Question about Psychotherapy.

[Esmeralda]

Hello,

I am pretty sure that what I have been suffering from all my (adult at least) life is CPTSD. I realised that when I came across info about this condition a few months ago and it was a big deal for me. I spoke to one GP about it (a locum doc) but she had never heard about it. By chance I had an appointment with my usual GP a few weeks ago and I mentioned it again. This time the doctor knew the condition and agreed I might have it and she referred me to a psychiatrist to make the possible diagnosis as the GP was not in position to make it.

I have no idea how long it will take before I can see a psychiatrist and I'm a bit worried that I won't get the diagnosis as it is such a new diagnosis in the medical world apparently. But I am very excited (among other things) that I might finally be on the road to getting the right diagnosis and treatment. Here I'd like to ask if anyone knows how likely it is to get a CPTSD diagnosis and the right treatment for it in the UK on the NHS?

Meanwhile, I have just been offered psychotherapy as I was on the waiting list for several months. I think it is psychodynamic psychotherapy. I did a short research and read that it is not recommended for PTSD (but no mention of CPTSD).

Would it be useful for me to start this psychodynamic psychotherapy now? Or wait to see a psychiatrist? Would psychotherapy be useful or a waste of time?

Thank you.

[Sceal]

Hello Esmeralda,

I know there are a few people in here who's talked about NHS, maybe they can help you out more in relation to that.

I just want to tell you that CPTSD isn't yet an official diagnosis - by that I mean it doesn't have any diagnosis codes. But there are talks that it will be included in the new ICD system that will (hopefully) arrive in 2018. The good news is that UK uses ICD as their diagnostic tool rather than DSM-5.

As for treatment, I think it varies from person to person which ones they respond best with. I would advice against digging into your trauma's on your own and before you're stabilized. With stabilized I mean in no immediate threat, or too high levels of consistent anxiety, doing alot of SI and so forth.
I've personally mostly done CBT, anxiety treatments and I am now doing DBT. So I have no direct experience with psychotherapy.

[sanmagic7]

hey, esmeralda,

i echo what sceal says about c-ptsd and therapy.  there are so many types of therapy, some of which are more attuned to trauma resolution than others.  i also believe that the relationship with the therapist is of prime importance.

different aspects of psychotherapy can help with different aspects of c-ptsd, but sometimes they will only go so far and no farther, at which time switching therapists is often the answer.   ideally, a therapist versed in complex trauma will be your best bet.  however, until you find one who is a good fit, a sensitive, caring therapist can be of extreme value, especially if you are new to knowing about c-ptsd.

i think that psychodynamic psychotherapy can be helpful and productive for you, for as long as you feel it is.  if it were me, i would give it a shot.  if it doesn't feel right, or you don't feel comfortable with the therapist, you can stop and go for someone else. 

now, i'm talking about how it works here in the states - i don't have experience with nhs.  we don't have waiting lists here, so it might work differently if you quit one therapist and want another.  that being said, please take my thoughts and see how they work for your situation there.  best to you with this.  big hug.

[Esmeralda]

Thank you so much for your replies, Sceal and Sanmagic.

From what I've heard it is so much easier to get therapy or counseling in the US than in the UK, unless you pay for it yourself.

I had to wait 10 months since the moment I was referred by my GP but the good news is that the lady who called and offered me an appointment said that if I couldn't attend at the time she was available (only one slot in the week) I could stay on top of the queue and wait for another therapist to become available.

As for the diagnosis, I know that the condition will be "officially" present in the medical book in 2018 but it is now in the process of being included, so it seems that the NHS professionals are getting informed about it already. The first time I heard about CPTSD was when I had a look at the NHS website, so it is already included in the NHS list of diseases.

Like I said, one GP I talked to hadn't heard about it but the other knew. I just hope that the psychiatrist I am going to see is also informed.. Not sure if there is any specialised treatment available yet. The diagnosis in itself would mean a lot to me if I got it.

Thank you again for your advice. I will go to the initial appointment with the psychologist and see how it goes.

Has anyone else here been given the diagnosis of PTSD by a relevant professional?

[Sceal]

I got mine diagnosed officially last year by a psychologist

[Eyessoblue]

Hi Esmeralda, I too am from the uk and got my ptsd diagnosis a year ago although I know it is more cptsd but because it's not on the dsm it can't be diagnosed. I've been really lucky through the nhs and have had on going help and support including counselling, Cbt, psychotherapy and EMDR. The EMDR has been life changing and I totally recommend it for cptsd if you get offered it, it's made me re process so many bad memories and I've cried like I never have before but felt comfortable in doing so where normally I try to suppress everything, with EMDR it just all comes out but it is a very exhausting process and can leave you a little on edge for a few days, but long term it's very effective.

[Esmeralda]

Thank you for your replies, Sceal and Eyessoblue.

It is encouraging to read about people who had a disgnosis and helpful treatments.

However, I made a typo (not sure how since I paid attention).

I wanted to know if anyone on here has actually been diagnosed with CPTSD, not ptsd. It seems to me that the two are very different things, even though the symptoms partly overlap. Yes, the condition called ptsd has been recognised in medicine for a long time and almost everyone know about it, while CPTSD is so new and unheard of.

Like I wrote, my GP was aware of the condition and she specifically referred my to a psychiatrist to see if I can be given this diagnosis, so it would seem that the diagnosis is already in use? I haven't heard from the psychiatrist yet and I am waiting impatiently.. If it turns out that I won't get the diagnosis I will be very disappointed.

So again - sorry for the mistake - anyone here with an "official" diagnosis of CPTSD?

[Eyessoblue]

Hey, no I won't get a diagnosis of cptsd , as it's not under the dsm5 which is the proper diagnosis psychiatrist book in the uk it has to be officially diagnosed which I believe it won't be until next yr? So although we all know we have this as there is no yet official diagnosis, it  can only be diagnosed as ptsd, that's what I've been told by my psychologist in the uk.

[Sceal]

When I was diagnosed by my former psychologists he told me there are 3 stages of PTSD, and he explained them in brief and then asked me which one I thought I fell under now that I knew that I had PTSD. I also knew I have some other diagnoses so I thought I had comorbid PTSD, but he said no. He said I got cPTSD. I didn't really get much info after that about what it entailed, I didn't really ask either. I had enough on my mind at the time. So, as far as I'm aware that is my official diagnosis.

[Esmeralda]

So I've had two sessions of psychotherapy and so far not so good.

The lady does not seem to "get" what I'm trying to say. She is young, possibly inexperienced.

The first session was ok but what happened was that I was mostly talking, trying to tell her as much as possible, in more general terms, about what my problems were. I also mentioned CPTSD and she said she knew what it was. In the end she told me that she was sorry I had been through so much and that she was impressed by how resourceful I was, which made me feel good as I am desperate for validation, having grown up with a NPD parent.

But the second session, yesterday, felt like a waste of my time. The psychologist "jumped" on something I said which wasn't very important to me and asked me where I thought it came from (in my past) and I told her about my mother, then she asked more questions about that and she was very focused on my anger about that, which is not my main issue.

Then it was the same - I was opening up, telling her how I felt "inside" and her responses made me feel that she really couldn't put herself in my shoes and relate and truly understand me. She was trying but it wasn't happening. I would say something, try to explain my emotions, and then she would sum it up in a way that did not resemble the way I felt. I would talk for a while and when I stopped there were long silences and she was just looking at me, which made me feel slightly uncomfortable and irritated.

She seemed lost. When I tried to correct her understanding she finally said that whatever she suggested I was saying "no, no, no", as if I thought there was no hope for me, and again it was not how I saw it from my perspective. She made it sound as if she couldn't help me because I was blocking all her ways of helping me. She kind of asked me at some point what we should do and I said she was supposed to be the one with the ideas and she replied that it was a huge pressure on her.

She also surprised me by summing up what she thought I was saying as "My life has always been crap, is crap and will always be crap". I have encountered several therapists in my life and all of them were polite and well-spoken, I wouldn't expect a therapist to use this kind of vocabulary.

In the end she apologised for having sounded like I had been doing something wrong during the session.

As per description of psychodynamic psychotherapy, she tried to ask my questions about my past to link stuff rom my past to my current problems with the aim of making me understand more about myself and in this way make changes to my current situation but I told her that I know and understand where my problems come for but I don't know how to change things as I am not in control of them (e.g. flashbacks ect).

Am I off for feeling that I did not gain anything from yesterday's session? I left the session feeling unsettled having talked about painful stuff, but not having made any progress and it felt like pointless upset.

[sanmagic7]

i've had some of the same feelings with my new t, who is supposedly a trauma therapist and said she's heard of both c-ptsd and alexithymia, but there have been several times when she's mirrored back to me what she thought i was meaning by what i'd said, and it wasn't what i'd meant at all.  so, i hear you on that.

i have no name for the type of therapy i'm undergoing, but it seems directionless to me.   i have to admit that it seems like i'm crying less than i have, which is one of the concerns i went to therapy for.  i've seen her twice, and had phone sessions twice.  the second session i confronted her about the uneasy feeling and ef that i experienced after the first session.

i'm going to give this a few more tries.  it just doesn't feel grounding to me.  may i suggest that you talk to your t about your concerns, see what she says.  after my first session, i wrote it all down in my journal, and read it to her.  that worked pretty well for me, instead of trying to remember all i needed to say.

best to you with this.  know that you're not alone, esmeralda.  the whole therapy field is experimental for us as clients, whether it's working for us, whether the t is a good fit for us.  please remember, you cannot do therapy wrong. 

i hope your t gets on board and does some research.  i hope mine does as well.  already, i've felt like i've been teaching her about some stuff where she doesn't have a clue.   we'll see.  sending a hug filled with clarity and strength.

[Esmeralda]

Thank you so much for sharing your experiences with me Sanmagic7 and for your encouragement.

I had my third session today, just a couple of hours ago.

A few days earlier I saw my GP who printed for me a copy of the reply she received from a psychiatrist, to whom she had referred me for diagnosis. The psychiatrist wrote that she would not offer me an appointment as I have started psychotherapy and the psychologist I'm seeing can "assess" me for C-PTSD and treat it.. She (the psychiatrist) also wrote, quote: "complex PTSD, which is quite similar to Borderline Personality Disorder". I have no idea why she mentioned that but it made me feel that maybe it was a good thing that I would not be seeing this psychiatrist.

It is extremely worrying for me that a consultant psychiatrist would automatically associate C-PTSD with BPD, for no apparent reason. I would find it distressing as a person who was abused by a parent with personality disorder to be disgnosed with a personality disorder instead of being recognised as a victim of one..

Because of that expression my T (psychologist I just saw) mistakenly thought that I had been diagnosed with BPD until the very end of the session when the misunderstanding came to light..

Anyway, I brought print outs of info about C-PTSD to today's session and read to my T all the info I thought was important and relevant. We also discussed the important of having the right diagnosis for me (it is very important for me indeed and I am anxious that I won't get it). Apparently, she cannot give me a formal diagnosis and it has to be a psychiatrist!! But she said she would think about the possibility of a diagnosis and I think she said she'd speak to someone about it (although I'm not sure I remember that correctly).

So yeah, I had to teach her about C-PTSD apparently. At least she said it was a good thing that I'd brought all these materials to  my surprise as I had been anxious and uncertain, worrying if it would be inappropriate.

However, the therapy also seem directionless. I read to her that there are recommended stages of therapy for people with C-PTSD and the first one is stabilisation, but she did not seem to offer anything like that.

Now I am feeling very stressed with physical symptoms occurring strongly. I am struggling to breathe..

Yes, the whole therapy field for C-PTSD sufferers seems experimental, chaotic and not established. It seems that I have to fight for the right diagnosis and treatment in some way.

Thank you again.

[Sceal]

Hello Esmeralda,

You write that the psychiatrist said that c-PTSD and BPD are quite similar. I have to say I'm not surprised why the psychiatrist said that, from what I've noticed is that alot of people who have c-PTSD as a result of traumatic events happening in childhood and teenage years have been either misdiagnosed with BPD, or have both c-PTSD and PD of some sort.
My understanding of PD's are that they are usually devellop during teenage and young adult life as a result of unstable upbringing in one form or another. Sometimes trauma, sometimes other things.

But similar doesn't mean it's the same thing.

I think it's great though that you've educated yourself on c-PTSD and it's a brave thing to bring what you've learned along to your T. Sometimes it's a bad fit, but sometimes the T just needs to learn alongside us as well. Maybe you bringing this to the session will encourage her to further look up on research in regards to PTSD and c-PTSD and also ask her colleagues for help and guidance.

I've also often felt that the therapy in stabilisation -phase is very directionless. I often have to return to this phase of the therapy, and it's frustrating. Both because it feels so slow, and because it feels as if I have to start all over again at the beginning. It's no fun. My only advice to you, is to bring up your concern to your T that you are feeling it's directionless and it would be nice if you two together could make a plan for the next few sessions. And also to be kind with yourself and try to be patient. It's hard work, but you can do it.

Of course, if you feel unsafe with this T, then that's not good at all!

[ah]

Hi Esmeralda,

Re. the psychiatrist equating C-PTSD with BPD... just my two cents, based on very bad personal experience in the past:

There's such stigma surrounding BPD, so much misunderstanding and often ignorance, so if a psychiatrist knows very little about trauma and also about BPD... they can equate the two but it's very mistaken, methinks.

Also if I'm blunt, it seems to me some professionals may be looking for a new fad, something newer than BPD to pin all the same stigmas on, and for some the newer diagnosis of C-PTSD may be it. I hope I'm wrong but from stuff I've read online in several languages, I doubt it. Therapists saying they're specialists in C-PTSD and saying harmful things.
C-PTSD isn't like PTSD so they aren't quite sure what to do with it, but it also isn't like BPD. It's its own thing.

My personal experience with this has been harsh. As a teenager my FOO managed to far too easily get me diagnosed with BPD because I was trying to speak up about the abuse happening to me. Pinning BPD on me was the perfect exit strategy for my FOO, it labeled my as a chronic manipulative liar so no one ever believed me, and they were free to destroy me completely without anyone stopping them.
It destroyed my life, my whole family took my abusers' side and later in life they also made sure my colleagues had the same lies fed to them.

I'm glad you won't be seeing this psychiatrist either. 

It's extremely worrying to me too. I'm 100% with you on this. Couldn't agree with you more, a person who was abused by personality disordered parents being re-traumatized by the psychiatrist in such a way is disheartening. Not because it's impossible to have BPD but because it's victim blaming at its worst, by an authority figure who can stop you from getting help for C-PTSD and send you down a mistaken therapy path.

Be firm when you meet good people, good therapists and friends. Give them the correct info and insist on it. Give them impressive formal written down things you print out so your words will have further weight to them. Where a non-traumatized person feels danger and has a temporary rush of anxiety that then weakens when the danger is gone, for us traumatized people we're living in constant danger because of terror we experienced.
So different.

I ache to think how many people (especially women) have had their lives totally destroyed by a mistaken BPD diagnosis and all of its stigma. And how many of them were abused and not only didn't get any of the help they needed but were also silenced like me.

[sanmagic7]

just as an update to my feeling 'directionless'.  my t told me to stop, basically, that i'd learned and known enough, and i needed to just be for a bit.  there was no history-taking, no questions about what happened, and that all felt foreign to me.  hence, directionless.

but i pretty much have been doing just that, and i'm feeling much better about it.  i think it cleared something out for me, maybe a need to control, but as i've mentioned elsewhere, i now feel as if i'm a magnet and things are coming to me in ways that didn't happen when i was 'pushing' for answers all the time.  it seems better, because it seems to be healing me.

i'm glad you're not having to see that psychiatrist, either.  i've seen too many people on this forum questioning whether they have c-ptsd or bi-polar disorder( which is also different from a personality disorder).    c-ptsd and bpd may have similar symptoms on some levels, but they're very different intrinsically.

i think it's great that you brought the info in for your t.  unfortunately, i believe we oftentimes do have to educate the professionals so that they can better see our needs and understand how best they can work with us for recovery.  i don't believe it's ever inappropriate to bring in pertinent info to the professionals.  i've done it for years, not only in the therapy professions, but medical professions as well.

i hope your t ends up helping you - that's the bottom line.  best to you with this.   big hug.