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Exposure therapy, support animals, flare in symptoms

KathK

Learning
Covers a few areas. Flaring at present, not helpful by some of my clinicians trying to dictate/mandate certain treatments etc in an uninformed way despite claiming they’re being trauma informed. Spoke with psychologist today and part of what we’ve worked out is doing a graded exposure plan with a few key words so appears it’s for me but shared with the doctors to educate them as I’m already doing graded exposure and they wanted exposure but didn’t think about a trauma informed approach, more a phobia and just expose approach.

If I’m in a clinical environment now I can barely keep my vision and balance let alone staying present, and it lingers. I’m struggling to stop isolating, and it’s rare I can leave my home without fur support; unfortunately it’s rare cats are recognised as MH assistance animals and it’s very difficult to access assistance dogs for MH in Australia, though we’re looking into it, so for now they’re classed as emotional support animals even though they’re that level between, feline still in training (10mths old) and canine only partial further training though very intuitive…the catch is accessibility.

So much coming up from past traumas and then additional incidents and traumas compounding the previous, and I’m basically in survival and numb/blank mode right now. I just can’t face people and my body reacts so strongly before my mind engaged with triggers and especially clinical environments since the medical trauma and then compounding incident both this year. I’m not sure what to do or add, I just know I’m struggling to push through the cptsd symptoms right now, even with graded exposure and sensory tools, and standing up to the doctors about them being inept at putting trauma informed care into practice, though my son’s doctor gave a couple of interesting suggestions I’m yet to try. I feel more blank, wiped and easily triggered (not to mention angry) than I recall in a long time, so far I’ve been able to channel the anger rather than punish myself for feeling it, but my physical health is going downhill. Not sure how best to juggle envy.
 
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gentle empathy and hopes of offering stabilizing support, kath. early therapy is tougher than tough to work through. i still pass through episodes that knock me off balance, but there are far fewer surprises than there were in the early going. awareness makes a huge diff. in making this post, you are already using my front-line tool in managing my symptoms. getting ^it^ into words and sharing those words in a safe space go a long way in figuring out what --if anything-- to do about ^it^.

in my own juggling of envy, i start with a meditation of, "is this jealousy --the fear of loss-- or envy --the desire to posses. i all too often confuse the two but the two have very different therapy approaches. the meditation often helps me clarify which tools i need for the remediation.

but that is me and every healing journey is unique.
steadying support while you find your own path.
hope healing happens here.
 
There were periods where I found stepping into a clinical setting was, all by itself, completely overwhelming. Sometimes, just spending a session working on how to stay grounded is progress. You can feel safe in these environments, but it’s not easy.

Sometimes taking a grounding kit can be really helpful. It’s a bit like a portable self-care first aid kit. Telling your T that the setting itself has become overwhelming and unsafe can let them know where you’re at, so that they don’t push you into being completely flooded.

Switching up the usual rules for clinical settings can help: asking to take off your shoes once you’re seated, asking to have the session outside under a tree, taking a blanket with you to put over your lap - anything that’s going to make the space feel safer for you.

it’s rare cats are recognised as MH assistance animals and it’s very difficult to access assistance dogs for MH in Australia
Yep. Cats can be emotional support animals, but aren’t recognised as assistance animals here in Aus. There are some not for profits around the country that will help you train your own dog to be a qualified assistance dog, which is where I started. Sometimes calling up organisations like Assistance Dogs Australia to talk through your situation can open doors that you may not have been expecting. They tend to have a fairly long waiting list, but their dogs are worth the wait, especially given ptsd is, for some of us, a lifelong condition.

Don’t give up. Recovery is hard. It gets worse before it gets better. But stick with it - you’re worth it.
 
Thanks…was typo in last line (meant ‘everything’)
I’ve lived with fluctuating levels of cptsd for nearly 20yrs, this time it’s more the medical side that’s coming up, there’s been incidents over the last couple of decades and incident 8mths ago set of the full blown trauma response. I had to do exposure therapy a decade or so ago after an assault in my kitchen, but trying to explain basic principles to the doctors who aren’t (weren’t, I have given them an earful and 1 is rethinking and trying to learn) even including me in decisions, well it’s triggering especially as whenever I’ve spoken up it’s resulted in more traumas, often assaults physically though of course there’s plenty of ways organisations can do harm without physical contact, and that’s been coming up too.
It’s so layered and then further traumas make it seem never-ending. I think I’m starting to function and move forward, then something happens and I get thrown off kilter. My arousal and reactivity levels haven’t been this high in years, nor do I recall feeling anger like this (though granted I spent years dissociating or punishing myself when I acknowledged or felt anger), having had symptoms manageable for a while and strategies including a backup circuit breaker admission, not only having such a strong flare and the fact that I can’t enter a clinical environment without dissociating after panic attacks etc (even with anxiolytics and sensory and breathing tools), but the ignorance of even my psychiatrists around trauma and how it can impact (physical responses, reactions to triggers, etc; graded exposure needing to be gradual and work towards being able to tolerate being in the location/setting without dissociation or going outside window of tolerance), though not being able to attend f2f and having had the relationship with clinicians strongly shaken it’s harder to speak with them and be open (though I’m explaining plenty of trauma basics to them).
I’ll look at options Re training assistance dog, though need to then check about NDIS funding options; at least for now most places I have to go are fine with our fur baby coming (yes, even the feline) though I’m avoiding going most places and rarely without fur support, though the hospital is a different story and I’m trying to keep to Telehealth there for now (though no idea how I’m going to manage a couple of day procedures in coming months, even with my pain specialist who understands the physical side of trauma better than any of the doctors and I’ve seen for nearing a decade and trust, I could barely keep from blacking out. If I had the certification for assistance dog I’d be able to bring her, but whilst the psychiatrist is happy for pup to attend when I’m up to f2f, the general hospital is unlikely to be as flexible.
Plus years of this and now most of my sessions with doctors is educating them so they don’t compound or exacerbate traumas and trauma reactions, especially given a couple of their colleagues caused additional traumas.
All the years working through things and learning to manage my arousal levels etc, then senior clinician causes trauma when I was vulnerable from carer burnout and that was the straw that triggered the ptsd to flare, particularly around medical settings and clinicians, and it was hard enough managing arousal levels but trying to discuss treatment options when in a setting that triggers the SNS reaction, and being older and with complex/chronic physical issues, it was hard enough when it was ‘just’ the ptsd, now it’s more complicated.
I’m rambling, so scattered of late, and basically hiding (ok probably more avoiding but also a mask of all being well when I’m wiped and struggling with intake, sleep, etc is too exhausting so hiding to avoid masking). Fur babies hollering for food and outing…
 
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