Therapy Making it worse

[Syd.vicious]

The past year or so has been really hard for me. I’m 19 and just started going to therapy for things that happened for years in my childhood. This year has been the first time I’ve admitted I needed help and that my anxiety and cptsd were out of control. (I didn’t know it was cptsd but makes sense now). With that I go to therapy once a week and after ever session I feel so drained and I am more likely to have nightmares or flashback that evening or the next day. It makes me not want to go or truly discuss things because if I discuss the worst I’m afraid the flashbacks will happen and become worse. I just feel like therapy is making me worse rather than helping me. People also say it gets worse before it gets better but I don’t think it’s suppose to get this bad. Recently it just makes me more suicidal because of the influx of flashbacks and nightmares. I have never been so suicidal and it scares me.

 

[osiris]

Hey @Syd.vicious. Welcome to the forum.

Sounds like a really rough time for you, and it is something people here can definitely relate to. Dealing with all the things that have caused the trauma can be really painful, and unfortunately I think it does have to get worse before it gets better.

That doesn’t mean that you can’t get through it though. Have you spoken to your T about this? If you let them know that sessions are leaving you feeling this way they can look at the pace or content of what you are going through - they can make adjustments depending on your window of tolerance, which might help.

Do you have anyone outside of therapy that you can also get support from? Being able to check in with someone could also be a good plan.

In between sessions try and be kind to yourself if you can. You are doing something brave by getting help and that is a hard but good thing.

Keep talking here if it helps, a trauma diary is something that lots of people find helpful too.

 

[Justmehere]

Well done for reaching out for help in therapy and elsewhere. Takes a lot of courage.

Have you told your therapist about your symptom spikes after sessions? Is your therapist a generalist, or do they specialize in trauma?

There are several phases and parts to trauma therapy. Simply going in each week and stirring it all up and leaving a wreck can end up reinforcing symptoms rather than lowering them. Recovering from PTSD is much about symptom management and reduction, not just talking about trauma. One of the key elements is working on a good base a skills so that when someone dives into the trauma, and when the spikes of symptoms comes, they have a base of skills to manage and reduce those spikes. Another part of good trauma therapy is working on containment when talking about trauma - or "putting the work away" rather than the brain continuing to process after sessions. There are also times where slowing down the pace is part of the path to recovery. Are these things the therapist has gone over with you?

 

[Friday]

People also say it gets worse before it gets better but I don’t think it’s suppose to get this bad.

Yes & no.

Dealing with trauma without stabilizing, first? Often/Usually results in varying degrees of symptom spikes leading to a whole host of reeeeally predictable results: unable to function in life (homeless & jobless), lost relationships (&/or explosive/toxic/exploitative/abusive/desperate relationships remain &/or are forged, whilst healthy relationships die), rapid decompensation, and death <<< HUGE risk of suicide attached, as well as accidental deaths (overdose, thrill seeking, exposure, starvation/dehydration, untreated illness & injury) from either f*cked up coping mechanisms or that inability to handle life.

I fought against the whole “stabilize first” thing for yeeeeears.

But I really cannot underline it’s importance, enough.

Stabilizing? Comes in 2 forms... both equally important / both have to be present.
- Life
- Mental/Emotional

Most people in the US have their life at least roughly stabilized before starting therapy, because there’s no way to pay for it, otherwise.

Meaning a person has a job/income, a place to live, and probably have regular interactions with others, even if one don’t have any relationships with others? One still has colleagues or classmates/ gas station attendants/ strangers passed on the street/ etc. (which may sound ridiculously isolated, in the need/want of real relationships; but still speaks to the ability to at least act human in public, which can shatter). Meaning don’t discount even seemingly meaningless interactions. It’s a step, if not a foundation to build upon.

((In socialized medicine countries, however, (and in some rare instances in the US) a person’s life may be in utter shambles whilst starting therapy.))

So, in the US at least, when one hears “stabilization” what’s usually being referred to is mental/emotional: with or without meds... learning the tools & strategies to keep oneself -at least relatively- sane during impossibly difficult times.

So, yes. It’s perfectly normal to be experiencing severe symptom spikes whilst in therapy, but? No. It’s not something that should just be sucked up (or to die for), but something that STRONLY indicates more stabilization is needed. Either in life, or in one’s mental & emotional arsenal. ALSO meaning : Talk to your therapist abot what’s happening. A good trauma therapist will stop any and all trauma-work to shore up your life &/or mental emotional skill-set. There’s couch to 5k for a reason. Not Day 1 Marathon. ANYTHING difficult or challenging needs a rather comprehensive lead-up & serious training to do well, without killing yourself.

 

[Rani G2]

Stabilizing? Comes in 2 forms... both equally important / both have to be present.
- Life
- Mental/Emotional

Most people in the US have their life at least roughly stabilized before starting therapy, because there’s no way to pay for it, otherwise.

I wish someone was able to describe therapy the way you do in 2003.

 

[Survivor3]

The past year or so has been really hard for me. I’m 19 and just started going to therapy for things that happened for years in my childhood. This year has been the first time I’ve admitted I needed help and that my anxiety and cptsd were out of control. (I didn’t know it was cptsd but makes sense now). With that I go to therapy once a week and after ever session I feel so drained and I am more likely to have nightmares or flashback that evening or the next day. It makes me not want to go or truly discuss things because if I discuss the worst I’m afraid the flashbacks will happen and become worse. I just feel like therapy is making me worse rather than helping me. People also say it gets worse before it gets better but I don’t think it’s suppose to get this bad. Recently it just makes me more suicidal because of the influx of flashbacks and nightmares. I have never been so suicidal and it scares me.

sorry that your feeling like that. It's true, it does get worse before it gets better because your telling someone the worst aspects of your life and so those thoughts and feelings are at the surface of your mind. When I was seeing my counsellor I would manage what I was talking about so that I wouldn't just disappear down a deep dark rabbit hole. Sometimes I would change the topic to something lighter and more positive to bring myself back up. All the best to you. S3

 

[Syd.vicious]

Hey @Syd.vicious. Welcome to the forum.

Sounds like a really rough time for you, and it is something people here can definitely relate to. Dealing with all the things that have caused the trauma can be really painful, and unfortunately I think it does have to get worse before it gets better.

That doesn’t mean that you can’t get through it though. Have you spoken to your T about this? If you let them know that sessions are leaving you feeling this way they can look at the pace or content of what you are going through - they can make adjustments depending on your window of tolerance, which might help.

Do you have anyone outside of therapy that you can also get support from? Being able to check in with someone could also be a good plan.

In between sessions try and be kind to yourself if you can. You are doing something brave by getting help and that is a hard but good thing.

Keep talking here if it helps, a trauma diary is something that lots of people find helpful too.

Thank you. I do have someone who helps to ground me on those really bad days. I have told my T but I think I have been holding back on how bad it is and that is obviously not helpful. I am going to be more open with how bad its been at my next session.

 

[Syd.vicious]

sorry that your feeling like that. It's true, it does get worse before it gets better because your telling someone the worst aspects of your life and so those thoughts and feelings are at the surface of your mind. When I was seeing my counsellor I would manage what I was talking about so that I wouldn't just disappear down a deep dark rabbit hole. Sometimes I would change the topic to something lighter and more positive to bring myself back up. All the best to you. S3

Yeah, see my biggest coping mechanism is sarcasm so when I'm leaving I'm "laughing" and distracted by my own jokes. Yet as soon as I get in the car to drive home and alone with my thoughts I start really spiraling. I think I need to start focusing on the current good things in my life at the end of the session rather than the beginning so I leave on a higher more positive note.

 

[Syd.vicious]

Yes & no.

Dealing with trauma without stabilizing, first? Often/Usually results in varying degrees of symptom spikes leading to a whole host of reeeeally predictable results: unable to function in life (homeless & jobless), lost relationships (&/or explosive/toxic/exploitative/abusive/desperate relationships remain &/or are forged, whilst healthy relationships die), rapid decompensation, and death <<< HUGE risk of suicide attached, as well as accidental deaths (overdose, thrill seeking, exposure, starvation/dehydration, untreated illness & injury) from either f*cked up coping mechanisms or that inability to handle life.

I fought against the whole “stabilize first” thing for yeeeeears.

But I really cannot underline it’s importance, enough.

Stabilizing? Comes in 2 forms... both equally important / both have to be present.
- Life
- Mental/Emotional

Most people in the US have their life at least roughly stabilized before starting therapy, because there’s no way to pay for it, otherwise.

Meaning a person has a job/income, a place to live, and probably have regular interactions with others, even if one don’t have any relationships with others? One still has colleagues or classmates/ gas station attendants/ strangers passed on the street/ etc. (which may sound ridiculously isolated, in the need/want of real relationships; but still speaks to the ability to at least act human in public, which can shatter). Meaning don’t discount even seemingly meaningless interactions. It’s a step, if not a foundation to build upon.

((In socialized medicine countries, however, (and in some rare instances in the US) a person’s life may be in utter shambles whilst starting therapy.))

So, in the US at least, when one hears “stabilization” what’s usually being referred to is mental/emotional: with or without meds... learning the tools & strategies to keep oneself -at least relatively- sane during impossibly difficult times.

So, yes. It’s perfectly normal to be experiencing severe symptom spikes whilst in therapy, but? No. It’s not something that should just be sucked up (or to die for), but something that STRONLY indicates more stabilization is needed. Either in life, or in one’s mental & emotional arsenal. ALSO meaning : Talk to your therapist abot what’s happening. A good trauma therapist will stop any and all trauma-work to shore up your life &/or mental emotional skill-set. There’s couch to 5k for a reason. Not Day 1 Marathon. ANYTHING difficult or challenging needs a rather comprehensive lead-up & serious training to do well, without killing yourself.

Yes, I see a trauma therapist and I do think I need to discuss how badly these sessions have been affecting me. Thank you for the advice. I am still very new to this world and been keeping stuff hidden for a long time so it is really hard for me to open up when I'm truly hurting even to my T. But I know that is the only way I will truly get any better.