Tips for Starting Therapy

The decision to start therapy can be intimidating.  For most individuals, there are some preconceived ideas about what therapy will entail and what therapists are like.  And, lets be honest, the media rarely paints an accurate picture of the therapy process.
GETTING STARTED
There are a couple of points to consider in getting started in the therapy process.  First, engaging fully in the therapy process is important.  This is also hard to do.  Change is hard.  Awareness is hard.  Rigorous honesty is hard.  And these are all pivotal parts of engaging fully in therapy. Sometimes things can feel like they're getting worse before they get better.  As a client, you are not just paying to be listened to and validated.  Your therapist is not a paid friend.  While being listened to is an important part of the therapy process, listening alone will not affect the change most clients are seeking.  Therapists have masters and doctorate degrees, they receive specialized training and certification.  Therapists have spent years studying human behavior, the process of change, relationship dynamics, conflict resolution, attachment and trauma wounds, addiction and communication.  It will be important for you to find a therapist who you  can have a connection with, who stays current with their training and expertise and who you can trust to walk you through the difficult and sometimes painful pathways of healing and self exploration.  Therapy is an art.  It's a lot more than just telling people what to do or what not to do.  The therapists who are good at what they do have spent time mastering the art of helping clients own their journey.  Therapists are trained to meet you where you are and work to facilitate insight and create an environment for growth and healing.
Therapy can be expensive, ranging anywhere from $80-$200 for a 50 minute session.  It's an investment and you should get a return on your investment.  However, this will take time.  Remember there are other things that we value that are expensive that we don't question spending money on, such as an attorney, a dentist or medication.  Therapy is one of the greatest gifts you can give yourself.  It's an investment in you.
DOING THE WORK
There are words and phrases in therapy that you will become familiar with.  These include sit with that, do the work, set and maintain healthy boundaries, projection, trauma bonds, enmeshment, living within limits, seek consultation, lean in, notice that and the list goes on.  Whether we are talking mind, body or spirit, healing is not pleasant and it rarely feels good.  This is important to remember as you embark on this journey.
When my younger brother was 18 years old, he and a couple of friends were playing with fire one night.  It was the week between Christmas and New Years and was a continuation of something that had started earlier that Summer, as they tried to rid the basketball pole of a wasp nest.  He was at a friends house, whose parents were not home at the time.  They were video taping the lighting of various objects on fire and watching, mesmerized as these items would burn.   As can happen with teens who believe they are invincible, they kept upping the ante and added gasoline to the mix in order to maximize the effect.  Unbeknownst to my brother, as he was dousing something with alcohol prior to lighting it on fire, the gasoline was also dripping onto his clothing.  My mom received a phone call  a few minutes later from my brother asking her to pick him up and take him to the Emergency Room.
My husband and I arrived at the hospital about an hour later and spent the next week making daily trips to the burn unit to visit with my brother.  The first night seemed the worst.  He was in so much pain, it was something you could feel as you entered the room.  Slowly over the next few days, we saw gradual progress: he would sit up, talk, open his eyes, make a joke.  We thought these were all good signs of healing.  The doctors however, informed the family not to put any stock in these improvements.  That the focus at this time was to get him strong enough for skin graft surgery.  That once he was stable enough for surgery, the surgery would put any progress we were witnessing back to square one.  The night after the surgery, we went to visit him at the hospital.  He really wasn't strong enough for a visit and didn't do much talking at all.  He was in too much pain to even open his eyes, let alone communicate.  This began a slow healing process that wasn't complete for about two years and had a lot of painful moments along the way.  It has been 20 years since that injury occurred.  My brother is married, has kids of his own and a thriving law practice.  You can still see the scars on his legs from the burns and the grafts.  My kids and his like to hear him tell the story.  It definitely shaped who he is today, knowing such pain, healing and growth.  As painful as the surgery was and as long as the healing process was, not having the surgery was not an option. A third-degree burn is referred to as a full thickness burn.  This type of burn destroys the outer layer of skin and the entire layer beneath. Large third-degree burns heal slowly and poorly without medical attention.  Because the epidermis and hair follicles are destroyed, the new skin heals slowly and if not treated properly can impair function and leave the skin without plasticity and movement.
It can be tempting during the therapy process to look for a bypass...an alternate route. This can happen for motorists to avoid other heavy traffic points or to drive around an obstruction. When commuting, a bypass is convenient and is looked upon favorably.  However, in therapy looking for a bypass is avoiding the possibility for self-transformation.  It's avoiding the difficult work that awaits us.  Yes, often times there is painful stuff to sort through in therapy.  We have to explore and examine difficult parts of ourselves and of our lives.  We have to be open to the existence of patterns that aren't pretty, decisions that should not have been made and choices we didn't understand.  We can find any number of ways to bypass and get creative about avoiding.  We can use sex, relationships, drama, work, technology, shopping, traveling and Netflix as ways to bypass the work that we need to do.  We can exhaust ourselves thinking that maybe if I am successful at work or make a certain amount of money or always look fashionable in my dress or find that special someone, or an exciting trip it will make up for the feeling that I am inadequate or don't know who I am or wonder if I truly am enough.  Spirituality is another way we can bypass; hoping to be able to pray it away, read scriptures for insight rather than walking through our own pain, going to temple as a way of bypassing what awaits us.  It can also be tempting to become extremely obedient and religiously regimented as a way of bypassing self-examination and binding God into our will because of our extreme obedience. While we may have many spiritual and moving moments as we engage in treatment, these moments do not exempt us from doing the hard work of examining, transforming and evolving.  The ACA (Adult Children of Alcoholics) workbook states regarding spiritual bypass: "the person is attempting to avoid the pain that can come with working through the trauma and neglect from childhood.  In some cases, the person attempts to jump ahead in the recovery  process without going through the entire process.  This path invariably fails or leads to dissatisfying results.  If one does succeed in having a spiritual experience, but avoids program work, the person can still remain mired in addictiveness or problematic relationships.  The spiritual experience may bring some form of enlightenment; however, the person can cling to old ways of living without embracing recovery.  A spiritual experience without grounded program work can produce an unhealthy ego.  With an inflated ego, the person can use the spiritual experience as a shield against working a full program" (page. 178-179).
Therapy is hard.  It can feel overwhelming to begin the process and there may be points along the way where we question why we started in the first place.  Therapy is also the beginning of investing in yourself as a person and in the life you are living. Beautiful things happen in therapy.  Transformation happens in therapy.  Healing and growth happen in therapy.  If you've considered starting this journey for yourself, find a qualified therapist that you can connect with and trust and make that investment.  

Life After Ashley Madison

When the infidelity site Ashley Madison was hacked, the details of 37 million user accounts were published on the Internet. Personal information like email addresses, account details and credit card information was released. Impact Team, the group that hacked the site and released the information, gave two motivations for doing so: First, they were critical of Ashley Madison's core mission of facilitating affairs and second, the hackers attacked the business practices of Ashley Madison.
What the hackers also released was panic, devastation, heartbreak and grief. The effects of this scandal are far reaching and certainly impact more than the 37 million paying members of this site.

If you or a loved one has been impacted by this breach, life has become unmanageable. The data is out and the fantasy of secrecy the site promised its users has crumbled. The Internet has once again shown that it cannot be trusted with our secrets. The following points are stepping stones for navigating the fall out and recovering hope:

• WAKE UP:  A crisis like this is a wake-up call about sexual patterns and can be an opportunity for further reflection and growth. Many individuals who are on the site can't fully explain why they did what they did. 
• BEWARE OF SHAME:  Shame is a constant awareness of our flaws, defects and imperfections. Shame is not the same as guilt. Shame is different in that it makes a person feel bad about who they are whereas guilt makes an individual feel bad about what they did. Adults shamed in childhood fear intimacy and tend to avoid real commitment in relationships. Commitment is a recovery principle and is important to the repair needed to move forward. Being able to challenge your shameful messages while also allowing yourself to feel appropriate guilt will help build self-awareness and compassion for the hurt you have caused. Adults shamed in childhood also tend to blame other people before they can accept any blame themselves. Accepting responsibility, owning up to the damage you've done and the hurt you've created allows you to be part of the solution. If you do not accept blame, it will only get worse    for  you as your life goes on and the intricate patterns of avoiding responsibility build. 
• START TALKING:   Now that the secret is out, it's time to get to work. For repairs to be made, the straying partner must work to show empathy and remorse. This is going to take time. It will be necessary to acknowledge the hurt and pain you caused as often as needed. Finding out a partner is on Ashley Madison may be the first time a spouse realizes the partner may not be happy and the relationship has problems. It is a good idea to seek professional help to walk through the difficult conversations and tackle the work that lies ahead. 
• CONNECT WITH REALITY:  The reality is you cheated. Whether you met the person you were contacting and actually had sex or viewed profiles, sent texts or emails and exchanged photos, the fact is this behavior is viewed as cheating. While you may feel the problems in your relationship or the stress in your life made you stray, the reality is there are others out there with similar problems who don't do what you did. 
• SEEK TREATMENT:  According to Rob Weiss, author and expert on digitally driven intimacy disorders, "when your sexual behavior is more in control of your time, decisions, fantasy and impulses than you are, treatment is advisable. Likewise, if loved ones knew the full extent of your secret sexual life and would be shocked or concerned, or if you live in fear of being "discovered", treatment is advisable. You may also want to consider treatment if you can't stop having the amount or type of sex that you know could harm your relationships, career, family life and reputation."  Many individuals struggling with infidelity or compulsive sexual behaviors experienced childhood trauma, neglect, abuse or loss and use sexual acting out as a way to cope with the painful emotions. 

If you have been impacted by this breach, you can take an anonymous, self-assessment for an objective view of the situation. For issues of sexual addiction, seeking a professional who is trained and certified as a sexual addiction therapist is important for both you and your spouse.


Jackie Pack, LCSW, CSAT-S

I Wasn't Ready to Say Goodbye

A little over a month ago my mom passed away unexpectedly. It was December 30, 2014. She was planning to have a sleepover with her grandkids that night. It was just a regular day and I had no idea the twist that was about to happen. I called my mom from work at 2:00 to tell her that my kids would be a little late for the sleepover. Just 15 minutes late. We talked on the phone for 5-10 minutes about nothing in particular. I had no idea that by 3:00pm she would be found unconscious in her home by my younger brother.  He called 911 but she never regained consciousness and was pronounced dead at 3:54pm.
My mom and I had a complicated relationship. We didn't always see eye to eye. We had our ups and downs but over the past two years we were making peace with each other and learning to see past our differences. I don't have regrets about the path our relationship took. It was what it was.
As I left the hospital and was driving home the words of the song from Les Miserables came to my mind: "to love another person is to see the face of God".  I believe that it is easy to love somebody when they are lovely. But to have love for somebody who has let you down, hurt you, disappointed you and fallen short of who you wanted them to be...who you needed them to be...well I think that is Godly. It is Godly because it is so much bigger than me, than her, than what was and what wasn't. And I can accept that. My mom didn't have an easy life.  She did the best she could, but was hurt by many things...mostly my dad and the loss of what she hoped to have. And as the saying goes "hurt people, hurt people."
Thomas Merton in his book No Man is an Island says "The beginning of love is the will to let those we love be perfectly themselves, the resolution not to twist them to fit our own image.  If in loving them we do not love what they are, but only their potential likeness to ourselves, then we do not love them: we only love the reflection of ourselves we find in them."
It has been a long and difficult month since her passing. I have found that sadness is a familiar companion. There's a game I find myself playing. I pretend that I can replay special days of my life. Certain characteristics show through as I flip through my favorite memories of my mom....the image of her walking towards me with a chair to join me on the sideline of my girls soccer game. Her recounting endless details of a story that aren't all that important. Her curiosity and love of learning. Watching her write in her journal or talking about books we both had read. It is so easy for me to play back some of my fondest memories. When I play this game, it reminds me that no matter how good those memories were, certain moments are gone forever. When I was a girl, I watched my mom and adopted the bits and pieces of her that fit me.  The talks and struggles we have had through this journey of our lives together have a great deal to do with the values I cherish as an adult and the person I have become. I truly believe that nothing in this life is wasted. Leaving the hospital that night, I felt like I could let go of so much and walk away with the memories I choose to keep of her.
Love is complicated, and yet our job is to love others without stopping to question whether or not they are worthy of that love. It's not our judgment to make. What we are asked to do is to love. To soften ourselves, our hurts and disappointments and to love. It is a life saving pursuit.
I love you mom!

Living with Intent vs. Self Will Run Riot

In the book, Alcoholics Anonymous, Bill W. described the core trait of alcoholics as self-centeredness—something he referred to as “self-will run riot.”  He further described the alcoholic as “an actor who wants to run the whole show; is forever trying to arrange the lights, the ballet, the scenery and the rest of the players in his own way.”  The reality that the vast majority of all people are self-centered can be a helpful realization in recovery.  This reality does not justify the self-centeredness of addicts or taking this self-centeredness to an extreme, as is the case with the self will run riot. However, it does help to explain why so often individuals find themselves in collision with others.  Whether it’s an extreme case of letting the self go unchecked as happens in addiction or a less extreme case such as getting impatient with the person in front of us at the checkout, driving aggressively in traffic, avoiding personal responsibility, watching too much television or becoming obsessive about our work or our workouts, self-centeredness creates chaos in our lives.  It’s a way of trying to live life on our own terms, rather than living life on life’s terms.

Living life on our terms gets in the way of developing a sense of self that is helpful because we are continually trying to control.  The Serenity Prayer speaks wisdom to addicts and to non-addicts alike.  The prayer begins with learning to accept external circumstances that we cannot change.  (God grant me the serenity to accept the things I cannot change.)We can spend a lot of unnecessary time and energy in attempting to change things we cannot control.  Once we recognize what it is that we cannot control, the next part of the prayer moves us on to another quality that we need to develop and that is courage. (Courage to change the things I can.) It is during this part of recovery that we begin to witness the integrity of an individual.  Now that the usual patterns of coping have been removed, something is required to surface when going through difficult circumstances or when faced with challenging times.  Integrity hasn’t had to stand up because acting out soothed the pain, or numbed the discomfort.  With those destructive pathways removed, the self is required to show up, to stand up and to make a decision about how to live life in this new way of being.  Individuals will continue to move forward in recovery when their discomfort with their present circumstances outweighs their discomfort with growth.  This requires us to be intentional in our actions.  Living with intent is the essence of the Serenity Prayer (and the wisdom to know the difference.)

History gives us several good examples, where individuals put in uncomfortable circumstances acted with intent and had a huge impact in their world and in our world:

When Nelson Mandela was thrown in jail in 1962, he had almost everything taken from him: his home, his reputation, his pride and, of course, his freedom. He chose to use those 27 years in jail to focus on what was really essential and to eliminate everything else, including his own  resentment.

In Man’s Search for Meaning, Victor Frankl concluded that everything can be taken from us except “the last of human freedom’s—to choose one’s own attitude in any given set of circumstances, to choose one’s own way.”  Frankl noted that the prisoners most likely to survive were those who had a vivid sense of purpose in life.  Even in the humiliation of the camps, something that was certainly beyond the prisoner’s control, they still found choices they did have. 

Rosa Parks’ quiet, but resolute refusal to give up her seat on a segregated bus in Montgomery, Alabama coalesced into forces that propelled the Civil Rights Movement and changed the course of history.  As Parks’ recalls: “when the bus driver saw me still sitting, he asked if I was going to stand up and I said ‘No’, I am not.” Contrary to popular belief, her courageous “No” did not grow out of a particularly assertive personality. Instead, her decision on the bus grew out of a deep conviction about what deliberate decision she wanted to make in that moment.  When the bus driver ordered her out of her seat she said: “I felt a determination cover my body like a quilt on a Winter night.”  She did not know how her decision would spark a movement that would reverberate around the world, but she did know her own mind.  She knew, even as she was being arrested that it would be the very last time she would ever ride in humiliation of this kind.  The discomfort of the present circumstances became more uncomfortable than the arrest and incarceration that followed. 

It may be unlikely that we will find ourselves in circumstances like Nelson Mandela, Victor Frankl or Rosa Parks, yet we can use their stories as inspiration for our own moments of courage.  We can think of the strength of conviction Rosa Parks exhibited, her courage to say no and to stand her ground.  We can recognize that if Victor Frankl could make choices in the desolation of a concentration camp, then we can start making choices in our daily lives as well.  And as Nelson Mandela taught us, when we focus on what is really essential in our lives, we often may find things we are clinging to like our resentment, that also need to be eliminated. 

Living with intent is hard.  It takes courage and wisdom.  It takes forethought and discipline.  It requires us to ask difficult questions and to examine our lives.  Living with intent helps guide us to a greater sense of purpose and help to chart our life’s path.  We may not be able to run the whole show, but by living with intent, we make deliberate choices about what we contribute to the whole production. 

Breathing

About a month ago, I was invited to fly to Nashville for a professionals weekend.  The invitation came at a time in my life that was filled with busyness and chaos. In March, I had disclosed to my two business partners that being in the partnership wasn't working for me and that I had made the very difficult decision to leave the partnership. This declaration was not met with enthusiasm or acceptance. It was the beginning of a series of free-fall moments for me. In this series of free-falls, there were many things that began to fall into alignment... And many things fell out of alignment. My busyness was kicked up several notches. My "to do" list became bottomless. My workaholism started creeping out of manageability. My time with and for my family dried up and just being present when one of my daughters or spouse was talking to me became very difficult. Gratefully, I had my quarterly weekend the beginning of March with one of my personal recovery groups that helped with perspective. I was also fortunate that in the beginning of this free-fall, I was introduced to a very wise woman, who is now my sponsor that I can text, email or call for consultation. I also had very wise counsel from friends, colleagues, family and associates who were willing to step forward and offer their truth and perspective.
This takes me back to receiving the invitation to attend the professionals weekend in Nashville. At this point, I had learned to say "yes" when opportunities landed at my doorstep. So, despite feeling the pressure of giving the time to my "to do" list, or the guilt of leaving my family for another weekend...I just said yes. I am so grateful that my family is supportive of me and whatever process I am in and they willingly sacrificed their time with me so that I could go.
The night before I left, daughter #2 was asking me what exactly I would be doing this weekend. I told her that I had no idea. I actually hadn't even had time to think about it since I had accepted the invitation. Sitting in the Denver airport on a layover, I remembered that I had gotten an email a few days prior from the people hosting the professionals weekend that I hadn't had the time to read. So I pulled up the email. Attached, I found a "what to bring list".  This would have been helpful prior to sitting in the Denver airport, where I realized I had not packed appropriately!  While this was a "professionals weekend", dressing as a professional would not be appropriate.
I began to feel uncomfortable when I had this realization. But that was ok, because that was just the beginning of feeling varying levels of discomfort the entire weekend!  It was also the beginning of surrendering to a process that was bigger than me and therefore transformative.
The second day into my professionals weekend, we participated in a Native American sweat lodge. I had never participated in a sweat lodge before and didn't know that much about it; other than it being a spiritual ritual and cleansing the body of toxins. Fortunately, my host took me to a nearby Walmart to get some appropriate clothing for this experience.
We were scheduled to be in the sweat lodge for 6 hours. Of course, there was discomfort about not knowing what to expect. And I recalled a news story from several years back about participants who died in a sweat lodge. But I was reassured that they did this on a regular basis. That our Native American leader had been doing these his whole life and that we would be perfectly safe...and we were.
Daniel, our leader, told us as we sat in a close knit circle inside the lodge, about the symbolism of a sweat lodge. The symbolism of re-birth. The lodge itself represents the female, the womb. The hot rocks that have been baking in a fire for many hours prior to our starting the process, was symbolic of the male.  And the rocks entering the lodge symbolic of conception and new life. He told us what the focus would be for each of the four rounds and then we got started. The rocks were placed, the herbs sprinkled, the water poured and the door closed so that it was pitch black, very hot and very humid. My tendency was to take shallow breaths. It didn't seem to me that breathing in such hot and humid breaths would be good for the lungs. It was difficult to breathe and taking short, shallow breaths was not sufficient for what my body needed. So despite my reasoning and best judgment, I pushed beyond the short, shallow breaths and took a long, deep breath. Allowing my lungs to fill to capacity. Because the air was so hot and so humid, I could literally feel the breathe as it came in through my nose and traveled through my body. I could feel the breath all the way to my core. And it felt good!
Sometime in round three, as I was laying on the cooler, damp, dirt floor of the lodge, with my eyes closed...just concentrating on my breathing, a thought occurred to me. When I entered this world, I claimed my life by breathing. While I don't remember that experience I imagine it wasn't easy. I would think there was struggle involved. That in a moment I had a choice...I could claim my life by taking a breath...or I could let my life slip past me and not claim it and never breathe. And the deeper the breath, the better.
At 44 years old, I have learned that life is a series of free-falls. It throws things at us that we did not see coming. Life can weigh us down, it can completely freak us out.  It can be difficult and we will struggle. During these times, our breathing may shift to short, shallow breaths. It may become difficult for us to breathe. Or we can disconnect and not even be mindful or aware that we are breathing, and what that feels like...what statement that makes. And yet, even in those circumstances, the same truth applies:  we claim or reclaim our life by breathing...and the deeper the better!

The Journey by Mary Oliver

This poem has been inspiring to me for many years.  I have had several "one day when I finally knew what I had to do:, which lead to a journey in which I didn't know the end when I began.  Step by step, I figured it out as I lived my truth.  It takes an incredible unfolding of resolve and strength, that sometimes surprises me because I didn't realize I even had it.  I am also surprised at the reactions of others in response to living one's truth.  I have never had regret when I respond to the call and allow myself to move forward in my journey.

One day you finally knew

what you had to do, and began,

though the voices around you

kept shouting

their bad advice--

though the whole house

began to tremble

and you felt the old tug

at your ankles.

"Mend my life!" 

each voice cried.

But you didn't stop.

You knew what you had to do,

though the wind pried

with its stiff fingers

at the very foundations,

though their melancholy

was terrible.

It was already late

enough, and a wild night,

and the road full of fallen

branches and stones.

But little by little,

as you left their voices behind,

the stars began to burn

through the sheets of clouds,

and there was a new voice

which you slowly

recognized as your own,

that kept you company

as you strode deeper and deeper

into the world,

determined to do

the only thing you could do--

determined to save

the only life you could save.

What Time Is It?

Have you ever thought about what advice you would give to your younger self?  If you could write and send a letter back to a younger version of yourself what would you say?  What wisdom have you gained at your current age, that your younger self might benefit from?  Dear 14 year old me: .....
When I was fourteen, my mom had some serious health issues related to her Chron's Disease that landed her in the hospital for several months.  From what I recall, she went into the hospital just prior to school getting out for the Summer.  After a serious surgery, some complications from being in the hospital and bad reactions to medications, the next school year had recently started when she was released from the hospital. As I have previously mentioned, my father wasn't around very often, so this left the 6 of us as kids, mostly on our own.  (We did have some help from neighbors and extended family).  My older sister, had a job that required her to work several afternoons during the week.  To me, it felt like I was mostly in charge at home.  I have some good memories during this time.  As brothers and sisters, we sometimes still share funny memories that are from this time period....songs we made up around the dinner table, jokes we told and ways we found to work together.  I don't know that it was all appropriate, given that a 14 year old and 16 year old were running the show, but we managed and we all made it through.
As I got older, and became an adult, a professional, a parent, an expert...I would find that in certain situations my current age didn't match the age I was feeling inside.  Often, when I would ask myself "how old do I feel?" the answer was often "14!", even though chronologically I was much older.  The effect this had on me was that often I wouldn't speak up, even if I was confident about what I would say.  Sometimes when I would speak up, I would find fault or doubt everything I had just said. I would become shy or withdrawn in certain social situations.  I wouldn't ask questions, and this fear would surface that somehow I would be found to be a fraud, even though I wasn't doing anything fraudulent.  For me, I was still able to function...after all at 14 years old, I had done a satisfactory job at running things in the "adult" world and playing an "adult" role even though I wasn't an adult.   But this feeling of "faking it" or being something I wasn't still lingered.  I began to realize that while I did a functional job at 14, I really didn't know what I didn't know....and I had a sense of that at that time. With the help of a good therapist, who was trained in EMDR, I was able to tend to those younger wounds, from my current age.
One of the pitfalls we can fall into when we are operating outside of our current age is the Drama Triangle. The "drama triangle" was developed by a well respected psychiatrist, and teacher of Transactional Analysis, named Stephen Karpman.  He defines three possible positions one can take when in the drama triangle:   the victim, the persecutor and the rescuer.  This resource has become an important tool I use both professionally and personally.  The drama triangle is also known as a "shame generator" because through it we unconsciously re-enact painful life scripts that create shame.  These scripts re-create feelings of anger, fear, guilt, entitlement, resentment or inadequacy and leave us feeling betrayed or exploited by others and keep us stuck in an altered version of reality.

                                                       Original Source © 1968 by the Transactional Analysis Bulletin.


In my experience, every dysfunctional interaction in our relationships...whether it's with others or the self, takes place in the drama triangle.  Until we become conscious of these dynamics, we cannot transform them into something that allows us to reclaim emotional, mental and spiritual well-being.
Everybody has a primary role or the role they are the most familiar with in the triangle.  It's usually the one they enter the drama triangle through.  We first learn our entry position role in our family of origin.  However, once we are in the triangle, we automatically rotate through all the positions, sometimes in a matter of minutes or even seconds.   For example, if a parent doesn't ask their child to take age-appropriate responsibility for themselves, they may grow up to become adults who feel inadequate at taking care of themselves (victim) or become resentful adults who blame others when they don't get taken care of in the way they think they should (persecutor).
VICTIM
When we refuse to take responsibility for ourselves, we are unconsciously choosing to react as Victim. Victim is often associated with  0-9 years of age, when we had the least amount of power in our lives and were the most dependent upon others for our needs.  The victim role is the wounded shadow of our inner child.  It's the part of us that is innocent, vulnerable and needy.  Of course, it's natural to need support throughout life.  However, it's when we are convinced that we need somebody to take care of us, believing that we are powerless or defective that it moves us into the victim position.
PERSECUTOR
Entitlement justifies the behavior of Persecutor..."it's ok to act this way because of what happened to me". There are many ways persecutors act out, however, persecutor behaviors are most often associated with adolescent rage.  It is easy to think that Persecutors are "bad" people.  They are not.  They are operating from a shame base.  They are wounded individuals who see the world as dangerous, which requires them to be ready to strike back and live in a defensive position.
RESCUER
The Rescuer has been described as a shadow of the mother principle, the God principle and is the classic co-dependent.  Instead of an appropriate expression of support and nurturing, the Rescuer tends to be overly responsible, to smother, control or manipulate--for other's own good, of course!  It's a misguided understanding of what it is to encourage, empower and protect.  Rescuing comes from a need to feel valued. Often, Rescuers have been falsely empowered during childhood.  Sometimes the rescuer will rescue themselves or others by denying reality.

HOW DO I GET OUT OF THE DRAMA TRIANGLE?

Living in the drama triangle creates misery and dysfunction.  Like the childhood game of musical chairs, all players sooner or later rotate positions.  Whenever we fail to take responsibility for ourselves, we end up in the triangle.  Taking responsibility is a key factor in moving us out of the drama triangle. A meaningful life requires a mindful willingness to get out of the triangle and to extend grace to those still trapped in it. Operating from our current age means we are willing to let go of the outcomes and accept life on life's terms. We learn that it is important for us to nurture ourselves, because at ( insert current age) 43 years of age, that is who is responsible for nurturing me.  We also learn that as adults, we have choices.  We have options.  As an adult, I cannot be abandoned, nor can I abandon other adults.  One of the practices I have learned, and still use is to ask myself What time is it?  If the answer is anything other than the current year or current age, I need to tend to what has come up.  The next question is Where am I?  If that answer does not match up to where I currently am....Here,  then again, a sign that I need to tend to some emotional things going on.  The third question is: What matters?  The answer I would like to hear back is this moment.  However, if the answer is something other than that, that is an indication that I need to do some exploring with myself, and possibly others who have earned the right to give input, in order to operate with all the wisdom and resources I have as a 43 year old woman.  

They say timing is everything.  In our relationships, the time we are acting or reacting from may mean the difference between healthy communication or the beginning of musical chairs.