• 💖 [Donate To Keep MyPTSD Online] 💖 Every contribution, no matter how small, fuels our mission and helps us continue to provide peer-to-peer services. Your generosity keeps us independent and available freely to the world. MyPTSD closes if we can't reach our annual goal.

Telling an emdr therapist that his cbt is not helpful for you

sidptitala

Confident
I have been in EMDR since September, with a therapist who mainly does CBT but does EMDR on the side (actually, being a therapist is a side profession for him too). EMDR has been really, crazy effective for some war trauma I picked up as an adult.

Fairly early on, the practitioner moved into CBT- which helped once I had processed the war stuff through EMDR already. Before EMDR, I was unable to tell him anything I was thinking or feeling during or about the trauma we were working on and couldn't remember important parts of it. I only knew these things after several EMDR sessions addressing it- and then CBT was helpful to identify when I was blaming myself for things that weren't my fault, bad thoughts about myself without evidence, etc.

BUT

I have a history of complex trauma and my therapist isn't used to working with this (most of his other clients are men who have had car accidents, or at least the ones he talks about with me are) . Right now we have moved into my childhood full of sexual abuse. He would rather do CBT about this than EMDR because he has identified core beliefs of mine that he believes should change- one being my belief that child abuse is incredibly common. He believes it is incredibly rare and that I would be healthier if I could think that too. We have been stuck on this point for several weeks- talking for hours and hours about it. He googled how common it is to try to prove his point to me- but when I later read the web page he found, it agrees more with me than with him. He hasn't done much reading in this area and I'm struggling to find any factual basis for his opinion about it. Something about the struggle to articulate my reality to a man who thinks it is just not real and I need to submit to his understanding is so deeply triggering to me- it's like he is trying to overcome my resistance.

I absolutely have beliefs that come from being raped repeatedly by my dad that I would love to change. But this is just not one of them and feels like a massive waste of time to me to spend hours every week trying to defend my right to feel that way. It feels retraumatizing, actually- and him typing 'emotional reasoning' into youtube and having me watch the first video about it that comes up doesn't convince me that there isn't truth to my feelings- especially when I can so easily find evidence that child abuse is exactly how it feels- widespread, endemic, everywhere.

I don't feel like I will get anywhere with this therapist if he doesn't learn to drop this, and let me identify for myself what my cognitive distortions are. He probably won't do this if I don't ask him to, as he has said that he finds these discussions productive (whereas they make me feel like i am dying and don't have a body and am reduced to a body all at the same time) . We won't see each other for a few weeks and he asked me to email him how I am getting on. I think I will have to ask him if we can leave that topic alone, or if he can do some research into it and accept the consensus about it. I have never done something like this before, asked a therapist to do or not do something.

Has anyone been in this position before? How have you handled it? Have you encountered this problem with CBT being applied clumsily?
 
i find cbt unhelpful (that’s being generous) for abuse trauma and would stop seeing him, personally. it’s very weird to me that he insists on this one point and i think that chronic csa really needs someone with experience treating complex trauma.
 
I am currently working with a CBT therapist who diagnosed me with complex trauma resulting from continuous sexual assault during my high school years. In fact, I was prepared for the process of re-traumatization. I viewed it as a poorly fused, broken bone that needed to be broken again and properly healed.
However, this approach wasn’t helpful because I couldn’t access any emotions related to the memories I had. Recently, my therapist and I agreed to leave things as they are. The most problematic issues for me include my current core beliefs, patterns, inability to experience positive emotions, and dissociation.
My therapist also suggested that I explore group therapy. If we find a suitable group, I plan to switch to that format for a year. I understand that changing therapists can be an uncomfortable experience, as it involves opening up to a new person. However, if you are unhappy with your current therapist, it’s worth considering finding someone else.
 
Thanks for your replies on this. I did end up contacting him and asking him some questions- and it helped but probably not enough. It was hard for me to understand why he thinks my opinions about this have to change- at its core I think he's assuming that this belief is limiting my behaviour while I think it's actually liberating it (because if I know abuse is common, then I don't have to have an existential crisis every time it seems ubiquitous in life, and can change my core belief that it happened to me because there's something uniquely wrong with me).

It's really hard for me to take him seriously that his view of my safety is more objective than mine- it has overwhelmingly not been the case for me that a straight white man can accurately assess how much I can get away with without inviting punishment. It has in fact been an important life lesson that I can not expect equal treatment. I really think I'm going to need to find a therapist that understands that or can at least take my word for it that my perception of injustice is real and I can trust it.

i think that chronic csa really needs someone with experience treating complex trauma.

I'm beginning to think this as well actually. This therapist really helped me with the war stuff. But he just lacks information about the common experiences I'm aware many survivors have (like revictimization, having family deny it happened, not being taken seriously by the legal system etc) and is proceeding on the basis that the likelihood of these things happening to me is very low. I know these are real problems I will need to figure out how to handle before telling people in my life.


this approach wasn’t helpful because I couldn’t access any emotions related to the memories I had.

I would absolutely have had the same experience as you without doing EMDR first. For me, the flood of memories, thoughts and emotions during EMDR was essential to being able to start doing CBT. Before starting the process the only information I could provide was the bare facts of what happened like in a police report, and I had no idea what I felt or thought during the experience itself. I'm not sure if that might be useful information for you in case EMDR is a possibility for you.
 
It is totally okay to draw boundaries with a therapist, or choose to stop seeing that therapist and find one who is better suited to your current needs. Our needs change over time. It's awesome that you've made some great progress with this person, but it sounds like they are not equipped to best help you at this point, regardless of how well-intentioned they are.

It's like with healthcare - you might have a trusted general practitioner who has helped you a lot in the past, but perhaps now you need a podiatrist, neurologist or cardiologist to best address your needs in the most effective and efficient manner, specifically tailored to the issue.

My advice would be to remember that at its core, this is a professional relationship, and you are the client. You are paying for professional services rendered. You can end the association by saying you appreciate their help, but you're declining to proceed or schedule further. Unless you want to, you don't have to explain why, or what your next steps are.

Side note - I do agree with you that child abuse is sadly quite common.
 
Has anyone been in this position before? How have you handled it? Have you encountered this problem with CBT being applied clumsily?
After 20-30 sessions of CBT successfully stopping my suicidal ideation, we settled into the last 2-3 meetings being about my therapist trying to convince me that I should accept that sex could be more casual and therefore less triggering.

As a male with CSA, I had become both hypersexual and hypervigilant and thus battling constantly with my need for sexual release and my need to run when I sensed danger. All my therapists have been female (I'm not sure that this is relevant) and insist that i have turned out to be a 'nice, kind, understanding guy' but they don't seem to understand the paradox that sex holds for survivors of abuse.

Quite often I feel that I'm being told to 'man-up' and one of my biggest traumas, even today, was my decision to remain celibate until marriage and my partner, finding this unacceptable even suggested I should 'play the field' and come back to her when I was ready to settle down. I told her that I had settled down — I didn't sleep around, as she suggested — married her and we've been married for 40+ years but I'm still traumatised by boundaries not being respected by my therapists and society in general (including my wife who still thinks that my sexual needs at 60+yo are because I'm 'sexually immature' with females) and suggesting that I'd be less traumatised if I had more sex partners — I can't win.

I terminated my sessions my psychologist and recently I have begun to feel that I should also terminate my psychiatric sessions because I'm hitting the same wall. I don't think that CSA is understood and think that therapists need to understand that we need 'trauma-informed' therapy (not just therapy).
 
I don't think that CSA is understood and think that therapists need to understand that we need 'trauma-informed' therapy (not just therapy).
You haven’t worked with a trauma therapist?

- General Therapy
- Trauma Informed Therapy (General or Disorder Specific)
- Trauma Therapists (All trauma & disorders/conditions resulting from -or exacerbated by- trauma)
- Trauma Therapists (Specializing in certain trauma types &/or a narrow range of disorders resulting from -or exacerbated by- trauma).
 
You haven’t worked with a trauma therapist?
Hi Friday, Considering your question, I'd have to say that while I respect my last two therapists, I feel that they were not nuanced — is 'tuned-in' a better phrase? — to trauma. My reasoning is that I sometimes would feel that I was being interrogated and felt triggered by the questions, as if I was being blamed for my distorted 'world-view'.

I have CPTSD and MDD and I acknowledge that it can't be easy treating someone like me with complex trauma but I don't like the feeling of being re-traumatised after a session. All I want is to feel better walking out of a session than I felt when I walked in.
 
My very trauma-informed therapist has triggered me in major ways sometimes! We think the difference is that she understands why when we explain that we are triggered, she is caring and sympathetic when this happens, and can use these events to understand the trauma and direct us to better outcomes.
 
Back
Top