Was Told By A Psychoanalytic That You Don´t Need "trauma Therapist" For Trauma

[WillowMarie]

I read here and on numerous other places that people said: it´s really beneficial if not necessary to see a trauma specialist.

From personal experience, I have not had any luck with non trauma specializing therapist. My last one (before I went to a specialist) even had "experience" in trauma. The problem that I have had is that no one really understood the dissociation or how my emotions worked. I had many times where therapist thought I was being difficult because I would shut down and my brain was absolutely quiet and I had a really hard time talking in these times. I even was told by some that there was nothing else they could do to help me. Which really sucks for me because I grew up knowing that no one would help me or stand up for me.

The difference with having a trauma specialist for me is that she understands dissociation, can usually spot me when I am, and knows how to help ground me. She also understands being triggered, watches how I respond to see if I am being triggered, and doesn't make me feel stupid/embarrassed for reacting to things. I no longer feel crazy because I know she understands, which was a big thing for me before because in the past, even by therapists, I have been minimized or told it is no big deal.

So I guess for me, *if* I was able to find a non specializing in trauma that would help/understand dissociation, the emotions/triggers surrounding trauma than I would use them. But again, from my personal experience (and I have had at least ten non specialists before realizing I needed a specialist), I did not find this until I went to an actual specializing in trauma therapist.

 

[greenleaf]

A lot also depends upon the specific therapist... I'd at least want to check into the experience and training re. trauma that the person has, including the type of issues you have in particular.

I think the "GP specializing in colds" comment is way too flippant.

In one listing of therapists I was looking at, each therapist had a list of topics they focus on, not just one topic. Quite a few mentioned trauma or ptsd in addition to a few other things. Virtually none *only* mentioned those. Some didn't mention them at all though so I personally would not likely choose someone not including trauma as a focus.

You can also interview therapists; ask them what treatment types they are familiar with, how they would deal with various situations... These things do take training, and I would think it's hard for a therapist to stay up-to-date in absolutely every issue; or perhaps more importantly, to be able to emotionally deal with every issue and be helpful re. it. Some have odd biases unrelated to their professed professional abilities, which may be due to their status as real human beings. :-) I once saw a therapist briefly who tried to convince me that all the abuse I remembered from my brother was actually due to my father's drinking too much. Well, I didn't remember him drinking too much. Probably because he didn't, and still doesn't. He has issues, but isn't alcoholic. The family dynamics must have reminded this therapist of her family or something, so she decided I was in denial. Go figure...

So, it takes work to find the right therapist, anyhow, and labels are only part of the story.

 

[Deleted member 1860]

@radicalgratitude,
Don't feel bad about knocking "The Courage To Heal". I never found it to be all that helpful, either. Actually, there are a number of highly rated self-help books out there which have provided me with little relief!

 

[Abstract]

UK a GP is not a General Physician but a General Practitioner

Apologies as I was only half functioning it seems. I too am in the UK and I started off trying to answer in accordance with the way Abby was wording things and from the context of how it was used I could see she meant what we call a general practitioner here. I then half flowed back to my own terminology. His comment very obviously refers to a general dr of the garden variety type and not to anyone specialising in anything.

Abby I remember now that I have answered you before about T's. I have had psychoanalysis and there are lots of things I like about it. It's excellent at revealing patterns of behaviour we practice. And yes, if they have done it properly like he was then they are highly trained. What is important to realise though is the type of training is still general. My psychodynamic T wasn't highly trained like that nor experienced but I understand the approach well and have serious concerns about people using this approach with trauma for a few reasons. Not if they mix it with other approaches and only if they are using it strictly. The focus is so much on personal responsibility that it is pretty harsh in an indirect way when it comes to trauma. If the analyst is good then they will ask very important questions to direct the therapy and challenge you but they will never advise or intervene much and so with both trauma and ED, if you are not very good at filling in all the things you need to learn yourself (such as grounding and coping skills) then you drift through years of therapy without any. I also have concerns about trying to speak through trauma itself in certain ways.

What you have to realise about therapists and approaches is that there is a lot of in-fighting between them. Pychoanalysts dismiss CBT, CBT practitioners dismiss psychoanalysts, personal centred therapists dismiss them both etc tec. In my opinion we have to educate ourselves so that we find an approach that fits us personally and I do think someone who uses multiple approaches is a good idea. Both because I think each approach has value and it's uses and because it is an indication that someone isn't too narrow minded.

As someone who had an eating disorder for almost 30 years and was deemed untreatable I personally think it is much easier to find someone helpful for ED's who isn't specialised than it is to find someone who is helpful with trauma who isn't specialised. And it isn't easy with ED's. There are also all sorts of possible problems that usually arise to do with physiological eating issues when one sees an ED specialist who doesn't understand trauma. Someone specialised with either has studied further specifically in the disorder and I would check how many people they have treated too as theory is only half the story.

The actual personality fit and rapport is also very important in t.

This is good advice:

if she or he is experience treating people with trauma histories, if she or he is experienced treating PTSD, and/or what percentage of her or his practice is patients with PTSD, or people with dissociative disorders.... received any specialized training in trauma.... meet with at least two or three therapists before making a decision about whom to see. ... want to find someone who feels right for you. So try to notice how you feel sitting with a potential therapist, and choose the one who you feel understood by and most comfortable with.

I think you sound a little like you think are supposed to get a trauma therapist because people here have said one should rather than you wanting one. This isn't about what others think and you need to do what you think is best.

 

[Abstract]

. Quite a few mentioned trauma or ptsd in addition to a few other things.

The only thing I have found with this greenleaf is that some people will list it if they have had no training but have had one client with PTSD. That is why asking what percentage of their practice is dealing with trauma is a great question. When they have a long list I tend to dismiss it entirely I'm afraid. I totally agree about the personality stuff though.

 

[radicalgratitude]

I am not seeing a trauma specialist at the moment, my T is specialized on eating disorders

I saw eating disorder specialists for a long time. I'm just going to tell you my experience, so take it for what it's worth: They were good therapists in that field with excellent track records for leading people to full recovery. In fact, I got to the point where I thought I was recovered. I was re-traumatized about a year ago and memories have been coming to the surface. Along with the memories have come all the eating disorder thought patterns and behaviors. The same ones that I worked hard to stop.

When I was seeing those eating disorder therapists (who also had experience seeing patients who were victimized but weren't trauma therapists) I would occasionally hear from people, "You really should be seeing a trauma therapist." If only I had listened to them.

Eating disorders with PTSD are a totally different can of worms than eating disorders without PTSD. Now that I am seeing a trauma therapist, we are basically starting at ground zero with the eating disorder but this time looking at it from a trauma perspective.

It's like I spent a lot of time pulling up dandelions from the yard and they have all returned. Now I am using a trowel and pulling them up by their roots.

 

[Abby]

Eating disorders with PTSD are a totally different can of worms than eating disorders without PTSD.

radicalgratitude, thank you for your answer! I found it very interesting, what you´re saying!

Exactly! I was once in a clinic for eating disorders, when I was already back on my normal weight though, and I definitely felt out of place. There was a lot of talking about people´s parents, especially their mothers and dysfunctional family patterns.

First of I felt strongly that I did NOT need to talk about my childhood or entire life history or even daily life problems. Maybe that was a part and interesting but the pressing matter for me was this huge event in the back of my mind and how my world was upside down etc etc
THIS is what I really needed to talk about. However, I didn´t have the courage to bring it up in group therapy and I also didn´t feel like people would understand.. I didn´t understand it myself.

I did not feel like the typical ED-patient at all. I was very sure that if my father hadn´t died and in this way, I would never have turned to something like anorexia.
The second factor for my eating disorder was that I was transferring to a professional dance school 6 months after his death
and when I was in that clinic, I just couldn´t wrap my head around how people could fall into an eating disorder,
if they lived in the "normal" world, where people do have "normal" bodies and it isn´t expected by anyone to be skinnier than "normal".
I was just thinking "why go through all that trouble in the normal world?"

Anyway, I think even if I had switched to the professional dance school at that time but without my father´s prior death, I would not have fallen into an eating disorder. I cannot know for sure, but this is just what I feel.

 

[Abstract]

The one way to be sure that you will get the type of approach that you haven't found helpful is to go towards psychonalysis/psychodynamic work. That is where you will most come across the internal mother concept I mentioned in your previous thread. It is a Fruedian concept.

Eating disorders never occur in healthy families and lives with no adversity. A lot of people will get it as a result of general (non criterion A) abuse in families, enmeshment which is a type of abuse, neglect, or adversity (such as bullying or loss) when they grow up and a significant amount of people will get it as a direct reaction to trauma. With sexual trauma there are a lot of complex effects because of physiological things. Like rightkindofme "rightly" (ha) said, dealing with it as if it is one thing when it is another is not going to work on a deeper level.

What seems like the biggest discrepancy for you though Aby is that yours is not related to childhood difficulties whether they are trauma based or not. You can't easily relate to others who have developed ED's early as a basic survival coping mechanism, an attempt to cope with physiological triggers or to whatever it was they were dealing with. Therefore them bringing therapy back to family dynamics misses the point entirely for you.

Are you diagnosed with PTSD? I am just wondering as depending on the type of loss that could explain some of this T's comments as natural death of a parent doesn't fall under criterion A for PTSD and would fall under the more general concept of trauma rather than a PTSD one if that makes sense. If it was an unnatural death then it would. Has a psychiatrist diagnosed you with PTSD? Just asking to be able to ascertain what would be most helpful for you therapy wise.

I have just looked back and it seems all your threads going back as far as June 2012 are about types of therapy and psychoanalysis in one way or the other.

 

[Abby]

The focus is so much on personal responsibility that it is pretty harsh in an indirect way when it comes to trauma.

abstract, I don´t know for sure. My therapist doesn´t talk much diagnoses. I know that she had to write something to the insurance company. In the beginning she wrote history of eating disorder and adjustment disorder. Only 4 or 5 months later, she diagnosed "trauma" and sent that to the insurance people. However, I´m not sure she diagnosed PTSD.

Either way, I don´t know if I have a full PTSD, however I definitely have symptoms of PTSD. Well... you could say "natural"
but it certainly didn´t feel natural. It was gruesome and cruel....
He died of cancer, which might not seem "big enough" or "bad enough" for to develop PTSD,
but researches have shown that children and young adults can develop PTSD symptoms and seldomly PTSDisorder when
having a parent die from cancer (along with cancer patients and parents of children who have cancer)

 

[Abstract]

Hi Abby, I am really sorry about your father. Cancer is a terrible thing. Yes, that would fall under an adjustment disorder rather than PTSD and that might be very relevant for you when it comes to treatment. If you want to know a little more then there are some good articles in the article section there is a link at the top of the screen.

Adjustment disorders now fall under trauma (the change is probably why trauma was added recently to how your t described this) and it would be the type of trauma the psychoanalyst was referring to when he said the things you quoted in the beginning of the quote. Experiences like this are what fill up a lot of therapists treatment rooms. He is right. Big events like you experienced can be life changing for people and there can be many of the symptoms of PTSD even though it isn't actually PTSD. The difference is the type of re-living that comes with PTSD and that affects many things.

Now that I know this it does change things quite a lot when it comes to what is likely to help you. I wouldn't dismiss your early relationship with your mother and the dynamics you described before. I know it was your fathers death that set all this off but when we react very badly to something like a loss and develop an adjustment disorder I think the seeds are often sown way before. Your feelings about his death are going to be affected by your dynamics in your family on a general level.

I would try to stay open to looking at those whilst making sure they actually help you work through the feelings about his death. There are possibly many things that it will bring up for you too such as your own mortality and feelings about illness and death and the process of being human and having a body that you need to feed and look after. Having messages from the dance school that you needed to be thin probably fed into the other stuff and resulted in this situation for you.

My advice would be to:

1. Be open to looking at the past. I don't think a psychoanalysis would be a bad choice as long as you are also seeing someone like an eating disorder registered dietician at the same time. It could be important with the issues around your fathers death.
2. See someone who understands eating disorders.
3. Make sure they are giving you new coping skills and helping you use them.
4. Make sure too that you are working hard yourself all the time to stop the behaviours.
5. Try to see someone who understands and deals with mourning and loss (they are usually very well trained in issues relating to death too). In the UK there is an organisation called Cruse and hopefully you will have something similar there. The best thing may be to do one lot of healing with one therapist and one type of therapy and then go to someone different for the next so you gain from the different expertises.

Do you have flashbacks?

 

[Abby]

Big events like you experienced can be life changing for people and there can be many of the symptoms of PTSD even though it isn't actually PTSD

What do you mean by that?

Adjustment disorders now fall under trauma (the change is probably why trauma was added recently to how your t described this)

Nope, that is not why. This is something she "newly" discovered in one session, when I was triggered and dissociated.
Only after that she said it was trauma and she newly added this. She also said she didn´t have personal experience with trauma, but had other patients where she worked with EMDR.

From what I´v read, there isn´t a list of things that can cause PTSD and things that cannot. It´s about how you experience things.
Living in an alcoholic household can cause PTSD or in an abusive relationship..

I feel like you maybe do not understand how I feel about it.

 

[Abby]

"An adjustment disorder (AD) occurs when an individual is unable to adjust to or cope with a particular stressor, like a major life event. Since people with this disorder normally have symptoms that depressed people do, such as general loss of interest, feelings of hopelessness and crying, this disorder is sometimes known as situational depression. Unlike major depression the disorder is caused by an outside stressor and generally resolves once the individual is able to adapt to the situation. One hypothesis for adjustment disorder is that it may represent a sub-threshold clinical syndrome.

This isn´t what I feel like.

see here
"
Cancer may be considered a traumatic event, and therefore, it may not be surprising to learn that someone may be able to develop PTSD from cancer. To be diagnosed with PTSD, a person must have experienced a traumatic life event where the following criteria are met:

The person experienced, witnessed, or was confronted with an event where there was the threat of or actual death or serious injury. The event may also have involved a threat to the person's physical well-being or the physical well-being of another person.
The person responded to the event with strong feelings of fear, helplessness, or horror.

When we think of traumatic events and PTSD, we often focus attention on life experiences such as physical or sexual assaults, combat exposure, natural disasters, or motor vehicle accidents. However, the experience of a life-threatening illness, such as cancer, also meets the above criteria and can therefore lead to the development of PTSD."