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Too Much, Not Enough?

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Sandstone

MyPTSD Pro
I just don't know what is true

I ran from the room last week, when T said we should start to talk about which Trauma was least bad.
I can convince myself that this was any or all of
  • basic cowardice
  • healthy self defence
  • the action of an Emotional Part
  • clinical incompetence
I have no idea which is the truth.

T phoned me and said maybe we need to go slower, but also that she doesn't yet know if we will get another batch of 16 sessions. The two don't seem to go together. Perhaps there really isn't anything wrong with me at all, perhaps that's why they are so unwilling to offer support. I said if she is told we won't get any more sessions then I'm stopping now; there seems little point in jumping in only to find I'm swimming alone in a pool of ***

She has listened to me saying that I don't know or show my distress until it takes over, but if I can't recognise it, and she can't recognise it, how will either of us know when it gets too much? I'm already contemplating unsafe behaviour, though that also relates to a personal complication.

I'm hopelessly confused and lost
 
I would add another item to the list. I would say systemic failure.

Getting to the bottom of trauma is not a 16 week and you're good process. I have worked on this (for myself) for coming up to 10 years. A therapist who is attempting to push you through due to deadlines imposed upon her , well, I don't think that is her fault, but I think that leaving you in the midst of stirred up crap isn't so great either.

Most likely an EP was activated, given what you have mentioned in your post. That is nothing to be ashamed of.

I would suggest not allowing your therapist to delve into the trauma (based on the EP activation) unless you know that there is a time commitment there. I am so sorry this is happening to you Stenni. Please, do not beat yourself up for your reaction. It is authentic to you history. It is absolutely nothing to be ashamed of.
 
@stenni - It seems so unfair whenever I read about someone not able to access therapy or to have their length of therapy dictated by someone other than you and the therapist. I agree that it would be horrible to delve into a trauma and then be left to pick up the pieces and continue on your own- that's what you've probably been trying to do your whole life- just carry the pieces and move on.

It's not the same, but perhaps this will help. When I did an inpatient program, I had a limited amount of time. I had to choose with the help of my therapist there, which skills were most important to work on. We skimmed the surfaces of trauma, but we didn't process it. Instead we focused on the difficult areas of my life- the places where I wasn't surviving so well any more- for me it was the ability to work and the ability to tolerate being around my children. So given the amount of time we had, we worked on plans for how I can manage to bring stability into my life. And then when I left, I had plans for continuing that. Even that left me feeling as if I returned home with a bunch of broken pieces that I still had to carry around- however, once I got over the re-acclimation-into-my-life period, those plans and skills were still there waiting for me. So if delving into processing trauma feels too large right now and if you are uncertain of the length of time you'll have, perhaps there are other ways to get something positive from the time you do have.

Your reaction during therapy doesn't need to be overly-analyzed and maybe you can just say "yep, that happened, let's move on" and not beat yourself up too much about why it happened or that it happened. I have run out of therapy before, too. I really hope that you can find some way to work with this therapist in whatever time you have so that you can find some positives.
 
@stenni the insurance part...No those two things are mutual exclusive. How much therapy you need and how much your insurance is willing to pay out are completely unrelated. Your therapist is rightly concerned because she wants you to make progress and is in a situation where the insurance folks are being complete dicks. She probably picked the wrong time to share that stuff about insurance with you as well.

*deep breath*

It seems that I am a long term trauma patient as well. I remember the first time I got a notice from my insurance that they were not going to be paying for therapy after a certain date. That date had passed and my therapist had not said anything. I KINDA lost my shit. That's when he explained that he had been in the middle of arguing with the insurance company to keep allowing me to come. He was rather upset that they had sent this information to me. Seems I got all kinds of upset about that one. I'm not sure what he had done but he finally got clearance through them and I am basically renewed each month now without question. I no longer see those notices in the mail.

Your therapist is right. If you're having that kind of reaction (hi same kind of stuff right here!!) in therapy then she DOES need to slow down. That's the frustrating part about therapy. It just can't be rushed. And sitting around telling yourself that you should be able to do this faster isn't going to help.

It's probably time to talk to her about how long she expects you SHOULD be in therapy and what your options are in that realm and then talk over how therapy is going and how to take it slower. The mechanics of it sound a lot easier than they are.

I would address with her the fact that insurance is being dicks and ask what can be done or if she knows how to work the system to get you more sessions.

I will have been in therapy for two years come January. I'm JUST getting to a place where I'm *ahem* stable and have something that resembles trust for my therapist (note I said resembles. I STILL don't trust that motherf*cker completely. I can't say why. I have no obvious reason NOT to trust him)
 
t is authentic to you history. It is absolutely nothing to be ashamed of.

That is one of the things I'm despairing at. So much of my traumatic past is about passively accepting and not resisting what was done. I was planning to get through this using that skill.I mean just chug along with whatever T said came next. And I can't even do that
 
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So much of my traumatic past is about passively accepting and not resting what was done.
Me too Stenni. I was so young that I couldn't do anything at the time. It is different for me at this time and 3/4's of the battle is realizing that. The thing is that because I was forced to be passive, I had to be led by therapists, others, to see what other options existed. It will come. I promise you that. Just keep working on it and do your very best not to be ashamed of it. You were innocent. You didn't have a chance at that time. Be kind to you as often as you can. :hug:'s my friend.
 
the insurance part
It's probably time to talk to her about how long she expects you SHOULD be in therapy and what your options are in that realm and then talk over how therapy is going and how to take it slower. The mechanics of it sound a lot easier than they are.

It's the NHS, so what is needed and what is available don't tally. After the first 16 weeks it was renewed for a further 16, but she is working out of area - there are endless restructures - and may not be allowed to.

And now I'm wondering if I want to work with her because she can't see what is happening. I can't believe I'm so opaque. Some time ago she suggested an additional diagnosis, and though I said to her "I find that very disturbing" she went straight on working with it. For the last three weeks, it's been as though she is sticking knives in me, I report that I'm bleeding and she says ' Right, let's try a bigger knife" I told her I was very zoned out all week, not really functional, hating myself, but she can't hear it.

But then I think perhaps I'm wrong, perhaps I 'm just making a fuss, perhaps I can actually do this

And then I think how when I've shown my distress it just results in services being withdrawn. Maybe it is purely co-incidence, but once I ran away from the opticians, and after that I never saw my support worker again. Once I cried at the Psychiatrist and wirh no notice they re configured so he was no longer in charge. Now I've run away and she tells me we may be terminated
 
I definitely don't see any cowardice here. Absolutely not.

It sounds like you got triggered/overwhelmed. (Or perhaps that an EP got activated - I don't know anything about that, so I've no idea, sorry!) And I think it sounds like she's pushing too hard, too fast. If you're telling her that you've been zoned out all week and that you haven't been able to function, it doesn't make sense to me that she continues to go in so forcefully.

I'm wondering whether she's trying to go fast and get through more stuff because of the potential limitation around the number of sessions. If that's the case, on the one hand, I can understand that pressure. On the other, her approach (including the pace) must be in service to you and this doesn't sound like it is. As others have said, you can't effectively process trauma and work on other trauma-related stuff in a small number of sessions so if she's trying to rush through it because the sessions may run out, I can't see that's going to really benefit you.

I think there's a real potential danger of her forcing the deep trauma work, stirring a load of very messy and difficult stuff up and then you being potentially left hanging with no support if the sessions aren't renewed - once Pandora's box has been opened and you've got all that stuff flying around, you can't just pop the lid back on and expect that to be fine, unfortunately. So that seems rather reckless of her.

Is she a trauma specialist? I'm not sure if you get a trauma specialist necessarily through the NHS? Because, if she's not, that would probably make sense in terms of her not being able to see when you're getting triggered/disregulated before you're too far gone. And in terms of her using such a forceful approach to progress the work ASAP.

I think it's understandable that you feel lost and confused at the moment with this. It's a tricky situation :-(
 
Your therapist is right. If you're having that kind of reaction (hi same kind of stuff right here!!) in therapy then she DOES need to slow down. That's the frustrating part about therapy. It just can't be rushed. And sitting around telling yourself that you should be able to do this faster isn't going to help.

My therapist says this all the time...but especially when I'm feeling frustrated, disappointed and impatient with myself because I'm not doing the work and making progress quickly enough. Thanks for the reminder :-)
 
Is she a trauma specialist?
I don't know if she is a specialist. She seems to understand and has gone through with me all the stuff about how trauma affects the brain, about the window of tolerance and about Structural Dissociation. But she always seems cautious and hesitant in her presentation. Maybe that is just her style, but it doesn't make sense of why she has been pushing so hard.

I think it must be that I don't give off enough signals. I expect to deal with stuff alone, and to be in trouble for needing any support
 
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