Fragmentation During Exposure Session

[Kobuck]

My therapist is utilizing Sensorimotor psychotherapy to treat my PTSD and Panic Disorder. I'm currently in the Sliver of Memory phase (exposure). When I'm asked to focus on the trauma I frequently freeze, cry, can't speak and my body jerks and trembles. My therapist has requested that I write down what I couldn't articulate during these sessions, but I don't really know how to describe what's happening inside me. The best I can do is to tell her that it's like a shit storm of simultaneous thoughts, emotions and physical feelings. I feel immense pressure to make progress, but it's not happening. We've been doing these sessions for 2 months now, It's exhausting and hyperarousal lasts for days.
I'm wondering if others have experienced something similar, what is was like for you and if your flashbacks and somatic symptoms decreased.

 

[coraxxx]

Hi Kobuck, welcome to the site!

I’m not acquainted with Sensimotor psychotherapy, but I’d say a flickering freeze/flight/fight/fawn response isn’t uncommon when the exposure is too fast, too soon. It really can aggravate you to have exposure forced on you and get all triggered and stressed and racing thoughts and not knowing. I did get very aggravated by having been pushed too fast and it sent me to lock myself in my apartment and not going out as much as I could.

I, personally, don’t think it’s good to go through exposure without having seriously good coping skills in hand. There is an idea that people have to verbally process the trauma to get over and while it’s true for certain persons, it’s not for others, Everyone has their vibe. Perhaps this kind of therapy is just too brutal for where you are now.

Also feeling pressured to "progress" is really counterproductive, it puts pressure and guilt where there is no reason to be. That’s really bad for a therapist to do.

Hoping you find the help and support you need. Welcome again!

 

[Movingforward10]

I also don't have experience in that. But , gosh, it sounds torturous.
To keep on and keep on and keep on feeling that disregulated : no thank you.
Therapy is hard. For sure. But to be retraumatised in each session and needing several days each time to regulate, only to go through all that again.

Do you think this is the right modality for you? Or the right time for this modality?

 

[Friday]

The best I can do is to tell her that it's like a shit storm of simultaneous thoughts, emotions and physical feelings.

Sounds like a fantastic description to me.

I'm wondering if others have experienced something similar, what is was like for you and if your flashbacks and somatic symptoms decreased.

Yep yep.

It takes me anywhere from less than 2 weeks to 6 months to blunt or completely eliminate a trigger or stressor; whilst the actual traumas themselves take me a few years, at a minimum. “Just” being able to write a super general timeline that blocked out trauma types took me 2 years.

Panic Attacks, Anxiety Attacks, Flashbacks, Dysreg, etc. always start decreasing immediately when I’m working on triggers & stressors (although my nightmares tend to uptick in the very beginning, there’s a sharp drop off)… because I’m only ever flickering along the very edges of them, until the edges start to move, and then I’m flirting along those edges, until those edges start to move, and on and on. The smallest symptom -slight increase in heart rate, prick of sweat, breathing shallowing, vision/hearing, hint of dissociation, etc.? Means I’m too close, too fast, and need to ghost back, before whispering forward, again. 99.9% of chipping away at triggers and stressors via exposure therapy? Is control + boredom. It’s all about the finesse, rather than brute force. (There IS a fast & dirty way, that is all brute force; but it’s 50/50 on whether the trigger/stressor decreases and vanishes or increases and sets itself in stone. It is reeeeeeeally not recommended. Nor safe, for that matter.)

Coming at the traumas themselves, however? There is a MASSIVE UPTICK in symptoms. Things get waaaaaaay worse, before they get better.

 

[Kobuck]

I, personally, don’t think it’s good to go through exposure without having seriously good coping skills in hand. There is an idea that people have to verbally process the trauma to get over and while it’s true for certain persons, it’s not for others, Everyone has their vibe. Perhaps this kind of therapy is just too brutal for where you are now.

Also feeling pressured to "progress" is really counterproductive, it puts pressure and guilt where there is no reason to be. That’s really bad for a therapist to do.

My therapist is patient with me. The pressure to make progress is mine and I do feel ashamed that I'm not making progress.

 

[Kobuck]

I also don't have experience in that. But , gosh, it sounds torturous.
To keep on and keep on and keep on feeling that disregulated : no thank you.
Therapy is hard. For sure. But to be retraumatised in each session and needing several days each time to regulate, only to go through all that again.

Do you think this is the right modality for you? Or the right time for this modality?

I have severe PTSD and Panic Disorder, therapists and psychiatrists have tried a many different treatment modalities to help me. Over the last three years I've made very little progress despite everyone's best efforts. During the first year my somatic symptoms were severe and I mostly froze and couldn't speak during sessions. EMDR traumatized me further, tapping just irritated and pissed me off. About a year ago I was transferred to a trauma specialist that utilizes Sensorimotor Psychotherapy and for 9 months the focus was on building trust, coping skills and resources. Now its the Sliver of Memory (exposure) part of the therapy. I made a lot of progress during the first nine months, but now not much. I believe the modality is the correct one for me, it's just really hard right now

Sounds like a fantastic description to me.

Yep yep.

It takes me anywhere from less than 2 weeks to 6 months to blunt or completely eliminate a trigger or stressor; whilst the actual traumas themselves take me a few years, at a minimum. “Just” being able to write a super general timeline that blocked out trauma types took me 2 years.

Panic Attacks, Anxiety Attacks, Flashbacks, Dysreg, etc. always start decreasing immediately when I’m working on triggers & stressors (although my nightmares tend to uptick in the very beginning, there’s a sharp drop off)… because I’m only ever flickering along the very edges of them, until the edges start to move, and then I’m flirting along those edges, until those edges start to move, and on and on. The smallest symptom -slight increase in heart rate, prick of sweat, breathing shallowing, vision/hearing, hint of dissociation, etc.? Means I’m too close, too fast, and need to ghost back, before whispering forward, again. 99.9% of chipping away at triggers and stressors via exposure therapy? Is control + boredom. It’s all about the finesse, rather than brute force. (There IS a fast & dirty way, that is all brute force; but it’s 50/50 on whether the trigger/stressor decreases and vanishes or increases and sets itself in stone. It is reeeeeeeally not recommended. Nor safe, for that matter.)

Coming at the traumas themselves, however? There is a MASSIVE UPTICK in symptoms. Things get waaaaaaay worse, before they get better.

Thank you!