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Why Am I Triggered By Cbt?

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How might these methods give me an aversion to/trigger for CBT like techniques?
I also suffered Childhood sexual abuse. My T does not think that CBT is of any use for it. He says simply telling me to change the way I think is not helpful, and instead we have processed the memories with EMDR which I have found very helpful. I have been seeing T for over 5 years now, although have not seen him for nearly 3 months - because currently I don't feel I need to.

My psychiatrist has published articles about complex trauma, and suggested that offering CBT for complex trauma is insulting to say the least. I find his attitude refreshing. I believe the focus on CBT will shift as more alternatives have their research published.
 
How might these methods give me an aversion to/trigger for CBT like techniques?
Based purely on your opening post, not one method of abuse listed has anything to do with TF-CBT or its methods. Based on what you've outlined, I would say any therapy delving into your trauma would give you quite a reaction, especially with a distrust of psychologists and psychiatrists being part of your abusers. I would expect you would have a reaction just talking with either one of those professions, and if you did / do, chances are you're triggered before you begin a discussion if focused on them and relating their qualification back to your abuse.

Its normal that a person dissociates themselves from such abuse, when talking about it. The person will often calmly just talk away about it all, but they've dissociated their emotional self from what is being said. Well... that is normal under such circumstance due to the abuse endured. The moment a therapist digs into a trauma, chances are you would become defensive.

That association between abuser and helper would affect you significantly I expect.

I honestly believe that only with time and trust you will chip away more at your trauma, based purely on what you've stated in your opening post. Have you done EMDR? Exposure therapy? I would expect similar reactions to them...

Purely rough guess... though based on your level of trauma, I would think the only approach would be very carefully considered relaxation combined with allowing you to completely control how deep you go at any given time, never digging, only responding to what you give freely and are willing to discuss. I think your depth of trauma would be difficult for any actual technique versus a purely empathetic, controlled, self paced process.
 
Based purely on your opening post, not one method of abuse listed has anything to do with TF-CBT or its methods. Based on what you've outlined, I would say any therapy delving into your trauma would give you quite a reaction, especially with a distrust of psychologists and psychiatrists being part of your abusers. I would expect you would have a reaction just talking with either one of those professions, and if you did / do, chances are you're triggered before you begin a discussion if focused on them and relating their qualification back to your abuse.

I tend to agree on looking into this more and discussing it. I do find attending therapy triggering and difficult, even after so many years confronting it. Any kind of interrogative querying of thought processes and behaviors, or suggestion I might be at fault/to blame for my distress can make me very symptomatic, and my T has developed a extremely gentle approach that is exactly as you outlined.

This is compounded by my earliest treatment by a very eminent psychiatrist (not one of the abusers) who was a strict freudian and who focused very much on behavior modification and having to control my external behavior and internal landscape so as to not become an abuser. It left me feeling like I was evil inside - like I had to be in control at every moment, hyper-vigilant about my internal processes, rather than just mindful of them, to a degree that has been damaging and very impacting to me.

I intend to come back to that more here, but haven't had the energy as yet.

I really appreciate your input on this :)
 
There is a difference in meaning, and I shouldn't have used that one word.

Just my 2cents... I suspect you were right on the nose with empathetic. Intentional or not.

_______
Just me waffling...

I know some of the advocacy groups that work with cults in the American SW only use therapists who were former children raised in cults themselves for the teens & young adults coming out of them. Just anecdotally, mind, what they told me when I bumped into them years back* ... That the peer to peer works when just about nothing else does. And that if they don't have enough Ts wih the background? (Cause I'm nosy and asked, because it didn't seem like there'd be a lot of people with that background)... That they pair a peer-counselor in with the trained counselor until client asks for solo sessions. But that they almost never do ask for solo sessions. Just makes me wonder about unintentional childhood conditioning (normal abuse) versus intentional conditioning (cults & similar)... If there's something different about the end result, or not. Of if it's just as simple as 2 therapists, both alike in dignity, easier for vets to talk to vets, alcoholics to alcoholics, cult members to cult members? Aka... Empathy is easier, like in most things, but not necessary, in most cases.

* Was doing the homeless thing, made friends with a bunch of boys who'd been turfed from one of the local cults & were turning tricks/hustling to survive. Meant I bumped into several of the outreach groups trying to get them off the streets & the girls outta the compounds.
 
Not to haggle too much over words...but...I think I do want empathy. I don't need my t to have gone throughout what I have but I need her to have some personal understanding of my pain, and not hold me at an impersonal distance.

Sensitive topic for me.
 
Me too, @ghotiff.

I think there's a misunderstanding about empathy - that you can only have it if you've experienced the exact same kind of event.

It's actually the ability to "step into someone elses' shoes", so to speak. To connect oneself emotionally/cognitively with the other person. Sympathy is observing - empathy is experiencing. But you can definitely have empathy for someone without having gone through what they've gone through. The simplest plane of it is personalization/imagination. You can empathize with a friend's story of being pulled over and getting a ticket because it's easy to imagine yourself having the same feelings in that situation (if the feelings were in the typical sphere of anxiety, stress, anger, etc).

If you are good at empathy, you can personalize yourself into situations that are quite far outside your realm of experience. You can effectively hear the way someone is describing something and basically internalize their pain as your own.
 
I don't misunderstand it in relation to exact... but to empathise you must have some experience that allows you to assimilate and truly feel what the other is feeling, to immerse yourself to their emotional level. To fake empathy is to sympathise / understand, based on definitions.

Therapists are trained to create a fake empathetic environment... that is their training and what they're paid to do. I will stick with... I used the wrong word.
 
I suspect that trauma generally has an effect of making people more sensitive to triggers, which also heightens a person's overall level of emotional sensitivity. Some people react with fighting instinct of aggressively shutting down or building up walls against triggers & emotions. Others react by flight, often some variation of avoidance or limiting feeling emotions. And others react by freeze, which often is dissociation or emotionally numbing.

When emotional suffering is an integral part of traumatic experience, it is easy to overgeneralize negative emotions or all emotions as the enemy or culprit.

However this approach can be highly counter-productive, and indirectly reinforces more fear conditioning. Which often translates into fear of feeling inner emotions, instead of fear of actual danger from external world.

This is where working on increasing empathy can help.

Let's start with a working definition of empathy as 'emotional sensitivity' which is generally used in reference to recognizing emotions in others. However empathy works both ways, the more you can recognize your own emotions, the more you can recognize it in others. But also the more you're insensitive or blind to your own emotions, the more you're insensitive or blind to other's emotions.

Empathy can then be broken down into two components: Feeling and Understanding emotions, some describe feeling as 'warm empathy', and understanding as 'cold empathy'. I am very good at cold empathy, but I think I lack some inner brain wiring for warm empathy.
Empathy can be divided into two major components:
* Affective empathy - the capacity to respond with an appropriate emotion to another's mental states.
* Cognitive empathy - the capacity to understand another's perspective or mental state.

Affective empathy can be subdivided into the following scales:
* Empathic concern: sympathy and compassion for others in response to their suffering.
* Personal distress: self-centered feelings of discomfort and anxiety in response to another's suffering.

Cognitive empathy can be subdivided into the following scales:
* Perspective taking: the tendency to spontaneously adopt others' psychological perspectives.
* Fantasy: the tendency to identify with fictional characters.

-- source: http://en.wikipedia.org/wiki/Empathy#Types
Now, why would empathy help with therapy, and how?

A therapist who is more empathetic will be able to better understand the emotional suffering underlying a patient's story. Also a patient who feels a therapist is empathetic naturally feels safer, communication is easier, and there can be more trust developed.

Does a therapist need to have similar life trauma experience to be genuinely empathetic to a patient?
No, but the therapist does need to be emotionally sensitive and aware of his own emotional suffering (shame, grief, fear, anxiety, anger, etc.). But many therapists aren't comfortable with doing their own emotional work, so they fake empathy and hide behind their expertise and position.

Developing more empathy can also naturally help with personal healing and relationships. Emotional sensitivity can help with predicting others behavior, translating to less fear, easier relationships and more connection. Also emotional sensitivity can help with understanding and working with inner children and unresolved emotional triggers.

But, emotional sensitivity can also have downsides. Just like Brene Brown's research discovered that 'you can't selectively numb emotions', it works the same vice-versa, you can't selectively un-numb emotions, so more empathy means you feel all emotions more intensely. This can initially lead to getting triggered more, inner children become more active, memories returning, etc. These situations can be seen as opportunities for exposure therapy and integration. But they could also be interpreted as threats. How you react or respond to it would be a good test of your prior CBT work, can you stay rational and open in the face of intense emotions?

and here's a funny video explaining empathy:
 
to empathise you must have some experience that allows you to assimilate and truly feel what the other is feeling, to immerse yourself to their emotional level.
Actually I think this sentence is dead on - and it's the concept of "some experience" that is all I was trying to get at, and degrees. We both have broken legs, straight empathy. You a leg, me an arm, pretty close. You a leg, me a rib - certain aspects of interior pain will be something I can empathize with, but other things, probably, no. You a leg, me a pinky finger, no, I can't empathize with much except possibly the initial pain - maybe - and it's a stretch. You a broken leg, me a broken vase that I liked alot - totally false empathy. Really bad analogies, but I think that's what I was meaning to say, that it's on a spectrum.

My therapist can empathize with my story on some aspects of the beating, because he's been in some brutal fights. He's got direct connections to some other physical pain things. But he's never been raped, and doesn't claim to know at all what it is like (thank goodness). But I do know that he grasps extreme pain - so for me, the speaker, I can relate to his sympathetic affirmation well, because I know there's a small degree of connection there.

But yeah, I think probably the majority of us know that sinking feeling when someone - especially your therapist - makes an attempt to say "I understand what that is like" when the analogy they give is incredibly off-base, and you know that they have no clue. You feel lonely, if what you are looking for is empathy/understanding. I think it's why support groups are really good for many people - it fills in the empathy piece.

Edit to add: @Valentino and I were cross-posting; I didn't mean to prolong the empathy discussion
/end thread-jack
 
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