#1 Dissociation
As you are well aware, there are many kinds of dissociation.  However, I have found that, fundamentally, dissociation refers to a disconnection between experience and emotion, or between mind and body. See if any of these dissociative remarks sound familiar:

Here is grieving client observation
— Number One:
“It’s like I’m outside of my body looking in.”
– Number Two:
“I have no idea what I’m feeling”

Dave, age 17, made a third dissociative observation when he stated, “I knew I should have felt something, but I didn’t feel anything.”  Dave was referring to an accidental cut to his hand which happened several days after his best friend, Jeremy, died from a drug overdose.  Dave stated, “It was a deep cut.  The doctor gave me 9 stitches.  At first, I just watched the blood flowing out.  I didn’t feel any fear or pain.  I knew what was going on,  I just didn’t care.  Then my mom saw it and she freaked.  Her scream sort of woke me up, I guess.”   Later on this track, I will describe a technique I suggested Dave use to avoid similar dissociation.

For #2 and #3 ‘D’s of Grief go to Grief Course.

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Since it appeared that Perry was doing everything right physically, we discussed possible emotional conflicts, since he was looking for an answer in this area.  Perry began to come to the conclusion that the reason for his continued decline in T-cells was his addiction to having anonymous sexual encounters and how he felt about them.  Perry stated, “I know it’s not a good thing, but it’s like an addiction.  I want to stop sleeping around, but I can’t.”  Would you agree that Perry’s anonymous sexual encounters may have been a great source of distress?

I stated to Perry, “Identifying anonymous sexual encounters as a possible factor for emotional distress is only half the battle.  Knowing you are addicted is only the first step in healing the underlying reasons for that addiction.  Overcoming addiction can take time and effort.”  Because Perry clearly wanted to begin to acknowledge and accept his feelings, I recommended he attend a Sex and Love Addicts Anonymous meeting.  At Perry’s first meeting, he was more of an observer than a participant.  But gradually Perry began to share his feelings with the group.  Perry also began to share his experiences, distress, and his guilt.

After three months of this process, Perry stated, “My T-cell count has more than doubled!!  It went from 150 to over 300!  Those meetings are the only thing I’ve changed in the last three months!  Can you believe it?”  Subsequent tests showed that Perry’s T-cell count has now climbed to almost 400.  However, Perry’s situation is not unique.  A number of other HIV positive clients have experienced major improvements in T-cell counts through what they, like Perry, feel is solely through emotional growth.

Are you treating a client like Perry? Could he or she benefit from emotional growth?

For #2  Other Techniques for Emotional Healing go to HIV/AIDS Course

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#1 Preoccupation
The first stage of the addictive experience is preoccupation.  Pedophiles become hostages of their own obsession.  Do you agree?  Their obsessions about child pornography or other sexual acts which involve children become intrusive on their daily activities.  Jim, age 34, stated, “I couldn’t get these images out of my head.  They invaded my life.  I would start work, but then, all of a sudden, I would get flashes of my nephew in my mind, doing things I wish I hadn’t thought of.  Personally, I’ve never enacted them out with him, but I will go to websites and try to instant message kids, just so I can flirt with the ideas.”

I stated to Jim, “Because of your obsession, every introduction and meeting passes through your sexually obsessive filter.  Normally, these obsessions begin to interfere with daily life, and other areas are affected.  Does that ever happen with you?”  Jim stated, “Yeah, I couldn’t concentrate on work, all I could think about were these images and how to make them come about.  I can’t sleep, so I spend most of my time on the internet.  Sometimes, when I’m chatting with people I know are adults, I’ll fantasize that they’re really young teens.”

Clients like Jim are addicted to sexual behavior, and, in the case of pedophiles, become addicted and preoccupied with the thought of sexual acts with children.  I stated to Jim, “I’d like you to think of this preoccupation as a warning sign that’s telling you to watch your steps.  When you begin to feel the obsession taking over, be mindful of it and of your behaviors.”  Think of your Jim.  Is he experiencing this sexual preoccupation?  How would you address his preoccupation?

For #2, 3 and 4 Stages of a Pedophilic Addictive Experience go to Internet Course

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#1 Anger Arising from Limitations
The first manifestation of anger is anger arising from limitations.  Clients who experience chronic pain find themselves constantly frustrated by the reduced scope of their abilities.  Because of their loss of independence, clients become angry at themselves for their lack of ability but also those who do not accept or recognize their limitations.  When another person asks a client to perform beyond their capabilities, the client becomes enraged at him or herself for not being able to accomplish it and also the other person for not recognizing and validating the client’s condition.

Carol, age 31, had an enflamed disc in her spine that caused her constant pain.  One day, a new manager at her office asked her to carry a box down to the warehouse.  Unable to carry the box, but also equally unable to explain her weakness to her manager, Carol instead asked one of her friends to do the task for her, but still complained about the ignorance of her new employer.  Carol stated, “He didn’t even ask me if I could carry that box, he just ordered me to!  He’s such an inconsiderate ass!  I bet if he expressed one ounce of concern for his employees, his head might implode.”

Carol’s unwarranted anger was quick in passing, but I still asked her to explain her condition to the manager the next day.  I stated, “I know that you know people cannot read minds.  If you do not explain to the people around you about your back pain, you will only find yourself becoming more and more angry at your situation.”  I asked Carol to make a list of people that should know about her condition to reduce the frequency of her angry outbursts.

Think of your Carol? Is he or she angry about his or her limitations?

For #2 and #3 Manifestations of Anger go to Pain Management Course

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