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Starting Prolonged Exposure Therapy (PE) (Advice?)

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brandic

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Hello there,

I start prolonged exposure therapy in two weeks. My doctor said that it is risky to go through this type of therapy because there is a high drop-out rate at about week 8 because of the pain/distress involved, and if a person drops out, that stress becomes their new baseline. Nevertheless, I need to address past traumas rather than focusing on everyday issues with only cognitive behavioral therapy (CBT). She explained that PTSD is like having a broken leg that has never healed correctly. CBT is like a crutch or cane; it can help in functioning, but it does not fix the broken leg. PE is like going in and re-breaking the leg so that it can be fixed. Up until this new doctor, I have not found a therapist that is willing to discuss past issues which I know affect me so much to this day, so I believe the risk is worth it.

I am curious to know what your experience with PE was like and am wondering if you have any tips on getting through it. I am particularly worried about conflicts with my husband and everyday stress as I am in my last semester of college. Should I wait until I graduate? What should I expect?

Thank you in advance. I am new here.
 
Hi,

Prolonged exposure worked wonders for me. In fact it took only three sessions to put a halt to the nightmares, flashbacks and panic attackes. I had tried EMDR, DBT, CBT, and many more therapies before hand. It was hard , painful but for me worth it. I found the other therapies skirted round the issues too much whereas PE tackled it head on.

Of course it is different for everyone but for me it has transformed my life completely. I posted earlier today actaully how my dreams now do PE rescripting which is slightly odd but not at all distressing.

I guess you won't know what affect it will have for you unless you give it a go.
 
My t said no to PE and does EMDR instead. It had to do with my inability to ground myself making it too risky. I guess she thought EMDR would give me more control of the memories. From what I've learned the most important thing in the really tough treatments is to be completely honest about how you feel in the hours and days afterwards so they can adjust the process as needed. No trying to just tough it out
 
@brandic
Welcome to the site. It is wonderful support system where you will always find at least one other person to relate to.
I hope this type of therapy works for you. I hope you have a lot of compassion for yourself and you as a child. To wake up the beast of the past consciously is not for the faint of heart.
I have never done this type of therapy. I only did Psychodynamic Psychotherapy for exactly 2 yrs 2.5 months when my baseline changed completely.... Just really couple weeks ago. I am grateful to wake up from a nightmare but it is doable. I will not lie to you the anxiety, fear and terror were real-ironically the same thing I went through as a child. Trauma work is like a child losing a loving mother is trauma but adult losing a loving mother is grieve. I grieved like I am retruamatized. It is tough. It is lonely and it scary but worth it.

My only advice is this do not do it if you do not have a strong marriage where you could trust the person with your life. If you do because we only have one life, have one person outside of therapist you can depend 100% and who is willing to be there for you... And hope they are not character from the truama Era.
It is doable. All you need is strong will to overcome and extreme compassion for the self.
 
Hello there,

I start prolonged exposure therapy in two weeks. My doctor said that it is risky to go through this type of therapy because there is a high drop-out rate at about week 8 because of the pain/distress involved, and if a person drops out, that stress becomes their new baseline. Nevertheless, I need to address past traumas rather than focusing on everyday issues with only cognitive behavioral therapy (CBT). She explained that PTSD is like having a broken leg that has never healed correctly. CBT is like a crutch or cane; it can help in functioning, but it does not fix the broken leg. PE is like going in and re-breaking the leg so that it can be fixed. Up until this new doctor, I have not found a therapist that is willing to discuss past issues which I know affect me so much to this day, so I believe the risk is worth it.

I am curious to know what your experience with PE was like and am wondering if you have any tips on getting through it. I am particularly worried about conflicts with my husband and everyday stress as I am in my last semester of college. Should I wait until I graduate? What should I expect?

Thank you in advance. I am new here.

Am scheduled to commence P.E. on Monday (March 2nd).

As I have no memories of the 'middle bits' of the violent crimes (x3), whenever I recount/retell what happened, my body just starts the fearful upsetting shakingey thing when I get up to the 'middle bit.'

Does P.E. help bring back memories of the 'middle bits'?

If not, I don't see how it will help me, & am concerned that this will be like torture.
 
What other options have you discussed with your doctor? I have mostly heard of exposure therapy being used for anxiety from trauma, not for processing the traumatic events themselves. In my experience exposure therapy is a last resort for PTSD until other methods have proven to not be effective.
 
What other options have you discussed with your doctor? I have mostly heard of exposure therapy being used for anxiety from trauma, not for processing the traumatic events themselves. In my experience exposure therapy is a last resort for PTSD until other methods have proven to not be effective.
I haven't actually been told anything about any other options. The T's been specifically trained in PE, so basically I think that's why he wants to try that particular method. But I've read that PE can actually worsen things initially, before things hopefully start to get way better later on. So the 'carrot' is that I might be free & clear if I do the 'hard yards.' A 'no pain no gain' kind of a thing.
 
my intention is not to discourage or derail by any means. Just curious, cuz like you said ‘no pain no gain’, I agree with the phrase. None of this work is easy, if it’s too easy....work harder right? Unless you need to rest and you’re destabilized.

I did do exposure work with my T....but before we got to that point there was a lot of work to build my skills to self-manage, identify, and be mindful so I could cope.

Concern is, if you race into it, can really mess with you. The level of trust needs to be there, will this T can catch when it’s too much and can help manage the symptoms....is something to ask yourself.

If this is what your T is trained in, it for sure helps....but it’s on your terms. When you’re ready. No other way about it.
Sure we can avoid stuff, but you’ll know.
Essential piece is, trust is vital. With trauma it’s often very difficult to catch the slippage, when things go astray and it’s hard to get back to baseline. A skilled T will know how far to push and when to back off with exposures.
 
I have mostly heard of exposure therapy being used for anxiety from trauma, not for processing the traumatic events themselves. In my experience exposure therapy is a last resort for PTSD until other methods have proven to not be effective.

That's just not correct.

PE is very effective & recommended set of therapy modalities for PTSD.
Check out APA standards if nothing else.

Ditto on the other hearsay you have. Works on the whole trauma, not just one symptom cluster arising of it & associated with it.
 
It's kind of you both to take the time to give your opinions here, thank you. I'm getting even more curious/confused about this PE stuff now, haha. My regular doctor told me that Ts generally prefer it if the patient's medicated, so that there's a drug helping to guard against things going off-the-rails. I'm trying to deal with all of this while staying unmedicated.
 
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