Nightmares getting worse

[FauxLiz]

My T is has proposed our doing CPT and I had been considering it but ever since we started talking about it and what it means (even though we haven't delved into the trauma events) my nightmares have been getting steadily worse. Some are specifically about the traumatic events, some variations of what happened but with unknown parties involved and the worst nightmares that I don't even remember when I wake up but have me paralyzed with fear waking up shaking unable to move or function.

I took prazosin in the past it really didn't do much and generally when I don't push processing my trauma I can manage the nightmares but they way they are lately I am missing work due to lack of sleep, fear left over from the nightmares that prevent me from leaving the house and struggling to function at times while at work.

I know the concept that things will get worse before they get better, but I am beginning to think that I would be better off not attempting to process my trauma in an outpatient setting as I can't afford to miss a bunch of work as a result of attempting to process things.

 

[blackemerald1]

but ever since we started talking about it and what it means (even though we haven't delved into the trauma events) my nightmares have been getting steadily worse.

Some are specifically about the traumatic events, some variations of what happene

^ Is this your brain responding with fear about the CPT and processing it? The contemplation of it rather than actually doing it?

The problem I see with this is if you don't proceed with CPT (or something else)the underlying cause (trauma) being the subject of the nightmares is not addressed so the cycle is going to keep happening. Maybe the nightmares will ease up when you get into it.

I've never found a medication that I'm able to take that reduces nightmares. Idk.. vivid imagination I think...

 

[FauxLiz]

@blackemerald1 it probably is my brain responding to contemplating processing and working through the CPT process but I just don't know if this is a good idea at this point and time in my life to try and push through in an outpatient setting. I have read through the entire training manual for therapist (I prefer to be well informed not just informed so that I don't get blindsided) and while I get the process the idea of spending 5+ hours a day preparing for, completing homework and finally sitting with the resulting challenges when there are days that I put in 12-16 hours at work and can't really afford to be on an emotional roller coaster, not sleeping, dealing with nightmares etc.

The idea that the nightmares will ease up once I get into makes sense but how far in to it? The protocol for SA is 16 weeks minimum of weekly sessions and daily homework. Even if I turn the corner halfway through the process that is two months at work that I have to be able to function and process simultaneously. And I have to do it without resorting to negative coping mechanism of drinking, medication abuse, cutting, other self-harm behaviors or suicidal ideation. That is a lot to ask of anyone.

 

[Justmehere]

Have you discussed these concern with the therapist? Do they have any suggestions how to handle it? It might be that now isn’t the time to jump into the trauma, but to keep doing work to stabilize and build up skills to handle trauma work and symptom spikes so you can go into it with greater confidence.

You could take trauma work off the table, as an experiment and see how it goes.

When I read through the manual, I didn’t get the impression it would be 5+ hours a day of homework, but I generally found CPT not the right fit for me for now, because of how it dives into the trauma.

There have been very promising studies on CPT-C, which is the version of CPT without the trauma narrative. CPT without the trauma narrative really is just a form of CBT.

I’ve used some of CPT on my own, without the trauma narrative, and it’s been helpful to reduce symptoms.

 

[FauxLiz]

We discussed the increase in nightmares and body memories during session last week and at the time I thought well it is already getting worse so we might as well push through but since I have been a wreck. I don't know if I agreed because I wanted to please my T (something I have issues with in dealing with authority figures), if it was because he has made me feel comfortable and trusting and I thought I could face things but ever since it is a complete struggle. My chronic pain issues are flaring up to the point of missing work and being worried that it will significantly impact a business trip next week.

As for the time commitment, it isn't 5 hours of homework a day it is two hours of preparation and ensuring that not acting on any negative coping behaviors or utilize anything that could affect the processing such taking anxiety meds. An hour of completing the homework and then two more hours of sitting with the results of the homework again not acting on any negative behaviors, not using anxiety meds to cope, not drinking or any other ways of numbing the emotions

 

[blackemerald1]

These are the reasons why I think I would not enter into this type of intensive treatment right now...

I have been a wreck.

Too fragile right now - so need some time to settle and build up resilience. Ask your T how I get to that point.

I wanted to please my T

Guilty of this too.. and it's not a good enough foundation. Leads to feeling less than capable when things go awry.

I thought I could face things but ever since it is a complete struggle

Contemplating the treatment is causing too much disruption. Sometimes avoiding is quite legitimate imo.

My chronic pain issues are flaring up

Emotional pain plus physical pain = being a wreck. So nope.

As for the time commitment,

That's a lot... I think I'd have to be feeling really stable, really well and really committed to push through.

I agree with you and @Justmehere. You are working full time too. In other words maybe you are not ready right now. But, given a little time and maybe some settling of a few external issues and the nightmares... you will be ready. It's not like it's a hospital admission where you will have nothing to do but focus on treatment.

 

[FauxLiz]

Thank you @Justmehere and @blackemerald1 it is good to get a different perspective. I want to be through with all of this and would push myself again to try but I suppose I need to remember back to late 2017 when I was working in a toxic organization and pushing myself to process and be done and things went bad really fast and ended with three hospitalizations and a job change.

 

[Justmehere]

Trauma tends to be something that people ignore entirely or dive right into deeply. It’s just another way freeze, fight or flight / and all or nothing thinking after trauma shows up.

I tend to have an approach of pushing myself until I’m flat on my face. I’ve had to learn the hard way, too many times, that pacing and timing of trauma work is part of recovering from the trauma.

I hope that you are able to find relief soon from the spike in symptoms.

 

[FauxLiz]

Thank you @Justmehere. I do need to work more on pacing and timing, sometimes I just feel like I am never going to get better and I am tired of spending so much time trying to deal with my past.

 

[katz]

I have woken up from nightmares also. Shaking and having to get up just to shake it off. I have to look around the room and assure myself that it was a nightmare, and that I'm safe.

Have you tried writing them down? This always gave me a chance to look at them later, so I could realize what they were. After I had viewed them and realized exactly what they were. They didn't bother me any more. I never had to think about them anymore.