Need Some Ideas About Safety

[sun seeker]

I could really use some ideas on this. There is a therapist I would really like to work with via Skype, but she is concerned about what would happen if the work triggered me into a state where I couldn't keep myself safe, and she wouldn't be here.

It's great that she is thinking ahead like this, and I wish all therapists were this conscientious about safety. But I don't want this to get in the way of what otherwise might be really helpful for me.

I actually don't think that the material I'd get into with this person would trigger me in that way (I have another therapist I am working with, and this would be a sort of adjunct in a different area of expertise). But I want her to feel confident, so am thinking about what might work.

Has anyone been in a situation like this? Any ideas?

 

[Suzetig]

What would you usually do if you left your face to face session and realised when you got home that you didn't feel safe? For me it's relatively rare to be triggered in session, it's more likely that I'm triggered as I process the session.

I've got a range of people and strategies I can call on (self soothing, grounding exercises, my husband, friends etc) and if I'm really struggling with myself, I'd contact my T and ask for support. Think about how you cope with being triggered when you're alone and write a plan of steps you'll take or exercises to work through - include crisis services etc if need be - and be honest about the potential that you might need her support between sessions from time to time.

 

[sun seeker]

What would you usually do if you left your face to face session and realised when you got home that you didn't feel safe?

Self-harm and sedate myself in the attempt to stop. Scream and cry in agony. It's a huge problem; I have frequently gone home from sessions in this state. And my therapist has now decided he is not going to be available when this happens. I've found crisis services to be no help, they don't understand.

So, yes, it's a big problem, and I really don't have the skills to handle it.

With this other therapist, I doubt this will come up because we'll be working on very different material. But I want her not to have to worry.

 

[Freedomfighter]

I could really use some ideas on this. There is a therapist I would really like to work with via Sk...

I think new technologies will rule our everyday lives very soon and that includes SKYPE. Because it is amazing what can be done with that. You can work with an employee or employer all over the globe, you can visit doctors that way, you can talk to loved ones that way.

Just think of the implications, not having to drive to a location to get any of those things done and how much more free time there would be if you could take care of your important business that way, I think that is a win win situation for sure.

 

[Suzetig]

So, yes, it's a big problem, and I really don't have the skills to handle it.

Have you done any stabilisation work at all with current T (I know it's been an issue in your work there)? You could look st DBT resources and start practicing those skills while you're feeling generally ok so you have something to draw on when you aren't so good. There are some good workbooks that could get you started - just know that it takes time, effort and real discipline to develop any kind of coping skills and it's best to try a few things when you're doing ok so that you aren't trying to cope with being triggered and learning a completely new skill at the same time.

I think it's a fair worry for your Skype T, you don't plan to get into anything but sometimes it does happen when we just don't expect it. Could she work with you on building a skills base to work from - so build stability with her before starting the other work?

 

[joeylittle]

I think it's a fair worry for your Skype T, you don't plan to get into anything but sometimes it does happen when we just don't expect it. Could she work with you on building a skills base to work from - so build stability with her before starting the other work?

I think this would address the bulk of the concern. I've done trauma work with my therapist over Skype, and it's not hard for me to also do a certain level of self-monitoring; if I believe a topic is going to lead me to risk just shutting the computer off mid-session, I'll say so, and we won't work directly on it, we will work on the anxiety around it instead.

It's all about clear communication and expectations.

 

[sun seeker]

Have you done any stabilisation work at all with current T (I know it's been an issue in your work there)?

No.

You could look st DBT resources and start practicing those skills while you're feeling generally ok so you have something to draw on when you aren't so good.

Yes, I intend to. I plan on getting the workbook this week.

it's not hard for me to also do a certain level of self-monitoring

Yes, I've also talked to my therapist and his supervisor about my need first for him to notice when I'm starting to lose it; eventually that will move into me noticing it too.

I've also suggested that I could set it up so I have support after the session, just in case. Hopefully all this will be enough. It sounds like this therapist could be a really useful adjunct to the work I am already doing. I'm already impressed with her concern about keeping clients safe.

 

[BlueOrange]

Do you have a nearby friend or neighbor that they could call & send to be with you & reduce self-harm behavior?

 

[Deleted member 34328]

Self-harm and sedate myself in the attempt to stop. Scream and cry in agony. It's a huge problem; I have frequently gone home from sessions in this state. And my therapist has now decided he is not going to be available when this happens

From what I've read in your posts, I find this bothers me the most. So often we need therapy support in between sessions. If your current therapist is not willing to be involved when you're in crisis, then perhaps he isn't the person you need the most. I think learning some good solid grounding techniques and other coping tools as has already been mentioned would and should be a priority. If the woman on skype can work with you on this, than I think she may be someone you might feel safe with. Her concerns are valid and speak rather highly of her.

 

[sun seeker]

Actually, it's not going to work out. She is too concerned about my safety to want to try it. :(

 

[Deleted member 34328]

I'm sorry to hear that. The right Therapist is out there. In the meantime, keep posting. We care. You may find a lot of helps on the many different threads. Always someone here to listen.

 

[sun seeker]

On second thought... or not thought, but having waited a little longer... this therapist is reconsidering and might be able to work with me after all.