Is my PTSD therapist gas-lighting me into thinking I now have a personality disorder?

TL;DR - Is it normal that after 5-6 months of no success with EMDR and Imagery Rescripting, they now think I have a personality or development disorder that needs to be tested for? I personally think they're jumping to conclusions, but am open to your input.

I was diagnosed with PTSD for childhood sexual abuse about 2 years ago. I was on a 1 year waitlist for EMDR treatment. We finally started. As someone who has very effective (but obviously messed up) coping mechanisms, I think I did the right thing by explaining that I needed some semblance of structure, and someone to "hold my hand" at the start of treatment. For more concrete requests, I did my research and asked if the therapist could (a) walk me through the EMDR treatment process (aka, what to expect, how best to prepare, what to look out for, etc.) in the first few sessions, and then (b) spend 5-10 minutes doing a "checking-in" or some grounding techniques after each session. (AKA "please don't end these virtual sessions with me alone in my apartment, sobbing and wanting to kill myself").

The EMDR therapist was always sympathetic to my requests when I expressed them, but he failed to give me what I asked for. We repeatedly ran out of time, and we'd end sessions with me completely distraught. When I did have the mental energy to challenge him and remind him I wanted a grounding activity, he would say that actually those techniques are no longer used in EMDR treatment.

I was already having weekly sessions, and they were always overwhelming. It took me about 5 days to recover, and before I knew it I was doing EMDR again and falling apart again. And wanting to die again. Then my therapist proposed meeting 2x a week over the summer, because people were on holiday so he had more availability (and not because it was necessarily better for my treatment). Later when I would challenge him again, and say I can't handle 2x a week, he came up with a new story that actually more frequent EMDR sessions were good for me.

I kept raising my hand and saying when things were too overwhelming, or when I was feeling suicidal, or when I desperately needed a break. Nothing changed. He pushed me or would "listen sympathetically" and take no action. One day it got especially bad and tried to kill myself. Thankfully my loved ones were able to intervene and help me. My partner was very upset. He'd seen me raise my hand and ask for help and fall apart, and trusted that my EMDR therapist knew what he was doing and was giving the right guidance.

After the suicide scare, we met with the therapist and head of treatment. We called them out for how they've been handling the treatment. I felt I was reasonable when I said I was fine to work with the same therapist again but he needed to change his approach and actually listen to my very simple requests. Otherwise, to please give me another EMDR therapist.

They decided to re-assess the whole treatment plan. They then randomly came back with a new story saying that I may have a personality or developmental disorder due to the ongoing abuse from the rest of my family. This "personality" thing had never come up in the multiple "intake assessments" I underwent when I was first diagnosed, and it never came up as a discussion topic any other time. It only came up after my partner and I called them out for (more or less) malpractice.

My priority is to just get better and to lead a normal life. I don't care if I also have a personality or developmental disorder that needs to be treated. I'll do whatever it takes to get better. But I think it's fair from my end to find this really fishy...like some sort of deflection or excuse, rather than accepting that their EMDR specialist messed up. Am I missing something? Does anyone have any input or perspective on this?
 

Movingforward10

MyPTSD Pro
I've got no idea if it is fishy or not, but what I am hearing is that your T wasn't hearing you and maybe as a result you can't trust what he says, and there is this lack of trust about their motive now to re diagnose you.

I wonder why you want to stay with this therapist when it sounds like it hasn't worked for you?
With this new diagnosis , does that mean it would transfer to someone else and also would the treatment change?

Can you get a second opinion about this new diagnosis?
 

Friday

Moderator
My priority is to just get better and to lead a normal life. I don't care if I also have a personality or developmental disorder that needs to be treated. I'll do whatever it takes to get better. But I think it's fair from my end to find this really fishy...like some sort of deflection or excuse, rather than accepting that their EMDR specialist messed up. Am I missing something? Does anyone have any input or perspective on this?
I think both possibilities are totally fair / equally likely.

Which means I absolutely would not continue on with this individual.
 

Sideways

Moderator
For me, diagnosis took years. And the exact nature of my mental illness only became apparent over the course of therapy, and particularly, therapies that weren't going to plan.

For example: it became apparent this was more than just a major depressive episode for me because of the way I responded to treatment for depression.

But, like @Friday , I'd also be considering, as a separate matter, whether this treatment provider is working for you, or whether it's time to try a different therapist, or a different approach.
 

Wendell_R

MyPTSD Pro
For more concrete requests, I did my research and asked if the therapist could (a) walk me through the EMDR treatment process (aka, what to expect, how best to prepare, what to look out for, etc.) in the first few sessions, and then (b) spend 5-10 minutes doing a "checking-in" or some grounding techniques after each session. (AKA "please don't end these virtual sessions with me alone in my apartment, sobbing and wanting to kill myself").
This is EXACTLY what my therapist does. She's advanced enough in EMDR that she's a consultant and helps with EMDR training events. So your research is spot on. Personally, it took me a lot of gentleness so I didn't associate EMDR with being hit (the tap-tap-tap triggered me a lot). And even now, when I'm settled and good at coping, we always ground and always have time to ground. Interestingly, she has told me that she's seen training videos or been in training sessions where she disagrees with what's done in the training--she says not enough time was spent in stabilization at the end.

I want to validate everything that you've done to ask for therapy that fits who you are, and where you are in your healing.

I can see how doing some testing could help them find a therapeutic path for you that would be more helpful, but it also seems that listening to what the client is feeling and experiencing is paramount, and figuring out how to make the treatment fit the client, instead of the other way around.
 

Sues

MyPTSD Pro
Your therapist is ignoring your needs and requests. This is a huge red flag for me. You absolutely need time to ground and recover after EMDR and before you get up and leave the office. AND you shouldn't have to ask for these things. Your therapist should already know this and be asking you and helping you.

we'd end sessions with me completely distraught.

This is scary. It's irresponsible and unethical of your therapist. I know it took a year to get in to see this therapist, but I hope you seriously consider finding a new therapist, one that is competent and knowledgeable. Please keep us posted.
 
I've got no idea if it is fishy or not, but what I am hearing is that your T wasn't hearing you and maybe as a result you can't trust what he says, and there is this lack of trust about their motive now to re diagnose you.

I wonder why you want to stay with this therapist when it sounds like it hasn't worked for you?
With this new diagnosis , does that mean it would transfer to someone else and also would the treatment change?

Can you get a second opinion about this new diagnosis?
Yeah I know what you mean. I didn't want to stay with the therapist, but felt I had to give it a chance. With the therapy team telling me I needed to "trust the process" and that they're highly skilled specialists who knew what they were doing, while I was simultaneously having worse anxiety and hyper-vigilance, I couldn't help but doubt myself/my instincts.

The new "possible" diagnosis means that this center cannot treat me anymore because they only deal with PTSD. I'd have to transfer elsewhere entirely. I just find it very odd, because even after the suicide scare, I've only asked for a simple tweak in the treatment: adding grounding techniques. Strange that rather than making this adjustment, they want to scrap the whole treatment and propose a new potential diagnosis...

As for getting a second opinion - I think it's a great idea. I've started my research this week.
 
I want to validate everything that you've done to ask for therapy that fits who you are, and where you are in your healing.

I can see how doing some testing could help them find a therapeutic path for you that would be more helpful, but it also seems that listening to what the client is feeling and experiencing is paramount, and figuring out how to make the treatment fit the client, instead of the other way around.
Thanks so much for saying this. The word "listening" hits me hard. Just having my therapist actually listen and hear me would be a big help.

Your therapist is ignoring your needs and requests. This is a huge red flag for me. You absolutely need time to ground and recover after EMDR and before you get up and leave the office. AND you shouldn't have to ask for these things. Your therapist should already know this and be asking you and helping you.

This is scary. It's irresponsible and unethical of your therapist. I know it took a year to get in to see this therapist, but I hope you seriously consider finding a new therapist, one that is competent and knowledgeable. Please keep us posted.
Thanks so much for saying this. It helps a lot. Thanks to everyone's comments and suggestions I'm going to look for a new therapist altogether.
 
B

Bonfire.

TL;DR - Is it normal that after 5-6 months of no success with EMDR and Imagery Rescripting, they now think I have a personality or development disorder that needs to be tested for? I personally think they're jumping to conclusions, but am open to your input.

I was diagnosed with PTSD for childhood sexual abuse about 2 years ago. I was on a 1 year waitlist for EMDR treatment. We finally started. As someone who has very effective (but obviously messed up) coping mechanisms, I think I did the right thing by explaining that I needed some semblance of structure, and someone to "hold my hand" at the start of treatment. For more concrete requests, I did my research and asked if the therapist could (a) walk me through the EMDR treatment process (aka, what to expect, how best to prepare, what to look out for, etc.) in the first few sessions, and then (b) spend 5-10 minutes doing a "checking-in" or some grounding techniques after each session. (AKA "please don't end these virtual sessions with me alone in my apartment, sobbing and wanting to kill myself").

The EMDR therapist was always sympathetic to my requests when I expressed them, but he failed to give me what I asked for. We repeatedly ran out of time, and we'd end sessions with me completely distraught. When I did have the mental energy to challenge him and remind him I wanted a grounding activity, he would say that actually those techniques are no longer used in EMDR treatment.

I was already having weekly sessions, and they were always overwhelming. It took me about 5 days to recover, and before I knew it I was doing EMDR again and falling apart again. And wanting to die again. Then my therapist proposed meeting 2x a week over the summer, because people were on holiday so he had more availability (and not because it was necessarily better for my treatment). Later when I would challenge him again, and say I can't handle 2x a week, he came up with a new story that actually more frequent EMDR sessions were good for me.

I kept raising my hand and saying when things were too overwhelming, or when I was feeling suicidal, or when I desperately needed a break. Nothing changed. He pushed me or would "listen sympathetically" and take no action. One day it got especially bad and tried to kill myself. Thankfully my loved ones were able to intervene and help me. My partner was very upset. He'd seen me raise my hand and ask for help and fall apart, and trusted that my EMDR therapist knew what he was doing and was giving the right guidance.

After the suicide scare, we met with the therapist and head of treatment. We called them out for how they've been handling the treatment. I felt I was reasonable when I said I was fine to work with the same therapist again but he needed to change his approach and actually listen to my very simple requests. Otherwise, to please give me another EMDR therapist.

They decided to re-assess the whole treatment plan. They then randomly came back with a new story saying that I may have a personality or developmental disorder due to the ongoing abuse from the rest of my family. This "personality" thing had never come up in the multiple "intake assessments" I underwent when I was first diagnosed, and it never came up as a discussion topic any other time. It only came up after my partner and I called them out for (more or less) malpractice.

My priority is to just get better and to lead a normal life. I don't care if I also have a personality or developmental disorder that needs to be treated. I'll do whatever it takes to get better. But I think it's fair from my end to find this really fishy...like some sort of deflection or excuse, rather than accepting that their EMDR specialist messed up. Am I missing something? Does anyone have any input or perspective on this?
Personally, EMDR is overrated. It is the 'new' thing. With any new thing everyone (therapists & perhaps clients) want it. It becomes the absolute cure for everything. If for unknown reasons it doesn't work, there must be something wrong with the client. Have a feeling a lot of practitioners want to brag about how successful they are..

My T investigated and was appauled, his word, at the number of clients that were worse and/or required hospitalization. He also saw successes. But far fewer than he expected.
I feel that if they are not consulting me, listening to what I report I need or is helping me, they are not treating me. They are administering a protocol.
 

EveHarrington

MyPTSD Pro
Ok, so question 1….

You asked for help with coping mechanisms. Did your therapist ensure that you had adequate ways of coping before he started treatment?

Ensuring that a client has sufficient coping mechanisms is an essential part of treatment BEFORE you start processing.

Are you aware of the three part treatment model that includes 1) safety and stabilization 2) processing and 3) rebuilding your life/reintegrating with society, etc?

I’m getting the feeling that you were shoved into step 2 but I’ll wait for your response first.

Edit. The first step of treatment can literally take years before one is ready to process. It’s not something that should be skipped or rushed.
 

Weemie

MyPTSD Pro
If you raise your hand and contradict many of these clinicians, they will take it personally and assign you a label as a "combative patient." As a patient who is both combative and personality disordered, this is separate from actually having a real disorder of fixed/stable traits. The difference is that my disordered symptoms appear throughout my life, and across multiple forms of relationships, whereas your symptoms only appear during a single stimulus: enduring this treatment.

This happens due to the clinician being unable to tolerate questions to their ego. Anyone who is fully conversant in EMDR understands that this is a treatment that promotes neurogenesis, and as such, can result in incredible destabilization for a patient which can even culminate in suicidal ideation if it is not directed apropriately. Which, because most therapists do not know how to interact with suicide, then results in being labeled with another disorder.
 
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