Quitting Therapy

[GWhizz]

Since I started therapy back in December last, I've had a lot of ambivalence about whether to quit or not. I find myself wanting to quit one week, then wanting to stay and deal with stuff the next. I know I didn't feel great before I started therapy, but sometimes I just feel so much worse. Others I feel great. I don't know if it's the therapy or the flashbacks etc getting the better of me. But for the 1st time since I've started, I have realised how much it's now consuming me and my life. I am sick of the unpredictable feelings (some of you will tell me this is the PTSD not the therapy, though I believe it's both).

I know things are meant to get worse before they get better. But if 6 months later I still feel seriously suicidal, does that not say it's not helping? Or that I need to try something else? I am on meds too and awaiting a psychiatry review, whenever that maybe.

I was even thinking a break maybe good. What do you guys think? Has anyone had any similar experience?

 

[Deleted member 19804]

I know how you feel. PTSD on its own is overwhelming enough, let alone when a therapist confronts you with it all the time. It's like being attacked from two sides.

But if you are feeling suicidal, I think you should absolutely NOT quit therapy. By that I don't mean you should force yourself to go beyond your limits to try and process your trauma. I mean that you should talk to your therapist about your feelings and together find out a way to get through this tough time. Perhaps your psychiatrist can prescribe you a new kind of medication that will help you stay on the right track. You don't have to do it all on your own.

What a lot of us seem (including me) seem to forget is that we hire our therapists, which makes us clients the ones in charge. You have every right to stand up for what you want and need from your therapist. In fact, most therapists really appreciate it when their clients are open and clear about what they want, as it helps them do their job better.

And if you don't feel like your current T can help you adequately, you can start looking for a new one. But don't just quit, it won't do you any good.

It's relatively easy to block the PTSD out temporarily, but I have found that it always come back to bite you in the butt. You have to get through the worst part to improve. But make sure to take care of yourself in the process.

Hope this helps

 

[I am .....]

@GWhizz I've been in extensive trauma therapy since the beginning of the year and like you feel like all the turbulent emotions and pain is consuming my life. I would love nothing more than to quit but logically I know this won't help or change anything except possibly make things even worse. I spoke to my T about exactly where I was at mentally and emotionally and have to admit as intimidating as it was for me it was the best choice I've made.

My T really surprised me. I have even more respect for her now. I know with PTSD it's common to think the worst but I was so off the mark. I can only hope that it strengthens our therapeutic relationship and aids my recovery. I strongly suggest you speak to your T and take it from there. Good luck with whatever you decide to do. Keep us posted.

 

[The Albatross]

My own tactic was to stick with it (therapy) and try to develop some coping skills for the thoughts and feelings that come up after a session. On some core level, I knew that if it was uncomfortable and problem inducing it was all the more reason I needed to continue the sessions.

Have you had a discussion in session with your Therapist about this (being concerned about still being highly suicidal after 6 months of treatment)?

I like what Snowwhite shared about staying in touch with the reason I hired my shrink. I had to keep that in the forefront of my mind. Not so much about being in charge, but more that the reasons why I sought treatment in the first place were not yet improved enough or resolved to give me some relief. I figured as long as I had the suicidal thoughts and was high risk, I had my back up against the wall. That was enough motivation for me to have difficult conversations and stick with the process.

After a session, what are you doing now? What can you do to self nurture yourself after a session and perhaps create new "post session" experiences to over-write the experiences you are having now?

 

[Hashi]

I'm sorry you're struggling so much and feeling so bad.

I saw your other thread about walking out of a session, and I have to say that it raised questions in my mind about your level of coping skills and stability - both what you're doing for yourself and how your therapist is approaching this with you. What you reported in that thread seemed to be your therapist offering to support you (eg you can text her) and I didn't get a sense of how much your therapist focusses on your skills and how the two of you approach therapy.

I'm always saying this, but I think we need a ton of grounding, coping and safety skills before considering trauma work in therapy. I was on a six month waiting list for therapy and had to find a way to cope with flashbacks and other symptoms on my own, and then when I started therapy there was no contact between sessions. So I'd spent six months working on coping and safety skills to a high level before I even started, and then I had no choice but to keep using those skills all the time. I think this made a big difference to my ability to get through trauma therapy.

I don't think there's anything wrong in being able to contact a therapist between sessions, by the way, or doing this if needed. I had this option with my second therapist, and I occasionally did it. I just think our own skills need to be the foundation, and need to be strong enough that we're essentially stable on our own first.

I would suggest talking with your therapist about skills and safety, both for you on your own, and in how the two of you approach sessions (from disruptions like room changes, to staying stable through trauma work). I recommend that you explore whether you can work with this therapist in a way that's less overwhelming, before making decisions about staying the way things are or quitting.

 

[Hashi]

Just to add - if I've understood correctly, you started therapy six months ago? If so, I don't think a break is a good idea. It takes time to establish a therapy relationship, and to interrupt that after only six months doesn't seem helpful to me.

Depending on the circumstances you might need to consider changing therapist, but that's different. If you feel you have a good trauma therapist who's the right fit for you, I think you would need to seriously question whether a break would be avoidance.

 

[Laura 2]

:hug: @GWhizz
It'll look easy for me to write here, but I have so been there.

Couple of things - your profile says you're in UK, so are you paying for therapy or going through the NHS?
I'm in the UK too and I know that the quality and quantity is very different from other countries and from area to area within the UK. (I'm amazed and in envy of the quality and amount of therapy people from other countries/areas write about here).

NHS PTSD treatment is, to put it very politely, mostly woefully lacking. I've been down the private route too with no success - one therapist did not even know what 'PTSD' stood for:banghead::wtf:. I cannot afford the one private psychologist who was very good (c.£90 per 50minute hour, weekly or twice weekly for probably 2-3yrs). From my experience, most therapists though just do not know how to treat PTSD, no matter who they work for.

So, whilst PTSD does make one far more sensitive and fragile, overall it's my opinion that good therapy fully takes this into account and works with those sensitivities. After all, that's what you're there for: they have to meet you where YOU are, you do not have to turn yourself inside out to the point of suicidality to meet their expectations, tick boxes, levels of poor knowledge etc. No matter how nice the therapist is and you want to please them...

Say if a street gang had broken your legs you wouldn't try to limp into the surgery, the doctors wouldn't be expecting you to be sorry for bothering them because you can't walk and they would do all they could to make sure you had proper treatment, transport, rehab therapy and supports. PTSD is an injury, just the same. I know some others here will disagree with me, but PTSD IS a physical injury to the brain, it's different from many mental illnesses which can be more amenable to 'adjustment of thinking' techniques and drugs. You can't think PTSD away.

FWIW, my experience has been that, when they weren't ignoring me, the NHS low level 'psychology specialists' kept 'reviewing' me and kept sending me to primary care IAPT counsellors = useless. A maximum of 12 weeks with a new person kicking around the fallacious CBT idea that your thinking is somehow skewed. The last 12wk guy could see it was inappropriate and was concerned enough to refer me to the NHS secondary care people for a proper assessment with a fully qualified psychiatrist. That appt came very quickly after the referral.

It has taken SEVEN years since PTSD diagnosis by one of the UK's top, top trauma specialists to get to see a proper psychiatrist under the NHS - by which time now, the trauma has been chronically and terrifyingly added to, turned into entrenched and very seriously incapacitating CPTSD, and rendered me about to be homeless.

What I personally take from all that is that:
- most MH professionals - sympathetic or not - know very little about PTSD and how to treat it

- the NHS system can often be very lacking and doesn't care (but there are definite practical advantages in seeing an NHS practitioner rather than a private one)

- there are some professionals who DO know what PTSD is and how to treat it

- you have to keep on looking for them - and parting ways with therapists along the way if necessary

- you have to see the wider context in which PTSD arises and is mistreated

- when you're so vulnerable and injured it's so easy to internalise other people's failings and you're even tacitly encouraged to see therapy failure as due to your problem, internalisation makes all your injuries much worse

- instead of blaming yourself and becoming suicidal, you have to get angry at the whole system that ignores or mistreats your suffering...and use that anger positively and creatively to challenge and keep on challenging the system - AND to keep yourself alive.

My point is that YOU ARE NOT THE PROBLEM. And I see no reason why you have to feel worse before you feel better. It's common sense to avoid more pain and we can only deal with looking at our pain/injuries when we are, as @Hashi points out, we are very well grounded and feel very safe and supported to do so (sorry, the offer of texting wouldn't do it for me). We wouldn't expect our orthopaedic doctors to keep on jumping up and down on our broken legs in order 'to make them better and stronger', would we?!! No, we need support and compassion and kindness, for people to really get what happened, that it was horrendous and so injurious that we need lots and lots of GOOD and safe things to happen to begin to soothe the festering injuries.

I don't know if anything there is helpful. It's my way of dealing with the whole horrific mess now. It's working better than when I was actively suicidal several years ago (and survived 3 serious attempts - at which the NHS ignored me even more....) All I know is that I would not be alive now if I'd kept on internalising other people's failings and kept on trying to believe it was my problem or that I was an inconvenience as many quietly wanted to make it.

 

[GWhizz]

@Snowwhite you're right - it is like an attack from both sides. The reason I have kept it up is because I felt I NEED it when feeling suicidal, it's just the fact that it's taking over everything, I felt I would be more free without it. Though I know the reason I've gotten to this point, is that it has come back to bite me in the ass after over 10 years of trying to block it out and pretend it didn't happen.

@I am ..... I have discussed this with her a lot when she texted to check in with me yesterday - in fact, it's something I've been struggling against for weeks now and it has strengthened our relationship, so much that I felt ready to begin telling her some of the deeper trauma details. I know I need to discuss this with her more. I just don't want her to call my G.P. and have him freaking on me, looking to hospitalise me or something :(...

@The Albatross I don't do much to self-nurture after sessions, have you any good suggestions? Last week after I walked out mid-session, I just went to get a coffee to collect myself before I had to go home to my baby. I didn't want to tell my partner that I'd walked out, but he saw how upset I was and then I told him. He wasn't happy about it.

He's a social worker and always being the carer, told me just to learn from it so I take a different action the next time I feel like that (he couldn't comprehend why a room change made any difference, but I have never told him about the sexual abuse, only the physical, emotional, spiritual, neglect etc. - I'm also struggling with a guilty conscience in this regard as I feel dishonest withholding something this big in a long-term relationship). You are right as @Snowwhite said about us being in charge. I just find it hard to assert myself in there and be directive. I know she will follow my lead though - she is telling me this but I feel lost sometimes.

@Hashi you've made a really good point about the coping skills, grounding techniques etc. I do not feel that these are intact or much developed even. However, my T was actually only working on building trust/rapport and support skills first. It was me who jumped the gun if I'm honest, and brought a written note with me last week. I was just fed up that it seems to be going on forever and really drawn out. I accept that you cannot rush/force this process though, my brain certainly is not able to keep up right now anyway.

My T discussed it with me yesterday - she said we could go back to the other room but it would have to be on a different day that I'm not available on so I just told her I'll try the new room again as I will probably have to use it somedays as I work random shifts and it's the only room she can avail of on a Thursday (I could skip a week if only off on Thursday but this may not be the best solution either). I told her I will try to communicate my discomfort in the room, rather than simply walking out.

She has instructed me not to write anything to bring, that we need to leave details for now and go a lot more slowly. She has just asked me to be kind and caring to myself in between the sessions. She also advised me to "relax" about worrying that I'm bothering her making contact, that she wants to struggle with me so that I'm not alone in this. She did before offer me to change therapists if I didn't feel she was suitable or a good match - but I do think she is amazing at her job and entirely committed to helping me with trauma work.

You are right that this maybe some part avoidance on my behalf, I know I am really struggling with the whole commitment to it all. I really like that you were able to establish more independent coping skills that you were then able to use to get you through tough points. The only problem I see with my T, is that she has this belief in me that I am a very strong and resilient individual, to have gotten to where I am based on my past experiences.

While I like this idea and see her point as confidence and esteem building, sometimes I think this assertion of hers is an unrealistic expectation of my coping skills. I maybe great at putting on a strong outward front and presentation, but inside I feel like a crumbling mess. It's really eating away at me. I feel like I'm burning on the inside.

Just to add, I live in Dublin and we don't have a huge amount of trauma specialist here. My psychotherapist has years of experience in this area and I really do feel she gets me 99.9% of the time, so I don't really want to leave her in the hope that I may find someone else.

Sorry this is so long, thanks for listening

 

[digger]

I quit therapy frequently (in my head), several times a day sometimes! My diary here is littered with the idea again and again. In reality, I keep going back and haven't actually missed a session. Progress feels so painfully slow at times, and sometimes doesn't feel like progress at all, it just feels like refreshing this shit over and over again and keeping it at the surface.

I have to remind myself though that not being in therapy wasn't working either and that burying this stuff only ever proves to be a temporary 'success'.

I know six months can feel like such a long time, but it took so much longer to create our problems. Six months is nothing really. Am I right in thinking you had to take a break from therapy sessions while you had surgery recently too? That, I think will have disrupted progress fairly majorly. You also said in another post I think that you had disclosed some details about your trauma at your last session? Sessions where I have done this have always led to a period of feeling extremely unsettled for me. It is scary to have these things 'out there' and I need to allow for time to adjust to that.

When I joined this forum, it was at a time when I really felt like I just couldn't carry on with therapy and was seriously on the verge of quitting. Of course the ideal solution would have been to discuss the issues and fears with my therapist, but mutism gets in the way a lot in our sessions and I was finding it way to difficult to express or discuss these things with her - whenever I do manage to though it has always been positive. This forum, posting my own threads and reading lots of others, has really helped me reframe what I expect from therapy - I think initially I didn't really get it to be honest - in the UK, therapy is not really something we grow up with as the norm I don't think, some other cultures seem to be far more adjusted to it.

My advice would be to devote your next session to talking about therapy and your feelings about it, rather than talking about trauma. I am in agreement with @The Albatross and @Hashi as well that self care and grounding skills, in and out of sessions, are so very important to build up and keep working on.

 

[Lucycat]

I agree with Hashi, that 6 months in therapy really is no time at all, especially if your Trauma took longer than that to happen. I have been in NHS therapy for 4 and a half years, and it is very helpful. The progress is incredibly slow,but looking back I can see huge improvements.

It is now 2 months since I last saw T. I don't feel I need him at the moment, but I know he is there and I can ask for an appointment at any time. The gaps between appointments are getting longer, but I am sure I will need him again, when the next crisis hits.

You really cannot rush this. Baby steps and patience!

 

[Alien Goodness]

Like what @Laura 2 wrote ^^^

I cannot comment specifically on @GWhizz situation, but it is quite common for a therapist to make a PTSD sufferer worse rather than better. This is because most therapists treat anxiety/fear conditions by using exposure techniques, making the client face up to their fears in order to overcome them. While this technique works for people with anxiety conditions like phobias, it can be disastrous for PSTD sufferers as it re-triggers the trauma memories increasing the fear, not decreasing the fear.

A therapist trained to treat PTSD will do loads of preparatory work such as described by @Hashi before tackling the actual trauma. I believe a key component is to feel safe with a therapist, and it is the therapist job to use his/her knowledge & skills to make a client feel safe. This is very hard for a therapist to do with PTSD sufferers which is why they need specific training.

I would recommend @GWhizz to talk to her therapist about how much PTSD training and how many PTSD clients the therapist has helped. If the answer is "none", then looking for another PTSD-trained therapist is the best way forward IMO.

 

[GWhizz]

@Laura 2 - i should change my profile to Ireland lol, I'm pretty sure it's even worse over here than the NHS. I'm actually going privately though, as otherwise I'd never get seen!

@digger yes mutism is always getting the better of me. My T has told me she does not want to go any deeper into the trauma for now especially. She wants to focus on building my safety both within and outside of therapy for now, so I agree I need to spend the next while focusing on the therapy itself and becoming more comfortable with the process.

@Lucycat I'm glad to hear you are now able to go long stretches between contacting/meeting with your T. I know I have been trying to hit the finish line ever since I began, and that 6 months is not long in the grand scheme of things