[athena2011]

I have written in the past about my therapy feeling like 'exposure therapy'. What I mean by that is that I bring up all these horrible things about my life and how I have always hated being me from my very first memories and in the process I remember all the similar events and feel like I am reliving them over and over again in T's office. The thing is though...actual exposure therapy, (which is often used for a phobia or PTSD) exposes the person to the feared situation/thing in such a way as to gradually get the person used to and ultimately unafraid of the thing that they fear. Unfortunately I am experiencing the opposite. More exposure for me = more trauma. It is cumulative. And if I think of the one type of person who therapy would NOT work for, it would be a person who gets MORE traumatized by exposure. My guess is that would be the case for most people with symptoms of Complex PTSD. Or, in a nutshell, basically somebody who has no stable identity, feels pretty much worthless, has chaotic relationships, feels hopeless, empty and would really rather not exist at all. This set of symptoms is usually caused by abuse or neglect in childhood.

So I mentioned this to T. I got the feeling the 'cumulative trauma' surprised him. We agreed a new approach is needed. I'm beginning to think that therapy could actually be extremely harmful for somebody like me unless I can break the pattern of cumulative trauma. My T is a Psychoanalyst, which seems awfully unstructured to me and I find that unsettling. However CBT didn't work so I thought I'd try something different. I would say that I do need help at the emotional level (which this form of therapy deals with) because I cannot think my way out of this in spite of being a rather analytical person. I've been doing this particular form of therapy for two years. I certainly expected more change by now.

Anyway, I thought I'd see if anybody else experiences this 'cumulative trauma' and/or if anybody has any ideas as to what would be a better approach for somebody who experiences this problem in therapy (well, outside of therapy too). Unfortunately when I asked my T this question, he put it back to me to answer. It makes me wonder what the heck they teach them in Psychoanalyst school! I get the feeling it's pretty much "Keep the patient talking and if you latch onto something that works, keep doing it". So, in that light, here's to speeding up the process...

[Fartraveler]

And if I think of the one type of person who therapy would NOT work for, it would be a person who gets MORE traumatized by exposure. My guess is that would be the case for most people with symptoms of Complex PTSD. Or, in a nutshell, basically somebody who has no stable identity, feels pretty much worthless, has chaotic relationships, feels hopeless, empty and would really rather not exist at all. This set of symptoms is usually caused by abuse or neglect in childhood.

I agree, and I have often felt this way.

My excellent therapist, who I worked with for six years, and who helped me so much, understood this, too, and did not push too far too fast.

On a more practical level, I have found that mindfulness/relaxation/breathing exercises help.

One mindfulness teacher taught me to find a safe place in my body to shelter in, when I need to. It's kind of like controlled, purposeful dissociation, and I've found that useful. (when I remember to do it.)

Thanks for your post.

[SoupDragon]

This is interesting and I think what I have been experiencing. I am going to start cognitive analytical therapy which has more structure and feels safer.After 2.5 years it just felt very stuck with the other type of T.

[Sunne]

I have complex trauma. Which is actually (for me) PTSD, DDNOS, and BPD.

I'm working with a trauma specalist which I think would be a good option for you. He has many approaches.. experiential humanistic, psychodynamic, some cbt. He does hypnosis, ego state therapy, grounding, mindfulness, EFT, EMDR, some DBT stuff, dream analysis, and other fancy stuff that helps me process the trauma, manage my emotions that come in regards to trauma, and to establish safety. Also a lot of focus is on the relationship.

I found, in the past that just talking about it doesn't really help. It wound me up and I left feeling very bad. Although talking does help, it needs to be in a controlled way (for me). It needs to be contained.

I need a therapist to be somewhat directive and usually trauma specialists are, so the client doesn't get re-traumatized by going too fast, ect.

[athena2011]

Originally Posted by Sunne

I have complex trauma. Which is actually (for me) PTSD, DDNOS, and BPD.

I'm working with a trauma specalist which I think would be a good option for you. He has many approaches.. experiential humanistic, psychodynamic, some cbt. He does hypnosis, ego state therapy, grounding, mindfulness, EFT, EMDR, some DBT stuff, dream analysis, and other fancy stuff that helps me process the trauma, manage my emotions that come in regards to trauma, and to establish safety. Also a lot of focus is on the relationship.

I found, in the past that just talking about it doesn't really help. It wound me up and I left feeling very bad. Although talking does help, it needs to be in a controlled way (for me). It needs to be contained.

I need a therapist to be somewhat directive and usually trauma specialists are, so the client doesn't get re-traumatized by going too fast, ect.

Sunne, you sound like you have a lot of the same problems as I have. Wow, your T sounds amazing. If I could find one like that, I think I'd feel much more confident of success. Although...I wonder if I fit the profile for a trauma specialist. I never had any one specific 'event' as far as I know. Just a basic neglect and disinterest on my parents' part in childhood which set up a series of horrible experiences and an almost complete inability to relate to anybody on a normal level. What do you think?

[athena2011]

Originally Posted by Fartraveler

I agree, and I have often felt this way.

My excellent therapist, who I worked with for six years, and who helped me so much, understood this, too, and did not push too far too fast.

On a more practical level, I have found that mindfulness/relaxation/breathing exercises help.

One mindfulness teacher taught me to find a safe place in my body to shelter in, when I need to. It's kind of like controlled, purposeful dissociation, and I've found that useful. (when I remember to do it.)

Thanks for your post.

Thanks for your comments Fartraveler. This is making me think that I have to make my T more aware when I'm getting overwhelmed by a rush of negative emotions. Also, as I am writing this, thinking that your 'mindfulness' reminder is helpful, I should also be relating it to therapy because I often realize towards the end of session that my body has been tensed up from head to toe for the entire time. I'm just so used to it, I forget to even mention it to my T. Probably not a good thing to be happening in practically every session.

[athena2011]

Originally Posted by SoupDragon

This is interesting and I think what I have been experiencing. I am going to start cognitive analytical therapy which has more structure and feels safer.After 2.5 years it just felt very stuck with the other type of T.

Thanks for your post SoupDragon. I've never heard of Cognitive Analytic Therapy before. At first I thought you meant CBT, but CAT sounds like it would be far more effective (at least from the description on Wikipedia). I hope it works for you. I'm going to see if it might be available here in Canada.

[Bill3]

Are you familiar with Subjective Units of Distress (SUDS)? This scale provides a quick way to let T know your level of distress during a session. Here is a version, from wikipedia:

10 = Feels unbearably bad, beside yourself, out of control as in a nervous breakdown, overwhelmed, at the end of your rope. You may feel so upset that you don't want to talk because you can't imagine how anyone could possibly understand your agitation.
9 = Feeling desperate. What most people call a 10 is actually a 9. Feeling extremely freaked out to the point that it almost feels unbearable and you are getting scared of what you might do. Feeling very, very bad, losing control of your emotions.
8 = Freaking out. The beginning of alienation.
7 = Starting to freak out, on the edge of some definitely bad feelings. You can maintain control with difficulty.
6 = Feeling bad to the point that you begin to think something ought to be done about the way you feel.
5 = Moderately upset, uncomfortable. Unpleasant feelings are still manageable with some effort.
4 = Somewhat upset to the point that you cannot easily ignore an unpleasant thought. You can handle it OK but don't feel good.
3 = Mildly upset. Worried, bothered to the point that you notice it.
2 = A little bit upset, but not noticeable unless you took care to pay attention to your feelings and then realize, "yes" there is something bothering me.
1 = No acute distress and feeling basically good. If you took special effort you might feel something unpleasant but not much.
0 = Peace, serenity, total relief. No more anxiety of any kind about any particular issue.

[~EnlightenMe~]

Originally Posted by Bill3

Are you familiar with Subjective Units of Distress (SUDS)? This scale provides a quick way to let T know your level of distress during a session. Here is a version, from wikipedia:

10 = Feels unbearably bad, beside yourself, out of control as in a nervous breakdown, overwhelmed, at the end of your rope. You may feel so upset that you don't want to talk because you can't imagine how anyone could possibly understand your agitation.
9 = Feeling desperate. What most people call a 10 is actually a 9. Feeling extremely freaked out to the point that it almost feels unbearable and you are getting scared of what you might do. Feeling very, very bad, losing control of your emotions.
8 = Freaking out. The beginning of alienation.
7 = Starting to freak out, on the edge of some definitely bad feelings. You can maintain control with difficulty.
6 = Feeling bad to the point that you begin to think something ought to be done about the way you feel.
5 = Moderately upset, uncomfortable. Unpleasant feelings are still manageable with some effort.
4 = Somewhat upset to the point that you cannot easily ignore an unpleasant thought. You can handle it OK but don't feel good.
3 = Mildly upset. Worried, bothered to the point that you notice it.
2 = A little bit upset, but not noticeable unless you took care to pay attention to your feelings and then realize, "yes" there is something bothering me.
1 = No acute distress and feeling basically good. If you took special effort you might feel something unpleasant but not much.
0 = Peace, serenity, total relief. No more anxiety of any kind about any particular issue.

Bill, I really like that scale! I have definitely been to a 9 before, and very close to a ten if not there. The problem is, you can be these levels and there's not much you can do. The hospital will only take actively suicidal patients. I guess you could call your therapist, but then that becomes too overwhelming for them. Thanks for the info.

[mcl6136]

Originally Posted by athena2011

I have written in the past about my therapy feeling like 'exposure therapy'. What I mean by that is that I bring up all these horrible things about my life and how I have always hated being me from my very first memories and in the process I remember all the similar events and feel like I am reliving them over and over again in T's office. The thing is though...actual exposure therapy, (which is often used for a phobia or PTSD) exposes the person to the feared situation/thing in such a way as to gradually get the person used to and ultimately unafraid of the thing that they fear. Unfortunately I am experiencing the opposite. More exposure for me = more trauma. It is cumulative. And if I think of the one type of person who therapy would NOT work for, it would be a person who gets MORE traumatized by exposure. My guess is that would be the case for most people with symptoms of Complex PTSD. Or, in a nutshell, basically somebody who has no stable identity, feels pretty much worthless, has chaotic relationships, feels hopeless, empty and would really rather not exist at all. This set of symptoms is usually caused by abuse or neglect in childhood.

So I mentioned this to T. I got the feeling the 'cumulative trauma' surprised him. We agreed a new approach is needed. I'm beginning to think that therapy could actually be extremely harmful for somebody like me unless I can break the pattern of cumulative trauma. My T is a Psychoanalyst, which seems awfully unstructured to me and I find that unsettling. However CBT didn't work so I thought I'd try something different. I would say that I do need help at the emotional level (which this form of therapy deals with) because I cannot think my way out of this in spite of being a rather analytical person. I've been doing this particular form of therapy for two years. I certainly expected more change by now.

Anyway, I thought I'd see if anybody else experiences this 'cumulative trauma' and/or if anybody has any ideas as to what would be a better approach for somebody who experiences this problem in therapy (well, outside of therapy too). Unfortunately when I asked my T this question, he put it back to me to answer. It makes me wonder what the heck they teach them in Psychoanalyst school! I get the feeling it's pretty much "Keep the patient talking and if you latch onto something that works, keep doing it". So, in that light, here's to speeding up the process...

this is what I experienced with the cold, distant T. I had made much progress in the past in therapy....with therapists' help, I had shifted careers, made a major cross-country re-location and found myself much happier.

But then I stumbled into psychoanalysis in its traditional form and it was a train wreck for me. I experienced it as inciting, re-traumatizing, and it set me back in a big way financially and emotionally.

People on this board talk a lot about the "fit" and the chemistry between client and T and I could not agree more! I would just add one more caveat: the "fit" between the client and the "school of therapy" or the approach seems vital.

For the last two months, I've been investigating very off-beat kinds of therapy, including art therapy and equine assisted therapy. Anything to get me off the "couch" and have some level of participation from the t...that's key here.

Psychoanalysis felt very much like cumulative trauma, week in and week out for me.

more exposure for me = more trauma + less money.

[minefield]

Hello, another therapy for you to consider is DBT although it is taylored for Borderline Personality Disorfer it fit those like us who have complex PTSD. It is designed to help you address the somebody who has no stable identity, feels pretty much worthless, has chaotic relationships, feels hopeless, empty and would really rather not exist at all. I have been advised that by addressing these first it makes the trauma faced more manageable. Well this is what they have just told me as they cancelled my CBT as they said I don't have the coping skills. Im challenging this but that is a whole other post lol...

[athena2011]

Originally Posted by minefield

Hello, another therapy for you to consider is DBT although it is taylored for Borderline Personality Disorfer it fit those like us who have complex PTSD. It is designed to help you address the somebody who has no stable identity, feels pretty much worthless, has chaotic relationships, feels hopeless, empty and would really rather not exist at all. I have been advised that by addressing these first it makes the trauma faced more manageable. Well this is what they have just told me as they cancelled my CBT as they said I don't have the coping skills. Im challenging this but that is a whole other post lol...

I actually use 'complex PTSD' and 'BPD' interchangeably. You obviously understand what BPD is as you have mentioned it in reference to the symptoms I mentioned, which are very much BPD traits. C-PTSD is pretty much the same thing but seems to come without the stigma and automatic judgement that the term 'BPD' can unfortunately invite. 'BPD' also sounds more intractable so I try not to use it in reference to myself as it makes me feel more hopeless. Unfortunately I can even get triggered by a simple DSM term. I have been keeping my eyes open for a DBT practitioner but have not come across one yet. Thank you for the reminder, Minefield. Oh, and BTW, I love your screen name - very descriptive.

[Sunne]

Psychodynamic sounds like it might be good.
A trauma therapist could work too, for reprocessing the neglect from childhood.

Something to look into!

Psychoanalitical would throw me for a loop, I think.

Good luck!

[minefield]

Hi chicken,

I am the same as you I hate the term Borderline or Emotionally Unstable Disorder as they try to fool you with into thinking it is something else. Like you I only show traits and a diagnosis of C-PTSD is far more accurate and gives a better description of what we suffer with. It is so frustrating that this is not yet a real disgnosis and think it should certainly be look at more seriously by those that make these decisions.

I agree it is actually a damaging diagnosis when used in reference to people like us, there is nothing wrong with our personalities we are victims and these traits are a consequence of being unable to handle these extreme emotions it is not a case that we can't cope with emotions our experiences are extreme and so are our emotions this is why they just say traits becuase they know that we do not actually fall into this diagnosis.

I am struggling to get any help at all so it is good that you have options and I hope you find a therapy that fits you. We are such a misunderstood patients and believe that the health services can and do make it worse as they play with things they do not know. Like you I could not cope with that lack of knowledge and confidence that some therapists have. Its exactly as you say we ask for help because we don't know the answers It frustrates me so much when they leave you to answer your own questions. I think you are right to start looking for another source of help as it sounds like your needs are more than he has the skills to work with.
Good luck in your search xxxx