Need therapist, but terrified and resistant

[mumstheword]

I am learning about methods of treatment here on this site. I just looked up therapists in my local area.
The thing is, they all sound terrifying.

I've had a mixed bag of success, seeking treatment.
I think I need more specialized help but the thought of trying out new therapists has gotten me in a twist.

I really don't trust people easily at all. I think opening up to people I don't know, who claim to be able to treat me and know all this stuff about my condition are pretty scary, in general.

I do see two free therapists at the moment.

One is a "Trauma Counsellor" I was on a list to see for a year or so and I've been seeing her for close to a year now. I like her but my condition has been so bad lately, I don't think she's qualified enough to help me get down to the nitty gritty, if you get my drift.

The other is a psychologist at uni. She's a free one too. Both of them validate me constantly, but is that enough to help me get better?

I've been so ill with it lately. Not like I used to be because I was severely ill and abused for many, many years, but it's rendered me nearly non-functional.

I mean I can do basics, wash, dress myself, even cook food sometimes, be kind to my partner and children. But beyond that I'm not doing too well.

Do I need a specialist therapist and if so, what should I be looking for in a therapist?

My main symptoms I struggle with now are;

Intermittent agoraphobia
Social anxiety
Social avoidance
freeze mode (a lot)
emotional flash backs
rumination
very low energy
Dull foggy brain
Huge memory loss and memory problems
Intermittent deep grief and depression
debilitating shame, self-disgust, and lack of social confidence (there are contexts where this is not so though)
Sometimes raging and crying (lots of crying, only mild raging)
I have been sleeping a lot in the day lately and not so.much at night, it is a big pain ...

Probably more but those are the main ones of late.

 

[The Albatross]

Perhaps you could flesh out more/write about how or why you found the ones you found by researching "terrifying"?

 

[mumstheword]

It was an emotional reaction to all of the therapists that came up when I googled
EMDR, or whatever that eye movement therapy is called, sorry, very vague, can't remember the initials.

Then I googled PTSD therapists for my local area each one that I read about I just felt an aversion for and a big rush of resistance to putting my self in the hands of a stranger who claims all that. Fear and mistrust of authority figures, I'd say.

I felt cynical, thinking, they say they are all that but what if they mess me up more?

I had a very bad experience with a psychiatrist and a series of humiliating and further demoralizing and disappointing experiences with a number of different psychologists and councellors in the past.

 

[The Albatross]

What is the quality or caliber of the therapeutic assistance you are currently receiving?

And how do you feel about those relationships/services?

 

[mumstheword]

I don't think they are trained in any kind of exposure type therapy. It seems like they just want to give me positive feedback about how great I am and validate that I've had a lot to deal with.

And how do you feel about those relationships/services?

I enjoy them. They are kind and positive, but I don't feel like I am getting support to get through the trauma that has damaged my brain, endocrine system and emotional body.

 

[One step at a time]

You have a lot of good self-awareness.

I think opening up to people I don't know, who claim to be able to treat me and know all this stuff about my condition are pretty scary, in general.

That's totally normal.
(1) A good therapist doesn't expect you to open up right away; they expect to earn your trust.
(2) They also will know their own limitations, and be able to communicate with you when you need more/better/different support. They will provide recommendations for where to go.
(3) So, one question is: can you bring this up with your current therapist/psychologist? Tell them or write to them that you feel you need more support, and ask that they help you find it?

I'm pretty wary of therapists myself. Last spring, when I had to talk to a therapist that I did not know, I literally handed the person a piece of paper on which I wrote:
(1) I have PTSD. I have had bad experiences. I do not trust you.
(2) I am here because [insert circumstances].
(3) I need [insert needs, starting with "need you to be very honest. no sugarcoating or talking around things."]
...in your case, you might include "help figuring out what I need in order to heal."
The person said "I don't expect you to trust me, and I will try to help with that. I promise to be honest with you." I still didn't trust her, but I decided her answer wasn't awful and we could work together.

 

[The Albatross]

Okay so... you currently have two service providers in your present that are giving you a positive experience... but you are giving preference emotionally for your past experience. Would that be correct to say?

 

[mumstheword]

Okay so... you currently have two service providers in your present that are giving you a positive...

I am giving preference to the fact that I've gotten much more debilitated by my illness lately. That I'm more lacking in functionality than ever, in some ways. Which is really just an indication that I've gotten too exhausted from "faking it" and putting on a brave face all the time.

I was very ill for a long time but had too much surviving and protecting of my children to do to deal with my life-long symptoms of PTSD, now it's like it won't let me shove it aside and take care of others or fake my way through.

It's gotten worse because it was untreated for many years, and traumatic event compounded upon traumatic event but I had to fight really hard to survive and then to try to save and protect my kids. Now they are ok, I can focus on myself more and I want to work efficiently and effectively to get better.

So I want to learn from others what sort of approach has helped them and what to look for in a good therapist.

I'm asking because of my cognitive distortion.

I don't know how to trust "sane people" as in people who've never gone through anything like this.

All the people I trust give me peer support.

Therapists I don't trust so much because maybe they only have book smarts and no real deep lived understanding, maybe they will be condescending or try to tell me inaccurate things about me that are unhelpful.

This I don't need to be out of pocket for.

I don't know what modalities actually help this kind of condition so I'm asking for seasoned therapy-attendees for their wisdom and experienced perspectives.

You have a lot of good self-awareness.

That's totally normal.
(1) A good therapist doesn't...

This is really helpful, thank you :-) i will refer to this when approaching someone new, and I will talk to my uni psychologist about seeing who she might recommend.

There are other psychologists at uni that mention they treat PTSD but they cost. So I'll ask my lovely freebie shrink who she thinks might be a good fit, coz she knows me well.

 

[One step at a time]

Some (highly subjective) thoughts on modalities (which you should take with a very large grain of salt because I am not a trained professional):
- CBT: focuses on interrupting repeating cycles of behavior/thoughts/feelings that feed into one another.
- DBT: focuses noticing and managing your reactions to stuff in the now. Recognizing and deescalating stress reactions, etc.
- good trauma therapy in general involves: stabilizing, slowly processing trauma as needed/tolerated, figuring out how to live with the consequences. [I like the videos Babette Rothschild has on youtube about "keys to safe trauma therapy," but she isn't the only person out there with a sound approach].
- EMDR: a particular technique for processing trauma that involves focusing on specific memories. Not always advisable for complex PTSD. [note: bearing in mind that "CPTSD" is not yet a diagnosis, here I use "complex" as a descriptor.]
- Somatic Experiencing: a particular technique for learning to stabilize yourself and live with/mitigate your PTSD symptoms. Relies on grounding in body, paying attention to what your body feels.
There are definitely other paths towards healing and other forms of therapy, but these are the ones I hear about most often.
Come back and let us know what comes out of that conversation, if you want. Rooting for you.

 

[Justmehere]

That a wonderful plan to talk to your current providers about finding a specialist.

Do I need a specialist therapist and if so, what should I be looking for in a therapist?

I used to see general therapists, and when they focused on building up skills to cope with emotions and symptoms, it was good and helped a lot. When it became about them just saying things to help me feel good about myself in the sessions or simple every-day-life coaching... eh, not so helpful. I didn't really make progress. Good trauma therapy is frankly usually a bit uncomfortable and challenging at times.

At the same time, studies have shown the single biggest factor in therapy helping is not the technique - that is a very important factor but not the most important. The most important is the relationship with the therapist. Keep that in mind as you sort all this out.

When I switched from general therapists to therapists trained in one or more trauma techniques (not just "trauma" listed amoung 30 other topics they treat) my own recovery and treatment became much harder and much more effective. I made more progress in 3 months than I had made in 3 years.

Common research backed trauma treatment techniques include: EMDR, DBT, CBT -- especially TF-CBT (trauma focused CBT) or mindfulness based CBT, some exposure therapy or prolonged exposure therapies, Somatic Experiencing, some psychodynamic techniques, Internal Family Systems, Acceptance and Commitment Therapy... and I'm sure I'm leaving a few out.

A good therapist for someone with ptsd and/or a trauma history should be able to explain what techniques they use to treat trauma.

They are kind and positive, but I don't feel like I am getting support to get through the trauma that has damaged my brain, endocrine system and emotional body.

With the level of symptoms and struggle with day to day functioning that you describe, I wouldn't recommend diving deep into exposures work with trauma off the bat. A trained trauma specialist would probably spend time on stabilization and building up skills at first. Trauma work can be a little destabilizing - you'll read all over on the forum that things usually get worse before they get better. This is why solid trauma trained therapists will work a lot on stabilization for a bit.

In therapy, if you are diving into talking about the trauma but not working on emotion regulation skills and ways to cope between sessions, then that often leaves someone feeling stuck and maybe a little worse. No one is doing anything wrong, but it might be a sign that something needs to shift.

I don't think they are trained in any kind of exposure type therapy. It seems like they just want to give me positive feedback about how great I am and validate that I've had a lot to deal with.

I think one of the conversations that you should have with your current team is to ask them for sure what they are trained in and how they plan to treat your symptoms. If they can't outline a general treatment plan to address the trauma and your symptoms, then I'd lean all the more towards askino about a trauma specialist.

As an alternative to switching therapists right now, I'd suggest considering adding a well structured skills based group therapy, if that is an option. I have really struggled with resistance with therapists for many reasons. I found group therapy to be an amazing tool to get past my resistance and trust issues with therapists. This isn't everyone's experience, but I gained SO MUCH by working with peers on gaining skills and processing through things with a therapist there to guide and teach the whole group.

One of the other things that stands out is how much you feel like the therapist will be condescending. I have run into a few arrogant therapists - generalists and specialists. I can't stand them. So I run from them... and I found therapists who were humble and that I clicked with better. Some of my sense of the therapists was my own distorted thinking. :/ My therapist now - she challenges me to share any bad feelings I have about her with her, because that negative transference is part of what a good trauma therapist can help someone work through. There is some amount of needing to find someone you click with, enough that you might be willing to risk talking with them about any negative feelings and thoughts hat come up about them - it goes back to that piece of the therapeutic relationship / alliance being a key part of the process.

If you do check out some trauma therapists, I'd plan on talking to at least a few to get a sense of how they do things and their style.