Starting CPT

[subtleomen]

Besides writing "why you think this event happened," will you be writing how it affected your life in the areas of power and control, safety, and self-esteem?

Yes, that's exactly it. I forgot about that part but it is on the instruction sheet my therapist provided. There's a 5th area as well, but I can not remember it right now.

 

[susannahsays]

Yikes. That WHY question really hit me in a not great way. Logically, there is nothing wrong with the question. For some reason, though, my mind really had an immediately negative reaction. It screamed out, "Why? What do you mean why?? Stuff just happens!" Which is pretty dumb considering the type of traumas I experienced.

Nothing to see here, folks.

 

[subtleomen]

Yikes. That WHY question really hit me in a not great way. Logically, there is nothing wrong with the question. For some reason, though, my mind really had an immediately negative reaction. It screamed out, "Why? What do you mean why?? Stuff just happens!" Which is pretty dumb considering the type of traumas I experienced.

Nothing to see here, folks.

My situation involves ongoing abuse/neglect by a parent. The "why" piece is fairly easy for me to make out. This parent was and is a sick, mentally ill person who simply repeated the cycle with me. As far as how it's affected me well that is a much deeper question. The effects are pervasive and life long. I haven't written my statement yet and my therapy session is tomorrow. I don't need to get it perfect, just do the best I can right now. This stuff is really like an onion...after one layer, there is another.

 

[susannahsays]

I wasn't really making a comment so much on the difficulty of distinguishing "why," so much as observing my mind's irrational knee-jerk reaction. The types of abuse that happened to me don't "just happen," so it was just interesting to me that I had that thought.

Good luck at your session tomorrow. Hope it goes well.

 

[subtleomen]

Second session is complete. This session consisted of reading my impact statement out loud while the Dr. listened and identified "stuck points". For those not familiar with this therapy, stuck points are basically distorted beliefs arising from the trauma(s).

I'll give a stripped down personal example:

WHAT HAPPENED?
My mother beat and berated me.

WHAT ARE MY BELIEFS IN RESPONSE?
I am a bad and defective person, so I deserved this treatment (This is the distorted thought/belief or "stuck point").

I was very nervous/anxious about doing this, but when I read it out loud it wasn't that big of a deal. I felt a small sense of relief simply because I had voiced all these things to another person.

My assignment prior to next week's session is to fill out a worksheet for each stuck point. Basically, the worksheet looks at the beliefs and their cause and tries to frame the thinking in a different light by questioning whether or not the belief is realistic. I think that just identifying the distorted thinking and acknowledging it for what it is will be very helpful.

 

[subtleomen]

Third session is complete. I avoided completing three stuck point worksheets until 1 hour prior to this session. Completing these right before put me into a flashback as I went into the session, and I wanted to rage. This actually turned out to be very helpful, even though it was uncomfortable.

A few minutes after I walked in, the therapist told me "Your interaction with me seems highly controlled on your end", which is 100% true. When I am in a flashback, I often dissociate, am expressionless and on high alert to make sure I am IN CONTROL and SAFE. This is typical most of the time for me, but is on another level during a flashback. So, I am going through the motions and following the procedure of CPT, but I am not emotionally invested in the process yet or in the relationship with my therapist. In the past, this type of behavior has allowed me to fool both the therapist and myself into thinking I am better...simply because I have "checked all the boxes". This is a self-defeating behavior of mine because through avoidant coping behaviors, I hide myself from the rest of the world and isolate myself. I struggle to connect with others out of fear for my own safety which is a new realization for me, though seems obvious looking back. That is why having a trained trauma specialist witness my flashback behavior and then work with me to dissect and understand it was very helpful. Basically, when I hide from others, I also hide from myself because I identify more closely with my shell persona, and dissociate from what is really going on inside me. In doing so, I have lost touch with reality and my own identity which has caused me a lot of confusion and struggle. I'm always "reinventing" myself and using that as a vehicle to obsess/avoid. It's maddening to have a shifting identity as an adult.

Shortly after this, the Dr. asked me to participate in an experiment. He asked me how safe I felt in the room with him on a scale of 1-100. I said 50, and that 50 is typical for me most of the time. He then asked if I would be willing to close my eyes, and I immediately said "No", but I also asked specific questions about what he wanted that for and for how long. After I got all the details, I became willing to try to close my eyes in the room alone with him and the door closed for 30 seconds. So of course I close my eyes, but my ears are WIDE OPEN because I am on high alert now. I hear movement that is not mine, and in my mind I have this picture of him getting up and approaching me from across the table. I had a thought something like "This motherf*cker is getting up to get you. You can't trust him, be ready to fight!". My instinct was to jump up and raise my fists, but I just opened my eyes instead. Turned out he hadn't left his seat and only moved his foot slightly. I made it 12 seconds. He then asked me "did what you thought might happen actually happen"? This is the nature of the type of questioning used in CPT. Of course it didn't, and most of me knew that it wouldn't, but I can not think my way out of the adrenalized fear response. I suppose that is the nature of PTSD.

The work out of the CPT manual in this third session consisted of reading and discussing the stuck point worksheets. During discussion of the stuck point beliefs, the Dr. engaged in the questioning that challenges those beliefs and guide the patient (me) to come up with evidence against them or a new way of thinking. I do find this to be very helpful because it helps me to identify what my distorted thinking is, AND to logically think of a new way of thinking about the world and how I fit in it. I also find this very challenging because I can logically think that these beliefs don't make any sense. In my mind I know that the beliefs are self-destructive and harmful. The problem is that these are emotional beliefs that I have tucked away for decades. My heart and mind are in two separate places and moving in different directions. It's difficult for one to access the other, so part of this work for me is connecting the two and untangling the decades of denial I used to cope with my situation.

Over the next week, I will be writing an account of the worst trauma I experienced and reading it out loud every day. If I can not make it through this writing in one sitting, I am supposed to draw a line where I stop each time, then pick back up when I can. The Dr. mentioned that this will likely put me into another flashback and that I should expect that. As a side note, I find that MMJ helps a lot with flashbacks. I am also to continue working stuck points, but in the context of present day manifestations. For example, "All the people in the grocery store are watching me. If they get too close, I might need to attack".

 

[subtleomen]

I need to comment here that during this week I have had an uptick in symptoms, particularly suicidal ideation, dysregulation and flashbacks. I was encouraged to find another person who has done this therapy and had the same experience. At the beginning of CPT, symptoms increase, but get better toward the end. Sort of "gets worse before it gets better" type deal.

 

[Karolina12]

A few minutes after I walked in, the therapist told me "Your interaction with me seems highly controlled on your end", which is 100% true. When I am in a flashback, I often dissociate, am expressionless and on high alert to make sure I am IN CONTROL and SAFE.

.....

He then asked me "did what you thought might happen actually happen"? This is the nature of the type of questioning used in CPT. Of course it didn't, and most of me knew that it wouldn't, but I can not think my way out of the adrenalized fear response. I suppose that is the nature of PTSD.

.....

I also find this very challenging because I can logically think that these beliefs don't make any sense. In my mind I know that the beliefs are self-destructive and harmful. The problem is that these are emotional beliefs that I have tucked away for decades. My heart and mind are in two separate places and moving in different directions. It's difficult for one to access the other, so part of this work for me is connecting the two and untangling the decades of denial I used to cope with my situation.

Thank you for sharing your experience. You have an incredible way of articulating what is going on with you and it is so helpful to me.

Good luck—can’t wait to hear how it all goes.

 

[subtleomen]

I am going in for session 4 today and this week has been very difficult. I've been in flashback more than half the time, been suicidal, and picked a fight with my spouse. My job and my child have kept me going. This therapy is difficult for me and at this point, I am not sure if my life is falling apart or coming together. One foot in front of the other is all I can do I guess. Not recovering is not an option. I have to keep going.

If I could do the last 15 years over, I would be single and living in a very small and manageable apartment or trailer. No idea how people live "normal middle-class lives". It really blows my mind, yet here I am living the life I thought I was supposed to.

 

[subtleomen]

So I have completed session 4 now and feel like I am over a hump. My verdict is that life is in fact, coming together. I still have a long way to go, but reading the initial trauma account to the Dr. helped to make sense of a lot of things. I read it, very quickly the first time and then after some discussion I was asked to read it again slowly and deliberately which I did. Then, I was asked how I felt. I gave an answer, but identifying feelings is often a struggle for me. So, the Dr. advised me to practice identifying feelings in my body, then connect that to an emotional state. I also have to credit this person as a therapist. He digs for clarity through gentle questioning until we come to the root, and he seems to know what he is looking for when doing so.

My next assignment is to write another trauma account, except this time my instructions are to be very descriptive with sensory words. Sight, smell, touch, etc. I will start on this tonight.

 

[hithere]

@subtleomen thank you for sharing your experiences after each session. I, too, had very similar responses and feelings--especially with the "stuck points" They were so helpful to put in black and white and yet a big, big disconnect with the "person" of me and my emotions. That part took a lot of time and work. Your therapist sounds great. Reading this is helping me so much to see some things about my failed therapy experience. Good luck with this next work of giving more detail, and sensory details. This part really, really helped me. One of the intense nervous symptom flashbacks really eased up tremondously after this portion of work. Good Luck.

 

[subtleomen]

I had some travel planned and couldn't post for a bit, but I have now completed sessions 5 and 6 and my symptoms are much less than what they were 3 weeks ago, along with a depression score reduced to 4. Not "out of the woods" or anything like that, but I am noticing a positive improvement.

I read an additional trauma account in session 5, which was more clear to be because I had access to those memories in more detail. This experience really helped to clarify things in my mind.

The homework after session 5 involved performing more work on stuck points, in which I realized that I was denying/minimizing the impact of a family member trying to seduce me when I was a teenager.

Session 6 was a discussion of these additional stuck point worksheets. The therapist must have had something else going on during this session because he was distracted. I noticed, but it didn't bother me enough to comment on and we still went through the work.

My work in between sessions involves identifying how this "stuck point" based problematic thinking manifests in my daily life and to fill out these worksheets for discussion at the next session. I really like that this therapy is focused on my belief system, rather than simply being talk therapy. I always found straight talk therapy to be too much on the surface.