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Grappling With Starting Cbt

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Sandstone

MyPTSD Pro
This is a vague ramble through my responses to the first three weeks of CBT. Sorry it's long

Finally! After three years of battling the NHS I am getting trauma focused CBT. But it is currently only scheduled for 16 weeks, and I can't believe that will magically be enough.
I have to catch a bus there, but not from the side of the road where I had a bit of a flashback.
I have to arrive in the town an hour early and it can be hard to find something to fill that hour that I can deal with. I tried browsing the charity shops, but that was too focussed on me to deal with. Last week I joined the library, and that may well be OK - a silent place where i know the rules.

I went to the first week determined to apply myself as fully as possible, grab it with both hands and make it work. The therapist set a clear structure, agreeing an agenda and was happy to arrange the room so I felt comfortable. Her agenda was on conveying theory, mine about reasons to trust. I left feeling positive, though tired, but was able to deal wit the statutory nutter at the bus-stop. The support worker said the next day that the therapist thought it went better than expected, and that I was very open. I think her expectations were coloured by the reports of the dreadful NHS therapist 18 months ago.

The second week was a bit harder, but pretty OK at the time. Again it was mainly focussed on theory, mostly stuff I knew and could assent to. Afterwards though I struggled badly for several days with the desire to run and hide. We'd spoken about my mild dissociation, and I'd said the first week hadn't neede me to detach myself but two other events had needed much more cutting off. She suggested looking at them in week 3, applying the 5 aspects model. (http://www.getselfhelp.co.uk/docs/5aspects.pdf ) I think I was afraid they would reveal too much. Daft , that is what I'm there for.
As the week ran on my thoughts moved on from "Got to run, got to hide" to " Of course I don't deserve or need this treatment". My dreams were full of Dickensian poverty stricken children, dying in rags.

In week 3 we set out an agenda, but as soon as I mentioned my reaction we diverted off onto that. There was some discussion about grounding.I need to ask her for a list and specific ways to practice them, though we agreed that it would be OK to buy a metronome. I told her about my ability to break safe place imagery.
I said we hadn't covered the agenda, but she indicated the notes she'd been writing and said no, we had used the model. I couldn't see that, as I wasn't wearing my glasses. I suspect I had some homework, probably about practising breathing.

Now I'm convinced it will all be cancelled and taken away from me. The fact that the support worker who was supposed to call the day after to check my stability hasn't phoned me is confirming that view. I dreamed I was battling with the clerks at a theme park, who wouldn't take my voucher to let me in, and told me I'd arrived too late to be allowed on any of the rides, I could only walk round and look.
My GP, one of the CPNs and my old private therapist thought it would only be safe for me to do this as an inpatient. Initially I agreed, but once it became clear the Trust would't spend that money I decided the focus had to be on what ever treatment I could get.

My will says I am going to do this, wholly and fully.
My fears say what if I can't do it, and end up harming myself and/or others in a bid to escape.
My mind sometimes says that the therapist is going to decide it isn't safe and I'll be back to months, years waiting for another decision, and sometimes says I need to get my act together. I keep catching myself inwardly repeating " I just won't think. I won't let anything bad happen".
 
I'm a little distressed at the non-response after several hours. I was hoping for some encouragement or shared experience. It is harder on the day that yet another report has been published in the UK criticising the authorities' failure to listen, believe and respond to grooming and abuse. The news reports on that have reminded me again of the times that my pleas for help have been ignored, denied or punished.

I must need to learn to ask more clearly.

I'm struggling and afraid. Can I have some support please?
 
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Sorry Stenni, blinding headache... but 16 weeks is good for CBT provided you apply yourself. It isn't necessarily "magically" enough... it's a tool... you get introduced, shake hands with it, use it in the "classroom" then take it into your own life.

Bring your glasses. I'd roll with your will at the moment and tell both your fears and mind to stuff it. Give it all you got sister.
 
I read your post earlier and was hoping someone who could relate more to you would respond. However, I can tell you that I wish you the best :) You are brave and strong!
 
I fully intend to go with my will. I've said I'll do it, so I shall, to the utmost. But that doesn't stop me being distressed and afraid of what that distress can do to me in between. I can't do what did before, but i don't yet have any other way to go.

re 16 weeks - yes I think that would be enough to learn "core" CBT. But this is meant to be the three stage stabilise, process, re-integrate trauma focussed version. I'm so afraid it will have to go too fast, and of what the consequences could be.

@The Albatross - look after your headache - thanks for responding despite it. Now I know I'm not invisible I can wait.
 
I am in long term therapy but I work for a trust that can only offer short term 12 or 20 wks. I also find it hard to believe that these time scales can and do make a difference, I guess it must be very focused and maybe more about the theory that you then apply to whatever you are struggling with. Maybe it would help to write down why you think perhaps you 'can't do it' sometimes working through those blocks with a T can be very valuable. I find reading and getting as much information on PTSD on trauma on therapy on anything that relates helps - if I can focus on that and write notes etc I feel I am doing something I am being proactive and therapy isn't something being 'done to me ' I am in it too.

I agree the news is bloody depressing - it's just everywhere - I don't understand how so many people could be so blind and uncaring.

Good luck - take one step at a time
 
@stenni. I was asleep :)

First off, let me say how impressed I am with your self insight.

I totally undserstand your fears of it being a short time frame and the risks of going too fast. I went too fast with my first T (not CBT) and it was a disaster.

If it was me approaching this I would not aim to be fully cured/processed but instead only a part of me. I don't know CBT well enough to make up a good example, but with my T we are focused on the goal of being the best parent I can be, and there is a lot of myself I have yet to share .. But if it directly related to my parenting this is where I push myself to be open to her.

I hope that helps.

If I can offer an insight, which may be totally wrong, it seems that without positive feedback (or negative or even worse no feedback) you assume the worst. Maybe this is something to put into the model in your link. If it's too confronting at the moment, that's totally okay.
 
Sorry I didn't reply after jumping up and down and demanding responses. It was 10pm so I went to bed - I try not to break that routine.

reading and getting as much information on PTSD on trauma on therapy on anything that relates helps - if I can focus on that and write notes etc I feel I am doing something I am being proactive
I did a lot of that two- three years ago, I have rrems of notes. but when I realised I couldn't cure myself through it I stopped. This time I've avoided looking at too much detail, because I'm afraid of appearing to check up on the therapists performance. Once again, that fear comes from the dreadful T who accused me of "wanting to take control" and also of "trying ti force her to take control". I am reading after the session to remind myself of the theory she teaches me, but I'm much more interested in application.

Does your T know about your concerns re: time scale - is there any possibility of it being extended?
At the initial meeting in December I said something about it. However I wasn't coping well at the time with the number of people present (5), and I think I was quite negative overall, so it may have seemed like part of that. It's taken so long to get here, I don't want to rock the boat.

Maybe it would help to write down why you think perhaps you 'can't do it'
I think there are two things i fear. On,e that I've told her, is that I absolutely believe that when we get to the processing bit she will look at me and say " What? You purport to have PTSD from such trivial things?" and even if I'm not actually thrown out, I 'll feel such guilt for making demands, and for wasting resources that others are desperate for
The second is that when I was working with the private T, who was wise and compassionate, and who I trusted, I still went too fast and ended up ODing, driving under the influence, crashing the car and being sectioned. I can't do that again.

I would not aim to be fully cured/processed but instead only a part of me.
My goal is to get "me" back. I used to like myself and enjoy my life. Maybe that is a bit big, but it is my motivation.
it seems that without positive feedback (or negative or even worse no feedback) you assume the worst.
Certainly in the light of experience I assume the worst of the Trust. I know that they can withdraw people and services at no notice, because they have done it several times.
I shall try applying that model to it as you suggest.
let me say how impressed I am with your self insight.
But I don't know what to do with that, how to apply it.
 
I can ask when you refer to 'the trust' which one you are referring to? If it's not too personal.
I totally understand your 'I can't end up in a mess again' I am sort of in the same place and have spent 9mths trying to find the courage to tackle it and get back to the 'hard stuff' rather than just working round the edges not really getting anywhere. I think maybe I am waiting for everything to be 'right'- for me to feel stable, my T to be totally consistent and for me to totally trust the process and of course in reality none of those things are going to magically happen - my T would say you have to take a risk and see it's ok and that's how this works - but what if it's not ok? He never seems to have an answer for that!!!

Your T is NOT going to minimise your trauma, it's not their job to pass judgement on where on the 'bad scale' a trauma sits - they are there to help you deal with the way it effects you, full stop.

When you say you want to get back to being 'me' is that me before trauma or me before PTSD ?
 
The Trust is the Norfolk and Suffolk NHS Foundation Trust. The one that has just gone into special measures, first in the country. I've had the misfortune to be under their care through the process of "radical redesign" which has ripped the heart out the services and the staff. Why do you ask?

waiting for everything to be 'right'- for me to feel stable,
that's the problem - I created a way to feel stable. It has been at the cost of cutting virtually everything out of my life, and making myself be much more dissociative than I was but I'm here, I'm alive. We went to my sister in law's funeral this week. It could so easily have been me. But I'm here, I'm alive, my husband and daughters didn't have to bury me. Maybe we differ though because my natural instinct is to jump in with both feet, not to wait. I've learned to think "That's terrifying, how shall I do it?", and so I don't know how to grade it.


When you say you want to get back to being 'me' is that me before trauma or me before PTSD ?
That's a bit complicated. I was abused from well before school age so don't really have a pre-trauma, and had the strange upbringing, so as a child/teen I was withdrawn and probably quite odd. But I re-invented myself, and learned from scratch how to have good friendships and relationships. My PTSD was very late onset, more than 25 years after the last trauma, brought about when a medical procedure painfully mirrored aspects of being raped. Or maybe there were always aspects of PTSD about but I controlled them by will power. So the "me" I want back is who I was five to fifteen years ago.

There are aspects of learning I want to take from the last three years though. I'm actually much less volatile, less inclined to react to a perceived slight and blow up than i used to be (Unless you put me in front of someone from the Trust who is telling me they aren't going to do anything).
 
I asked about ' the trust' because I work for a charitable 'trust 'for this sector and was just trying to get a picture of where your support was coming from - it sounds like you've had an appalling experience with these people no wonder they have been put into special measures. I am very grateful that at the moment I can afford private therapy and as such don't have to wrangle with the NHS - that would just be too much, well done for sticking with it, you deserve better.

Our history sounds pretty similar, I coped pretty well and got through, by reinventing, though I did end up going from one abusive relationship to another - I think I have changed so much through PTSD and through actually facing things that there is no going back to the me that coped ok before - but instead I have to totally start again and build a new updated version and therapy for me (on a good day) is about deconstructing every bit of 'old me' and putting the blocks down to build 'new me'. Ha made that sound like its soooo easy - it's not it's painful, slow and fustrating but there is no going back only moving forwards.
 
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