Is therapy like you thought it would be?

Oh this is SO hard. It took me almost 3 years to begin to trust Tweedledum. I never "trusted" Disaster 2...but I was "comfortable" with her. I'm also comfortable with T C but there's no trust there...yet. I'm hoping it takes me less than 3 years.

Disaster 2 DOES need serious help. She goes to therapy off and on (her T is in the same practice as my T ) and has been diagnosed twice with bipolar but she refuses that diagnosis. She will only "agree" to an MDD dx. She really needs to be in therapy regularly and/or spend some time on an inpatient ward. The investigator that's assigned to the case has told me that she's quite sure the disaster is in love with me. She has told me to take precautions. (She and T C both know that the disaster stalks me.) Also, she IS under supervision. She's not licensed yet! The state opened a case on her supervisor too. It's a stressful mess.

Thanks for your great words and insights!

It is hard, we are all here with similar situations and in different levels of our therapy process. We know how hard this is to trust and let those walls down enough to let someone help us. That's why we need to support each other in this process but the end result is totally your decision. You know more about the situation than anyone. I'm confident you will make the right choices
The "disaster" sounds like a very troubled person, that's sad but no reason for you to take it lightly. If you find she's stalking you make police reports and NEVER EVER meet her somewhere alone. Just hope she gets the help she needs and moves on to someone who can return the love she needs.
When's your next appointment?

Troubled is a nice way of putting it lol. It's really not funny but I have to laugh to keep from spiraling from it all. The investigator has made a police report but we were told from the Justice Center that I cannot be granted an OoP unless she's made threats to my life on more than one occasion or has physically harmed me. So basically they can't intervene until it's too late. I don't fear for my life at this point but she is very unstable. (She doesn't take her meds like she should.) She just comes by my house and sits under my window and texts/emails. She doesn't come to my door because I have a camera. I never go outside when she comes by. She has approached me at public events and tries to intimidate me but I've been able to walk away and get lost in the crowd. Thankfully her T appointment day is Thursday (when she bothers to go) and my days are on Tuesday & Friday. But T C has told me to be cautious on my days and if I feel unsafe to let him know & he will come outside to get me and walk me back afterward. I've been going for 5 months and haven't had a problem yet. So keeping my fingers crossed on that one.

I had an appointment with T C this morning. He's promised my Fridays are booked indefinitely. I think I can breathe a sigh of relief. He even offered me a 3rd day, which I turned down for now, but told him that might change during problem weeks and I would let him know. So this weekend I am going to work on a timeline that pinpoints that problem weeks and give it to him on Tuesday and we'll go from there.

How are you doing with just the group? Have you tried the exercises on that website?

Sounds like things are working out better for you and your T. That's great.
Still trying to make the adjustment from PE therapy to group CPT. Two very different modalities and there really wasn't any decompress time between them.

Is your group T understanding of that? Making that big change?

I think she is. She's not bothering me about participating right now. I expect she will want more eventually though.

OMG yes she will. (I got kicked out of IOP because I wouldn't participate!) I'm very happy that she's letting you get used to the format first though. Does she offer any one on one? I know some group Ts will offer it like once or twice a month.

I don't know about the one on one. Don't know if I would be comfortable doing that with her just yet. I have thought about giving her what I have written about some of the main traumas, or what I thought were the main traumas. Doing the PE therapy has uncovered more, or maybe shown that there's more trauma associated with the one trauma. Kind of hard to explain. It's frustrating to know that so much trauma has occurred and that I had it stowed away for so long and that this one event caused all of that to roll out of the closet. I am a hoarder so maybe I do the same thing with trauma. Except trauma is not something I would pick up to save, or even pick up. I guess in my life I didn't identify events as being traumatic, just seemed to be normal life for me. Imagine my surprise to find out there were so many and now I can't get them back in the closet to leave me alone. It's like trying to get toothpaste back in the tube, messy.

This breaks my heart for you. I think you explained very well and your frustration is very well placed. I don't understand why your PE therapy had to end when there is so much going on.

"I guess in my life I didn't identify events as being traumatic, just seemed to be normal life for me." - This. I could have written this myself. I completely get it.

I think it's a great idea to give her what you have written. Since you aren't comfortable just yet with possibly talking to her one on one, reading what you have written will help her understand you better and she'll know better how to help. I'm not sure how that group works, but I know you said it wasn't focused on trauma, do you talk at all? Or is it more like DBT and you just learn coping skills?

Well PE therapy is focused on one index trauma. But going through that trauma lead to the the other traumas. I feel like I have three index traumas, and many more below that on the list.

CPT seems to be the same way so far. The initial impact assignment wanted to know a little about the index trauma but no details. It wanted who was at fault, how it has impacted me, etc. Just skirting around the details. Unfortunately there doesn't seem to be any people here that have gone through the CPT therapy to advise if it will be more detail later or not. I don't even know if the facilitator would want to know about past traumas and/or details. I would feel pretty foolish putting that on her and then her say she didn't need to know all that.

So I guess it does focus on trauma a little, but maybe more about developing skills to identify why you feel the emotions that you do and are they justified. I do talk some, when no one else does. I'm content in being quiet and listening and trying to figure out how this applies to me. Often I drift off to some other place and then come back to group in a rather confused state, wondering what I missed. I don't know I've checked out mentally until I come back. I've tried grounding exercises to try to stop doing this but it hasn't worked very well. I guess the strength of the mind wanting to leave the situation is stronger than attempt to ground. Not sure that makes sense.

I tried DBT earlier and wasn't in a place for that to benefit me. Seemed triggering and there were a lot of women in there that were very emotional which triggered me. So I had to leave. The CPT is all guys except for me. I hope that doesn't keep them from talking. Doesn't seem to right now. But they may be thinking that I'm not talking because of them.

I think all the groups are beneficial but that you need to be in the right space in your therapy for them to be fully understood.

Found this site for CPT -https://www.ptsd.va.gov/public/treatment/therapy-med/cognitive_processing_therapy.asp

Cognitive Processing Therapy for PTSD

Practice guidelines have identified that trauma-focused psychotherapies have the most evidence for treating PTSD. Cognitive Processing Therapy (CPT) is one type of trauma-focused psychotherapy.
CPT teaches you how to evaluate and change the upsetting thoughts you have had since your trauma. By changing your thoughts, you can change how you feel.
How Does It Work?

Trauma can change the way you think about yourself and the world. You may believe you are to blame for what happened or that the world is a dangerous place. These kinds of thoughts keep you stuck in your PTSD and cause you to miss out on things you used to enjoy.
CPT teaches you a new way to handle these upsetting thoughts. In CPT, you will learn skills that can help you decide whether there are more helpful ways to think about your trauma. You will learn how to examine whether the facts support your thought or do not support your thought. And ultimately, you can decide whether or not it makes sense to take a new perspective.
What Can I Expect?

Your provider will start off by giving you an overview of the treatment. Together, you will review some information about PTSD to help you better understand your symptoms. Your provider will ask about the type of trauma you experienced, but you will not need to go into great detail right away. Your provider will also ask you to do some writing about how your trauma has affected you.
Over the next several sessions, you will talk about any negative or unhelpful thoughts you have been having about the trauma, and you will work together to consider other ways of thinking about the situation. You will use worksheets in session and at home that help you learn this strategy. CPT can also include writing about the details of your trauma, if you and your provider decide this is right for you.
This may sound difficult at first, but writing about the trauma may help you cope with emotions like anger, sadness and guilt. Towards the end of therapy, you and your provider will focus on some specific areas of your life that may have been affected by the trauma, including your sense of safety, trust, control, self-esteem, and intimacy.
How Long Does Treatment Last?

CPT usually involves 12 weekly sessions (so treatment lasts about 3 months), but this can vary. Sessions are 60 to 90 minutes each. You may start to feel better after a few sessions. And the benefits of CPT often last long after your final session with your provider.
What Are the Risks?

It may be difficult to talk or write about trauma-related memories or beliefs, especially at first. These feelings are usually brief and people tend to feel better as they keep doing CPT. Most people who complete CPT find that the benefits outweigh any initial discomfort.
Group or Individual?

CPT can be done individually, where you meet one-to-one with a provider. CPT can also be done in a group with one or two providers and about 6-10 other people who also have PTSD. However, there is more research evidence supporting individual CPT than group CPT.
Will I Talk in Detail about My Trauma?

You will not need to talk about the specific details of your trauma, but you will be asked to talk about your beliefs and feelings related to the trauma. You can choose to do a type of CPT that involves writing about the details of the trauma, but this is optional.
If you and your provider decide that writing about the trauma is right for you, this writing assignment will be done at home after your third session. You will read this written trauma account out loud in your next session. If you are in group CPT, you will read through your written trauma account with a provider -- but not in front of the whole group. There is also another type of CPT that does not ask you to write about the details of your trauma.
Will I Have Homework?

You will do some writing and complete worksheets between sessions. Take-home worksheets help you practice in real life the skills you learn during your therapy visits. Most people find that the more effort and energy they put into these assignments, the more they get out of CPT.
Does VA Have an App for That?

Yes, CPT Coach is a mobile app that you can use while you are doing CPT with a provider. CPT Coach can help you to learn more about CPT and PTSD symptoms, and the app helps you stay organized with worksheets as you complete treatment. CPT Coach is free and can be downloaded on most mobile devi

Right...so I'm wondering why you can't continue PE to work on the rest of the traumas? It doesn't seem responsible of the system to stop that work. 😕

I can't imagine a T saying that she didn't want/need more info! If you're shy about it, do you think you could ask her what she thinks about reading what you've written? Even if it can't be addressed in group, maybe just having someone see/hear you and your feelings will be a big help? Sorry if I'm reaching here, I've never been in this situation, and you deserve the best care. 🤗

It makes total sense!!! And I do this all the time. T C taught me the 5 Things grounding technique and it's a terrific tool...have you tried that? It's honestly the only grounding tool that works for me at this moment.

This is another reason why I got kicked out of IOP...I got triggered by all the overly emotional women in the group, and I got up and left the room quite frequently. The men didn't "bother" me at all...just the women crying and sobbing so loudly. I'm sure the men in your group understand that it's hard to talk right away, they were all new once too. ☺️👍🏻

SO far the men haven't cried, I hope it stays that way.

This is interesting. T C is a Psy.D. and he's always taking CE courses and reading all the studies on treatments/techniques. He told me last week that they are finding that CBT/CPT is actually not helpful when processing trauma. I'm going to show this to him and see what he thinks. (Just so I know...I don't want you thinking that I am pushing T C's opinion on you!)

So again I ask...why was your one on one stopped? I'm very sorry if my questions are triggering and/or hurt you, I'm just trying to wrap my head around it. 😕

No, I would love to hear his take on it. Your questions are not triggering at all
I think the one on one was stopped because sessions are limited in that program. Kind of like the CPT group, it's 12 sessions no mater what comes up.

I didn't get to ask him about this yesterday but it's on my list for Friday.

I just don't fully understand therapy limits. Who has the right to say "you get 12 sessions and then you're on your own."? It's ridiculous. Don't these people know anything about the healing process? I mean seriously...what do they lose by allowing unlimited time? Ugh.

I think that's just the for this group. Otherwise she couldn't start another group and there are so many veterans that need help. I'm okay with the 12 sessions at least I know it will end at some point and a goal to work for. After that who knows where I will go if anywhere. I think a client should have a permanent T who they could talk to between groups, someone they could go to for questions and guidance. For me I think talking to a T about all the traumas and getting them out there would be the best way to start, then go to groups to get the tools. Seems like it's backwards at the VA, give you tools but you don't know what, or how to fix the problem, or what the problem is.

Don't ask your T about my situation. You are paying him to help you and you need to focus on that. I will be okay and it will all work out some way. I do appreciate your concern though , I really do.

We have a lot of time to work on me. Literally years. It's ok to spend some time asking about the CPT! And it IS good for me to know too! Disaster 2 forced her CBT "skills" on me and made me think I was absolutely crazy for having the thoughts I do. This is how the CBT conversation came up between me & C in the first place. She really screwed me up, so I'm needing a deprogramming from her version of therapy and learn "proper" therapy and techniques.

I know there are so many veterans out there that need help. It hurts me to see them falling through the cracks due to terrible healthcare. My grandfather, three uncles and my aunt have all served. My father-in-law is also a veteran. IMO veterans deserve the best of everything available. You are the reason we have freedom. I give to the Wounded Warriors project every month to help pay medical costs. (Hmmm...I wonder if they provide mental health coverage?) You absolutely, 100% deserve a permanent T. You deserve unlimited sessions. I'm wondering if the VA won't help, can you get lost cost private insurance to pick up extra expenses? Medicare, Medicaid? Are you on disability? I am on permanent disability and even though I have private insurance, I still have Medicare. It picks up the costs that my insurance doesn't cover 100%. Or what about going through your county's free services? Like here we have SA centers that treat people for free, and the health department also offers free/low cost treatment.

Not on disability yet, still waiting on the process. I own my house so no medicaid. I agree veterans deserve better, but it's always been that way. The government sees veterans as disposable people, it's truly a shame.

I had to get a lawyer before my disability came through. I tried 3x on my own but he got it through in less than 2 weeks. Then I got paid over $30k in back pay from the times I was denied. Totally worth his small fee!

About the CPT/CBT...C said the studies that have been done in the last few years show that cognitive work with people who have CPTSD can be harmful if they haven't fully processed all their trauma. To tell people they need to reframe their thinking, and that their thoughts are "wrong" can cause another trauma. The way he explained it and the writings he showed me made total sense. He said for Disaster 2 to have pushed CBT on me like she did is enough in itself to warrant her being evaluated by her supervisor. I don't know how long you've been in therapy, but I'm 4 years in and have never talked about my trauma to any extent. I've never been through my whole story even once. He said that there is no way someone in my position can possibly go through CBT and "grasp it" because I don't know the full extent of all the trauma. I'm not relaying this as well as he explained it, but I hope it makes some sense coming from me!

I agree, the trauma's should be explored and find some common threads and move forward with that. Just seems like a backwards process to me. It makes me feel stupid and lose hope in getting better when I can't understand what is expected of me and how it applies to me.

Why do you feel stupid?? It's the VA that should feel terrible! Please don't lose hope! Have you thought about going through a health department for a free T? Do you have to go through VA? I can't find the answer to this now, but can your PE T request extra sessions? I don't want you to get discouraged, I'm rooting for you!

It will be okay, just have to go through the process. Maybe it will get better, I'm on session 4 of 12, so maybe it will get better. Thanks for caring you're so sweet.

I won't pay for therapy if I had to, no help for CPTSD.