Dissociation preventing any progress in therapy

[Deleted member 39476]

You seem to get very caught up in the hopelessness of your extreme and complex situation.

You have a really good point but in a really tragic way I'm really distorted thinking is still accurate. Are the fears people have during a panic attack realistic? Probably not, more likely not even close. What about the sense of hopelessness a person gets when experiencing an emotional flashback to a time of severe helplessness, is the feeling accurate? Certainly not. However, if you experience that in a very severe intensity, on a severely chronic basis, especially in a way that has shown to be resistant to many forms of treatment, and cripples you in day to day life, there is actually a solid argument to be made that the feelings are, in a very ironic and roundabout way, accurate. "I'm worried that I cannot successfully treat my chronic and severe worrying" sounds silly but is a very honest look at the situation. Especially given the even greater cruel irony that the more worried you are about whether or not you will recover, the less likely you are to recover.

Over-generalisation is a cognitive distortion, and it seems to be making it really difficult for you to be able to identify some pretty major successes that you've had with your recovery so far, and I can imagine that would make the future seem impossibly hopeless.

It's not like I don't think I have made steps, I have accomplished a lot in therapy. In all honesty I'm probably really lucky because I have a really good therapist that I like a lot, and have made a lot more progress than some people do in a lifetime. The problem is that in the present I'm so severely disturbed that I fantasize about death, I have felt this bad nearly 24/7 for the last year and a half, and it feels like I'm banging my head against a brick wall in therapy because almost all the techniques that are designed to help people in my situation actually make me feel significantly worse. It's really really hard to appreciate the positive aspects of it when the negative aspects happen to be totally destroying your life.

And yet you've described using distraction in this thread, and also becoming completely engrossed in video games...?

In my opinion fight or flight obsession and distraction are not at all the same thing as mindfulness. To illustrate a really potent example, I have two monitors on my desk so that I can run two tasks at once on my computer. When I was healthier I would usually only use the main one, and if I used the second one at all it was just for a secondary task like having a music library open so I don't have to switch between tasks. Right now I am always looking for something to do because my mind is racing with negativity and anxiety all the time, so I look for a game to immerse myself in. It doesn't work because I am not capable of concentrating so usually I open up a second game to play on the second monitor that I play when I experience any down-time in my main game, even if its just a few seconds of down time. If that isn't bad enough, what I find is that no matter which task I put where, I am always looking at my second monitor. I have such an extreme aversion to being mindful that I am perpetually distracted by the secondary task/game. That doesn't mean I'm being mindful at all, it just means my mind is obsessing about something secondary to keep my mind off of the primary task, because my mind associates the primary task with being mindful, being mindful with awful thoughts and memories, and those thoughts and memories with intense pain. I really am not being hyperbolic when I say I am never mindful, even right now as I write this long body of text, the only reason I can do it coherently at all is because my mind is obsessing about this as a way of avoiding what I actually should have been doing for the past hour which is brushing my teeth and going to bed.

 

[Justmehere]

However, if you experience that in a very severe intensity, on a severely chronic basis, especially in a way that has shown to be resistant to many forms of treatment, and cripples you in day to day life, there is actually a solid argument to be made that the feelings are, in a very ironic and roundabout way, accurate

I understand the severity of symptoms you have, but I would not refer to your symptoms as "treatment resistant."

You resist most forms of treatment for the severity of symptoms you describe.

You have made choices to refuse higher levels of care, group therapies, other medications, other therapies, etc, for one reason or another. Have you ever tried holding ice in a panic attack? 4 square breathing? Volunteering online to build up a sense of self worth? Journaling in a trauma diary? Changing how you do IFS and EMDR?

You resist suggestion after suggestion to treat your symptoms. Willfully. As a choice. You are clear, and have written over and over in this thread, "I will not..." It is totally your choice to refuse various treatment options, but it's not the same as having a treatment resistant condition.

Feelings are not facts. They have great value, but they are not facts.

You describe trying to find out the age of the monster.... as an example of how you have already set a boundary with it and ask it to leave the room... and that isn't how that work is done at all.

Every suggestion given, even with how to change the one type of therapy you are willing to do, you dismiss all the as something you have done, and then describe doing it, but you don't actually describe the new thing being suggested to you.

Every time someone suggests building on something you have done well to cope as a tool to build on, you ignore that as well. You twist everything to be another example of your helplessness. Again and again.

I believe your primary focus needs to be on the learned helplessness, not diving into talking to "monsters," because you are not as helpless as you believe yourself to be.

 

[Deleted member 39476]

You resist suggestion after suggestion to treat your symptoms. Willfully. As a choice.

I can't stand the attitude that any of this shit is a choice, it isn't. If any of these suggestions made me feel better at all, I wouldn't be resisting them. I have gone over in specific detail on almost all of them already. I already know that group therapy won't help, I already know hospitalization is a bad idea, I already know antipsychotics are a bad idea, I have tried the breathing exercises, I already know most of the top-down "challenging thought patterns" idea cannot work for me. I'm sure your response is going to be "but you didn't try some of them" I understand how they work and have tried things similar enough to know that they won't work. Especially the ones that require significant executing control and will power.

Every suggestion given, even with how to change the one type of therapy you are willing to do, you dismiss all the as something you have done, and then describe doing it, but you don't actually describe the new thing being suggested to you.

I also really really hate the idea that these options are supposed to feel bad. They absolutely are not. The amount of times someone has told me that the bad feelings that come with almost all of these techniques are normal, and how they are supposed to go, is totally ridiculous. These are techniques that are designed specifically to make you feel better in the short term, and most of them make me feel worse.

You describe trying to find out the age of the monster.... as an example of how you have already set a boundary with it and ask it to leave the room... and that isn't how that work is done at all.

No...I used that as a specific example of how it is impossible for me to set boundaries.

 

[Sideways]

These are techniques that are designed specifically to make you feel better in the short term, and most of them make me feel worse

Wrong.

You'll find thread after thread here where someone has been told "It gets worse before it gets better ". Because it does. For all of us.

On this forum, the suffering you're describing is not unique. The feelings you have about treatment approaches are not unique. We actually do get what it's like.

You are not treatment resistant. You are resisting treatment. You're doing that to yourself. That is a choice.

 

[Justmehere]

Are you willing to try other ways of setting boundaries in IFS? If the answer is no, that's totally your choice.

You are indeed making many choices in yoir treatment. (No one has remotely implied you can choose to not have symptoms, so please don't put those words in my mouth.) You are indeed making choices about what you will and will not try to manage symptoms. You have many reasons for these choices and they are indeed your choice.

While I am concerned you are making self sabatiging choices, I think it's great you have the right of choice in what treatments you choose to do and not.

In all of this I see you expressing a clear "no" over and over. Maybe that is empowering for you to have that choice now to essentially say no over and over? How does it feel for you to set the clear boundary that you won't try grounding skills, group therapy, other therapies, or partial hospitalization?

 

[Deleted member 39476]

You'll find thread after thread here where someone has been told "It gets worse before it gets better ". Because it does. For all of us.

In general in therapy that is true, that does not apply to the grounding exercises though. Going into trauma? yeah no doubt that gets worse before it gets better, but breathing exercises, grounding exercises, thought challenging, etc, are supposed to be short term relief, in the past I have used them for that and it is really clear what they offer and what they do, and they simply do not offer anything to me at this point of severe stress.

In all of this I see you expressing a clear "no" over and over. Maybe that is empowering for you to have that choice now to essentially say no over and over? How does it feel for you to set the clear boundary that you won't try grounding skills, group therapy, other therapies, or partial hospitalization?

I have tried at least 10 different grounding skills and put serious effort into them, they cause me to get worse instead of better. I can't open up properly in a group setting so group therapy does not offer me much. I have tried at least 5 different therapies, almost every one that has been recommended I am either currently doing, have tried and found no benefit, or are things I know will offer me no benefit like CBT. I know that on a deep level, not a learned helplessness, self sabotaging level, CBT cannot help me in my current condition.

Are you willing to try other ways of setting boundaries in IFS? If the answer is no, that's totally your choice.

I mean maybe, I guess it would depend on what you mean by that. That kind of thing seriously brings into play some confusing philosophy though, when you get to this level of internal disturbance and division, it becomes a question of who exactly is setting the boundary, who is in control. My toxic part is stronger than my consciousness. I don't have the willpower to resist a lot of what it wants to do.

 

[Sideways]

No.

Breathing exercises, grounding techniques, mindfulness, cbt, medication, yoga, exercise, talk therapy, emdr...take your pick. They very often make things worse in the short term.

You're writing stuff off because it's not providing you with instant relief. It's not intended to. Recovery? Isn't that easy. Very few things provide instant relief.

You're choosing ignorance over the possibility of starting to recover.

 

[Justmehere]

In regards to breathing and grounding skills, let's try walking through two of them:

How did 4 square breathing work for you? Is there a specific step that brought on symptoms with that specific breathing technique? Were you able to get through this the first cycle, or all 4? It was taught to me by an ER doctor who uses it often with child and adult PTSD sufferers in severe crises/otherwise unable to function due to symptoms. Much more severely symptomatic PTSD patients than what even you describe.

How did holding ice work for you? Can you describe your experience further with that specific grounding skill?


Are you familiar with Peter Levine's book, "Waking the Tiger"? It might be a really helpful read and would explain why avoiding symptoms keeps us stuck, and why symptoms get worse at first as a normal part of the recovery process. It has to do with how trauma is somatically stored in the body.

 

[JEKBreatheandBelieve]

In general in therapy that is true, that does not apply to the grounding exercises though.

From my own experience, that's not true. It very much applies to grounding techniques because you are working on staying in the here and now and not in trauma time or flashback, which means resistance is likely to occur. I never thought any of these things were possible. Then, I practiced a few and they helped. Then, I went into the hospital and learned why I was resistant and worked on more techniques. It didn't feel good and it was definitely a case where things got worse before better and I was definitely in a better place doing it in the hospital than I was at home and I never could have pictured myself saying these things 4 years ago when things were at their worst.

 

[Deleted member 39476]

How did 4 square breathing work for you?

More or less it just causes me to panic badly. I can't breathe out slowly without pursing my lips because there is so much pressure that I just forcefully let it all out. When I hold it I feel like I'm going to suffocate. I find it useful when I am very stressed out, maybe 7-8, but when I am in 9 territory it just doesn't help me at all.

It very much applies to grounding techniques because you are working on staying in the here and now and not in trauma time or flashback

The way it goes in my experience is whenever I try to ground myself, it is a lot like dumping a bucket of water on a prisoner while you are torturing him so that he doesn't pass out. Sort of like I'm living in a dream, and when I try any grounding exercise, whether it is holding an icecube, smelling a potent scent, pressing my feet into the floor, etc, it feels like I'm being ripped out of my dream and waking up in an extremely unpleasant situation. In therapy numerous times we tried different grounding things rather persistently over the course of half an hour, and it just gets worse and worse the more I do it.

 

[JEKBreatheandBelieve]

Sort of like I'm living in a dream, and when I try any grounding exercise, whether it is holding an icecube, smelling a potent scent, pressing my feet into the floor, etc, it feels like I'm being ripped out of my dream and waking up in an extremely unpleasant situation. In therapy numerous times we tried different grounding things rather persistently over the course of half an hour, and it just gets worse and worse the more I do it.

I can relate. That's how it used to be.

 

[Deleted member 39476]

I can relate. That's how it used to be.

It's horrific stuff. Just a minute ago I went outside for a quick walk, heard someone cutting wood with a big electric saw, and immediately my knees went weak, mind blanked out, and I dissociated into this image of me waking up in a dark basement somewhere, where presumably a saw is being used as a weapon. I'm in such a sensitive state right now that random sounds just invade my mind and my mind finds a scary scenario to fit the sound.