What does your therapist do if/when you’re unable to speak?

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Rosebud

MyPTSD Pro
I came back to add @ButterflyBean , that all growth or healing is worth it.

But I agree here with what someone said about it's not wise to use a sledgehammer (kind of defeats the purpose?), and I personally have had the throat-closing/ loss of voice experience frequently (especially when afraid, and I suppose I just realized, sometimes triggered).

I do think I understand healing is more than any detail.* I have been told I don't have to say everything.

I also learned over 99% of how we think/ feel/ react comes from what is held subconsciously (it would overwhelm our conscious brain with sheer detail if not otherwise), and as a child we have Theta brain waves predominantly taking in the info and forming those memories, and we don't access them as easily as an adult if not relaxed. So I wouldn't worry about it, work on safety and trust maybe instead.

Hugs to you. :hug:

( * ETA, Maybe more so, what does the detail infer, determine or represent? What do those words mean about your thoughts about you, others, life, the present and future; your core beliefs? And similarly, what meaning does not saying those words have to you? How does not saying them, or not being able to say them, make you feel?)
 
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barefoot

Sponsor
@ButterflyBean - sorry, I misread/misunderstood your OP. For some reason, I thought you meant that your physical limitations with your hands meant that you weren’t able to write there and then in session...which I took to mean that it might be possible for you to write a few bits down in your own time/space in advance of the session. Apologies!

Are you able to produce something similar on a computer?

Am curious to know...are you able to say the words yourself, when you’re on your own and not dysregulated/triggered?

Rather unhelpfully, I can’t really think of many things that my T has specifically said/done - probably because I’m dysregulated at the time! ;-)

Sometimes she asks if I’m ok. Or how I’m doing. Or if I’m struggling. Other times she’ll say that I seem to be struggling (I have some visible, physical cues that things are going pear-shaped, which I find quite annoying that I can’t conceal it but I guess it’s good information for her to see and pick up on!)

She’s sometimes asked if I want to stand up/move. Or if I want to step outside or get some air. A couple of tasks, she’s asked me if I want to go home. I think those sorts of things are her making it explicit that I have a choice - that I’m not trapped in the room, that I can leave if I want to and that’s ok.

She sometimes suggests we pause and then she’ll talk about something else. She’ll generally then ask me about my cats! I still won’t necessarily be able to actually answer her if I’m in the middle of a full-on voice hijack, but it does tend to let things settle a bit. And I might then finally be able to nod or say ‘mm’ or something.

She has also sometimes says reassuring things...just simple things that it’s ok, that things will come when they come, we don’t have to rush etc.

So, no earth shattering solutions! But she manages to be compassionate and reassuring with her presence. She knows how frustrating and distressing I find it when I can’t speak. And, in the moment, it does feel that she’s with me somehow in it. Even though I don’t think there’s really anything either of us can do about it in the moment when it happens.

Anyway...no, you’re definitely not alone with this. It’s hard to deal with.

If it helps at all, my T did say fairly recently that, since we got rid of dissociation, it is very possible that there will come a time when I won’t ‘lose my voice.’ I know you’re not affected by dissociation, but all these things are defences. I think there is hope for us in beating whichever ones we rely on the most :-)
 
@ButterflyBean - sorry, I misread/misunderstood your OP. For some reason, I thought you meant that your physical limitations with your hands meant that you weren’t able to write there and then in session...which I took to mean that it might be possible for you to write a few bits down in your own time/space in advance of the session. Apologies!

Are you able to produce something similar on a computer
@barefoot - no apologies necessary! I’m not very good at explaining my physical limitations in writing especially in a public forum. I’m happy to clarify and appreciate you working through this very difficult experience with me!

As such, brainstorming on a computer sounds like a great idea on the surface. However, I use voice-to-text, which is not always accurate, and editing takes energy/is time consuming. All great ideas and suggestions though. If it weren’t for the time and energy thing, I even thought about doing some journaling/stream of consciousness writing, which brings me to your next question:
Am curious to know...are you able to say the words yourself, when you’re on your own and not dysregulated/triggered?
Not exactly...I can’t say the words that the person said to me out loud, but I can hear them repeatedly in my head by the person who said them. I can then say them silently to myself, which only solidifies the inappropriateness and magnifies the frustration/anger that I can’t speak them out loud to my T...
Other times she’ll say that I seem to be struggling (I have some visible, physical cues that things are going pear-shaped...

A couple of times, she’s asked me if I want to go home. I think those sorts of things are her making it explicit that I have a choice - that I’m not trapped in the room, that I can leave if I want to and that’s ok.
What are the visible cues/what does your T notice if you don’t mind me asking? I find this interesting to read/think about especially since I’ve been feeling trapped in my body and the therapy process lately… I know I obviously can’t change my physical limitations, but I think continuing the discussion about their effects on the therapy process, and the amount of pressure I feel from such a process, is worth more attention...

Last but not least, this:
She has also sometimes says reassuring things...just simple things that it’s ok, that things will come when they come, we don’t have to rush etc.

If it helps at all, my T did say fairly recently that, since we got rid of dissociation, it is very possible that there will come a time when I won’t ‘lose my voice.’ I know you’re not affected by dissociation, but all these things are defenses.
I’m curious, is there a specific phrase that you find most reassuring? Is she in tune with when you need reassurance, or can you ask for it? I’ve had a running list for some time now, which my T has seen, but I’m afraid to ask for help and reassurance most of the time. I also think that losing my voice is a positive sign in that I (younger self) am getting in touch with intense feelings. However, I think I may be fighting too hard to stay present because dissociation honestly scares the hell out of me; therefore, I’m not able to express myself because I’m too focused on not disassociating. Does that make sense?

Anyway, thank you again for your willingness to continue processing this with me! Feeling less alone, and having a place to talk about the hard stuff, really does make a difference! I think what I really want right now is to feel less trapped and for things to be less chaotic and complicated! I feel like I’ve been living by the three C’s lately: crisis, chaos, and complications everywhere I turn! I really do appreciate you and your support! :-)
 
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TruthSeeker

MyPTSD Pro
Hi again,

I honestly don’t post much, so it’s unusual for me to make two separate threads in a matter of days; however, the most bothersome issue that I’m facing in therapy is literally tearing at my insides. I’m experiencing tons of intense, internal conflict, and I’m not sure what to do. I can text or email my T between sessions if necessary, but I don’t do that often, and doing so causes more internal conflict in itself.

Anyway, I posted about my inability to discuss a particular detail of a recent, traumatic incident with my T in a previous thread, which can be found here: How do I express myself to my T? The post talks about finding different ways to express myself other than writing in session and/or via email in between. However, my follow-up questions are: Does your T do anything specific when you find yourself unable to speak? Does he or she notice your difficulty and point it out? How does he or she help you become unstuck aside from changing the subject?

I really want to be able to say a certain detail out loud! I’m really trying to think of ways around the “stuckness and fear“ without engaging in physical activities. I know that I’ll feel better once the info is out in the open, and I can begin processing the associated emotions. I’ve encountered situations where my little one hasn’t had the words to express herself; only now, the words were said to me, I know what they are, and can repeat them in my head, but I can’t say them out loud even though I want to so badly.

Any experiences with, or about, what your T actually does in session to help you in feel safe enough to are extremely, and gratefully, appreciated!

@ButterflyBean I draw things I have trouble saying. I hand the drawing to my T. She looks it over, and asks yes no questions. From there, the conversation improves....she eventually gets the point. My T often lets the "silence" sit a while, and she often waits. So, drawing, art, photography, and writing things on paper have helped. She thought it a good idea for me to go to adjunct art therapy-so I start this week. Just ideas.
 

TruthSeeker

MyPTSD Pro
@ButterflyBean I draw things I have trouble saying. I hand the drawing to my T. She looks it over, and asks yes no questions. From there, the conversation improves....she eventually gets the point. My T often lets the "silence" sit a while, and she often waits. So, drawing, art, photography, and writing things on paper have helped. She thought it a good idea for me to go to adjunct art therapy-so I start this week. Just ideas.

I'm sorry, I missed the part about your hands. Can you tear paper and glue? You can make collages, things in picture form, or make collages on the computer to explain difficult feelings and memories. You can text-speech poetry-doesn't have to rhyme. I just think of a theme and write poetry. I send her all kinds of writing before I see her via email when it comes to me...
 

susannahsays

Confident
Last time I had trouble speaking, the therapist was rather unhelpful. She asked me why I had come if I wasn't going to say anything.
 

barefoot

Sponsor
What are the visible cues/what does your T notice if you don’t mind me asking?

Apparently, when I’m struggling (and therefore getting spacey, freezing or losing my voice is more likely) I move around a lot. So, I stay sitting down but move the top half of my body around a lot eg sitting forward then sitting back and I tap my feet a lot. Then I go completely still (I guess when I freeze)

I also get a red rash over my chest and throat.

And I have an anxiety re my throat, which means that, when I’m stressed/struggling I sometimes clear my throat/cough compulsively.

So...yeah...there are definitely some noticeable signs - we’ve worked together for 5 years so she can now spot the signs quickly.

I’m curious, is there a specific phrase that you find most reassuring?

Not really. For me, it’s not really about what she’s actually saying. I guess it’s more that she feels calm/with me/supportive energetically with her presence.

I suppose I quite like it when she reflects back that I’m struggling/feeling frustrated because then I know that she knows that something’s going on internally and that I’m not just choosing not to speak. She knows there is something I want to express and I’m trying...I just physically can’t get my voice to work.


s she in tune with when you need reassurance, or can you ask for it?

I never ask for it. It doesn’t ever cross my mind to ask. And, as I just mentioned, it’s not really about what she says...it’s more that I find it reassuring that she stays with me in the struggle and that she doesn’t judge or criticise.

I also think that losing my voice is a positive sign in that I (younger self) am getting in touch with intense feelings

Yes, I guess so. Although if you’re losing your voice because you’re really triggered (as happened to me a couple of months ago) maybe that’s a sign that you’re outside your window of tolerance and need to regulate?

However, I think I may be fighting too hard to stay present because dissociation honestly scares the hell out of me

Oh, I misunderstood again! I thought your earlier post meant you don’t experience dissociation? But you mean you do but you focus hard on staying present so you don’t dissociate? If you’re able to fight it and stay present, that’s great!

I remember when I pretty much stopped dissociating, my T warned me that my mind might create a new defence to go in its place. Maybe that’s voice hijacking. This getting rid of defences lark is like playing whack-a-mole! You finally manage to get rid of one and then another one pops up when you’re not expecting it to!
 

flowerapple

Confident
My first T would ask me where I was, or what I was thinking about. And then try to bring me back to where I am, just making me point out things in her office, so I would be present. She once suggested eye contact, but I told her I hated it and it made me really uncomfortable, but maybe it might help you. She would also always remind me to sit up, and have straighten my back, so that Im not slouching, and put my feet firmly on the floor together. Sometimes she would have me do the body muscle thing, where you start from the toes and work your way up.

When it's something to say that I'm having difficulty saying, she always reminds me that she has heard many things and that she won't judge me for what I say. My current T also says this, plus she also reminds me that she will be able to handle it because as a T she has been trained in hearing these things, and she practices self-care so she will be able to handle it, even on the off chance that it does shock her, but it has nothing to do with me, and has everything to do with the person who did it.

They both would always let me know that if I don't even tell them what it is that is so bothersome to me, and afraid that they might judge, then they won't even be able to decide for themselves. By not telling her because I'm afraid of what she thinks, it's almost like I'm assuming what she is thinking, and then she says that "to assume is to make an ass out of u and me" which then makes me laugh and lightens the tension a bit.

She says I have to tell her in order for her to even make a judgement. She tends to tell me this if I tell her my judgment for what it is, like it's stupid, or wrong, or embarrassing, or disgusting. She says that she won't be able to decide if that is the case if she doesn't even know what it is.

They both also tell me to stop overthinking it, which I think is the most helpful thing for me. I tend to get really silent, and if I say anything, it tends to be a bunch of "umm", or "ugh". So they would tell me to just say whatever it is in my head, just as it is. They say don't try to fix the wording, so it sounds better, or to spare her because I shouldn't be concerned about her feelings because this time is about my feelings, and she is equipped and able to deal troubling things, and that this time is about me being able to do the same. She says if it's all jumbled in my head, then I should say the jumble, and after that we can deal with putting it together and making sense of it.

The hardest part is the moment just before you start saying it. Once you finally start, it slowly gets better, not easier, but better, in that once you say start saying it, and I start to feel the weight lifting off of me and when I notice that she isn't having any bad reaction, that helps too. Sometimes too, I might look at the floor while I say it, or ask her to turn around, or email her while I'm in the session then she checks it right there, stuff like that. Once I get the words out, I end up feeling a relief that I was able to make a step. And, you know once you say it, then it's out there, and you can't take it back, and you're able to deal with it, and at the same time, you know it will never leave that room, so while it's out there, it's safe, and that's comforting for me to think about.

Hope this answered you're question. I feel like I rambled on and on. Good luck.
 

mylunareclipse

MyPTSD Pro
This happened to me today in a more severe form for the first time with this therapist. Usually, I just cannot talk and that's it. But today couldn't talk, couldn't move, couldn't see, couldn't do anything. Not sure how much time passed, maybe 15-20 min? He didn't do anything I think. He just sat there and I kept going deeper and deeper. Until finally he said: can I help you, and I flinched with fear and slightly started coming back. Not sure what I wanted/needed him to do. I feel so alone in these episodes.
 

katz

MyPTSD Pro
@Skywatcher - what does your T do to help ground/bring you back when you dissociate especially when you’re experiencing difficult feelings? Does she say or do anything that you find particularly helpful and/or reassuring? I’m looking for new things to try when I feel unsafe in session hoping that can I speak when I feel safer... Self soothing is still too uncomfortable/hard even after several years; my T and I have a solid working relationship, but trust is still extremely difficult because I keep getting re-traumatized by other healthcare professionals.

I learned to just look around the room and to assure myself that this is where I am now and that "it was all in the past". "They can't hurt you again -no one can".

It may take a few minutes to convince myself and I may even get up and walk around or use the bathroom. But, it gets me thru it. Sometimes I can even look inside me and try to figure out what it is that triggered me. When I figure it out, (color of the chair, sound of the clock) then I can tell myself what it is and "poof" the scared part is gone- and usually doesn't return. Whew!
 
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