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Ha thanks, Dee

Agreed! I really think service dogs are an underutilized resource! They're a big commitment, but so worth it.

Deep pressure therapy (which is sort of code for training your dog to cuddle with you) has made a huge difference for me!!!

Good luck to you in this journey!

Hope I'm not hijacking your thread, Dee!

In case anyone's interested, here's a decently comprehensive list & explanation of work/tasks that psychiatric service dogs can be trained for.

http://www.iaadp.org/psd_tasks.html

Happy for you, Dee!

I'm owner training my dog as a service dog.

The absolute best resource I've found has been http://www.psychdogpartners.org/.

They've done a fantastic job breaking down information relating to psychiatric service dogs. The email based forum is also an awesome fount of knowledge.

I would recommend anyone interested in a service dog to check out their information. There's a LOT of misinformation about service dogs to be found out there, so you really should be cautious. This nonprofit does a great job clarifying rumors vs facts/laws as well as advocating for disability rights pertaining to service dog use.

Hey Kizzie, yes, please do! Don't give me credit or anything since it's a compilation of other letters plus some of my own wording.

I think I'll reformat it a bit before sending it. More bullet points, fewer paragraphs to make it more digestible. I sort of doubt that someone's going to read it carefully, we're a society of skimmers!

I know I'm not alone in having trouble advocating for myself! I do think it would be a helpful resource for our community to have on hand at least as an idea to start your own letter from.

I don't know your situation, but I have my own dysfunctional family as experience... it sounds like you need better boundaries with your family.

I took back my holidays a few years ago. No more fighting/manipulation/physical stress reactions. Sometimes I'm sad to not have my own family to be with, but I'm all the more thankful to have friends (a family of choice) to celebrate with.

Have you explored the potential for limiting contact with these people?

Experiences as a child taught me not to advocate for myself, and taught me to doubt my experience of reality.

I'm conditioned to be "ok" no matter what and to make sure that no one is upset by me under any circumstances, even if that means keeping them from extending genuine care and support.

So... going to the doctor is really hard for me.

My therapist is encouraging me to see a GP for the first time in years and really discuss everything that I've kept bottled up to the detriment of my health.

I compiled the following letter from others found online, I thought it would be helpful to share with this community.

My therapist said these are reasonable accommodations... but I know I'll feel terrified asking for them! Without her help I never would have known that I could even hope to advocate for myself.

Does anyone else have suggestions for communicating with doctors/ navigating the stressful world of healthcare?






Dr. _____,

I'm writing because I am a soon-to-be patient of yours, and there are a few things that I think it would be beneficial for you to know prior to our first appointment on (date).

I am a survivor of childhood physical and emotional abuse, physical and emotional neglect, and sexual abuse. My medical records will not reflect these things specifically as this is the first time I have communicated them to a medical professional. I've recently entered a new season of safety in my life, with limited or eliminated contact with my abusers, and I am seeking to find a physician who will partner with me in my future health care and help me to address the lingering effects of abuse on my health which have been partially or fully unaddressed.

Because of my history, meeting new doctors and undergoing physical exams can be extremely anxiety provoking for me. My counselor has helped me to assess what I may need in order to feel safe in medical environments and during medical procedures/exams. I thought it would be best to share some of that prior to seeing you.

One thing that is extremely helpful to me is if the first appointment with a new provider can be a consult in which there will be only discussion and no exam. I believe that this is what we have scheduled on (date), and I just wanted to confirm that need.

During the appointment, I will likely be anxious, and will have trouble processing the information we discuss. It is a struggle for me to express what I am thinking and feeling, and whether or not I am feeling safe. It's likely that I will become dissociative during/following a physical exam or during/following discussion of health topics related to the abuse. This dissociative state may or may not be apparent to an observer. For these reasons, if possible, I would like to request to be scheduled for slightly longer appointments than usual, so that I can have time to get grounded, process information, and ask questions.

For a variety of reasons (including history of head trauma, neglect, iron-deficiency, and Complex-PTSD) I will be unable to remember in detail what we've discussed following our appointment. I will take notes during the appointment and may record our conversations; but, if possible, I would like to request to be supplied with a copy of your records from each appointment.

I have trouble initiating dialogue, which is why I thought it was important to send this letter prior to our first appointment. I am very willing to talk about the content of this letter, but I will do much better if I am asked questions, rather than having to start the conversation. Especially in our first appointment, it will be helpful if you will initiate conversation.

Additional accommodations I would like to request include:

• Being in a position during exams where I can have eye contact with someone at all times.

• Being reassured that I can ask questions about any part of my care.

• Having an explanation of procedures. Including knowing that I will be touched, how and where I will be touched, and if I should expect discomfort.

• Assurance that staff want to know what they can do to make me more comfortable, and that they will not be angry or upset if I request something to be done differently.

• Patient reassurance of safety should I exhibit signs of a panic attack, startle when touched, or experience pain during an exam.

• If it is necessary for a male medical professional to be involved in my care, I request that a female medical professional also be present.

I am hopeful about working with you for my ongoing care, and I truly appreciate the time you are taking to read this letter. Please include this letter in my medical records for future reference.

If you have any concerns or would like to touch base about anything prior to our first appointment, please leave a message on my cell and I will return your call promptly: _________.

Sincere thanks,

Meursault is so right... try not to doubt yourself  when you experience the insanity of "the system".

As much as you can, in whatever form you need to, try to advocate for yourself when you're treated this way. Easier said than done, I know.

[A LOT]

Oh forgiveness... what a loaded topic!

Since religion has already been mentioned I want to try to offer the Christian/biblical teaching on forgiveness without the manipulations of a 12 step program or abusive leader. Please don't read this as me being preachy, I just want to represent something that gets so often distorted.

A lot of well meaning people in the church with an entirely wrong understanding of forgiveness have done A LOT of harm to hurting people by pushing forgiveness at all costs. Then there are those who would use your faith against you and tell you to forgive as a way to not take responsibility for their own reprehensible behavior. Neither of these things are ok!!! And when we are able, we should stand up for true forgiveness and not accept these counterfeits.

It can be helpful to think of forgiveness in "legal" terms.

There have to be 2 parties involved. I can't forgive someone from the peace of my own bedroom... forgiveness requires both parties.

Forgiveness also requires repentance (an apology, acknowledging that wrong has been done and trust has been broken, with a sincere intent to turn away from the offending behavior). 

Forgiveness then says that you will not pursue the matter further: not seeking to punish or hold it over their head as leverage. The matter is openly acknowledged (none of this forgive & forget nonsense!!) and you both move on from that point.

Forgiveness acknowledges that there was damage caused to one party and that the offended party has reason to be hurt. Any continued relationship after forgiveness can be quite boundaried! The offending party now has the opportunity to prove their trustworthiness and the sincerity of their repentance from a safe distance. The offended party controls when boundaries are relaxed. 

What was so remarkable about Christ was that in the cross he represents both the offended party and the offender. His sacrifice is what allows us un-boundaried access to God.

I can't forgive my abusers because they haven't acknowledged wrongdoing.

What I can do is choose to be open to the possibility of future (boundaried) reconciliation. Not hardening myself to the point that if they ever offer true repentance I'm unable to respond.

I think that a lot of people mean acceptance when they say forgiveness. I can accept that what happened actually happened and that it's in the past. And I can choose to work on the resulting issues from the harm that occurred in the past: addressing my anger, shame, emotions, etc. and seeking to live a healthier, happier life moving forward.

Hope this perspective on forgiveness is helpful to someone!

A great expounding of the topic from a Christian worldview can be found in the book:

From Forgiven to Forgiving: Learning to Forgive One Another God's Way by Jay E Adams

Another book that helped me understand forgiveness and boundaries is:

Bold Love by Dan Allender and Tremper Longman

[protect your recovery!!!!!]

When I first came to the board I was in bad shape and so easily triggered that it's almost funny in hindsight. I had more than a couple panic attacks sparked just from the way the emojis dance around on screen while you're posting. Talk about hypervigilance!!

I think I'm moving past the place you described of experiencing the flood of entirely unchecked emotions, but I know it well! It's brutal to be emotionally dis-regulated.

First & foremost: protect your recovery!!!!!

There's a great deal on here that I don't read for the risk of being triggered. I avoid the journals altogether, but I'm thankful for those of you who are able to engage with people's stories in the journals. It means so much to be validated in that way!

Trust your intuition, you will know where to draw that line for yourself. And in case you don't... this is the perfect opportunity to practice getting in touch with your intuition. Ask yourself if the title or first line of text is upsetting to you, really check-in with your body and thoughts. If you experience a shift (elevated heart rate, suddenly tapping your foot, chewing your nails, clenching your fists, etc.) then be honest with and kind to yourself and step away from the forum.

As for getting stuck, I've wondered the same thing. I tend to come here to read posts when there's something going on in my life that I want to avoid thinking about. It's something of a security blanket. I do think it would be healthier to stop myself when I come to the forum and give myself some kind of self-care first (bath, food, etc.)... then proceed to the forum if it's still of interest to me and I'm sure I'm accessing it for the right reasons.

Hope my experience is helpful to you!

I like that, woodsgnome! I've also heard it as False Evidence Appearing Real.

Sienna, I don't see the link you meant to post. I'm interested in reading that... thanks for sharing!

I went through this too.

It absolutely knocked me out of commission when I first started dealing with everything in therapy. I asked my therapist if this is what I had to look forward to now (basically, is it always going to hurt so much and cause my life to come to a screeching halt?). To paraphrase, she said yes, if you stay engaged in the world (not dissociating, denying, etc.) that things are going to effect you.

But here's the most important part of what she said: "it's never as bad as the first time". I was having all the trauma memories come flooding in and assigning them proper context for the first time (naming them as abuse/neglect/manipulation/etc.). That gave me hope.  Now when hard things come up or happen in the present I notice that it doesn't rock my world as badly.

I guess what I'm trying to say is... I know what you're going through is hard, it really sucks. You're not alone. And if you stay committed to not living in dissociation then it CAN get better.

Dissociation can be our friend, we just can't live there. It's a defense mechanism for a reason! I'm sure it's kept me from ending my life in the past when I felt I couldn't be alone with my thoughts. For instance, descending into a Netflix binge gave me some time to catch my breath and slowly pick apart a situation with my npd mom without having to deal with it 24/7. We just can't stay there or it stops serving us and starts running our lives!!

I don't know you at all, and haven't read any of your other posts so can't even offer an  'educated' guess, so I certainly can't answer this question for you.

An unstable therapist is in the position to do a lot of damage to their patients. That said, I believe you can choose to focus on treating things that are largely not trauma-related.

I do think that your experiences can be an asset to you, potentially making you more empathetic and observant. My therapist was abused as a child. I do believe that her background has helped our work together. But she did her own work before she went back to school to be a therapist. Now she's as steady as they come.

If you have a lot of unresolved issues, maybe now isn't the time... If you have the desire to help others, maybe look for a career that allows you to do that without going as 'deep' as therapists do. A starter career that can let you get your feet wet in a helping profession, and pursue therapy later in life if you still feel the call?

Hey Anna, thanks for the advice. I think you're absolutely right about exercising caution and seeking to be wise in discerning whom to trust with such sensitive information. Thank you for the reminder.

I tend to be someone who doesn't share anything personal, so I'm having trouble finding the middle ground between the extremes!

Those are excellent questions!!! I agree that these things should take time, but I have to say something for anyone to get to know me. I think a little 'forcing' is going to be required (with safe people, of course) or I'll stay silent forever. There's never going to be a right or perfect time to break the ice, I'm going to have to do the hard thing even though it's painful and uncomfortable.

Thanks for sharing, sanmagic7. I got a dog a few months ago and have been considering training her for service work.

This site has a lot of helpful information if anyone is interested:
http://www.psychdogpartners.org