Sufferer New to this - difficult therapy sessions - domestic violence

[Sweetleaf]

I'm going to get to the "difficult therapy sessions" part, but I'll give some of my history to start off with, just a general picture. I was in an extremely abusive domestic relationship for 3.5 years. Bone-breaking tier physical abuse, constant emotional abuse, and rape every day multiple times a day. Back to back to back to back to back. During all of this I also had loaded guns pointed at me many times, was threatened with knives, screwdrivers, and all sorts of implements. Many times I was purely lucky to not be injured by those implements, as he did come at me with them and engage in physical struggles at times. I've been beaten with a lot of things, too. I was forced to use a hard uneven stool as the only thing I could sit on, and I was also subjected to starvation. I got out of it about a month and a half ago.

I've since been diagnosed with PTSD, so I'm very new to knowing I have it and being able to put a label on all the symptoms I have, and have had.

My therapist, who I have been working with for about as long as I've been out of the situation, specializes in EMDR therapy. Until recently, I haven't been stable enough for us to even go into that. The abuse ended because I entered a state of psychosis. I was in that for about two weeks before the abuse ended, and two weeks after, in which I experienced the absolute peak of it. It felt like an eternity, and my memory is fuzzy about a lot of what happened during that time. At the peak of it I was extremely paranoid (while also experiencing pronoia, interestingly enough), delusional, and I was experiencing 100% realistic hallucinations, mainly auditory but also some completely real looking visual ones. It was a very scary experience. I didn't even know what was going on until after, and I don't remember a lot of what happened.

After that it took some time for my brain to come back online, pull itself back together and all that. Here is where the thread topic comes in. On Monday, I saw my therapist and she thought I was ready to begin EMDR, so we did a session where we gathered information about what I thought was the most difficult aspect of my trauma. I'm having a hard time trying to get myself to type out the details about it, so I'll leave it at that for now and refer to it without delving deeper into the specific subject matter. I described some of what happened in detail, some of what I was forced to do in detail, and there was a lot that I couldn't bring myself to explain at that time. I actually can't remember some of the session, but eventually it got to a part where she wanted me to come up with imagery to represent that whole aspect of my trauma. I had a hard time thinking of something, putting an imagine on it, but then one popped into my head and I couldn't think of anything else. It was an image that is extremely triggering and distressing, even violating. All I could think of were such images. It was hard to even get myself to describe it to her, which was only a three word thing to blurt out.

Since that session, I've been having a harder time generally speaking. The imagery brought up keeps coming into my head, I keep repetitively thinking about that stuff and there is a marked decline in my general state. I've been dissociating more, I've been acting more subdued and withdrawn, and I feel really sensitive to triggers. It's really hard to not think about the things I brought up in that session. I've been thinking of that stuff more and more with time, since that session, and it overrides my thoughts and focus, and the whole outside world. I don't even know what else to say.

 

[EveHarrington]

A month and a half?

You’re only a month and a half post trauma?

Ok, it’s time to find a new therapist!

A month and a half isn’t nearly enough time to assess you to see if you are stable enough for EMDR, let alone ensure that you know coping skills to get you through the process.

Seriously, find a new therapist. This one is not ensuring that you get through the process in the safest way possible.

And now you’re experiencing exactly what I’m warning against. Heightened symptoms that you have no clue how to deal with because you dont know enough coping skills to get you through the moment.

I think the stabilization period of therapy should be a number of months to ensure a client knows many coping skills and how to use them when distressed. It’s imperative that a period of stabilization happen before processing is started.

 

[Ronin]

Agreed with Eve I think it's too soon, to go into any of it.

I'd focus on having stability - as much as you can - with where you're now, external stability and a sense of safety, having the basics covered (food, sleep, medication, hygiene, safe people), keeping knack on reality enough for daily functioning, having support network ev. medication for a case of recurring psychotic states, super small soothing things in the now. Not the past.

 

[Rumors]

First, let me say I am really sorry you had to go through that. It sounds simply horrifying. I imagine it would be incredibly difficult to feel any safety this close to the trauma. With that said, I can only tell you that it is important to remember while doing emdr that you are safe. It's really hard because in one sense they want you to feel the pain of the situation while remaining safe. It is like an oxymoron. Lol. I, too, loose my words but partially because some of what happened to me was when I was very young and had adult verbal skills. Take it slow... sending you good mojo. Hang in there!

 

[Justmehere]

Welcome to the forums!

Usually EMDR starts off with the smaller things then goes to the big things. EMDR is known for stirring up symptoms between sessions and I’m in agreement with others, it’s too soon. There should be a lot more skills building. It’s recommended to be used with extra caution for those with dissociative experiences - and with the history of recent psychosis and memory issues, it seems like a reasonable caution to apply in your situation as well.

If your therapist has walked you through any grounding or self care skills, now is the time to use them as much as possible. It will help to lower symptoms or at least tolerate them easier.

 

[Deleted member 37474]

Adding to what @Rumors said, feeling safe and staying (as my therapist recently said) 60 percent there in the present day room (with your T.) My emdr T taught me how to distance myself enough from the trauma to stay present and still see it. One way is to imagine watching it in a tiny picture frame across the room. Or watching you watching it on a small tv or movie screen. I created a thick glass barrier and watch from outside the room. The key is to not relive it, but watch it happen from a far. That brings up enough disturbance for the process. You can always say stop. A good T that knows you will recognize or stop you from disassociating or bring you right back when you do. After and sometimes before/during the process you would do some positive image tapping or visualization. Also breathing exercises. Before delving into trauma, my T had me do emdr on my “happy places.” All prep work. Also, there is no way I could do my “worst thing” in emdr when we started. We just started that this week and I am 6 months in with this process. I hope you can share with your T that you need to slow down and learn some grounding techniques. Good luck and I hope that you can heal from all of this pain.

 

[Deleted member 44579]

Hi @Tibergrace.. That's awful, I'm so sorry you had to endure that.

As@justmehere grounding techniques are very important for you just now. So is feeling safe... Medication may help?.. To be honest you're dealing with so much I'm not surprised you are dissociating.. I would be to.

I don't think there needs to be such a rush with therapy... It's your time.. And if possible discuss all this with your therapist.

Im glad weird thing to say I know that you found this forum.. These are good people, kind, supportive and will help you as much as they can. Please take care.. Alot of self soothing.. Like baths.. And hugs...

 

[Sweetleaf]

I think a large part of why she thought I was ready was that I improved rapidly and markedly from my state of psychosis. My therapist even remarked on how I had improved way faster than she expected, getting back into normal activities and returning to the way I used to do things. It's clear now that I was stabilizing but not due to overcoming the trauma, but rather from not deeply thinking about it/confronting it. I also wasn't having any more crazy thoughts or irrational paranoia. I still don't think I'm having any very irrational paranoia (an example of the irrational paranoia I've had: having to call my therapist, freaking out, and have her convince me that my mother wasn't trying to manipulate me).

I think the issue is this: I did exit the psychotic state, and I did become much more "here" and relatively normal feeling. I became much more emotionally stable - though perhaps a better descriptor would be "lacking a lot of emotion" to be honest. Lacking both highs and lows, just extremely neutral and blank feeling, while not being so blank I'm apathetic. But until this last therapy session I was very much ignoring the past. By that I mean I was just not focusing on it, I was too in the present, enjoying freedom and being able to do things again, catching up on things I missed out on or couldn't do during the trauma, watching shows I couldn't watch (any shows that exist, so I have a lot of new material to watch), so on and so forth. I was super in the present. When I did talk about the trauma or think about it, it was generally the easier-to-deal-with aspects of it, or very simplified in-a-nutshell versions of it, when I felt like I could talk about it. Even when I would watch shows, like Game of Thrones (binge watched all of it with my sister), I had to fast-forward through all of the sex and rape scenes - I just turned my head away during the torture scenes and some of the violence, while feeling really intense but bearing it and enjoying the story regardless.

My presentation - the way people perceive me from the outside - is often very different from my internal feelings. I had to get really good at hiding my internal feelings, during the trauma. By the end of it I could get hit or even have ribs broken and show no reaction. I was once slammed down on a metal corner with his entire body weight on top of me, dropping me down onto the corner and pushing me into it, breaking ribs, and I didn't howl in pain like I had for previous bone breaks. I didn't even feel the pain until hours later, or at least I don't remember feeling the pain until then. When I think about that (including right now) I can feel it all over again though, as if I did feel the pain during the action that broke my ribs (again). My hands are shaking just typing this out. For a while my startle reaction was internally very strong, but I would show no signs whatsoever on the outside. Like I would feel very startled, but not react with my physical body. Now I've normalized a bit in regards to that.. I still have a very strong startle reaction, it's just now I outwardly react in accordance with my internal reaction. I think maybe my lack of outward reaction and difficulty saying things has lead my therapist to believe I'm better off than I actually am.

Now it's become clear to me that I still have a lot of shit to deal with. For example, I just got back from an appointment to get my knees checked out (turns out one of my kneecaps is out of place and rubbing against the other bones - I don't even remember the incident of initial injury that caused it, my memory of it starts a few hours after it happened, getting told by my abuser that I hurt my knee... sure "I" hurt my knee... f*cker). I had to have my knees both thoroughly checked out, involving someone positioning me during the x-rays, and the doctor feeling my knee, lower leg, and parts of my thigh in the examination. The thigh feeling part (checking my quads etc) was highly triggering. Outwardly I kept my cool or at least didn't freak out, but my palms got extremely sweaty, my pulse went up, and I had to do a lot of grounding to be able to tolerate it. Breathing exercises, clenching one fist, then the other, etc. Internally I was kinda freaking out, thinking of past events, etc. The doctor kept having to continuously tell me to relax my leg muscles, I kept tensing up. Started to dissociate but kept myself grounded and made it through. I don't know exactly what to do in those situations - I have physical therapy starting next week, I made sure to get a female physical therapist for that, but I still worry that all the physical contact is going to trigger the shit out of me again. If it had gone on for much longer I would have had a really hard time holding myself together - what do I even do in those situations?

@EveHarrington : This therapist has done pretty good so far, until the last session - and she's also working with me pro-bono, I think I will talk to her about how I reacted to that session, she is qualified in a lot of things so she might be able to help me using different techniques rather than diving right into EMDR. She has given me a lot of grounding and coping skills, though I definitely think I could use more work on all of that, especially now.

@Ronin : Thankfully I do have a lot of external support, mainly from my mother and my sister. As far as medication goes, I take bupropion daily, which has been working wonderfully - I've been less scatterbrained and more focused, less anxious, more level headed. I might need a dosage increase though. I also have diazepam which I take on an as-needed basis. At first I needed it multiple times a day, but now I need it like once a week or so. It's funny you mention hygiene - I actually had to re-learn a lot of basic self-care things which I wasn't allowed/able to do during the abuse. Sleep was initially a major issue, especially during the psychotic episode, but now that seems pretty under control. I use doxylamine succinate, 25-50mg, every night to fall asleep. Average 5-7 hours of sleep per night, sometimes 8 or 9 hour sleep periods happen. I've got the basics covered, I think I just need to sit back and only do the basics for a while, rather than trying to delve into the trauma. About the psychosis - I've only ever had that one psychotic episode and I REALLY REALLY do not want that to ever happen again. I haven't slipped back into it yet, and I really hope I don't. I feel like the psychosis itself was pretty traumatizing. I don't think I will go back to that place, so I'm not going to seek anti-psychotics unless it does repeat.

@Rumors : I do feel varying degrees of safety - I've definitely improved in that I'm not worried about being attacked 24/7, and I feel pretty safe at home, though I definitely do have some "not feeling safe" issues still. Walking to my car used to feel extremely scary, especially in the dark. Now I just feel on edge, I more casually look around me, and check reflections, rather than scanning my surroundings thoroughly with quick head movements that look paranoid as f*ck lol. I still feel pretty uneasy in the dark, but I no longer feel like someone is going to jump out and grab me, and I don't feel watched in the dark anymore. During therapy I don't feel unsafe, necessarily, it's more that this last session I felt really disturbed, uneasy, disgusted, revolted, unsettled, and even violated - violated by my own thoughts no less. Like I just want to go "f*ck you brain why are you doing this!" I guess reading over what I just wrote, I don't feel very safe at therapy if we're talking about that stuff. I logically know I'm physically safe, but emotionally I feel attacked, not by my therapist, but by my own thoughts and memories.

@Justmehere : I think maybe my therapist thought I was doing better than I really was. I do have a hard time expressing myself often, at therapy, or going into full detail on a lot of things. I think she was thinking that I had become practically unaffected and so just wanted to work on whatever was the biggest problem in my life in relation to my trauma, but I definitely think that has backfired now. I actually filled out some dissociation questionnaire thing at the start of the appointment, but I don't think I had the time to properly answer the questions. I didn't have time to properly consider the percentage of time that I spend in such states - prior to that visit, I barely even knew what dissociation was, and it didn't really click until after when I read up more on it. The wording of the questions was also confusing, and I take a lot of things pretty literally so while I had similar experiences to some of the questions, they didn't fit in with the wording. Afterwards I now recognize the times I've dissociated. During the trauma, I would actually be walking around in a dissociated state most of the time. I should have been given the questionnarie and told to come back with it the next week. I think you're all correct: it was definitely too early. I heavily have had to use my grounding skills today, especially during the appointment to check out my knee. I was feeling pretty intense right from the moment I woke up. I've also had this physical feeling in my head that I had during the more intense times after the trauma, though it's gone away for the present time. Hard to describe it.

@TexCat : I totally jive with that, I definitely didn't feel 60% there last session, lol. I felt very there at the beginning before we delved into the trauma, but once we started working on that, it was another story. The methods you talk about actually sound like they might be really helpful, thank you. I've used imagery to deal with things in my head in the past e.g. picturing my anxiety as a rat gnawing away at my brain, the "anxiety rat." I really need to remember the "you can always say stop" part. I definitely should have done that during the last session. Oh well, now I know better. I think it might be hard for others to tell when I'm dissociating sometimes. Sometimes it would be very apparent, other times I carry out actions, but it's like I'm watching a movie from first-person prespective - a movie of me doing whatever I'm doing, but it doesn't feel like I'm in control of it or anything, it feels like my body is just automatically doing stuff, and it all feels extremely unreal and surreal, everything does in those moments. It doesn't feel like I'm actually there, it just feels like I'm stuck observing and sensing things rather than really being in my body. Hard to describe. Anyway, in those moments I could see it being hard for the outside observer to tell that I'm dissociating. I think part of this is because I spent a lot of time in such states during the abuse. They still feel very unsettling though.

I haven't even done any EMDR or anything about my "happy places." Nothing whatsoever. I don't know if my therapist is doing a bad job or if I just seem way better off than I really am. I definitely don't think I'll be able to dive deeper into the "worst aspect" this next session, if just scratching the surface has made me feel the way I do now, days later.

@Xena : It feels good to know others would be having the same issues (that goes for all of you I guess lol). I'm definitely going to be discussing all of this with my therapist next session. I'm glad I found this place too, you guys have given much better advice and support just in responses to one post, than I have gotten anywhere else. Right now I'm on bupropion but I might need the dose to be increased. Just 150mg per day atm. I haven't had any baths actually, only showers. I might try that, though I don't know if it'll make my back/ribs hurt lol. I have truckloads of physical pain from past injuries.

Anyway thanks for all the responses. I'm definitely going to be bringing all of this up with my therapist next time, and you guys have helped me figure out what to say.

 

[lostforgottensoul]

A month and a half isn’t nearly enough time to assess you to see if you are stable enough for EMDR, let alone ensure that you know coping skills to get you through the process.

Agreed. I was a few years into therapy before EMDR. It went bad, we stopped and am now only trying to go back to it a few yrs after my bad reaction. Now that I am more stable and have way more coping skills.

Many therapists go way too fast. It took years to build the trust I have with my therapist to even close my eyes and not freak out on him. If he tried EMDR before we did he wouldn't of been able to get me to relax with my eyes closed and even then it was very difficult and he kept talking so I knew where he was the entire time my eyes was closed. And I had been seeing him for years. A few months? Forget it!

 

[Sweetleaf]

I haven't done any of the closed-eyes stuff, yet. All she's done is gather information... I imagine if just doing that makes me react like this, her trying to do the closed-eyes stuff would probably go pretty bad, right?

I go to a weekly trauma sensitive yoga group, and can't keep my eyes closed there.

 

[lostforgottensoul]

@Tibergrace, I would question your therapist about why they think you are ready for EMDR this soon. There is no rush to do EMDR. My experience is unique and my reaction not typical but if you stuggle being able to feel safe with your eyes closed, as I do, I would question the heck out of doing EMDR this soon. It is memory processing and even if my one experience isn't typical, memory processing isn't a walk in the park and you need to be able to cope afterwards. Do you have coping skills? Have you guys gone down that road of teaching you coping skills? If not you need to do at least that first in my opinion.

 

[Sweetleaf]

I do have some coping skills, but I feel like I could probably use more in my toolbox. A lot of it is just grounding stuff. Butterfly hugs, breathing exercises, playing with this really long looped string I have, playing instruments (just played guitar really loudly for a little while to distract myself), alternating foot tapping, etc. I also use some aromatherapy stuff to help calm me down and refocus/draw attention away from bad thoughts and feelings. Primarily it's this lavender oil, and this spearmint & eucalyptus lotion.

Is that good stuff? Are there good coping skills I'm totally missing out on?

I'm definitely going to present my therapist with how I felt about the last session and see what she thinks I should do. I don't think she realizes I'm so unprepared to delve deeper.