[Astrada]

Would a therapist combine the two, or work on each separately? I think my Gad very much affects my CPTSD but, I don't really know, just guessing based on what I feel. If it does, how would that work? Thanks.

[zoiecat]

I'm not an expert but I think your GAD is caused by your c-ptsd or more specifically the things that caused the C PTSD. I never considered myself a person that had anxiety but I do have C PTSD and depression and DID. My therapist is always talking about my anxiety from the things that happen to me as a child. I also read somewhere that did is classified as an anxiety disorder brought about by extreme trauma and anxiety and childhood. I assume c-ptsd is similarly related.

That being said I would assume that your therapist would work on the issues that caused your c-ptsd oh so same issues are probably related to causing the GAD. That's just my opinion like I said I'm not an expert.

[feileacan]

In my mind the particular diagnoses do not matter that much at all in these kinds of situations. I don't think there is any particular treatment that would be really specific to CPTSD or that would be really specific to GAD, simply because those labels themselves represent something that manifest in very different way in different people. According to my understanding these labels are just used to represent complex conditions that can vary tremendously person by person.

I think in those situations (actually, in any situation) the therapist should really work with the person, regardless of what labels/diagnoses the person has been assigned to. The diagnoses do not need therapy, the person does, and I can't even imagine what it could mean to try to separate the symptoms that lead into assigning any of those two labels (I assume that the symptoms overlaps in great degree anyway) and work on them separately.

Considering that you have been given such complex diagnoses I in your place would look for a therapist who wouldn't pay much attention to diagnoses at all and just work with you with whatever material comes up in sessions. It's probably going to be a long treatment anyway.

[ElectricManatee]

I agree with zoiecat and feileacan. I also think you may want to make sure you find a T who has training and experience with trauma. Best of luck to you!

[Carmina]

Can't see how you could separate one from the other really, in your case (as in mine) the GAD is just one symptom of the underlying trauma, not a thing in itself.

[TuscanSicilian]

GAD & PTSD both fall under the category of Anxiety Disorders. One comment above is solid advice-get a counselor who’s been trained to treat PTSD. Are you seeing a mental health medical provider for medications, if at all?

[feileacan]

Somehow I don't have much belief that someone who would be trained to treat PTSD would be automatically effective in treating CPTSD. After all, PTSD is a concrete thing stemming from concrete trauma while CPTSD is not necessarily a concrete thing, stemming from many small traumas that no one might even not remember anymore or that happened so early in life, so that cognitive narrative memories were never formed about these things. I doubt that proficiency with PTSD makes someone effective in treating CPTSD. That's my opinion though.

For trauma, supposedly the general guidelines are:
Phase 1: Safety and stabilisation
Phase 2: Remembrance and Mourning
Phase 3: Reconnection and Integration

[feileacan]

But how do you remember and mourn something you don't really remember? Things that happened while your were up to 2 years old? Things that were so common in your life from very early on that they became your normality (like neglect and abandonment for instance)? I can't think of a way how it can work like this then. These things can give backslashes too, at least they have for me. But the backslashes are purely emotional and there is zero memory or narrative attached to them.

Originally Posted by feileacan

But how do you remember and mourn something you don't really remember? Things that happened while your were up to 2 years old? Things that were so common in your life from very early on that they became your normality (like neglect and abandonment for instance)? I can't think of a way how it can work like this then. These things can give backslashes too, at least they have for me. But the backslashes are purely emotional and there is zero memory or narrative attached to them.

I don't know exactly how I mourn the neglect. I cry a lot over the lack of safety and protection and nurture.

There are years of my life I don't remember, no narrative and no memory except emotions of deep sadness sparked by the contrast of T's warmth vs the emotional barrenness of my upbringing.

" Child neglect represents particular challenges for adult survivors because they must grieve for things they never had and thus never had the chance to lose" -- Sandra Bloom

[Astrada]

Thank you everyone. I very much appreciate your thoughts on this.

It's sort of complicated (or not lol). Yes, very critical mother, I could do nothing right, good enough for her. Which I think is where my anxiety comes from (I have always assumed anyway, coz I have always had anxiety as far back as I remember).

Work related CPTSD, just diagnosed. Although have probably had it previously (but my anxiety was so out of control I didn't see the therapy through, so the issue was left untreated, my bad).

Regarding therapy, the work psych strongly recommends ERDM therapy. G.P. has just today referred me to a ERDM therapist (who actually covers a whole range of therapy's) and is considered one of the best for trauma.

I would hope he will actually look at the whole picture (me) and go from there with best treatment (coz I have no idea what's best).

Don't know when I'll get an appointment, it's workcover, which makes things more complicated, but G.P. says asap, and if can't get appointment soon, to let him know and he will contact psych to get me in asap lol.

[Carmina]

Personally I think remembering and 'working through' traumatic experiences may be beneficial when they are isolated and /or more tangible ones with a clearer narrative, but I can't see how it could help if it's something that was so everyday and bound up on such a fundamental and preverbal/non declarative, affective level with insecure attachments and dysregulatory attunement. This poisons our relationship with others in the here and now and with the world.

Right now I am exploring more embodied therapy approaches, particularly using creative expression (for me I relate to art, music, dance) but also things like walking and other forms of activity (maybe even baking and gardening). I think the secret lies in being able to be attuned to someone (a therapist) who creates a warm holding environment within which I can explore and be enabled to renew my sense of attachment to others and not feel so fearful and unsafe with others and in the world.

[feileacan]

Originally Posted by Carmina

I think the secret lies in being able to be attuned to someone (a therapist) who creates a warm holding environment within which I can explore and be enabled to renew my sense of attachment to others and not feel so fearful and unsafe with others and in the world.

That has been my experience as well. I really doubt that some trauma therapy protocol (like EMRD) would have been useful at all for me because I don't have any single traumatic memories to work with - the whole everyday life of my childhood was traumatic, probably from very early on.

Originally Posted by feileacan

But how do you remember and mourn something you don't really remember? Things that happened while your were up to 2 years old? Things that were so common in your life from very early on that they became your normality (like neglect and abandonment for instance)? I can't think of a way how it can work like this then. These things can give backslashes too, at least they have for me. But the backslashes are purely emotional and there is zero memory or narrative attached to them.

Originally Posted by QuietMind

I don't know exactly how I mourn the neglect. I cry a lot over the lack of safety and protection and nurture.

There are years of my life I don't remember, no narrative and no memory except emotions of deep sadness sparked by the contrast of T's warmth vs the emotional barrenness of my upbringing.

" Child neglect represents particular challenges for adult survivors because they must grieve for things they never had and thus never had the chance to lose" -- Sandra Bloom

Hi feileacan, I was thinking further about your question and found this. Wanted to share: https://lifeinabind.com/2015/12/13/g...-about-things/

"I have often read that one must grieve what was lost or was missing – but I have no idea how to grieve something that wasn’t there; something that is nebulous and unremembered. Save that, as my therapist has pointed out, it is remembered by virtue of the transference that is experienced during sessions. Even so, I have only recently learned how to grieve a person rather than bury feelings of loss – and I have no idea how to apply those lessons to grieving a lack of unconditional acceptance and connection in my past."

[Elio]

Originally Posted by feileacan

But how do you remember and mourn something you don't really remember? Things that happened while your were up to 2 years old? Things that were so common in your life from very early on that they became your normality (like neglect and abandonment for instance)? I can't think of a way how it can work like this then. These things can give backslashes too, at least they have for me. But the backslashes are purely emotional and there is zero memory or narrative attached to them.

I have found that sometimes my grieving doesn't have an object, action, or moment in time; it is just a feeling. I will spend a session just crying and being with the sadness of something that has no thing. We don't try to figure out what the sadness is towards or what I am specifically grieving. My T has hinted at it possibly being the body. I have started calling it a peaceful sadness or pure sadness, where the feeling is no longer complicated by anger, hurt, humiliation, guilt or anything else. AND it does seem like for me, there is a shift inside after these sessions.