The Pros and Cons of Support Groups for Trauma Survivors - Part 2

Leonard Holmes, Ph.D.                      http://mentalhealth.about.com

Leonard Holmes - Why did you start TimePassages?

Lisa Varhola - I have always known I was a survivor of abuse (at least by age 13 when I found out from my best friend that not all parents beat their kids) and I thought I was getting through life pretty okay without thinking about it. Looking back now, I can see how I was really just getting through it by the skin of my teeth. I landed myself in one abusive relationship after another from the time I left home and struggled with serious bouts with depression, and ... I was in and out of therapy over these issues for many years. After several oddly diverse employment changes (another long story) and two failed long-term relationships I found myself in a eventually calm, non-abusive (physically speaking) relationship. And this is when the "___" really hit the fan. I wonder if when you aren't so busy just trying to survive each day -- when things in life around you are finally non-threatening -- if this is when you begin to remember all the things you unknowingly have put so much energy into forgetting .........

My life -finally- was at it's best but then the nightmares began. Then numerous unexplainable suicide attempts (seemingly for no reason) -- I hadn't attempted suicide in years (since age 15). Flashbacks of things I would never do or think or feel. I began fleeing from therapist to therapist and each of them came to the same conclusion: a Dissociative Disorder. No way, I thought. I was sure I was schizophrenic. I was seeking (demanding?) therapy for schizophrenia, in fact. I didn't want the diagnosis they gave me! As much as I didn't believe them or want this to be so, the evidence always came back to the same dx and I finally (reluctantly at times) began pursuing treatment for the diagnosis of Dissociative Identity Disorder (DID) (back then, MPD).

I discovered America Online around the same time I was also in the beginning stages of therapy for Dissociative Identity Disorder. Feeling confused and afraid of the diagnosis of MPD, I did a search on AOL (not expecting to find anything) and to my surprise there were dozens of members with the MPD diagnosis, a message board, and a newly formed private online support group.

I began to participate on the message boards and in the private meetings. However, it wasn't long before I found myself craving more "intellectual" discussion on the subject. I'm a very analytical person. I challenge my memories and my feelings - possibly even "to a fault." I felt disappointed that the message areas and the private group seemed more like a "come on in and have a crisis" gathering. So I splintered off from the existing groups and formed new meeting areas that were more topic oriented. The response was overwhelming and word got out to several other support groups about the meetings I hosted and I was asked to join in their rally for AOL to create specific areas for DD/DID/DDnos alongside other mental health/health diagnoses. I spent many months trying to get an area created that met the needs of the Dissociative Disorders Community and when it seemed to be going nowhere (other than costing me a fortune as AOL charged an hourly fee back then) my husband suggested the internet.

So, here I am - me and mine - and TimePassages online (which is now a private website you must apply to). The site is geared towards acceptance of the disorder by those who suffer from it and has educating the world as a secondary goal now.

Leonard Holmes - What have you learned about this type of online support forum since you started?

Lisa Varhola - Honestly? It is highly rewarding and terribly exhausting.

The population of survivors diagnosed with a "dissociative disorder" is staggering. The number of applicants to Timepassages who are diagnosed with "Dissociative Identity Disorder" shocked even me (but then I'm the one who still wishes I could deny my abuse happened, let alone, the fragmentation of my mind). So, it is very rewarding to know I offer survivors of this population a place that is relatively safe to discuss their issues of abuse.

It is exhausting because I'm also a survivor with my own painful and debilitating issues to resolve. Oftentimes, even the members seem to forget this and I have found myself consumed with feeling left high and dry with no where to turn when their issues cross-over onto mine and vice-versa.

So, mostly I suppose I'm still learning as I go. Not being a mental health professional, I have learned a lot about the schematics of living consumed by the pain from an abusive past while I can't help but wonder, at times, if this sort of online endeavor would be best left up to the mental health professionals in the field (pending, of course, the controversy over 'online therapy' in general). However, let's be realistic ... professionals in this field certainly have their plates quite full (between patient crisis and never-ending survival when most days the odds can seem against us [the client], along with the 'in-the-news' FMS controversy, and just plain getting to know the many fragmented-selves of each patient). Who can keep up with it all?

I guess we all will continue to grow and learn as more scientific research becomes available and as increased therapeutic approach treatments are confirmed. I wrote to at least a dozen authoritative leaders in this disorder before I even began TimePassages. Only one responded (the rest of my mail-sends were either returned undeliverable or without response). The most authoritative of them all, Dr. Kluft, was opposed to the endeavor (though he didn't say why). I'm not sure at this point where I stand but to say that "no matter what is best or right in the eyes of others, for this population, survivors will continue to band together in the intended supportive settings online," and I can only hope that my website is one that will promote healing - not hinder it.

Leonard Holmes - What are some of the ways the you have seen it help people?

Lisa Varhola - Leonard, some days I'm so overwhelmed by the whole site I just want to call it quits, but all I have to do is review the 'Survivors Forum Archives' to realize this resource does seem to help and it definitely works (for gaining perspective), if only as an outlet to continue to sort through the pain -between- therapy sessions.

It's amazing how many questions those of us with this diagnosis have regarding precisely the same type of emotion/s surrounding any given situation. There is an understanding among these members that is incredibly validating and I'm convinced this makes the way for continued survivorship.

For example, I may not have had that particular incident [as described in a post] happen to me, but the feelings ... oh yes ... the feelings and the fear and the confusion and the difficulty sorting through it all regarding something from my own life - this I do understand all too well. We [survivors of abuse] seem to have this mutual understanding and empathy among us at all times - even if we don't share the precise experience.

Personally, I feel each of us has our own story of pain and abuse. And no two survivors will have endured the exact same sequence of abusive situations or circumstances behind it all. Yet the end result is the same regardless. The confusion, the anger, and the feelings of betrayal, rejection, abandonment - they all exist no matter what the "story." And it's extremely helpful to know we aren't monsters for feeling these feelings or confusion. It's nice to know there is some place to voice these feelings where others will not tell us how horrible we are for thinking and feeling the way we do about being rejected, abandoned, beat, ridiculed, and terribly abused by the very people the world pretty much dictates we must trust, love, and believe in ... It is ultimately up to the individual to find resolution to their own pain from the past, but "when you can't see the forest for the trees" (the mass of pain inside can prevent us from seeing anything outside of us) it really does help to hear others pointing out their own tree in the scary forest, and then another, and another, until you finally begin to realize you have stepped back from your own overwhelming pain far enough to see the whole forest (the world as it has been/is being abused). It is then - as you know you are not alone in this dreadful, dark forest (of abuse) - that you just know you have to become more determined to get to the other side. You know... if they can do it (continue to survive), so can I!

Leonard Holmes - Have there been any problems? Can you say a bit about them in general terms?

Lisa Varhola - Most of the problems where TimePassages is concerned seem to stem between the expectations of the members in general and myself, as a survivor and the TimePassages administrator ... (but I keep trying to remind myself it happens everywhere and that this is an age-old 'internet vs. face-to-face' dilemma we all encounter in the online world).

As far as forum interaction goes I've not been informed of any real problem among the members. So, I guess I'd have to say I personally cringe most when someone new joining opens with "I don't think I have this disorder, what do you think...?" and they proceed to describe an incident or the symptoms they are experiencing. Fortunately, most members respond appropriately by explaining how they know only for themselves and how they feel the person needs to seek the guidance of a qualified Mental Health Professional.

I strongly emphasize that TimePassages is a peer-support website, not one officiated by mental health professionals. Thus, it is not a site for diagnosing and/or confirming the disorder, but rather a gathering of understanding and supportive people/s also facing the emotional pain this disorder entails who wish to 'help others while they help themselves' to deal with and accept the everyday difficulties from surviving abuse.

The only real episode of upset that occurred among a large number of members was over an incident of one alter-identity "preaching" the healing truth as if it were the *only* true way to recovery. I'm a very spiritual person (at least most of me is) and I enjoy hearing the perspectives of varied religions and what their truth means to those who pursue that particular journey, however, I failed initially to make it clear that we should keep our religious-specific journey's outside the door when visiting VOK. And how do you put something like that gently but firmly? Fortunately, the incident was resolved privately without too many hurt feelings. I think a website such as this really must stress that support is knowledge of alternatives and experience by example; most of all that we never forget that for survivors, being told what to do, when to do it, and how to do it can create ambivalence (as it may trigger some of the abuse that was inflicted upon us as children). There simply isn't just *one absolute* path to recovery. It is as varied as the people in this world. What works for one may not work for another. We each have to find what works best as an individual and just go with it.

Leonard Holmes - How are your discussion forums similar to and different from real world support groups?

Lisa Varhola - I have attended 8 real-life support groups for survivors of abuse over 10 years (3 of which were designated for those with "Dissociative Identities Disorder") and my response is based, in part, on my personal experiences between the two:

First of all, in a DD/DID oriented group, I myself was extremely triggered by the multitude of 'the many within others.' I literally witnessed the switching of group members who were triggered by the discussion(?) and the sudden change of environment had a frightening affect on me (I'll never forget when one girl flew from her seat, over a couch, and banged herself repeatedly against a window in what I now recall only as a "slo-mo" moment and no one in the group ever knew why). Maybe I was disillusioned about what it means to attend a real life "support group" for those who suffer multiplicity. And, while it may work for some, I personally need a more rigid backdrop in which to discuss what I'm dealing with. One not so open to the actual moment and reactions of others. I don't think such surprises are so easily comprehended in the moment and can even become an issue that is stored away as 'traumatic' for an even longer time. So I prefer online support to any other .... here's why:

When online, you can exit from an online support group at any time where you might be feeling triggered or upset with the material presented.

In real-life groups there are usually contracts/agreements where you commit that you will not exit the group in session (ie: must stay through the duration) without any regard to your ability to process what comes up internally for yourself while others' issues in the group are being discussed. In private therapy it is one-on-one and issues can be faced accordingly, but in groups the facilitator must choose the most prominent issue to sort through for the betterment of whomever and all relate.

These agreements are intended for your own well-being as a therapist can't very well leap from a session in progress to check on the one leaving. However, it also goes against a survivors own innate ability to "go away," "leave," or tend to one's selves if forced to stay in a place where suddenly feeling unsafe.

Computer/Online Support groups are generally available around the clock (somewhere/sometime from anywhere in the world). These groups supplement support between therapy sessions and have even been known to encourage a survivor (through others who have been there/done that) to bring up an issue in therapy they otherwise might continue to avoid discussing and/or dealing with.

Most online survivors' groups are without a fee (unless you pay online connect fees). But be warned they are without condition of healing or explicitly helping you as well. For me, this makes online support a very good supplement to weekly therapy and even as the only option for those survivors who have limited insurance/financial resources. Personally, I would much rather seek another survivor online when I'm in a bad place than to call my therapist in the middle of the night (which I feel is a major risk for more abandonment/rejection issues plus - most therapists are now without option but to charge for phone calls outside of therapy). I strongly encourage survivors to only attend groups where a supportive nature/atmosphere is the key ... free-for-all discussions may be more detrimental than validating.

At some groups (at least at TimePassages, in particular) there are numerous discussion areas designed for very specific issues in recovery for survivors of "Dissociative Identities Disorder." This allows members to avoid the areas they are not yet ready to deal with (or to disregard those that simply aren't an issue at all) while focusing on the specific issue they are dealing with in recovery. I feel this helps us not to get too side-tracked from processing the 'issues at hand' on the individual journey. Of course, the drawback to offering this many designated areas is that since no two survivors are on the same path to healing, what is an issue, say, for me, today may not be for you so you may not find someone else today dealing with anything close to your particular situation at the same time. But, at least at TimePassages, someone almost always will be there to sympathize even if they can't relate directly.

Online computer groups may always have one major drawback overall: Most of these support areas are not moderated by mental health professionals; and even if they were there is still a major lacking in the ability to know just how one person might be reacting to the moment/material as is more obvious in face-to-face therapy.

In Closing, Lisa had the following to say:

I have no doubt in my mind this disorder was under-diagnosed for years. My God, I shiver to think what might have been done to "cure me" (given my symptoms) in the 20's up to now. As for it being 'over-diagnosed' in the 90's - well, only time will tell ... but we all need to become involved in the 'education of' and the 'solution for' this very real "ill of society" simply because the number of cases reported each year for child abuse is devastating.

I simply want to help out if I can and all I can. While TimePassages is -not- about administering online therapy, it is about acceptance of the diagnosis and about finding ways to overcome the debilitating effects it has on our every day life (as a survivor and for those who love us and live with us). And since this world is so busied with so many problems, and because child abuse is so prevalent, if someone doesn't step up to help I wonder if we all may sink with the ship.

I'm working on the best "TimePassages" yet (scheduled for Jan '98) for those who 'suffer today from the abuse of yesterday' ... I want to continue to grow in a way that not only educates and arms the survivor to live a better today, but to also help the world understand what tomorrow will bring if the world continues to ignore the effects of abuse on our children.

Through thick and thin, those who have endured the pain of childhood abuse and lived to tell about it ARE survivors! TimePassages will continue to be there if you need us.

(Unforuntely, TimePassages has not been available for some time now, and I haven't heard from Lisa.)

Here are the features which cover these issues:

• The Debate over Recovered Memories: A $5.8 million award sparks renewed interest in the discussion of recovered memories and false memories.
• Guest Column from the Memory Wars: A patient who attended a controversial treatment program speaks out.
• Pros and Cons of Support Groups for Trauma Survivors. Part 1: Real life and Online groups both have advantages and disadvantages.
• Pros and Cons of Support Groups for Trauma Survivors. Part 2: An interview with Lisa Varhola about her experiences with online support groups.
• The U.S. Government files Charges Against Therapists: Should all Therapists worry about this?
• New Research on Recovered Memories: A new Dutch study documents that memory for abuse can be lost and then recovered.
• Corroboration of Child Abuse Memories: Elizabeth Bowman, M.D. reviews the literature on recovered memories which have been corroborated.
• Reliability and Suggestibility of Child Abuse Memories - Part I
  A look at the literature on hypnosis and memory and the implications for recovered memories.
• Reliability and Suggestibility of Child Abuse Memories - Part 2
  Further information on these issues

What do you think?
Mental Health Resources Bookstore
Mental Health Search

Leonard Holmes, Ph.D.                      http://mentalhealth.about.com

Previous Features