Post therapy session struggles

[Supermum]

I’ve been in therapy over 18 months after falling in a heap 4 years ago. My psychologist has been doing schema therapy with me and we have been doing chair work etc . The sessions can be very overwhelming and triggering and I struggle enormously with the after effects of these sessions. My psychologist is aware and helping to find ways to work through my difficulties but my time with him is coming to a close as it’s with the public health system so I have to find a new psychologist which is daunting and anxiety provoking and I just feel like I just cannot manage all this on top of the constant reel  of traumatic memories and invasive  thoughts mixed with the guilt and the punishment thoughts it’s just a bit much . Any other experiences like this and ways to deal with the after effects of therapy etc would be helpful 

[Croix]

Dear L~

I'll start by saying I'm not a doctor so my opinions are just based on my own experiences.

You past injuries from abuse are ones that have a huge effect and the therapy you have been undertaking - chair work - is highly confrontational. Not everyone is ready for that for a long time, and entering into it too early may simply make things worse.

The fact the health system allows 12 months is really irrelevant, it is how you are that should be the decider

i have similar experience with an early version of CBT which was highly unpleasant and did me no good. I simply was not ready.

Unfortunatly there is a tendency for some medical professionals to throw back responsibility on the  consumer when it is not appropriate. Therapy is in fact two persons closely engaged.. That does not mean one does not try to take ownership of one's condition, but by oneself it can simply be too big a task as the stage one is at.

This sounds like it what is happening here. OK you have been given some techniques and I'm sure you  have been trying them, however they have not stopped or eased the suicidal thoughts, self harm/punishment, risk taking and use of alcohol.

They may in fact be the wrong tools, or simply given too early and rely too much on your sole efforts.

I'll offer you a tool I use, it's called BeyondNow and is a safty plan wiht a difference. Apart from all the  normal things you would expect, emergency phone numbers etc, it has a section where you enter in things that have pleased you , distracted you - even made you laugh.

This is difficult to do by yourself when down, but builds up over time - particularly if someone else who knows you can help you remember the good things.

See part II below...

[Croix]

Part II

Sorry, ran out of space

When I feel overwhelmed I've no brain power left for making decisions and this app is ideal, just reach for your phone and go through to whatever takes your fancy. Things do have to be specific -a particular song by a particular group for instance -not just 'listen ot music'. The brain may have no room for decisions.

I've built up all sorts of things over time, from YouTube clips of comedians, music, TV shows, books, walking outside wiht the dog, going to see a friend , or even just a cafe. As you build up the list the app becomes more effective.

Healing a deep injury takes time and assistance, and none of that is you fault

Croix

[Supermum]

Thank you :folded_hands: I feel

like I wasn’t accomplishing everything I should in the time allowed . Like I was failing the tasks set before me which just made me feel even worse and worry endlessly causing more stress than I feel i am prepared for.  Thank you for making he feel I’m not failing but just learning with skills learnt . 


I feel like a performing seal sometimes and that if I don’t tick the boxes and achieve what it expected I don’t get the reward !

I have downloaded this app and will use see how it works . Thank you again for being a advocate for my thoughts and feelings x 

Just to add the effects of me not accomplishing all that is expected of me is to make me feel 

worse and punish myself more !? A double edge sword that doesn’t achieve anything. I got told by my psychiatrist that I have now been been given the skills so should be able to use them and why can’t I basically ? That It’s My choice and my decision….. again triggering feelings of inadequacy and self hatred that I can’t do and I can’t just switch these feelings off 

[Croix]

Dear Supermum~

Of course when authority figures such as psychiatrists and psychologists say something you tend to take their word. Similarly if Medicare says a set number of sessions are allowed you tend to beleive that is based on clinical judgement (rather than trying to balance the nation's budget). So you end up achieving less than they say they expect.

It is really the system letting you down, not you failing. Your medical team should have recognized that you were not deriving benefit and should have planned for different or longer strategies you could employ, even if it meant well beyong those sessions. If that is all you could afford then those strategies have to take that into account too - not just be blind to the results of stopping too soon

It certainly took me longer than 18 months to reach a reasonable state of recover, in fact several years.

Frankly those expectations  do more damage than anything. For some unknown reason people that have been abused do blame themselves wihtout  cause -even though there is no justification. You were injured by someone else and it is as simple as that. So when things do not go by a medical  plan it too becomes that subject of self-blame.

Next time you see a psych point out these problem, adverse reaction to therapy  and timescale, then work out a plan together that is realistic!

So have a fish, you are doing OK

Croix

[Supermum]

Thank you once again for your reply and support. 

I feel I have benefitted from schema therapy to a degree as I have more insight into why I feel / behave react the way I do . That it makes sense and is logical, I try to access skills when I need to and sometimes it helps sometimes it’s just to overwhelming and distressing to even direct my brain and actions to access what Im supposed to do never mind do them. 
it’s quite ironic that the MH plan and services that are there to help to you in fact cause more self doubt and self blame than they should when you don’t suddenly become functioning . 

I am a highly functioning person , I work full time as a health professional and still run a household etc etc but secretly I can manage this a this is mostly structured , following policies and doin things that are ritualistic so easy to do on auto pilot

if you will . However if anything changes or there’s drama or things I cannot foresee or control that’s when all

my albeit crap Coping strategies go into disarray . Mix a highly demanding job with stressful work conditions and stress at home etc and it’s a perfect storm . 

My psychiatrist saying I should be managing now is the insult to injury . They opened the box and asked me to work with what was inside then they left at the tip of the iceberg and the start of the journey . I feel abandoned and vulnerable and just want to close the lid and put it back on the shelf . At least burying it was easier ish than dealing with it alone or with limited support . 

I will mention what you have highlighted but I very much doubt it will have any impact . I expressed how I felt which was emotionally led and probably a little too aggressively and got told that this was unacceptable and I’d crossed the boundaries and this behaviour wouldn’t be tolerated . It came from a place of panic and fear and yes in hindsight I should have been calmer but this is what I’m seeing them for ? If I could manage these emotions then I wouldn’t be seeing mental

health professionals ? The irony …

[Croix]

Dear Supermum~

I guess there are a couple of things that occur to me.

The first is one normally in life needs to plan for a worst case scenario. If in the ordinary course of events you can mange because your work is basically mapped out for you that is fine, however if the unexpected happens and you do not feel equal to it then things get very unpleasant. 

Is there any possibility you can reduce the perfect storm of ordinary work plus hi stress work plus stress at home? An obvious thing that may be completely off-track is to reduce working hours.What is your   judgment?

OK so schema therapy can have it's place, but if this therapy and exercises cause you so much distress that you put that emotional and strongly to your medical team then something's wrong.

Apart for assessing on an ongoing basis the effects as well as the progress being made I think they should be robust enough to cope sympathetically with a patient who does become upset telling then how their therapy is making them feel. And listen to what she says.

There is a complete change in mindset between labeling a patient 'uncooperative' or 'crossing boundaries' and thinking that my (the therapist's) choice of therapy is ineffective. One blames the patient, the other allows the therapist to self examine.

Based on what oyu have said I would not find their performance confidence-inspiring. Have you at any stage sought a second opinion?

Croix

[Supermum]

I don’t know how to feel about what you have said . I absolutely see what you are saying but it wasn’t just my therapist that came to the conclusion I was out of order , it was the meeting with the psychiatrist and my case worker when they discussed what I’d said and how upset I was.  That’s 3 mental health workers …. So it must be me ? 
I have started with a new psychologist so it will be interesting to see what light she sheds on things and what direction she feels we should go . 

We are after all a slave to the professionals and Im no expert I don’t know how I’m supposed to feel ? I just know I don’t feel ok and I just feel detached, like I’m just acting in a play doing  what people expect me to do. I don’t know really .. 

L 

[Croix]

Dear L~

Um, I can only say what I'd think in this situation, so I'm not suggesting any particular course of action, you are in charge of you and your treatment and the best judge of how you feel. Actually you have given a pretty long list of your negative states both during and after therapy sessions, as well as exercises at home. They sound far to much to ignore. When I was given an early version of CBT many years ago I had similar reactions and my treatment was changed.

OK so the 3 medical professionals thought that you may have expressed yourself with too much emphasis, maybe they look at things from a different perspective. It is always easy to blame oneself, particularity if others seem to be saying you are not doing what they expect.

Still I'm not sure how much choice you had, it is all very well to go along wiht what is handed to you, but at some stage there has to be a reality check. If the therapy is too distressing them you have to indicate that. Otherwise the treatment will simply continue in the same vein.

If your medical team is saying the manner in which you expressed yourself was unacceptable that's one thing. Frankly in my case if I reach a certain level of distress my manner may reflect that.

I really hope you can have a discussion right at the start with your new psychologist and list the same reactions as you have here, and see if treatment that is not as distressing can be considered.

Croix

[Supermum]

Thank you as always for being honest and by shining a different light on my perspective. Sometimes you cannot always see the wood for the trees as they say .  Plus you always show compassion and tenderness which I appreciate . 

I am seeing her Wednesday morning so I have written down some things I have talked on this forum and will be discussing a way forward that I can work with comfortably . 

thank you again for giving me a choice when my mind thinks I don’t have one . 
L x

[Supermum]

So should I go to a MH facility to detox from alcohol then plan my next move ? 

I’m not sure ? I have a place for Thursday ?