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What Are Therapists Supposed To Do When Healing Ptsd In Your Opinion?

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Edina

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Therapy has been "successful" according to my therapist, and I am very happy with the therapy I have had, but once every second week isn't all that much, in some sense. I sort of need 24/7 therapy, it feels like at times, and I am not very functional between the sessions, though I am getting better.

My therapist has said I can talk about whatever I want, and so I have not really talked about what happened to me much. He doesn't know details. I have mostly talked about how I am doing. He is very smart, and sees instantly where I have what he calls "inefficient coping mechanisms" and explains them very well to me and it helps as general advices, and I see that they are general for my life, too, even if they are more prevalent because of the PTSD. He also points out when he sees changes in how I cope, for example when I started talking about the trauma as traumatic instead of laughing while talking about it... ("For the first time today, you had what I would call a more connected reaction to something extreme happening, instead of laughing while talking about it, you looked sad, so don't apologize for the tears, please, it makes more sense and is more how we are supposed to be when we are healthy than the laughter. ")

I like the therapy a lot, to be honest, and that is a bit of a surprise, given that I'm not the kind of person to like therapy normally, since I don't like to talk about things that make me feel weak. But since I can talk about "whatever" it helps a lot for me.

I do sometimes wonder if I "should" know more about PTSD or not, or if it is better to be oblivious and just heal? I don't know too much. I was diagnosed only after 4-5 months of therapy (but I already knew my diagnosis, of course). It felt nice that the therapist took his time to conclude, as it feels more real. His diagnosis was "PTSD. No loss of reality, but with severe dissosiative coping mechanisms". I don't totally know what this means, but it seems to be linked to the example above about how I don't have "normal" emotional reactions to trauma? (he says my emotional reactions are normal for traumatised people, but that they aren't "normal" reactions to trauma in the sense that I'm not showing appropriate emotions (I laugh at pain and smile while talking about extreme experiences, apparently). I hope that made sense, my English is bad today, I think.

So, I guess I like the general approach and the focus on "today" instead of "what happened". I also like that he is "general" instead of "trauma specific". And I like that he pulls information out of the things I say without there being a specific topic or plan to the therapy. What about you, how is therapy for you and what works and what doesn't work?
 
I do sometimes wonder if I "should" know more about PTSD or not, or if it is better to be oblivious and just heal?
Good question! I've asked myself the same too. I think do whats natural to you. If you want to read up, if you think it helps, then read up. Dont do it in a way that you feel you have to experience your problem the way they say in the books, or to tick off certain symptoms. I'm always a little bit embarrassed to admit to my therapist that I probably spend the guts of an hour a week reading about what I'm experiencing online.
 
Here's a challenge for you....

How successful is therapy given that you are non-functioning between sessions? Do you really think its a good thing that you're not getting into the trauma and processing it? It seems like he is good at getting you to work on the first stage of healing, ie becoming safe, learning coping mechanisms and such, but he won't be able to take you the rest of the way as he isn't someone you can process your trauma with.

Having said that, I am now looking for a non-trauma therapist. However, I have already processed my trauma and I'm in the third stage of healing which is ultimately getting my functional life back and rejoining society.

I've seen a number of posts in the last few days where people think they can avoid the processing bit and substitute other types of therapy for it. Unfortunately, it doesn't really work this way. I know its a fear of delving back into the trauma, but the thing is, therapy isn't supposed to be easy. We really do need to process the trauma. Processing allows us to stop the triggers before they begin, whereas all this coping mechanism stuff stops triggers after we've experienced them. Its the difference between getting off of the roller coaster altogether or merely having the highs and lows reduced. Which one would you choose?
 
He IS a trauma specialist, so maybe he'll change tactics when I get better?

Am I supposed to function better at this point you think? I have no idea what I "should" feel like. I got help quite late (after 8 months) and the initial threat is still there, so it's hard to get better for me. I don't use medication. Nobody suggested it.

As for processing, how necessary is it in your opinion (and why?) I don't know if I even want to do any processing... ? I want to forget and move on.

And happy new year! :-D
 
Maybe just come right out and ask him what the treatment plan is for you. I wonder of he is just focusing on stabilization for now and then move into processing.
 
Sorry, I was thrown off as you mentioned that he takes a general approach and focuses on today. This is an approach that some trauma therapists take. I think that this is a valid approach, however I still believe that (for most of us), we benefit the most by processing our trauma in one way or another as opposed to focusing solely on the here and now. Maybe you aren't ready to dive into the trauma yet? If not, then I can see why your therapist is taking this approach. I also think it would be a good idea to talk to him and see what the game plan is. The other thing that I'd like to mention is that many of us go through a number of different therapists and do a number of different types of therapy as no one modality seems to be enough to "fix" us. I know that I've personally tried quite a few different types of therapy, some mainstream, others not so mainstream, and they've all (well almost all!) have added to my healing. So maybe you need to explore different types of therapy as well? That is, if you've gotten all that you can out of one therapist.
 
Ahh! I get it, Solara! You are totally right! I need to go deep to heal. This is what I meant by needing 24/7 therapy to heal me, to have time to get to the core of the problem, and that takes a lot more time and focus than 1 hour a week, or like lately 1 hour every second week. It inevitable has taken ALL my time for a year, as my mind has wanted to push through faster.

I just realized I have done the deep therapy on myself a bit, by writing down everything that happened to me (anonymous blog), talking with random people online for hours to try and penetrate what happened to me, reading a lot about others in similar situations, and also by self-medicating (medication meant to get deeper into the consciousness (not addictive substances)) and after I got a bit better, by meditating, quitting cigarettes and then by slowly forcing myself to get out in fresh air, meet people once in a while and finding ways to relax my body.

My self-help program has gone from "stopping the immediate crisis internally" to "fixing mental patterns and understanding both the situation and me" to "balancing emotions and relaxing body".

For a year I don't think I have done much but trying to get through it, and I think I have gotten a lot better lately. But it surely isn't the therapy that helped, rather what I have done of crazier and not so crazy self-therapy. Maybe that is why the therapists says his therapy has helped - he sees results? Just they never really came because of his work directly. His work functions on a much more general realm, where I get a chance to see how I could function better in general.

Do others have therapists that they get that far with? I can't understand how one can get so far with an unknown person for just a few hours now and then? I don't even dare to admit everything to my therapist, out of fear he'll report me as unfit mother (suicidal thoughts for example, would never be mentioned to him, so I always told him I'm fine even back when I wasn't fine).

So, I guess I agree with you in the end: There is no way I could have healed if I had not gone deep/through the happening, but I don't see how a therapist can even do that without YEARS AND YEARS of work? I think I would even feel bad if I had to tell him everything and then say - only follow up on it all once a week - I'd not get through all my thoughts about the initial happening even in a year... And then to start processing it? No time.)

I started this thread thinking this isn't something a therapist can even do, as there is no time, and thus, for me (as the control freak I am), therapy seems to be something I do to myself, and the therapist becomes a person I can use to ask questions during that journey.
 
I wonder if part of the difficulty is your own expectations of what therapy is and isn't. My experience is that the work done in weekly therapy sessions really sets the framework for the work I need to do in between times. All my processing can't possibly happen in one hourly session per week - it's not my therapists job to "heal" me, I see it as her job to support me in my own process of healing, it sounds like you're doing lots of work on yourself, which is as it should be. It would be worth exploring how your therapist sees your treatment going, how they see themselves supporting you to process your trauma etc.

You also said that the threat was still present in your life, I imagine your therapist will want to help you function at the moment - it's a fairly challenging thing to try and process trauma when the threat is still current, when you're still living with it.
 
Thank you @Suzetig. I wish I was as eloquent. I find it so hard to put things in words, but you said it beautifully.

It has been challenging to heal while the threat was still present, but I am lucky, and it seems the threat is going away. :-)
 
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