Has "fronting" To Therapists Ever Cost You?

[formicism]

So, I have a question, but first preamble:

One of the symptoms of my trauma is a deep mistrust for people who wield power over me, especially medical professionals. In general, I try to hide my symptoms as much as possible (something I learned to do as a teenager years before, when I was depressed, since expressing my feelings or revealing myself to be in any way "compromised" always got me into trouble). It's almost second-nature to present myself as charming, composed, and self-possessed to people I don't have very good reason to trust.

Unfortunately, this is also what severely delayed diagnosis: I was in therapy for a good year until I had to actually request a PTSD diagnostic. Prior to that, I had a psychiatrist tell me outright that he couldn't just take my word that I was in distress, that therapists and psychiatrists pay more attention to body language and physical self-expression than to what their patients are actually saying. I get that this man is obviously something of a hack, but has this happened to anyone else? Now I feel like I have to "perform" my PTSD for providers (psychiatrists in particular, since the appointments are very short and sparse) in order to be taken seriously. As it happens, I now receive care in a building that has deeply triggering associations, so it's impossible for me to maintain the facade of calm competence, which has turned out to be helpful.

I think it's kind of gross. Society teaches us to hide our symptoms, since they reveal us as fragile and therefore less reliable or capable or whatever nonsense, but then when we hide them with any success, people assume that we're just fine, and artificially inflating the problem.

 

[EveHarrington]

Your analysis is spot on.

Society wants us to appear normal while the psychiatric world wants us to be very outwardly symptomatic in order to take us seriously.

I've developed a dichotomy of sorts to deal with it all. I "fake it til I make it" in the real world while holding nothing back in the psychiatric world.

Unfortunately this is the best way I've found to get my needs met.

I've had similar experiences to yours; not being taken seriously because I learned to hide too well. It was a shock to be discounted like that but I learned a valuable lesson.

 

[formicism]

yeah, "fake it till you make it" is like a mantra for me! But it's problematic when it's set against this expectation that I should be able to just "release" my trauma whenever it's convenient or necessary... evidently the latter is a skill I haven't developed yet...

 

[UnKnown-Self]

Absolutely and "perform" was the word I used when expressing my feeling about it so thank you for letting me know I am not the only one who has felt that way.

The official PTSD diagnosis will often happen when one gets to the point where hospitalization is required. At least that is my personal experience so far so don't take that as fact.
The problem/catch with this I have found is once you change psychiatrists/therapists you are often back at square one.

Using my personal experience as an example: I was first diagnosed with PTSD in around 1982 while in rehab. That place no longer exists so I imagine the records don't either. The second time was about 1994 but unless I want to pay for the cost of getting my medical records which probably no longer exist I am SOL. There were a couple other times in the 90s. Then there was 2003 (?). The problem is not only getting medical records but traumatic living does not do much for the memory and while in the midst of it, record keeping is not one's main priority and once through the episode all one wants to do is move on and forget it, especially if you weren't really helped much but feeling well enough to stuff it/ deny it and carry on for the time being.
Then there was 2015 and I was diagnosed with PTSD but when I moved from one part of the program to the other within the same facility I was informed each time I "graduated" say from PHP ( partial hospitalization program) To IOP (intense out patient) and then to individual once a week therapy, my file did not follow me but a new one was created and the new psychiatrist/therapist had the choice/power what have you to decide if that was actually my diagnosis. So yes, I was expected to perform again and again because my words was not good enough and is stated as "patient reported" such and such but they did not witness the melt down, can't see the thoughts in your head and so basically don't believe you.

One of the trademarks of PTSD is the shame and secret keeping ingrained in the brain and emotional network along with self denial that is probably encouraged by others.

So if you keep coming across medical professionals who expect you to "perform" leave that place immediately. But don't ever give up hope or stop trying. Keep going to the next therapist and the next until you find the right one. That's what I'm doing and I hope this new one is the "one".
The frustrating part is understanding when you do find someone you feel comfortable with, they can't immediately diagnose you. Not because they want you to perform but because they need to learn your history and trust has to be built just like any relationship.
That process is slow going with once a week 50 minute visits but it is better than being in the hospital. Not only will you not continue with any therapist you work with in the hospital since their job is inpatient but where you have to be to get admitted to the hospital is nothing I would wish on anyone.

Please don't give up, keep looking for a therapist you can work with and in the meantime keep posting. It will get you through.

Welcome to the forum!!

 

[Ocean5]

Yes I was same way. People always assumed I was just guy next door with ideal life. I knew something was wrong with me, but didn't want to see therapist or p-doc.

I guess in a good / bad way when I first went to p-doc / therapist I was really messed up. I opened-up - put everything on table. So my body language would have been obviously since I finally broke down "wanting help" for once.

She was reading my body language for sure. When I would try to hide emotions - she'd even comment how my body said otherwise....after I'd ask her, "Why are you asking me that?"

It also helped I wrote everything out (history/symptoms) before for her to read. So she knew what she was dealing with.

 

[Sideways]

Shame doesn't help!

My shame about my trauma history, and wanting to keep it hidden from the rest of the world, has made me a master of disguise (being DID plays a bit of a role as well!).

I was originally diagnosed with Bipolar II (which is probably accurate). Fast forward 2 years, which included 12 months straight in hospital seeing my doc 5 days a week, and one of my adult traumas finally came out and I was diagnosed with ptsd. It was another year before we finally made it to C-ptsd. I'd spent 20+ years hiding my trauma from the world because of the shame, and when I met up with my doc, it wasn't any different - still hiding everything.

The only good thing I can say about it is occasionally I find myself in a social setting where having my trauma on display for the world to see would be unhelpful and unnecessary, and in those situations, I can still "front" like the best of them. So it's part survival strategy, part pain in the proverbial, depending on the setting.

 

[Deleted member 29920]

Yes I can hide my anxiety pretty well and wasn't taken too seriously when I first asked for help. I sometimes worry if I show my weaknesses they'll think I'm malingering, it's a no-win situation!

 

[Friday]

As someone who struggles with / knee-jerk is minimizing.... It seems like most therapists & doctors are constantly working towards the middle. Trying to get clients to right-size problems;

It's nothing! No worries! >>> Okay. Fine. There's maaaaaaaybe something wrong.
OMFG. Worst thing ever! >>> Okay. Fine. There's maaaaaaaybe something right.

ETA... As far as costing me, because I put up a good front? Not as far as I know.

 

[Ocean5]

I guess I got lucky in that I was a real mess by that time (over 15 pages of forms to fill out before I arrived. Some self-test). P-doc/therapist said she wished her other clients were so honest. I just wanted "help" by that point. But all the history triggered me more before I went. At same time helped me to understand what was really happening to me.

 

[The Albatross]

I didn't have the finances or the time to "front" anything. I needed and wanted assistance fast. I got it... pretty fast too. 9 months in therapy for PTSD... and am not altogether fan-fricking-tastcic but am well above where I was before. Why'd I quit? $$$$.

 

[theshadowoftheliving]

I'm too functional for most therapists to take me seriously.

Fronting the symptoms is all I can do to get myself noticed sometimes.

 

[katz]

My mask is so "proof" that no one knows that inside I'm screaming for help. I've seen so many T, and done so much "self therapy" and reading, that when I go see one--to start over-again, I almost know more that they do. I've not been with one that has been able to penetrate my mask. Even the family thinks that I'm fine now. How far from the truth they all are.