How Do You Build Trust With Your Therapist?

[crazy8]

How do other people manage the insurmountable task of identifying perceptions vs. reality of how you are being treated, with complex PTSD?

 

[fyredrift23]

Hi, crazy8 :)

Your topic is such a good one! I'm glad members of the community have responded so honestly and eloquently. I agree with what has been said, definitely, and I hope those posts and this one can be of help to you :)

In response to your 2nd question, I don't have complex PTSD, but I do have Depression. I've been in therapy for 2 years now, and, like the others have said, it took a little while for me to really start trusting my therapist (or T). He's a really sweet man, and it has been, for the most part, a true joy working with him. However, there are things from my past that have definitely influenced how I interact with him and how I interpret his behavior with me.

Let me start by congratulating you for taking such giant steps towards feeling better! Therapy can be quite a challenging endeavor, so I hope you can feel proud of yourself for the work you have done and continue to do. :tup:

Still, I have irrational fears of him manipulating me, abandoning me, or otherwise mistreating me. It's not him; I have these feelings with any person whom I share vulnerable emotions with because of my past.

You said it all right here! Your fears aren't really "irrational." They have developed as a direct consequence of past experiences you have had. They were created to keep you safe and to keep you alive. To share is to be vulnerable, and it's much more easy to be hurt (and more devastating) when we feel this way. It makes perfect sense that, in the face of your sharing such personal pieces of your self, you proceed with caution, even when you aren't consciously meaning to.

Personally, it was pretty risky for me to be vulnerable growing up. Many times, I was not able to really express myself and share my true feelings, no matter what they were. Displaying happiness (to a certain extent) was fine, but I couldn't really show sadness or fear without being perceived as weak. I couldn't show anger without being perceived as "crazy" and "out of control." So, you know, I didn't. I just pretended to be happy or whatever the hell it was the other person wanted me to feel. Years of doing this led me to become quite out of touch with my true feelings and desires.

I basically could not trust that, if I were to be vulnerable, I wouldn't be ridiculed or embarrassed, dismissed or criticized. You really had to prove yourself to me in order for you to earn my trust. I simply couldn't share like that without being very very confident that you wouldn't hurt me or try to take advantage of me. So, as you might imagine, this continued into my early adulthood. As much as I want to be close to people and "let them in," I get absolutely terrified the closer they come to me. My friends who I've known for years can freely and openly share deep stuff with me, but I still have to struggle and fight to do the same with them.

Once I started therapy, I was able to communicate to my T how difficult and dangerous/risky it had been for me to share and be open and vulnerable in my past. Over the next few months, I gradually came around to trusting him. I could tell right away that he "got me" and really cared about me and wanted to help me. But, that still didn't stop me from hesitating to open up, even though this whole therapy thing was for my benefit. He understands my difficulty as being a direct result of a myriad of past events. He knows how hard it is for me to share with anyone.

Now, 2 years in, trusting my T has become significantly easier. However, I do still struggle to determine how he is coming across to me. I feel a lot of resistance and disbelief that he could view me as a sweet, smart, and good person, even when he's told me so himself. The only way I've really been able to differentiate truth from misconception is by examining how I feel and comparing that with what I know to be true about my T. Normally, whenever I'm feeling negative vibes or hesitation or wariness, I look at the situation more closely to better determine if my reaction is appropriate or not. Like others were saying, since, over time, he's proven to me that he considers my feelings, isn't trying to hurt me, won't ignore me, etc, I can compare those facts with whatever is floating around in my head.

Another thing I do that really helps is I journal and send him emails. I have brought my journal in to a session to share, but he normally wants me to read it to him. That got to be too overwhelming, so now I just use the journal to organize my own thoughts and feelings and get them down on paper. Sending him emails (randomly, throughout the week) has tremendously helped me to bypass my numerous defense mechanisms that would make sharing near impossible for me to do. I'll think of something really important that I want to discuss at our next session, but then forget it once I'm there. I'll downplay something that's really bothering me to the point of discounting it so it becomes insignificant. I'll lie to my T or tell half-truths to make it appear like I'm doing better than I really am. The list goes on. But, being able to send him an email whenever and however often I would like has significantly reduced the power of my defense mechanisms. I normally express myself well verbally, but I get so jumbled up when it comes to talking about the heavy stuff we dive into during therapy that writing has become a much better option. I can express myself so much better that way!

Anyway, I hope some of this helps! And I'm really glad you found a therapist you work well with :happy:

 

[BloomInWinter]

My trauma therapist explained to me that trust is a product of consistent performance over time.

No matter what goes on inside of us, as our therapists remain consistent, dedicated, and open with us, we eventually extend trust. If we've never experienced that type of unbroken trust ever before, it takes even longer.

At the very basic level, we all must begin at some point by being willing to take it on faith that our therapist is basically a caring human being who desires to help us, even though mistakes will happen.

I only really began getting better once I was able to force myself to ignore all the old tapes in my head telling me to run. Also, to not act on the impulse to just quit rather than go back and be honest about my feelings. But I kept making myself go back, and eventually his consistent, kind, understanding demeanor helped me see just how very deeply my ability to trust has separated me from other human beings.

Trust will come. Keep being honest with your therapist about all you think, even if it is unflattering or feels strange. Working through those very things is the proving ground where he/she can earn your trust.

 

[mytai]

I wrote an elaborate letter today, but was too emotional after having a flashback today in therapy to show it to him :-( We did actually end up discussing a few of the things in it, though. I just choke up and either dissociate or have a flashback episode when I try to speak about anything deeply emotional. Maybe someday...

I had almost the same situation the first time I tried the letter, instead of a flashback I was scared, upset, and panicky. I found that handing over the letter when I first get there eases the fear of handing it to my T, then she asks if she can read it.

I'm the same way with anything emotional at all, I either dissociate or I'm too fearful to talk because of past therapy and abuse. The letter thing is the only thing I've found so far (only a few months) that has worked in avoiding dissociating while trying to communicate emotional topics for me. It also gives my T the ability to ask questions, answering questions is easier than trying to start from scratch for me at least.

I'm sorry you had a hard time :( Don't give up, keep trying. It will come.

 

[EverOnly358]

@crazy8, I've wondered a lot about this myself. (I'm have complex PTSD, too.)

This is the Complex PTSD speaking! These are very common issues and your therapist will be well aware of it. It took ages for me to really trust my T.

If you don't mind me asking... like how long specifically? I fear this will never be possible for me! Months? Years? Decades? ;)

Every time he shows you compassion and understanding a little piece of that support will be put into place.

@Candleflames, This is something I'm really worried about. I spent a whole session crying non-stop (first I was triggered and then I had an emotional flashback), and my therapist ended up yelling at me (she said she was just "speaking firmly" but it felt to me like she was yelling at me... I know that's just my history, but still). I'm not sure if this is good or bad. Maybe I won't listen otherwise? Maybe I would become too dependent on her if she was too compassionate and understanding towards me. It left me doubting I could ever trust her, no matter how hard I tried. Now I'm wondering if she's a good fit. Given my history of abuse, I will just accept any sort of bad treatment. How do I know when a therapist is good or not? Any thoughts? (I really hope it's okay to ask anyone who has some insight.) I really related to this quote, if it helps...

@Abstract you hit the hammer on the nail again in this post! This is a CONSTANT battle for me. I am so grossly unaware of when someone is trying to hurt me or when I am feeling irrationally hurt because of my past. I often have to step back, think about it and try to logically deduce the likely explanation for the person's actions, whether or not they did something to purposely or accidentally hurt me, and then figure out how to respond after that! It's such a laborious, time-intensive, and nearly impossible task.

@Hashi, I really liked your whole post, it was super helpful.

Basically I chose to act 'as if' I can trust him until I do.

That's basically where I'm at. I'm trying to remember that my therapist may very well be trustworthy. That's she's not perfect and she makes mistakes. That's the best I can do right now.

Sorry if this is too long, I think this is an excellent thread,
D123

 

[Lucycat]

f you don't mind me asking... like how long specifically?

I think it took me a few months to learn to trust. Following this there have been times when I felt as if the relationship was 'ruptured' but T was always quick to repair it. I guess after getting that first level of trust I was able to tell him that he had said or done something that didn't feel right. There have been times when he aplogised and times when I have done so. It is not an even ride, but the trust can be further built on. I am now at a stage that I completely trust him, but there is still that tiny nugget in my brain that questions 'what next?'

I spent a whole session crying non-stop

I have done this in many of the sessions in the first year. I never got yelled at. T just waited sometimes, and others, through the tears asked me to try and think of why I was specifically crying at that time. It really slows down the therapy, but at the same time I feel is part of the process of feeling and allowing emotions for the first time in your life.

 

[Candleflames]

I don't know if I'm the best person to to answer your question, @D123. I think this topic would make a good thread of it's own. There might even be one already.

I can tell you it took me a few months to really walk away thinking I had one of the good docs on my team. I had a kind of aha moment. I walked away from a session one day and realized that my doc had just totally called me on my shit. He did it so gently that it felt like the natural and logical progression of the session. I didn't feel defensive or or hurt at all. A few months ago I realized there are things that I want him to know, not fell like he should or needs to, but that I want him to. For me that is a big distinction.

On the other side I have had one lousy therapist. Her comments felt like a slap in the face at times and I felt like there was this underlying competition.

I have to say I have never had a therapist yell at me. I have seen a councilor yell at another member of our group but that was when I was in a "tough love" program as a teen so it was to be expected. Plus there was this parent/child dynamic. I think the biggest indication that I am working with the right therapists is that I feel like we are working together as a team and I feel safe in their offices. I'm not always comfortable but I do feel safe.

 

[crazy8]

I normally express myself well verbally, but I get so jumbled up when it comes to talking about the heavy stuff we dive into during therapy that writing has become a much better option. I can express myself so much better that way!

Ha, I could have written that sentence! I've been doing a lot of writing, and sharing with him little by little. It's still extremely difficult to even share stuff and have him read it. I actually had a flashback episode just because he offered to read it. It must have been the fear of vulnerability and my trust issues that triggered it.

 

[crazy8]

It really slows down the therapy, but at the same time I feel is part of the process of feeling and allowing emotions for the first time in your life.

My T always tells me this when I dissociate or cry or have a flashback (one of these things happens in nearly every session). He says to just let the emotions come and don't try to push them down. I don't even know how just "let them come," ha. I am trying, though. He is helping me be mindful of emotions. Hopefully it will start to help sometime soon.

 

[Britt.f7]

I agree that it takes time. I notice that I share in bits. I don't dump everything. Not emotion wise. She doesn't push me. Not in a bad way I should say. A therapist should push you a little, how else do you get better? But I don't mean in a fearful, negative, way. Anyhow, I have some sessions where I don't talk about anything too deep, and other sessions that I let the ball drop(so to speak).

 

[Rissy215]

How do you all test them to help you feel more comfortable trusting them with bigger issues?

 

[digger]

@Rissy215 - I haven't deliberately set out to test her, but seeing how she has reacted to some of the smaller issues that I find slightly easier to talk about, seeing how she has reacted when I can't talk, seeing how she has reacted when I had flashbacks or dissociated etc has all helped to build towards more trust.