topic Struggling with therapy in PTSD and trauma

Struggling with therapy

Rupes79 — Sat, 10 Jul 2021 23:41:43 GMT

Hi All,

I started therapy a few months ago to work through a fairly traumatic life event. Leading up to the therapy I was functioning quite normally but I wasn’t happy. My psychologist diagnosed me with mild depression.

About six weeks ago I started getting very anxious before each session. I would drink too much alcohol in the days leading up to therapy and it was occupying all my thoughts. I feel like my depression has increased and I’ve had to double the dose of my medication which has horrible side effects.

I cancelled this weeks session because I was simply too worked up and distressed to go ahead with it. My psychologist wants me to continue as she thinks we are making progress but the more I think about it the more anxious and depressed I become. I’ve been thinking suicidal thoughts and I am not really sure of the difference between thinking and acting on suicide. I don’t want to talk to anyone I know about this for fear of alarming them but I am a little worried.

Any advice would be appreciated.

Cheers

Adam

Struggling with therapy

Sophie_M — Sun, 11 Jul 2021 00:05:12 GMT

Hi Rupes79,

Thank you for sharing your story with us here. It takes a lot of courage to reach out for support, you also never know who will read this post and feel less alone in their own experiences. We are so sorry to hear that you have been feeling anxious and having suicidal thoughts. We understand that this must be very overwhelming for you, please know that you never have to go through this alone, and support is always here for you.

If you would like to talk to someone we would recommend that you get in contact with the Beyond Blue Support Service. They are available 24/7 by phone on 1300 22 4636 or on Webchat 1pm-12am AEST on our website: www.beyondblue.org.au/getsupport  One of our friendly counsellors will be able to talk through these feelings with you and can offer support, advice and referrals.

We also strongly urge that in overwhelming moments you get in touch with our friends at Lifeline (13 11 14) or the Suicide Call Back Service (1300 659 467).

Please feel free to keep reaching out here on your thread whenever you feel up to it

Struggling with therapy

Guest9337 — Sun, 11 Jul 2021 03:57:40 GMT

G'day Rupes79,

Welcome to the forums here on bb, it's a good and safe place - hang around whenever you like.

I've been through trauma too, and though our experiences were unique, I have no doubt some of it will be shared.

I see working through trauma like the following metaphor.

Working through trauma is a mathematical optimisation problem. I'm aiming to do just enough work to make progress, but not so much work that I am retraumatised. The work being thinking/feeling/acting/speaking about trauma.

So yeh, we will sometimes be highly motivated to push hard up against the trauma memories, and other times we will be anxious/tired/stressed/(something) and want to avoid memories/thoughts/feelings of the trauma.

All that described, and more or in between too are perfectly valid feelings of our experience.

One role of the sessions is for you to discover where you are to be conscious about it whilst also noticing ones feelings.

Have a time defined, well deserved holiday and then get back on the bike mate.

How long do you want off from "working through it"? Once you've got that number, book an appointment for just after it.

good luck.

Struggling with therapy

Rupes79 — Sun, 11 Jul 2021 05:17:04 GMT

Hi david ‘n’ goliath

Thanks for your kind words and advice. I like your metaphor around the mathematical equation and doing just enough and not too much. I think what I’ve inadvertently done is push too far ahead, or perhaps my psychologist has pushed me too far.

So the question becomes how do you find that threshold where you’re able to work on it without it making things worse?

Im not sure whether to continue with the existing psychologist or start again with someone new? I feel a bit disappointed with the current one but also not sure I can bear starting again from scratch with a new one.

thanks

Struggling with therapy

Guest9337 — Sun, 11 Jul 2021 06:13:29 GMT

"how do you find that threshold where you’re able to work on it without it making things worse?"

Gather data through observation of oneself and accepting OR rejecting others stated observations about oneself. Metacognition. Thinking about thinking. Thinking about feelings. Feelings about a feeling.

Here is a metacognitive question, not actually a paradox : Are we comfortable being uncomfortable?

Like for example ur not sure whether to continue with existing psychologist. Well from a mathematical optimisation metaphor - that's like doing part of the problem and throwing the paper away, and starting afresh, might be useful or not. In an exam situation we never throw anything we've done away, might get points for it, but in "real" life, sure we do discard stuff.

We could infer that ones current psychologist has already gathered (x hours) of information about you and is closer than any other psychologist towards optimising the solution of working through trauma. So data wise, he/she is closer than anyone else except yourself to a solution i.e they've got some data no one else has. For now I assume all Psychs are the same, just to simplify this part of the metaphor, but we recognise that there is some truth in the idea that one psych may actually be better suited to you, than any other psych.

Do you want to re-tell those parts of your story to a different person?

or Would you prefer to continue telling your story to the current psych?

The re-telling has a cost as well we note. Fracking hurts just about every time we re-tell the trauma, hurts just to think about it!

So we use our emotions to guide us by examining each of the options presented before us.

To yourself > Which option feels like it will hurt less? 1. Doing nothing. 2. Sticking with current psych. 3. Moving to unknown psych. 4. Alternatives...

So with that question we are using our feelings to guide our thinking. Well we can flip that too...

Which option do you rationally/logically think will hurt you less? 1, 2, 3, 4...

Then you've gathered quite a bit of data about yourself and you'll be closer to your answer and how you feel about that answer.

Then act, book the next appointment, because psychologists are trained in metacognition, it is a field of study for them. OR maybe continue to give yourself a holiday OR ...? But sometime eventually action is needed more than avoiding thought/feeling, you know that already, trauma must be worked through.

im still here mate,good luck. word countgone

Struggling with therapy

Rupes79 — Sun, 11 Jul 2021 08:25:06 GMT

Thanks mate. Very wise words and very helpful. I’m not sure if your questions were rhetorical or not but my thoughts as per below.

Doing nothing = less hurt but I’ve done nothing for 7 years and been unhappy

Changing therapists seems like too much work

Going back to current therapist is too painful at the moment and creates the most hurt.

I think I need to take your advice about having that break. Pulling back for a moment and building back up my strength. Just need to get myself out of this up and down cycle I am in at the moment. It is quite debilitating.

Thanks again.

Struggling with therapy

Guest9337 — Sun, 11 Jul 2021 09:02:37 GMT

Yo, I'm still here.

So, I'll give ya a bit more info hey. A projection into the future...

Eventually avoiding the trauma itself causes trauma, the act of repression of the feelings/thoughts associated with trauma pushes our body to respond physiologically. Apparently the longer we avoid thoughts/feelings about trauma, the worse our physical health gets, perhaps even our mental health deteriorates.

We may find ourselves even less able to work through the trauma because we are less healthy. If that happens extremely I would name it a death spiral down down down. Darkness and ruin are likely down that path.

Some people do work trauma through on their own I suppose, spose it's theoretically possible.

So mate, pick a specific duration for your holiday, enjoy it and then get back to working through it. Looks to me you'll have to go through the entire process again to choose how long a holiday you need. Appreciate all this hard work, we are working through trauma by just deciding how long to holiday away from it.

1 hour?

1 day?

1 week?

1 month?

2 months?

quarter?

Which metacognitively feels optimum? Think/feel then feel/think over each one, then make the decision.

Struggling with therapy

Rupes79 — Sun, 11 Jul 2021 12:37:49 GMT

David is there a definition for trauma? How do I know what I am dealing is trauma?

Do you think having a partner deal with addiction for 7 years and having it directly effect me, without knowing about the addiction for the first 5 years, would create a traumatic experience?

Struggling with therapy

Guest9337 — Sun, 11 Jul 2021 13:15:00 GMT

Hey Rupes79. Yeh there's a few definitions of trauma. Beyondblue presents a few examples on their "Trauma" webpage and also presents a brief about the topic.

One MedicineNet webpage discussion divides trauma up into physical and psychological, and then sub divides each of those into acute trauma, chronic trauma, complex trauma. So acute is exposure to short term, like one shocking event. Chronic is exposure to prolonged traumatic events. Complex is exposure to multiple varied traumatic incidents.

So yeh, being exposed to partners addiction for years could be traumatic, might not be though. Do you think it was traumatic? Another way to think is... Does your ex-partner feel/think being addicted was traumatic for them? Viewing another persons trauma maybe traumatic for the viewer, it's called vicarious trauma i think.

How do you feel about the addiction?

Where you traumatised by their hiding/lying about the addiction? Did you loose faith in other people, because of what the partner did to you?

Do you feel disgust, remorse, guilt or other unpleasant feelings when considering the relationship and partners addiction?

Because feelings is what psychological trauma is about, one person might find having swear words used against them as traumatic, another person might find it normal, and yet another person find it funny incoherent nonsense.

We all react to events uniquely/differently.

Struggling with therapy

Rupes79 — Sun, 11 Jul 2021 13:31:48 GMT

Hi david ‘n’ goliath

Thanks again for your reponse. It’s not actually my ex-partner. We are still together. I stuck by him as I loved him and I was all he had. If I’d left him I’m sure he wouldn’t have survived. He tells me so all the time.

I actually think I suffered more from his addiction than he did. He agrees with me on that. He’s a lot stronger than I am but even allowing for that I probably wore more of the pain.

Do I feel traumatised by it? I think the answer is yes. Had the question been asked of me 6 months ago I would have said no but when you start digging through it, having suppressed it for so long, you realise how much you suffered.

Its taken both a physical and mental toll on me. I’ve had very debilitating physical symptoms brought on by stress as well as frequent anxiety attacks and more recently depression. Looking back my mood has been low for some time and I cannot recall being happy in the last 7 years.

There are certain behaviours that have become ingrained and I cannot change them. I’m suffering from a mild form of OCD as well. This is what I am working through with the psychologist (or was until recently).

I have triggers that take me back to the worst times. Even the mention of certain words by people (innocent everyday words) fill me with dread and a desperation to change the topic of conversation. If this addiction is raised in any context I immediately shut down and become fearful my/ his secret will somehow be exposed.

I will look at the definitions on the website but when you are a relatively normal functioning human being and have this part of your life forever hanging over your head you cannot shake or move on from that creates resentment and fear and still drives my behaviour to date then yeah I guess I would say I feel traumatised by it.

Struggling with therapy

Guest9337 — Sun, 11 Jul 2021 14:40:23 GMT

You are most welcome Rupes79!

Love can transmute much trauma, I imagine you are proud of sticking with your partner through tough times. I have a certain pride and satisfaction about my own commitment to my marriage vows, in this for better or worse, in sickness or in health etc.

I'm just looking at your posted time line... (time is the variable I focus on here for you.)

7 years in relationship. 5 years not knowing of partners addiction, 2 years knowing, last few months of therapy, 6 weeks experiencing anxiety re therapy, drinking too much over days, cancelled recent therapy this week, and quite a few posts on bb and with me today.

Would you edit any of my last paragraph, adding, subtracting, changing anything there focusing on duration and/or time? A timeline.

One standard for holidays is 4 weeks a year. Maybe if you've been silently repressing your feelings/thoughts about the trauma for 2 years, then actively worked at it for a few months but started drinking say about 6 weeks ago. Maybe 2 weeks holiday away from it, through to maybe 2 months for an extended holiday away seems to me a reasonable estimation of the possible duration for your holiday.

But if you are thinking/feeling about it on your own during the planned holiday > are you ruminating or working through on your own, does it feel beneficial or do you think it's beneficial?

Cause if you are still thinking/feeling too much unpleasantness unsupported, you may well actually be better off seeking professional help sooner than later... but it can take quite some time for the psych to have an appointment available so... things are complexifying quite rapidly.

What if you delay so long you take up drinking every day, or every hour?

People do form "maladaptive" coping techniques as a reaction to trauma. I presume one doesn't want to become an alcoholic to avoid working through ones trauma! Alcoholism increases trauma I reckon. I suppose it is theoretically possible one could lower ones inhibitions by drinking alcohol and thus possibly open oneself up to such feelings/thoughts, but how much alcohol would be optimal for that, idk? Seems a slippery slope down down down again. Alcohol is a known depressive.

Becoming addicted (to something) oneself, as a response to ones' partners addiction. Nope, that wouldn't be good hey?

Crikey this is heavy stuff, I'm glad I have the tour de france on. I have a few more hours in me tonight, so Rupes I'm still listening.

Struggling with therapy

Rupes79 — Sun, 11 Jul 2021 22:34:01 GMT

Thanks mate, appreciate the time you’re taking to respond and help.

Even though I didn’t know about the addiction for 5 years I was still suffering because of it. Probably more so as didn’t know why we were going through what we were.

The drinking is not what I would consider an addiction. I don’t even enjoy it, in fact most times I dread it but there are days where I just have to take my mind away from the awful thoughts and this is the only way I have to cope on occasions.

In terms of the holiday you speak of I’m not sure what to do there. In two minds about how I move forward from here. I don’t want to waste the work I have done but also don’t want to make things worse if you know what I mean?

Struggling with therapy

Guest9337 — Mon, 12 Jul 2021 00:31:27 GMT

Ultimately we put our heart in the right place and then act.

Giving oneself space is part of the process. Goes along the lines of. Do I feel/think better today than yesterday, or last week, or last month? Is the space working for me, does the space continue to feel like its expanding and I'm getting free-er or is the space collapsing inwards making one feel trapped, or being static and unchanging?

The repeated processes of feeling about thinking, thinking about feeling, those metacognitive processes you practice will become more accurate, more able to make a decent estimate of what you need.

So it might go like this... Monday morning I thought/felt about the holiday away from trauma for 5 minutes and came to no conclusion. So I put it aside to go about work/play/ 'normal" life. Monday night I felt/thought about the holiday away from trauma whilst in a very safe place like bed (maybe) just before sleep and still have no decision.

And so on, each day of the week, and with each action of going through that process one comes closer to a decision, or believing that maybe such n such might be a better option, or that one needs to keep going through the processes alone or with help.

Am I delaying because I've given myself a well earned holiday away and I intend to go back, or am I delaying because I want to do it all on my own, or am I delaying because my family raised me up to seek help from only family, or am I delaying to avoid opening an old wound because I'm comfortable with the old wounds pain, or whatever else comes up...

Eventually one may notice all the exact motivations behind ones actions or inactions. Integration may coalesce and apparently that's a good thing to happen.

I don't feel particularly confident about any of that potential advice - I have become strung out from not enough sleep. My thoughts/feelings have affected my sleep, I feel more awake now than 5 hours ago, but I am not confident my awakeness translates into useful thought.

Struggling with therapy

Rupes79 — Mon, 12 Jul 2021 02:07:41 GMT

It’s good advice again mate thank you.

I think right now the holiday is what’s needed but I know it won’t be long and it will be not so much a holiday but avoidance - I am good at this.

I guess I just need to be alert to this and when I catch myself in avoidance phase I start to look for the courage to continue.

Struggling with therapy

topsy_ — Mon, 12 Jul 2021 11:01:53 GMT

Hello Rupes and David

I've been following along & hope you don’t mind a couple of other ideas?

Do you have a GP Rupes? If so, perhaps you could briefly explain the difficulty & get his/her take on it.

Also, if you continue with the same psychologist, could you maybe space out the appointments to have more time in between. So instead of fortnightly for example it could be every three weeks or every month. This could give you more recovery time. Time to consolidate yourself with time to spare before you have to face up to going again.

Whatever you decide, I wish you all the best, T.

Struggling with therapy

Rupes79 — Mon, 12 Jul 2021 11:38:48 GMT

Hi Topsy,

Not at all, thanks for sharing.

Re the GP he’s great and I’ve been seeing him for over ten years and we have a great relationship but I’m not sure he’s able to offer too much advice in this area. I don’t think it’s his speciality as valuable as he is to me.

I was speaking with the only friend I have shared any of my issues with (he has a counselling background) and his thoughts were maybe I need to devote a session or two to getting on top of the depression first. Regain some strength and stability before I embark on treating the issue I set out to resolve.

It sounds like good advice to me and I thought of raising it with my psychologist but don’t want her to think that I am trying to take over.

I might bring it up on my next session and see what happens.

Any thoughts are welcome and appreciated.

Thanks