Therapy And Technique For Exposure

[bluedressinggown]

I don't know if this is exposure therapy or not, but just wanted to write about it. I haven't been able to speak about the thing that happened to me, because I start crying. I know in my head that its not even a big deal-but i cant talk about it. Its wierd. Even when it happened I thought it was fairly amusing and dont remember being distressed at all. I just took it in my stride- I feel like it only started to effect me when it had knock on effects in my life- ie stopping me from working etc.

Anyway the therapist really has nothing much to go off-because I refuse to talk on the whole. Anyway, he asked me to speak in the present tense and talk to myself going throught the whole event from start to finish- and end where I get to a place of 'safety'. I have to do this each day- and if I get distressed at any point I have to stop and go to my safe place which is meant to be a desert Island, although I might change it because I imagine Tsunami's in my desert island so it doesn't really work. Anyway. I've done it for 2 days. I talk really slowly, and get to right before the 'event' then cannot speak. I just stare into space. But I'm not upset. Or distressed. I just go blank. I'm wondering should I push myself to go futher? Is it normal that I'm not upset when I talk to myself?

 

[Seasounds]

Exposure therapy takes different forms, and it sounds like you are doing a form of it. I like that you are in charge.
My thoughts and opinions:

• It sounds like you are being overly traumatized by your current exercise-not being able to speak and staring into space. I've never benefited from pushing out a memory when I would be frozen afterwards. You can slow down even more.
• Working with trauma is always a balancing act, of balancing safety, ability to reveal parts of the memory, and being able to function well (enough), being able to easily stay associated to the present, afterwards.
• Getting practice in 'grounding and self care' techniques may be very helpful, and exploring Mindfulness may help. You'll be able to sense when you are too overwhelmed, and then stop the memory recall, for a while, as you weave in safety with the grounding and Mindfulness activities. Relating to your body's cues, with soothing actions, is key.
• Practicing breathing, humming, laughing, all get your respiratory tract working quickly. Singing a happy song and physically moving, after you share or write, is a great way to mobilize your breathing and shift your focus, to help you associate.
• Can you take the pressure off, for a while, and just work on safety with your therapist; letting the therapist get to know you, and you get to know the therapist? Making a plan where the therapist helps you be aware of your 'overwhelm cues' so the therapist can help you 'regulate' your experience?
• Safe relationships, in this forum, in person, and in groups, in therapy, are key to getting through trauma. Safe relationships provide the safety to live through, and after, the telling of trauma-where most of us were directly or indirectly told we would be punished or be killed, if we told others. Yet telling others breaks the curse of trauma.

Hope this helps, hope you get much support from this forum. You are doing good work.

 

[Lucycat]

and if I get distressed at any point I have to stop and go to my safe place which is meant to be a desert Island, although I might change it because I imagine Tsunami's in my desert island so it doesn't really work. Anyway. I've done it for 2 days

If your 'place of safety' isn't safe then it is serving no purpose. I think you need to go back to basics. Find a place of safety that really works for you before you push yourself any further. No wonder you go blank. This sounds like a dangerous strategy at present.

 

[bluedressinggown]

My therapist was asking me to think of a safe place- gave me a few examples, I just couldn't think of anything. SO really I just picked a desert Island because it was something he suggested. I have no experience of desert islands. So it's hard to imagine. But as I said- it gets inflitrated by bad things. Like I imagine the small dinosaurs from Jurassic Park chasing me. That's what I'm like in day to day too- the slightest noise- I imagine apocolypse. The boiler makes a sound- I think it is going to blow up. Etc etc. So I have imagined a wood- with birds, and a stream, and dappled light and wild flowers. That seems to work better- and nothing has come along to ruin it yet. But I'm only on day 2.

The thing about my situation is that I am getting therapy paid for on an insurance claim. I've been able to get it relatively quickly because of this. However, I only have 12 sessions allocated. I don't think I'm allowed any more. So I feel like there is a time limit to this. I have been on the waiting list with my GP for months, and an appointment has finally come through for free therapy starting next week. By then I will have had 7 sessions privately. Both parties know about this. They have said that when the free therapy comes through, go to one session and then decide which you prefer. Free therapy have allocated me 16 sessions. I am getting on well with the private therapist, so would like to stick with him. But if I do that, I can't see 2 different therapists, so I will have to turn down the free therapy. What if the private therapy doesn't work? I only have 5 sessions left. I haven't even spoken properly about trauma. And then I get to the 12th session and there is still unresolved issues, but by then, I will have to go back on a long waiting list for free therapy. So I need to get better quickly. But Iknow rushing it is bad. I really don't know what to do. I wish I hadn't taken up the free therapy, but if I hadn't I would have been dealing with this on my own for weeks while I waited on the list. Sorry- I feel really indulgent to have 2 therapists. I would rather not have the choice because it is stressing me out a lot. I'm sorry for those who don't get any therapy at all.

Is it a really dangerous strategy? Like isn't the point to make you anxious- so that you are exposed, and then anxiety levels drop eventually? I don't feel like I get anxious at all. I just can't recall anything. I know those thoughts are there- because they tend to pop back into my head later on and they go round and round and round in my head, generally before I go to sleep.

 

[Lucycat]

Is it a really dangerous strategy? Like isn't the point to make you anxious- so that you are exposed, and then anxiety levels drop eventually?

Yes, but your place of safety is what is supposed to reduce your anxiety. Exposure - then safety. If you are not feeling anxious then I would suggest you are not getting exposure. Not dangerous at all - just not effective either.

When I first started therapy I was overwhelmed with distress. I always had to retreat to my safe haven in my head. We looked at my trauma for literally just a few seconds at a time. Just what was bearable and then practiced safety.

I cannot decide from your posts whether you are being pushed too far and dissociating, or simply not being pushed far enough to actually access your traumatic memories.

 

[bluedressinggown]

In therapy- I get very distressed. For talking about less than I have tried on my own. I don't know maybe it is because thereapist asks the questions and it's harder to avoid them? I'm not sure. Doing this talking to myself thing- I just physically seem unable to progress to the next point. I can't verbalise it. I can think it later on, but at that moment I have a blank. I'm wondering if I'm just in denial- avoiding the subject maybe. It's just that I have until Thursday- so I don't know if I should force myself- or if that is even possible? Or if I should do what I can and leave it at that. I get worried I'm being lazy.

 

[Jane.l]

I am doing this at the moment I think it's called 'gradual exposure' and I have the same problem with 'safe' places in that whatever,where ever I try and imagine it gets sabotaged - so I don't even try with that at the moment and like you I dissociate madly from -in my case a flashback - that I am exposing my brain to.

Sorry can't help much today - having a crap day but just wanted to say - you are not the only one feeling this way .

 

[Hashi]

It sounds like dissociation - zoning out/numbing. Which is what happens when we don't feel safe. Being with your therapist is probably keeping you in the present more because you're interacting. If so, then that's why there's more distress with your therapist. You're dissociating less and feeling more.

In my view safety is the most important part of trauma work. Otherwise it's either ineffective or it's overwhelming - sometimes both at the same time. You can't skip the safety part.

When you talk about therapy on the insurance claim and free therapy, are they the same type of therapy? For example are they exposure therapy, CBT, some other therapy?

 

[Deleted member 1860]

My processing was similar in that I had to go through the whole process and end up safe, with a few differences. I had to start in a real "happy" memory from my past, work through the trauma, and then end up in a "happy" moment (which was also safe), from post-trauma. This reinforced the idea that I was happy before so I could be happy again, because my happy/safe after memory was actually real, not some made up place in my mind. I think it helped me to have my "safe" place more firmly grounded to reality than a theoretical island in the middle of the ocean. (This happens to be my other happy place, and I live there with my pet cheetah named "anxiety"----I have no idea where this came from, lol, as I spoke about it while in a dissociative state of sorts during therapy.)

 

[bluedressinggown]

ok. thanks for your help- interesting to get your input, especially about why I get distressed in the therapy and why I don't at home. I've discovered that I do dissociate although I didn't realise the extent or what was what so maybe that is what it is.

Both therapists I have been offered are trauma specialists apparently. One is just called a CBT therapist and the others title is High Intensity Therapist. The one I'm with now privately is CBT and the other Is the free one. Although I've been told they both specialise in trauma cbt.

 

[bluedressinggown]

Hi- Just thought I would consult you guys again. I wrote a list of a few of my concentration problems last week and read them out to therapist. He says it all sounds like dissociation. Wanted me to do a questionannire but didnt have one with him so I guess I will do that when I see him next. More and more I believe that he is right in thinking this. I just want to ask you guys for help though with the task at hand. I couldnt talk about the trauma last week. I explained to him that I dont get distressed at home, I just stop speaking. He asked me if I would talk about it now- but i refused and got upset. So he has set me the same task again- and its my target to start at the beginning of the session next week then tell him all of it.

The thing is this week I still cannot talk to myself about it. I can only get so far. I don't get distressed- I just stop talking- im wondering if I lose interest? Surely if I lose interest though- then I should notice pTSD symptoms going? I should be able to talk to him about it if I lose interest myself? Or is it dissociation? I dont always daydream sometimes I just think about something else. OR avoidance? Im just getting super stressed that I have to talk about it on Friday and I do not seem to be able todo it. Note that this PTSD isnt from anything really disturbing just an accident but I seem to have blown it all out of proportion. Its driving me mad.

 

[Jane.l]

Sounds like you are dissociating and your brain is shutting things down to protect you - I have this a lot ! It is frustrating - you could try writing it down sometimes I can do that - takes forever though because I keep zoning out - still might be worth a go .