Failed At Emdr Again - Where Now?

[Maggiemay]

Thanks guys - really helped me feel less of a failure. I guess I learnt a lot about myself and as T has admitted, both of us underestimated the severity of my dissociation. Hopefully it'll evidence when I see the psych that I have a dissociation disorder (most likely depersonalization disorder) comorbid with BPD and PTSD. It explains a lot.

Tried normal CBT before and was ineffective - I could do all the strategies, but they had no impact - I 'psuedo mentalise' I appeared to understand but on an emotional level I struggle a lot.

I was left retraumatised last year after paying attention to hot spots so prolonged exposure may cause me o relapse . T I was seeing refused to work on truam,as as it was too unsafe & specialist trauma service rejected me for being too complex...

Sigh...

 

[Abstract]

Maggie, it sounds to me like you first need to up your coping skills and get a little better handle on the dissociation. Have you ever tried DBT and mindfulness?

What have you done when it comes to grounding and general self care and coping? CBT didn't work for me either. What approach does your t use other than EMDR?

 

[Maggiemay]

We've done a hotchpotch really, no one approach. We did some schema work which helped reintegrate my fragments and some reliving - going back and talking to little me. These sessions were the most helpful, but equally incredibly distressing at the time. We seem to do a lot of talking which will never work for me given my pseudo metalizations and somatisation - all meaningless.

She's lovely and gone above and beyond to contain me. She is amazing and taught me so much. Maybe tho I need someone more experienced to help. We have discussed sensorimotor therapy in the past, that may help esp with body memories...

Never done DBT or mindfulness. I did go through a therapeutic community tho 10yrs ago for those with personality disorders/complex Intensive group therapy 5 days a week 9-3. I learnt so much then and helped loads with BPD.

I always thought I had good coping strategies, but it seems I don't have enough. Done a lot of work on grounding and staying in the present, but not enough. I think the 1st step at the no is identifying and understanding my dissociation.

 

[anthony]

If you're throwing around BPD and dissociative disorders, then DBT is the CBT method for you.

 

[Hashi]

Maybe tho I need someone more experienced to help.

Got to say, if you and she are booked onto the same workshop months away about understanding dissociation (I might have read that in a different thread)... is she the best person to be seeing about this?

What is her experience?

 

[Abstract]

Gosh. I would like to know more about what Hashi mentioned.

BPD, I suspect most of us with dissociative issues, as well as those with addictions, OCD tendencies etc all tend to have difficulty with emotion regulation. We might be OK if we didn't have the enormous strain of trauma and related effects of trauma but since this is a reality for us we need a lot of skills to be able to remain in the present and to manage and accept intense emotional states.

DBT is really good at that. It focusses on building emotion moderation skills, grounding skills that form part of everyday living, and developing interpersonal skills that make relationships easier.

I too would love to know more about you t's qualifications. It's great you have had positive experiences with her. What's important now though is to have the correct help moving forward.

 

[Maggiemay]

Anthony - for some reason DBT scares me. I don't know much about it but know a lot is focussed on coping strategies for typically BPD behaviours e.g. self harm and suicide ideation. Although I have a history of these in the past, they aren't current difficulties. But I may be wrong...

Hashi - you're right, it's a course run my PODS (positive outcomes for dissociative survivors) and focusses on trauma and the body as I get A LOT of body memories and sensory flashbacks. She has worked with those with PDs before, but as she said the other day, we both underestimated my dissociation... Sigh...

Abstract - you make DBT look a lot less scary, thanks :) She's a Dr. Of psychology so knows a lot of stuff. But only been practising for 5 years. She's so supportive, but maybe I need to look else where. Issue is I trust her a lot - taken a long time to get to this point...

 

[Abstract]

Does she specialise in trauma or has she done extra studying of trauma Maggie? Do you feel she just underestimated your level of dissociation but is very knowledgeable of dissociation or do you feel she underestimated it and doesn't know as much as she needs to?

DBT is used for many things these days. It's great you have the self harm and SI under control. :tup: DBT helps these things because it develops emotion tolerance and the acceptance of both self and difficult situations. It also builds interpersonal skills and which is very useful for many people.

There are aspects of it that are very helpful for dissociation and managing safety. Would you like to share what your perception is of it? That way we can see if it is likely to be a problem for you.

One way it can be done is in group over a long period of time and ideally the person would still continue with normal therapy.

 

[Maggiemay]

She has done a lot of trauma work, but I know I'm the most complex she's treated, but she refuses to give up and contains me. I am starting to think she doesn't know what to do... Let's see what happens next time I see her.

People I know who have ha DBT have not been working, I need to keep my job as it's my reason for being.

My perception of debt or dissociation? Sorry, feeling thick...

 

[Abstract]

No worries. Your perception of what DBT is. You say the people you know who have done it were not working. Do you think you may have an aversion to DBT because you feel it will associate you with something you don't want to be associated with?

I am starting to think she doesn't know what to do...

I think it would be worthwhile having a definite answer to if she has specifically studied trauma or not and if she is used to and has experience of dealing with those with similar dissociation as yours. Personally I wouldn't want to just hope and see how it pans out and would rather have definite answers so that I could weigh up my options and make an informed decision.

Personally it would concern me if I was the most complex case the person had dealt with. Just my take though and this is about what you decide is best for you.

 

[BloomInWinter]

No matter how rough a session nor whether or not we achieve our goals my therapist and I were aiming for, I never label it as a failure. I showed up, I tried, and that is always a win.

So it is for you. You've never failed in therapy if you've tried. Be gentle with yourself.

 

[Maggiemay]

You may be right Abstract - I've fought so hard to stay working. After 4 months off sick last year I could have given up, but I kept fighting and now have a new job that's not without its own challenges, but I need it to have some self worth, routine & normality in my life.

The person I know who went through it was acting out a lot with serious self harming issues, I guess I've associated it with the dark place I was in 10years ago.

I think she doesn't want to give up on me as that'll just feed into my fear I'm too much and can't be contained. She has helped me so much, but mostly through breaking boundaries e.g. I text/email her regularly between sessions.

Thanks BloomInWinter, I guess you're right ;)