Resident Psychiatrist Is Not A Therapist

[aut555]

I don't know what year.

I didn't ask. What kinds of specialties do psychiatrists have?

Our conversat...

That's a pretty typical complainant about psy MD's. Their bedside manner can be atrocious. They learn through internships, pyg rotations, etc. They specialize in scripts primarily. And able to stabilise homicidal delusional patients, the good ones at least. Maybe ask her about her approach to therapy and how she would apply this to you. I am grasping at straws here.

 

[Dana1010]

Someone who is more literal/linear/head-based would likely work better in the PE framework. Someone more intuitive/circular/gut-based, probably in SE. I also think anyone with trauma 'repeats', where they might have trouble separating their narratives, would possibly prefer SE.

Don't you feel like it has to be both? Even major body work proponents like Van Der Kolk say that their therapy is still very talky.

I had one therapist with whom I was supposed to be doing SE, but our therapy was mostly talk with some grounding practices and noticing sensations. Was she doing it wrong?

How much does PE take the body into account?

I would think even in hardcore SE, you would have to do some talking to bring those bodily sensations up so they can be worked on in the first place. Am I wrong?

 

[joeylittle]

Don't you feel like it has to be both? Even major body work proponents like Van Der Kolk say that their therapy is still very talky.

Yes - but there's a difference in how the work progresses, and what the client is being asked to monitor. The more 'brain-work' people like Shapiro believes in the connection between trauma and the body as well - and both modalities let the client describe things however they like.

Same goals - re-intregration of traumatic memory to resolve trauma disorder symptoms. Different techniques.

This is a case study written my a somatic practitioner. It's a bit of a long read, but it's really illuminating.
Healing Trauma Somatic Experiencing
From the article:

By focusing on one aspect of her physical sensations, we will be led into her body’s memory of the trauma. By moving slowly, and utilizing various techniques that prevent re-traumatization, her body will guide her through her own natural set of experiences, and gradually release the stuck pattern.

Something that is unique about the somatic approach is that 'aspect' idea - sort of like, all roads lead to Rome. You can take any entry point and work your way through. Then, you are always working with how the body responds, it's the metric, in a way.

Whereas, in EMDR, the metric is more focused on cognition - how much negative charge a specific thought is carrying. If you are naturally attuned to your body, you're going to be aware of how your whole system responds to thoughts becoming neutral. But if you aren't, it's not necessarily going to be pointed out to you.

This interview with Francine Shapiro (creator of EMDR) is a nice, short read, and talks a little bit more about what the rationale behind the process is. She also addresses PE and CPT: Using EMDR Therapy to Heal Your Past: Interview with Creator Francine Shapiro | Psych Central

I think what's important is that once the content of the trauma is articulated - you could call it the plot, the arc, the story...whatever - each modality will proceed through that content in distinct ways. All of those ways provide a framework. And a good practitioner will be working within a framework that is very comfortable to them, and they will be able to guide the client through it in a fairly elastic way (meaning, they can respond to the individual quirks of processing that each person has).

But there's a structure.

'Talk therapy', just as it is, will apply any number of different tools from any number of toolkits - but it's not a structured process. It would kind of fall apart if it were, because it very much needs to be driven only by the present needs of the client.

But someone seeking trauma therapy has a more specific need to address - they are having trouble with their past experience(s) interrupting their present life. And simply talking about it, with no plan at all, isn't really going to be most effective for most people. It still might help, but it also might not.

 

[Dana1010]

And simply talking about it, with no plan at all, isn't really going to be most effective for most people. It still might help, but it also might not.

Sounds to me like PE comes pretty close to "simply talking about it." Not that I'm complaining. I personally have found "just talking about it" to be helpful when I've been allowed to do it. Being shut down by therapists who for whatever reason don't want to hear it has been my number one problem. Which is pretty scary, because that is seriously the bare minimum a therapist should be able to do.

 

[anthony]

Well, they're all CBT foundations expanded upon, trauma approaches that is. If you went into PE, TF-CBT, EMDR, SIT, CPT, and the long list of psychodynamic approaches, one would work for you. Whether you want it to work at that given time in your life, thats another thing entirely.

 

[katz]

Saw a resident psychiatrist for "therapy" today. Sample quote: "When you say 'triggered,' what does th...

Ditto! I'm having a terrible time finding one too. My insurance won't cover anything and each time I have found one--they left. (3) Moved, retired, quit the business.
--keep looking.

 

[katz]

Well, they're all CBT foundations expanded upon, trauma approaches that is. If you went into PE, TF-CBT, EM...

Thanks.