Sufferer PTSD Diagnosed, CSA Resolved Yet Dissociation Continues

[Wendell_R]

My life had become such a mess that I doubt very many trauma therapists would want to work with me.

This is a very, very common thought, and it's not at all true. A difficulty is that there are many therapists who say they work with trauma, but they don't have the necessary background. You might need to look a while to find the right one.

An experienced therapist that truly specializes in trauma would very much want to work with you.

 

[spinningmytires]

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 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 suspect that three of my male medical doctors had intentionally though subtly attempted to trigger me during my follow-up exam. The first caused me to suddenly flinch, as he had moved his hand towards me very quickly before I knew what it was. Perhaps, my amygdala had appeared abnormally enlarged in my brain MRI.

The second doctor was sitting too close to me for too long and increasingly and so, I think I had began to dissociate. Any other woman would have likely said, 'Would you please move back a bit and allow my more space?' But then, I just fawned while being very much aware of his actions. Then he soon took my blood-pressure where my heart rate was 40 beats above my normal sitting rate.

The third doctor just suddenly grabbed and pulled on my cotton jersey for no apparent reason. Then he paused for about 10 seconds perhaps to observe my reaction. I did nothing and only quietly sat there. I like all of my doctors. I feel quite certain that they would never do anything to harm me. And yet, even here I will dissociate.

"Free Talk" is not so easy, especially, when my T would be subtly trying to devert this safe topic to the unspeakable subject of sex. He didn't need to use any words. With my first T, we never did opened talk about sex and if we did it was always very brief. I was on Valium for my first 4 years of therapy. If not for this drug my anxieties would have been so extremely high that, I likely wouldn't have gone to therapy. I was getting diarrhea before every session.

 

[spinningmytires]

This is a very, very common thought, and it's not at all true. A difficulty is that there are many therapists who say they work with trauma, but they don't have the necessary background. You might need to look a while to find the right one.

An experienced therapist that truly specializes in trauma would very much want to work with you.

Thank you for your encouraging words.

 

[Friday]

From my own experience... the traumas I’ve actually sorted don’t have any kind of triggers/stressors or symptoms associated with them.

That said? The coping mechanisms I’ve used for years and decades are an entirely different matter. As are the habits of a lifetime. Marry either of those 2 things to my personality? If I want to change a coping mechanism, or change a habit, it’s going to be a rather large undertaking.

I’ve found it doesn’t really matter much if I first started using it during or after trauma; or to mainly deal with symptoms, to deal with both symptoms and life, or just life. It matters SOME... just not much.

Conversely? I have, in the past, chipped away at all my symptoms WITHOUT touching the root cause (trauma) with a 10 foot pole. That’s not the recommended way to go about things, but I didn’t know that, at the time. I just figured this was the way I was, now, the cost of doing business. And I didn’t like it. So I essentially made a list of all the things I didn’t like about myself, and started working on changing them. In whatever ways just sort of made sense. <<< I wasn’t working with anyone on this, it didn’t even occur me to. So I didn’t know this was a disorder & it’s symptoms, or coping mechanisms I used to deal with those symptoms. I didn’t like myself, but I’m the only person I’ve got / am all I have to work with in this life. So I set out to become the person I wanted to be. >>> The DOWNSIDE of this is that not processing the trauma that causes things, meant I was essentially loading a spring-loaded-trap. So that when the right combo of stress & new trauma & loss of coping mechanisms hit me? All my old trauma and symptoms came leaping out. But I had 10 good years in between those times.

 

[spinningmytires]

From my own experience... the traumas I’ve actually sorted don’t have any kind of triggers/stressors or symptoms associated with them.

That said? The coping mechanisms I’ve used for years and decades are an entirely different matter. As are the habits of a lifetime. Marry either of those 2 things to my personality? If I want to change a coping mechanism, or change a habit, it’s going to be a rather large undertaking.

I’ve found it doesn’t really matter much if I first started using it during or after trauma; or to mainly deal with symptoms, to deal with both symptoms and life, or just life. It matters SOME... just not much.

Conversely? I have, in the past, chipped away at all my symptoms WITHOUT touching the root cause (trauma) with a 10 foot pole. That’s not the recommended way to go about things, but I didn’t know that, at the time. I just figured this was the way I was, now, the cost of doing business. And I didn’t like it.

At about age 9, I had discovered on my own that I could subdue my panic-attacks by holding my breath. This I often did in grade school when frightened by my angry, over-demanding school teachers. I then had aphasia (difficulty in reading, writing and expression) though no one knew this was my problem. My 2018 MRI diagnosed my development brain damage. I wasn't surprised. My mother once told me that I wasn't crying as an infant and that this worried her. Perhaps this damage occurred during my whooping cough illness at 6 weeks. Add this to my CSA trauma and I had to develop some badly needed coping mechanisms.

My father's non contact sexual abuse was 'almost or nearly always hidden' from me -- hidden enough that I could then easily forget about it. I thought everything was normal within my father-daughter relationship. Later, it took me 4 years of therapy to realize that I was being sexually abused. Then I still have difficulty realizing it because I wasn't being touched. In this case I have few triggers. I know of only one vivid frightening recall of him exposed himself to me when I was about age 4. After that incident, I had no conscious-awareness (no conscious triggers?) of his abuse until age 24.

As for the one very frightening visual image that continues to occur within my mind. I don't understand what it is about. It's an imagined image of a dark figure quietly standing in the doorway of my darkened kitchen when I'm standing at the kitchen sink. Because it is standing in the doorway I can see that it is the same size as an adult. Yet, I don't knew if its even male or female and I don't see any clothing. It doesn't appear to be naked but such very dark. I can recall telling my first T about this frightening, reoccurring visual image when I was in my mid 20s. During the 1970s, I was telling him that I was then visualizing or imagining this figure as standing behind me in my grandparents driveway. My T then said this visualization was only my imagination and that I should learn to tolerate these things. So here, again, I felt that this also demanded another coping mechanisms.

 

[spinningmytires]

From my own experience... the traumas I’ve actually sorted don’t have any kind of triggers/stressors or symptoms associated with them.


Conversely? I have, in the past, chipped away at all my symptoms WITHOUT touching the root cause (trauma) with a 10 foot pole. That’s not the recommended way to go about things, but I didn’t know that, at the time. I just figured this was the way I was, now, the cost of doing business. And I didn’t like it. So I essentially made a list of all the things I didn’t like about myself, and started working on changing them. In whatever ways just sort of made sense. <<< I wasn’t working with anyone on this, it didn’t even occur me to. So I didn’t know this was a disorder & it’s symptoms, or coping mechanisms I used to deal with those symptoms. I didn’t like myself, but I’m the only person I’ve got / am all I have to work with in this life. So I set out to become the person I wanted to be. >>> The DOWNSIDE of this is that not processing the trauma that causes things, meant I was essentially loading a spring-loaded-trap. So that when the right combo of stress & new trauma & loss of coping mechanisms hit me? All my old trauma and symptoms came leaping out. But I had 10 good years in between those times.

For me also, the triggers haven't been there. When avoidance wasn't possible, I suspect I either panicked or I dissociated. Not until my mid 20s had I begun to feel relatively comfortable around people to have then joined social groups. My dissociation, I apparently use when I might had otherwise experienced a more embarrassing and awkward panic state.

I use to fear these panic-attacks in themselves. I didn't want other people to know I was experiencing them and especially, not in the middle of a casual conversation. I couldn't understand why I was experiencing them. They seemed so mysterious and powerful, in that I couldn't control them. They would occur randomly, as if, out of nowhere. During my mid 20s these panic-attacks were at their very worse. Eventually, I got to the point where I was counting them at about 8 panic-attacks per day. Counting them seemed to help me to see them more objectively.

I still think that these panic-attacks might have been a side-effect of the Elavil anti-depressant I was taking at that time, from my mid 20s to early 30s. My T, a psychiatrist, had died suddenly in 1978. I had been seeing him for 12 years. I badly grieved over his death. I had no other medical doctors at that time and so I then discontinued the Elavil with no problem.

My heart might still likely be racing during my dissociative states yet, I'm not aware of it. Outwardly, most people seem to think I'm pretty well adjusted. Little do they know just how much I've been suffering and struggling within myself.

Generally, I've kept to myself during my life and yes, I had assumed that this was just my personality. Yet, choosing solitude isn't the same thing as avoidance. This avoidance was never my choice.

'Chipping away at my symptoms' -- this I had done as well. I've had to often tolerate my anxieties. This is a good way of describing it and it takes years and way too many years while one's life grows increasingly more empty during the process.

Changing my habit of dissociating? Yes, this would be a huge undertaking. And I'm not even aware of doing it anymore. I've always been this way.

I suspect I might never know the root cause of my trauma. Actually I don't want to know what that is. I'm mentioned a frightening and somewhat similar visualization to my many therapists, where each had given me their own explanations for it. In a nutshell, this is what they said:

In the mid 70s, my T said, this was only my imagination. He then advised me to learn to tolerate these visualizations. I wanted to believe him. End of discussion. Did these frightening experiences ever no away? No they didn't.

In 1988, my seconded T said, do realize that you won't find any help for this experience. It would be best if you never mentioned this again -- not even with me. Okay, that ended our discussion on this topic. During the following session, he then, asks me, if, I had ever been sexually abused as a child. I answered no, while not realizing that the non contact sexual abuse by my father WAS actually CSA. He then said well, I think you were sexually abused and I want you to see another therapists for CSA. I refused because I couldn't afford to see two therapists and because my abuse by my father had been supposedly resolved. We never discussed this issue again.

In 2001, another T (I saw him only once) had said that I was only imagining this as a way of avoiding my real more frightening memories of sexual abuse. He wanted me to take anti-psychotic medication, claiming that the drug would make this experiences go away. I refused the drug and terminated.

Later in 2001, another T had placed me in a suggestive hypnotic state, where I had then begun to scream as she then pulled me back to my awareness. She then said, this was your father sexually molesting you. I than told her that I only knew that this had not been a memory of molestation by my father and that I had no memory of my father ever molesting me. She then said, that this wouldn't be a problem as I could just simply create a false memory of him molesting me in my mind. I didn't like that idea and so later that day I terminated.

In 2002, another T said, that she wanted to go around my frightening experiences. I asked to what? There was little else to talk about. Our sessions became totally emotionally flat. I began to talk to the walls, floor and furniture. This was just too extremely painful for me and so I terminated.

In 2019, another T simply said, that she hadn't the training to help me and so that was that.

Later in 2019, my T said that she could not find the source of my trauma -- not even after our 6 sessions. So again I terminated.

At this point I must ask, why bother? This is why I initially asked this group if, my PTSD might still be helped if the source of my trauma was an unknown.

I also find it difficult to like myself while living in this dysfunctional state. Life often seems to come so easily to other people. My energy level is easily drained if it is there at all. As for the hard work, I too have only myself.

Looking back, I only became consciously aware of this repeated and frightening visual image within my mind at about the same time I had become aware of my father's non contact sexual abuse during the early 1970s. I use to wash my hair in the kitchen sink and would often begin to panic. I'd have to lift my head to look behind me to reassure myself that nothing was there. I hadn't become physically intimate with anyone until 1973. Yet without any mutual emotional intimacy I broke off my relationship with my then boyfriend after two years. No regrets.

So when you wrote, "All my trauma and symptoms came leaping out" the added stress and new traumas can overwhelm these previously acquired coping mechanisms. The trauma, its symptoms and emotional pain never really goes away. This I know.

I call recall in about 1970, when my T was encouraging me to return to my artwork and painting. I was then often trying to paint abstract forms using only my imagination. At that time, I can remember how very fearful I was to visualize anything within my mind, which artists often do when painting. I would actually become physically ill with fear. Eventually I did overcome it. Now, this frightening and vague visual image only seems to happen when I'm standing at my kitchen sink.

 

[joeylittle]

Hi @spinningmytires, welcome.

I'm curious about a few things you've said, and so am writing with some questions - I hope that's OK.

I was diagnosed with 'PTSD -- suspected victim of sexual abuse' after my brain surgery in 2018.

Do you mind my asking, what was the brain surgery for? And, what prompted the diagnosis?

Later, it took me 4 years of therapy to realize that I was being sexually abused. Then I still have difficulty realizing it because I wasn't being touched. In this case I have few triggers. I know of only one vivid frightening recall of him exposed himself to me when I was about age 4.

So, you do have one very clear traumatic memory (of your father exposing himself to you). I'm assuming that this incident is what you mean by non-contact sexual abuse. Is that correct?

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.

Can you share a little more about these behaviors of his that bothered you?

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

It doesn't necessarily matter - though it will very likely affect/limit which treatment modalities you can use....

 

[spinningmytires]

Hi @spinningmytires, welcome.

I'm curious about a few things you've said, and so am writing with some questions - I hope that's OK.
Do you mind my asking, what was the brain surgery for? And, what prompted the diagnosis?

So, you do have one very clear traumatic memory (of your father exposing himself to you). I'm assuming that this incident is what you mean by non-contact sexual abuse. Is that correct?
Can you share a little more about these behaviors of his that bothered you?
It doesn't necessarily matter - though it will very likely affect/limit which treatment modalities you can use....

@joeylittle

My brain surgery removed a benign tumor/cyst from my cerebellum in 2018. It was blocking my CSF and had resulting in a coma that lasting several hours. My first scan was in 2014 due to vertigo (ear infection). That's when they discovered this rare, slow growing tumor. I was told that I was born with it. The cyst however was growing rapidly and this was my problem. I now have a bit of cerebellar defunction.

The PTSD diagnosis? In mid 2018 after my brain surgery my medical records added: PTDS -- suspected victim of sex abuse. Perhaps, my MRI revealed something. I suspect that my rehab doctor might have confirmed my PTSD diagnosis in mid 2018 during my surgery followup testing. I had dissociated during this long (50 minute) exam. My heart rate during this exam was 40 beats faster than normal. I sspect that, some of what he'd done had caused me to dissociate.

Yes, I have one very clear trauma memory. When my father had exposed himself to me. I was age 4, I suspect. This occurred one summer afternoon. My mother was then sitting on the front porch, where she couldn't have seen him. Even if, she had entered the house, he would have still had plenty of time to cover himself. I remember standing in the doorway of his bedroom, facing him. I was about 5 to 7 feet away from him while frozen in fear.

He was just standing beside his bed, in the nude while facing me and looking at me. He just stood there with his blobbing erection. He did nothing. He didn't turn around nor grab a pillow or bed sheet to cover himself. I then thought his erection was some kind of strange creature moving about in front of him, as my father's arms were at his sides. I couldn't understand why this creature had no eyes. Nor could I undestand why my father wasn't making any attempt to protect me from it. I thought, surely, he knew I was frightened of it. I can recall at that time feeling so very betrayed that my father was then no long protecting me from harm. He didn't seem to care that I was frightened.

I turned and ran to my mothers lap, crying with fear. My father soon followed behind me though he remained inside the house. My mother then spoke only a few word to him from the porch, He spoke at few words back. Then that was the end of it. I only recalled this incident at age 24 and when I did mention this to my mother, she responded by saying that, she also remembered the incident and that he had only been sleep-walking that afternoon. I doubted her explanation.

When I was about 8 years old, I can recall once seeing my father sniffing either mine or my sister's panties which. he has retrieved from the dirty-clothes hamper. At the time, I hadn't realized the connection.

Yes, I would describe my sexual abuse as always having been 'non contact sexual abuse' because I have no memory of ever being touched. My first T was aware that my father and I were living alone together thought I rarely saw him. This occurred from age 22 to age 32. Other family members had then moved away.

My T apparently didn't think my father was physically or sexually abusing me. My T did knew that, my father would often be fondling his penis while talking to me. My T and I had briefly discussed this issue. I was then seeing my T every 4 weeks. My T never actually labeled this as non contact sexual abuse. I only realized that my father's behavior was considered sexual abuse while talking to another online group in 2000.

Why I have this new 2018 diagnosis of: 'PTSD - suspected victim of sexual abuse' I don't know. Other than when I was age 27 and with my boyfriend, I've been physically alone for most of my life. I've never told my doctors I'd been sexually abused. My first T and my PCP both knew about my father's non contact sexual abuse.

My father's behavior greatly bothered me (I could always feel my tension) though, I always tried to hide my awareness that, he'd be fondling his penis inside his pants while talking to me. He apparently knew that I could see what he was doing and I had no control over this situation. I also never knew with any certainty just how far he would go with it. Of course, he'd always turn and walk away after a minute or so. Afterwards, I'd immediately forget that it ever happened. A few times, I had briefly noticed him standing over me as I was turning over in my sleep yet not fully awake. He would then quickly turn and walk away.

I think, if, I had been able to speak up at that moment and said, 'Dad, stop fondling your penis in front of me.' I wouldn't have been stuck in my dissociation. And so I felt captured and frozen. If I where to ever escape this situation, I had to first acknowledge/ accept the reality of this situation and this I wasn't able to accept.

 

[joeylittle]

My brain surgery removed a benign tumor/cyst from my cerebellum in 2018.

Thanks for sharing that; it's always helpful to know more context.

The PTSD diagnosis? In mid 2018 after my brain surgery my medical records added: PTDS -- suspected victim of sex abuse. Perhaps, my MRI revealed something. I suspect that my rehab doctor might have confirmed my PTSD diagnosis in mid 2018 during my surgery followup testing. I had dissociated during this long (50 minute) exam. My heart rate during this exam was 40 beats faster than normal. I sspect that, some of what he'd done had caused me to dissociate.

And thanks for sharing this.

No-one would be able to make a PTSD diagnosis off of an MRI, or off of an exam. There's an interview process you'd need to go through. An accelerated heart rate isn't an indicator, either.

It's possible your therapist can't find the source of your trauma because you don't actually have PTSD. You might have something else going on (mental health-wise)...have you considered the possibility that this is not PTSD?

 

[Justmehere]

Almost everyone dissociates, it's a matter of how much they do it. Unmanaged dissociation can be really awful to endure. There are other conditions other than PTSD than can cause dissociation. It's a way of coping with overwhelming feelings. Find other ways to cope with the feelings and the dissociation will hopefully improve. EMDR is very hard to do with dissociation, and it sounds like you have solidly processed the events. A DBT group or therapist may be more useful in resolving the symptoms than talked based therapy alone.

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

One doesn't need to dig up a specific trauma to resolve the symptoms of PTSD or any other trauma related disorder.

 

[spinningmytires]

Thanks for sharing that; it's always helpful to know more context.

And thanks for sharing this.

No-one would be able to make a PTSD diagnosis off of an MRI, or off of an exam. There's an interview process you'd need to go through. An accelerated heart rate isn't an indicator, either.

It's possible your therapist can't find the source of your trauma because you don't actually have PTSD. You might have something else going on (mental health-wise)...have you considered the possibility that this is not PTSD?

I was quite surprised to see this diagnosis of PTSD in my medical records. Before this 2018 diagnosis I hadn't been in therapy nor had I been psychologically interviewed since 2001 or 2002. My brain surgeon, rehab doctor and PCP had advised me to get more therapy in 2018. My PCP is still advising me to get therapy but how and for what. Yet, they've never said anything beyond that. I know my stress/ cortisol levels have been very high. But then, stress in itself, don't suggest PTSD.

For some reason, I don't do well in talk therapy. I first began to realize this during my mid 20s that, I can't be completely open with my T about every aspect of my life. There is a limit to our understanding of another person's experience. This has been my harsh painful reality. And no amount of therapy will ever alter this limited understanding. Perhaps, this is what defines me as an individual.

I can't understand why my T would believe that I could possibly erase bits and pieces of my experience just because my T said it wasn't so. Had my T assumed that my mind was made of Swiss Cheese or that, I'd be far better off if it were. Hopefully, I can undo my emotional suffering, as I have done in the past. Yet I can't undo the experience.

 

[Justmehere]

Why I have this new 2018 diagnosis of: 'PTSD - suspected victim of sexual abuse' I don't know. Other than when I was age 27 and with my boyfriend, I've been physically alone for most of my life. I've never told my doctors I'd been sexually abused. My first T and my PCP both knew about my father's non contact sexual abuse.

I'd be careful of putting too much into this. Chances are, your PCP made a remark of non-contact sexual abuse somewhere and the team that skimmed those records, like the surgical team, may have then grown that into a flag for the surgery. There's a habit in medical care to have *possible* PTSD patients flagged for anesthesiologists prior to surgery. There is a reputation of PTSD sufferers fighting off staff coming out of surgery/being harder to sedate. The way the diagnosis was listed and not discussed with you sounds like it might have not been based on a deep understanding of symptoms and struggle, but instead on a suspicion. Nothing more. Docs will have a working diagnosis listed all the time that they later change with more information.

Yet I can't undo the experience.

You don't need to. Healing isn't about returning to a state in which the events that we find disturbing never happened. It's about building the kind of life we want to have now. Sometimes that means looking back, sometimes it means building up new habits in life. Whatever the cause, you have a habit of coping via numbing out. There are ways to replace that with new habits - which is a core part of trauma treatment and healing. It's not about the exact incident. It's about how you are responding now.