Dissociation preventing any progress in therapy

[EveHarrington]

It seems to me like people are trying to give you feedback on what works for them but you just reject it.

This kind of mindset is going to work against you.

Justmehere is discussing the basics of CBT (a proven therapy for PTSD), but you reject that concept outright?

And why resistance to inpatient treatment? I honestly think you don't understand that it's not just for people who need to be kept safe. It's also intensive for those who need more stabilization and healing than outpatient treatment can provide.

So just a few challenges to your beliefs that could help you in the long run.

And PS did you miss my earlier reply asking about meds?

 

[Justmehere]

No one has suggested you changed your symptoms through sheer willpower. Many people have provided many great suggestions - people who have been just as symptomatic and gained great benefit from therapies designed for this level of symptomology.

You are quite resistant to trying any suggestions or making any changes to your current course of action. What does your therapist suggest doing?

If what you are doing is working for you then by all means, keep doing what you are doing. If you want different results, you will have to try something different.

 

[JEKBreatheandBelieve]

And why resistance to inpatient treatment? I honestly think you don't understand that it's not just for people who need to be kept safe. It's also intensive for those who need more stabilization and healing than outpatient treatment can provide.

I agree with this. I was so resistant to hospitalization because that wasn't for me. It was too scary and I didn't believe that I fell under the category of needing hospitalization, but since I got to a point that nothing was helping and I went to a hospital for help, I've changed my mind. I went to a hospital program that specializes in trauma and dissociation and it made a world of difference for me. Took me a while to make progress as I just didn't want to or believe I could change what was going on, but little by little I tried what they put forth and it's helped loads. It hasn't cured the struggle, but it sure gave me a larger toolbox and better understanding of why the strategies are so important.

 

[barefoot]

I have only scanned this thread so apologies if I have misunderstood anything or if I'm just repeating what others have said. But a few things caught my eye that I wanted to comment on.

Firstly, as I think some others have advised, if your everyday functioning is so poor and your anxiety and symptoms are so high off the scale, I would imagine that digging into and trying to process trauma (through EMDR or any other method) is not going to be helpful right now.

I haven't tried EMDR but have still dissociated a lot in therapy. And a fair amount outside of therapy! I've been in therapy for almost three years now and the last six months I haven't dissociated. This is progress! But it felt like forever getting to that point and I don't know that it's been gone forever - and I have no idea really what changed to get to that point! It has just taken time. And I have done plenty of sessions where the purpose of the session was simply (!) for me to keep my head in the room and stay in relationship with my therapist. It felt very tedious and frustration when I was so keen to push on and make progress. But you really can't force this stuff.

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.

Body awareness has always freaked me out too. Like you, even if my therapist wanted me to say what I felt in my big toe, my head was totally gone in an instant. A bit like @shimmerz though, I think my breakthrough (though that sounds profound and dramatic, which wasn't the way it happened!) was when I had a surgery earlier this year. I had to do a lot of physio afterwards. I've had to go to the gym. Very challenging and I struggled a lot with these things that required me to connect to my body. In the end though, it did come down to me thinking, hang on, after 15 years of chronic pain, I've finally ended up with a surgeon who's confident he can help and I've had this surgery and now it's on me to do the rest. And if I can't or won't do the rest of the work that needs to be done, I won't get as good a result. And after all this time, stress and pain, I want to really try to ensure that I get the best outcome I can. So, I kept going, I kept trying, I kept showing up for appointments and sessions, I kept doing what I could (which sometimes was only a couple of minutes) and I kept focused on the outcome I wanted. It wasn't easy. But that realisation/reframing really did help and now I am in a better position with body stuff than I was (I'm by no means great with it now - far from it - but there is an improvement, which I can keep trying to build on)

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

Not sure I agree with this. And it's not really about this:

there's no way I could willpower my way out of this kind of stressful thought.

It's perhaps more about reframing or focusing on what's really important/an outcome or something. A bit like I did with the choice I made about my post-surgery stuff. I don't think anyone is suggesting you can just use will power to think differently about something.

And re mindfulness - I agree with others that it can be an active thing not simply a passive, clear your mind meditation type thing. If the body stuff is freaking you out right now, can you try being mindful with something that doesn't need a huge connection to your body and physicality. For instance, colouring in? The mindfulness is more on putting your focus on choosing your colours and keeping neatly within the lines and seeing your picture emerging etc rather than "how does this pen feel in my hand?" It's one that has worked for me, anyway.

Also, I agree with whoever said about getting into a routine of breathing exercises morning and night as it's great for stimulating the para sympathetic nervous system. I know they are not for everyone as I have seen people post here before that they send them into a panic. The only reason I mentioned it here really was to say that, again, it doesn't have to be a clear your mind activity, which sometimes people really struggle with. When I do mine, I somehow sort of split my mind. Not sure if it is healthy or not, but it works for me! Part of me counts but I don't put a lot of conscious effort/focus there - it's like the counting is sort of happening in the background on auto pilot but it's keeping me on track and in a good rhythm. The main part of my brain is just thinking. Not stressful thoughts and not thinking about my body or my breath. Just thinking about the day...something that I did at work, a conversation I had, something I've just watched on TV.

Don't know if any of that helps?

You do sound a bit resigned to the fact that nothing works, nothing will work and you're beyond help? I don't think any of us are beyond help.

 

[Deleted member 39476]

Don't know if any of that helps?

Mindfulness itself is what I cannot do. There is no context where I can be mindful at all, as mindfulness itself is impossible under this much stress. I was told by my therapist to do the breathing exercises twice a day but I get the same experience a lot of people here do where all it does is cause me worse dissociation and panic. All this is very frustrating because your advice and the advice of a lot of the other people here is genuinely really good advice, it's just that I've already attempted almost everything recommended and hasn't helped so far, hence why I'm getting so resigned to my fate. Even in controlled, safe, comfortable circumstances in the room with my therapist none of these strategies have brought my stress level down, I think they are simply just not applicable under such an extreme degree of stress.

I don't think anyone is suggesting you can just use will power to think differently about something.

It's attempting to consciously control your feelings. People are going to say that isn't the case, but I think it really is, which is why I dislike that method so much. If it was really just about refocusing nobody would keep pushing that method after I say it doesn't help at all, the fact that people continue to push it past that point means they really do believe it's a control/willpower thing. I think the logic is just really bad honestly. They treat it like I'm just not putting enough effort into trying it, and that the method is supposed to be difficult and painful but still helpful. I have done it in the correct mindset for it. It's not difficult, it's not painful, and the effects are immediately positive. It just doesn't offer anything valuable under this severe of stress, when you feel like you're going to die, challenging negative thought patterns just doesn't accomplish anything. It's mainly useful in the context of trying to maintain a positive state once you enter one.

 

[Justmehere]

What does your therapist recommend you do?

 

[shimmerz]

I've finally ended up with a surgeon who's confident he can help and I've had this surgery and now it's on me to do the rest.

This is it. The ticket to healing. Great job! Honestly, I have found that it isn't good enough to just say 'I love myself' but rather the conscious decision to change attitudes. We learned so much crap about not valuing our bodies through our trauma. I am so very pleased that this helped you so! Keep rocking @barefoot!

 

[Deleted member 39476]

What does your therapist recommend you do?

As coping techniques at various points he's recommended safe place visualizing, deep breathing exercises, mindfulness meditation, when none of those things helped at all he realized I had a dissociation problem and then recommended numerous different grounding exercises to try, none of those help either. As general recommendations he recommended getting regular exercise, doing yoga, meditating a couple times a day even if only for a short period of time, eating healthy, going to bed and waking up at a regular time, just in general maintaining a balanced healthy lifestyle. At this point though with none of those things working and almost all of them actually making me feel significantly worse instead of better, he recommends basically trying to show myself compassion when I can, spending a lot of time around friends, keeping my hands busy, and just generally being patient until we can work out the root cause of all this stress in therapy, which we think is a very deep internal conflict between parts.

 

[EveHarrington]

Same question, why aren't you exploring medicinal routes to calm your system? In the grand scheme of things you've tried almost nothing.

 

[shimmerz]

numerous different grounding exercises to try, none of those help either. As general recommendations he recommended getting regular exercise, doing yoga, meditating a couple times a day even if only for a short period of time, eating healthy, going to bed and waking up at a regular time, just in general maintaining a balanced healthy lifestyle.

I so totally get this. Like on a visceral level. I think, if I think back (and please take note that I got out of it, so you aren't doing all of this for nothing) anyway, if i think back, I am going to say that I spent the majority of this time learning how to read these new reactions. What they meant, how I could help myself feel better. I mean seriously, it felt to me through all of that that I was on the set of 'The Body Snatchers'. Like a portion of my brain was the old me but that my body and the traumatized part of my mind, which was hijacking the crap out of me, was this foreign freaking being that was occupying me.

And I resisted for such a long time. But eventually I had to say to myself, okay, let's learn how to read/control/sooth/manage/LOVE all of this crap because it looks like i am stuck with it.

May not be the same with you. But I had to get over the fact that I felt so goddammed betrayed. Not by my abusers - but by my own self!

Best of luck to you. I am cheering for you.

 

[Justmehere]

Has your therapist discussed with you the concept of "learned helplessness"? It sometimes develops in those who have survived severe complex trauma. When someone can't escape trauma for an extended period of time, they sometimes begin to believe they are truly helpless. They become resigned, and no longer try to escape the trauma... even when options for escape are presented to them. They learned they are helpless, and even when the trauma is over, they struggle to take action to recover. They have one reason after another they are not able to do xyz. I am not sure if you have developed learned helplessness or not, but it might be worthwhile exploring that more in therapy. It's an extremely understandable thing when people develop it learned helplessness as a response to trauma and it can take time to work through. It can be explored without using CBT. It is a common defense mechanism, like denial or other defense mechanisms, used to cope with tthe emeritus pain the best someone knows how.

I think you want things to change very badly. I can see the desperation you feeel about your situation and symptoms. I also think you might very well be stuck in a pattern of learned helplessness. That's not a knock on you, I've been there.

You are very clear you are unable to do EMDR, are not willing to change the way you do EMDR, and you are not willing to try any other forms of therapy. You are very clear you are unable (helpless) to control your symptoms. You are very clear you are unable to perform daily acts of living, such as brushing your teeth or eating. You are very clear you are unwilling to pursue a higher level of care. You are very clear you are sticking with your therapists style and techniques and that none of it is working it that it's generally making you worse, but you will try no other options.

When someone points out something you are able to do well, like post on the forums, and provides suggestions on how to build on that one capacity to begin to feel better, you disregard that suggestion as not being helpful and return to emphasize to us that you are deeply suffering (and I do believe you are) and that your symptoms are out of control (and I do believe they are out of control) and that you are totally helpless to engage in more or less any therpautic support to recover.

I think it's time to revisit the purpose of this thread. If it is to be heard about how bad things are right now, people here, including myself, hear you in that. PTSD freaking stinks and is miserable to endure and can be quite severe. Folks here really get that. I think people also really do understand that you are very deeply suffering.

If the purpose of this thread is to figure out what you can change what you are doing in treatment or outside of treatment in order to start feeling better, are there any suggestions here given so far that might be willing to try?

You have done well to communicate everything that won't work and what you are willing to try to do.

Is there anything that anyone has suggested to you that might have stirred up any thought of next steps you might be able to take to try something new?

Since you have found very few responses on this thread to be helpful, if any at all, is there any specific way you can direct people as to how they can best help you in their responses on this thread?

Or have you really truly resigned yourself to hopelessness and the belief that you are truly helpless to benefit from any therapy and recover in any way?

 

[barefoot]

Mindfulness itself is what I cannot do. There is no context where I can be mindful at all, as mindfulness itself is impossible under this much stress

So, you cannot focus your attention on anything, in any way, to any extent, for any length of time? Not intending that to be snarky at all, so I hope it doesn't come across that way! But if it is that bad, constantly, I am amazed that you are able to function day-to-day at all!

I've already attempted almost everything recommended

Is there anything in the suggestions here that you haven't already tried, which you are open to having a go at?

Even in controlled, safe, comfortable circumstances in the room with my therapist none of these strategies have brought my stress level down

Just to say, I really like my therapist and 99% of the time it is a very safe space for me in sessions. That said, I cannot practise things in front of her. Whenever we have tried to do breathing exercises or guided visualisations or body scans or whatever, I have felt so self-conscious and my anxiety have rocketed and I have got totally stressed and distressed (and then dissociated!) But I can watch her demo it to me, then go away and try on my own. And some I've got on with and others I haven't.

I imagine you are going to say they don't work when you're on your own either but just wanted to put that out there.

It's attempting to consciously control your feelings.

Ok, I get that that's where you stand with the idea. For me though, it's about challenging my thoughts and beliefs, not about trying to forcibly control/change my feelings. For me, the focus on thoughts/beliefs/attitudes comes first. Feelings follow. So, with my surgery situation, after I chose the perspective of wanting to do everything I could in order to have the best physical recovery I could, I felt calmer and more empowered and more determined to stick with the rehab, however small I had to start. And, obviously, I chose a perspective that, on reflection, resonated - not just choosing any perspective I could conjure up and try to make myself believe, just because it sounded good when I didn't have a real...sense of it...if that makes sense?

If it was really just about refocusing nobody would keep pushing that method after I say it doesn't help at all, the fact that people continue to push it past that point means they really do believe it's a control/willpower thing. I think the logic is just really bad honestly. They treat it like I'm just not putting enough effort into trying it

I don't see anyone "pushing it" and it is certainly not my intention to push something on to you so that you agree with me. And I don't see anyone here treating you as though you are not trying hard enough. None of this is one size fits all. We are all unique, as are our stories and our journeys. People are sharing their experiences with you in the hope that something may be useful for you.

I'm not really sure what kind of responses you are wanting from us here. What is it you were hoping for when you started the thread?

I really feel for you and I'm sorry that you are struggling.

Keep rocking @barefoot!

Thank you @shimmerz! I still have a long, long way to go but I can certainly trace a few significant progress points back to the surgery. Thanks for the acknowledgement :-)