Socratic Questioning in CPT

[Justmehere]

If we could do CPT collaboratively, and stick to the questions on the worksheets only, I’d be so up for it. We could use that as the exposure work. It would have a limit. But. Ugh. Not sure that’s possible.

 

[hithere]

If we could do CPT collaboratively, and stick to the questions on the worksheets only, I’d be so up for it. We could use that as the exposure work. It would have a limit. But. Ugh. Not sure that’s possible.

I understand not thinking the time limit would work. It puts a heavy pressure on. But if you tried it and it's too much you can. pull back from it, if you have a kind therapist who is engaged in the process.

The one thing I would change for cpt is the times when you read the account out loud to your therapist, I would make those sessions intentionally closer to two hours. Because 45 minutes is not long enough to read that account and then calm my physical sysmtem down, I was so dissociated at the end of reading the account, then it was 45 minutes are up; and I had to leave-- I don't have a memory walking out the building or driving home. All I remember is that evening I drank an entire bottle of wine without meaning to and I did it in like 20 minutes... it wasn't good. I truly believe 45 minutes for reading the account, then another 45 minutes to try and come back to normal and give some support and assurance to the client -- those are my thoughts on it. anyway

 

[Abstract]

So glad @hithere can give such helpful input.

If we could do CPT collaboratively

Not a loaded question at all - do you think she could do that with you?

 

[Justmehere]

You all have good suggestions!

I don’t know if I will be seeing this particular therapist again or not. That’s up in the air. The last session was helpful, collaborative, and ok. That was weeks ago. I’m not sure if we will have more sessions. It’s up in the air.

I think something started to click for me today using CPT on my own to handle work triggers. It’s too hard to explain, but it has me very curious to keep playing around with it. Even a little hopeful, and that’s something I could really use right now.

 

[Abstract]

Just wanted to say I can see so much progress for you with all this! You are really starting to break things down and find more clarity.

Even a little hopeful, and that’s something I could really use right now.

Once things settle down dont lose hold of this. Its something you still have access to. There are always options and choices even when they arent what we envisioned. Sometimes they can turn out to be the best thing for us. At the moment this is horrible for you and that is normal.

 

[Justmehere]

There are two types of CPT. One where someone talks about the trauma. One where someone doesn’t. It turns out that we can’t do the version of CPT that doesn’t involve reading the trauma narrative over and over and and over out loud.

The therapist is also adamant that I will be socraticallu questioned at length is sessions. We can not modify it to a style that is more like dialogue and less where the therapy itself is triggering, and more of dealing with the trauma itself. We could do the traumatic interrogation while kidnapped as the trauma event. Requesting a plan to manage the trigger that is the lengthy questionings is not “how it’s done” and even though she said the manuals were online and encourage me to go look them up, and we had no sessions unexpectedly for a month afterwards, it was a sigh of avoidance of the work for me to read through it and do the worksheets myself and ask to go over them and ask how it all gets handled so I wouldn’t just fall apart more while doing this. It wasn’t wrong for me to do that it also was avoidance and not appropriate. She also did not have the manual to start it even though she had weeks advance notice that I wanted to talk further about doing it and do it. She took all other treatment options except prolonged exposure therapy off the table which would be that she triggers me in session and I regulate on my own, which is oddly what we already do. So.

Back to Socratic questioning. I told her I don’t have innate wisdom and I’m not sure how this is supposed to work and why a therapy based on lengthy extensive questionanswer question answer question answer sessions is supposed to help when multiple sessions of doing that already leave me feeling disgusted with myself as a person and really confused as to what the goal was and what I was doing wrong to continue to have the same questions asked over and over. My answers are not satisfactory. I don’t understand how this would help when unacceptable answers are not defined and not allowed. I have to guess what the acceptable answer or suggestion or direction is based on the questions and comply appropriately or treatment will end. That is apparently how CPT would be done. After reading a narrative of trauma over and over and over.

I want to end myself just thinking about going through this. Therapy is apparently where I sit down shut up, obey, answer the question, and if I do not provide the answer that is acceptable will be asked again and again and again, and if the correct answer is not given, support will be taken and I will be confronted that I’m resisting and not doing enough and I will be required to regulate and I am to apolybskills to do that. I will not be coached on doing that in sessions. CPT is being offered because I am not stable enough to do somatic experiencing which was working. All agree it was working. It is taken because I am not stable enough and I need to answer the questions.

I would rather die than keep doing sessions of answer question answer question answer and not even a moment of something like reflective listening by the therapist.

I don’t understand why we couldn’t go over the worksheets nor do the version that don’t require writing and reading about the trauma over and over. I have written obsessively about it and we have bee over the details many times. Why not ever deal with the distorted thoughts or stuck points it brings up?

I tried to tell her what I did on my own that was helpful and it was quickly turned into she asks a question and I am to comply and answer, she asks another question, and I am to answer.... and when I counted 23 questions in a row and I was so triggered that I was then being confronted (through questions) that I was numbing out... I wanted to run to the bathroom and self injure to make it all stop. I am required to regulate and not have walls which means no getting numb. I am not and will not be coached on ways to regulate in session if we did CPT.

I don’t understand how these long strings of questions help anyone. Some challenging questions, sure! But this? I’m not even sure this is CPT, the dialogues in the manual actually have more statements and less questions, but even the sample dialogues bother me. I found some use in doing the worksheets on my own. I thought we could have a dialogue about it. I didn’t know that doing the worksheets on my own was a sign of my pathology.

Maybe I can find a different person to do CPT. I’m not sure this is the goal or purpose or normal methods of CPT or Socratic questioning. I don’t know that the only thing the therapist says in sessions is to be questions and questions only.

 

[whiteraven]

I have started CPT, but since my therapist has been away, we haven't gotten very far. He knows the creator of this therapy and, while he sticks with the worksheets, he is VERY flexible. If I told him I couldn't manage something, he'd back off and/or take another approach.

When I think about this, I think 2 things. I would try to take in the questions/see them as a way to explore your thinking. Meet them with curiosity. I know that's hard, but practice will make it easier. If the questions come across as an interrogation, it might be helpful to talk about that with your therapist. If she is unwilling to slow down and take a gentler approach, perhaps it would be useful to try it out with another therapist.

 

[Justmehere]

I can't believe I'm about to write this, as it might be the most ridiculous of posts and moments, but oh well... A satirical cartoon episode helped me understand this easier. (LOL) In the episode, a character named is FREAKING OUT because of a joke political situation, and several characters try to talk them out of the fear. Does. not. work. So then one character has a realization that what they need is basically empathetic presence, not people to fix him and his fear. The character with this epiphany asks him questions, and eventually through Socratic questioning, comes to a realization that his friend is really there for him and freaking out isn't helpful.

So. Ya know. It's a really dumb TV show. But even those characters had more empathy than I experience during this method.

I did an intake of sorts, with lots of Socratic Questioning, only it was at a place where I already feel safe and ok. The person did it with empathy and compassion. I wasn't triggered. I realized some things to change. It was hard, but helpful. We were able to walk around, take breaks, do other things, and then come back to it.

So maybe the real issue for me isn't so much the method, but the context and the amount of compassion or empathy that I'm able to take in - which is partly on the person doing it, and partly on me. If I don't feel like someone is on my side, has compassion for me, accepts me, etc... and just starts questioning the crap out of me, like has happened in therapy, it freaks me out more. But when there is a shared goal and empathy, it is different. Not comfortable (I didn't sign up for comfortable) but helpful and constructive.

Annnnnnd.... there might be something really wrong with myself and/or my life when the minimal joke empathy of a ridiculous and crass cartoon is something that stirs up the desire for empathetic face to face connection in my life. I've sunk so low.

 

[ButterflyBean]

@Justmehere I just wanted to say how awesome this realization is! With all you’ve recently been through therapeutically, I sincerely hope that “the intake of sorts”, and experience with some type of empathetic compassion, provided some sense of positive hope! You certainly deserve endless amounts of hope! Do you have another appointment scheduled? I hope you feel less stuck for the moment.

 

[Justmehere]

No, but working on finding and figuring out what I need - and crossing off what I don’t need!