Opinions needed, please read. I need help/input about T

I have CPTSD and I've mustered up the courage to do trauma work. I'm unfamiliar with the process, but I trust my therapist.

That said, I seriously am questioning the timing. I was ready to get going on trauma work...but had a huge mental pause yesterday. I'm sole caretaker to my dying stepdad. I love him very much and I want to take care of him. The stress did put me in IP several weeks ago (bipolar mixed episode). He has terminal pancreatic cancer and he's declining rapidly.

His death will be a huge loss for me. I've grieved the loss of my biological parents and it takes time. I'm OK with it. It's difficult, but necessary.

I'm also a single mom and taking care of my child is very important to me, of course. She's a teenager but she still needs her mother. We are close.

QUESTION: Why does my T want to start trauma work now? I'm disabled, going through a major life event (which is why I hired her...to help me cope) with a dying loved one....with massive responsibilities for caretaking and settling his estate after he passes away? I've already learned I need to put my self-care first to take care of my stepdad. My stability is crucial. Is adding trauma therapy right now logical?

I can't fathom how this is an appropriate time to do serious trauma therapy. I've had a lot of trauma...I think it will take time. Why now? The added stress could easily trigger a bipolar episode, as well.

I'd appreciate feedback and opinions. She's a relatively new T. I like her and trust her - but now I am seriously questioning her timing. Is her judgment off? Does she have a financial motive (she's a single mom - maybe is financially motivated for her) to keep sessions frequent for an extended period?

I pay out of pocket, no sliding scale. She has trauma experience...but something feels "off." I thought maybe it was avoidance on my part, but I don't think so. I want to do trauma work and improve my life. But right now?! My trust that I'm in good hands with T is wavering due to this.

Thanks.

The best thing about my T is that she NEVER put pressure on me to come more often than I wanted to. When you talk about traumatic things for the first time, it can cause panic attacks and dreams. Sometimes the panic attacks/thoughts can interfere with driving (the distraction can be dangerous). I feel like if you have a T who allows you to time how often you see them (verses dictating to you), then you will feel more in control of the therapy process. I don't know what her motives are but it is your money so you should be able to decide the pace of your treatment.

Sounds like a really rough time to be going through! I could be very wrong, but maybe your T is thinking "no time like the present" to start trauma therapy. Maybe starting on trauma might give you some new coping strategies, which may help out in future situations.

Understandably, you're not in an easy place at the moment, and in my opinion, if you believe that you're not ready to start on it, then you should voice that to your T. Have you done this?

Sorry things are so rough

I think that this is something that you should decide. T should be ready to do the work when you are ready but by no means should she tell you when you should do it. If you feel that the timing is wrong then it probably is wrong. Don't ignore this voice inside you!

I'm completely new to therapy to heal trauma. My T has no personal or professional experience with grief...so she can't relate, IMO. That's normal, but may be problematic. Thanks for your reply.

I see my T this week and I think I'll tell her I want to work on trauma at some point in the future with her. I will tell her, for now, I need her support regarding my stepdad and I'll need to be settled into the grieving process after he dies. I will know when the time is right. I just can't pinpoint it now. Thanks.

Thanks. I have good intuition and it's ringing loud and clear. It's not the right time. I have a lot going on. I don't want to get side-tracked from it. Likewise, I want to put my best effort into trauma therapy. I do not think I can do this at the same time and my mental stability will be at high risk. Thanks again.

Yeah I think that is totally fair. She can't pressure you into these things, and by the sounds of it, you're not exactly resisting. But it is always good to discuss any concerns like this with your T, that way they know where you're at with it all. Sometimes it's like you have to basically spell it out for them. I don't know if that's their plan, but it seems to happen to me a bit hah..

Thank you. I have Panic Disorder and it's rough. I also have nightmares a lot. Thanks for the head's up that panic attacks and nightmares are common during trauma therapy. I'll be mindful when driving, too. This sounds intense.

You sound like you have a lot of clarity on this. Definitely talk to your T about it and postpone it.

I have unprocessed trauma, too, and my T has been incredibly patient waiting for me to be ready to go into it. He does push me (appropriately) from time to time. The one thing he says that I am starting to believe to be true is that it is still affecting me, it's just coming out "sideways." I'm getting triggered in real life, stuck in activation, and am having some flashbacks.

His point is that NOT going into the trauma for me is probably as or more disruptive than going into the trauma would be. That doesn't necessarily sounds like it's true in your case, but I think it is in mine (which doesn't stop me from running away from the trauma every time we try to approach it though).

I would say don't touch trauma with a ten foot pole. IMHO your self-protecting instincts are sound and you should listen to them. Don't do anything that would jeopardize your stability while you have so much on your plate. Use this time to further develop the coping and self-care skills you need right now and will need when you do trauma work down the line. To me the major part of trauma work is learning to center and re-center yourself when the past feels like the present. That is something you can learn at any time.

Also find out what exactly she means by trauma work? What does she envision will happen? What are her thoughts on retraumatizing? What kind of framework does she use and what kind of evidence supports it? Is she in supervision with someone competent and experienced?

Reread your original post. It sounds like you have thought this through and have come to your own conclusions. It sounds like you like her but an important part of you has serious concerns about her judgment. To me those concerns sound valid. Trust yourself.

Sorry to hear that you are having such a hard time, there's really an awful lot happening in your life at the moment.

I think, trauma work in therapy should happen when you are ready for it. T giving a small nudge might be ok, but 'forcing' you head on into confrontation is not ok.

My T keeps emphasizing that stability is important for trauma work. Stability as in life circumstances as well as the client learning to find stability on their own...

Trauma work in itself can be quite exhausting, so stable life circumstances do help in the process to find one's balance again.

Do talk with you T about this and be open, trust your gut feeling/s. That you feel that this is not the right timing for you. And you are the person that matters most in this therapy process.

Wishing you all the strength you need in this difficult time.
c_r

Favorite Jeans, thanks so much for your reply. Your first sentence and your advice resonate with me.

And, you ask good questions about what type of trauma treatment, etc.? A lot is unknown. I want to know all the therapeutic techniques for PTSD/trauma.

My partner mentioned finding a highly qualified therapy "retreat" .... we'd have to research it, but if there is a tranquil place with a private room, non-hospital setting, soothing/rejuvenating environment that does trauma work...maybe I could go there for several weeks after my life calms down. I can't afford it now, but I could do it after...my stepdad passes. (It hurts typing it.). I think it could also help me with processing grief.

I wonder if such a place exists...I could follow up in therapy afterwards. Thinking...but have definitely decided there is no rush. Trauma treatment isn't happening right now.

Thanks again

Cinnamon roll, thank you. My T knows my stability is fragile. It's my bipolar 1 that is a struggle although I have anxiety disorders, too. Yes, I'm going to tell T I want to wait. She knows I recently got out of IP (mood unit) for a mixed episode. She knows my circumstances with my stepdad. Hmmm....

Also, Ts work for us. They provide a service and work for us because we decided to hire them. My old T reminded me that "he worked for me"....it's easy to bend to a T's preference and put them on a pedestal. I like my T, but she's a service provider for my mental health. I'm calling the shot on my treatment plan.

my T waited 6 years for me to finally talk about the real traumas. he's still kinda waiting because i dip in and out of the trauma work. which he is fine with. he knows i need breaks. can you ask your T to help you build up coping skills outside of therapy before you really start discussing trauma? i think it's necessary to have a solid grounding of things you can use to get yourself back to 'reality' after a trauma work session. if i had dived into trauma work without these tools in place i would have just drowned in the deep end

places like this do exist. some of them are hospital like settings, some arent. usually the ones that aren't are more expensive and not covered by insurance. but dont denounce the hospital-like ones. there are 2 i can think of off the top of my head. PM me if you want info

Trust your instincts!! I agree with you that the timing is awful for trauma work. My old t used to say that trauma work is like prepping for a marathon. You need to be in a good place to start. Can you explore other therapists?

I agree with growly...can you consider another therapist? This one is being reckless. I can't imagine my therapist trying to process trauma while I'm in the middle of coping with a dying parent and emotionally stressed. Trust your guts.

The first stage of trauma therapy, at least from what I've read, involves building your coping skills and learning techniques to control anxiety and stress. Is it possible that what she's referring to? If so, these same techniques could help you in processing what is going on with your step dad. My condolences by the way. I lost my mom to Pancreatic Cancer in 2002.

It could be that your t thinks you starting on trauma stuff will help you through whatever the next few months hold. For me, starting on trauma work was not destabilizing; in fact getting started lowered my anxiety because I started to think that I could actually get through it even if I wasn't there yet. I'm still not there; T3 thinks slow and steady is way better than fast.

Based on my experience, EMDR, SE and Brain spotting are the best ways to approach trauma. Brain spotting is my favorite.

I think that is really, really wise.

It's hurt me to do more intense therapy with too many life stressors. I've needed more supportive therapy.

Totally understand what you mean by fragile. Everyday is a struggle keeping it together as i never fully climbed out of the environmental issues before diving into therapy. Prolonged stress wears you down.

I can't say anything about her motives, but I would think most therapists would be able to do supportive therapy in lieu of trauma therapy. You could start off with establishing a relationship and getting support and then start the trauma therapy when you are ready. It might not be a bad idea to see someone while you are going through this-and just not do exploratory type therapy. Someone to lean on.

I'm sorry about your stepdad and wish you this best.

You are absolutely right. This is not the appropriate time to do the trauma work and, as a therapist, I am surprised that your therapist is insisting on that right now. He shouldn't be insisting on something that doesn't feel right to you under any circumstances, period. But at the time when the client is clearly struggling with a very challenging life situation and is emotionally not stable already, it is irresponsible to push them into doing trauma work that takes up a lot of emotional energy and may put quite a bit of additional stress. In the time of crisis therapy is supposed to be supportive and should be targeted at stabilizing the client not taking the risk of driving them into a total mental breakdown. If I were you I would insist on not going forward with trauma work. You need to deal with your challenging circumstances at the moment and you need your therapist to be emotionally supportive right now. This is not the time to dig into the old wounds and to sort them out.