What Do You Think About This Approach?

[Abby]

I have read a lot about trauma work. We just recently started to go into it in therapy. I start to talk about "memories" and my therapists cuts right in and puts a picture less frightening and less horrific in my mind. She does this in asking, what would you have needed? What would have been better?

Though I get the point in this, I´m slightly confused. I read about trauma therapy that you usually have to talk about all the details, without being interrupted, to actually BELIEVE what you are saying and make it more real. I don´t get to talk that much with this approach and I don´t get to talk details because my therapist interrupts me before and doesn't ask about details. She says I shouldn't go into it.

So I don´t really get "in the flow of things" from back then this way. With asking this she always gets me back into the moment and I don´t have a chance to really "go back" there in time. Don´t I have to? I'm not sure, don't I have to tell EVERYTHING to really believe it?

I have read you're not supposed to alter the past but integrate it and see it as it was.
With all your feelings in that time. Well I'm confused anyway about what happened back there and what I felt, and I don´t want reality get mixed up with a positive fantasy that just is not true.

Can you help? Do you know this approach?

 

[saffy]

Hi Abbey

I feel that the approach your therapist is working on is to do with safety and stabilizing.

There is an interesting article that another person on here has led me to in the discussion thread and I think it is going to be good for you to read it.

http://www.janinafisher.com/pdfs/stabilize.pdf

I hope this helps you. :)

best wishes
Saffy :)

 

[safenow]

I read about trauma therapy that you usually have to talk about all the details, without being interrupted, to actually BELIEVE what you are saying and make it more real.

I am not sure where you read that, but it is incorrect. It is much safer, and more healing for you to not go into the details, but rather to acknowledge it happened, then learn ways to overcome those triggers from the details.

When a person with PTSD rehashes every detail of each trauma, it tends to reinforce the negative. What you want to do is remove the negative and reinforce the positive. I wish I had your therapist when I was younger. I am sure I would have healed a lot faster.

don't I have to tell EVERYTHING to really believe it?

OH sugar. You might not know this, but you believe it already. It is real. You really did live it. Now is the time to heal from it. To conquer that nasty trauma and get on with life. To learn to be safe and happy. To have peace. Your therapist is helping you to do that. Keep up the good work.

 

[Abby]

I read it in "Trauma and Recovery" by Judith Herman, which is supposed to be very good and accurate. It says you have to do this to not just "talk" about it in a detached manner but really feel all the emotions attached to it. I also read it about therapy approaches.

Well, of course I KNOW it happened, but I don´t really feel like I believe it. I mean it doesn´t seem real and I read that´s perfectly normal.

 

[safenow]

you have to do this to not just "talk" about it in a detached manner but really feel all the emotions attached to it.

Trust me, there will come times when you will definitely "feel all the emotions", that is called a "flashback". Then, you will be grateful for how your therapist is teaching you a safe approach and ways you wish things had been rather than how they were. That will help more in the long run, than "feeling" them each time you talk about them.

Stay safe. You are very normal for what you've been through. And i don't even know all you have been through. But I know what I've been through, and what others have been through, and we all have times when we feel that way.

I can remember a time, when I didn't know that everything I was feeling was normal. I thought every child was brought up the way I was. I thought it was my fault, that perhaps I hadn't locked that bedroom window, since I didn't sleep in that room. I thought my father loved me but since he wasn't home, it wasn't his fault things happened. I thought a was just I "bad" child. I thought maybe I had somehow invited those horrible men to follow me home. I thought maybe those who told lies about me were telling the truth, since I couldn't remember a lot of things. I thought maybe I was crazy because I was so different than other people. It took me many years in therapy and many trips in and out of mental hospitals to put things in the proper perspective. I hope and pray it won't take you as many years as it did me.

 

[Hashi]

I think the approach sounds strange. What does your therapist call the type of therapy she does? Does she say she's a trauma therapist? Is she a psychotherapist?

I agree that it's good to ground and think about other things if you're destabilised. I also agree that you don't have to rehash every minute of every trauma. I do think, though, that there's a certain amount of talking and processing that's necessary at some point in order to heal.

Have you and your therapist talked about the goals you're working to? I'm wondering whether she has an aim that's more about managing symptoms, or even some sort of "reprogramming", and you have an aim that's more about processing and healing? Personally, I think there's healing beyond just managing symptoms. I know many people don't believe in complete recovery from symptoms, but I do.

I'm afraid I can't completely agree with what others have said. I'm an advocate of talking and processing enough to heal - that doesn't have to be every detail, but in my view it needs to be something. I think it's important to have a witness and it's important for processing. There was a thread about it a little while ago, here [DLMURL]https://www.ptsdforum.org/c/threads/what-does-processing-trauma-really-mean.27858/[/DLMURL]. I said what I think about it in that thread, so I won't repeat that here.

I would say, that "going back there in time" isn't how I see it. It's about talking about it as a past event while knowing you're safely in the present. Letting it be real has to be done with a lot of safety. The therapist interrupting, stopping you and asking you to think about something else isn't my idea of safety, though, unless you're overwhelmed at a particular point. It sounds like this is your therapist's overall approach, though, not a response to you becoming unstable.

I'd be interested to know how your therapist describes her approach.

It isn't some sort of neuro-linguistic programming (NLP) or something like that, is it?

 

[Abstract]

I have to say as I was reading it and way before I read what hashi said I was thinking, "NLP" (neuro linguistic programming). It certainly sounds like it. Do you know what her qualifications are Abby? I think it would be wise to check what approach or approaches she uses.

I don't know enough to say more about what one should and shouldnt do. I have read a fair amount but I can't say I truly understand how deep one needs to go in and how much of the material one needs to cover. I am still learning but I do absolutely think one has to process the emotions because essentially they are one of the main elements that have been incorrectly stored.

 

[piratelady]

I am in agreement with Hashi. I have had more than one therapist urge me to discuss my trauma in detail. "In Detail" did not mean going over every second of it, but not just glaze over either with "I was abused." I was told there were mutiple benefits to it:

1. By talking about it in detail, you are processing it. You feel the emotions, but with someone there (the therapist) to help you understand it and process it.
2. Talking about it and feeling it will help habituate you to it and help lessen the triggers.
3. The therapist is there to bear witness to what happened, you no longer have to carry the burden of what happened all on your own.

That being said, I have yet to get to the point where I can process my trauma as said above. Life and a lack of good coping techniques have stalled that. The important thing is for the therapist to ensure you are stable and have sufficient coping strategies to be able to soothe yourself, as symptoms tend to spike. Also, it is important that the therapist is competent so they don't cause more harm than good.

 

[piratelady]

Also, here is a link to a reply by anthony in another thread about the types of therapy for PTSD.

[DLMURL]https://www.ptsdforum.org/c/threads/free-online-treatment-for-ptsd-via-macquarie-university-in-australia.19044/#post-257895[/DLMURL]

 

[Hashi]

Just to comment on anthony's post that piratelady has linked to - I don't always see things the same way as the generally accepted view here. My personal experience is that I don't need prolonged exposure or stress innoculation therapy, in fact they aren't good for me. That isn't avoidance, I'm doing other types of therapy that use different approaches. However, many people do find them helpful. I think it depends on the individual.

Cognitive trauma therapy (talking about what happened in a safe and healing way, with a psychotherapist) I agree with for sure. Abby, it sounds like that's what you've been reading about in the books and it's what your therapist isn't giving you.

 

[Abby]

Well, thank you for all your answers.

I´m a little confused now, if what my therapist is doing is a good thing or a not good enough/strange thing :/

Yes, she is a psychotherapist and licensed and no she is not a trauma therapist but she says she has experience with other trauma patients.

Yes, well, I feel like I ought to talk more detailed about it, but I´m not sure if I can without bursting into tears :(

So maybe I should just ask her what kind of approach it is she is using?
What if it doesn´t have a name and it is simply her "own" approach?

I read something about "reframing" and feel like that is what she might be doing?!

Thank you again for your replies! :) It´s good to be able to talk about experienced people here :)

 

[Abstract]

Abby,

I am sorry this is upsetting for you. You may well find she has an explanation that works of course. I think it would be a good thing to discuss it directly with her even though I can very much understand how upsetting that idea is. It seems you felt uncomfortable with this before any responses even and therefore need to have your concerns put to rest. Its Ok too if you end up crying even though I understand how horrible it feels to do so.

One possible way would be to say that you thought that you had to feel the feelings from the past to process them. And is she doing NLP with you? Maybe you could also ask her to explain her approach to treating PTSD.

Personally I think asking her if it is NLP will make her need to explain her approach more and name it as if it is not then she will want to explain the difference.

If you are feeling brave then maybe you can ask her how many people she has treated for PTSD. I think that very quickly clears up exactly how much experience they have or have not got. If you feel you cannot do so in person then would you consider doing so via email?

Reframing tends to rather be about looking at something from a different perspective rather than looking at what one needed and imagining the past being different. I hope that makes sense. :O_o: