Mistrust of therapy for cptsd

Started by Rainagain, May 20, 2018, 10:37:15 AM

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Rainagain

I would like to offer my experience as something that might be useful for people to consider, its the reason I am suspicious of therapy but it has a deeper significance to therapy as a treatment for disorder (I think).

My cptsd arose due to my life being in danger and the situation being made worse by my employer.

Now, during the main difficult time I had weekly counselling sessions and I discussed my feelings and what was happening to me.

The counselling went on for almost 2 years, this was the period during which I developed cptsd.

I was under constant threat, my caregiver was undermining me to protect themselves and preventing me from moving to a place of safety. It was a very difficult time.

Counselling did not protect me from developing the cptsd disorder.

If counselling were some sort of cure for cptsd then it should have prevented cptsd from arising, I think.

I suppose I don't have much faith in counselling as a cure because for me it did not work as an antidote or a protective measure like an inoculation against a disease.

Maybe its unfair for me to expect weekly counselling to ward off the harm caused by protracted existential threat.

But therapists are offering their services to help historic trauma, and it doesn't even work as an emergency first aid type measure.

The same goes for meds, I was on lots of them, they didn't prevent my cptsd from developing and subsequently didn't help cure it.

I think the fact that cptsd is a disorder caused by trauma is significant. I and my hind brain were experiencing the stress of threat and so talking things over was little use, I was experiencing trauma vividly and continuously, 40 minutes a week of talking didn't help, but how could it?

Makes me wonder how therapy sessions can help with trauma that went on for years and happened years ago.

I'm not sure lived experience of trauma is available for therapy, it happened, it changed the mind and body and the facts can't be changed or reinterpreted in some sort of non traumatic way to make them less damaging.

I sound negative about therapy. But what I think is that it is unrealistic to expect therapy to help much because the cptsd disorder is such a huge thing.

Similarly, changing some brain chemistry with meds isn't going to alter what has happened. It might take the edge off a little but alcohol is far more effective in that regard, no wonder people have trouble with drink.

The power of trauma seems so much greater than the power of meds and therapy.

I'm wondering what others think, I don't blame therapists or doctors for having a go at repairs. I just think they don't have the tools to fix this problem, its too big.

radical

I agree and disagree, Rainagain.

Firstly, I'm sorry you went through this and that you were betrayed by the very people you shoudl have been able to trust and rely on.  There are no words.

The effects of chronic trauma probably can't be prevented by talking to a therapist while the overwhelming events are unfolding.  Trauma is about our systems' normal coping mechanisms being overwhelmed.  Our stress responses evolved to protect us from brief and discrete crises, like a tiger approaching.  We were never equipped to have this kind of arousal jammed on.  It takes a huge toll on our bodies, brains and minds.  It probably causes pretty significant brain and endocrine changes, and those changes probably make up a big part of why it is so hard to recover from CPTSD.  It's likely to take a whole lot to get the system into 'normal' mode.

I believe the right kind of therapy, with the right person can help, but also that the wrong kind of therapy with the wrong person can make things worse  For most of us (maybe all) betrayal from people we should have been able to trust is a huge part of the problem  It's hard, ( but not impossible) to restore faith and trust in humanity, the world, and ourselves without finding trust with another person. We learn (or don't learn) trust as infants within close relationships and it is as biological as it is, psychological.  We are so relational that eye contact, soothing touch and voices, and attunement still help us calm our overwrought systems as adults.  One problem can be letting anyone close enough.  Good quality therapy can really help with this, imo, both in being genuinely seen and heard, and being mirrored in what we are feeling, and being able to communicate with someone who really is trustworthy and who understands what we are going through.  This can alter our brains and bodies.


It's never going to be the whole or the only answer, though and there are many other ways of working with our frazzled biology.


As to drugs, there are some drugs that can drastically increase neuroplasticity and can therefore go some way to repairing the loss of connectivity between networks and also regenerate neurons.  The loss of both are very likely to be a big part of the CPTSD jigsaw.  Other things like exercise, social contact and pschotherapy can also increase neuroplasticity.  I also believe that it is understandable for us to turn to meds to take the edge off the pain and to get through the days and to sleep at night.  I wouldn't judge anyone for taking analgesics for physical pain. It's all about informed choice, imo.

Having said that, my own experience has been that much of both the therapy and the medications I've taken over the years were counter-productive.

ah

#2
Rainagain,

I agree with Radical this is a complicated question, and there's probably no 'right' answer. There are so many different types of therapy, client, situations and people.

You got me thinking. Not sure this will help, but just in case it makes sense to anyone else (you and me included):

I think it might depend on whether you're in danger now, or processing the consequences of danger that's already passed.

I totally agree with you therapy has its limits, especially with circumstances. Talking about an existential danger that's out there, objectively in your life, just talking isn't enough. It's partial at best. If you're in danger now and you can neither run or fight, you may have cptsd in the making because the cause of the trauma keeps hurting you. Circumstances keep hurting you.

Once circumstances are changed but the trauma is left behind... then therapy can do a world of good, I think, working on one's inner world and what that hurt left behind.

I relate very much to what you say, especially re. my physical health. People keep confusing circumstances with interpretation of circumstances, in my experience. It's so prevalent I've stopped trying to share anything. Often people want to believe suffering is a bad mood, abuse is a fight, violence is a disagreement, helplessness is pessimism, unhappiness is weakness, 'etc... :whistling: But you were in danger. The danger that caused your cptsd wasn't in your head. You didn't just feel you were in danger, you were in actual danger. It was real and it went on.

It may be a bit like treating an ER patient with a broken leg by putting a band aid on the external bruise but sending them home with the broken leg untreated. Possibly?

Also, therapy isn't meant to stop your body from reacting normally and appropriately to its surroundings. Ptsd and Cptsd are appropriate reactions to extremely dangerous circumstances.
All the books I've read about trauma leave me believing protection from that danger, safety, and protection from helplessness are crucial. Well, but all that's in an ideal world but we don't live there, we live in the messy world of things that are out of our control and pain that we often can't avoid.

:Idunno:

Eyessoblue

I'm mixed with this too, Therapy itself just seemed to make cptsd worse but emdr with therapy changed a lot for me, I still need some more but at the moment nhs guidelines are preventing me from doing so , I have to go back on the never ending waiting list which in itself makes me feel worse. Once I'd had emdr tho I had about 13 sessions I could really feel things shifting for me so I definitely wouldn't knock this, but finding a good trauma trained therapist who understands what cptsd is, that's a whole different story! Mine is good but appointments are only 50 mins, she's always late and once a week for 6-12 weeks isn't great but I guess better then nothing!

woodsgnome

#4
Despite the hype and marketing, therapy at its best is more art form than science. Its success or failure rests in large part on a huge sum of variables, ranging from methodologies to the individual background and personalities involved. This has been complicated in recent years by the increasing intrusion of insurance providers and governmental agencies in how therapy is carried out.

Therapy's prospects remind me more of an old buddhist saying about the finger pointing to the moon. The finger doesn't get you to the moon, it just points out a direction (it may not even be the correct one). One has to regard the finger as providing the initial suggestion; then go about finding the actual moon on one's own initiative.

I'll admit I would much prefer regarding therapy as being able to create the fix, but after 20 years of various therapies and therapist/counsellors, I've realized it doesn't pan out that easily.

While I've finally found someone I consider my best therapist, I also understand that ultimately it's still my own trip and at best we're working together to find some way to live out this misery. It took lots of uncomfortable trial and error before I reached that conclusion, however.

Rainagain, you ended your post by observing: "The power of trauma seems so much greater than the power of meds and therapy." Somewhat sadly, I think that's more the rule than the exception.

:hug:






Rainagain

Thank you all so much for your replies.

I'm trying to get an impartial objective grasp of things, my inclination is to think in black and white terms but everything is more complicated really.

I'm no longer in constant obvious danger but my psychiatrist has agreed to leave any further interventions until my court case ends in a year or two -hopefully.

There will always be a slight threat to my life, its reached and past its maximum now and the likelihood will diminish with time, sort of.

Its a continuation of the trauma by other means.

But its OK, its my choice to fight and I'm committed to it.

I'm not ready to look for the moon yet, I'm still struggling with the traumatic situation.

I've mentioned before that EMDR helped me with processing an earlier catastrophic trauma, this later stuff was continuous so might not be possible to use emdr, not sure, will look into it later, maybe.

But thank you for your very thoughtful responses, as a collective the level of understanding and knowledge on here is humbling.

I've had a week or two of being angry and a bit scary to behold, (fast talking, obsessive, restless, just alarming). I'm calming down again now though and trying to think more deeply about things, the hindbrain doesn't do deep thought really.

Ah- neither run nor fight? Exactly, betrayed into that situation for over 2 years. That's what did me in I think.

I know my stuff isn't as severe as many on here, childhood trauma is far worse.

But the effect my lesser trauma has on me is still pretty profound and overwhelming, a video of me when agitated could be used as an advert for what triggered looks like, its almost funny.

Then there's also a video my gf made of me after I've come down through exhaustion, asleep with eyes open, rapid blinking, basically a total zombie, lost time, the whole 9 yards...

Thanks again guys, you rock.

Deep Blue

Quote from: Rainagain on May 20, 2018, 10:37:15 AM
The power of trauma seems so much greater than the power of meds and therapy.

I feel ya Rain. Sometimes the power of trauma feels insurmountable.  We do the best we can to get through it.  I don't have answers either  :Idunno:  I'm just glad I'm not looking by myself anymore  :grouphug:

briasmith12

Quote from: ah on May 20, 2018, 01:16:54 PM

I relate very much to what you say, especially re. my physical health. People keep confusing circumstances with interpretation of circumstances, in my experience. It's so prevalent I've stopped trying to share anything. Often people want to believe suffering is a bad mood, abuse is a fight, violence is a disagreement, helplessness is pessimism, unhappiness is weakness, 'etc... :whistling: But you were in danger. The danger that caused your cptsd wasn't in your head. You didn't just feel you were in danger, you were in actual danger. It was real and it went on.


This is inspired, Ah, and great insight. May I quote this on another site?

Quote from: Rainagain on May 20, 2018, 11:35:33 PM

I know my stuff isn't as severe as many on here, childhood trauma is far worse.

But the effect my lesser trauma has on me is still pretty profound and overwhelming, a video of me when agitated could be used as an advert for what triggered looks like, its almost funny.

Then there's also a video my gf made of me after I've come down through exhaustion, asleep with eyes open, rapid blinking, basically a total zombie, lost time, the whole 9 yards...

Thanks again guys, you rock.

Rain,
I don't know how much severity has to do with it.  Trauma is trauma, and especially if you were dealing with PTSD (or similar) due to a previous situation, the prolonged situation compounds and builds and then you find yourself where you, unfortunately, are now. Both can be crippling. I find myself unable to work more than p/t (and even that is exhausting) due to prolonged and varied childhood traumas, whereas previously I could work 60+ hours a week to avoid life. I was triggered by a violent situation at my work where I had to escort an incredibly angry person out of the building for the safety of others. I dissociated during the entire thing. I barely remember it. Then a few weeks later I was witness again to a violent situation between customers. But that has led to an accelerated spiral and I've hit the lowest I've been in months/years. I was coping, albeit badly, before the most recent incidents, the first being life-threatening, and even though my meds have been doubled and I've gone through loads of CBT and MBSR, the trauma is far greater than any help could be right now.
I suppose my point is that all of it matters. Trauma is trauma is trauma. CSA is not worse than DV, it's just different. Different triggers, different therapies, different impacts on life. TBH, this time around I'm not looking for grand solutions or healing. I'm looking for a way to just get through the day. Sometimes, that's all we can do. :hug:

Rainagain

Such thoughtful posts on this thread. Wanted to add some more information.

I have been told my counsellor was wrong to undertake general supportive chat therapy whilst I was in such extreme conditions, I should apparently have been referred on.

But even if that's right it doesn't undermine therapy generally, just my poor experience.

The meds didn't help prevent deterioration, subsequent meds haven't helped either. But they don't work for all people. That doesn't mean they don't work at all, just didn't for me.

Its a personal subjective experience, trauma and recovery (or not).

My black and white thinking and my personal experiences are exactly that, an individual situation which has to be seen as that.

What is more significant is that others report problems with meds, others have trouble accessing treatment or progressing with their treatment.

So my situation is unique, but very similar to the unique situation faced by everyone else here.