Any experiences of using nhs "traumatic stress services"?

[Teasel]

Key to me getting this help was getting referred to - I think they call it secondary mental health instead of iapt. Wasn't an easy ride, and only got the referral I needed after a psychotic episode. I got incorrectly diagnosed with bpd twice before being referred to the PTSD team for assessment.

I've heard ptsd treatment provision is a lotto depending on where you live. One if the reasons I have not left my abusive ex, as to do so would have made me ineligible to continue treatment.

 

[Mee]

as to do so would have made me ineligible to continue treatment.

Sigh and shake head and offers hug if you accept them.

 

[RVA21]

I felt it was not hearing the cause of my trauma

That's exactly how I felt when they gave me CBT too. I've read some stuff about attachment and one book said CBT isn't helpful for people with certain attachment styles. Can't remember which ones - maybe disorganised. One psychologist actually cut me off and changed the subject when I was in the middle of telling her about one of my traumas (which does still impact my life today).

 

[Mee]

That's exactly how I felt when they gave me CBT too. I've read some stuff about attachment and one book said CBT isn't helpful for people with certain attachment styles. Can't remember which ones - maybe disorganised. One psychologist actually cut me off and changed the subject when I was in the middle of telling her about one of my traumas (which does still impact my life today).

Ah yeah. That’s me disorganised ( fearful / avoidant). @barefoot have you tried a Cbt approach before?

 

[barefoot]

Sorry it's taken me a while to reply and thanks for your responses.

@berlinda - wow, it sounds like you'd had access to some great stuff! Thanks for outlining it all so clearly - really helpful. The groups you've described are the kinds of things I'm hoping for but I don't know for sure if that's a realistic hope because I haven't been given details and, as we've all said, services two vary by area.

I wondered if it would really make a difference as I thought I was pretty educated about PTSD already but I learned some things that were extremely helpful to me.

the psycho-education helped me to understand ptsd in a way that just cleared up a lot of the shame

This all sounds great! My on-going struggle with shame is probably the key reason why I'm looking to potentially access the trauma service.

It being a group was really good for me too. Was a relief actually, to be in the company of others who are like me and to feel accepted and understood.

Yes, I get this. When I did a CBTi course for my parasomnias, I didn't find the CBT parts of the course very useful. But it was quite reassuring somehow to meet some other people who did freaky things in their sleep! Not that we all talked about our own experiences very much...it wasn't a very 'sharey' group. But I guess there was just a knowing within the group that we were all having night time challenges that most people don't experience and don't understand.

we would not be expected to share painful experiences

Yes...I don't think I'd be very good at it if the emphasis was on sharing painful experiences...!

the happiness Trap by Russ harris

Will have a look at this.

It's un-paralyzing me!

This is brilliant! :)

If I had the option of waiting a year or two for courses like Berlinda is getting I’d take it and keep seeing my T in the meantime.

Yes, I think this is what I'm thinking. I'm definitely not going to go ahead with the general CBT (albeit with a therapist who's had 'a bit of training' in trauma/PTSD) But I'm still frozen in action. Haven't called the woman back to ask her to swap me onto the other waiting list. And there is a huge part of me that wishes I hadn't gone down this route at all. And I spoke to my T about it this week and also wish I'd kept my mouth shut about it there :(

I felt it was not hearing the cause of my trauma-

I can understand that...

One if the reasons I have not left my abusive ex, as to do so would have made me ineligible to continue treatment.

So sorry to hear this – what an awful position to be in!

I've read some stuff about attachment and one book said CBT isn't helpful for people with certain attachment styles

Interesting...I'll look into this...

@barefoot have you tried a Cbt approach before?

Only on the CBTi course I did for my night terrors/night time hallucinations. I found it frustratingly simplistic.

 

[barefoot]

I spent a whole therapy session this week filling my T in on all this. Telling her about getting the referral to the trauma service from my GP, then the stressful phone call and the confusion about which part of the service I was accessing, now having to make a decision but not wanting to phone the woman back...and also telling her that I'm feeling angry about some specific trauma info being shared with the person who did that assessment call (either because she had access to my medical records, which include a note about it, or because my GP wrote it in her referral) and that the person on the call then blurted it out as though it was nothing and used language I would never use to describe it...

It doesn't feel ok that something so private and personal (and non-essential for the assessment) has been shared without my permission. And it just reinforces my belief that doctors aren't trustworthy.

And that's really the bit I most wanted to talk through with my T. But I got caught up in all the other stuff because I felt I had to explain the background and context to her, to explain why it was that I was on this phone call in the first place where someone then threw me a loop by confronting me with an historic traumatic experience.

And I think it was a mistake. T looked quite baffled – I don't think she thinks a referral to either service is a good idea. She kept asking what it is I'm looking for there...what I'm hoping to get as an outcome...and I couldn't really say and just kept saying 'that there might be something helpful.' Which I know sounded lame. And she kept pushing and asking what in particular I'm looking for help with. And I don't really know so couldn't articulate it and she was just looking confused and I felt awkward.

Then I felt obliged to try to reassure her that it was nothing to do with her...it's not that I think our working together is unhelpful so it's not like I don't think she's helping and that I want to find someone else instead. But this service is a free, specialist resource near where I live, so it feels like a no-brainer not to at least see if there's something useful...but that I don't want her to think it's about her...and it's a year or so wait anyway and I don't even know yet if I want to do it...and it's definitely not about her...etc etc.

She laughed a bit awkwardly and said 'okaaaay' in a tone that sounded like 'yeah, right.'

I think in my efforts to have her not feel bad, I probably sounded like I was protesting too much...and then probably made her feel like this is about her! And, I know it's not our job to take care of our T's feelings. And I'm sure she's fine. But it felt awkward.

And, as usual, I wish I'd just kept my mouth shut and kept it all to myself.

 

[RVA21]

It sounds like you're looking for more specialised trauma therapy - which you've said your current therapist can't do? Is that right?

Also -

More recently we have spent more time on my work/business than anything else - I guess that really I have been using her more as a business mentor. Which has been very helpful. But I think I now find it a bit difficult to switch between different topics - eg from having a few sessions of business coaching to then doing deeper therapy stuff. Plus, since she's not a trauma therapist (as many UK therapists aren't!) I wonder whether a more specialised approach would create something a bit different and perhaps kickstart things a bit again.

I understand how that would make it difficult to then jump from business to deeper trauma stuff. You also mentioned about wondering if the trauma services could help you with shame in an earlier post?

Maybe your therapist was just concerned she isn't doing enough to help you?

You're well within your rights to look for the other therapy though, it's all about your healing at the end of the day.

 

[barefoot]

It sounds like you're looking for more specialised trauma therapy - which you've said your current therapist can't do?

The thing is, she's the only therapist I've ever had, so I don't have anything/anyone else to compare her with! She doesn't describe herself as a trauma specialist. But then, not many therapists in the UK do, I don't think. So, I think I have in my head – go to the trauma service as they will have more specialist expertise and will therefore be able to help you in a different way....but I have no idea if that's true!

I understand how that would make it difficult to then jump from business to deeper trauma stuff

It can be difficult to switch gears sometimes...

You also mentioned about wondering if the trauma services could help you with shame in an earlier post?

Yeah...because I think it's something I still struggle with quite a lot. I find it so excruciating even saying the word shame out loud! I'm not sure if I just have hope for this trauma service...that they will be able to somehow create a shift that I haven't been able to make. At the moment, if I try to talk to my T about shame or if I'm sharing something (an experience etc) that evokes a lot of shame...I tend to shut down, lose my voice, dissociate etc. So, it sort of stops us in our tracks and gets in the way. So, I'd like to think that hardcore trauma experts (I don't even know if that's what they are - or even what that really means) at the trauma service will be able to crack this. But, in reality, I think the same things will happen...shame will get triggered and I will shut down, space out and not be able to speak. So, perhaps t isn't anything about my T or the trauma service and who will be able to do it better/who will help me more. Maybe the issue is just that I can't do it :-(

Maybe your therapist was just concerned she isn't doing enough to help you?

Yes, maybe. A long time ago (3 years+) when we were going through a rough patch (!) she got a bit defensive about some feedback I was giving her and something like she didn't feel that I thought she was enough. And I remember getting all panicky about that and falling over myself to reassure her that I didn't feel that way. And, truth be told, I didn't feel that way....that kind of felt more like her stuff (that she didn't feel enough rather than I didn't think she was), in my mind. But I think that's partly why I was quick to say it wasn't about her the other day. And, again, yes, I know it's not my job to make sure she feels ok!

I did wonder earlier if all the pressing me to get me to say what I really wanted from the trauma service was actually her trying to find out what I was looking for so that she could see if she could do that...

I don't know. It all feels a lot more complicated...which is why I quite wish I hadn't bothered with any of it.

 

[RVA21]

You say maybe you just can't do it but I think with practice you would be capable of doing it, of doing anything you need to in therapy. You're able to explain things really well on here and maybe it is just a matter of someone giving plenty support and encouragement to you?

Might it be helpful to write down some of these thoughts and take with you to your next session with her? She could read some of how you're feeling and you might be able to avoid shutting down to an extent?

(The reason I ask about writing it down is because I recently - for the first time ever in therapy - gave my therapist a written timeline and brief outline of stuff I'd talked about with a previous therapist - and I found it massively helpful. One, because it saved so much time. And two, because I didn't need to say any of the difficult words and thoughts I was having as I do tend to start crying and find it very hard to stop).

 

[Mee]

I think it’s true that how therapists describe themselves is really different- not just Uk to North America, but other places have differences too.

My therapist specialises in sexual trauma and has also worked extensively with perpetrators. BUT she works as a general therapist. I recall her reasoning is that with so many people having experienced sexual trauma and sexual trauma rarely appearing in isolation of other ACE factors or environmental issues she thinks all therapists should be more trauma informed. Sadly of course- we know that’s not true.

I do think that being met in such a way that you felt you were assuring your therapist it wasn’t about her is unfortunate.

FWIW I think it’s great you have bothered with it all. This is all so challenging but it’s an environment in which you should be safe to put your needs first.

 

[barefoot]

I think with practice you would be capable of doing it, of doing anything you need to in therapy.

Thanks for the encouragement! Though I've been in therapy for 5 years now, and it feels like that should have been ample time to practise!

You're able to explain things really well on here and maybe it is just a matter of someone giving plenty support and encouragement to you?

She is very patient, caring and encouraging. Sometimes I'm not sure that's a big help though. Because it can feel very uncomfortable.

Might it be helpful to write down some of these thoughts and take with you to your next session

I sometimes do big brainstorms of topics on flip chart sheets and take them in. We then look at them together and it gives me some structure and focus to talk through things. And it helps to say some things that are hard to say (or can sometimes mean I don't have to say those things at all). It works really well. I haven't done that for a while.

And sometimes if my voice gets hijacked in a session but my head hasn't checked out, she'll ask if I want to write down what I want to say.

So, yes, writing can be useful. And I'm glad you found a useful in to discussing some difficult things by writing out your timeline.

I often think that if we could sit in different rooms and text each other, therapy would feel much more bearable and be much more productive! :)

I recall her reasoning is that with so many people having experienced sexual trauma and sexual trauma rarely appearing in isolation of other ACE factors or environmental issues she thinks all therapists should be more trauma informed.

Yes, exactly. My T has said that she has lots of experience working with women who suffered abuse as children or who have been sexually assaulted. So, I don't think out of her comfort zone/experience/skill set in terms of the sorts of traumatic experiences that form the context of our work together. I'm not really sure what her training is.

I do think that being met in such a way that you felt you were assuring your therapist it wasn’t about her is unfortunate.

To be honest though, I think this is more on me than it is on her. It's not that 'she made me feel' that I had to reassure her...it was my anxiety that made me feel/do that, I think.

She wasn't off or defensive or anything in our last session. She really just seemed surprised/confused that I was suddenly going down an NHS route five years into our work together. And I guess, it is a bit odd for her to be working with me long term and we generally have a good relationship and open communication...and then I suddenly say that I'm considering a different option. I imagine it did come out of the blue for her.

And then I think me feeling awkward meant I over-compensated on the reassurance front...which I think meant she was then a little awkward for a while...

it’s an environment in which you should be safe to put your needs first.

Needs/neediness/feeling needy...that's a difficult area.

 

[RVA21]

I think you need to be kinder on yourself because there's no set timescale for people to work through different things in therapy.

Does the encouragement feel uncomfortable because it's something you're not used to?

Maybe it's time for some more brainstorming on paper again then?

Lol, yes that would be easier if they're not in the room, I have thought that myself in the past! :) Seriously, I was surprised when I gave my T the written stuff, it was such a relief to not have to say some of it out loud and then she asked me questions about some of it and it felt much more manageable.