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Sufferer PTSD Diagnosed, CSA Resolved Yet Dissociation Continues

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I was diagnosed with 'PTSD -- suspected victim of sexual abuse' after my brain surgery in 2018. From about age 4 to age 35, I had experienced non-contact sexual abuse by my father. By age 24, both my T and I thought I had resolved my sexual abuse issues.

By age 28 I was falling back into depression. My search for any meaningful relationship was beginning to seem highly unlikely. Not until age 55 had I again become sexually intimate with a long-time, internet friend. We're still good friends though he lives a four hour drive away from me. Now, at age 73, I think I might have only learned to dissociate during physical intimacy, as I had previously learned to dissociate during my father's non-contact sexual abuse.

In 2019 I was again evaluated by a psychiatrist -- I've had several therapists over the years. She told me that she knew of no drug that could help me. (I've been off all psychotropic drugs since 1978) She also said that I was very open and that, if, I did decide to go back into therapy that, she would recommend that I see an older Phd and that, EMDR wouldn't help me.

So last summer I did see a Phd. During our sixth session she told me that she still couldn't find the source of my trauma. Over my lifetime, I've had over 500 hours of talk-therapy and I wasn't holding back any information from this T. So with very little else to talk about, I terminated.

My life situation is almost unbelievably dire. Now my PTSD might only be one small part of it. My CSA was only 'non contact' sexual abuse, as I can recall. Later on, none of my few intimate relationships had been physically nor emotionally close enough to have been sexually abusive. The man I had been seeing intimately during my mid 50s was a perfect gentleman.

I think I just dissociate whenever I feel the least bit unsafe or uncertain about another person's intentions. I'm not even consciously aware that I'm being hyper-vigilant. I'm not aware of feeling any anxiety when being examined by a medical doctor nor when talking to my T.

If my T can't find the source of my trauma does this really matter in regards to my PTSD recovery?

Perhaps a better option for me might be to seek an alternate or supportive therapy rather than a trauma-therapist? Have you any suggestions because at this point I am lost?

I realize that PTSD doesn't just go away on its own. Yet, my many years of talk-therapy have helped me to ease some of my symptoms. My doctors have recently advised me to get more therapy.
 
I am very dissociative and have recently reentered therapy after some new flashbacks. Although I know the sources of my trauma, I can't always remember the specifics of all my memories or abuse and that can sometimes make addressing/processing the trauma difficult. My T and I are at the moment working on using metacognitive strategies to keep me in the present when very triggered. We are also working towards realisation. One thing I discovered was although I knew of my trauma and had been in therapy to deal with it quite a long while ago, although I thought I had, not all parts of me had completely accepted it. I don't know if that's a possibility? Other than that, perhaps therapy for you could be more about strategies for how you can stay present in the times that you notice you are dissociating...?
 
Have you considered EMDR with someone who has worked with dissociative patients? That modality works even if you don't go back to the trauma itself. My primary trauma happened when I was so young that I don't remember any of it. The EMDR I do brings up experiences of the flashbacks and fears and dissociation, and then learning how to transform those experiences into a safer place.
 
I have using a 'sensory disruption strategy' (for lack of a better term) to help keep me in the present moment when I notice a flashback beginning to happen. I will immediately touch objects that are around me while trying to direct my attention onto their tactile sensations. I have even tried switching the room's lighting on and off a few times -- anything that will help disrupt my focus away from the flashback will help. Telling myself that I am safe and that there is nothing behind me and that I am only imagining this doesn't help me at all. The best strategy that I have used is this sensory disruption.

I only have one flashback and I don't know what it's about. I do know what triggers it and it's nearly always the same trigger and in the same location inside my house. I've been experiencing this flashback for at least 30 years. I'll go though stages where I won't experience it for several months and then at others times it might happen nearly once a week.

When I initially worked through my non contact childhood sexual abuse with my T. I apparently had not sensory memory related to this abuse, as I wasn't being touched.
My work was in consciously accepting the fact that my father had sexualized his interest in me. I hesitate to use the word 'love' because my father had totally rejected me emotionally. He was lacking the necessary emotional maturity to have setup the proper boundaries within our father-daughter relationship.

I think my father felt extremely guilty about his sexual feelings and that his guilt feelings had somehow been transferred onto me. Perhaps, I then because the 'bad child' who was caused him to feel bad about himself while I had actually done nothing.

I realize now that I dissociate and sometimes fawn during more personal interactions where I might not feel totally safe. I noticed this happening to me two years ago during my cerebellar neurological testing where the doctor had been sitting very close to me. He than checked my blood-pressure. My heart rate was 40 beats faster than normal while I had been just quietly sitting there. I was totally unaware of this and had only read this later in my medial report.
 
Have you considered EMDR with someone who has worked with dissociative patients? That modality works even if you don't go back to the trauma itself. My primary trauma happened when I was so young that I don't remember any of it. The EMDR I do brings up experiences of the flashbacks and fears and dissociation, and then learning how to transform those experiences into a safer place.

I was evaluated by a psychiatrist in 2019 and she told me that EMDR wouldn't work for me. I know of only one trigger and it doesn't take much effort to evoke my panic state. I will begin to feel chills in the back of my neck then through my back. Then, I'll sort of begin to drift into an altered state where I panic because I can't let go of this thought that something is standing quiety behind me.

The dissociation that I experience seems more like an emotional numbness and denial of my currently real situation. I have noticed that I fawn in stuations where another woman without this PTSD would have responded quite differently.

I might have also been traumatized when I was 6 weeks of age. I then had whooping cough (pertussis) and wasn't always able to breathe. I would turn blue and wasn't expected to survive. All that my family could do was to lift me upright in hopes that my congestion would clear my airways. My mother once told me that I wasn't crying during my infancy. I think this might have also disrupted my parent-child bonding.
 
I might have also been traumatized when I was 6 weeks of age. I then had whooping cough (pertussis) and wasn't always able to breathe. I would turn blue and wasn't expected to survive. All that my family could do was to lift me upright in hopes that my congestion would clear my airways. My mother once told me that I wasn't crying during my infancy. I think this might have also disrupted my parent-child bonding.
I have parallels--
  • born 2 month premature, & spent my first few days of life in an incubator
  • whacked on the back at age 18 months, got a peanut stuck in my throat, got pneumonia, and spent a few days at the hospital
  • very poor parent-child bonding
Just saying that one can recover from this, if you find the right path. Although I'm seeing a trauma therapist right now, I found a lot of healing with a therapist that did CBT. What mattered wasn't the CBT approach; what mattered was that I was able to trust her and that we had a deep relationship that helped to heal the attachment trauma.
 
Well, she only made this bold stated after my hour long, face to face interview with another psychologist. I've read that in some cases EMDR doesn't work well with patients who dissociate. I've already had over 500 talk sessions which, at this point, no longer seem to address my PTSD. During my 5 week stay in the hospital after brain surgery, they also had an opportunity to observe me.

During my 6 talk sessions in 2019 with my T, I wasn't feeling any anxiety. It is possible that I was in a dissociated state and unaware but I think not. I could easily talk about my CSA now without feeling anxiety or shame. Perhaps, this might be why this T haven't focused much attention on it. I was basically permitted to talk freely about anything during those first 6 sessions. As to what I felt was relevant in my current situation wasn't always viewed as relevant from her perspective. And so here we often clashed.

Anyway, my 2019 talk sessions were in extreme contrast to my first talk-therapy sessions from age 19 to 24, where my anxiety levels had been extremely high. Part of my problem prior to age 24 was that, I couldn't accept the fact that I was a sexual being. By rejecting my own sexuality I was in away able to feel relatively safe in my relationship with my father and with everyone else. My T had then told me that although I was in my early 20s, I had been emotionally stuck at about age 11.

If my T hasn't anyway of evoking my flashback or anxiety would EMDR even work?
 
If my T hasn't anyway of evoking my flashback or anxiety would EMDR even work?
Don't take what I'm going to say as solid advice! I'm not sure about this. My therapist has done things, intentionally or unintentionally, that have caused me to be anxious or triggered. I've also done things in her office that I know would push my limits and possibly trigger me. There's an important part of therapy of learning how to go to an uncomfortable place, and then learn that you are safe. It is possible to do EMDR with someone with dissociation, but it is tricky.

I was basically permitted to talk freely about anything during those first 6 sessions.
I think a really good therapist would be able to see that freely talking could lead you to dissociate or to pick those topics that felt safe and not anxiety provoking. If I was looking for a new therapist/guru/modality, I would share exactly what you've shared in your last post.
 
I have parallels--
  • born 2 month premature, & spent my first few days of life in an incubator
  • whacked on the back at age 18 months, got a peanut stuck in my throat, got pneumonia, and spent a few days at the hospital
  • very poor parent-child bonding
Just saying that one can recover from this, if you find the right path. Although I'm seeing a trauma therapist right now, I found a lot of healing with a therapist that did CBT. What mattered wasn't the CBT approach; what mattered was that I was able to trust her and that we had a deep relationship that helped to heal the attachment trauma.

This is great that you have found a lot of healing in your CBT therapy. This deep, trusting relationship just wasn't there for you when you were so very much alone. Can you recall any of this trauma that you had experienced at 18 months?

I suspect that we might hold memories of these early traumas though some will argue that our infant brain is lacking the ability to store such memories. I would suspect that these memories might be purely tactile.

As an infant with whooping cough, my air-ways had been blocked numerous times. At about age 9, I took swimming lessons only to discover that I couldn't tolerate the fluids filling my senus as we'd repeatedly lower our heads under the water. This disruption of my normal breathing pattern I just couldn't tolerate. My panic state would suddenly jump sky high and yet the other kids seems to be doing just fine.
 
Pretty bold statement. Might be worth trying to find a trauma therapist experienced with EMDR and see what they say.

The two therapists that I saw in 2019 were supposedly both trauma therapists. Perhaps, they weren't trained in EMDR. The first, I saw for only two sessions then, she told me that she hadn't the training to help me. The second therapist told me that she couldn't find the source of my trauma after I had told her absolutely everything that I know.

According to my medical records they suspect my PTSD has resulted from sexual abuse. While I had supposedly resolved my CSA by age 24. I had had only a few sexual experiences between age 24 and 28 though none were abusive. On the other hand, my father had continued his abusive behavior towards me until I was about 35. He eventually stopped due to his health problems, I'd suspect. I was then sleeping in the attic just to get away from him. I was still bothered by his behavioir where I would see him doing it. I'd freeze while pretending that I hadn't noticed him doing it.

If anything of my traumas had been overlooked, I had written them down in my carefully categorized sequence of life events and given this paperwork to my T. Hopefully she read it though some therapists will say that they won't read such material because that wasn't how they were trained.

I've been getting mixed messages from different doctors and psychologists. The psychiatrist who stated that EMDR wouldn't work for me, in 2019, than also said, "As you sure that you want to do this?" as she wrinkled her face. On the other hand, my three medial doctors had repeatedly advised me to get more therapy.

I think I likely could intentionally trigger my frightening flashback which sends chills down my spine, I just don't know what this is about.
 
Pretty bold statement. Might be worth trying to find a trauma therapist experienced with EMDR and see what they say.

My life had become such a mess that I doubt very many trauma therapists would want to work with me. My case is just too overwhelming. I'm not trying to be negative in saying this. Perhaps, they themselves feel that my situation is just too much... it's like going down the rabbit hole. And then I've had so much years of therapy that haven't resolved much beyond easing some of my symptoms.
 
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