Interesting Technique My Therapist Wants To Use...

[katyjane]

On the first introductory session she got me to explain in detail the flashbacks and events around it. For the next she wants me to write down and then read out the events. I am sceptical of her methods.. I messaged her asking how reading it will help, what technique of therapy would be used etc.

She replied-
"By saying out loud it becomes real and you can deal with it. If we don't say it we are blocking it out so never dealing with it do it keeps coming back as flashbacks and nightmares.
Or if you don't wantbto write it down you can just say it to me if that helps.
So Monday then at 2.30pm.
Regards"


Wtf? Is this how other therapists work?!

 

[joeylittle]

Is this how other therapists work?!

It sounds like one of the protocols for the Prolonged Exposure (PE) technique, which is one of the few evidence-based therapies for PTSD.

But, in PE, I don't think it would be explained quite the way she did - the notion is to normalize/integrate the memory through the use of repetition of the event. Repetition of the story desensitizes, and ultimately, it becomes part of your integrated memories of the past. I'm not explaining that brilliantly, but that about how it goes.

 

[katyjane]

You explained it well. My friend had exposure therapy for agoraphobia. His therapist would get him to go out further and further each session.

Is it one of the more invasive therapy methods for ptsd?

I'm worried she seems to think one session of saying it out loud will fix it. Over time, gradually, I see how it could work. It just seems feels like too much too fast.

 

[Mina]

That sounds a lot like what I did with my first therapist, among other tactics. Very triggering, but eventually helpful. However, I'd already established a trust relationship with her when we started it, which was critical to my being comfortable enough with A - confronting the memories myself, and B - sharing them with her. It doesn't sound like you have such a basis yet. Perhaps you could suggest a broader discussion for a while to establish trust before digging into the really tough stuff?

 

[joeylittle]

Is it one of the more invasive therapy methods for ptsd?

It's been criticized by some practitioners for being too harsh, and potentially retraumatizing. I don't believe there's any actual evidence for that. I think it depends very much on your stability overall, and how well you are able to regulate your symptoms.

I'm worried she seems to think one session of saying it out loud will fix it.

Yeah, that's not actually how it works. So, either she's wanting to use a telling of the trauma arc as a way to create a baseline for you, and then will move onto another therapeutic approach, or she's not properly describing how things will proceed over the next number of weeks as you apply PE.

How do you feel about your skills right now, in terms of symptom management? And do you have any outside support?

 

[Lotis]

On the first introductory session she got me to explain in detail the flashbacks and events around it.

On your first session? I would be very very weary of discussing any of my memories with a therapist I just met. Am I understanding you correctly in that this was during your first session and in another session she wants you to start revealing to her what happened in detail? I would be very cautious. I could not do that personally.
With that said, I could see how saying outloud some of what happened could help but again I would really have to be trustful of my therapist to even go there.
~L

 

[Gs172003]

On the first introductory session she got me to explain in detail the flashbacks and events around it....

I believe it's a type of exposure therapy. Mine made me go to the last place I lived with the ex. It freaking sucked.

 

[NatBird]

@katyjane
Sounds like it could be Narrative Exposure Therapy. My Trauma Therapist talked to me about doing this or EMDR. Did she ask to create a timeline of events or...? What makes you skeptical?

 

[VioletButterfly]

@katyjane - If you are questioning this approach, then something inside of you is raising a red flag and trying to get your attention. Maybe this isn't the right approach for you right now. Perhaps, it might be more prudent for you to discuss your reactions to your T's request and direction, and to form a trusting bond with her first before going into deeper waters.

I have trusted T's many times instead of heeding my own internal voice to the contrary. This has resulted in harm in many regards, re-traumatization, and the loss of many years of my life in trying to heal/sort it all out. It has also compounded my trauma and led to a great deal of agony through which I have suffered and am still dealing with.

Please trust your gut and take care of yourself. VB

 

[Lola Nocheprieta]

How are you feeling about this now, @katyjane, after hearing from folks? Even in PE and other exposure therapies, the therapeutic alliance, ie, the trust developed over time in your relationship with your therapist (T) is of paramount importance. You are part of your own treatment team and you have the right to decide how and when to move forward. Like @joeylittle asked, how do you feel about your own symptom management skills? Do you need to work on stabilization or grounding techniques first, before jumping into discussing the details of your flashbacks and or the trauma(s)? My T and I worked on stabilization and developing a strong therapeutic relationship for 10 months before getting into prolonged imaginal exposure. Now, after all that time, I feel comfortable letting her push me a little bit, because I know she respects my boundaries and I trust her clinical judgment. But I wouldn't have felt comfortable with her pushing me at the very beginning!

Hope you feel comfortable setting some boundaries and going at your own pace in therapy, and that with that and some skills in place, you can do some good work, some good healing, in therapy!

 

[katyjane]

My apologies for leaving half way through the post. I had a bad week and got stuck in isolation mode. I'm sorry it's taken me so long to re-emerge, you all have responded with really insightful and encouraging posts that I appreciate.

@Mina that's great you found it helpful. You're right, I really haven't built up that sense of trust yet with the therapist. I don't think I could do what you did so soon. That's a great idea about sticking to other issues in the mean time.

@joeylittle - thank you for explaining (far better than the therapist did!) the technique used.
I have very few coping skills at the moment. My attempts at managing symptoms have ended up doing more harm than good. (Relapsed into eating disorder trying to control suicidal thoughts). I also recently relapsed with a substance abuse problem, have only been clean/ sober for a few weeks.
I recently moved house and have no real support system around me. The support I did have, I have isolated myself away from as I feel too ashamed to see people.
Reading this back makes me realise I really need to manage these issues. I thought they were just secondary symptoms, that it would be better to focus on the cause, but perhaps not?

@Lotis - Yep. The first time I met her, she got me to explain the events and flashbacks. :/ I felt so uncomfortable. I really wish I had just spoken up about this. She kept prodding me for more details. There wasn't really any cooling down period, there was a bit of an abrupt ending.

@missy meier - Oh my gosh, that must of been really tough. :/
Do you think it helped overall? I really hope it did.

@NatBird - Thank you for the name, I've never heard of it before.
She didn't ask for a timelime, just for me to write the worst events out.
I just felt extremely uneasy, the first intro session seemed all over the place and unprofessional. She was more interested in hearing about the traumatic events and flashbacks than anything else and kept asking for more and more detail, asking questions like 'did he rape you?'. There was no background history (for other mental health problems) and she seemed to lack knowledge regarding trauma. It didnt fill me with confidence when she mispronouced basic psychology therapy techniques and didn't know what SNRI's were. The intro session felt a bit too intrusive, I thought it would be a getting to know each other session, were we discussed a mental health timeline, the therapeutic technique she used, giving me a rough idea of what the sessions would be about. It was nothing like that and was more jumbled up than this paragraph! :p

Sorry have more to write but shall have to come back later as phone is about to die.

 

[joeylittle]

Reading this back makes me realise I really need to manage these issues. I thought they were just secondary symptoms, that it would be better to focus on the cause, but perhaps not?

It's always a judgement call, for the individual. Yes, eventually you need to get to the root of things - but you've had many big changes recently, and you need to be able to be your own support system. I'd personally recommend what you've written here - get your symptoms better under control, and make sure that you can access self-stabilization skills. That's not necessarily going to take incredibly long. But it would be good to have some coping tools in place before digging into the tougher stuff.

Just my opinion.