What Could Your Therapist Say That Would Help You?

[heidi]

I feel like the practice of therapy itself could work on focusing on tactics to get through the day while battling this. I feel like what is available right now isn't very helpful because they have no idea what it's like. i.e. safe spots, etc.

 

[lighteningdarkness]

I too have ongoing thoughts about taking my own life. My therapist knows this, she asks me straight and honestly about plans and risk management but has generally not spoken about it. Last session she did say 'think about how final it would be'. Most of this, of course, is linked to what I say to her and how I am managing it. She knows that I feel very shameful about this, so doesn't labour on about it - just cuts to deal with the fundemental reason I am ashamed and wanting to die.

One of the most helpful things she does is validate my feelings, underline the facts and correct my cognition. She'll say 'what was done to you was terrible', 'that shouldn't have happened', 'he was wrong' etc. It's stuff that I don't fundementally believe, so hearing someone I trust say it has a particularly strong impact.

Last week she also said that we will summarise all that I have achieved in such a short period of time. Wait to see if it helps.

When you speak about doing more 'distraction' this sounds like what I call grounding? Focusing on the moment, what's physically around you? I find that particularly good when the feeling to end it gets really strong - f*ck thinking about everything else, past / future, people, coping skills and just focus on the physical feeling of being alive, what's round you, colours, sensations. If you have a 'safe place' (real or imaginary) this is also a great part of a safety plan.

I know what you mean about ACTUALLY feeling something was / is good as opposed to vaguely thinking it, or trying to make yourself believe it. i get this too, you know ' I used to really enjoy this therefore I must be now'....I think that the ability to experience pleasure is affected by the PTSD / depression,

 

[maddog]

I've been thinking a lot about this thread, trying to figure out exactly what it is that means most to me about my interactions with my T and why they are so positive in my life.

I agree that validation of my thoughts, feelings and experiences is a huge factor. It matters, a lot, to hear him tell me that given all that's happened, it's perfectly understandable that I should think/feel/behave the way I am etc. He often says that things really couldn't be any other way, confirms that my current reality is perfectly normal given my past and focuses on the parts of my reality that offer the greatest potential for my future and improvement.

But you know, it isn't anything that he *says* that helps me most. Beyond a certain point, I find that words are just that, and particularly when they reflect sentiments that I find it impossible to believe, such as those addressing my self worth etc, I find that the words just miss me altogether and can sometimes just distress me more. What matters is that he actually demonstrates and models the sentiments those words contain, and reflects them in his behaviour towards me.

A classic example is his constant reasurances to me that no matter what I tell him or how I behave, he will never judge me or treat me any differently or with anything other than respect. He can say such things to me a hundred times and yet when it matters I can't find belief in them. But to have seen him demonstrate that lack of judgment and unconditional acceptance of me time and time again, in spite of the countless horrific things I have said and the appallingly messy ways in which I have fallen apart in his presence, really, really impacts on me. It is perhaps the most validating experience I have had in my entire life, and actions, as they say, speak so much louder than words.

I guess I say all that to say that in some ways, it's what my T does, rather than what he says, that helps me the most.

Maddog