Has anyone tried CPT?

We've very recently switched to a trauma specialist and after our first session he said he wanted to do Cognitive Processing Therapy with us.

Reading into CPT, it seems it has a great track record of helping with PTSD but there's two parts of the therapy we think might be problematic. One is that you have to find the "index trauma", which is the event that causes the worst of the PTSD symptoms. The problem is that varies with each one of us and we can't just pick one that fits for the whole system. There's just too many. The second problem is that you're supposed to write down and then read in session a full account of the 'index trauma'. We really don't want to do that and honestly, it seems kind of sick to make someone else have to listen to it.

Has anyone here ever tried CPT before? And if so can you share your experiences? We're really worried about how to deal with this during our upcoming therapy session.

I've not heard of CPT before but I imagine it has similar issues to EMDR. So it would need to be modified to deal with complex trauma or dissociative disorders because there isn't a single event and the memories are often divided and stored separately. Also incorporating a lot of work on stability alongside the trauma work.

Is your trauma specialist familiar with DID?

it is not like EMDR. More like a version of prolonged exposure.
if it is done completely in therapy, that is, always reading it to the T who is present to help, this is a pretty decent method to treat cPTSD. Some Ts ask you to read stuff to yourself at home and that is possible for very simple PTSD but not for complex/relational trauma.
It is usually not used for DID and would need serious modifications and a well trained DID T to somehow make that work properly.
I have not heard of a DID system yet who used CPT successfully. Usually trauma treatment for DID looks different.
because it is essentially a CBT tool for prolonged exposure it belongs to the rougher kinds of trauma treatment, for patient and T. I wouldn't do it. EMDR would actually be less difficult to pull off.

Has this T read the ISSTD guidelines for treating DID? If not, maybe you can contact him to ask him to do so before the next session. CPT seriously does NOT sound like a good idea. I don't know anything about it other than what you described, but there ISN'T an index trauma for DID. And underlying any specific events would be the disorganized attachment that prevented you from having a way to process them at the time. That's why establishing a solid, trusting relationship with a T has to happen first, before any trauma processing can happen.

Thank you all for the comments.

We see him early next week and we'll definitely raise these concerns first thing. I don't know if he has much experience with DID, but he did say that he's worked with several cases of CPTSD and with dissociative clients before which gave me hope.

there is a reason why cPTSD is a different dx from DID. and by dissociation they often mean depersonalisation/derealisation, not structural dissociation of memories and identity.
make sure that the T reads the ISSTD guidelines. you can find them here
http://www.isst-d.org/downloads/guidelines_revised2011.pdf

Also look into the 3 phases for DID treatment
Some info what should happen at that time can be found here
https://www.psychforums.com/dissociative-identity/topic203580.html

exposure therapy is not always recommended treatment. processing of memories usually comes after some serious work is done concerning communication within the DID system. TheGang is right, it needs a different approach. and trauma therapy is WAY more than processing traumatic memories. there is so much else that broke that will not be fixed if you just try to process memories.

Introducing the idea of exposure work after the first session looks extremely like this T doesn't know what they are doing concerning DID. only single trauma is usually approached this fast and ruthlessly.

We've heard about it, but we don't think it would help us personally. Like the above people have said, we all have different fears, different memories some of us barely have trauma memories.
I think CPT would be really complicated for people with DID

For us the concept of CPT is terrifying.

this is, of course, only our opinion, but it doesn't look like something we would want to pursue. It feels to simple for something as complex for OSDD, much less DID.

DuckToTheFace wrote:Reading into CPT, it seems it has a great track record of helping with PTSD but there's two parts of the therapy we think might be problematic. One is that you have to find the "index trauma", which is the event that causes the worst of the PTSD symptoms. The problem is that varies with each one of us and we can't just pick one that fits for the whole system. There's just too many.

You've hit the nail on the head with just that. As others have mentioned, going quickly to trauma processing -- let alone going straight to the worst of the trauma -- is recommended against! If your T doesn't fully understand yet, DID does not equal PTSD! It's not even "like PTSD, just more of it," as some might imagine.