[Val12]

[Warning: this has description of some of my PTSD symptoms]

I have made no progress with my PTSD therapist after re-experiencing all of my traumas (related to being ill and near-death). They don't agree, but said we start a new phase where I build a new life for myself. I told them that I have two big problems (that were not treated for the decades since they started) that remain that are keeping me stuck and unable to live a “new” life:

• symptoms of the PTSD: I startle at every sound to the point of chest pains and hyperventilating. I once slammed into a closed door because someone said my name (unexpectedly, but with an indoor voice) and my body reacted by telling me to run. I have at least weekly graphic nightmares about being pursued, being gravely ill or dying/being murdered. And other things.

• Severe OCD: I compulsively wash my hands to the point of cracking and bleeding. I panic over people/things/food being unclean and getting me sick and then me dying so I limit what I eat and (even before the pandemic) limit where I go. I have intrusive thoughts and have to go through rituals several times a day to counter each bad thoughts to make sure bad things don't happen to me. I fear (to the point of panic attacks) certain words,colors, numbers. There are many other things

They told me that the answer to treating all of this is mindfulness of thought so for 4 weeks, we have been spending most of the sessions me imagine putting thoughts that pop into my head into boxes, on clouds, on conveyor belts. I keep asking how this will help with my two big problems because I don't understand and they say that being able to recognize and label my thoughts will cause them to stop so the OCD will stop and being able to tell myself I had a nightmare or I got started will stop this from happening.

The thing is THIS SOUNDS WRONG. I feel like I can do mindfulness of my current thoughts until I pass out, but it's not going to stop the nightmares from coming or my body from reacting like I'm in a war. It doesn't make sense that simply identifying that I have an urge to wash my hands or a thought that this food looks contaminated or that my body feels “off” so I worry I have (yet another) disease is going to stop my fear or me from engaging in safety behaviors.


I've heard OCD needs to be treated with response and exposure so I can't see how doing 30 minute daily sessions of imaging my thoughts falling into buckets is going to help.


On the other hand, I'm not a professional so maybe I'm wrong and am not being open to trying something that will help me.

[ArtleyWilkins]

It is going to take WAY longer than 4 weeks to even begin making a dent in your automatic thoughts.

It can work, but it is a long process (if they tell you differently they aren't being truthful).

My PTSD symptoms have for all intents and purposes gone away. They were very severe. My therapist worked with me largely using behavioral approaches to become actively cognizant of my thinking and to gain more control over that thinking so that my reactions weren't running the show.

It took the better part of 8 years before I had worked through enough of my trauma AND gained the ability to have better control over my thinking so that the PTSD symptoms finally most went away. I might have been a slow learner, but my therapist actually never claimed I was taking too long. In fact, considering the level of my trauma along with a string of immediate crises in the middle of trying to deal with the past, he always felt I was keep a steady pace.

It was slow, but I did start understanding a bit at a time. It took a great deal of practice, even with the most mundane of events, before I started really internalizing what I was trying to do.

I ended therapy about 8 years ago when I knew I had finally reached a place where the PTSD was no longer an issue, I had stabilized so that depression and anxiety wasn't really much of an issue, and I recognized I was doing for myself what my therapist used to have to help me through.

The skills I STILL use in my daily life are those behavior skills. They are my way of staying centered and sane and stable now.

Btw: I hated mindfulness, and that was the one technique I honestly forbade him to use. The technique itself was triggering to me because of the type of trauma I had experienced. He didn't quite understand that, but we agreed to disagree, and he stuck with the other behavioral approaches that were working just fine for me. The CBT/REBT-type of approaches worked very well IN COMBINATION with other talk therapies.

[Val12]

Originally Posted by ArtleyWilkins

It is going to take WAY longer than 4 weeks to even begin making a dent in your automatic thoughts.

It can work, but it is a long process (if they tell you differently they aren't being truthful).

My PTSD symptoms have for all intents and purposes gone away. They were very severe. My therapist worked with me largely using behavioral approaches to become actively cognizant of my thinking and to gain more control over that thinking so that my reactions weren't running the show.

It took the better part of 8 years before I had worked through enough of my trauma AND gained the ability to have better control over my thinking so that the PTSD symptoms finally most went away. I might have been a slow learner, but my therapist actually never claimed I was taking too long. In fact, considering the level of my trauma along with a string of immediate crises in the middle of trying to deal with the past, he always felt I was keep a steady pace.

It was slow, but I did start understanding a bit at a time. It took a great deal of practice, even with the most mundane of events, before I started really internalizing what I was trying to do.

I ended therapy about 8 years ago when I knew I had finally reached a place where the PTSD was no longer an issue, I had stabilized so that depression and anxiety wasn't really much of an issue, and I recognized I was doing for myself what my therapist used to have to help me through.

The skills I STILL use in my daily life are those behavior skills. They are my way of staying centered and sane and stable now.

Btw: I hated mindfulness, and that was the one technique I honestly forbade him to use. The technique itself was triggering to me because of the type of trauma I had experienced. He didn't quite understand that, but we agreed to disagree, and he stuck with the other behavioral approaches that were working just fine for me. The CBT/REBT-type of approaches worked very well IN COMBINATION with other talk therapies.

So you did CBT/REBT? The thing is that the treatment they are suggesting is ONLY mindfulness of thought. They say that practicing it daily for like 30 min (imaging my thoughts on clouds, etc) will stop my PTSD and OCD symptoms, but that sounds wrong.

[ArtleyWilkins]

Some people swear by mindfulness. I wasn't sold. At all. Fortunately, my therapist hadn't started with mindfulness, nor did he ascribe to a one-size-fits-all philosophy of therapy. Because what he had started with had been working, and because I had such a visceral repulsion to mindfulness, he respected my opinion (even though he didn't really agree with it), and he went fully back to what was working previously. It's going to have to be a conversation you have with your therapist.

The one thing I know is that if something is feeling completely wrong in your therapy, YOU have the right to refuse. That may require leaving that therapist and finding someone different. You have to be willing to do that. But don't get into a drawn out battle of wills with a therapist; they'll either hear you and work with you, or they won't. It isn't worth the time or money to butt heads. Therapy is about you; not the therapist. Do what is right for you.

[SlumberKitty]

[LonesomeTonight]

haven't really heard of mindfulness for OCD specifically (I have OCD, including contamination fears). It can help with generalized anxiety, which I also have. I'm not familiar with PTSD treatments, but it certainly doesn't seem like 4 weeks of mindfulness would be enough to help based on your symptoms.

For OCD, from what I've read, the most proven method for treating is Exposure and Response Prevention therapy, which is a type of CBT. Actually, my T is currently working on something like that with me for my fears of going outside or driving anywhere that have come about lately due to Covid. Where at first, I'm just opening the door onto my back (fenced-in) patio and standing there for two minutes. Once I've done that enough times that anxiety is decreasing, I go a bit further on the patio or stand there longer. Then things like being on front porch, then sitting in my car, then starting the car, then driving up the block. All very incrementally (so far, I have just gotten to go a bit further on the patio, but I only started a few days ago).


My ex-T had started doing something like ERP with me for the contamination fears, and we got to the point of my writing a very exaggerated story that was like my worst nightmare of dining out, then other things happened in my life, the ERP got put on hold, and we never really went back to it. It can be scary and difficult, but the idea is basically for you to (gradually) see that certain things aren't really a threat. (Of course, the problem is, some things like being out in public right now *could* be a health threat, so...)

[stopdog]

You don't have to endure something that isn't helping - therapists don't know what is right for people - they just guess and throw stuff out there. Tell the therapist it isn't working and try something else.

[Val12]

Originally Posted by ArtleyWilkins

The one thing I know is that if something is feeling completely wrong in your therapy, YOU have the right to refuse. That may require leaving that therapist and finding someone different. You have to be willing to do that. But don't get into a drawn out battle of wills with a therapist; they'll either hear you and work with you, or they won't. It isn't worth the time or money to butt heads. Therapy is about you; not the therapist. Do what is right for you.

Originally Posted by SlumberKitty

I keep having this urge to put my foot down, but second-guess myself thinking that maybe they know better because they are so insistent it is the answer and what if I'm being stubborn and will miss out on treatment because I think I know better.

Originally Posted by LonesomeTonight

For OCD, from what I've read, the most proven method for treating is Exposure and Response Prevention therapy, which is a type of CBT.

That's what I heard, too, but my therapist never mentions ERP or any kind of CBT treatment. They say mindfulness of thought is the treatment and that's it. The only thing.

Originally Posted by stopdog

You don't have to endure something that isn't helping - therapists don't know what is right for people - they just guess and throw stuff out there. Tell the therapist it isn't working and try something else.

I always feel like since they're professionals, maybe they know better and I'm just being difficult and preventing myself from being helped.

[ChickenNoodleSoup]

Therapy is (at least in my opinion) a bit different from something like going to a regular doctor for a cold or something like that. If you go to a doctor having a cold, they will ask you about your symptoms, look at some things and then they *probably* know better than you whether it really is a cold, what might help and what probably won't. You usually do not argue with them in such situations or tell them that you think they should do something like an MRI even though they are sure it's a cold.

Therapy is different in that while you have a diagnosis that other people have as well (PTSD and OCD), what helps you best depends on you and your personal experience. Some people will do great with mindfulness for PTSD. Some will think it's too hard to do and will give up way earlier than you. Some will think it helps, but also want to discuss they experiences and talk about other things, mix approaches.

A therapist can't really know what will work best for you just like that, they can't read your thoughts or know what it's like for you. Even though they are the professional in the situation, in many ways you are more knowledgeable, because you experience your issues, not them. I always like to think of the therapists role as 'helping you helping yourself' more than them just helping you. But the only way to efficiently do that is by communicating what helps and what does not. If you think mindfulness does not help or is not enough, you can (and should) tell your therapist that this is not helping, that you'd like to try something else.

It can also be that this therapist isn't the best fit for you, maybe they are really sold on mindfulness and want to only do that. In that case, it's usually best to just look for a new one, therapy is a lot about working together as a team, you need to listen to them and try out the things they suggest, but equally they need to listen to you and change up their approach if it doesn't work for you. If they can't do that, then it's better to find a different therapist who can than to spend time and effort trying something that ultimately will probably not help.

[Rive.]

Psychotherapy is not an exact science. Some treatment options work for some clients and others don't. Not everyone is the same, hence treatment can feel like trial and error as a result. A bit like meds adjustment.

So, they may have suggested that approach but if you have tried it and it doesn't work, it is worth exploring other options and letting them know accordingly. You need a higher level of intervention.