Sufferer PTSD Diagnosed, CSA Resolved Yet Dissociation Continues

[spinningmytires]

I'd be careful of putting too much into this. Chances are, your PCP made a remark of non-contact sexual abuse somewhere

Docs will have a working diagnosis listed all the time that they later change with more information.

You don't need to. Healing isn't about returning to a state in which the events that we find disturbing never happened. It's about building the kind of life we want to have now. Sometimes that means looking back, sometimes it means building up new habits in life. Whatever the cause, you have a habit of coping via numbing out. There are ways to replace that with new habits - which is a core part of trauma treatment and healing.

It's not about the exact incident. It's about how you are responding now.

@Justmehere My PCP knows that I'm too anatomically small to have been sexually assaulted abused ....not by any usual means. Other doctors might have noticed this as well. I haven't had intercourse since age 27. Changes occur.

In February 2019, I was interviewed by a psychologist then, a psychiatrist. Yet this psychiatrist, in 2019, hadn't removed my 'PTSD as active' diagnosis from my medical records. It's still there. I'll ask my PCP in a few weeks when I see her.

The problem with my talk therapy is that it never feels right to me. And I don't see how my T can feel right about it, either. I only quit when I can't handle being beaten up anymore. I hate to have to say this but its true. I'm sure my T doesn't mean to be beating me up yet, this is exactly how I feel in therapy and why I terminate. We're always in opposition to each other. My only recourse has been to stop talking and leave.

Hopefully, there's a work-around for these ongoing conflicts because I can't really cope with my talk therapy anymore. It only brings me down more and more.

So then why can't we just work on my disturbing emotional issues (these exist within the present moment) without being in continuous conflict over the trauma source. I am willing to not talk about my trauma in therapy if, this is fine with my T. I think this is why my last T, the Ph.D said she couldn't find the source of my trauma.

This being said, my trauma therapist had best still work with me as a 'whole person' rather than as only the 'part of me' that they choose to work with. I suspect that I'm outside of their comfort zone and I can't change this. This might be part of the conflict. They're only human.

 

[spinningmytires]

No-one would be able to make a PTSD diagnosis off of an MRI, or off of an exam. There's an interview process you'd need to go through. An accelerated heart rate isn't an indicator, either.

It's possible your therapist can't find the source of your trauma because you don't actually have PTSD. You might have something else going on (mental health-wise)...have you considered the possibility that this is not PTSD?

@joeylittle In 2019, I did have an interview with a psychologist then, a psychiatrist a few weeks later. The psychiatrist said that she knew of no drug that could help me. Then said I should seek an older Ph.D for therapy and that EMDR wouldn't help. Lastly she said, "Are you sure you really want to do this?" as she made a disgruntled face. Was she advising me against this, I wondered.

Anyway, I saw this Ph.D for 6 talk sessions last summer and even though she told me that she couldn't find the source of my trauma, this 'PTSD as active' diagnosis is still listed in my medical records. I don't know what to think.

 

[joeylittle]

The psychiatrist said that she knew of no drug that could help me.

That's because there IS no drug for PTSD. There are only medications to address prominent symptoms. If you aren't suffering from any that are making activities of daily life difficult, there's no need to prescribe.

Then said I should seek an older Ph.D for therapy and that EMDR wouldn't help.

EMDR only helps when there's a specific memory to work on. You could, for example, do EMDR on the memory of your father exposing himself, and the other times you remember him being promiscuous around you. But it will only help you if you're experiencing distress from those memories. If you aren't, then EMDR won't do anything.

I suspect she suggested a Ph.D because your diagnosis is actually, unclear - and someone with more experience would be able to draw on a broader knowledge base.

Lastly she said, "Are you sure you really want to do this?" as she made a disgruntled face.

Again, I'm only hypothesizing - but I suspect it's because she wasn't sure there was anything you needed to work on, re: trauma.

Anyway, I saw this Ph.D for 6 talk sessions last summer and even though she told me that she couldn't find the source of my trauma, this 'PTSD as active' diagnosis is still listed in my medical records.

People get mis-diagnosed all the time. Getting records updated can be a complex and labor-intensive process.

Do you feel traumatized?

And: When was the last time you were asked to fill out any type of mental health questionnaire for a doctor or therapist?

 

[Justmehere]

My PCP knows that I'm too anatomically small to have been sexually assaulted abused ....not by any usual means.

Regardless if you were abused or not, most people who go through trauma or disturbing incidents don't end up with PTSD. (Also sexual abuse can occur without penetration.) Some people who go through disturbing incidents or trauma end up with other mental health conditions or none at all.

You are focused on the incident, but abuse or suspected abuse alone doesn't mean PTSD. Based on your symptoms, it's not super clear you have PTSD. You might, and you might not. It also could be that you might have PTSD and something else. That's something to work out with the treatment providers - including why PTSD was/is listed as a working diagnosis. I'm glad you'll talk to your PCP. They are not really super trained though in mental health diagnostics. I strongly suggest getting a work up with testing by a good phd. In light of the surgery, a neuropsych might a route worth considering.

So then why can't we just work on my disturbing emotional issues (these exist within the present moment) without being in continuous conflict over the trauma source.

You can.

The single most influential person in terms of the topics and results of therapy is the client. It might be helpful to claim your role in the driver's seat in your recovery. "No" is a complete sentence, even in therapy. It's allowed.

A lot of people with and without PTSD don't talk about the trauma or disturbing incidents in their life. It's really very common. If you had a therapist jump into parts work or hyper focus on the trauma, or digging to find the trauma, and that's not your thing, ditch 'em. Talk therapy has value, but talk therapy also has it's limits. When I go to therapy, I don't talk about the trauma I went through. I did that in the past, I may again someday, but I'm in a season of my life where I'm not talking about the trauma. I need to focus on me, the whole me. Therapists respect this. I set the boundary up front and deal with the now.

You are not what happened to you in the past or your reaction to it. You are a whole person. Sometimes it can take some time to find the right person and tools to sort this stuff out.

 

[spinningmytires]

That's because there IS no drug for PTSD. There are only medications to address prominent symptoms. If you aren't suffering from any that are making activities of daily life difficult, there's no need to prescribe.

EMDR only helps when there's a specific memory to work on. You could, for example, do EMDR on the memory of your father exposing himself, and the other times you remember him being promiscuous around you. But it will only help you if you're experiencing distress from those memories. If you aren't, then EMDR won't do anything.

I suspect she suggested a Ph.D because your diagnosis is actually, unclear - and someone with more experience would be able to draw on a broader knowledge base.


Do you feel traumatized?

And: When was the last time you were asked to fill out any type of mental health questionnaire for a doctor or therapist?

I'm daily life aside from my depression and irregular sleep pattern is okay. I haven't taken any drugs since 1978. I was on Valium during my first 4 years of talk therapy then on an anti-depressants until 1978. The anti-depressants never seems to help.

I filled out a mental health questionnaire, with interview in 2001 before entering talk therapy in 2001. I did also have an interview with a psychiatrist at that time. She prescribed an anti-psychotic drug which I'd never taken. My T at the time thought I was taking the drug, perhaps, because I wasn't triggering during our sessions. This T had assumed I'd been molested by my father and just couldn't remember it. Only when she'd placed me under hypnoses had I shown much emotion at all other than grieve. But no triggers.

You asked, "Do I feel traumatized?" Yes I do. I'm just no long distressed by my father's abuse. The only specific memory I have regarding my trauma occurred in mid December of 1988, late at night while I was alone in my backyard. I had been hearing a strange sound that shouldn't have been there for perhaps 10 minutes or more. I was then beginning to question what this sound might be.

I was then beginning to realize that I was trapped. I wanted to hit them so much but I couldn't see them. And then I didn't like what I was feeling. Then I just suddenly calmed down for no apparent reason and thought that everything was normal. But then things weren't normal. And so I just ignored these strange things as I walked back to the house. And while removing my jacket I noticed that my clothing was messed up. Yet my messed up clothing haven't bothered at that time. This memory only began to bother me a few days later and has bothered me ever since. Is this a trauma memory.

 

[spinningmytires]

Regardless if you were abused or not, most people who go through trauma or disturbing incidents don't end up with PTSD. (Also sexual abuse can occur without penetration.) Some people who go through disturbing incidents or trauma end up with other mental health conditions or none at all.

You are focused on the incident, but abuse or suspected abuse alone doesn't mean PTSD. Based on your symptoms, it's not super clear you have PTSD. You might, and you might not. It also could be that you might have PTSD and something else. That's something to work out with the treatment providers - including why PTSD was/is listed as a working diagnosis. I'm glad you'll talk to your PCP. They are not really super trained though in mental health diagnostics. I strongly suggest getting a work up with testing by a good phd. In light of the surgery, a neuropsych might a route worth considering.

You can.

The single most influential person in terms of the topics and results of therapy is the client. It might be helpful to claim your role in the driver's seat in your recovery. "No" is a complete sentence, even in therapy. It's allowed.

A lot of people with and without PTSD don't talk about the trauma or disturbing incidents in their life. It's really very common. If you had a therapist jump into parts work or hyper focus on the trauma, or digging to find the trauma, and that's not your thing, ditch 'em. Talk therapy has value, but talk therapy also has it's limits. When I go to therapy, I don't talk about the trauma I went through. I did that in the past, I may again someday, but I'm in a season of my life where I'm not talking about the trauma. I need to focus on me, the whole me. Therapists respect this. I set the boundary up front and deal with the now.

You are not what happened to you in the past or your reaction to it. You are a whole person. Sometimes it can take some time to find the right person and tools to sort this stuff out.

@Justmehere This PCP has been my doctor for the past 20 years. Though our conversations have been brief we do talk more at length now that before. I suspect too that she might checking my cognitive functioning, as I'm age 73. Although one tumor was removed, I know that I have two more smaller ones in my cranial fossa. These doctors aren't saying much, as they likely don't want to stress me out. I might be just fine. These tumors grow very slowly and are generally found in the cerebellum and cranial fossa area. I was born with them. I was only told to watch for symptoms.

My development brain damage effects my language skills and ability to process symbolic associations, as I was told at age 35. I confuse words as I type and it's frustrating. My reading speed is equal to that of a second grader. I do far better when vocalizing as there it isn't even noticeable.

You wrote, "The single most influential person in terms of topics and results of therapy is the client." I think my therapists have only understood the second part of this statement. The first part might be broadly posted across their wall. My T can view any trauma topic as being a diversion, especially, when they aren't noticing any trauma triggers or anxirty as I talk about this trauma topic. And so, from their perspective it looks more like a diversion.

 

[spinningmytires]

EMDR only helps when there's a specific memory to work on. You could, for example, do EMDR on the memory of your father exposing himself, and the other times you remember him being promiscuous around you. But it will only help you if you're experiencing distress from those memories. If you aren't, then EMDR won't do anything.

Do you feel traumatized?

@joeylittle Yesterday, I suddenly realized that I might have one specific trauma memory to possibly work on. I wrote about this trauma experience yesterday in this thread.

While describing my trauma memory, I noticed that there had been a brief moment when I had questioned my perceptions and was not quite fully in a dissociate state. This was the moment where I had begun to feel extremely emotional and threatened.

So yesterday while sitting at my computer and briefly describing and typing out this most vivid trauma memory event, I very suddenly overwhelmed with emotion. I began to clinch my fists while raising my arms in the air. My breathing became short and rapid as I began to shriek while striking my fists against my front thigh, at times.

I had been sitting at my computer at that time and quite suddenly began to intensely emote. I knew I had to pull myself back out of that increasingly intense emotional state which I then did. I soon calmed down and began to weep. Then, this same intense surge of emotion had begun to raised within me a second time, where I was again was able to quickly calm down again then weep. I then just curling up in bed for awhile to comfort myself. Later I felt like my 'normal self' again. No flashbacks nor additional recall.

I really don't want to know the details within this trauma memory. Physically I haven't suffered any injuries that I've noticed. What concerns me, now, is rather my quality of life in the present moment and of how I can best learn to feel safe in my relationships with others and within the 'here and now.'

I feel good about how I was able to pull myself back out of this intensely disturbing emotionally state so quickly. I didn't want to experience this emotional state for any length of time. And certainly not when I'm alone.

This traumatic memory experience seems quite similar to how I felt when my T had placed me under hypnosis in 2001. During both experiences I was shrieking with my fists clinched and arms held high. In both experiences I was unable to see whatever it was that was threatening me. In both I had also felt trapped.

I was also surprised that this very emotional trauma memory recall had caused me to weep yesterday. I rarely ever cry. I haven't broken down and cried at all, not since my rehab doctor had visited me after brain surgery in 2018. Six weeks later, I'd visited this same doctor, again, for my followup where, I had dissociated in his office. He had apparently observed me as 'switching on and off' a few times.

 

[spinningmytires]

My doctors have recently advised me to get more therapy.

Again, my PCP recently asked me to seek therapy …so I explained why talk therapy no longer helps me. I then asked her, if, she knew who had diagnosed me with PTSD in 2018. She said she didn't know. Really Is this possible?

The following day, my PCP had apparently removed this PTSD diagnosis from my online medical records and had replaced it with Dissociation Episodes. The 'Suspected Victim of Sexual Abuse' is still listed as active. Can my PCP make these changes, herself, as she is not a psychologist?

She then asked me to describe my father's non contact sexual abuse, again …yawning, I described. I then told my PCP that, I had terminated my previous talk therapy because my T was often making absurdly irrational comments in response to what I was saying. I can only assume that she was speaking nonsense to me because she might have assumed I was fabricating my experiences. I was not. Yet without her respectful communication, not even after our 6th session, I quit. Perhaps, this had been her attempt to discourage me from talking about my deeper personal experiences. I don't know.

Yet, there always seems to be a point where my T will 'cut me off' from whatever I am saying. For example, my past therapists had responded by saying things like, that's only your imagination …don't ever mention this again …your mind is making these things up to cover up what really happened to you …this was your father molesting you …I want to go around this. So then, my last T had responded to my experiences with her own irrational explanations. And when I tried to point out her errors in judgment she replied with a firm and often repeated, "No, you are mistaken!" If my T is going to throw logic out the window, there is no discussion and I'm leaving.

My PCP then said, I needed to stay with the same therapist for more than a few sessions. Yes, I know this and I did stay with my first T for 12 years and my second T for 13 years. But then we never talked about any underlying trauma of suspected sexual abuse. My CSA hadn't ever been discussed during my first 4 years of talk therapy as I was then totally unaware that this abuse was happening to me. Not until age 24 had I become consciously aware of it. Perhaps I'm still lacking in awareness.

Even after my CSA had been resolved, some of my symptoms persisted. My psychiatrist then prescribed Elavil for my depression which never helped, while telling me that my ongoing anxieties and panic-attacks were caused by my vivid imagination. What vivid imagination? One blurry motionless dark spot floating around in my mind and I don't know what that is about and then I'll sometimes begin to panic when washing my hair in the kitchen sink. These fears had seemed to come out of nowhere. Fortunately most are gone now. In regards to psychosis, no one had ever suggested that I take anti-psychotic drugs other than just one T in 2001. I only saw him one time and never took the anti-psychotic drugs. No drugs for me since 1978.

I then told my PCP, about a few of my past altered-state experiences. Now I suspect this might be why my PCP recently added this new diagnosis of 'Dissociative Episodes' to my medical records.

Briefly, I had described that in 1978, I thought I had suddenly died in my sleep. This experience wasn't frightening nor did it seem 'dream like.' I had then attempted to awaken myself only to realize that I couldn't. And so I attempted to grasp my blankets in my effort to awaken myself only to realize that nothing seemed physically solid to me. I wasn't feeling any emotion at that time perhaps because I wasn't perceiving myself as having any physical body. I was experiencing myself as being alone and unable to see anything but a total darkness. I can only conclude that I might have been in some kind of altered-state where I was unable to awaken myself. Or was it that I was already awake.

I realize that I'm grasping at straws here or perhaps, have fallen into the rabbit hole in my effort to explore what might had possibly been mistaken as a trauma of sexual abuse. So where is this 'suspected sexual abuser' anyway but in my mind, as I suspect this might be what my PCP is now thinking.

So after I'd briefly described a few of my altered-states to my PCP, she then asked, "How many of these experiences have you had?" I answered, several. She then say, "No, you just told me that you had only 'one' experience!" Then she went on to say, 'you aren't being truthful …you're making these things up as you go along …don't you see what you are doing?' I replied, "No, I never said I had only one experience." Actually I've had several and have been journaling them for over 20 years.

Perhaps I should be the one asking the questions, such as, Why am I actively listed as a 'suspected victim of sexual abuse?' And why am I still having these dissociation episodes?

So as my PCP was leaving the exam room, she said, "I think you are schizophrenic and that you are living in denial of your schizophrenia." I thought wow …perhaps I shouldn't have mentioned these altered-states. These altered-states aren't anything new to me. I've been struggling with them for most of my life. Fortunately they might only last a few minutes, if that. Then too, these experiences doesn't happen very often.

She has been my PCP for the past 20 years. I would think that, by now, she would realize that I've always been truthful with her.

 

[spinningmytires]

Again, my PCP recently asked me to seek therapy …so I explained why talk therapy no longer helps me. I then asked her, if, she knew who had diagnosed me with PTSD in 2018. She said she didn't know. Really Is this possible?

The following day, my PCP had apparently removed this PTSD diagnosis from my online medical records and had replaced it with Dissociation Episodes. The 'Suspected Victim of Sexual Abuse' is still listed as active. Can my PCP make these changes, herself, as she is not a psychologist?

She then asked me to describe my father's non contact sexual abuse, again …yawning, I described. I then told my PCP that, I had terminated my previous talk therapy because my T was often making absurdly irrational comments in response to what I was saying. I can only assume that she was speaking nonsense to me because she might have assumed I was fabricating my experiences. I was not. Yet without her respectful communication, not even after our 6th session, I quit. Perhaps, this had been her attempt to discourage me from talking about my deeper personal experiences. I don't know.

Yet, there always seems to be a point where my T will 'cut me off' from whatever I am saying. For example, my past therapists had responded by saying things like, that's only your imagination …don't ever mention this again …your mind is making these things up to cover up what really happened to you …this was your father molesting you …I want to go around this. So then, my last T had responded to my experiences with her own irrational explanations. And when I tried to point out her errors in judgment she replied with a firm and often repeated, "No, you are mistaken!" If my T is going to throw logic out the window, there is no discussion and I'm leaving.

My PCP then said, I needed to stay with the same therapist for more than a few sessions. Yes, I know this and I did stay with my first T for 12 years and my second T for 13 years. But then we never talked about any underlying trauma of suspected sexual abuse. My CSA hadn't ever been discussed during my first 4 years of talk therapy as I was then totally unaware that this abuse was happening to me. Not until age 24 had I become consciously aware of it. Perhaps I'm still lacking in awareness.

Even after my CSA had been resolved, some of my symptoms persisted. My psychiatrist then prescribed Elavil for my depression which never helped, while telling me that my ongoing anxieties and panic-attacks were caused by my vivid imagination. What vivid imagination? One blurry motionless dark spot floating around in my mind and I don't know what that is about and then I'll sometimes begin to panic when washing my hair in the kitchen sink. These fears had seemed to come out of nowhere. Fortunately most are gone now. In regards to psychosis, no one had ever suggested that I take anti-psychotic drugs other than just one T in 2001. I only saw him one time and never took the anti-psychotic drugs. No drugs for me since 1978.

I then told my PCP, about a few of my past altered-state experiences. Now I suspect this might be why my PCP recently added this new diagnosis of 'Dissociative Episodes' to my medical records.

Briefly, I had described that in 1978, I thought I had suddenly died in my sleep. This experience wasn't frightening nor did it seem 'dream like.' I had then attempted to awaken myself only to realize that I couldn't. And so I attempted to grasp my blankets in my effort to awaken myself only to realize that nothing seemed physically solid to me. I wasn't feeling any emotion at that time perhaps because I wasn't perceiving myself as having any physical body. I was experiencing myself as being alone and unable to see anything but a total darkness. I can only conclude that I might have been in some kind of altered-state where I was unable to awaken myself. Or was it that I was already awake.

I realize that I'm grasping at straws here or perhaps, have fallen into the rabbit hole in my effort to explore what might had possibly been mistaken as a trauma of sexual abuse. So where is this 'suspected sexual abuser' anyway but in my mind, as I suspect this might be what my PCP is now thinking.

So after I'd briefly described a few of my altered-states to my PCP, she then asked, "How many of these experiences have you had?" I answered, several. She then say, "No, you just told me that you had only 'one' experience!" Then she went on to say, 'you aren't being truthful …you're making these things up as you go along …don't you see what you are doing?' I replied, "No, I never said I had only one experience." Actually I've had several and have been journaling them for over 20 years.

Perhaps I should be the one asking the questions, such as, Why am I actively listed as a 'suspected victim of sexual abuse?' And why am I still having these dissociation episodes?

So as my PCP was leaving the exam room, she said, "I think you are schizophrenic and that you are living in denial of your schizophrenia." I thought wow …perhaps I shouldn't have mentioned these altered-states. These altered-states aren't anything new to me. I've been struggling with them for most of my life. Fortunately they might only last a few minutes, if that. Then too, these experiences doesn't happen very often.

She has been my PCP for the past 20 years. I would think that, by now, she would realize that I've always been truthful with her.

I'm scheduled to see a new PhD next week. I've been out of therapy for well over a year now. But now I'm wondering if I should tell this new PhD about my unexplainable experiences. I had mentioned these experiences to all of my previous several therapists since my mid 20s -- Yet after telling them my relationship with my T would always grow more distant.

I've noticed that my therapists will then become more disengaged within my therapy. Or my T will become almost hostile in stating their disbelief in what I've been describing as my experience. Perhaps out of precaution my T might then decide not to investigate these unexplainable experiences as this might only re-traumatize me. Yet I'd only mentioned having these experiences because my memories of them continue to disturb me. Then too, during this experience I had felt no fear nor emotion and perhaps, because at that time I wasn't perceiving myself as having a physical body. Perhaps this might also be why my PCP had interpreted this experience as being a dissociative episode.

I can certainly understand my therapist's avoidance of this issue along with their precautions. But then here again, my feelings of isolation will increase as I then realize that I'll seem unreal to my T …as if I'm only a fabrication, misinterpretation or delusion. And then how can anymore truly relate to that.

Sometimes I have to decide what information to share with my T. They might simply be asking me about my difficulty when falling asleep at night. And so should I really tell them why I fear closing my eyes in my darkened room and that this sometimes reminds me of another experience that still disturbs me. This experience I had recently tried to explain to my PCP a few months ago, where she then stated, that she thinks I'm schizophrenic and living in denial of my schizophrenia.

My PCP. also recently replaced my PTSD diagnosis with Dissociative Episodes after I'd tried to explain to her my seemingly 'out of body' experience which actually occurred in 1978 and possibly not again until once in 1997, as far as I can recall. As for my diagnosis of mood disorder and GAD …I'd agree as I've always feared sexual intimacy with a life-time of low-grade depression. Yet this 'suspected victimization of sexual abuse' that is still in my medical records is a mystery to me. My last recall of sexual abuse occurred during my CSA, by my father, which was previously resolved. My father died 20 years ago. Anyway…

In addition to this experience of seeing a total darkness during this experience I was then also consciously aware of being unable to perceive my physical body during that time. At first, I thought I was merely dreaming until I began to realize that I was unable to awaken myself. (Was this because I was already consciously awake …was this another episode of sleep-paralysis that was unlike the other sleep-paralysis episodes before it …I have to wonder)

And so within this experience I tried grabbing hold of my bed sheets thinking that that bit of physical sensation might help to awaken me -- yet it was then that I realized that nothing of any physical nature was perceivable to me. I had at that time tried to scream but then I couldn't feel any movement within my chest, breath nor vocal cords. Nor could I hear my scream. I seemed as if to be suspended within an empty space void of light.

And so I began to think that I must have suddenly died during my sleep. And yet I can recall being puzzled as to why I was still able to think. This experience might explain why I don't always feel safe when falling asleep at night. Or might I be far better off if I never mention having had these experiences to my T.