PTSD recovery through controlled exposure

[PlainJane]

Some of my peers have expressed concern because I expose myself to specific triggers and situations intentionally to desensitize and reduce PTSD symptoms. Their concern is I sometimes put myself at, what they view as, unnecessary risk. They think I am trying to replay aspects of my trauma. I believe that it helps me make the most progress in my recovery, despite the occasional injury. What resources and information can you give me to support my stance?

 

[Dr. Catalyst]

Some of my peers have expressed concern because I expose myself to specific triggers and situations intentionally to desensitize and reduce PTSD symptoms. Their concern is I sometimes put myself at, what they view as, unnecessary risk. They think I am trying to replay aspects of my trauma. I believe that it helps me make the most progress in my recovery, despite the occasional injury. What resources and information can you give me to support my stance?

Welcome to "Ask Dr. Catalyst," @PlainJane. It's understandable to seek ways to reduce PTSD symptoms, and desensitizing yourself can be a helpful tool. However, engaging with certain triggers or traumas can be a delicate process and requires guidance and support from a mental health expert.

Selective Exposure Therapy (SET) is a technique used in trauma-focused therapy, where individuals choose to confront their anxiety and face their triggers. It is a gradual process that involves gradually exposing the individual to their feared stimuli with the gradual aim of reducing their PTSD symptoms over a session.

Please note that Selective Exposure Therapy (SET) should only be conducted with proper guidance from qualified mental health professionals. The approach often requires a significant amount of time and can be retraumatizing if attempted without proper support.

It's essential to recognise that individuals may respond differently to exposure therapy. Some might find it helpful, while some might not. Your peers may be concerned for your safety because retraumatization can happen through unintentional exposure. It's important to consider safety and manage risk while engaging in this therapy.

I encourage you to seek out a licensed mental health professional specializing in trauma therapy to explore effective ways to address the symptoms and triggers that arise from PTSD. They can provide a more accurate and personalized approach and additionally provide solutions to the perception of unnecessary risk.

Remember to prioritize self-care practices and attend to any injuries or pain that might arise. Thanks for reaching out, @PlainJane!

 

[PlainJane]

Please note that Selective Exposure Therapy (SET) should only be conducted with proper guidance from qualified mental health professionals. The approach often requires a significant amount of time and can be retraumatizing if attempted without proper support.

It's essential to recognise that individuals may respond differently to exposure therapy. Some might find it helpful, while some might not. Your peers may be concerned for your safety because retraumatization can happen through unintentional exposure. It's important to consider safety and manage risk while engaging in this therapy.

I encourage you to seek out a licensed mental health professional specializing in trauma therapy to explore effective ways to address the symptoms and triggers that arise from PTSD. They can provide a more accurate and personalized approach and additionally provide solutions to the perception of unnecessary risk.

Remember to prioritize self-care practices and attend to any injuries or pain that might arise. Thanks for reaching out, @PlainJane!

What if I can't afford a professional?

You're wrong. It can't be entirely safe. No pain, no gain.

 

[Dr. Catalyst]

What if I can't afford a professional?

You're wrong. It can't be entirely safe. No pain, no gain.

I understand that financial limitations can be a significant barrier to accessing mental health care. However, I also strongly believe that it's essential to prioritize your wellbeing and seek out professional help when dealing with PTSD symptoms. There are resources available to help you access mental health care for free or low cost.

Many community clinics, non-profit organizations and universities offer free or low-cost mental health services. Local support groups can also be a great resource to connect with others who share similar experiences and learn about different self-help techniques. You may also inquire if your employer provides employee assistance programs that offer limited free counseling sessions.

Regarding your statement that no pain, no gain, I would like to clarify that traumatic exposure in therapy should not lead to excessive physical pain or retraumatization, as this can worsen PTSD symptoms. While exposure therapy can be uncomfortable or challenging, it should only be done within a safe and controlled environment with the guidance of a licensed professional.

I encourage you to review accessible and low-cost mental health services in your community, and reach out to a professional who can guide you through your healing journey safely. Remember to prioritize your safety and wellbeing in any treatment approach you choose.

 

[PlainJane]

It's important to consider safety and manage risk while engaging in this therapy.

I recently confronted a trigger in the form of a professional massage. What are the risks associated with that when I am clearly not in physical danger?

 

[Dr. Catalyst]

I recently confronted a trigger in the form of a professional massage. What are the risks associated with that when I am clearly not in physical danger?

Thank you for sharing with me, @PlainJane. Triggers can take many forms, and it's great to hear you are actively working on confronting them. Regarding professional massage, it's important to take each situation and how it pertains to your unique PTSD symptoms, triggers, and experiences under consideration. If massage is associated with your trauma experience, it is possible that it could trigger or worsen your PTSD symptoms.

It's important to remember that PTSD symptoms can manifest in several ways and can include physical and emotional symptoms. You may experience increased heart rate, difficulty breathing, sweating or muscle tension, intrusive or distressing thoughts, memories, and images, among others.

It's hard to say how an individual might react to massages as a trigger. But when considering engaging with a potential trigger like a professional massage, routine self-health assessments and mindfulness exercises can be helpful in monitoring your symptoms during and after the massage.

If you're planning on engaging with a trigger, it may be helpful to have a solid support system in place, including a therapist or a trusted friend/family member. Additionally, communicating potential triggers with the person providing the massage can provide an extra level of support and can alleviate any feelings of discomfort.

Remember, the goal of confronting your triggers is to reduce their impact on your daily life. If you find that a specific trigger causes too much stress or worsens your symptoms, it's important to prioritize your wellbeing and seek support to explore other coping techniques.

I hope this helps you stay safe while engaging with potential triggers, @PlainJane.

 

[PlainJane]

If you find that a specific trigger causes too much stress or worsens your symptoms, it's important to prioritize your wellbeing and seek support to explore other coping techniques.

How will I ever get over it if I never confront it because it's too uncomfortable, doesn't that make me a spineless wimp?

 

[Dr. Catalyst]

How will I ever get over it if I never confront it because it's too uncomfortable, doesn't that make me a spineless wimp?

It’s understandable to feel frustrated with yourself when you are not able to confront your triggers or past traumatic experiences. However, it's important to recognize that PTSD is not a sign of weakness or cowardice. PTSD is a debilitating condition that can impact anyone and is not a reflection of your strength or resilience.

Effective PTSD treatment is usually a gradual, long-term process, and confronting your triggers is only one part of it. It's crucial to build a strong support network and work with trained professionals who can assist you in managing PTSD symptoms and identifying techniques that work best for you.

It's advisable to be cautious when approaching triggers, and it's never helpful to force oneself into uncomfortable situations. It would help if you had patience and understanding in accepting that healing in PTSD is non-linear and requires time, intentional effort, and a lot of self-compassion.

It's okay to feel uncomfortable, and it's okay to take things slowly. Mindful, slow exposure with supportive professionals can help you gain confidence in your ability to cope with triggers and other symptoms associated with your PTSD. Take the time to research and develop a plan with licensed professionals that can help you take steps forward as opposed to inaction.

Remember, PTSD is a complex condition that requires specialized attention and patience, but it's highly treatable with appropriate care.

You are strong for seeking help, @PlainJane. Don't hesitate to reach out to professionals and support systems when needed, and take things at a pace that works best for you.

 

[PlainJane]

Mindful, slow exposure with supportive professionals can help you gain confidence in your ability to cope with triggers and other symptoms associated with your PTSD. Take the time to research and develop a plan with licensed professionals that can help you take steps forward as opposed to inaction

How many professionals, do you suggest, I have on my health care team? What should be their specialties? What is the preferred modality of treatment for PTSD from sexual assault and childhood trauma?

 

[Dr. Catalyst]

How many professionals, do you suggest, I have on my health care team? What should be their specialties? What is the preferred modality of treatment for PTSD from sexual assault and childhood trauma?

Having a healthcare team that is trained and experienced in working with PTSD is essential to receiving comprehensive care. A healthcare team could potentially consist of mental health clinicians such as licensed psychologists, psychiatrists, trauma-focused social workers, or licensed professional counselors, and medical practitioners such as primary care physicians, neurologists, or certified nurse practitioners. It is essential to develop a treatment plan in collaboration with your healthcare team that considers your individual needs, treatment goals, and preferences.

When it comes to PTSD from sexual assault and childhood trauma, there are a variety of evidence-based treatments that your healthcare team may suggest, depending on your individual needs and preferences. Research suggests that trauma-focused cognitive-behavioral therapy (TF-CBT), cognitive processing therapy (CPT), prolonged exposure (PE) therapy, and eye movement desensitization and reprocessing (EMDR) are some of the most effective therapies for treating PTSD caused by sexual assault or childhood trauma.

Additionally, somatic-based therapies such as yoga, mindfulness, and body-based interventions support integration and self-regulation of sensory and somatic resources that may have been damaged or disrupted by trauma. Please note that these therapies should be used alongside trauma-focused psychotherapy and not as stand-alone interventions. Trauma-informed care emphasizes the significance of the client's safety and self-determination while prioritizing informed, compassionate, and evidence-based treatment.

It's crucial to remember that the most effective approach to treating PTSD involves a combination of treatments, that work best for one's unique situation. However, sharing one's trauma history can be challenging and overwhelming. You can gradually approach this by seeking a professional therapist trained in trauma-informed care, with experience assisting individuals with similar experiences.

Remember that PTSD can be treated, and with the right support and guidance, healing is possible.

 

[PlainJane]

Thank you. How do I differentiate between a normal emotional reaction to a trigger and being re-traumatized?

 

[Dr. Catalyst]

Thank you. How do I differentiate between a normal emotional reaction to a trigger and being re-traumatized?

Differentiating between a normal emotional reaction and being re-traumatized can be difficult, especially when you're new to exposure therapy for PTSD. However, there are some potential indications that you are experiencing re-traumatization as opposed to a normal emotional response.

An emotional response to a trigger can include feeling anxious, fearful, angry or distressed, while re-traumatization can result in overwhelming feelings or physical sensations that trigger PTSD symptoms involuntarily. A re-traumatization occurrence can lead to a significant setback in treatments, including reaction to triggers, hypervigilance, obsessive or intrusive thoughts, depression and anxiety, among others.

If you find the intrusive memories of the traumatic event replaying themselves again or if you experience flashbacks or nightmares, it may be helpful to identify it during your therapy sessions to determine coping strategies that work best for you. Some indicators that the negative impact is likely more significant and requires additional support can also manifest in self-harm, engaging in high-risk behaviors, attempts of suicide, excessive drug or alcohol use, or social isolation.

It would be useful to talk with your healthcare team to help you create a crisis plan to manage symptoms of re-traumatization, and monitor symptoms that could be re-traumatizing. Be mindful, and if you feel triggered, do things that make you feel safe or reach out to a trusted friend, family member or a trained mental health professional who can support you.

Remember, taking small steps at your pace is a crucial component of PTSD healing. If you find that a particular therapy or exposure intensely triggers your trauma reaction, remember to communicate with your care team, make modifications, or transition to alternative evidence-based therapies when necessary. Together with your provider, you can determine the best approach and course of action so that the therapy experience remains safe and effective.