Regular Therapy Vs Trauma Therapy?

[alis]

Hi!

Do most people here see therapists specialized to deal with Trauma?

I know there is EDMR therapy- but that's more a process of therapeutic methods to deal with trauma right?

I work with DBT and I guess CBT talk therapy, but I don't know if my T is specially equipped? Sometimes I feel like I overwhelm her. Or I feel the need to sometimes sensor some things. Or just that I'm afraid to even say certain things. Like sometimes I have to close my eyes in order to say things or answer certain questions...

Mainly my question is have you found any difference between Trauma T and regular T ?

 

[Kintsugi]

Having a trauma specialist (or sexual abuse specialist or childhood trauma specialist particularly) has been critical for me.

Not a good example, but... I saw a CBT T at my college for a bit. On the first session, she told me I clearly knew more about PTSD than she did. :bored:

 

[Missycat]

I had telephone counselling initially and this was before i was diagnosed with ptsd. My counsellor advised i saw a therapist specifically trained in dealing with trauma , partly due to the emdr but mostly due to having the training and experience. My T is trained in numerous therapy strategies and is trained and experienced in trauma inc csa.

 

[kilted]

I'm on therapist No. 6. Of those only the last 3 have been useful. None of them were trauma "specialists" but they were skilled therapists and interested in what made me tick. My view is that every therapist should be a trauma specialist because that's 90% of their caseload when in training.

What makes the difference is the relationship with the therapist.... they "get" you, and operate in a safe and ethical way that delivers a trusting relationship held within a secure firm boundary. Too many times there are "specialists" who know the subject inside out, but have no empathy or ability to develop a relationship... there's a big difference between saying you're a "specialist" with the certificates on the wall and actually being able to enable change in people.... because making a difference is 30% knowledge, 70% relational mysticism.

There's a bit of meta analysis research somewhere that says the major factors in therapeutic effectiveness are.. (in order)
1) The strength of the relationship between the therapist and client
2) The clients underlying desire to change
3) The modality/training of the therapist
4) The environment within which the therapy occurs.

 

[watundah]

I had a truckload of counselors who shuffled my folder amongst their caseloads. Now I have a T who has a CV of training with experts and understands dissociation, emotional flashbacks, repressed memories, the effects of neglect and sexual abuse and all of those things. For me, it made a big difference because she could "see" what was going on while others did not and has the skills to support me. People often say talk therapy alone won't fix PTSD; you need mindfulness, grounding exercises, somatic work, or other specific practices to wade through all of it. Maybe you can get all that from someone who isn't an expert, but I never did.

I agree with kilted that relationship is key and you would think trauma is the #1 reason folks land on the couch. But PTSD is a specific animal, also.

 

[claroscuro]

Having a T who specializes in trauma was crucial for me. I had 3 regular T's years ago, and only once I started with my specialist did I realize how much damage the previous ones had done toward my diagnosis at the time and the underlying problems. Specialists are just better trained at recognizing, understanding, and helping you overcome trauma.

 

[Lola Nocheprieta]

the major factors in therapeutic effectiveness are.. (in order)
1) The strength of the relationship between the therapist and client

I agree with kilted's whole post. I don't think you always need a specialist, the relationship is more important. My T is not a specialist, but she is very skillful, has good instincts, and "gets" me. Of all the Ts I've had, I have the strongest therapeutic alliance with her.

That said, there is a world of difference between what we do as "supportive counseling" and when we are focused specifically on the trauma. In regular, supportive counseling we focus on what I'm dealing with right now, and we do a lot of skills-building (DBT and CBT work.) She's very compassionate, but she can be tough with me, too, reminding me to use my skills, etc. We talk around the trauma. We don't unpack anything that is going to set me back, make me dissociate, or plunge me into depression. There's just not enough time in a 50-minute session to pull me apart then put me back together again so I can go out and face the world.

Trauma-Focused Therapy is just that, we focus on the past, on the trauma, pretty exclusively. I did one round of Prolonged Exposure (PE) -- one type of PTSD-specific form of brief therapy -- and let me tell you, it was nothing like any therapy I had ever done before. It was excruciating just focusing on one memory the whole time (like 75-90 minutes), over and over, for 10 weeks. It increased my symptoms initially and was very painful, very challenging. But I stuck it out and my PTSD symptoms of hypervigilence, nightmares, and much of the shame associated with that particular memory decreased significantly. Painful as it was, we are planning to do another round, on a different memory, in the summer. I am actually, well, I wouldn't say looking forward to it, but I feel ready for it.

I hope this helped!

 

[Crow]

I had a dozen therapists before my current T. Honestly they made life worse. My current T was not a trauma specialist when I started with her but now specializes in somatic psychotherapy using emdr, brainspotting, Somatic Experiencing. I'm nearing the end of trauma therapy because she knows what she's doing. It's been so important to feel like she can handle anything I throw at her.

 

[watundah]

One thing I forgot is that trauma therapy is usually long, slow and frustrating. A trauma T may realize that decades old defenses take a while to change vs 10 sessions and out.

 

[talon]

Hi!

Do most people here see therapists specialized to deal with Trauma?

I know there is EDMR therapy- b...

The answer is yes and no. Therapists are like any other profession they having a diverse experience or lack of. Best communicate as honestly as you can to ensure your therapist is ok and able to give you the very best she can

 

[ShodokanJenn]

My T is not a "trauma T" per se. He is the leading T in our region when it comes to trauma, though. He uses a variety of treatment modalities, and in my experience uses a perfect blend of patience, persistence, assertiveness, and mutual decision making. He's walked me through SO much, from learning to trust, to identifying my emotions, to tolerating my emotions, to slowly (VERY slowly) beginning to talk about what happened, and now we're doing full on exposure therapy. I'm not a candidate for EMDR due to the nature of the traumas and the extent of my current dissociative issues, but we're doing so much healing work without it that I don't feel like I've missed out at all.

I say all that to point out that a T doesn't HAVE to be a "Trauma T" to be able to help. It's more about the relationship and their knowledge and style and the compatibility between the two of you. And whether they are equipped to handle your trauma. I've seen several very good T's who simply were not equipped to handle my trauma, so I didn't really get anywhere with them. I also saw one abysmal T who sent me into a nearly fatal tailspin. And she WAS a trauma T, employed by the military to counsel vets. So she SHOULD have been able to handle my trauma. But it was beyond her, and she started grasping at straws, and did so much damage.

SO don't be afraid to try multiple T's. You'll probably get a sense of who you can work with. And a good T, if they get to a point where they are no longer equipped to help you, will help you find someone who CAN help. And the work you do, even if you don't get to the trauma processing itself, can be invaluable.

 

[alis]

thanks for all these great answers!!