I think there is a lot of danger in tearing down defenses and opening wounds - especially when it's done intensely in therapy for an hour or two a week and then the client is left to deal with the fall out for the rest of the time. I had one therapist who told me to keep it all in a mental box on a shelf without ever explaining how one does that. For me, I was able to maintain (although not terribly well) a facade of being just fine during the week - while my mind was roiling constantly, obsessing over my thoughts and feelings, wondering if I was going insane...and the only "safe" space was the therapist's office - which then developed into an obsession about the therapist himself. Does he care? Is this transference? What the F**K is going on here? (This is a composite description, there were numerous therapists - some adequate, some dismal).

And I bought into the whole "it's going to get worse before it gets better" - only it got worse for YEARS.

A couple of things were helpful for me - and I had to go find my own "program" - mostly because there isn't a one stop shop for any of this. First, I had a therapist who, while not actively helpful with "treatment" was able to sit and listen. He did tell me several times, he wondered why he was there - and, at the time, I just needed a place to go and someone to listen without judging or trying to fix me. We tried to do trauma work together, but he was not trained in it (and was very much aware of that) and I ended up retraumatized after every exposure.

So I did a full DBT program - very much by the book - it helped me learn to ground and self-regulate without actually delving into any trauma. Basically, I learned skills I wasn't taught as a child and also had relief from constantly picking at the trauma wounds, since we were specifically told not to deal with it.

Then I found a therapist who did Somatic Experiencing and learned how to dip in and out of the trauma memories - a totally different type of exposure therapy. Presumably, this helps in changing neural pathways...for me, it was life changing.

Throughout it all, I kept the therapist who just sat there - because he was safe. I struggle a lot with whether or not I was wasting my money on what was essentially a paid warm body (I likened it to seeing a prostitute) - but ended up deciding that since I could afford it, it seemed to keep me more stable so it was worth it.

All of this took years of trial and error - looking for what worked and what didn't work for me. A lot of it was terribly frustrating - misdiagnoses, bad therapists, therapists with good intentions but lack of understanding, hospitalizations, and on and on. I think the most frustrating part was the assumption (on my part, but clearly encouraged by the industry) that there is one cure (talking therapy, exposure therapy, group therapy) and if it doesn't work, the client must be at fault.

I do get the mistrust and disdain for the industry as a whole - but I had life-threatening issues that needed to be resolved...and, for some reason, I was able to keep pushing and searching until I cobbled together my own treatment plan.

I see a lot of myself in what you've written, Esme. I can't tell you to stay or leave this therapist. What I would highly recommend, however, is that you find a way to ground yourself. The one thing that has come out in the research about trauma is that the first step is stability. And it's not a one time thing - if you've got the grounding tools and you start trauma work, then find yourself unmoored, you stop and go back to stabilizing.

You might be interested in the work that Porges has done regarding windows of tolerance. The goal in this model of trauma therapy (Van der Kolk, Levine, etc.) is to expand the window of tolerance without leaping outside of it.