Research What makes a good trauma service?

[RK176]

I do 90 minute emdr sessions with my VA T and my regular t and I have added 90 minutes sessions recently. I agree with the others - 50 minutes simply aren't enough. It takes me so long to calm down that by the time I'm able to talk the session is over.

I would love to be able to do 2 hour session - -though it would be exhausting.

Yes, I work quite intently with clients but obviously within the clients capabilities and safety zone, most clients are exhausted by the end of our sessions so I do wonder whether the personality and modality of the therapist influences it at all. I may try out some 90 minute sessions in my private practice and see how it goes.

 

[grit]

I agree the typical 50 min weekly to deal with (in my case) cptds is problem but I also see it depends on the person and the life experience of that person.
For me what worked the best... In conjuction with dyad is group therapy that focuses on empathic communication. In other words, the focus is to speak from subjective stance without projection since most childhood truama are hurt in the arena of projection of a trusted person gone awry.

I find a strict group therapy about boundaries and commitment creates a very powerful connection with others and the group leader... I find real live experience or trauma shared this way and being empathically held live melted a lot of primitive defenses and shame.

I feel group therapy is not popular but I also know truama is always conducted in isolation or secrecy... So to be seen and validated by others live was for me a life change experience.

If I was a therapist, I would ask the person what would work for them to recover all time, energy and financially and go from there.

My two cents

 

[RK176]

I agree the typical 50 min weekly to deal with (in my case) cptds is problem but I also see it depends on the person and the life experience of that person.
For me what worked the best... In conjuction with dyad is group therapy that focuses on empathic communication. In other words, the focus is to speak from subjective stance without projection since most childhood truama are hurt in the arena of projection of a trusted person gone awry.

I find a strict group therapy about boundaries and commitment creates a very powerful connection with others and the group leader... I find real live experience or trauma shared this way and being empathically held live melted a lot of primitive defenses and shame.

If I was a therapist, I would ask the person what would work for them to recover all time, energy and financially and go from there.

My two cents

Thank you for your comments, I really appreciate them. That is what I am hoping by running training groups and therapy simultaneously as issues often manifest within a relational context with CPTSD so therapy can help deal with that as it arises. Hoping that this will help people recover quicker and with better outcomes (That's my theory anyway and until I try it out, wont know for sure)

 

[grit]

I just did your survey and the question about trust in therapy.... You did not provide a text field but I differ to the masses.
There is a quote from kohut... Cannot remember it fully but something like the therapist should become like a person from the past that did not 100%destroy the client... Where Freud thought like nahhh the therapist should eventually became like the loved and positive parent in order to work through childhood issues.
In my therapy experience and having a lot of negative reactions and working through, I will say my experience is somewhere between Freud and kohut... In such. To be in real transference of my childhood, I feel not trusting the therapist.... And it is up to the therapist to make sure this feeling of not trusting is good sign.. Rather than teaching the pretend "must trust the therapist".

In my journey, not trusting the therapist but keep coming back every week and working through showed me the power of recovery is inside of me.

So now that I trust my therapy... I feel I am no longer in that developmental area where my trust was broken.. And I am feeling healhier but I needed to experience not trusting the therapist consciously to understand my childhood experiences in different light.

Not sure this makes sense but the gist of is there is a need for working through not trusting the therapist and this is not automatic in therapy.

Thank you for taking time to get different perspectives on how to treat trauma... We are all different but same so it is really unique experience between you and that person. I am only sharing my perspective as I lived.

 

[RK176]

I just did your survey and the question about trust in therapy.... You did not provide a text field but I differ to the masses.
There is a quote from kohut... Cannot remember it fully but something like the therapist should become like a person from the past that did not 100%destroy the client... Where Freud thought like nahhh the therapist should eventually became like the loved and positive parent in order to work through childhood issues.
In my therapy experience and having a lot of negative reactions and working through, I will say my experience is somewhere between Freud and kohut... In such. To be in real transference of my childhood, I feel not trusting the therapist.... And it is up to the therapist to make sure this feeling of not trusting is good sign.. Rather than teaching the pretend "must trust the therapist".

In my journey, not trusting the therapist but keep coming back every week and working through showed me the power of recovery is inside of me.

So now that I trust my therapy... I feel I am no longer in that developmental area where my trust was broken.. And I am feeling healhier but I needed to experience not trusting the therapist consciously to understand my childhood experiences in different light.

Not sure this makes sense but the gist of is there is a need for working through not trusting the therapist and this is not automatic in therapy.

Thank you for taking time to get different perspectives on how to treat trauma... We are all different but same so it is really unique experience between you and that person. I am only sharing my perspective as I lived.

Thanks for completing my survey and for your comments. I think I understand what you mean and if it's what I think, then I agree. For me, the most successful outcomes has been with clients who have initially distrusted me and then I have had a totally transparent conversation with them and told them that it was OK to mistrust me (as at the end of the day why would someone trust a stranger when they have spent their entire life having their trust broken) This then had the reverse effect in that our relationship became much stronger. I find it really difficult to be anything but honest and transparent so there is no other way for me to be. Is that the kind of thing you were meaning?

 

[grit]

Yes that is what I meant and it is not that people spent their entire lives with broken trust... It is more IMHO to check the reality that you do not trust people you do not know and therapist are not exception to the rule. It is sort of narcissistic breeding to have a profession that deals with such intimate matter to start with trust...sure for some people who have already trust foundation. But most cpts this may not be the case.. Of course but not for all. So yes... It is good to allow and work through the not trusting phase rather than you trust the therapist... It sounds dogmatic.

BTW, I just want to mention this was my experience as I did not go to therapy until my mid 40s. I suppose being in therapy for many years a lot of people may have this foundation worked through already. Trust in Others or trust in self are so foundational and people are at different levels. that is all I meant.

Thank you for your deep discussion.

 

[RK176]

Yes that is what I meant and it is not that people spent their entire lives with broken trust... It is more IMHO to check the reality that you do not trust people you do not know and therapist are not exception to the rule. It is sort of narcissistic breeding to have a profession that deals with such intimate matter to start with trust...sure for some people who have already trust foundation. But most cpts this may not be the case.. Of course but not for all. So yes... It is good to allow and work through the not trusting phase rather than you trust the therapist... It sounds dogmatic.

BTW, I just want to mention this was my experience as I did not go to therapy until my mid 40s. I suppose being in therapy for many years a lot of people may have this foundation worked through already. Trust in Others or trust in self are so foundational and people are at different levels. that is all I meant.

Thank you for your deep discussion.

I think your experience is reflective of a lot of people. I think the reason for including the trust question is that I have a real interest in how trust develops and I do think it's so important for other therapists to understand how to build and develop trust on a deeper level so that clients can get the best from therapy.

Thank you for sharing your experience and I think what you have said is really valuable.

 

[Ronin]

Time of meets, yes.

But also therapists knowing some trauma locks in differently.

Need waay different stabilization and looking at things way and how to talk if talking fighting vs. just rape vs murder of people and same bad griefs vs not saving people vs. just stress of week vs one that locks into aall of that.

And therapists that think fighting is the same land as abuse in what it does to your body and heart and head are not right.

Bad stuff is bad stuff but issues of it differ. Can't use same meds for different cause coughs.

 

[Rumors]

Have you had much experience of therapists who do 2 hour sessions? I have personally never done one

yes, I have only had 2 therapists ever. My first one retired and shifted me over to a partner. The one I have now does the 2 hour sessions. I hate the feeling that I am so messed up that I need that, but honestly it keeps me moving forward. I haven't always had the need for 2 hour sessions bc I wasn't ready to do the hard work on my traumas. However, I really started digging in to working on my trauma so she made it available. I also do EMDR at times and it can be a bit hard for a few days following. She likened it to intensive outpatient therapy programs and bc I am pretty private and introverted, she knew I would never consider that as an option. We spend time meditating and grounding and that takes time. Trauma talk isn't the entire time and we discuss our kids and everyday life stuff as well. For me, trust is a big thing. It has taken me almost 5 years to trust her with my story. I had to baby step in until I felt like I could be open. I hope this helps..

 

[RK176]

yes, I have only had 2 therapists ever. My first one retired and shifted me over to a partner. The one I have now does the 2 hour sessions. I hate the feeling that I am so messed up that I need that, but honestly it keeps me moving forward. I haven't always had the need for 2 hour sessions bc I wasn't ready to do the hard work on my traumas. However, I really started digging in to working on my trauma so she made it available. I also do EMDR at times and it can be a bit hard for a few days following. She likened it to intensive outpatient therapy programs and bc I am pretty private and introverted, she knew I would never consider that as an option. We spend time meditating and grounding and that takes time. Trauma talk isn't the entire time and we discuss our kids and everyday life stuff as well. For me, trust is a big thing. It has taken me almost 5 years to trust her with my story. I had to baby step in until I felt like I could be open. I hope this helps..

I am so pleased that you managed to get the help that you needed in the end and you have a counsellor who works for you. I am also so sorry for you and everyone on this thread that things happened to you that you needed help in the first place. I really wish you the best of luck in the future and remember its hard but recovery can be achieved :).

 

[Mach123]

It's a matter of stages I think. The beginning is crisis intervention and stabilization and I certainly don't need that now. My needs are totally different 10 years later.

But then there are the different therapies and bodywork and I wouldn't know what would work best? I have never heard of some of the therapies mentiond here. I don't know if different kinds of trauma should be grouped together?

Ok that's enough for me I'm.getting a headache lol. I'm glad you want to help. I think it's important that we (survivors ) try and work with others. I try and answer posts when people feel suicidal. This helps me. I felt suicidal to one degree or another much of my life and that is an awful feeling and I don't want anyone to suffer that because they experienced trauma.

 

[RK176]

It's a matter of stages I think. The beginning is crisis intervention and stabilization and I certainly don't need that now. My needs are totally different 10 years later.

But then there are the different therapies and bodywork and I wouldn't know what would work best? I have never heard of some of the therapies mentiond here. I don't know if different kinds of trauma should be grouped together?

Ok that's enough for me I'm.getting a headache lol. I'm glad you want to help. I think it's important that we (survivors ) try and work with others. I try and answer posts when people feel suicidal. This helps me. I felt suicidal to one degree or another much of my life and that is an awful feeling and I don't want anyone to suffer that because they experienced trauma.

Yes I usually start with stabalisation. Everyone is different and I try to adapt to the clients needs although the core elements of the work are the same e.g stabalisation, building relationship, building safety etc. I am so sorry that you have experienced suicidal feelings. In my experience there is still a taboo around the subject but it really is ok to have those thoughts and feelings as that's a normal reaction when you have been through so much pain. I am glad that you have been able to help other people who feel the same way as you and you have found solace in it. Have a good day.