Dissociation preventing any progress in therapy

[EveHarrington]

The thing is we generally don't do any EMDR, we tried it a few times to see what would happen, and then...

So you've tried a few antidepressants.

What is "the hard stuff" and why is that a bad idea for you?

 

[Deleted member 39476]

How is your day to day functioning?

Really poor basically. I'm not exaggerating anything when I say I'm in fight or flight (or in my case freeze) 24/7, even while I sleep. Even if I wanted to do some of the more methodical tasks that are valuable, such as writing in a journal, attempting to meditate, making a conscious effort to break negative thought patterns, etc, I can't do it because I'm just so on edge literally all the time. The dynamic for me would be totally different if I was reasonably calm for 1 hour a day even. The last time I was calm for a period longer than a couple minutes was over a year ago and it lasted only a few hours after a really productive therapy session. In my day to day life I can't sleep well, I can't work at all, I can't wake up, I have basically no control over myself, I eat compulsively, fail to maintain even very basic things like laundry and dishes, basically utter dysfunction in all categories. I can't even brush my teeth twice a day even though I know how important it is to do, the act of going out of my way to do something mundane for a couple minutes causes me such a severe degree of stress that I can't make myself do it. Often I find that when I'm brushing my teeth or having a shower, I end up staring at myself in a mirror or just sitting in the shower spaced out for minutes at a time. At one point I tried to journal how I was feeling once every day for a month. I did it for a week and then a month later realized that at some point I just totally forgot to do it, or got distracted, and then never did it again. I cannot even exercise consistently anymore because if I hear a loud noise or see anything stressful I blank out and lose control of my body mostly.

All that is mainly the reason I'm talking here. My therapist is really good at what he does, has tried numerous strategies each with their own merits, and recommended many important things like meditating, yoga, martial arts, exercise, healthy diet, and helped teach me how to do them when I had difficulty, but the degree of disturbance is so high that I just can't do it.

What is "the hard stuff" and why is that a bad idea for you?

By hard stuff I mean things like benzos or painkillers. The kind of things that help for a couple hours then leave you far worse off than before you took them, it would be of no help for me because my symptoms are all 24/7, there's no way I could do them without developing a really bad habit.

I would like to add that I fully understand and respect the value of all of these techniques, methods, perspectives, in normal context. I have felt reasonably normal before, used these techniques and they did feel good and help. When I came down from the severe arousal and just felt mildly anxious and mildly depressed, my thoughts were mostly neutral/positive, but I was aware when negativity was creeping in, I used some CBT techniques to work with it, I used the deep breathing and mindfulness, brought myself back down to calm. The problem is that none of those techniques (at least for me,) work with someone who is going through a panic attack, emotional flashback, whatever you would call it. When you're dealing with someone who is one of those extreme states, first you must bring them down to a more normal state and then apply the other techniques.

My problem is that I am always in one of those states, and all the techniques I have ever tried to bring myself down either fail or backfire and make the situation worse.

 

[Suzetig]

he problem is that none of those techniques (at least for me,) work with someone who is going through a panic attack, emotional flashback, whatever you would call it. When you're dealing with someone who is one of those extreme states, first you must bring them down to a more normal state and then apply the other techniques.

That's not true in terms techniques not working. These techniques are specifically to help ground you when you are in those states. You may feel they don't work for you but I'd suggest you need some form of inpatient support if you literally have no control over yourself. I do remember being in the state you describe for a very long time - it was a slow chipping away but I'm much more grounded now and can tell when I'm in a flashback now, which I couldn't at one point, so constant were my flashbacks that I thought that's just how I was.

How are you feeling when you post here, for example? Your posts seem pretty coherent so I'm guessing you're not in a panic or flashback. Maybe starting a diary here - not for trauma content just yet but to mark a place, reach out to people etc could be the start of you regulating yourself.

 

[Deleted member 39476]

snippty snab

They don't do anything for me though. Every single grounding technique I have ever tried just cause me to re-enter a state of severe panic, which then causes worse dissociation. I have some control over myself but it is really poor. For example if I feel the urge to eat compulsively, I more or less cannot resist, if I try to consciously resist the urge to do it I basically collapse on the ground because the stress is way too much. I can't make myself brush my teeth twice a day, some part of me only lets me do it a minimum of once a day. Otherwise I am basically in control, I have never cut myself. I can tell when I'm in a flashback, I am always in a flashback. Maybe panic attack is the wrong word to use but I have been this extremely heightened, severe fight or flight mode constantly for about a straight year.

I enjoy posting and doing things that I can consciously delve into I guess because for some reason my mind works really well if not better than usual when I'm feeling like this. My emotions are so badly dysfunctional that my conscious mind is basically totally seperated from them. It is an extremely strange dynamic to say the least, if I tried to journal how I felt every day, within 3 days if not within 1 day, I would end up putting it off like I put off every other responsibility in my life until I feel better, which currently is never.

 

[EveHarrington]

Really poor basically. I'm not exaggerating anything when I say I'm in fight or flight (or in my case f...

Is there a reason you haven't tried antipsychotics?

 

[shimmerz]

Every single grounding technique I have ever tried just cause me to re-enter a state of severe panic, which then causes worse dissociation.

Yeah, I can absolutely relate to this.

I am always in a flashback.

Yep. Me too. It was a freaking nightmare. Can't truly describe how that feels. And people didn't believe me when they told me to 'breathe' and I would go into a crazy flashback and drop to the ground.

I did a ton of work with visualization techniques. I built myself a 'safe place' in my mind that I would practice going to when I felt any strength at all. Esoteric stuff helped me. A shaman that took me on journeys, a trauma t who helped me sort out the things that were going on in my life (yes, talk, but not CBT) that were aggravating my stress. Learning how to rid myself of the stresses that were unnecessary or being forced upon me. And learning what it felt like when even one form of stress had been taken away from me. Could I breathe better? Was I not eating so much? Was my head calmer, etc.

I hate to say it but it was when I started mindfully brushing my teeth 'I am doing this because I am taking care of my body' that really seemed to have me turn the corner and start thinking in terms of my body and what it needed. It allowed me to see that I had personal responsibility in this process of healing. You may not be ready for that yet, but you could set that as a goal and give yourself HUGE congratulations when you can do it. And that may be one day a month for crying out loud. But you did it. Honest to god, this way of living is so different from the way we were all brainwashed into thinking is the meaning of success.

Nobody can do it but you. What I have suggested here may totally be the wrong things for you. Or unattainable for now. When people talk about baby steps, that is a big deal. Is there EVER a time that you are not activated the way you are describing? If so, what are you doing at the time? Actually, now that I think about it, aromatherapy helped a ton. It engaged my brain, my olfactory system, it helped to engage my left and right hemispheres, which is ultimately the name of the game when it comes to healing. Research activities that engage your non dominant hemisphere of the brain. Colouring with no expectations to the end result? Writing or playing a game with my non dominant hand.
I know where you are at. Been there, done that. It was like living a freaking horror flick. But you can get out of it. Not with the 'mainstream' mindfulness stuff yet. Not with CBT. But with really sorting out when you feel less reactive and working from there. I used SUDS for this.

Link Removed

Also, some research, or asking your T about the Window of Tolerance and how you can apply it to learn how to be more in tune with your state. Not because you want to measure how bad it is, but rather to see what 'calmer' (not calm, because you aren't there yet) is. Also, your T needs to be super in tune with your existing Window of Tolerance. Now is not the time for him to be taunting your fight/flight/freeze/fawn system.

Look for supportive people. Do as much work as you can on raising your awareness of state. Work with your T to figure out what eases you (even a tiny bit). Now is NOT the time to be working on your trauma. Your job right now, is to figure out what gives you relief.

 

[Deleted member 39476]

Yeah, I can absolutely relate to this.

On the SUDS scale I'm probably like a mid 9 most of the time. My stress level is so ridiculous that the tiniest stimuli sometimes knock me out. A while ago I was walking down a hallway and heard a door creak, got so overwhelmed that I hit the ground. My shrink uses all of these strategies already that's what scares me so much. Tried aromatherapy, caused me way too much stress, have been taking the babiest of baby steps and even the slightest misstep causes total triggering so its like taking baby steps on thin ice, T is very cautious about not doing anything uncomfortable, very mindful of my fight flight system, tried all these strategies and many more. If you have felt how I feel you understand how basically nothing works at all when you are this stressed out. You have to have at least some shred of self compassion, shred of relaxation, some tolerance for stress, some degree of being present/mindful, some ounce of feeling safe for any coping strategy to actually work, and I'm fully chronically outside of the window of tolerance.

You asked how often I come down and honestly a few times a week I come down to an 8 instead of a 9, maybe once a month I come down to a 7 instead of an 8, and even in those times my level of stress is too high to really take responsibility and put any work in. I have felt it before, I have came down to a ~4/10 stress level, still stressed but at a tolerable level, I have applied these techniques and they helped me manage my symptoms, but since then I have been in 24/7 unmanageable stress for a straight year, desperate for something, anything, to lower my stress level.

 

[shimmerz]

Yep, am fully aware of how this feels. I have no idea how I survived it.

You asked how often I come down

I am wondering if there is some form of a pattern here with your SUDS levels. Is there any correlation that you can find with your SUDS going down? Anything you can see to make this distinction in feeling so anxious work for you?

You didn't mention anything about visualization. I swear to you that it was that that stopped me from having night terrors. It may or may not call to you, but wondering if you and your T have ever used it at all.

 

[Deleted member 39476]

I am wondering if there is some form of a pattern here with your SUDS levels. Is there any correlation that you can find with your SUDS going down? Anything you can see to make this distinction in feeling so anxious work for you?

You didn't mention anything about visualization.

Generally the only things that make me feel a tiny bit better are very unhealthy addictive things so I can't touch them. My issues stem from problems with my mother as a child so getting positive attention from a woman fills the void a bit, but as you might imagine not in a healthy way at all. Being with people in general tends to make me feel a bit better but its a completely double edged sword because I am usually simultaneously enjoying attention while also being very anxious that my friends don't actually like me, or that I'm making a fool of myself, things like that. I haven't found literally anything that just makes me feel a little bit better without having an obvious downside to it, so far everything has been unhealthy.

One of the first things I ever tried in therapy was the "safe space" technique of visualising a place in your mind where you feel safe, going there internally, trying to get as good of a picture as possible, taking in what it would sound like, smell like, look like, etc, while also managing deep breathing. What I found is that there is no place I can imagine where I would feel safe at all, and that no matter how pleasant the place is, my anxious mind finds a way to corrupt it, projecting a bunch of darkness and negativity into whatever I'm trying to imagine. That was when I felt much better than I do now too, back then I was probably floating around a 7 stress.

 

[Justmehere]

On the SUDS scale I'm probably like a mid 9 most of the time.

Have you talked to your therapist about a partial hospitalization or specialized inpatient program? With your level of poor functioning and out of control symptoms, EMDR for trauma processing should not even be approached.

myself. I can tell when I'm in a flashback, I am always in a flashback.

A flashback is actually a pretty infrequent dissociative experience where one acts as if the past is happening right now with no connection to the here and now. One can't post while in a flashback. But you do post here and quite well - so I'd second the recommendation to check out starting a trauma diary. It could be a great way to begin to approach using some skills to challenge all or nothing thinking that's part of the many things keeping you stuck in this horrible place of such high PTSD symptoms.

 

[JEKBreatheandBelieve]

One of the first things I ever tried in therapy was the "safe space" technique of visualising a place in your mind where you feel safe

I changed the name of this technique to "comfort place" (since I don't believe in safe) and it helped me to find a place in my mind that is comforting. It took a lot of tries, but I can do it now. I wouldn't even be able to get anywhere with safe involved, but comfort I can do.

 

[Deleted member 39476]

Have you talked to your therapist about a partial hospitalization or specialized inpatient program? ….

There's no reason for me to be in a hospital at all. In the context of complex ptsd flashbacks take on a different meaning of re-experiencing really intense emotional traumas from childhood without remembering them. In that context I am experiencing that nearly all the time.

skills to challenge all or nothing thinking that's part of the many things keeping you stuck in this horrible place of such high PTSD symptoms.

I don't buy this at all. The split extreme thinking is a symptom of the feelings never the cause, the thing that has to change is my emotions first. I truly don't believe anyone has changed thinking first then as a result had their feelings calm, its probably almost always the other way around. Either way even if that was a solution for somebody it isn't a solution for me there's no way I could willpower my way out of this kind of stressful thought.