Therapy: Healing Vs Tools

[StellaBlue]

Like the some of the others who have posted in this thread, I needed to learn a lot of skills before I could actually start working specifically with my trauma(s). However, I don't think it's an either/or. I found that by learning distress tolerance/self-soothing, grounding and emotional regulation skills, I was actually "healing" - slowly, subtly, but healing none-the-less. For example, my desire to resort to "maladaptive coping mechanisms" was greatly reduced when I was able to access these new skills and use them effectively. This, in turn, helped reduce the constant shame and anxiety, allowing me to feel more compassionate towards myself (and the world around me)...which feels very healing.

I guess my question too, would be, what does "healing" mean to you? For me, it's being able to be in my body, to have periods of time without intense shame and suicide ideation, to actually be able to stay in the moment and enjoy it.

For now, I've lost a lot of the need to muck around in the trauma memories and am, instead, focusing on somatic work, which has been very healing as well. Like @Suzetig, I am getting caught out by triggers less frequently - and I'm also recognizing when I am triggered, what that physically feels like, naming it, and figuring out how to work with it. I'm also learning how to take care of myself emotionally - recognizing when things are getting shaky (stress cup is getting full) - and taking preemptive action. But I wouldn't have been able to do this work now if I hadn't first learned a lot of the "tools" I have at my disposal.

 

[Missycat]

its not second nature to me yet but i am better at dealing with flashbacks, nightmares and triggers and recognise more when i need to look after myself. Whilst the tools were designed to support me through dealing with the trauma they have helped with other aspects too ie ocd, anger, anxiety and poor sleep. Im not there yet but am going in the right direction.
I hope you are able to heal too.

 

[watundah]

Thanks. Sometimes it's difficult for me to understand how all of the pieces work together in order to plod forward. Your responses have been helpful.

 

[Abstract]

I have so many conflicting feelings about this stuff and don't know if even the question will ever seem straight forward for me. I know that CBT early on did way more harm than good for me and its all I had T wise for a long time. I also know that learning mindfulness and radical acceptance was life changing and saving. I know that the biggest changes for me still came from talk therapies. They gave me space to see myself. And allow the denial to shift just a little.

Looking back I am at last starting to make sense of it and what happened. I was in almost complete denial and avoidance. As a result and a result of not seeing trauma specialising therapists I wasn't diagnosed for a very very long time despite receiving lots of therapy. I didn't get the skills training I really needed. Like grounding. The focus was on cognitive distortions and the like. The relational aspects of CBT skills training rather than the trauma specific skills training. Oh my goodness - if someone had just recognised and treated my dissociation.

I'm not saying I don't do cognitive distortions. I do. I'm just saying that a/ I was way to fragile to cope with that approach back then and unable to show it and b/ I have way more pressing relational stuff to deal with.

I needed to be connected to myself, my feelings and other people. Still a constant struggle. CBT distanced me from almost all. I'm glad I know the concepts now but self taught DBT has been a million times better for me.

In a perfect world I now think: I would be diagnosed early and taught grounding, mindfulness and radical acceptance. Had someone work with me on trust and self awareness (I believe this is the type of t you are talking about). Been given DBT to teach myself. Treated unhelpful coping such as eating disorders and addictions. Then trauma and exposure therapy as well as ongoing attachment/trust work.

I'm waffling terribly but what I'm trying to say is that I think there are many types of skill training and that I think a lot of what suits is down to personality, timing and the skill of the t. I don't believe it is ever wise to do trauma work without first having trauma coping skills and being in enough control of potentially dangerous coping (self harm, addictions etc). I totally hear you when it comes to the healing of the more subtle forms of t. That's one of the main things T needs to be for me. Hope that makes a teeny bit of sense.

 

[Friday]

My understanding is :

Tools allow one to deal with the symptoms they already have and are f*cking up their life.
Trauma work goes after what's causing the symptoms to begin with.

If trauma work were fast, it might make sense to just do that, first.

Since it's not fast, it makes sense to learn to be able to deal with symptoms that can kill you, first. Since it's not only not fast, but also makes symptoms worse for awhile, it would be extremely negligent to make someone's life worse, with absolutely no foundation in how to withstand that or deal with things as they come up.

 

[Abstract]

I agree totally but would add that for some of us building/tolerating enough trust and connection to the T is the hurdle that stops us being able to do all of the above. Or it is what slows it down and makes treatment more complex. It also somehow seems to process aspects of trauma.

Its why I still can't get back into therapy. I walk through the door and my trauma symptoms go crazy. There is an additional dimension on top of skills and exposure therapy that for some is very relevant for trauma. One that often has to be managed at the same time.

 

[Dana1010]

If someone is stable enough that they're not going to harm themselves or kill themselves, then skill building can indeed wait.

I strongly agree with this. Beware the therapist who is all too happy to tell you session after useless session that you need to stabilize before you can process. Some of them are just dragging their feet because they'd rather not hear about the hard stuff, or they wouldn't know what to do with it if you told them. You don't want to get suckered by one of these twits only to find you've been sitting in "therapy" for months for nothing.

I had a therpist who was fond of telling me diving in to trauma without coping skills would hurt me more than help me. Well and good, but she gave me basically nothing in the way of coping, except telling me to mentally take my trauma and put it in a "container." All you have to do with trauma is put it in a "container?!" Why didn't I think of that?!

Maybe I'm in the minority here, but I've only ever found the "hard" sessions to be cleansing and liberating. We're talking about an hour a week here, after all.

The need for coping tools vs. processing needs to be assessed directly alongside how stable you already are. If you're relatively stable, and they continue to stress how you need stabilizing before you can talk about trauma, you might be dealing with a lazy or incompetent therapist who just wants to make things easy for themselves.

 

[StellaBlue]

or they wouldn't know what to do with it if you told them.

Indeed. I had a therapist who claimed to specialize in trauma. When she finally agreed that I was stable enough, she told me she had borrowed a book on treating trauma from another therapist (it was Edna Foa's Prolonged Exposure for PTSD - and this was after I told her I wouldn't do exposure therapy again). I guess she thought our "bond" was tight enough that I would agree to be her crash test dummy.

 

[Abstract]

Normally certain types of skill building is the priority when the person is harming themselves, is at risk of killing themselves or may even be at risk of harming others if they don;t have enough control over their symptoms and selves. One of these isn't that uncommon in PTSD. As for those t's just avoiding talking about trauma - in my experience that was almost all the t's I had who didn't specialise in this area. Lots of harm from that. What almost finished me off though was the one who started digging around without any knowledge and without equipping me with anything relevant..

That's truly horrendous about your therapist!!

 

[mamachick]

Albatract-had a marraige counselor with PhD that didnt know anything about ptsd or trauma, or couples either. I spoke of something very sensative, and he compared it with his wife being disappointed that his 40 yr old son had not been attending the catholic church anymore. DUh HUh He was nice but had no skills and it was so pathetic. Does more damage than anything.

 

[mamachick]

He even condoned my husband pushing me down the steps, saying many loose temper some times. OK the, I wont complain anymore now that I know its normal for your clients. I didnt go back after that.

 

[quadratus]

In the last few weeks, I hear many people referencing therapy as a place to learn new tools for managi...

It probably does seem backwards. We do feel the memories are the biggy, and if we can just change the past our troubles will be over. Unfortunately is it not that easy. Fortunately there is a soln. Living it today changes the way we react to a memory of past event. For me, I've found the problem is in the body, and "my mind creates a crises to match how i feel inside". A past event is perfect. I feel trapped, and a past event is a trap.