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What Went Wrong In Therapy - Trying To Work It Out

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ghotiff

MyPTSD Pro
I started this thread in response to a request for further info from @Pencil.

The below may be a little long, but I would love to be able to help each other. I start with a new T in a few days and I'm very nervous and still trying to come to terms with what when wrong (and how it went wrong) with my ex T. I'm hoping if I understand, then I will manage my new T better.

I started therapy work with the goal of improving my parenting. The first thing that went wrong is when I went to my local doctor for a referral and she assumed that I was abusing my kids and actually put that on the paperwork for the request for therapy. (Ahhhhh!!!!!) I had to hold really strong to get her to remove it. My issue with my kids is NOT that I'm abusive, its that I am a bit overprotective and they are growing up and I would like to feel more comfortable allowing them more independence.

I then went to the T. I’m still trying to piece together what went wrong in T and reading other peoples threads have helped me articulate it…but I’m sure I haven’t worked it all out yet.

Basically her approach was memory recovery work. Her goal was to have me remember and describe to her the sexual abuse that happened. I have always had a clear memory of a few specific events, but I know more happened as I have information with respect to timelines etc). I had trouble telling her what I remembered and she encouraged me to write it down and hand it over to her (this meant I told her things I wasn't ready to tell her). She also wanted me to remember more and gave me exercises to ‘help’ me remember more (they didn’t work and I felt like a failure, with the added bonus of putting me in a really dark place).

Throughout the process I had been trying to tell my T that I was heading to a bad place (I get a freeze response and so its really hard, and sometimes impossible, to talk). I told her how I was struggling at home afterwards and also that I struggled during our T sessions, how I would be blacking out (tunnel vision, going black etc) while she was talking and I was struggling to stay present. She replied with commenting that I was very hard to read, and she couldn’t tell when I was upset. Point is that she was pushing way too hard and she was not able to tell that this is what she was doing, and when I tried to explain it to her, she didn’t ‘get’ it. Even when I told her about my SI, she acknowledged it from a theoretical level…but didn’t see it as an issue, and we continued to push on.

At one session while doing memory recovery she then started to theorise of what may have happened, including her proposing a very specific ‘threat’ that one of my abusers may have made. To my current memory, he never performed/made that threat and this ‘threat’ of hers gave me nightmares and made me scared of my bedroom (which previously was a source of comfort and my abuse never happened in any of my bedrooms). I texted her about this and how it wasn’t going well…to cut a long story short, the conclusion was to reduce the frequency of my T sessions. At the time I agreed that the T sessions were making me worse, and that reducing the frequency would reduce the impact.

Eventually, I had the courage to stop going and the longer I have been away the more I can see that the course of therapy I was on was damaging to me. Its been about 2mths since I've seen anyone and I'm getting better. My SI has gone, the number of hours I spend in bed each day recovering have decreased...but...I'm nowhere near as well as I was 6mths ago (ie prior to starting T). Prior to starting T I had heaps of limitations (eg rules to avoid a myriad of triggers), but my life was pretty okay.

I'm really scared of seeing this new T. My husband doesn't want me to go. He sees the current not-quite-functioning me and just wants me to be back to who I was 6mths ago (he never minded my limitations). I'm not sure if or how I can get back to who I was 6mths ago. I don't know what to do. Every fibre of my being regrets starting this process. I knew it was a risk (which is why I put it off for 20 years)...I thought I'd be able to cope, but I'm not coping.

Sorry for the long rant. Thanks for listening. If anyone has suggestions or insights, I would love to hear them.
 
Since I have only had one therapist and I think I kinda hit the jackpot with him I can't tell you much about "managing" your new therapist. HOWEVER, I would say, talk to him/her about what happened and your concerns asap. You shouldn't feel like you have to "manage" your therapist.

One thing that my therapist DID figure out is that we tried to push through too fast at first. We had to back up, back down and start with just getting to a place of trust. It's taken about 3 months for me to feel comfortable and for him to figure me out and see me with a base line of who I really am: not triggered and freaked out but the calm person I am on a really good day.

Don't quit on therapy. That was something else that my therapist made clear for me: We have opened that box and now that it is open, I have to work harder to keep things under control. His promise is that once we get to a place where I am finally able to work on the actual trauma again, things will start to get better. (with also the promise that it might get worse while we are working on the hard stuff and a promise of more support during those times)

I am about 5 months in and for the first time, my therapist brought up doing EMDR again last week and asked if I thought I was ready for it. I "made that face" again according to my therapist, and he reminded me that I am in control of when we do it. He obviously thinks we can start venturing there again in the next month or so. All that to say, therapy should be something that you are working on together. It's not dictated by the therapist. You DO have the right to say no.

Communicate your fears and what went wrong. I would talk about or write about what happened in therapy in general terms that made it difficult for you to continue with the last person. Remember that your therapist isn't a mind reader. I have had to come out and say plainly: I am thinking about suicide. I have to do this because on the outside I look calm and yes, am hard to read (that's part of who I am and how I learned to protecting myself) I can't assume that if I drop hints he will sort it out. He knows that my SI fluctuates wildly and triggered by certain things

Communicate your concerns about SI as much as possible. My therapist understands that I have a plan. HE knows WHERE my plan is(It's not at my house) I know how to set it in place and he understands that it is as much a comfort as it is a threat to me. He also trusts that if I get to a bad spot I will text and if I am in a really bad place and about to follow through or am in real danger of following through that I will call.

Hell, my therapist and I talk about my sleep cycles and my running at the beginning of each session. How much have I slept and how much have I been running because the are good barometers of how I am actually doing. Your therapist should get to know you that well.
 
My last T went in like a bull in a china shop, didn't give me any opportunity to get to know him or feel safe with him, and I was dissociating all over the place, with the whole tunnelvision, out of body experiences, S.I, nightmares, panic attack crap going on. Finally he got sick of me not trusting him, but I never really got the opportunity to trust him, he went in hard from the start, it was basically deal with it, this stuff is never pleasant. I wanted to give up, this was my third fail, although the first two were due to their issues as they wanted to avoid it and pretend my past never happened and that I should ignore it. Others on this site told me to try again, and it was excellent advice, that I am glad I never gave up

This new T is so different, I was very upfront about why the last T didn't work for me, about my need to feel safe before working on the other stuff, and it mostly has been a very different experience, although when I was ready, we went back to the stuff I couldn't deal with before. Don't give up just because they aren't the right person for you, because they are out there, and when you find that person you will know. You get no where without trust, and you won't trust or feel comfortable with anyone who doesn't hear you.
 
There are way too many dysfunctional, idiotic and downright dangerous therapists. I've had two. And then there was the one who saved my life, and who did it in such a way that I didn't realize it at the time. I hope with all my heart your new T can undo the damage of the last one. And if she turns out to be another frog, we'll be here until you find a good one.

I'm not surprised you blew, I'm surprised at how ... normal your blowing up was.
 
Thanks for all your comments.

And if she turns out to be another frog, we'll be here until you find a good one.
This means so much to me. I know all of your will be here and honestly I think this forum is the only reason I'm coping as well as I am at the moment.

I keep hearing the 'trust' thing...that you are meant to trust your T. I don't get this and I certainly don't know how I would determine if I did trust a T. I don't trust anyone. In my life (insert sob music here) I learnt that no-one can be trusted. I told so many people what was going on...a number of them listened and encouraged me to open up ... but all walked away with never a backward glance and I left in the same dangerous situation as before. Anyway...I don't see myself ever trusting anyone. Sure I'm paying her and so she will pretend lots of things and see me when its convenient to her, but as soon as its no longer worth it to her (eg new client, same money, less issues) then I'll be left on my own again.

I was very upfront about why the last T didn't work for me, about my need to feel safe before working on the other stuff
I thought it would be wrong and disrespectful to my ex-T to do this, but I am so frustrated with where I am at now, I think this maybe the right conversation for my first session. Maybe this is a good test to see if she passes...That is, see if my new-T can hear me and understand what went wrong and comment appropriately on what she plans to do differently.

Remember that your therapist isn't a mind reader. I have had to come out and say plainly: I am thinking about suicide.
Just venting here...but this is what I did. How much clearer can you be than stating that you've started thinking about suicide again, and its been years since you've felt this way!!!! Sometimes I feel that people will only believe me if I carried through (don't worry, I'm not thinking about it anymore)...its just that sometimes I feel that people don't take me seriously.

on the outside I look calm and yes, am hard to read (that's part of who I am and how I learned to protecting myself)
Yes - this is me also. Maybe what went wrong is that on all occasions when I stated the problems to my T (including suicide thoughts), I said them as facts. I wasn't emotional, I was factual because that is where I go when things are bad. Maybe she didn't 'get' it because I'm factual aka "cold". But a trained therapist, should know better?
 
About the "trust" thing. This is just my take on it. My first session, my T kind of felt things out. I'm pretty sure he expected a "simple, straightforward" case that involved one, discrete traumatic incident as an adult. Which wasn't unreasonable, considering that I'd said it wasn't a big deal. The first session was different that any other as a result. By the end of the first session he was pretty aware that talking about things was going to be a challenge. From then on, he handled things differently and went slower.

So, the first thing I'd suggest as "a sign of an ok therapist" is whether or not they are paying attention and readjusting "their plan" to fit you and the circumstances. Beware of preconceived notions on their part and the unwillingness to give those notions up.

I would think the first thing would be to talk about what your goals and objectives are. If you want to improve your parenting skills and that's all you want to do, I can't see where you'd have to go in depth about your own childhood at all. You need to know how to handle things NOW more than you need to know why you feel as you do. Not that working on the "why" of it is a bad thing. It's just a separate, but related issue.

I don't know that I'd even WANT to try to "manage" my therapist. He's got a much better idea how to do what he does than I do. But, he HAS told me that managing my therapeutic goals is very much "my job" and he checks in now and then to see if I still think we're on track.

Sure I'm paying her and so she will pretend lots of things and see me when its convenient to her, but as soon as its no longer worth it to her (eg new client, same money, less issues) then I'll be left on my own again.
You'll find this isn't always true. Some people go into the field because they actually care. Some people like a challenge too. It's quite possible for people to actually LIKE the people they're working with.

Can your family trust YOU? I'm guessing they can, that you are dependable and trustworthy. Do you really think you're the only person in the world who IS? (You're not.) There does seem to be a shortage of dependable people, but there are some out there. Really there are!
 
Thanks @Link Removed, your posts are always so supportive and helpful.

So, the first thing I'd suggest as "a sign of an ok therapist" is whether or not they are paying attention and readjusting "their plan" to fit you and the circumstances
Good idea, I need to do this. Thanks for the suggestion.

goals and objectives are. If you want to improve your parenting skills and that's all you want to do
I have been wondering if my new T will ask about my goals, so maybe this should be another thing on my list to check. My goals from 6mths ago were to improve my parenting. My goals now is to get me back to my pre-therapy state.

Do you really think you're the only person in the world who IS?
A good point. Mind you I don't think I'm 100% trustworthy, I make mistakes too.

I don't know that I'd even WANT to try to "manage" my therapist. He's got a much better idea how to do what he does than I do
I did trust my ex-T.... it is my misplaced trust is what got me into this current mess.
 
Pacing is the basic safety scaffolding holding trauma therapy in the "window of tolerance." Patients deserve to set the pacing, and the therapist is obligated to monitor it for signs of flooding.

Non-trauma informed therapists operate differently. They are taught to push people through their resistance, which can be devastating to trauma patients.

We must always advocate and stand up for ourselves. We don't need to feel guilty for standing up for ourselves. A good therapist knows this and will respect the window of tolerance, because they know that pushing through it actually sets us back in therapy.
 
I do not WANT to "manage" my therapist. Recent experience has taught me I NEED to "manage" my therapist.

The dream is to have someone that is skilled and competent to improve my life. But....my last one caused a lot of damage which I didn't really 'get' at the time, because she was recommended, and experienced in childhood sexual abuse. At the time I thought all the things that others have during good therapy, ie, it shouldn't be a walk in the park, I should push myself, I will get worse before it gets better....so I did what I was told, I opened up, I dredged things up from my past that I previously had locked away. When it started to get bad I thought that this is what was meant to happen, and held onto the idea that it was going to get better. Even when individual events (that I think where 'wrong') happened, I thought that maybe I misunderstood, maybe I was missing the point. Sometimes, even now, I think this was the case (eg my comments in the 'anger' thread).

Anyway, point is....I still don't quite get how to make sure this new therapist will be good for me. I'm starting to piece together information from others here, but I'm still not confident.
 
I think a gut feel goes a long way. My ex therapist 'did things' that, individually, sounded good, while I FELT that it wasn't. I still have contact with her, a year later, and only now do friends who at first convinced me she was an angel, tell me that she is not. My gut told me things were not okay, but I couldn't justify it to myself or anyone else. If someone is trustworthy you will know it, even if you can't 'do' it.
 
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