When treatment itself is the trigger?

[Sunset]

I think...I think the first thing, the thing I really need, is for someone to explain things in a way that makes sense. My life, my experience, is trauma followed by trauma followed by trauma again. Often it's out of the blue, even someone you thought you could trust. I can't believe the world is safe when again and again it's proven that it's not safe.

I especially can't when the people who have been the worst to me often said it was for my own good. Indeed in at least some cases they believed it. That goes back to childhood, to a religious education that was supposedly for my benefit that left some pretty deep problems. To psychological treatments as well, that left an 8 year old girl suicidal from the pills she had been given because she wouldn't pay attention in class, and let it go on because kids that age "just want attention". Yet I believe these people really did think they were helping me.

You're right, I do want to be acknowledged. And I want to feel like I'm not helpless, like I'm not spending my life running from this bad situation or that. I'm sick of keeping my head down until things blow over, or running from another toxic situation. But the stuff I've gotten in therapy doesn't address that.

What I want addressed is why. Why do these things keep happening. What can I do when bad situations come seemingly out of nowhere and every avenue of resistance is closed. And they were truly closed, I have spent many hours both in and out of the situations, comparing notes with others, even talking to experts, only to come to the same conclusion over and over again, that the only thing I could realistically do is run.

And then I go in to therapy and it just seems so...petty and unrealistic. Talks about not worrying from someone who's never had to think about how they're paying the next month's rent. Talks about boundaries from people who actually have the power to enforce them. Stuff that while nice doesn't seem to really relate to the situation I'm actually in. Telling me that all this bad stuff is unlikely so I shouldn't worry about when a ton of these "unlikely" thing have happened to me.

I want someone who will engage with me where I am, not where they seem to think I should be. I want someone who can tell me why these things keep happening and how to avoid them. I want someone who will believe me even though my life is probably kind of improbable, who won't try to treat me for negative thinking when the truth is I recognized a shitty situation for what it was. I want someone who can tell me I'm not helpless and really mean it, not someone who will say the words and then put forward a bunch of unrealistic "solutions" to problems (why didn't you make a totally illegal recording so you could take it to the police?) and get mad when I don't take them.

 

[ghotiff]

I lucked up with my new T. I wish for you to find someone as good. She is like night and day to my first T. I'm paying privately which is expensive but we so far are managing the costs.

 

[digger]

Is your wanting and needing these things now, stronger than your need for acknowledgement that someone got it wrong before, is what I'm asking I think?

Correct me if I'm wrong, but in your earlier posts at least, that seemed to be the thing you were focussed on. I understand why, but, I guess what I'm worried about for you, and would be worried about for myself, is that it could become a self fulfilling prophecy. You keep refusing to get help now because of a bad experience with getting help in the past - you get worse because you're not getting help - you end up in a situation where people have no choice but to intervene and do the things you fear most.

As I said before, I don't know how "the system" works where you are so I'm unsure of why you need to go through it? That's what I was asking when i asked what you need from the system itself. What you need from the system isn't necessarily the same as what you need from a therapist, which is why I asked about what you needed from both. Is it that you need a diagnosis, or meds, or a referral? Do you need something specifically from the system in order to get help, or can you get help elsewhere?

 

[Sunset]

It's sort of all tied up together. So for me a major problem is, well these things happened in the past. But I keep being told that strings of events like that don't happen. So with therapy, for example, it keeps me really off balance, because I feel like what I'm being told the risks are doesn't match what I've experienced, especially combined with the knowledge that the same people who are saying the risks are low are often the ones dismissing my experience.

It's like living in a world where you've been assaulted, and a lot of your friends are assaulted. And you ask how do I protect my self from assault, and people tell you don't worry about it, it doesn't happen that often. And worse, you go and say you were assaulted, and people tell you that you weren't really assaulted at all. You'd really start to question if it happens more often than you're being told it happens, and it's just being swept under the rug.

So that's sort of where I feel like I need to start. I need to start with what happened and some semblance of explanation for why, because otherwise I can't trust someone going forward. If someone won't properly acknowledge what happened in the past, I can't trust them to properly tell me what I need to do in the future.

 

[Sunset]

As far as the system goes - yes, I do need meds from them, much as I hate having to rely on them for it. But also, it seems every other avenue I pursue sends me right back and tells me we can't do medical stuff you have to go to a therapist. And I don't have any money to pay for stuff that's not insured.

 

[ghotiff]

" If someone won't properly acknowledge what happened in the past, I can't trust them to properly tell me what I need to do in the future."

I totally get this. Well said.

 

[digger]

Okay, well my take on it is this, and I appreciate you might not agree.

You sound pretty clued up at the moment about what went wrong before, about what you need, and just as importantly what you don't need. I would rather go into the process of looking for a therapist in this frame of mind than wait until I was desperate for help and probably less focussed on these things as a consequence of that.

I do understand where you're coming from and how hard that makes it to get the help you need. When trust gets broken, especially when you're someone who has trust issues anyway, it is extremely damaging. But at some point you're going to have to make that leap of faith with someone if you want help. Better to do that now while you're clear and what you want and need, no?

My therapist has had to work bloody hard to earn my trust, and has to keep working hard to keep it. A good therapist will not be expecting your instant trust. They are out there.

 

[digger]

Are there any mental health charities where you live, or charities relating to your trauma history that might be able to advocate for you, or provide recommendations or support with the process of finding suitable therapy for you? A third, independent, party being involved might help give you a bit more confidence?

 

[Sunset]

The trouble I'm having is that I've often found - like I said earlier - that saying I've had these issues before makes them more likely to be scrutinizing my behavior for signs I'm suicidal. And I'm constantly afraid that I'd end up back in a position where I'm being forced into treatment, if I go in and am at all honest. But I also don't feel like I can really develop the trust I need without seeing how the therapist handles certain things. It takes a lot of trust to ask the questions I feel like I'd need to ask to develop that trust.

I don't think there's anything to help that I've found. Most places I've gone seem to deny that unnecessary forced treatment can itself be traumatic. The attitude is sort of "well the worst that can happen is you have to sped a month or two locked up" like that's not all that bad. And I'm terrified, especially with both various physical problems that can look psychological (eating issues) and my insane reactions to meds.

 

[digger]

But I also don't feel like I can really develop the trust I need without seeing how the therapist handles certain things. It takes a lot of trust to ask the questions I feel like I'd need to ask to develop that trust.

I get that and it sucks, but at the same time, unfortunately only you can break that cycle. As I said earlier in the thread, there comes a point where we have to take a leap of faith sometimes. That doesn't have to be faith in the system, or trust in the therapist before they've earned it, but faith and trust in yourself to be able to do this, because the cold truth of it is, it's only you who can. The therapist can't prove they are trustworthy until you let them.

I know it's not always a popular approach on here, but I do think that with some things we just have to get bloody tough with ourselves initially to get ourselves over some of the hurdles in our way. And unfortunately I think that's all you can do in this situation.

One other suggestion, if you were reading this same thread but it had been posted by someone else, someone with the exact same situation, what advice would you give them? Does that advice concur with the dialogue going on in your head about your own situation? Sometimes I find it helps to step outside of myself for a bit and try and view it from a more objective angle. Doesn't always help, but it's generally worth a try.

 

[joeylittle]

I also don't feel like I can really develop the trust I need without seeing how the therapist handles certain things. It takes a lot of trust to ask the questions I feel like I'd need to ask to develop that trust.

This struck a chord with me. I am chronically suicidal. When asked, "are you having suicidal thoughts", my initial answer was always "no", for the reasons you describe. And then I learned the lingo. So for a big chunk of time, when I was seeing lots of different psych doctors (in hospital settings, where the fact that they could just have you stay feels more frightening) I learned how to tell them about the differentiation between my suicidal thoughts (ideation) and actual suicidal urges (plans).

Most of the time, I could honestly say: "I've had these kinds of thoughts since I was quite young. My suicidal thoughts are very firmly ideation, not actual planning. I don't have a method, I don't have a date, I have not made any arrangements for my finances or said any goodbyes. Being alive is an incredibly painful experience for me, and every day I wish I was dead. But I have no intention of acting on that. I have very strong impulse control. I am safe."

Pretty much, that was the speech. And that was how I was able to really talk about it as a symptom of my depression.

When I was getting to know my current therapist, very early on, I asked what it would take for him to send me to the hospital. I needed to know that we were speaking the same language. We had the conversation calmly, using psych terms (ideation, para-suicidal behavior, criteria for risk to self, impulse control).

Having that conversation is what created trust between us concerning this issue. Not the other way round.

I think you're struggling with two things at once. You are (legitimately) afraid of the consequences of being honest in a psychiatric situation. But also, you are (legitimately) incredibly angry about how you weren't believed, and you have really strong unresolved issues with that doctor who gave you so much trouble.

My best advice would be to get more acquainted with what the terms and criterion are around suicide and risk; the DSM lays it out, and larger health institutions do have a codified policy. Kind of like @digger suggested, see if you can step outside your own experience and analyze how to express yourself using more clinical, less emotional language.

No, it's not "right" that anyone should have to do that much work. But honestly, it helps. At least, it did for me.

 

[kagamine]

I strongly resonate with everything you've said here @Sunset . I also have a very difficult time with therapy because of the treatment I've received in past care, and I'm very cautious about what I say to who, and where. Learning what it is specifically that health care providers look to for red flags is immensely helpful. If you're chronically suicidal, the best way to express that would be along the lines of what @joeylittle said, my go to answer for suicide related questions are "Nothing I'm actually planning to do"

I don't know specifically how the psych system works in the states, but from what I gather it's similar to how it works up here as far as involuntary admissions go. Were you a minor at the time? Because that actually makes a huge difference in how easy it is to admit you against your will. If you are an adult now, they have to have more grounds to put you anywhere you don't want to be, as a child they always will side on caution, and as soon as you say the S word or act in a way that's alarming to them a psychiatrist is already assessing for inpatient admission.

I don't know your situation specifically, but at least in my case most of the trauma I experienced in psych treatment was through the hospital. So I use community agencies. But even going over the fact that therapy in and of itself is triggering to you can help tone it down a notch. The floor my therapist has her office in has a self locking door to keep unauthorized people from overhearing and breaking confidentiality (they deal with family and children services a lot so it's mostly about liability) and it was so immensely triggering I almost quit. So instead we sat outside the door for however long it took each time before we went in, and eventually my anxiety subsided enough that I could handle it. My point is good therapists will be more than willing to accommodate

Another thing that helps in researching your therapist beforehand and making sure it's a good fit. Not all therapists vibe with the psychiatric system, so looking people up online can give you a good idea of their opinions and if they match yours.