist has provided me with a list of songs she likes or is currently listening to...those lists became my back up evidence that she does care on those days where I try to trick myself into believing that she is not around, or she does not care. I have a couple of playlists on my iPod that are dedicated to the songs she has given me and I can whip them out and feel immediate connectedness and attachment. It's a small piece of her that I can carry with me, and has been a life saver on many occasions.

Music also serves a great function with me trying to reach out to my therapist with attachment. If I am feeling like she is far away and I can't get in touch with our alliance I know that I can look for new music and send her my current playlists and generally she'll listen to them if she has a chance. For me, knowing that she is connecting with me outside of our sessions through music makes our relationship less temporary and I feel safe knowing she has my music and she is connected somewhere out there.

Simply put, it's good stuff that can be very healing.
Below is a list of some of the songs we've connected over. (Coldplay is a theme, we're both big fans)

Hate Me - Blue October
Speed - Cary Pierce
32 Flavors - Ani DiFranco
See you Soon - Coldplay
Hardest Part - Coldplay
Angry Angel - Imogen Heap
The Walk - Imogen Heap
A Sorta Fairytale - Tori Amos
Black Swan - Thom Yorke
In the Sun - Michael Stipe and Chris Martin
Apologize - Timbaland featuring One Republic (I Know, it's embarrassing)
The Scientist - Coldplay
Stand Still, Look Pretty - The Wreckers
Sick Cycle Carousel - Lifehouse
Simon - Lifehouse
My Wish - Rascal Flatts
Ready, Set, Don't Go - Miley Cyrus, feat. Billy Ray Cyrus (don't ask)
Consequence - The Notwist
Missing - Evanescence
Let Go - Frou Frou
And the following are songs that I haven't really share with my therapist, but I keep handy to help me remember our connection: (less to do with our relationship and more to do with things I wish I could say about my past)

Best I Ever Had - Vertical Horizon
Some of Us - Starsailor
Say it's possible - Terra Naomi
A better son/daughter - Rilo Kiley
Broken Bridge - Daughter Darling
I don't blame you - CatPower
Somewhere only we know - Keane
Here with me - Dido
I dare you to move - Switchfoot
Fall Away - The Fray

And now for a little humor, songs on my June playlist that are just plain embarrassing and ridiculous!

Hoes in different area codes - Ludacris
Drop it like its hot - Snoop Dog (my sister is amazed at my ability to remember all the lyrics)
Cupid's Chokehold - Gym Class Heros
Gold Digger - Kayne West
Brick House - The commodores
Have you ever seen the rain - Creedence Clearwater Revival
Boyz-N-da-Hood - Dynamite Hack
Fuck It - Eamon
Crazy - Gnarls Barkley

Childhood PhotoShare

All this thinking about the past made me look back on some photos. So I scanned a few to share.

That's me at about 9 months old, my mother is holding me.

This is me on my Mom's birthday...I was 6 I think

My first and only birthday party when I was in foster care.

Stitches, no so thrilled. My Dad had hit me with a piece of metal.

Our family. My Dad, me brother and sister on Easter. My mom took the picture.

Dressed up in my ballet costume for a school play.

This is about 2 months before being admitted to Childrens.

6-30, Post Tx

Well, it was a good session. I know that the general consensus inside is that it was one of the better sessions we've had in weeks. I was worried though because on the way there, I stopped at the gas station to break a twenty and on the way out cops had stopped traffic for a funeral procession. There is something about them that sends me into a deep panic. Watching all the people driving behind a hearse, knowing all of them have lost someone important to them is terrible. It's reminds me of the awful feelings I had when my father died. The funeral procession made me so uncontrollably angry. I didn't want people looking at us, I wanted to be alone with it. Sorry, I was sidetracked.

Considering I saw that, I thought we would open with it, then quickly decided it was something I could cope with on my own and we jumped into what's been going on over the weekend. It was quickly summarized and then we moved into working with Charlotte. Since I guessed this is where we would be headed, I had made it very clear to Charlotte that there was to be no acting out, no intense crazy, and promised her that if she tried really hard I'd let her hit iTunes and purchase 5 new songs and create a new play-list. IT WORKED. My therapist did not know this, but it seemed irrelevant. They spoke for most of the session and Charlotte remained as calm as could be. She talked slowly and tried very hard to be honest and open, which is no easy task for her. It did not really relieve anything, but it opened the door for more communication which is all I could ask for at this point.

I really want to push my therapist and Charlotte to talk about the foster care experience, however I trust my therapist when it comes to pacing...she knows what she is doing so I won't rush things.

6-30, Pre-Tx Rundown

Alright, I decided it would be helpful for me to keep track of my therapy appointments and progress as a part of this blog. Monday's are usually the only days that I can do a 'pre-post' because the additional appointment in the week I am coming from work or going to my appointment before work. I have Sunday and Monday off. We'll see how this pans out.

A quick re-cap of where therapy is these days:
We've been working with Charlotte for the past several weeks. I had an admission to The Ridgeview Institute for 5 weeks from March through April to deal with an ED relapse. When I got out we stayed status quo in therapy and then with my stability going well we jumped into dealing with Charlotte. Unfortunately this has caused an ED relapse. My therapist went on a quick vacation a few weeks ago, which normally she informs us way in advance of her leaving, however this time she forgot to mention it until the session before our last before her leaving. Generally we do ok when she vacations and welcome the therapy break, but because Charlotte was so activated this caused a lot of internal stress and distortion. Charlotte made it about abandonment and convinced herself that our therapist was never returning, re-enacting the childhood abandonment. Upon the therapist's return, she announced that she was engaged.

Now many people may interpret this as something that a therapist should not disclose. And I agree. The reasons behind her disclosure was simply to help manage all the thoughts and feelings that we would present when we noticed her engagement ring. As a child, we could not often rely on the information that was being presented to us verbally and we became hyper sensitive to environmental changes. We narrow consistency down to actual pieces of our environment. For example, we interpret the stability of our therapist down to the way she dresses and her consistency in that. If something alters in her appearance a great shift in our brain occurs and we have to categorize it as a simple change or a catastrophic change. Over the years this sensitivity has greatly decreased and managed to a point where it rarely effects us, however...an engagement ring on her finger would not be something we could contain. She knows this and as she is trying to work with Charlotte to build trust and rapport, just showing up with an engagement ring could seriously risk the relationship. Our therapist even had the decency to not wear the ring until after she told us. One day we hope to get to a point where our environment doesn't influence our thoughts and that we can trust a relationship based on feelings, not environmental factors, but hey, it's where we are and something we are working on.

So the subsequent sessions after this disclosure have led to conversations about the transference we have about what it meant previously to have someone become engaged or make a life change that brings up feelings of abandonment. We're on the topic of our foster care experience and it's given us insight to the parallels we have formed in our thinking between our therapist and our foster mother. These insights are new, we have never really talked about that experience in efforts to preserve it's importance and intensity. Over the weekend we sent out several e-mails to our therapist (which she usually doesn't respond to, just kind of uses it for our tangible containment) describing the foster care experience and I believe that is where our session today will take us.

I do hope that she works with Charlotte today, because inside it's a hot mess with her so activated and distorted. Currently, acting out on our eating disorder is making things difficult and for me personally, I hate when we are so involved in ED behaviors. I hate counting calories and always thinking about food but never having any. I hate constantly knowing our weight. I despise the feelings of guilt when we do consume food. It's tiring.