Relationship Therapist In Training - What Advice Can You Give Me?

[orangeweezel]

Hello everyone. I am therapist currently in my Masters program studying Clinical Psychology with an emphasis in Marriage and Family Therapy. I am trying to research more on PTSD and thought this group of people would be able to teach me more than any book could. I have a general knowledge of PTSD and have learned what was taught in my grad program, but I would love to hear an insider perspective on anything you think will be relevant for me to know in my work as a therapist. I want to be as educated as I can in order to help those I work with in the future. I highly respect everyone here in their quests to work toward healing and would love to be better equipped to support and encourage others working through their own trauma.

Thank you in advance for any help you can offer in helping me grow as a clinician!

Rachael

 

[desiderata310]

Just read.
Most people are going to say here what we can't or won't say to a therapist.
The list of stuff you should "know" about is far too long.

 

[abby96]

Have a cozy but professional space. Not like a huge desk between you and your client, with them in an uncomfortable plastic chair. Maybe even cusions on the floor....a few options for clients (I love sitting on the floor)

I move a lot, fidget, curl up. Some therapists inadvertently shamed me for this ("do you think you might have ADD?") Like they weren't just as awkward about my body as I was and that was just extra shaming. CPTSD (early near death and medical procedures, and abuse). Symptoms: anorexia, alcoholism, self-injury, suicide attempts, mildly dissociative, don't feel okay in my body. I'm doing body-focused trauma therapy (Somatic Experiencing)...good fit for me. So maybe read up on the body connection to trauma and envision a space that allows clients to feel comfortable and move if needed. Maybe a few stuffed animals. Interesting things to look at but overall calm and grounding space. Patiently try to ask the client to describe what he/she feels without jumping in to tell them what it is. It might be a slow process, but more real if it is their process without too much interpretation...only where it seems helpful.

If someone stops talking, don't mirror their awkwardness and shut them out (I feel abandoned). Ask them questions, gently, that allow them to nod...just to know they are still connected. Keep asking easy questions and work on a bunch of techniques to help with grounding. It helps when my therapist holds my feet against the floor, especially if I'm "floating" or feel like I'm levitating. She never abandons me with that but is prepared to keep the connection going at a quieter, slower level. Slow processing is healthier than figuring it all out in a few sessions. It can take a lot of time. Even if a client wants to rush to fix themselves, help them working on grounding, pacing, keeping the processing and healing moving slowly and at a manageable pace.

Good luck!

 

[sun seeker]

Yes, it's like @desiderata310 said. This is a very open-ended question, so open ended in fact that you're going to get a lot of stumped people not knowing where to begin. A few months back there was another therapist in training here asking a similar question. My answer at the time was something like this: imagine that you are going about your life when an alien knocks on your door and when you answer it, says "I'm conducting research into life on your planet, can you take a few minutes to tell me what it's like to be human?" What would you say?

PTSD affects every aspect of a person's life. Nothing, but nothing, remains untouched. If you can articulate some specific questions, you will get answers that guide you to a better understanding. Keep it general and you'll get a lot of frustration.

Something else you can do is read through some of the extensive Therapy forum on this site. There is lots there to keep you busy. If you come up with specific questions as you read, by all means come back and ask us. Good luck.

 

[Samantha_38]

I was one of those "stumped" people. I agree with the rest so far. It's too hard to explain everything, but honestly you could watch chat for an hour and get a lot of good information just from that.

Good luck!

 

[Friday]

You've got good instincts, Rachel. I've learned more about PTSD here, from others like me -including stellar resources to plumb-, than I have in school or therapy. Ya wanna know the ins and outs? Yep. Straight to the trenches. Good on ya.

Like the others I'd encourage you to read read read as much as you can on here. TheVault tab up top as a great place to start. For specific questions, feel free to jump in and ask. (Open ended ones have the dual problem in that there's simply so much, as well as being kind of counter-disorder. Like asking an ADHD kid to sit still ;) That's my comorbid disorder, so I example it out a bit) I usually kick newbies these 2 resources as hands down the most useful to me:

The Ptsd Cup Explanation

https://www.myptsd.com/threads/understanding-post-traumatic-stress-disorder-ptsd.86476/

Here are a few of some of my other favorites

Link Removed

Stressor vs. Trigger - What Is A Trigger?

Killing Is Not What Messes With Your Head

The Ideal Carer

Waiting

Things To Know When Dealing With PTSD (As a Carer)

I'm constantly finding new & amazing information on this site... It is an absolute treasure trove of information, spanning years with thousands of people with PTSD & the people who love (and are exasperated by) them from all over the globe. And there are new posts every day. Some absolutely killer ongoing conversations.

Welcome.

 

[Deleted member 1860]

Please, DON'T watch chat for an hour and think it's representative of us as a whole! Sometimes chat is serious. Sometimes people are at their wits end. Sometimes it's lighthearted and we good around. Sometimes people use chat as a venue to just drain other people. It really is a mixed bag. Read threads if you want the most info. Chat tends to not get as deep, even for serious matters.

 

[Friday]

Also... If you expect to be dealing with PTSD on a fairly regular basis either with sufferers or supporters (near a military base, or other target population dense area like tornado alley or Lousiana/ Katrina & other flood survivors)?

I would strongly suggest starting to network with local trauma therapists, see who you get on with, can work with. Getting some good teamwork going. Trauma therapy is very different from most other forms of therapy. If my original (amazing, but out of his depth with non sexual abuse PTSD) therapist had had any contacts so we could have 2 prong approached? So they could share notes & each work their own front? (Like a psychiatrist / counselor one does med management one does counseling team approach) It would have been inordinately helpful.

 

[Suzetig]

Undertake your own therapy and really work on yourself. Seriously, you'll learn what it's like to be a client, to make yourself completely vulnerable to someone else, what a therapeutic relationship is like from the clients side, how challenging it can be to show the parts of yourself you struggle with most to someone you pay for the privilege. You'll also find out how skewed that relationship can feel at times, the power imbalance and the way the most stupid things can take on meaning for clients.

I know most course have a therapy requirement, I guess what I'm saying is don't dial it in, or treat it like an academic exercise, find someone you can work with long term and do it. That one thing will enable you to empathise with your clients and understand the importance of relationship and boundaries more than anything else you could do. Good luck with your training, you sound like you're coming from a good place.

 

[mamachick]

I agree with everything others have said. Knowledge is a great thing and there are lots of books out there, professional papers, and special trainings even after you get your masters. Many bigger cities have a trauma center where they might allow you to do an internship or training and that would be a great opportunity to get some hands on knowledge.

I had my masters in Counseling Psychology for several years before a single incident on top of some daily situation brought about my ptsd. I can only tell you that when you attend such a program, you learn a lot of stuff and are able to diagnose and treat, there many overlapping symptoms and things, that you already know before making a conclusion. When I was in grad school, I actually believed that I had experienced depression in my past and had been treated with anti depressants and therapy. Well, I guess I had not really experienced depression. Because the depression was diagnosed long before ptsd, and the depression was so disabling that I could not function. I probably had experienced some minor depression, associated with grief. I am only validating what others have said, it is so life altering, so unique to each, that it is almost impossible to describe.

One small bit of advice, never be afraid to ask. Ask when you see subtle changes, what is going on, what are you feeling right now, what is happening, I thought I noticed a change when xyz, can you tell me about it, etc. Like others said, ask specifics here, listen and read all you can, and if the opportunity is there and you have some interest, get training that is not required. I spent over 100 hours in intensive day long trauma trainings that included those with ptsd and DID among other things, and still was not prepared for the experience. I survived so many life adversities and was strong, or thought so anyway. Take care of yourself. I think burn out rate is high. It cant be easy work. I was a trainee, so the beginning was mostly observation, moving on to some therapy work, art therapy and so forth. As I look back, I can see it through the clients eyes in a way that I did not, or could not at that time.

I dont practice at the time. I dont diagnose. I have been on a break from work for several years and do not know that I will ever be able to return. I am resistant to that thought, but am a realist.

Think of hanging a ball and chain around your neck that is your own weight, then go about your daily obligations. Its only my opinion, but I would have rather lost my limbs. A stranger might even open a door for someone with a visual disability. At times, some irrate driver giving me the finger can send me back home without the intended plan for the day. Of course I self talk, stay positive and talk through many things, but at times all the resources and skills still fail me. Any threat can become critical, and you can tell yourself that you are irrational and that might work. You can talk on forum and analyze, I was doing so well, why this incident, and never come up with an answer. For me, it can drive me crazy and that might be because I am very analytic, or was at one time.

I wish you the best and am sure you will find answers. There is nowhere to go but forward, just like the rest of us.

 

[The Albatross]

Welcome. If I had any advice I guess it would be to stay up on research and continuing education venues in your area of specialty. As your specialty is "Marriage and Family Therapy" though I imagine there might be some components about PTSD I guess my question would be why are you asking people on a PTSD forum? But that aside, "The Vault" (at the top of the page in the black header, there are various good resources.

 

[sun seeker]

As your specialty is "Marriage and Family Therapy" though I imagine there might be some components about PTSD I guess my question would be why are you asking people on a PTSD forum?

I'm not the OP, but I think it's a great thing to combine the two specialties. I recently started what will eventually become family therapy with my mother (we haven't gotten to the point yet where I feel able to be in the same room with her and are working with the therapist separately). One of the things I demanded before I would consider doing this was that we find a family therapist with a solid background in trauma. Anyone without this background, I felt, would try to work on a level that was too superficial and wouldn't be able to help me create the safety I need to make family therapy work, or even make it possible. We got lucky and there was such a person in a small town.

I did have one other thought. To work with people with trauma issues, and especially if the trauma comes from childhood, you need lots and lots and LOTS of patience. It takes time. It takes creating safety and trust, which can be one step forward and two steps back over a long period of time. Then working on processing, while being sensitive to pacing so the client doesn't become overwhelmed. Then there might be coaching and encouragement on all the life skills that got missed while the person was busy surviving. All the while there will be lots of pauses and detours to deal with crises as they come up. Insurance plans that cover 8-12 sessions and then expect people to be cured aren't going to cut it.