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Treatment options / do you need a specialist T?

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Treatment options / do you need a specialist T?

Postby fireheart » Thu Mar 08, 2018 9:07 am

I have a question about treatment for DID + complex PTSD + depression.

Currently am seeing a therapist twice a week. Have been seeing her for more than 2 years.

First we figured out that I have DID. Then we started to do EMDR here and there. The plan: do EMDR with all parts to help them process their traumas.

However, I've been getting more and more depressed in the last year. Now it's gotten to a point where I feel like I can't function or take care of myself. I feel very hopeless. I don't feel stable enough to do more trauma work.

In fact, we never went over grounding skills or emotion regulation. I found a great book called "Coping with trauma-related dissociation" which includes a lot of those skills, and proposed working through that book with her to gain (or get better at) some of those skills. I'm starting to feel like I am carrying the therapy on my own. She's not a specialist and has told me: "This is just as new to me as it is to you." Which is fine, but it doesn't help the feelings of hopelessness.

In the last year, as I've been getting more depressed, I focused more and more on living healthily and living a balanced life. For example, I started doing yoga every day for an hour. It doesn't seem to make much of a difference in how I feel, and I'm starting to feel exhausted.

What other options do I have? Does it seem like a bad idea to keep seeing this therapist? Maybe I would need more intensive therapy? Or use medication? See a physiotherapist? Try to find additional therapy?

Does anyone have experience with DID + depression? And its treatment?

Much love,
Fox
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Re: Treatment options / do you need a specialist T?

Postby birdsong87 » Thu Mar 08, 2018 10:53 am

I think yout T got the steps mixed up a little.
find the recommended order of DID therapy here
https://www.psychforums.com/dissociative-identity/topic203580.html

When we first saw a T and got diagnosed she started with EMDR right away. we didnt work together as a system. we didnt even know everyone. we surely didnt work together and nobody had any more grounding skills than the safe place and containment exercise. we didnt know a thing about emotional regulation, safe connection to people, boy we even still lived in an abusive household!
we got depressed. very badly. the EMDR never changed the scene. we failed to have everyone included in it so we could just look at a fragment of it, and that never did the job.
we had to take antidepressants then. there is a depression too deep for other actions to be taken.

we recovered when we left that T. got more engaged with life. caught up on having fun. and not having any more EMDR sessions!

years later we had some more EMDR and that was helpful.

the authors of "coping with trauma related dissociation" brought out a book for Ts, called "Treating trauma-related dissociation". the 3 phase model is explained in there. maybe your T should read it.

I personally think that nothing is wrong with you, the depression is a natural reaction to treatment you were not properly prepared for.
Dx: DID cPTSD
L (host 1); Asti (host 2); Annett (teen protector); Maya (child); Age (observer); Thamara (child); Danielle (aut. teen); Mike (caregiver) and others
our blog on resources: https://www.dis-sos.com
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Re: Treatment options / do you need a specialist T?

Postby Una+ » Thu Mar 08, 2018 2:43 pm

Ditto.

This T is not following good practice in doing EMDR with a dissociative client, without first doing a lot of preliminary work to establish safety and stability. And she has not stopped the EMDR, which is a second beginner mistake. There are books and training courses about doing EMDR with dissociative clients.

Those books mentioned already in this thread are great! Another remedial step you can suggest to this T is to join ISSTD and take one of their basic training courses. There are in-person courses and webinar distance courses. Once she has acquired the basic concepts of working with DID then she can seek consultation with an expert. Without that foundation she won't be able to make effective use of consultation, nor is an expert likely to agree to consult.
Dx DID older woman married w kids. 0 Una, host + 3, 1, 5. 1 animal. 2 older man. 3 teen girl. 4 girl behind amnesia wall. 5 girl in love. Our thread.
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Re: Treatment options / do you need a specialist T?

Postby IainEtc » Thu Mar 08, 2018 4:27 pm

Hi,

Our T started with EMDR because nobody told her we're DID and things kind of fell apart. She stopped immediately and went to grounding. Later Host said 'Aren't we doing EMDR?' She said 'Not till you're ready'. She's smart.

Iain
Iain - 14, Colin - 17, Evan - 7, Cody - 16, Raven, & Host - the adult out front

When they say 'be yourself',
which one do they mean?
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Re: Treatment options / do you need a specialist T?

Postby littleDaria » Fri Mar 09, 2018 12:18 am

our T knows of our DID and has decades of experience with dissociation. Working with a T who has no experience with DID feels counter intuitive to us; would you call a carpenter for a plumbing problem? You mention depression; our T (and our psychiatrist, and our crisis counselor) told us that, when it comes to trauma therapy, things tend to get worse before they get better, and wow, they were not kidding. That said, it is absolutely worth it. We feel our trauma therapy is the first real therapy we have ever had in our 50 years on this earth.
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Ophelia (8) | Alia (6) | Denise (4) [possibly original] | Aura (3) | Newt (2/3) | Boo (2)
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Re: Treatment options / do you need a specialist T?

Postby fireheart » Sat Mar 17, 2018 8:32 am

Thanks so much for your replies!

It's been very helpful and validating. I asked T to buy the "Treating trauma-related dissociation" book and she's ordered it now. She still seems to be somewhat taken aback that I want to go back to phase 1 therapy, instead of doing phase 2 therapy; but honestly, system communication has been pretty awful lately and I'm quite destabilized still. Even working through the first two chapters of the book and learning two new grounding exercises has been tremendously helpful.

I tried meds this week (Xanax, slow re-uptake version) and it was a disaster! Instead of lowering anxiety it gave us panic attacks, especially when littles fronted. After telling my therapist, she said she will ask some colleagues whether they know of a psychiatrist with experience working with DID. I hope I'm not asking for something that's impossible (getting better). Until then, I don't think I'm willing to try more meds.

About feeling like I'm carrying the treatment by myself my T said that she's giving me so much autonomy because she thinks I will be very resistant to her if she tries to push me in a certain direction. There's some truth in that, but I do want her to do her homework. :/
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Re: Treatment options / do you need a specialist T?

Postby birdsong87 » Sat Mar 17, 2018 11:00 am

see the frown on my face... if is normal to go back and forth between phase 1 and 2. Its not like there are clear lines and now you are stable and you only do trauma work. you are not a machine!!

We as a system react funny to all kinds of antidepressants. I wish it was different. But they mess with our brain really badly. We get thru with workout, light therapy, supplements and creative activities. Kind of bad, but we make it thru.

Our T will move, so we will be looking for a new one next year.
Can't imagine working with someone who is new to it all. Not now. a new T would have to read our whole ######6 blog and be ok with us knowing more than her. Most get seriously intimidated.
Asti& Annett
Dx: DID cPTSD
L (host 1); Asti (host 2); Annett (teen protector); Maya (child); Age (observer); Thamara (child); Danielle (aut. teen); Mike (caregiver) and others
our blog on resources: https://www.dis-sos.com
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Re: Treatment options / do you need a specialist T?

Postby TheGangsAllHere » Sat Mar 17, 2018 3:16 pm

fireheart wrote:About feeling like I'm carrying the treatment by myself my T said that she's giving me so much autonomy because she thinks I will be very resistant to her if she tries to push me in a certain direction. There's some truth in that, but I do want her to do her homework. :/


That's kind of a cop-out on her part, I think. You would be resistant because you can't trust that she knows what she's doing and that it would be the right direction.

Also, I don't think there should be any pushing going on, anyway. There should be encouraging, and guiding, but I would be "resistant" to any kind of pushing in any direction by my T. I'm(We're) steering this thing, with his expert guidance, support, and awareness of the big picture, because he doesn't know the terrain and the obstacles that are specific to me(us) and my(our) experiences.
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Re: Treatment options / do you need a specialist T?

Postby fireheart » Fri Apr 06, 2018 7:29 am

It's been a while - I just 'woke up' again two days ago. Sorry about that.

Hi Asti & Annett, thanks for your reply. The first part made me laugh! Thanks for sharing about how you deal with depression. It sounds like activities and those sorts of things are feasable and helpful things, maybe for us too.
I'm sorry your T will move. It sucks that most Ts get intimidated when a client knows more than they do. I also had a T like that once, who would say: "Well, you're making me feel like a grad school student again! We're not here to discuss! I'm the therapist!" It's a sign of their own insecurity, really. I hope you'll be able to find a suitable new T. Maybe your T has a good referral? I saw that you made a post about finding a T on your blog, so you're probably dealing well with the practical steps.

Hi TheGangsAllHere,
Thank you for sort of standing up for me. It's a very good reminder that a T should not push, but rather encourage and guide...

Now as for how I'm doing; still largely the same. I quit the medication because of the panic attacks. Then went away. I think the body was ill, and another alter, S., mainly fronted for the next weeks. This week I returned, after a movie triggered a little and I felt like I had to comfort him. From what I've read/been told there was a bit of a rupture with T. We are working through the book 'Coping with trauma-related dissociation' and in session I share my answers to the homework. But there was an answer I didn't want to share with T. She kept pushing, and we completely shut down. Full-on freeze response, unable to move, unable to talk. Switched to another alter, who felt incredibly angry, but still couldn't move. Then switched back, was just fine, had no idea what just happened. Later the alter who switched in during the shut down told S. what happened.

How do others work with the book? I think it should've been okay if I didn't want to share an answer... I mean, she doesn't have a RIGHT to my answers or something. This week she asked us if we wanted to tell something about our answers; that's already a better approach, in my opinion...

I also told her about the depression - which is apparently only carried by me - it seemed like T got kind of annoyed with my negativity. You know, that I don't enjoy things at all (other parts do). But I just took my first theatre class, and I'm exercizing more. It's not enjoyable for me, but it seems to help the others.

I'm starting to think that maybe 'going away' is a coping skill we use for depression. Me and S. tend to go away for longer periods of time, especially when we're having a rough time. Sometimes she gets depressed or very triggered, and sometimes I do - and in those times we seem to just disappear for a while. Then we reappear after a while and tend to feel somewhat better. We sort of complement each other - one us will stay to function. How does this work? Does someone have experience with something similar?

Also, I notice that I want to share the progress we make with internal communication with T - but she doesn't seem to know how to respond and... it makes me feel very ashamed for sharing. Last session she asked: "Is this important?" and it made me feel SO ashamed. I don't know what I want from her in those moments, but it's not that. :( I guess I just want her to be supportive? I want to share it because it's important to me and it's a treatment goal... But I told her about a new little who wrote in our journal and she looked at me as if I was crazy. When I let her read what she wrote she seemed more empathetic, but... why wouldn't she be able to take my word for it? Does it really sound that weird? Ugh. Therapy is hard! :/
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Re: Treatment options / do you need a specialist T?

Postby birdsong87 » Fri Apr 06, 2018 10:32 am

it sounds like your T is making mistakes, but learning from them.
for some people having to give an answer is triggering because abusers used to do the same. you already know that you have a right to keep it for yourself.

does your T have supervision? by someone who knows about DID related difficulties?
we burned out a T who first got confused, then angry and disgusted by us. she was overwhelmed, didn't talk to anyone and her defenses went up.
sometimes the feelings we sense in a T are like that. sometimes it is a misinterpretation and we project our own fears, that they might be annoyed. sometimes Ts subsciously feel our projection and act according to it, confirming our fears... it is complex, which is why it is best to talk about it for more clarity.

I "went away" for a while because I was close to burning out. I struggle with depression more than the others. Asti started co-hosting after that and things got easier for me.

we believe that the most important thing in therapy is a sense of connection. when we feel connected we dissociate less in session. we dont feel ashamed about questions and remarks. if we try to do any vulnerable work while feeling disconnected we get hurt.
Dx: DID cPTSD
L (host 1); Asti (host 2); Annett (teen protector); Maya (child); Age (observer); Thamara (child); Danielle (aut. teen); Mike (caregiver) and others
our blog on resources: https://www.dis-sos.com
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