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Experiences of TF-CBT/Dredging Up The Past in Therapy

Thread starter #1
Hi guys,

Hope everyone is well.

My clinic wants me to start trauma focused CBT. I've done CBT before and found it reasonably helpful but it's mainly been depression symptom focused and hasn't been very in depth into the past.

I really want to give it my all but I'm really scared about the part that says "Trauma Narrative Development and Processing" and "Gradual Exposure." I have never talked about these things with anyone and I'm scarred that bringing it up will simply make my problems worse.

I have already have pretty severe reactions to therapy/diagnosis sessions that have touched on these things. The waiting list is three months so I have a lot of time to think/worry about this.

What have other peoples experiences been with this? Have you found TF-CBT helpful and is it worth going over everything again?
 
#2
For me my therapist went very slow and was careful not to re-traumatize me. I have been in therapy for over 2 years, long enough that I can't quite remember when I started :). I have found this to be helpful. But, we couldn't move forward until I felt safe and had clear boundaries with my therapist. I am seeing my relationship with him is the foundation to being able to work on difficult things, always at the pace that is best for me. He sees when I am a dissociating and is able to help me ground. It has been difficult but worth all of the work for the moments of peace I have now. The good days are starting to outnumber the bad ones.
 
#5
I think it's critical to go slow and to have a therapist who listens to you, especially about what happened between sessions, and is not driven by a schedule of getting through a certain number of topics in a certain time frame. If the trauma narrative is too triggering, then there are still CBT things that can be helpful. For example, for some things that trigger me, I've learned new ways of looking at it that help me take it less personally. I've also found that CBT work on my people skills (which suffered over the years because of my PTSD) to be very helpful, and that helped me feel closer to people.
 
#7
When you come off the wait list, I'd recommend using the first session to exploring more about it, talk about your concerns, ask how they can be handled, express your need for pacing of the work - which is built into it and the therapist should be very receptive.
I have already have pretty severe reactions to therapy/diagnosis sessions that have touched on these things.
If you are also having a symptoms outside of sessions, then it's worth considering a therapy that can help reduce the symptoms long haul. Short term experience for long term gain. It's a well studied therapy and I found it useful (and I'm not a huge fan in many ways of going over trauma over and over.)
 
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#8
I haven’t done CBT for trauma but have done EMDR. For me i would be working on and processing a lot of difficult stuff, which often caused me to dissociate. My Ts focus was on building a strong relationship where i could trust her, feel safe and go at a pace that i felt comfortable with. We had agreed grounding techniques to call upon when thinks got tough. I think these are important if you are going to be doing some difficult trauma work.
 
#9
Exposure therapy has been the single most useful thing for me... bar none.

The hardest part about it? Is the boredom. Because that’s the sweet spot you spend 99.9% of your time in. Tiny little FLICKER of response, back up & hang out on the chill-zone. Flicker, chill, bored. Bored bored bored. Repeat.

When your heart rate rising 5 bpm, (I’ve had breakfasts that make me more excited), or a half a second of shivers (Ummm... the cute guy on the street gets more of a physiological response!), is the goal? PFFT! You’re kidding, right?!? Nope. That’s the target. Just barely brushing along the edges of it with a feather. And the edges? Move. Like you hit them with a jackhammer.

If you know horses, at all? Think about what happens when you run at them, versus when you walk, stand, walk, stand, wait. The distance dramatically narrows when you move slow, until they actually come to you. Charge at them? They run away, and the distance grows. Exposure therapy is moving sloooooooowly. Stopping. Relaxing. Waiting patiently. Moving sloooooowly. So the horse never spooks. But in this? You’re the horse. If you’ve spooked? You’re moving too fast. Slow down. Back up. Relax. And you come into your own self. Rather than reacting in panic.
 
Thread starter #10
@Friday
Thanks for the reply, that's pretty reassuring honestly :)

@Missycat

Thank you so much for the advice! I will bear that in mind. I've been looking into some grounding techniques and they definitely sound useful

@Justmehere

Thank you for the advice, I will definitely do that! it's really useful to hear from someone who's been there
 
#11
I've found that working with competent CBT therapists who would talk with me about my past traumatic experiences has been helpful to me...as long as I was working with a therapist who I felt knew what he or she was doing.

Some therapists that I used to work with gave me advice about my past trauma that I felt was bad advice, which didn't help.
 
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