Exposure Therapy How it works Advice or others experiences welcome

[Elizabeth CP]

I have started exposure therapy for PTSD. I originally started earlier this year but the lockdown made it impossible to continue. Yesterday the psych showed me pictures then photos, news reports & finally videos. I had to watch the video several times until it stopped causing high anxiety.

I'm supposed to look up similar pictures on the computer at home between appointments. The aim is to become able to cope when I see or hear triggering images or information. Up til now I've been getting worse & then having to escape each time things trigger me which then leads to further avoidance & makes me worse.

I would like to hear others experience & ideas to help me

[ecomama]

Hi Elizabeth

Thankyou for starting this thread, I also have PTSD, maybe C-PTSD, but was also diagnosed with anxiety.

I'm very sorry you've felt distressed. I hope things work out for you with this therapy!

Today, my 3rd session was via zoom for the first time. Sessions 1 & 2 were via phone so I've never 'met' her.
My specialist trauma psychologist (STP) started a little "exposure therapy" with me today.

My STP intends to do "prolonged exposure therapy" with CBT once we can meet in person in July, with the approval of my Counsellor who I've been seeing for around 4y. I'm sure my counsellor will agree.
Do you think prolonged exposure therapy and simply stated exposure therapy are the same thing? I get the feeling they are not.

STP said I did well in self-settling after mild exposure today. SO she gave me huge homework to do which she explained is exposure therapy in itself. I'll have to set aside a few hours to write it all and then to do some grounding & self-care after.

She aims to have me be able to "Journal" myself through any future exposure therapy should needs arise at a later stage. Or between sessions soon.

Homework: I'm to write about an action I'm avoiding & describe precisely every thought, bodily sensation, everything... so when she reads it, she can feel what I'm going through. Dealing with the trigger itself, providing reasons why these reactions occur and "filing" the memories to have zero emotional attachment are the aims.

She described prolonged E.T. as extremely challenging. My triggers are experiential, past IRL events. She intends to take me back to the event, for me to relive the entire event, then to teach me how to deal as above. There are many such events for me but she feels confident that prolonged E.T. with one event may enable me to generalize the newly learned responses to cover several. Many events were of similar "type".

The broadest aim of hers for me is to not avoid ANYTHING I want to do because of the traumas / previous triggers. To be free of them. She thinks we can achieve this - we'll see lol.

I understand that "effective" therapy for PTSD and C-PTSD is stated to take between 20-30 sessions then lifelong support (cited - Blue Knot Foundation).

It seems like your E.T. is slightly different in format also maybe the triggers you're having are different in "type" than myself?

Maybe our psychologists are "tailoring" programs due to our specific needs. I hope so! What do you think?

EM

[Elizabeth CP]

Thanks for your reply. I'm unsure if there is a difference between exposure therapy & prolonged ET. I think prolonged ET reflects the length of time expected to achieve the aim.

I think the psych needs to tailor the therapy to the individual. In earlier sessions I was asked to explain what had happened in detail. This also entailed learning strategies to calm myself down when my anxiety rose too high. He also tried to help me reframe my thoughts about what had happened to me. There is a lot of guilt feelings & poor self worth linked to my perception of how I acted during the trauma. Subsequent events reinforced this thinking.

We moved on to being exposed to related photos news reports & videos because I'm being increasingly triggered by people mentioning things or seeing things on the TV or elsewhere. Rushing out of church or other gathering because I've been triggered is embarrassing but just escalates the situation. Over the last few years I'm being triggered by things which previously was fine & knowing I'm safe & trying to tell myself that this trigger has nothing to do with trauma for me or others just makes me feel stupid for reacting like I do. My psych tried showing me different things of increasing levels of confrontation to gauge my reaction and then help me to cope effectively. I imagine for other forms of PTSD this would not be appropriate.

I think you goal of not avoiding ANYTHING you want to do is worthwhile. In my case I need to work out what situations need to be avoided because of their danger. Other things I need to learn to manage so I can take appropriate steps to avoid harm without avoiding the situation totally. I was caught in a bushfire as a child. Our home was burnt to the ground & we had to walk out through burning bush to escape. It isn't appropriate to learn to cope in a real bushfire situation but I want to be able to visit places & do things I enjoy in the summer when there is no real danger rather than avoiding things in case I am triggered.

[ecomama]

Hi Elizabeth

You don't have to share anything you don't want to or are triggered by. I hope nothing I write triggers you. HUGS!

I understand with PTSD triggers seems to "grow" exponentially and spread to others... mine skyrocketed 'out of control' about 4-6 weeks ago. That's how I described them at the time.

It seems to be this way ie out of control, until I can do MORE than identify them.

My psych pointed out yesterday that I need a cognitive / 'reasonable' explanation of them eg their LINK to the trauma and which trauma, moreover WHO caused the trauma. So she is listing the base of the trigger... eg exH or mother etc.

Then the exposure therapy and later the prolonged E.T.
Settling strategies.
Then "filing" these and snapping the emotive connection.

It's incredible that you survived the fires as a child, I'm very sorry for your trauma and losses.
Our home was set on fire by arsonists when I was a child, we are lucky to have survived. But did.

Fire is not a trigger / trauma for me - not sure why or I could be dissociating IDK.

Have you been able to identify all that triggers you?

I'm trying to rationalize my fears of doing this therapy by reminding myself that living WITH the triggers and ensuing dissociation is not manageable at all.

BTW it was my psychs goal not mine lol, to not avoid ANYTHING due to triggers, I couldn't have dared aim so high.

EM

[Elizabeth CP]

Thanks EM, Sorry I haven't replied. Things have been busy with husband's appointments, babysitting my daughters kids so she could do some things she really needed to do & several appointments with my GP due to some health issues. My mood hasn't been great &the spike in cases in Melbourne hasn't helped.

I have found your posts helpful putting things into perspective helping me understand what is happening.

My last appointment was postponed because my husband had to go to hospital & I wasn't sure if I'd be free for the appointment because I couldn't guarantee when my husband needed bringing home. My next appointment is next week but now it won't be face to face so I'm unsure whether to cancel as it is too hard over zoom,

[Elizabeth CP]

Just an update to allow me to reflect on what is happening. After restrictions eased I was able to see the psych face to face & restarted exposure therapy by watching some videos of fires. Next appointment cancelled because I had to pick up husband from hospital. Then lockdown 2.0 started. I decided online therapy wouldn't work so rang up & got permission for face to face session yesterday.

He read news articles to me. Photos of fires were OK but listening to descriptions of fires impacting people really sent anxiety high. I managed to listen to the articles 3 times with anxiety levels slightly decreasing each time.

I now have homework looking up articles myself & reading them repeatedly until I can manage without going to pieces. I'm surprised how some things don't trigger me too much but other things affect me greatly

[Elizabeth CP]

I drove to see the therapist yesterday. Sat in the car while waiting for the right time.Trying to avoid sitting in the waiting room wearing a mask. Then phone call to say psych was sick so drove home. Next appointment wasn't available for 3 weeks!!!! I had to stop the practise set because my mood & anxiety have been so bad due to the situation in Victoria. Although they are totally unrelated I seem to have fallen into the same very negative thought patterns & unhelpful behaviours re the pandemic as I used at the time of original trauma. This leaves me paralysed to do anything useful as there is no hope. In the original trauma I believed I was going to die so paced up & down waiting for the end.

[Ggrand]

Hello Dear Elizabeth..

Expose therapy is so very difficult, especially when your doing at home as homework..You’re doing a job job Elizabeth....I feel that you can only do it when your not feeling so down...

Ive been doing exposure therapy with my mh supporter, she is taking me into the bigger town to see my Therapist..then instead of going home, she takes me to small cafes so I get used of being around people...A few times I’ve been triggered, other times I’m okay...not sure why...My mh worker noted that I get triggered when there is more then one man sitting and having coffee...

Maybe looking at different fire, some are triggering because the picture is similar to what you witnessed and the others are not....

Re the pandemic..Do you think that the feeling of being trapped and no where is safe..is triggering those negative thoughts again...just me thinking aloud..

Please Elizabeth...Try not to give up your hope..it’s important that you find it and hold onto it....There is hope for the future lovely Elizabeth...this will end..When I don’t know..but I do believe with all my heart that it will....

Im really sorry that your psych was sick today and you didn’t get to see them...That’s okay Elizabeth to stop your homework until you feel up to it..I think pushing ourselves to do things when we are not up to it can be way to challenging for you....Please be gentle with you..You need to care for you lovely lady...and if that means letting the homework wait..then please do so...I’m sure your psych will be understanding...

Here for you Elizabeth if you need to vent or talk here..

Sending you Kind thoughts with care and hope..🌹💜🌈..

Grandy..

[Elizabeth CP]

Thanks Grandy for your kind words. I spoke to my counsellor today by phone (not the exposure therapist) about how bad I've been & the way my thoughts have reverted back to those of the original trauma. It was very heavy going as he asked me a lot about the fire & what happened. I struggled to speak at times because it was so upsetting. He then tried to get me to explain the differences between then & now to try to break the link between them. He thinks my low motivation is to be expected under the circumstances but he tried to make some suggestions for me to try to help. Unsure how I'll go. Today's terrible figures re Covid 19 certainly not helping. All these restrictions which seem never ending make it impossible to do things that normally help.

[Ggrand]

Dear Elizabeth...

I hope your okay Elizabeth, talking to our counsellor can be very hard and we can get very overwhelmed sometimes, I’m sorry that happened to you..

I hope your able to try out his suggestions, only if you feel safe enough to try them...Please don’t push yourself to much to try them...You need to be very gentle with you..

My motivation is really low.. I think because it’s just me here and it’s hard for me to tell me to do things that needs doing..if that makes any sense..

I mostly don’t listen to the news any more..It’s too sad for me...Maybe if you only watch the news every second or third day, it might help to ease any anxiety it’s causing you..I believe that it will end..or fade out in time...Just wish that people did the right thing and follow the new health rules..then it will end sooner..

I hope you manage to sleep well tonight..

Kind thoughts with care..

Grandy..