How do you know when therapy is causing too much pain?

[JustForToday]

So I took a summer vacation from therapy. For three glorious months I was functioning better, more social than I've been in years, getting back into healthy coping mechanisms like yoga and meditation, and, for the first time in probably a decade, thinking I might have a future where I could be happy, healthy, productive and not ruled by anxiety, hypervigilance and depression. Well I started back up with my therapist and it's even worse than before I left (I took the break in hopes I'd be able to cope better after some "me time"). I know therapy is supposed to be painful. I know that means it's working. But how much pain is too much? These last few weeks I've been completely immobilized. I haven't left the house in a week (since my last appointment) and I cancelled my other support services because I'm too anxious and depressed to keep my appointments. I've been having multiple panic attacks a day, and each one seems more intense and definitely lasts longer. My night terrors are back, and as a result I've pretty much stopped sleeping. Basically, I've been a sobbing, vomiting, panicking, sleepless, immobilized mess for weeks now. My therapist seems to think this is a good thing (at least she doesn't seem upset that I'm so miserable), but my family and my other mental health support workers think this is way too much pain and stress for me, especially because I have a long history of serious suicide attempts and self harm. I'm not suicidal and I haven't self harmed in over a year now, but everyone except my therapist seems concerned that being in this much emotional pain might trigger me to start self harming again. I'm miserable, like really, REALLY, miserable, and I feel like my therapist is terrorizing, dehumanizing, traumatizing and attacking me (she's not though - she's totally ethical, and I know that cognitively, I just have a long history of trauma related to mental health professionals). Is this a normal and healthy experience of pain in therapy? I feel like my mind is fracturing into a million pieces and everything good and stabilizing is dissolving underneath me. Is this how everyone feels when they make progress in therapy?

 

[UnicornSightings]

So I took a summer vacation from therapy. For three glorious months I was functioning better, more...

I honestly have no idea what the right answer is for this as I don't know what your trauma is, and even if I did, I'm not you and don't have all your experiences and thought processes. Here's what I can say: You go to therapy because there's something you want to accomplish. You have a goal or goals and the reason is that you think meeting those goals will make your life better. If you're functioning well without therapy (and it sounds like you are) then why did you go back? What is your aim there? Are you going because you think you're supposed to or is there something you think your therapist can provide for you?

 

[JustForToday]

I honestly have no idea what the right answer is for this as I don't know what your trauma is,...

This is where I'm confused. Yes, I have a goal: to be healthier, work through past trauma and function better (I do function better when not seeing my therapist, but therapy or no therapy my overall functioning would still be considered extremely low). Yes, I think therapy can help me achieve this goal. However, I'm not sure this mode of therapy (psychodynamic) is the best way to help me achieve this goal (hence my question of how much pain is too much) and, if I am in the best type of therapy to help me reach that goal I'm honestly not sure that my goal is worth this constant pain. It just seems like most people I hear talking about therapy hit a rough patch where things get worse for a few (or several) months and they're in serious emotional pain but then things generally start to get better. They start to feel better, function better, cope better, and begin to see that working through that pain is worth it. I'm just asking whether or not it's normal for the pain of therapy to cause you to be immobilized for days after every single session - especially considering I've been in weekly therapy for 3 1/2 years already and I've never felt that it's been helpful. Normal? Not normal?

 

[EveHarrington]

I don't think you can ask this of everyone given that your trauma was at the hands of mental health professionals.

I really think you should ask this only of people who were traumatized by mental health professionals, otherwise you're not really going to get an accurate picture of what therapy should be like for someone with your type of trauma.

ie most of us would likely say that this is beyond the scope of healthy therapy.....but if you asked us what happens if we are around figures like those who abused us, we'd likely say this reaction is completely normal. In other words, given your type of trauma, this is likely par for the course IMHO.

 

[Friday]

Is this how everyone feels when they make progress in therapy?

This is why the 2 trauma professionals I really like/respect & want to work with wont do trauma therapy with me... Yet. Because I'm not stable enough & my life isn't stable enough. And, yes, symptoms are absolutely going to ramp up, and functionality is going to crash down, and things are going to get worse before they get better. So I have to be in a place where when that happens it doesn't stop the world.

It took me a long time to get on board with that concept, but doing a very brief run of trauma therapy in order to go testify about some of my past ate maybe a year of my life? As in a few months of dealing with trauma before I was stable enough to, it took me about 12-18 months (somewhere in there, my time sense sucks, it was a hard year) to get back to my level of functioning from before I started.

I was very specifically TOLD this would happen. Also that -ideally- it's a start don't stop scenario. It's going to be really, really bad, but stopping would just prolong the bad instead of seeing improvement. I don't know about that part, because I didn't do it. Pandora's box was already kicked open, then we forced it open wider, and then I had to quit. Maybe, if we'd kept going, I'd be better by now. Maybe I'd be dead, or institutionalized, or in jail. I don't know. What I do know is that before I try, again? I need my life squared away. So that when things get bad again, they don't get that bad.

 

[Deleted member 8714]

whether or not it's normal for the pain of therapy to cause you to be immobilized for days after every single session

For me it was normal. I was basically a basket case after each session with my T for the first ten years of therapy.

My history is ritual abuse and therapeutic abuse. It took four years to heal to a "functional state" from the abuse by a therapist. It still affects me to this day. A person in a position of power who was supposed to help me deal with my abuse used her position of power to control my healing and therefore my life. The T who helped me heal said that I couldn't work on my childhood abuse until I worked through the therapeutic abuse. It was a long haul.

It's been 22 years since I started working on ritual abuse, and I'm finally at a place where I'm not immobilized after the T sessions. Though I do find I need to "sleep it off" afterward. I find that's healthy for me. I don't dwell on what I worked on with the T as I did before. Therapy and my abuse used to consume my life for the rest of the week until the next T session.

Though I've got to say as well that I had flooding of memories when I started therapy 22 years ago. And my PTSD and DID were extremely symptomatic. The first T I ever saw for ritual abuse told me I had the worst PTSD she'd ever seen.

My PTSD symptoms now are less than before and I'm integrated. Yet when I get triggered...that's a different story.

 

[Sideways]

Ok, so it is painful when therapy is working. But just because it's painful, isn't conclusive evidence that you're onto something good. Unproductive therapy can be pretty painful as well!

One of my past Ts wanted to 'deal with my trauma' in a really direct way. And mostly, that was just destabilising. I was waaaaay to distressed to be processing anything effectively. Even with my current, much more experienced trauma T, we dig a bit at it, then back off, rinse and repeat.

The quality of life in the future is what we're in it for. But that doesn't mean we should completely disregard how we're traveling right now. And if right now is completely overwhelming, it's totally okay to slow things down of change direction.

Focusing on skills, stuff that makes today more meaningful and (gasp) enjoyable? Is time really well spent. In my view? The time I've spent on improving my experience of "today" has been just as helpful as time spent dealing with my trauma, and has ultimately made the task of processing my trauma not just more doable, but also quicker. Being too durn distressed does, at some point, make the whole processing thing stagnate completely.

So if it's all just getting too much? Talk to your T about focusing on some skills that will improve the way you cope, and the way you live. Take the focus off trauma for a while. May well be the best therapy decision you ever made:)

 

[MyWillow]

I'm a push ahead at all costs, go hard or go home kind of person and I took that into my first experience of therapy. That went well. Not. Much to my shock I finally realised I wasn't remembering much of my sessions and had to learn all about dissociation. Fortunately my therapist has smarts about her and has backed off big time. It's still not fun but we are focussing much more on the here and now and stabilisation. I'm not so keen on the get it over and done with approach anymore!