Rumination is an anxiety disorder, but not PTSD?

Skywatcher

MyPTSD Pro
I was reading an article written for trauma therapists on what to do. In one part it said that ptsd will cause clients to avoid everything about their trauma and to work on discussing and getting exposure to it. It also said that if a client is ruminating, it is trauma looping in their mind—an anxiety response to trauma but not PTSD (???). It said to approach those clients by not discussing trauma, but helping them to stop.

I have an official diagnosis of PTSD and GAD. (Also, “complex” tossed on there). I’ve noticed that my therapist sort of follows what this article says. We don’t talk about my trauma thoughts that cause loops. We use emdr flash. When it comes to stuff I avoid that have trauma reasons, we discuss the connection and work towards finding ways to function—also flash. We used to use traditional emdr and I kind of miss the approach because I felt more support in dealing with the target. (But i became overwhelmed)

I think she is mainly dealing with my rumination and she says that once we bring my distress level down we can work out the details that tend to bother me the most.

I thought rumination was part of PTSD. Is it not? Is it why I also have the GAD diagnosis? Is it why this healing process is taking so long for me?
 

Chris-duck

MyPTSD Pro
As I understand it rumination is indicative of an anxiety disorder outside of PTSD. But it really depends on context n what you mean by rumination. Like yeah, avoidance has to exist for it to be PTSD. But that looks different to different people.

Like I'll ruminate about the kinda side bits of trauma shit. But avoid looking at uh the actual trauma bit. But yeah. Avoidance is basically apparently what creates/maintains PTSD. So zero avoidance equals no PTSD, from my understanding. But that looks different for everyone.
 

Friday

Moderator
@Skywatcher ...If you have GAD then you most likely have the same symptom, from 2 sources.

Just like, because I have ADHD, I have quite a lot of duplicate symptoms.

But even though the symptom itself is the same on paper, because the cause is different... it often expresses differently (or even very differently, in seemingly opposite ways) and is best managed ...yep!...differently. Sometimes, of course, it’s impossible to tell if this is an ADHD thing or PTSD thing. Then I have to try both methods of dealing, to see which one “works”. And sometimes neither works, because those symptoms “marry” and only doing one of the other won’t touch it... I have to use both sets. At the same time. To get any traction. What’s even more vexing? Sometimes when comorbid symptoms marry, instead of duplicating, you end up with a completely different symptom. >.< Untangling that one? Is a real sonnuvabitch

Same symptom. 2 sources. 3 ways to manage it.
Same symptom. 2 sources. Appears as a totally different symptom.

Comorbid dx’s get complicated fast. Because they interact with each other.

I was under the impression that rumination was part of ptsd and depression. I don't know....!
All disorders share symptoms.

But even if the exact same phrase is used to describe the symptom? It still often has wildly different meanings.

“I can’t stop thinking about”

- PTSD
- OCD
- GAD
- ADHD
- Grief
- New Love / betrayed love
- Shame
- Hope
- Excitement
- Fear
- etc.

To use can’t stop thinking about & locking the front door, as an example?

PTSD - Or something bad will happen, again.
OCD - Or something bad will happen... unless.
GAD - Did I lock the door? But what if...?!?
ADHD - Did I lock the door? And 85 things loosely related to locks, 33 to doors, 51 to the past, 22 to movement, and 200 to various aspects of any of those things.
 
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Skywatcher

MyPTSD Pro
I’m starting to think that my GAD tends to run over my ptsd triggers. For example, my therapist asked me to imagine viewing my young self’s trauma as a movie. She kept mentioning how to imagine looking at it beginning to end at a distance as a movie. She kept saying “movie camera.” Next thing I know, I’m under a blanket cowering away from her and telling her to stop saying camera. I feel like she said it 100 times and I wanted to run out of there, if I could move. I was actually proud of myself that I was able to tell her “stop saying that.”

—that was definitely ptsd.

Then, the week following developed into a loop of a very specific part of the trauma, which wouldn’t be considered trauma, without what happened next. So, did my ptsd exposure trigger my GAD?

I’m starting to think that GAD is worse than my ptsd. I hate it. I wonder if my ptsd has actually gotten better? Like I have gotten pretty good at pulling out of flashbacks and I’m okay at breathing through a minor trigger. But the GAD occupies my mind. Currently, my younger parts are convinced that my therapist is going to abandon us. We had a rupture and despite our history of working through things I can’t stop looping on it. T did point me to a helpful Tara Brach thing about “responding not to react.” I’m curious which condition that applies to. And dissociation, where does that fall? I wish I could use it again—We spent so much work on not using it to cope with things and being present.
 

joeylittle

Administrator
But the GAD occupies my mind. Currently, my younger parts are convinced that my therapist is going to abandon us. We had a rupture and despite our history of working through things I can’t stop looping on it.
You might bring this up with your T (if you haven't) - it sounds more like an attachment issue, than generalized anxiety. If your anxiety is nearly always around relational issues, that can indicate one of a few different attachment dysfunctions. Which, BTW, nearly everyone has to some degree. Like all the symptoms, they don't really become 'symptoms' until they occur to a degree that it disturbs your functioning. It sounds like this does that - but worth teasing out more in therapy.

I was reading an article written for trauma therapists on what to do. In one part it said that ptsd will cause clients to avoid everything about their trauma and to work on discussing and getting exposure to it. It also said that if a client is ruminating, it is trauma looping in their mind—an anxiety response to trauma but not PTSD (???). It said to approach those clients by not discussing trauma, but helping them to stop.
I'm just curious, do you remember where the article was?
 

grief

Sponsor
immersion is certainly a part of ptsd. i am only realizing now that the direction my life has taken is directly proportional to my own trauma. i deal with trauma all day every day, when i am not actively encountering someone else's trauma i am researching trauma and implementing tools specifically designed to deal with trauma. i tend to refer to it as immersion and i have been in several states over it in the past. when i am stable i feel confident and proud of myself for what i do but when i am unstable i repetitively expose myself to things that are damaging and triggering. it is not necessarily my trauma but it is certainly trauma-adjacent.
 

Skywatcher

MyPTSD Pro
@joeylittle Yes, I do have attachment and abandonment issues that we work on a lot. My main problem in conflict, misunderstandings and relational triggers is that my mind makes things so much bigger than they are and it will then set my nervous system into chaos and I try to solve the situation on my own in my head over and over again which builds more anxiety. This is why the Tara Brach Youtube really helps me.
Learning to Respond Not React - Tara Brach

The “article” was a blog by a therapist.
Top 5 mistakes therapists make when treating clients with trauma
 

ruborcoraxxx

MyPTSD Pro
immersion is certainly a part of ptsd. i am only realizing now that the direction my life has taken is directly proportional to my own trauma. i deal with trauma all day every day, when i am not actively encountering someone else's trauma i am researching trauma and implementing tools specifically designed to deal with trauma. i tend to refer to it as immersion and i have been in several states over it in the past. when i am stable i feel confident and proud of myself for what i do but when i am unstable i repetitively expose myself to things that are damaging and triggering. it is not necessarily my trauma but it is certainly trauma-adjacent.
Yeah, as indirectly finding something either to live through or to grip your mind on. It has an aspect of compulsion. Perhaps it has a protective role because while you're stuck in ruminations at least you don't run mad and blast your life/relationships, as that can happen stupidly fast. At least it's how I feel it's for me. Then the fear of dropping the rumination enters in the rumination itself, yahoo. Even while being in therapy it's hard to drop. Ranting and worrying can be a real shield and it keeps adapting and transforming as you try to undo it.
 

grief

Sponsor
Perhaps it has a protective role because while you're stuck in ruminations at least you don't run mad and blast your life/relationships, as that can happen stupidly fast.
this is particularly poignant. i have noticed within myself that now that i am attempting to "move forward" i have suddenly and without warning become very much unstable. like i am balancing on a board on a ball. the past gives you solid ground, the future is often uncertain. i also expect that within ptsd the brain forms traumatic memories differently, and the brain likely become accustomed to traumatic-style memories and seeks what is familiar.
 

joeylittle

Administrator
The “article” was a blog by a therapist.
Thanks for sharing that. I don't know if you'd find this helpful to know - but that observation about how to handle rumination inside of working with a trauma client - I find it not entirely well-thought-out; it's a little bit of an oversimplification of something that's more appropriate to managing BPD, than PTSD - the therapist in the article specifically mentions that she's most experienced with comorbid PTSD/BPD, so that kind of angle on things makes sense.

I do think there's wisdom in the idea that we need to have some degree of stabilization before proceeding into trauma processing. And stabilization requires time and application of symptom management skills.
Then, the week following developed into a loop of a very specific part of the trauma, which wouldn’t be considered trauma, without what happened next. So, did my ptsd exposure trigger my GAD?
It's just as possible that the loop you were experiencing was the recurrence of intrusive thoughts, rather than rumination. It's really, really hard to know with a lot of these things.

Have you and your therapist taken a break from doing trauma processing, and are right now working on refreshing your stabilization skills? Or - does that seem like what you'd like to be doing?
 
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