“Thank you for your vulnerability, Dr. Marich.”
Since coming out unapologetically as a woman in recovery from a dissociative disorder in 2018, I’ve received so many messages and social media replies that begin with this greeting. Being “out” has many meanings and layers for me—I’ve never hidden the fact that I’m in recovery from alcoholism and drug addiction, even though my advisers in the mental health field cautioned me about the perils of broadcasting it. In 2015 I made the decision to come out in every area of my life—to my professional following and to my conservative family—as bisexual, even though I never kept it a secret from my friends. Inspired by a Robert Ackerman teaching, I realized that I could not be a healthy woman in long-term recovery unless honesty prevailed about everything. And this led me to coming out with the dissociative disorder. Dissociative disorders are still highly stigmatized and largely misunderstood in the mental health professions, let alone by the general public. So many clinicians are afraid of us destabilizing and if the public even recognizes what a dissociative disorder is, old school portrayals of multiple personality disorders as seen in the movies generally serve as the association. In reality we are just people with many parts that form to protect the core self or to meet a need, generally in response to trauma. Sometimes the parts play well with each other, other times they don’t. With each vulnerable step I’ve taken further out of the shame closet, especially as a public figure in my field, I’ve learned an important lesson about vulnerability—people are simultaneously in awe of it and terrified of its power.
In this piece, which I write on my eighteenth recovery anniversary, I share what being out in my position has taught me, and continues to teach me about vulnerability. Before deepening this exploration, let’s get on the same page about what vulnerability means. Even though Brené Brown has made the word vulnerability popular in her stellar work over the last decade, people do not seem aware of its true meaning. Vulnerability is not just something you can simply define by one of Brené’s often-memed quotes. Vulnerability is more than just taking a risk or putting yourself out there into the metaphorical arena. At its core, being vulnerable is about engaging in trauma work, aware that this healing work can and usually does cause more pain in the process. If you’ve ever taken a course with me or have read one of my books, you know that I am a language nerd, and that my working definition of trauma is any unhealed wound—physical, emotional, sexual, or spiritual. This simplified definition derives from the word origin of the English word trauma—it comes from the Greek word meaning wound. Well guess what? Vulnerability comes from the Latin vulnarare, meaning to wound; another form, vulnerabilis, means injurious or wounding.
While the pop psychology understanding of vulnerability implies that one might get hurt if they want to take risks to grow, I will go a step farther and contend that hurt of all kind is inevitable. Here’s the lesson I’ve learned in my processes of coming out: Vulnerability is facing our wounding head-on and then deciding what we’re going to do in response to its impact. Are we going to ignore the wounds and thus open ourselves up to being hurt even more, or will we take the chance of feeling the pain we’ve stuffed down all the way through in order to experience freedom on the other side? I will spare you the details of my entire trauma narrative, yet I'll paint enough of a picture to qualify. By age four it was clear to me that I was too sensitive to survive the life I’d been dealt. By age nine I was already thinking of ways to destroy myself because I didn’t feel safe either at home or at school, and by 19 I was in full-blown addiction, the ultimate response of a developing brain that was bonded to dissociation in order to survive. I was born suseptible; life made me increasingly more vulnerable. Hurt was my baseline, and even though I got sober at 23, it wasn’t until 25 that the chronic suicidal ideation largely dissipated. Had I kept all of this bottled in, assuming I would have survived past my thirties, I’d still be hurting, albeit in a much more pervasive way and I’d not be writing this today as a sober woman. Sharing the pain with others is imperative, and I first learned how to do this privately with an amazingly trauma-focused sponsor in a 12-step program, then through high quality trauma therapy. I agree with Brené’s fundamental teaching that shame cannot survive when it is shared in safe spaces.
So why choose to be so public? Isn’t that the opposite of a safe space? In many ways, yes. Even though speaking freely about one’s recovery can be encouraged in certain circles, there is still a faction of the mental health field that is extremely uncomfortable with the practice. A painful lesson I’ve learned is that some people, including other professionals, can be downright hateful with their comments, or dismiss me as someone who can’t be trusted because I am either too unstable or I make it all about me. Some of these comments have been shared directly with me, in public forums or at conferences. Others have suggested that what I have to share from my lived experience isn’t as valuable as what the literature can back up with numbers and protocols. And others get downright silent and squeamish when I talk about surviving a clinically significant dissociative disorder and all that accompanies it (e.g., suicidal ideation, self-injury, addiction). A great deal that has been said behind my back has also been relayed to me—particularly that I have no boundaries for sharing so much of my story, or that it’s dangerous that I’ve let myself be the client in EMDR demonstration videos, letting colleagues work on me.
I expected all of these criticisms when I wrote my coming out article in 2018. I have three very easy answers for these critics that I’ve realized in the two years of ardent advocacy work that’s followed: (a) academic work in dissociation is important, and so is lived experience—we lose our soul as clinical professionals when we minimize that, (b) I don’t share anything publicly that I haven’t first addressed privately; may I suggest you look at what bothers you the most about my disclosures and ask if this is revealing something unhealed in you, (c) why haven’t you let someone do a public demonstration on you? While I respect everyone’s right to privately work on what they need to, if you are a clinical trainer or public figure, showing your vulnerability, i.e., your wounds will always help to diffuse the horrific us vs. them divide that promotes mental health stigma in society. Add these all to the pile of lessons.
I am public for all of the people, especially other professionals, thanking me for being so open in my position of privilege about things that our field has kept shrouded in mystery and shame. Especially dissociation. This is a particularly powerful lesson I’ve learned about vulnerability—when you put yourself out there and take a further beating for it—people who are prepared to hear it will be challenged into healing action. I’ve bore witness to many professional “comings out” as someone with a dissociative disorder, often for the first time. There is so much fear that they will be misunderstood (at best) or terminated (at worst) in their settings or larger clinical communities if they speak freely. Many people with dissociative disorders keep their condition hidden from their partners and their families, scared of the ramifications. For many of us it’s just easier to label what we have as something else—like PTSD or a bipolar disorder.
Yet in reality, dissociative minds have a masterful capacity to solve complex puzzles—we are often the most brilliant thinkers and leaders in any of our chosen professions. We are the ones who, if unafraid, jump in there and get things done, watching the professional committees in our fields wax on philosophically and theoretically about what should be done. Our dissociative minds are made of heart and soul, and when that can be appreciated and worked with instead of denigrated, the world can and will be changed for the better. When I know that my public sharing can validate even one other person with a dissociative disorder or other condition that is accompanied by a great deal of dissociation, being vulnerable in the way I’ve chosen to be feels more than worth it. I live for the day when public vulnerability is accepted as the norm and not seen as something out of the ordinary; I work to make that future a reality. And while recognizing this mission as my life's work is one of the most important lessons of my coming out, it's not the most important.
Dissociation was the hardest "coming out" because of the stigma that surrounds it. My ex-husband threatened to use it against me. When he tried and failed, I was no longer afraid to speak up about the way my mind works. Going through that divorce and surviving these attempts to discredit me was severely wounding. Vulnerable feels like an insufficient word to describe the experience. While sharing the fruits of my healing so publicly seems to have helped others, being vulnerable in this way has been imperative to my own continued healing. Every time I share something publicly, I feel like I am baring my naked soul in a similar way that one might bare their naked body in public. Yet today I can look at that nakedness and appreciate the woman who is bearing it. And I hope that for as many years as I have left in this body, I will continue to “come out” and honor vulnerability in a way that challenges others while also strengthening my capacity to heal through the radical practice of being honest.
So here I am today…eighteen years sober, “adult years,” if you will. I am still sifting through the layers and healing them as they are revealed and peeled back. I remain a hopeless train wreck in the romantic relationship department. Every time I try to date, I’m reminded of what my late friend Denise S. used to tell me—our relational parts of our lives can be the last to heal because they were the first to get wounded. I stay in my own counseling to address these injuries, knowing that I’m headed in the direction of greater health. I am navigating the waters of our current social climate, and I take my role as an anti-racist professional committed to doing my part to end the sting of systemic racism. I also know that the greatest service I can provide is to continue to do my own trauma work and help others to do the same. That’s how I changed for the better as a human and as a citizen, yet I cannot rest on this progress. I’m currently taking a good, hard look at how I’ve benefited from the American system existing as it is. And I know that getting uncomfortable and yes, vulnerable, is required on my part to make a real difference. This may involve me losing more family members, more friends, and more colleagues. Being vulnerable has taught me and continues to teach me that when I put myself out there honestly, things will always work out as they are intended. And I will feel inevitably feel healthier and more restored to sanity in the process.
Photography and Body Art by Michael John Gargano
Defects of Character or Emotional Parts: Using Structural Dissociation to Reframe Step Six by Michael Gargano, LMHC, CASAC-2
“We were entirely ready to have God remove all these defects of character.”
--Alcoholics Anonymous, Step 6
Treatment centers and 12-step communities need to begin normalizing dissociation within the addicted person’s experience. Trauma and dissociation are often left out of the discussion in addiction treatment and recovery worlds. Survivors of abuse, neglect, abandonment, and other traumatic experiences note with consistency and frequency the value of compartmentalization plays in daily life functioning and avoidance of traumatic memories. As an addiction and trauma specialist, I’ve heard countless clients describe how and why it became necessary to stuff events, emotions, sensations, thoughts, actions, and images deep into the catacombs of the psyche. The self that seeks recovery may sometimes feel like a fraud, fake, or not real, as a result. And this can make the phrase defects of character in Step 6 difficult for addicted survivors of trauma to navigate. Looking at Step 6 through the lens of structural dissociation, may offer the field, recovery communities, and people we serve new insight into both trauma-informing and dissociation-informing the steps. What we commonly call defects of character within 12-Step Literature can be more accurately viewed as dissociative parts of self that impede spiritual progress, acceptance, connectedness, healthy relationships, and recovery
A cursory overview of the Theory of Structural Dissociation is needed to help us understand its theoretical and clinical framework. The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization, a ground-breaking book on trauma and dissociation, written by Onno van der Hart, Ellert R.S. Nijenhus, & Kathy Steele, proposes human beings are not born with an integrated personality. Our early formative life experiences shape our personality, thoughts, feelings, and behaviors. In healthy development our caretakers help us to meaningfully integrate and adapt to our environment. Attachment wounds stemming caretakers who could not meet our essential needs, sooth us, and provide us with restorative experiences sets the stage for fragmentation of the self. The discussion presented in this blog will prepare us to draw connections to how structural dissociation relates to 12 Step work and a trauma-informed approach to embracing our dissociative parts. We challenge the notion of character defects as it is traditionally understood in recovery circles as the term defects of character does not align with a trauma-informed approach. This contention is made with full recognition that the steps can and do work for millions, including me. And it’s also time to have this discussion.
The conception of dissociative parts of the personality is not new. The theory of structural dissociation of the personality is a cogent, comprehensive, and concise description of dissociative parts. The theory holds every person has what is commonly referred to as an Apparently Normal Self/Part (ANP). The ANP is the survivor self or the core persona that is seen by others in public, holds a job, raises a family, forms attachments, and does everything that we often ascribe to the executive functioning in our brains. In response to a traumatic event the ANP fragments with the formation of an Emotional Part (EP). The EPs form to protect the ANP from the wounding that has occurred.
The self as EP displays evolutionary defense mechanisms, emotional reactions, and action systems to protect the core self. Action systems guide us to notice and be drawn to stimuli. They restrict our field of consciousness to relevant stimuli and promote certain action tendencies while inhibiting others. For example, when a fire alarm suddenly goes off, the self as EP may signal “Danger, Danger, Danger!” and the action system related to panic may activate. The action system related to rational thought and decision making may be disinhibited. These mechanisms include responses based on flight, fight, freeze, and submission. If a dissociated part is fixated in a particular action system or subsystem, they may be unable to cope or perceive with their situations because their perceptions are colored by the goals, and a restricted field of consciousness will be restricted to stimuli relevant to that subsystem.
I believe Dr. Bob and Bill W.’s vision of step work helps us to heal our structural dissociation. Step Six invites recovery seekers to dig deeply and invite our EPs into their healing journey. Up to this point in our recovery experience we have accepted the nature of our addiction, we took steps to find a new path, embraced a belief that a power greater than ourselves could restore us to sanity, made a searching and fearless inventory, faced our dissociation, and now we are tasked with integration. Bill W.’s commentary on Step Six hones in on the addicted person’s compulsive tendency for self-destruction and annihilation. We work against our instinct for self-preservation. The commentary goes on to describe structural dissociation like language in discussion of how our drives far exceed their usefulness. The founders of Alcoholics Anonymous understood parts of self. Bill W. writes in 12 Steps and 12 Traditions commentary on Step Six: “When our instincts drive us blindly or willfully demand that they supply us with more satisfaction or pleasure than are possible or due us.” He is talking about an EP. Bill recognized EPs operating within recovery seekers more than 80 years ago.
The goal of Step Six is not to eradicate our EPs. Total integration of all dissociative parts of self will not happen overnight. Some parts of self will mature or extinguish. Others will take a lifetime to heal. Parts work, trauma work, and working the steps are circular pursuits. We may need to go through the Steps several times to gain a new way of relating in the world. The wisdom of this Step is we are cautioned to “be content with patient improvement.” It is important to seek proper therapy with someone skilled in dissociation and parts work who can help you understand the emotional parts of your personality. In our parts work some of our parts may not want to work on the spiritual aspects of the program. Some might attempt to destroy the whole system. We did not will these EPs to exist. Our minds fractured in a beautiful way to keep us safe, secure, and protected. However, the actions, thoughts, and impulses of our EPs caused us insurmountable problems as we sought to change old patterns.
Change is difficult. Sometimes we get into a routine and become complacent with our EPs. Take procrastination, for example. By not completing a task on time, one does not have to risk failure. This EP could be protecting us also from people hurting us by seeing our vulnerability. Turning in assignments late or showing up on time for appointments means our EPs remain in control of who gets to see our vulnerable side. Procrastination, like other destructive tendencies, could be an EP part designed to hide reality from us.
Our EPs have secondary gains which make it difficult to heal them. Skillful work in this area will explore the systems and rules at play. We will not be perfect in this work nor do we need to be. In Step Six we work to renegotiate the boundaries with our EPs and the alliances between them. Our work here is to meet our needs in more adaptive ways so our lives as ANP is fuller, richer, and more meaningful.
In my recovery experience I relied heavily on EMDR therapy, sponsorship, and the 12-step recovery meetings and literature to heal my fragmented self. I believed I could be restored to sanity. I trusted my Higher Power would allow me to get where I needed to go in the often hard and emotional trauma work, I set for to complete. I had a mindfulness and yoga practice that helped me settle inward to listen to my emotional parts. I had faith in my therapist who guided me through parts work and trauma reprocessing. I was able to see for the first time how my EPs impinged on my ability to live unchained. My EPs were my minds grasps of relating to a world which no longer existed. We must face facets of our personality which do not paint us in a good light. The Shadow side of the personality we must not fear. Step 6 and parts work are reparative processes. What I have learned is I do not have to live in survival mode any longer. Because of this work I can meet needs without reliance on old compulsive behaviors. I can risk authenticity and vulnerability without fear of rejection.
Sexual addiction and recovery can be controversial constructs. Unlike addictions to chemicals or substances, sex and sexuality are intrinsic facets of healthy human life and development. The goal of recovery from sexual addiction for most people is not to give up sex or the expression of one’s sexuality in its entirety. Rather, the purpose of recovery is to live a fulfilled life embracing a healthier model of sexual expression. Recovery is about setting boundaries and freeing one’s self of the suffering caused by acting out.
Like eating disorders, shopping addiction, and gambling, sex addiction is a process addiction. Process addictions are generally described as behaviors that are habitual and provide the person with an emotional high. The problematic behavior is often repeated to gain an increased high. A negative feedback loop forms wherein the individual cannot stop the behavior despite negative consequences. The origins of these addictions are rooted in trauma. Most people do not wake up one day and say, “Hey I think I’d like to become a sex addict.” Wounds leave their mark. The pain endured over time often becomes unbearable and prompts a form of escapism we see as addiction.
Shame often keeps people from seeking the help so desperately needed to develop healthier lifestyles in their journey for sexual recovery. Sex Addicts Anonymous (SAA) Green Book reminds recovery seekers:
Sexual addiction is not just a bad habit. Nor is it the result of poor self-control, a lack of morals, or a series of mistakes. If it were something we could stop on our own, the negative consequences would be enough to make us stop. Many of us tried to cure ourselves with religious or spiritual practice, moral discipline, or self-improvement. Despite our sincerity and our best efforts, we continued to act out. Our behavior eluded all rational attempts at explanation or correction. We had to face the fact that we had a disease, and that we could not stop the addictive behavior by ourselves (p. 9).
My name is Michael and I am a recovering sex addict, anorexic, and alcoholic. What follows comes from my lived experience as a person in recovery and as a clinician trained in trauma, addiction, and mental health. I work the twelve steps and traditions of Alcoholics Anonymous (AA) and Sex Addicts Anonymous (SAA). I will forever be indebted Eye Movement Desensitization and Reprocessing Therapy (EMDR) and to 12-step recovery programs for the gift of living free from the bondage of addictions.
The spiritual principles, tools, and suggestions contained within 12-step recovery helped me to find a life that was worth living. I learned that I deserved to be recovered, loved, and that I have worth. Recovery and trauma work helped me to thrive and accept who I am, was, and can be. In an earlier piece I wrote about the Step 1: “We admitted we were powerless over alcohol and sex, and that our lives became unmanageable.” The process to admit that I was powerless and that my life had become unmanageable took what felt like a lifetime to achieve. I bought the SAA Green Book and read through the entire text cover to cover in search for the answer of how to remain in sexual recovery.
The first task of this sexual recovery journey started 90 days of abstinence from all sexual behaviors. Let me tell you that it the most difficult thing I ever had to do in my life. I experienced withdrawal symptoms which included body shakes, anxiety, depression, angst, despair, craving, hypersensitivity, suicidal thoughts, and intense dreams. That list does not do justice to my lived experience during that time. It was a miserable experience, and yet a necessary one for recovery in my eyes.
When I joined SAA, I continued to hear a concept called “3 Circles.” It was all everyone talked about in meetings and in literature. In the Fellowship these three circles are how each member defines what is addictive and healthy sexual behavior for themselves. The program is quick to recognize the personal nature of addiction to sex. Not every human being acts out in the same way. For some their addiction is pornography. And for others it may be masturbation, destructive relationships, power and control, romantic obsession, cruising the streets for sexual partners, cybersex, prostitution, cross-dressing, having affairs, and fantasy. The list is endless.
Understanding what is addictive and is healthy requires distance and reflection. That 90-day embargo on sex and thinking or acting on sexual thoughts/desires were critical. The help of incredible trauma-informed sponsorship and therapy also played a major role in my recovery. I recall early in recovery listening to others share first step presentations about their powerlessness and unmanageability. I got into recovery in a Pre-COVID19 world with no local SAA meetings. My only options were telephone meetings all over the country.
Living with an addiction in isolation often drove me to act out. The beauty of phone and video meetings with others was that I could stay connected. I leaned early on in my process that recovery thrives in connectedness. I made several phone meetings part of my routine schedule. I volunteered on calls to read literature. During meetings I spoke up about my struggles and desires for a life built on a firm bedrock of recovery. It did not matter the time of day or hour of night. I made meetings a priority in my life. I stayed for fellowship hour at the end of each call. I exchanged numbers with other recovering sex addicts, and made phone calls during the week to talk about life, recovery, successes, and struggles.
I already received the gift of desperation. I needed something to give me hope in my life. As I called into these meetings, I heard men and women who shared their experience of what it was like, consequences of their acting out, and steps to stay in recovery. I sat and reflected on my own life after each presentation. I saw patterns of what behaviors I could not control. My first SAA sponsor, Adam, was a man who attended these phone meetings. We exchanged contact information and started to work the steps. I owe him a debt of gratitude for helping me to define what sexual recovery would look like for me. We have never met face to face. We conduct step work via email and phone calls. Sponsorship and meetings are my lifelines for connectedness. These are some of the tools in my recovery toolkit:
The Three Circles (diagrammed below) consist of three concentric circles. Each level represents a layer of addiction and recovery. Inner Circle behaviors are ones that cannot be safely practiced and/or controlled (seeking out emotionally unavailable people, pornography, drug use, alcohol use, disordered eating, etc.). Middle circle behaviors are actions, desires or behaviors that may lead to a slip or are risky (using sex to avoid emotions, lying, hiding, justification, etc.). Outer circle behaviors promote recovery (healthy sex based on choice, mutuality, and respect; meetings, sponsor, therapy, family time, staying connected, hobbies, step work, spiritual community time, dating, writing, dancing, creating music, etc.).
The process was a spiritual awakening. For the first time I could see my addiction; it had a name. It was real. It had a list of behaviors and symptoms. Defining healthy sexuality shifted my understanding. The best advice I received from my sponsor was live in the outer circle. What a jewel that insight was. The way I interacted with people and my surroundings changed. I noticed a shift in mind, body, and spirit. I felt alive again.
As a professional and a person in recovery it was important to define my boundaries especially around addiction. I carried intense shame for my addictions. I often felt that I lived a double life. My recovery work centered around integration of all the parts and pieces of myself. I never could be who I was. All the parts of me were cut off. Sexuality was one piece. Intellectual me was another. Emotional side was another. Creativity was lost in the abyss. I felt if I came out about my addictions or my parts of self, I would be shunned from the profession. My recovery integrated into every domain of my life. I turned a new leaf thanks to the program, recovery support systems, and others who have opened the door that I may walked through.
I am who I am. I will not change this inner-knowing for any person or institution. The process of recovery has instilled within me radical acceptance for who I am. I am not alone. Acceptance, I discovered, was key to healing. Once I made a thorough first step and opened the flood gates of the past, I quickly realized the need for trauma work. I could not stay in recovery from sex addiction without resolving the past that impeded on my present life. Spiritual awakening lead me to start EMDR.
I went to see Tom Buckles, LMHC, a former professor and licensed mental health clinician, who offered EMDR treatment. I quickly learned about my dissociative mind and how my parts of self directly influenced my acting out behaviors. Each of my eleven parts represented a wounded piece of my life. These parts were cut off facets of my life. I recall asking each of the parts to work together to help me heal. I believe because of this dissociative trauma work I was able to heal. At each session we completed between 4-5 trauma memories. I continued to see gains in EMDR. I started running, and I never thought I would be the running type. I restarted playing instruments, painting. My relationships with others took on a deeper meaning. I was free! I could remain present.
I have learned that my circles may change over time. In order to move something out of my inner or middle circle it requires an honest and willing conversation with my sponsor, recovery community and close friends whom I trust. My spirituality also plays a key role in helping to keep me on the road. Throughout this journey I have relied on faith to guide me. I turned over everything to the Higher Power of my understanding. I went back to the Roman Catholic Church, made confession, took spiritual direction, restarted mindfulness and yogic Practices, practiced spiritual principles in all my affairs. I remained open to what the universe, other people both inside and outside the fellowship, and my higher power were teaching me. I was an eager student.
The 3 Circles tool evolves with the person. Recovery is not stagnant. As I grew in healthiness and worked on the traumatic events that feed my addictions, sexuality took on a richer meaning for me. Today I am open to the potential in any situation. SAA and EMDR gave me the gift to live in the moment. Both 12-step programming and EMDR allowed me to face what seemed previously impossible. Today I can live a life that I never dreamed was possible. I realize today that sexuality is creativity and a vital life force. I channel that energy for good.
Today, I am a trained EMDR therapist. I get to help others in their quest to heal.
Recovery made this possible.
Painting by Michael Gargano
To read more about Michael and his work click HERE
Institute for creative mindfulness
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