HELP! Today's therapy session went horribly wrong. Panic during a ‘relaxation’ exercise??

[DogTired]

Night time, and I can't fight off my demons anymore. It goes like this.
Combat exposed me to horrific things. After 30 years plus of coping, BANG! They're back, in glorious color..
The flashbacks I can cope with but the nightmares are not nice. Not nice at all.
I see, feel, smell, hear, and relive, in real time, while interacting with the team I worked with.
The 'film' runs in 3 ways.
1. The nightmare runs it's course. I wake up, usually noisily. My wife can calm me down BUT that's sleep for the night finished.
2. The nightmare is running, I'm either thrashing about or talking in a language I once knew. Wife wakes me, mid dream, calms me, I go back to sleep.
3. The nightmare runs, I don't wake up or wake the wife, but in the morning we have to change the bed as I'm soaked in sweat. Nice eh.

Today the therapist tried a little bit of 'relaxation training' over a secure video link.
To say I reacted BADLY during it, is putting it politely. Panic, the shakes, and utter confusion.
To the question "What the hell just happened"? The therapist just sat there seemingly lost for words.
I think I scared him as he is going to consult his senior therapist on why and what to do next and that was the video call finished.

Now I'm thinking was "relaxation training" a code word for hypnosis as I have no idea what happened to trigger such a reaction.
I literally "woke up" in a state of confusion, swamped by emotions and pain, I've seldom experienced for years.

Simple question. Has anyone experienced something like this?

 

[Sideways]

Simple question. Has anyone experienced something like this?

Oh yeah!

I’ve sat in a group therapy session and watched the ptsd sufferers drop like flies during ‘breathing exercises’ done badly. I’ve run from the room crying during a guided relaxation more than once.

If you look around, there’s meditation classes, and then there’s trauma-sensitive meditation classes. Guided relaxation, and trauma-sensitive guided relaxation. Yoga, and trauma-sensitive yoga.

That’s a thing, because what you experienced is a very normal reaction for a ptsd sufferer. Relaxation methods, effective ones, are intended to trip off the parasympathetic nervous system (the system our body has for calming the f*ck down).

But with ptsd on board, any one or all of the bodily systems that change when the PNS is triggered are potential triggers. Slowed breathing, dropping heart, dropping cortisol or adrenaline, even becoming aware of the body (since most of us are living pretty dissociated from our body) - any of these can trip off a panic attack for a ptsd sufferer.

Very common.

The flip side is if you can find a relaxation technique that you can do safely (look for that ‘trauma-sensitive’ prologue!), harnessing control of your PNS can, ultimately, mean never having a panic attack again…because you learn to control the system in your brain and body that’s messing with that.

Which also means: less, and lower anxiety, better digestive health, better sleep, more effective exercise, better concentration, better heart health, better lung health, less chronic pain…the list goes on and on and on!

But yeah, for a newbie therapist who isn’t aware of that, even just asking their patient to “notice your breath” (which is a pretty standard way to help a human become almost instantly more relaxed) has a good chance of triggering a panic attack in someone who has ptsd.

 

[DogTired]

Oh yeah!

I’ve sat in a group therapy session and watched the ptsd sufferers drop like flies during ‘breathing exercises’ done badly. I’ve run from the room crying during a guided relaxation more than once.

If you look around, there’s meditation classes, and then there’s trauma-sensitive meditation classes. Guided relaxation, and trauma-sensitive guided relaxation. Yoga, and trauma-sensitive yoga.

That’s a thing, because what you experienced is a very normal reaction for a ptsd sufferer. Relaxation methods, effective ones, are intended to trip off the parasympathetic nervous system (the system our body has for calming the f*ck down).

But with ptsd on board, any one or all of the bodily systems that change when the PNS is triggered are potential triggers. Slowed breathing, dropping heart, dropping cortisol or adrenaline, even becoming aware of the body (since most of us are living pretty dissociated from our body) - any of these can trip off a panic attack for a ptsd sufferer.

Very common.

The flip side is if you can find a relaxation technique that you can do safely (look for that ‘trauma-sensitive’ prologue!), harnessing control of your PNS can, ultimately, mean never having a panic attack again…because you learn to control the system in your brain and body that’s messing with that.

Which also means: less, and lower anxiety, better digestive health, better sleep, more effective exercise, better concentration, better heart health, better lung health, less chronic pain…the list goes on and on and on!

But yeah, for a newbie therapist who isn’t aware of that, even just asking their patient to “notice your breath” (which is a pretty standard way to help a human become almost instantly more relaxed) has a good chance of triggering a panic attack in someone who has ptsd.

.
Thank you for your reply sideways, calmed me down a lot.
It also helps knowing when the fuse blew, that helped to explain the memory wipe I experienced.
Ordinarily, if I need to calm down, I listen to music and once wrapped up by the emotion in that music, I have a nap, awaking very calm.

UK based, the therapist is 230 miles away from me and group sessions just don't happen.
So when things go wrong, it's left to the wife to calm me down.
Not a nice thing for her to cope with plus all the other 5h1t that I can exhibit.

Poor National Health Service mental health treatment around me but a private therapist is way too expensive for our pockets.
Ho Hum, and soldier on.

 

[Movingforward10]

I'm really glad what @Sideways said has helped you to calm down. That's really positive.


I second what sideways says: totally common to have a massive reaction to something, not understand why, be left in this awful state.
It's something to reflect on for sure with your T and yourself. Once you have stabilised a bit it would be good to see what triggered it. Sometimes triggers can be so oddly connected that it makes no sense. But realising that helps.
And sometimes these triggers come on so fast, it's hard for us and T's to notice before it's too late. It took my T some time to work it out as she said I changed very quickly from one state into another. T's have to learn about us.

Also, just because T seemed helpless in that moment doesn't mean that he is. It could just mean the whole transference/countertransference thing. Which is so easily done because T's are so present with us that they can make a mistake and get caught up in our feelings. Meaning that your T could have been picking up your feelings and identifying with them too much in that moment which meant he couldn't guide you like he usually does. And it's great he is consulting with his supervisor. That is a sign of a good T. He has realised he needs to. And will come back next session more prepared..

These sessions, whilst excruciatingly painful, are actually moments of change and growth. Once you have got through the other side and through this horrible bit .....

 

[DogTired]

I'm really glad what @Sideways said has helped you to calm down. That's really positive.


I second what sideways says: totally common to have a massive reaction to something, not understand why, be left in this awful state.
It's something to reflect on for sure with your T and yourself. Once you have stabilised a bit it would be good to see what triggered it. Sometimes triggers can be so oddly connected that it makes no sense. But realising that helps.
And sometimes these triggers come on so fast, it's hard for us and T's to notice before it's too late. It took my T some time to work it out as she said I changed very quickly from one state into another. T's have to learn about us.

Also, just because T seemed helpless in that moment doesn't mean that he is. It could just mean the whole transference/countertransference thing. Which is so easily done because T's are so present with us that they can make a mistake and get caught up in our feelings. Meaning that your T could have been picking up your feelings and identifying with them too much in that moment which meant he couldn't guide you like he usually does. And it's great he is consulting with his supervisor. That is a sign of a good T. He has realised he needs to. And will come back next session more prepared..

These sessions, whilst excruciatingly painful, are actually moments of change and growth. Once you have got through the other side and through this horrible bit .....

Thanks for your reply. Things are starting to make sense now.

 

[arfie]

Now I'm thinking was "relaxation training" a code word for hypnosis as I have no idea what happened to trigger such a reaction.

in my personal recovery from child sex trafficking, my breakthrough sessions felt worse than the original trauma. the relaxation techniques felt like an enemy conspiracy to get me to let my guard down so THEY could attack anew.

for what it's worth
guided meditations still don't work for me. i keep wanting to tell the guide to shut up and let me think. by the time the guide is finished droning, my flight instincts are wound pretty tight.

 

[ellzeena]

Night time, and I can't fight off my demons anymore. It goes like this.
Combat exposed me to horrific things. After 30 years plus of coping, BANG! They're back, in glorious color..
The flashbacks I can cope with but the nightmares are not nice. Not nice at all.
I see, feel, smell, hear, and relive, in real time, while interacting with the team I worked with.
The 'film' runs in 3 ways.
1. The nightmare runs it's course. I wake up, usually noisily. My wife can calm me down BUT that's sleep for the night finished.
2. The nightmare is running, I'm either thrashing about or talking in a language I once knew. Wife wakes me, mid dream, calms me, I go back to sleep.
3. The nightmare runs, I don't wake up or wake the wife, but in the morning we have to change the bed as I'm soaked in sweat. Nice eh.

Today the therapist tried a little bit of 'relaxation training' over a secure video link.
To say I reacted BADLY during it, is putting it politely. Panic, the shakes, and utter confusion.
To the question "What the hell just happened"? The therapist just sat there seemingly lost for words.
I think I scared him as he is going to consult his senior therapist on why and what to do next and that was the video call finished.

Now I'm thinking was "relaxation training" a code word for hypnosis as I have no idea what happened to trigger such a reaction.
I literally "woke up" in a state of confusion, swamped by emotions and pain, I've seldom experienced for years.

Simple question. Has anyone experienced something like this?

PTSD is something you can't really ever defeat, at least I never have, but mine isn't war related. However, I know that certain "therapy" methodologies can be outright dangerous. I've had 3 psychiatrists tell me never to do EMDR. Before you embark on any sort of therapy that involves confronting these thoughts and memories, you better know that your therapist is absolutely 100% qualified and has a GREAT DEAL of experience dealing with complex PTSD. No kids fresh out of school over one of those useless internet sites, forget that, dangerous.

Any sort of technique that involves confronting the actual memory, instead of its screen presentation (which is the dream) has to be done IN PERSON. You have to be grounded, you have to feel absolutely safe, you have to trust that therapist 100%, that therapist needs to know you VERY WELL and be able to observe you during the process so s/he can interrupt and stop it if you're reacting badly. THAT IS A TERRIBLE THERAPIST YOU HAVE.

I have to assume you've tried the VA? I know it's a "joke", I hear about that, but they are really stepping up their war related PTSD interventions. AT least you might get recommendation to a private therapist who actually knows what s/he is doing. I haven't done this but I've read ketamine therapy is good for PTSD. Again, proceed with caution. I never found medication to be helpful at all but my problem isn't based on exposure to the sorts of things that haunt you, so it's not the same at all. Choose the therapist very very carefully. The wrong one can do alot of damage. I'd stop with this one altogether. Dreams can be symbolic and there's also a way to attempt lucid dreaming, which involves planning ahead of time and the actual changing of the dream itself while you are having it. I don't know if this would work when serious PTSD is involved. And to tell you "well, they're only dreams" is absurd because clearly your body reacts as if you're actually there.

Seroquel (quetiapine) can potentially help treat PTSD nightmares, as studies indicate it can be effective in managing insomnia and nightmares associated with PTSD, although it's typically considered an "off-label" use and not the first-line treatment for PTSD symptoms. This is a medication you can talk to a psychiatrist about. Since this is an off label use, I can't tell you how many psychiatrists would prescribe it for PTSD but the VA should have one who will. I'm in a group for PTSD sufferers and I've read some take this medication at night and it helps. I'm so sorry you're living with this.

 

[DogTired]

Hi ellzeena Firstly, I'm UK based.
History. Late 1980's, trying to stop ethnic cleansing, 7 days a week, non stop for 6 months with all the 5h1t that went with doing that.
While the West's police ( UN / NATO / US / Europe) and their bastard politicians looked on.

Nest? Now physically wrecked, mentally Fk'd, I ended up in a PROPER hospital in France.
NOTHING like the "league of nations 3rd grade English and qualifications well dubious at best", melting pots you find in the UK's NHS today.

Then it was aggressive therapy. There was no twee Eyeball tennis then, confront, hard truths, again and again until it no longer registered on the Richter scale.
Finally equipped when ready with a "Defense Passive" trick that worked up till a couple of years ago, and discharged.
Down 17 kg, and a strong desire to drown in Slivovitz Morning, midday, and Tea time.
Only gripe? One shrink was a dope peddler. Everyday a new pill, and me walking around like a zombie. That was until I "politely" told him in pretty good French (from working with a French operative) where he could stick his pills (clue, the sun don't shine there'). And gently returned to humanity over the next 5 years.

What went wrong? Not very social media and war video that smacked me around once too often.
As a result "Defense passive" no longer working, everything came flooding back (including a renewed strong desire to source liter bottles of Slivovitz).
That last one I beat very quickly (No money). The flashbacks sort of OK, but the nightmares! Jeez. They read like my diary only worse.
Help for me is ALWAYS very close at hand, my lovely wife.

Then, I'm looking for professional help. First stop doctor. East European, Sort of understandable, admitting she knew little about PTSD.
Called back to see her 2 weeks later, She had done some homework. 8/10 for effort.
Assessed soon after by a proper shrink who sat back after doing the tick list some will be well familiar with and said in easy language, "You're FUBAR" (only a bit politer). After that, I started the poorer man's VA equivalent (aka NHS Mental Health). Know how fast paint dries in the UK?
Slowly, REALLY REALLY slowly. Or about as fast as UK's mental health system works.
S0 I turned to a veterans charity. and now you're up to date.

PTSD. Yes I know PTSD cannot be beaten. It can be watered down if you like, enough to live with but never goes away.
Enter my current therapist. The result you've just read.

Now the finale. I'm not alone, I'm not uncommon, and certainly not unique.
There are 100's of 1000's of combat vets in the world with PTSD and healthcare ranges from fantastic to crap level (that one would be the UK).
At least the US VA exists. Here in the UK its rich charities (living in huge mansions) who pretend they care, or little 'vet run' groups who really do care, to the NHS who don't really give a flying Fk. Why?? Government funding for Mental health has been cut all over. Leaving over 2 million People on waiting lists for NHS mental health support in England alone.

It's the same story the world over. Everyone loves a soldier, or emergency worker, who protects them.
VERY FEW want to look after those who get broken and then "become a burden".



.

 

[Wendell_R]

Yes, I have had very similar reactions. A good trauma therapist suggested that I could take down one of her stuffed animals from a shelf--afterwards, I had a huge bad reaction related to feelings of getting in trouble/not deserving. I have had flashbacks triggered by trauma-informed meditation/body exercises. I have had bad flashbacks when a therapist tried playing a children's game with us.

There's a silver lining in all of this. My past therapist said that one thing that made working with me very productive was that when something went wrong, I was able to speak up and say what was happening or what didn't work. A good therapist will then use that feedback to learn about your responses and to change their approach appropriately. PTSD has all sorts of surprises--having bad reactions in therapy happens. The trick is how we respond. Your honesty about your response is a good first step.

 

[DogTired]

Thank you for your reply Wendell_r.
I've always worked on the notion that feedback and Intel about me is a good thing as it helps them who would help me.
Problem is occasionally some won't react positively and a few take it as criticism.
When they do that, I explain, as said, why I give feedback.
It's not that I think I know it all, because I don't know 5h1t, and readily admit it.
However some will still turn nasty, and that's the end to me and them. No second chances.
After all I'm not there to fight anyone, so don't fight me.

 

[Sues]

I've also had similar things happen. Relaxing does not feel safe, so it's not only hard to do, it's also triggering because of things that have happened. I have a really good trauma therapist now, and he knows me well. That took time, and we had a couple of set backs where I went back and told him about what he said or did that was not ok with me. He apologized, and we moved forward. He said that me telling him what and why it bothered me helped him to know how to better help me and navigate therapy with me.

 

[Roland]

Oh yeah!

I’ve sat in a group therapy session and watched the ptsd sufferers drop like flies during ‘breathing exercises’ done badly. I’ve run from the room crying during a guided relaxation more than once.

If you look around, there’s meditation classes, and then there’s trauma-sensitive meditation classes. Guided relaxation, and trauma-sensitive guided relaxation. Yoga, and trauma-sensitive yoga.

That’s a thing, because what you experienced is a very normal reaction for a ptsd sufferer. Relaxation methods, effective ones, are intended to trip off the parasympathetic nervous system (the system our body has for calming the f*ck down).

But with ptsd on board, any one or all of the bodily systems that change when the PNS is triggered are potential triggers. Slowed breathing, dropping heart, dropping cortisol or adrenaline, even becoming aware of the body (since most of us are living pretty dissociated from our body) - any of these can trip off a panic attack for a ptsd sufferer.

Very common.

The flip side is if you can find a relaxation technique that you can do safely (look for that ‘trauma-sensitive’ prologue!), harnessing control of your PNS can, ultimately, mean never having a panic attack again…because you learn to control the system in your brain and body that’s messing with that.

Which also means: less, and lower anxiety, better digestive health, better sleep, more effective exercise, better concentration, better heart health, better lung health, less chronic pain…the list goes on and on and on!

But yeah, for a newbie therapist who isn’t aware of that, even just asking their patient to “notice your breath” (which is a pretty standard way to help a human become almost instantly more relaxed) has a good chance of triggering a panic attack in someone who has ptsd.

Thanks for explaining this. I've experienced this as well. Most grounding exercises freak me out.