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Finally Some Good News On My Healing Path

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@recoveringfromptsd

I'm a fan of you and what you're doing.

For me personally, facing my fears head on has been the single most important baby step I can take in every situation I'm facing.

I've had to face a workplace bully/sexual harasser who was ongoing. I had to be tough and report each and every thing, including present my case before a round table of my boss and the HR staff.

It worked out and he got fired. He was also harassing his boss, who was female.

*It was the bully and the stress of seeing him at work that made me get major flashbacks and opened Pandora's Box with my past. It was ironically a good but painful episode because I was able to remember my past and distance myself and my kids from my abusers. That alone makes it all worth it.

Then, there was facing the abusive family members, and cutting them out of my life. Since taking that step and using this forum and some Therapy, I've learned to process all the stuff that fell out of Pandora's Box, including having a lot of flashbacks and intrusive memories from the traumas.

I'm very proud to say that it does definitely get better. It does feel a bit rough when it's all new stuff surfacing, but with support and tools, it gets better quickly enough (For me it took a year to learn because I am stubborn and did it all on my own.) to matter.

When I finally found a good T. her tips and those I found myself combine to make me more resilient than I could have imagined before.

I'm still a work in progress, but I would someday hope to share what I learned and try to help others going through the same kinds of things with their PTSD and flashbacks.

Tolerance of unpleasant emotions is a big part of what I have still been working on, and I would most likely benefit from DBT, although I do not self-harm or SI. It would help my social skills and emotion regulation.

...all the best to you,

Muse
 
@Muse, I like everything you had to say. Good for you!

@recoveringfromptsd, what Muse says is in line with what I would say. You have to turn and face your worst fears, which proves that you can do it. I will write more later to give you some info on PE, at least my understanding and experience with it.
 
@recoveringfromptsd

I'm a fan of you and what you're doing.

For me personally, facin...

@Muse thats for the support, from my perspective I have been stuffing and avoiding my whole life, such that most of my life was nothing more than SI/SH and Hospitalizations with gaps of struggle in between. My maladaptive behaviors are so severe, and my distortions so extreme, the way I see it is I will never be happy, and nothing will change unless I challenge myself head on. It does not matter if the process leads to times I need help coping or a hospitalization, the difference is each time I learn more and cope better. However some of the new skills I got from SP, and PHP and soon to be DBT I hopefully will be able to cope with the process and be safe.

I know if I don't I will be perpetually unhappy, and likely to end up with the chronic SI I used to to have.

I am going to do what ever it takes to be able to put this stuff where it belongs and keep it there which is in the past.
 
I should mention I have already figured out that one of my areas I have to work on is Distress Tolerance, and the other is Radical Acceptance, they both deal with my hyper vigilance, and by working hard on those, dealing with uncomfortable stuff will get easier as well as helping me cope better with situations I have no control over, as that area drives me nuts.
 
I should mention I have already figured out that one of my areas I have to work on is Distre...

That's great! Are your docs thinking of having you do DBT and PE simultaneously, or the DBT first? PE is not for everyone, and not for the fainthearted; you definitely sound like you have the right attitude and instincts. Here's what I can share with you about PE, based on my experience. It would be helpful probably if others who have done PE also chime in.

My PTSD and major depression (MDD) got severely reactivated about a year ago, after I had been doing really well for over a decade. My symptoms (nightmares, flashbacks, intrusive thoughts, rumination, dissociation) were worsening and affecting me at work, and I sought treatment. However, I started self-harming again, and had to really admit how emotionally unstable I had become. Thus, my T & I didn't even attempt trauma-focused therapy but instead worked on stabilization for about 10 months. "Stabilization," for me, included a 90-minute, weekly drop-in skills group based on DBT (not DBT therapy or a DBT group itself.) Additionally, I go to a 90-minute, weekly Yoga for Depression & Anxiety class where the yoga instructor is also a psychotherapist. Attending those regularly have been a huge part of my being able to regulate my emotions and tolerate distress. I really went back to basics, reminding myself to use various grounding skills, like carrying a crystal around with me to squeeze when I feel overwhelmed, or essential oils to smell when I start to dissociate. Only once I was much more stable (and my meds had been adjusted and augmented), including NOT having self-harmed for a period of time and agreeing that I would not self-harm at all during the treatment, did my T and I attempt PE.

Here are some things you need to know about PE:

  • Ideally, PE is done in 90-minute sessions weekly (but it is possible to do less. My sessions are usually 90 minutes, but sometimes we only have 75 minutes, and that's okay.
  • You start out by learning a breathing strategy which you must practice every day.
  • You learn a system for rating how distressed you are. This is called Subjective Units of Distress (SUDS.) For me, a zero is being alone on a beautiful beach, absolutely no stress! A 100, on the other hand, is when I was actually going through my traumas (child sexual abuse, physical abuse, rape.) A 50 is right in the middle. You will work on this with whomever is doing the PE with you.
  • You think about all the various things you avoid because of your trauma/PTSD. Then you rank them in terms of how much distress they cause you. For example, cooking with others makes me very anxious, and I get irritable and controlling and just hate having anyone with me in my kitchen. That's about a 50 for me. On the other hand, certain yoga positions cause me to have flashbacks and body memories, with a lot of physiological symptoms. That's more like a 70-80.
  • In vivo exposure is when you approach those things that you have been avoiding. Be careful where you decide to start! You want to challenge yourself to be able to do those things that are objectively safe, but not flood your system so that you end up in bed. However, you will in fact have panic and experience a lot of symptoms -- tolerating that and learning that those feelings are valid, but not necessarily a true fact of danger, and learning and feeling for yourself that if you can wait it out, those feelings will subside, is the whole point of PE. You have to invoke a certain degree of distress (fear, anxiety, extreme emotions, etc.) to unlearn the association of the trauma with things that are objectively safe.
  • You do the in vivo exposure as home work, on your own in real life. You will work with your T on exactly what to pick and how to do that. Then you track your SUDS right before and after, plus the highest SUDS during.
  • In my cooking example, I know that my wife will not throw the frying pan at my head like my dad did if the pancakes aren't perfect. I know this intellectually, but I still feel super anxious whenever anyone is even in the kitchen with me while I am cooking. It sounds a little foolish, but taking baby steps to start tolerating her in the kitchen with me is scary! Little by little I am learning in real life, in my body, not just in my head, that it is safe (and maybe even enjoyable) to have loved ones in the kitchen with me. We are working up to sharing cooking tasks. My SUDS before was a 30, the highest SUDS while doing the exposure was 50 (at the beginning I was so anxious), and then by the end it dropped back down to a 30.
  • Imaginal exposure: After you've done some relatively easy in vivo exposure, you will start with the imaginal exposure. This is where you imagine one memory of your trauma(s) (maybe the worst time you can remember, or what is currently bothering you so much now) very vividly, and recount that to your T in session. Depending on the length of the memory and how long it takes you to tell it, you might even repeat it. You tell it as if it is happening, in the present tense. This is different than usual talk therapy. It is not a conversation, you have to stay in the memory and it is so hard and painful! But a good T will help you stay in the right emotional space. You don't want to be detached and unemotional, but you don't want to be overwhelmed and dissociate, either. My T is amazing at this, and I work really hard to stick with it when all I want to do is shut up and curl up in a little ball.
  • After about 30-60 minutes of doing the imaginal exposure, then you process it with your T. We talk about what that was like for me, to tell the story. How painful it is. We talk about how the feelings have changed from week to week. We talk about insights, cognitive distortions, how and why this memory keeps influencing me in the present, etc. And especially, we work on differentiating the past from the present.
  • Oh, and you tape record the imaginal exposure! You have to listen to it once a day and record your SUDS. PE is no joke, it's f*cking intense.:wtf: Many people find their symptoms get worse at first. Some people just can't tolerate PE, or are not ready for it. Some people start but then quit PE.
  • There have been times where I wanted to quit. There was a week when I avoided the HW, put myself in a sleep coma for 3 days, and wanted so badly to hurt myself. I reached out to my T, and we seriously considered stopping. But we didn't. You don't stop just because it's hard. I didn't self-harm and I recommitted and we talked a lot about support and strategies. I have a very strong therapeutic relationship with my T; I would not engage in this type of therapy with anyone I didn't feel totally safe with and whose judgment I completely trusted.
I am going into week 7 of 9 or 10 imaginal exposure sessions. We started the in vivo HW about 2-3 sessions earlier. Personally, I know I am getting better, but it's been a very hard road. My symptoms significantly worsened at the beginning and middle. I have only recently felt significantly more calm, less depressed, and have been having less self-harm urges and less overall PTSD symptoms. I can do things I wasn't able to do, and I'm not just gritting my teeth and white knuckling it. Yay, me! :tup: I still have 3-4 sessions left to go (then we will take a break and reevaluate doing another round on a different memory.) Supposedly with PE you continue to see improvement (symptom reduction) even well after you finish the therapy. It's very well-researched, it's just not for everyone.

Good luck, and let us know how things go! Gentle hugs to you if you accept them :hug:
 
@Lola Nocheprieta Well, to start of my usual hypervigilance I try to control stuff and situations to my comfort zone. While that is a great avoidance tactic it has kept me from having an distress tolerance, I am just beginning to change that behavior and letting others do what they do and just trust they are working for my benefit. That's like climbing a mountain to me, so that's a huge change for me. So I am going to let them guide when and how these steps are done, and in what order, etc. I am going to just do the work, and that's enough for me to handle by it's self.

As for the process itself, I know its going to be a slow, and careful process. I am already myself trying to address being ready for this, so that I already have a lot of structure in my daily life to get me the stability to do this kind of work.

One thing I have focused on a lot, and that is staying grounded all the time. PERIOD. When I am grounded I tend to be able to stay safe and not have urges.

The only reason SP TDU allowed me to be D/C was because after my emotional flashback weekend they changed my observation level and would not change it until I could address what happened, which lead me breaking down the entire thing in detail, and the result was that the only way I would be able to prevent these emotional flashbacks since I can't control them was to not just ground myself after being triggered, but also be very grounded always period. And that was the goal I had to achieve before they would change my level, after that I was able to be safe so they could D/C me.

What I have not said is my emotional flashbacks are very dangerous, not just to me, this one I had I ended up with very bloody arms and torn up, and that was just from my fingers. My reactions were all over the place, extreme, crazy. I had to be put in 4 points for about an hour to get it under control. Sort of like a danger panic reaction on steroids when no real danger was actually present.

So they were very concerned about my emotional flashbacks, they rarely happen (sometimes decades apart), but when they do happen it is very dangerous. So they put me on Naltrexone to help with them.

Since being super grounded was the goal I had to meet to get D/C from SP, I have gotten real good at staying grounded. And I have gone to great lengths to prepare my spaces to stay grounded. When I go somewhere I try to make a mindful inventory of what I see, so I can have visual anchors to ground to if I need them. I thing about being grounded all the time. It's my number 1 priority.

So this I know is just the beginning of a long process I need and must go thru, the alternative of not doing this work in the ends leads to an unacceptable so the best path is do what it takes.
 
@recoveringfromptsd, I am in awe of your fighting spirit and persistence. You rock! I never thought of it as being grounded all the time. I just think of it as having to go back to basics, again and again and again, and then yet again. And then some more. And a little more. And then again. Breathing, noticing, smelling and touching things to stay present. And so on.

I'm so sorry for what you must have been through, and how hard you've had to fight to stay alive. I'm glad you're on this forum and that you are getting some good, wrap around support and services. I am so proud of you that you were able to meet that standard of grounding 100% of the time and develop some impressive skills that enabled you to stay safe and get d/c from SP.

You definitely sound like you've got the right attitude and skills to recover, by whatever method, including PE! It sounds like you will benefit a lot from DBT, with its focus on distress tolerance, emotion regulation, mindfulness, and interpersonal effectiveness skills. I have faith that not only can you recover, but that you will recover!

Keeping you in my thoughts, recovering!
 
@Lola Nocheprieta I agree 100 percent, but for me at this point in my life it's not just a matter all doing to recover, like when I went in the hospital, if I did not get in, there was nothing to live for, as I was tired of things they way they have been, and in recovery it's the same way. I ABSOLUTELY HAVE TO CHANGE and the benefit of that is recovery.

As for the grounding, I outlined the incident that happened in the hospital. Until that happened I was like everyone else there, learning and not always getting it, and it was slow, to ground, to contain, opposite action, dial down, etc. but in response to a trigger, FB or intrusion, and I was only just beginning to be able to ground, until then the staff were having to bring me back to the here and now a lot. But after that incident, it came down to how do I deal with something that is outside of my control. And the only answer is prevention, that's when it became apparent that grounding had to be then and from then on, staying grounded all the time.

Actually by having that focus it has benefit a lot, I have been triggered many times, and always was able to ground before slipping into the past. By being really grounded to begin with, using things like anchors, frozen orange, etc. re-enforced being grounded, to stay that way, I guess you could give it name "hypergrounding".

It's actually worked very well, and when you think about, I could just leave it at that, and things would be good. But I can't do that, I need more to life, I need to undo the damage of the past, and over time change some of those maladaptive behaviors.

Also I have to worry about my Manic Depression, because if I had a problem with that, for some reason or another (getting phy sick is all it takes to throw that off), problems with that may affect my ability to think and thus stay grounded. Last thing I want to is to have FB will manic or depressed as they will just get amplified. I figure by changing the maladaptive behaviors and over time addressing the source of the FB I will get to a point where Manic Depression problems are minor bumps in the road.
 
Yes, the frozen orange! I love that. I work with adult graduate students with disabilities and have many with PTSD. I like that because they can hold the orange in class and rub the skin and smell the pungent but pleasant citrus smell and it just looks like they are fidgeting with their snack! No one has to know they are trying not to dissociate, and if that helps them to remain in class, it's great. Then, when they take exams with us they can bring an orange or other grounding tools with them into the exam room.

Take good care and keep up the good work!
 
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